20010938.pdfDATE RECIIVII,,
&
F PERMIT EXPIRES
CITY OF EDMONDS
USE PERM T
ZONE N U , IIE R
IUITE�IPTI
JAOCRESS
CONSTRUCTION PERMIT APPLICATION
-OFT"
_AVE, _
_00
OWNER NAMEINAME OF BU 50"
210 130 061�1&1 v'2"'c'jNaF,5 i-h r
PLAT NAMEISUDDIVISION
NO, -T 10
LID EE S
MAILING ADDRESS
--foo
C
PUBLIC RIGHT OF WAY PER .111MAL STREET MAP
EXISTING — PROPOSED
o"
P-1 R.1 1 0
0
R.q-d 0
CITY ZIP
Fu;mow?5� KA,
REQUIRED IT
NAME
�TR SIZE
NO. OF FIXTURES
V REQUIRED
YEPAO NO 0
.3
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
NEW 616INS,- AV- ON
CITY
jAf.6,Tb94.�,A6T0 --TQ VO a FrC kp 4o A`- PXT _10
NAME
'p—RceLo—ms
REVIEWETq,,,,4
I ADOIEIS
0&
FIRE RE IEWEDBY DATE
ZIP
775--1
VARIANCE OR CU
SHORELINE 0
n
A
INSPECTION
v RE 'D
YES ONO
1PBOND
OS ED
STATE LICENSE NUMBER
r
tH9CKEDB
SERA REVIEW
COMPLETE I EXEMP T
UP
x
SIGN AREA
P710SP0,16"JA
j
EIGHT
ALLOWED PROPOSED
W 1/-/*'
PROPERTY>X ACCOUNT FICEL NO-
N RESIDENTIAL PLUMBING I MECH
A:TION NOAM�MIRCIIL 0 MPLIANCEOR
0 CHANGE OF USE
C3 A, T HT
C] REMODEL ME K .�,5)
LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SETBACKS (FT)
q�NT SUE REAR
Ne
PROPOSED SETBACKS (FT.)
FRONT URSIDE REAR
06IF-17NA
lz
PARKING LOT A EA P ORE
REQ�. I P! VIDEO
REPAIR GRADING CYGS 'FENCE
cl X ITI
IIEMA115_
0 DEMOLISH C3 TANK OTHER
M M29
0 GARAGE C] R IND WALL
CARPORT F=R RENEWAL
r (TYPEOPUSE. BUSINESS OR ACTIVITY) EXPLAIN:
CHECKEDBY ITYPE
;qrT�
77
C(" 0 CUPANT
1 GROUP
UMBER
0 OF
'o STORIES
NUMBER
DWELIJNG'� =R�.R.T�'CSAL
UNITS
N .. E.
SPECIAL INSPECTOR ]AREA
RE
FE.U, D 0 YES
I OCCUPANT
LOAD
DESCRIBE WORK TOES DONE
A-W /MAt&l 0
REMARKS
PROGRESS INSPECTIONS PER UBC I08/FINAL INSPECTION REO'
421 hivi
-5(Cq4 Ad',V (a) NON -i L(J) AAV S196le-
-,-VAI
f /00:;51
VALUATION
FEE
1 SO
LOT SLOPE Sig In -114, ��6z—
VST'
