20020151.pdf.1
DATE RECEIV
CITY OF EDMONDS
USE ERNI T
ZONE U,
PN EIE R
CONSTRUCTION PERMIT APPLICATION
JOB SUITEIAPT#
AODRES,,,<,/, 'ZI -
OWNER ME 01
15 jA1 j1INESS
PLAT NAME/SUBDIVISION NO. LOT NO, I NO,
MAILINU ADDRESS
D FEE
'�D
V
lLB.0 FIGHT OF WAY PER OFFICIAL STREET MAP Is. I ""M
P-ld
CITY ZIP ITELEPHONE
EXISTING — PROPOSED— m—u.n X. s. 13
s...."e-Insd a
L4. �7
REQUIRED DEDICATION— IT U,&,Q.d
13
NAME
METER SIZE LINE SIZE NO, 01 'IXTUR" P'V REQUIRED
YES 0 NOA
ADDRESS
REMARKS
z
Xt
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLK)RAINAGE
CITY ZIP
ITILIPHONE
NAME
t'
ENGINEERING NEVIEWEDIDATE
?-Izrl
/3 0 L'�
FIRE REVIEWED By DATE
z
CITY ZIP
M
�11PHONI
0. ut-lf77-33'�.312
st
STATE LICENSE NUMBER EXPIRATION CHECKED By
# SPECTION PRO
VARIANCE OR CU SHORELINE OR ADS IN OSND
REO'D TED
ITI
V�& A 'a-�*
Ei
E3 YES [3NO
-2_,�
SERA REVIEW SIGN AREA HEIGHT
ALLOWED PROPOSED
;I PROPERTY TAX ACCOUNT PASO
/y/ 0�' eNO !S- &/
CO PLETE I EXEMPT ALLOWED 11101derll
I
EXI,
a rn
LOT COVERAGE REQUIRED SETBACKS S`F) PROPOSED SETBACKS tFT)
C
NEW PLUMBING I MECH
0 ESIDENTIAL FLU
AL ED PROPOSED FRONT SIDE REAR FRONT US SIDE REAR
LOW
IT, 0
�
z 0
COMP.LIAN.. 0.
0 COMMERCIAL CHAN
ADDITION E OF USE
8 0
C
REMODEL APARTMENT [3 SIGN
7 IA. Y DATE
G.
-in
3: ITI
In z
[3 REPAIR r GRADING YDS 0 F NOE
_3 1 X FT)
REMARKS
C:
OTHER
0 DEMOLISH E] TANK El
>
3:
0 GARAGE RETAINING WALL
ROCKERY, [:) RENEWAL
0
CARPORT
OWE OF USE BUSINESS O=;7
I o n
A�w
F C.14STRU H311 -COUPAN
CHECKED BY JTY�
GROUP ��
ill NUMBER UNUIER OFAI _r
WELL.. AREAS
/ I CRITICAL
or �4STLdIIES I
—
OOCU
IPECIILEIDNIIECIO' JAIEA LOAD _"
HEQUIF
" 9
Infrill
UNIT NUM BER
Ej YES
DESCRIBE WORK TO BE DONE
REMARKS
se 0 M
C: cl)
PROGRESS INSPECTIONS PER UBC 1104MINAL INSPECTION REQ'D
IN S�
C 0)
'Z h4 fd, cl', 4-o I-
ITI 0
Z
'0 Q)
VAL A IN
T $
VALUATION $
'0
z
tPBOGRESS
In Description FEE
Description FEE
- it
St ",
CD
Plan i,..k
Plan Check
z
HEAT SOURCE LOT SLOPE Is
Building
iltn'd"T.
PLAN CHE� VESTED DATE
Plumbing
Plumbing
IT
'514
ja u2z�
Mechanical
Mechanical
THIS PERMIT AUTHORIZED ONLY THE ORKNOTED. THIS PERMIT COVERS WORK TO
it BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON-EPUSUC
Grading Recording Fee
23 DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, FTC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review City Surcharge
PER ITAPPLICATION: INDAYS
� PROVID
PERMIT LIMITS I YEAR D WOAKIS STARTED WITHIN 1110DAYS
Engr. Inspection State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT. ON BEHAL OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
Receipt sit
EDMONDS, WASHINGTON, ITS OFFICIALS, EMILOYIES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR R NATURE, AR SING DIRECTLY OR INDIRECTLY
DAMAGESOFW HATUE I'
Fire Review
MIT
FROM THE ISSUANCE OF THIS PERMIT SSUANCE OF THIS PER SHALL NOT
Fire Inspection Total A oumDue "�":T
C
EEMED TO Moot WAIVE OR REDUCE ANY REQUIREMENT OF ANY CIT Y ORDWANDE
ONOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
---
Landscape Insp. IqAz
I I
I HEREBY ACKNOWLE BE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN 19 CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
This application is not a permit until signed by on,
CALL
TION; AND IN DOING TH WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOUTI ELABOR CODE OF THE STATE OF WASHINGTON RELATING TO
ON OF THE
80dieg Ofti ha., hl�,Ilud D.puly� end Fees be. P. d. end
FOR INSPECTION lot 1, alkeowledg,el 1, space p—ionuL
WORKMEN�_COMFEI,4�ATIO=UFIANCE AND CW 1817.
01`71��PNA'Tpv �
SIGrURE OWN A Eq 10 E SIGNED
7TEl
(425)
771 -0220 -HE
DATF
ATTENTibN
Off 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221 'M� '?o�
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE - YELLOW - IN'SPEVOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX PINK - OWNER - SOLD - ASSESS08
FINAL PROJECT APPROVAL FORM
TOWv�,
DATE:
MEMOTO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE�-
ENGINEERING DIVISION DATE�-
--------PLANNING DIVISION DATE -
PROJECT
SITE ADDRESS
PERMIT ADB#---------DATE INSPECTED Vail -
DESCRIPTION OF WORK TO BE INSPECTED W,47er-
-VAIK
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
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED RECEIVED
ci Copy of CONDITIONS given to owner/contractor by inspector JUL 2 - 2002
I . I ENGINEERING DIVISION
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
ci Copy of CORRECTION NOTICE given to owner/contractor by inspector
1.
2. ro 2,
3. UVI
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROV
Date Sign_
ocaprvl.doc.l:temp:bldg:fonnslO/01
z
9
0
M
M 0
0
80
C
M
M Z
,0 --1
z
0 -n
n
M M
t; -
0
C M.
9 Cn
Q 0
z
7-1
z
co
z
0
i
0
M
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .................
FOUNDATION:
Footing ......................
wall I .............. a ..........
z
Pier/Porch ................
01
0
J
Retaining Wall
Slab Insulation ..........
PLUMBING:
0M
C:
Underground .............
Ma
0
0
Rough -in
Commercial Final
x M
M z
HEATING:.
Gas Test ....................
Gas Piping .................
Equipment .................
Commercial Final
M
EXTERIOR SHEATHING
0
NAILING . .........................
C
FRAMING ............ ...........
M 0
FIRST FLOOR FRAMING
INSULATION ................
Floor Insulation
z
Wall Insulation ...........
co
Ceiling Insulation
z
SHEETROCK NAILING
0
171
SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ..................
AN 1A
IV47
A A 'A .ft