20020189.pdfE"XPIRM���
CITY OF EDMONDS
us
ZONE
PERMIT
NUMBER
CONSTRUCTION PERMIT APPLICATION
JOB
IUITIIAITI
R M N "O"U" BE
0 . MkM_FJNAMEOF BUSIM BE
ADDRESS
PILAT NAMEISUBDIVISION NO.
LOT NO. L�D NO.
A No A.DE SS
AILING ADDRESS
I
PUBLIC
D FEE $
. _,,:�.-r L
JA
RIGHT OF WAY PER OFFICIAL STREET MAP
13
CITY TEL -P;7��
JTW!��
EXISTING - PROPOSED
- I Ireq-w ds
REQUIRED DEDICATION-
F!
-7
METER SIZE
LINE SIZE
NO� OF FIXTURES
PAV REQUIRED
I
YES 0 NO 13
e
ENGINEERING REVIEWEDIDATE
ADDRESS
FIRE REVIEWED BY DATE
STATE LICENSE NUMBER EXPIRATION DATE
VARIANCE OR CU SHORELINE OR ADS# INSPECTION OSNO
Pao
RECID TEC
ES 0 NO I
NY PARCEL NO.
SERA REVIEW ,.,I AREA HEIGHT
COMPLETE P ED PROPOSED
E�ZPT
We
_00/ _t51 1_)1-_13
E.P t4l
, gN 'L
NEW
11 RESIDENTIAL 1�r-1 CEC.
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FTL
ALLOWED PROPOSED FRONT SIDE BEAR FRONWT R SIDE BEAR
0 ADDITION
/7,' o COMPLIA CE OR
2 COMMERCIAL
CHANGE OF USE
PARKING
�/REMODEL
APARTMENT ]ON
0
I LOT AREA DATE
REGD.'[=IDE
);2;W_
REPAIR
0 1
0 "'No CYDS (INCE X
EMAIKI*
C OA6V AMD ,Nw
IL
0 DEMOLISH
TANK WHER
(AAI14Gla��
[3 GARAGE
CARPORT
[3 RETAINING WALL
1, [3 RENEWAL
OCKERY
Alpfj, _3
aYPE OF USE, BUSINESS
OR EXPLJVN:
,ee
g
7.iVITY)
- - -
..sCKED.1 11112�MJIUCTI.11 0 UPANT
GROUP
NUMBER
OF
UMBER OF CRITICAL
WELLING AREAS
OCCURA:
STORIES NITS NUMBER
DESCRIBE WORK TO BE DONE
JIRROGRESS
LOAD
-41
REMARKS
INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D
VALUATION $ 4'X�
FEE
PLAN CHECK7:,
VESTED DATE
Plumbing
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS
PERMIT COVERS WORK TO
Mechanical
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUSUC
Grading
Recording Fee
M DOMAIN (CURBS, SIDEIVALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
C SEPARATE PERMISSION.
90eview
- —
2
RE MITAPPUCAIION: 180DAY.
-50—
City Surcharge
—
_f_�
PERMIT UMM, I YEAR -PROVIDED WORK IS STARTED WITHIN 18....
State Surcharge
See BACK 01 PINK PERMIT FOR MORE INFORMATION
'APPLI ANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUC ESORS
Traffic Mitigation
Plan Chk Deposit
IN ...EST. AGREES To INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGMTAON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
Receipt #
ALL CLAIMS FOR DA ES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCEGOF THIS PERMIT ISSUANCE Of THIS PERMIT SHALL NOT HE
DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF NYCITYORDINANCE
Fire Inspection
Total Amount Due
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE MY ORDINANCE PROVISION.-
-
Landscapoinsp.
Receipt #
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THU OWNER, OR THE DULY AUTHORIZED AD NT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
This sppftati.� i—Is pannit-11 sigred by .
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE Of WASHINGTON RELATING TO
FOR INSPECTION
Bulifto Meet .1 hIsIhot Deputy: wd Foes are Paid. and
.�elpti,,ck,c,l,dg,di,spacep,o,ided.
WORKMEN'S COMPENSATI=SURANCE AND RCW 182T III
TFIiNA1S ATU :1
SIGNATURE
=)E SIGNED
(425)
771-0220
ATTENTION—,-
TO
EXT 1333
NE11ASI!�� DI E
JQ 'U
IT IS UNLAWFUL USE OR OCCUPY A BUILDING 013 STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI.
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
ORIONAL�FILE YELLOW. INSPECTOR
PINK - OWNER GOLD - ASSESSOR
10101
z
Cl)
m
0
C)
0 C
m
to
E:
:� co
0 -n
m M
0
0
ri)
alt
M 0
z
71
z
9 1,
35
m
C, of Cbmabo
certift"Cate of ettupantp
DEPARTMENT OF BUILDINGS
PER UNIFORM BUILDING CODE SECTION 109
At, 8020 --_______Building Permit #: #N200
189
Occupancy established by this ceitificate:
Dwelling Units: -N/A**
No. Stories: I
B
Type Construction: V-N
Basement: No
Maximum Occupant Load -49-- _(Per U.B.C. 1002)
Room capacity signs, when required, must remain posted at all times.
owner of Building: Jacqu Mavo Address: 417 Main S . Edmonds, VIA 98020
THE Cottage Restaurant HAS BEEN INSPECTED AND APPROVED AS COMPLYING WITH THE REQUIREMENTS OF THE 1997
_Thai
EDITION OF THE UNIFORM BUILDING CODE AS ADOPTED BY THE CITY FOR THE GROUP AND DIVISION OF OCCUPANCY AND THE USE FOR
WHICH THE PROPOSED OCCUPANCY IS CLASSIFIED.
Issued this 19th day*f__Ap_r1I, 2002
CHIEF B FFICIAL
BY:
This cerilkata shall be posted in a c—,0—Ia NMI— and shall not be ro—ad, mutilated � niauved oW Own be rnaintained In Ieglt,[e condilinn Wall 5— Any �hanp Ofo-,P&KY —Onmnd,aa I, bolding pennit am a nm
Certf�toof�parmylss�byftOtydEd�dsauticongoifidal.
I
FINALPROACT APEROVAL FORM
TO)A--
DATE:
MEMO TO: pERmrr COORDINATOR, BUILDING DIVISION
FIRE DEPARTMENT DATE —
FROM:
ENGINEERING DIVISION DATE-
2n=�:PLANNING DIVISION DATE—.!�--/B-0'Z
PROJECT
SITE ADDRESS—t
PERmrrt2&2 �-/ �ADB#-------PATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTFD--,Y����
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:
X GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractorby inspector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date. Sigu�
ocaprvl.doc.l:tenip:bldg:fonnsIO/OI
z
0
C M
M0
0
80
C
M
M z
jo -i
C Z
�3:
0)
0 -n
A
x 9
M M
0
M
a)
Cn
M0
Z
z
z
M
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ................
FOUNDATION:
Footing ......................
wall
Pier/Porch .................
-04
Retaining Wall ...........
Slab Insulation
PLUMBING:
Underground .............
M
Rough -in
0
..................
-10
Commercial Final
HEATING:
ITI
IT!
ID
Gas Test ....................
Gas P, ping ................
0 -n
Equipment
Commercial Final
M M
EXTERIOR SHEATHING
NAILING ..........................
0
FRAMING .....................
Q 0
FIRST FLOOR FRAMING...
INSULATION ..........
;13 -
-4
Floor Insulation
Wall Insulation ...........
3:
w
Coiling Insulation
z
0
SHEETROCK NAILING
-I
0
SPECIAL INSPECTION
ITI