PLAN CHECK NO: Zo Vii-ED DATE PLUMBING —
MECHANICAL I
'I -
THIS PERMIT AUTHORIZES ONLY THEVR#,NOTED. This PERMIT COVER S WORKTO
PERMIT AUTHORIZES ON LY THE 7 NOTED THIS BE
- T-UEE , ON PRIVATE PR-P-RTVO AN, CONSTRUCT
t: BE DONE ON PRIVATE PA TY OR NYCONSTAUCTIONONTHE UBLIC
OPER GRIVE%.AA REQUIRE GRADINGIFILL
0. U.BS ... WAL.- .B"E AYE MA ... ES El
YS
I DOMAIN !CURDS. SIDEWALKS, ,MARQUEES, ETC.) WILL
OMAJN SEPARATE FEFIIH.�'.-
2 SEPARATE PER SSION.
CHARGE
PLO T.. I . G
PERMIT APPLICATI N: 180 DAYS
PERMIT LIMIT. I YEAR - ROVIDE. WORK IS STARTED WITHIN 180 DAYS
P ENG REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENG. INSPECTION FEE
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
IN INTEREST. AGREES TO �NOEMNIFY. DEFEND AND HOLD HARMLESS THE F ZNDSCTA, PING
OM CITY
EDMONDS, WASHINGTON. TS OFFICIALS, EMPLOYEES AND AGENTS FR ANYAND IN EC ON FEE
I ALLCLAM' 'FOR GAMAGES01 WHATEVER NATURE, ARISING DtFE.Tl OF INDIRECTLY E jCE
FROM THE SU�NCE OF TH19 PERMIT. ISSUANCE 01 THIS PSFM T SHALL NOT BE PLAN CHECK DEPOSIT
EORREDVCEANYAEGUIRE.NTOFANY ITY.RDINANCE
'Y WAV OF EC
DEEMEGp=W ECEIr"
NOR LIM AY THE CITY S ABILITY TO EHl.FCE ANY DINANCE PROVISION - TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT,, HAVE READ THIS APPLICATION THAT THE INFORMATION
GIVEN 15 CORRECT. AND THAT AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
THEOWNER IAGREETO Ly WITH CITY AND STATE LAWS REGULATING CONSTRUC CALL Thl, Ppllcat.o. 11 P-- -., "g-
T CO-`AUT.ORlZED THEREBY, NO PERSONWILLIBE E Ild F111 110 olld,
ION, AND IN DOING THE WORK '.1 DYED - ' puly
IN VIOLATION OF THE LABOR,�ODE OF THE STATE OF ASHINGTON RE AJING TO FOR INSPECTION Pt �dpd --d.d
WORK%JENSCOMPENSATj9,jMtA CEANDRCW1827 -slg;NED (425) At,& SIG�ATUR
5
771-0220 ftt'&SED BY DATE
ATTENTION EXT 1333
ITISUNLA FULTOUSE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
I W AIDE AND APPROVAL OR A CERTIFI- OrlO`lNALLflLE - YELLOW - INS'PECTdR
A FINAL N "ECTION IAS BEEN M
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER - r.CI n - ASSESSOR
5�8
z
0
0 M
co
m 0
80
a
� m
mm
010
In
M rn
a
0
0
z
(i)
z
9
0
m
FINAL PROJECT APPROVAL -FORM
TO:J2AdJ____
DATE: z4
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE —
ENGINEERING DIVISION DATE —
PLANNING DIVISION DATE -9-9 -6�2_
10
PROJECT2
SITE ADDRESS
P, rLI DATE INSPECTED
,RMIT
DESCRIPTION OF WORK TO BE INSPECTED_�� _S
A field inspection was conducted to determine final compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL
APPROVAL WITH CONDITIONS NOTE'
GRANT PROJECT
C1 Copy ofCONDMONS given to owner/contractorby inspector
1.
FAILED FINAI., INSPECTION - OUTSTANDING ISSUES
C, Copy of CORRECTION NOTICE given to owner/contractor by inspector
1.
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date— Sign ------
ocaprvl.doc.l:tcmp:bldg:fomisIO/OI
z
0 1
0
M
M 0
—1 0
0 0
C
:� K
M M
z
,0-4
C: F
3:
0 _n
n
-4
3:9
M M
U CO
0 r-
0 M
C U)
9 (D
M L)
Z
.H�
X
--I
z
--I
U)
z
0
i
0
M
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing......................
Wall.........................
PieT/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
' a
Underground .............
Fough-in ..................
commercial Final
HEATING:
r
Gasesil ...............
Gas Piping .................
Equipment
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAM196 ........................
FIRST FLOOR FRAMING
INSULATION ...................
Floor insulation
Wall Insulation ...........
Ceiling insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
CZ
OCCUPANCY .......... �:--
i
4C�Wf- 40 "70*-%5016 W111-
0
SM
MR
M
CE
0
M
C
Ic
a
z
M
Q DATE REC:EIVEO,,,..l
PERMIT EXPIRES
USE PE R T
CITY OF EDMONDS Z NE "MMIER gQL1-
CONSTRUCTION PEhMIT APPLICATION 'OBB,ss
11111AIT'
ADD
OWNER NAMEINAME OF BU FIFTW Z)aJTff
FLAT NAME/SUBDIVISION NO. LOTHO. L�O NO.
