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20020321.pdfP ERMIT EXPIRES USE PERMIT ZONE( CITY OF EDMONDS NUMBER �Z'b CONSTRUCTION PERMIT APPLICATION JOE — IUITEIAIT I ANNEJ NAMEINAME OF BUSINESS 7 _ I C "S — _a-e-,,j C- S6/1-,0�2+,S PLAT NAME/SUBDJVISION NO. LOT N11. L�.D 1'1�Cs AAILING ADDRESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP ;ITY EXISTING — PROPOSED— c REQUIRED DEDICATION— FT Wcre, I.". 4AME METER SIZE I PRV REQUIRED Is YES 0 No REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE Ar C 14 re7uf�, as :ITY, ZIP =IIE 5t-- C�'� 51- ROD-0 11r), T11L,1 ji� I , _4LI96S e_-1 Ir 0 L:g f�5 /Ate_ I UAML� M-1- ^fIrw 1110> T!:tw E GINEERING ADDRESS IDA. U,,-) FIRE REVIEWED BY DA?E CITY ZIP IRL AS 0 TELEIH —OM---- 4.1.g (a_� —,(6 —C) Z-- ,&L STATE UC NSENUMBER I EIIRA�7�Tl CHE VARIANCE OR CU SHORELINE OR ADB# --------------- INS 'E�TIONI : D 0q0 / / _11 tvis-g000-147— EGO leis mWO POSTEC IROPERTY TAX ACCO p2a; SEPA REVIEW COMPLETE 111:�� SIGN AREA ALLOWED PROPOSED HEIGHT PI 5LA 96o, /0 1 EXP , 1 0 1;'111 ZI I NEW RESIDENTIAL LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) I MECH ALL OWED PROPOSED FRONT SIDE READ FRONT QRSIDE READ [3 ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE A/A I y/6 )V/C REMODEL APARTMENT SIGN PARKI REGO PROVIDED LOT ARiE� PLANNING R!VIEWED BY DATE FENCE I to 17- REPAIR 0 GRADING CYOS I X FT) A-i by,/- 4,.11A 0 DEMOLISH n TANK 0 OTHER gi o GARAGE 0 RETAIN[No WALL CARPORT ROOKERY El RENEWAL w/-,/ /Ju eh (TYPE OF USE, BUSINESS OR ACTftRY) EXPLAINy I _ I I DESCRIBE WORK TO BE DONE CHECKEDBY 1](T UO PECIAL INSPECTOR QUIRECE] YES IAIEA//f Sf RE Description FEE Description FEE tjr-l' iwj�rs Plan Check q7 I Building ATIE PLAN CHM- VESTED DATE Plumbing [so , Mechanical /30 THUS PERMIT AUTHORIZE. ONLY THE WORK OTED. THIS PERMIT COVERS WORK 1. HE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading Recording Fee D Z! OMAIN (CURBS, SIDEWALKS, EHIPIRWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review City Surcharge PE MITAPPLICATION: INDAYS -1 PERMIT LIMIT I YEAR -PROVIDED WORK IS STARTED WITHIN 180DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspisoti., ' gki, a�q (I,, State Surcharge 60 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Traffic Mitigation Plan Chk Deposit : �7_ IN INTEREST AGREES TO INDEMNIFY. DEIIND AND HOLD HARMI-EsS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE . ARIS No DIRECTLY OR INDIRECTLY R - I view LInspection Receipt # FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE F THIS PERMIT SHALL NOT BE O'EOEMEDITTO MO.DIFY WAIVEE OR REDUCE REQUIREMENT OF ANY CITY IT n. Fire so Total Amount Due ANY ORDINANC� RIM INAYW�YT CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION, 21 L L. so PIS s! ,ndscapeinsp. 77 Receipt I HEREBY ACKNOWLEDGE THAT � HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN APPLICATION APP R- VAI IS CORRECc AND THAT AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC. CALL Is net a p,recit,iffil signed by Me TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF IHE STATE OF WASHINGTON RELATING TO LbeiThesappalak, ding Olfic� FOR INSPECTION receipt I re`Msibar DbP1rY: I'd Fees I—k—ledgOd In spay ale paid. and R—idad. WORKMENS COMPENS=INSURA4, AND= I , 7. 0 FFCJ L NAT D E /At NATURE to 0 DATE SIGNED (425) 771-0220 RLEASfEQ ISME AV 1CIM a luri EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 4 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 771-0221 CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 �A - INSPECTOR 10101 FAX PINK - OWNER - GOLD - ASSESSOR z 0 =j 0 R1 :;5i U5 � C3 M C: M 0 0 C: In ITI z to -1 X 0 _111711 ,n -4 3:9 M ITI 0 V; 0 r- 091 C C fn M 0 z M z ca z 0 d 0 In FINAL PROJECT APPROVAL FORM TO:_ DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: FIRE DEPARTMENT DATE z ENGINEERING DIVISION DATE 0 P G DIVISION DATE PROJECT —31�2- /'&/Z f�> M M 0 SITE ADDRESS 2 C) 0 8C M PERMIT # 1,- 6,*5 Z 0 7� L--ADBk DATEINSPECTED M Z DESCRIPTION OF WORK TO BE INSPECTED 29 0) A field Inspection was conducted to determine final compliance with approved plans. Final approval O'n denotes that there are no objections from the above signed Department to the release of x rn M PERFORMANCE BONDS and the granting of: -0) 0, M 0) FINAL PROJECT APPROVAL Q 0 Z ------Z-GRANT ;U z GRANT PROJECT APPROVAL WITH CONDITIONS NOTED 0) E3 Copy of CONDITIONS given to owner/contractor by inspector z 0 q M FAILED FINAL INSPECTION - OUTSTANDING ISSUES a Copy of CORRECTION NOTICE given to owner/contractor by inspector 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Sign_ ocaprvl.doc.l:temp:bldg:fonnsIO/OI FINAL PROJECT APPROVAL FORM TO: DATE: MEMO TO: PERMIT COORDINATOIZ, BUILDING DIVISION FROM: ____YIRE DEPARTMENT DATE� ENGINEERING DIVISION DATE PLANNING DIVISION DATE PROJECT_!SJ&" 614YI-7 srrE ADDRESS la T1- St I VL/ PERMIT# ADBk__DATEiNsPEcTED__ 41104�10 3 DESCRIPTION OF WORK TO BE INSPEC 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 WrrH CONDITIONS NOTED a Copy of CONDITIONS given to owner/contractor by inspector I FAILED FINAL INSPECTION - OUTSTANDING ISSUES a Copy of CORRECTION NOTICE given to owner/contractor by inspector 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Sign_ ocaprvl.doc.l:temp:bldg:fonnsIO/OI z 9 0 0 in C M 0 80 M M Z a-4 co O"n n _q M M 065 0 r- rn z 0 z -4 z 0 A 0 M Y TO: DATE: MEMO TO: PERWr COORDINATOR, BUILDING DIVISION FROM: FIRE DEPARTMENT DATE-- DIVISIONDATE-- z 9 PLANNING DIVISION DATE 4-1171 0 m PROJECT V5 -i am SITE ADDRESS. MO 0 80 C --4 r X M PERMIT 6P-2,a-oZ-p3'2(____ADB# 2.-ba- IA2� DATEINSPECTED 4- 7/ M Z DESCRIPTION OF WORK TO BE INSPECTED A field inspection was conducted to determine final compliance with approved plans. Final approval 0 -n n denotes that there are no objections from the above signed Department to the release of PERFORMANCE BONDS and the granting of: m m 065 0 r- GRANT FINAL PROJECT APPROVAL m Cn co Q, 0 z 0�&, rr-�4 4 X z GRANT PROJECT APPROVAL WITH CONDITIONS NOTED (3 Copy of CONDITIONS given to owner/contractor by inspector C/) z 0 4 0 m FAILED FINAL INSPECTION - OUTSTANDING ISSUES a Copy of CORRECTION NOTICE given to owner/contractor by inspector 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Sign_ ocaprvl.doc.l:tevV.bidg:formslO/01 RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing...................... wall ....................... — Pier/Porch .. ............... Z Retaining Wall ........... Stab Insulation .......... PLUMBING: Underground 1711 Roughdn ................... M 0 C Commercial Final M HEATING: IT1 z Gas Test .................... gL .............. Gas Pipin GZ . . ..... Equipment ................. 0 -n Commercial Final pri m EXTERIOR SHEATHING 00) 0 r NAILING .......................... Ion 0 M C CA FRAMING ..................... — .. ..... ...... Q 0 FIRST FLOOR FRAMING z 74 INSULATION ................... ;U Floor Insulation > z Wall Insulation Ceiling insulation z SHEETROCK NAILING SPECIAL INSPECTION 0 M MISCELLANEOUS FINAL APPROVAL FOR OCCUPANCY .................. 1110,11111or 7#, L93 SideSewer# AwoutPWd$—Rece1,pt#— Datelssue Explim WaterMeterSize- AmountPaIdLTde—ZReil DaftPardsSed— now tmount ftd $-2L:.ReMIPt