L 0 FEE $
MAILING ADDRESS PUBLIC MIGHT OF WAY PER OFFICIAL STREET Al Pl— R-
4100 9Ar'�N .11-pu�—"-0 8
0- CITY jr4�;5E — EXISYING — PROPOSED 11"—.--- 0
ZIP
.2_ I RE.U'R---E-I-ATI--- FT
EWON 95, V*, 9x (07 0
�NAIE --�iETER SIZE I LINE SIZE I NC.OFFIXTURES PRV REQUIRED
NIP, - YES 0 No 13 IZ
REMARKS 1
ADDRESS OWNEnICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
NEW 15161W,- IALL 04 f`PV
CITY ZIP
ITIL11HOIJI
'15
NAME
C"
M"rLLL BE
ADDRESS
--
FIRE REVIEWED BY
TELEPH NE
75-
;4VITA c)ozopt-3 775-
OR CU
SHORILINEi!OW
ADO. 0 15,V_
STATE LICENSE NUMBER
5f6'&lT+-+032JT 'f/�WFC(370
E
JE.1
COMPLETE EVT
SIGN -FIEA
PROPERTqX ACCOUNT PARCET.7
12003 7
'W.EW [3 RESIDENTIAL PLUMBING I MECH
COMPLIA SO
ADDITION COMMERCIAL E NC USR
CHANG OF E
0 REMODEL 0 APARTMENT
REPAIR GRADING ... S 0 �FINCE FT)
C3 DEMOLISH 0 TANK 0 �OTHER
ARAGE
0 G.ARP.RT 0 RETAINING WALL RENEWAL
ED., , C]
LOT COVERXGE
ALLOWED PROPOSED
if
REQUIRED SETBACKS (FT.)
FPONT SIDE BEAR
PARKING
REQ
=�
LOT AREA
Pzo—mn-
_S
AAZ.
I\AE�6n W-7 OF 1111
_Lt\i
TIVITY) EXPLAIN:
TY MOU-1
CHECKEDRY
TYP T�
ice
NUMBER
OF
STORIES
NUMIEROF
DWEL NO
L
UNITS
ARE S
IIER
SPECIALEIDNSPECTOR JAREA
REOUIR 0 YES
DESCRIBE WORK TO BE DONE I M--9rrAW, AN P MMAMINTAmlp
MVOUP�Ov I"Mp c?Ig5:::'op-y
REMA K.
INSPECTIONS PER UBC 1081F]
lAfr
tXia,6;
I AoqC2 �a) t4ON -(L LLA42 SIN&E
14. 11—
HEAT SOURCE GLAZING I
LOTSLOPE
Butt,01*6 il
PLAN CHECK NO: —
oT, u zo
STED DATE
rE
PLUMBING
ME HANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COlibIl WORK TO
j=
BE DONE ON PRI—E PROPERTY ONLY ANY CONSTRUCTION ON THE PUBLIC
GRAD!NGIFILL
.
DOMAIN (CURDS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
g�.VIE
m
t:
SEPARATE PERMISSION.
U 'CHARGE
PERMIT APPLICA7`10 DAYS
NitS190
PERMIT LIMIT-. I YEAR ' PROVIDEDWOR STARTED WITHIN 180 DAYS
tINFORMATIO
SEE
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
CHG. INSPECTION FEE
APKICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSI GNS AND SUCCESORS
I N INTEREST. AGREES TO INDEMNIF�' DEFEND AND HOLD HARMLESS THE CITY OF
LANDSCAPING
EDMONDS. WASHINGTON. ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM 4NIANO
ALLCLAIMS FOR DAMArES OF WHATEVER NATURE. ARISING DIRECTLYO RINDIRECTLY
INSPECTION FEE
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REOUIRR%MAENYTOO�F ANY CITY ORDINANCE
NORLIM IT IN ANYWAYTHE CITY'S ABILITY �O ENFO �N DINAWCE PROVISION.
-rOTAL AMOUNTDUE
I HIAIBY ACKNOWLEDGE THATIHAVE READ THIS APPL CATION: THAT THE
K
GIVEN IS CORRECT. AND THAT AM THE OWNER. OR TkE DULY AUTHORIZED AGENT OF
7HEOWNER. I AGREE TOCOMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC'
CALL
TION AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN Vibl-ATION OF THE LABOR�OQDE OF THE STATE OF WASHINGTON RELATI�G To
FOR INSPECTR
WOR;gN'S COMPENSAT!pja9B0fkANCE AND RCW 18.27.
-
DATE Sl�.NEO
(425)
771-0220
A17ENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CEFITIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
VALUATION
lr�
'etk-'ms.
WE M Id
OATS
m
0
z
0
ch
m
a
M, 0
0
0 C
0 -n
m M
a
0
0
r
c"
z
m
_WSIEC ION
REHEIGHT
BOND
POSTED
AUj;D
PROPOSED SETBACKS (FT)
FRONT UR SIDE BEAR
DATE
9 A P T-T —�Q`
GC UPA NT
ROUP
_EPAANTI
'T'
kL INSPECTION REQ'D
FEE
1,60
ON APPROVAL
. w."
O,p,ly: ,,d F— ,, plld� ld
)dged—p... p—d,d,
0416INAL'fILE YELLOW- INS�ECTOR
PINK - OWNER GOLD - ASSESSOR