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20020340A.pdf
DATE RECEIVED C>? PERMIT EXPIRES USE 1E CITY OF EDMONDS ZONE NURII MBER �V(7 :, CONSTRUCTION PERMIT APPLICATION d0B SDITE/APTX OWN ADOftESS �`j ��y% NAMElNAME OF BUSIN SS (� �J •� PLAT NAMEISUBDIVISION NO. 77INO. LID NO. •/'�v'' \tc it i MAILING ADDRESS LID FEE $ �'�✓ ` V/ %C ' + ��f.> �J(/f-2-- PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP s� ro Paqueirae e flep'd CITY,^,,, 21P Tf,LEPH E E%ISTING PROPOSED—nepec.nneequlred N.q-u4ed p /,tL'-� .bewelk C ,L�/.>(/��Cf1t�• it • L 7e,)„�c� REQUIRED DEDICATION FT Wq�gO requkee 0 NAME !/ (( S� 77y g717 METER SIZE LINE SIZE NO. OF FIXTURES PRY REQUIRED Is 7 YES 0 NO i - ADDRESS REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE ' CITY - ZIP TELEPHONE O I IL'r. _��T; NAME EN INE�E/RING WEOJDAT ADDRESS �,,, 1,� } 11)VT 1v /hY • F�L%. ��DZ"'� 21P(r TE PHONE FIRE REVIEWED BY DATE Z STATE LICENSE NUMBER EXPIRATIO DATE M ED Y VARIANCE OR CU SHORELINE CR ADBX INSPECTION BOND POSTED 0 <� U�'J M�.. 1�7 L--?7 YES -10 ❑ ED m PROPERTY TAX A,,C..Cry�qOUM PARCEL NO. HEIGHT SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED ' } ++�� CIO V,-j' �� ©!9I d of VV EXP (A ❑ NEW RESIDENTIAL ❑ pLUMSING / MECH LOT COVERAGE REGU]RED SETBACKS (FT.) PROPOSED BETSACKS (FT.) I 0 m 0 ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAP O 1 rCTI ❑ ADDITION ❑ COAIMERCIAL ❑ CHANGE OF USE 3 I 0 C REMODEL APARTMENT ❑ ❑ ❑ SIGN PARKING LOT AREA PIANNING REVIEWED BY DAT 9 REOD PROVIDED m m �/�-,} �� C "' yr" t4 1 Z G FENCE ❑ REPAIR ❑ '{j'P/�yJ/_fX/, CYOS ❑ ( X Ff) BE.ARKS - • I _,Y ?M MMOLISH ❑ AN� K OTHEfl� q '!L%�� G�I"Ibt Ro Nn� �Al ✓t�Z- C ( r "I . = — G—ARAGE RETAINING WALL ❑ CARPORT ❑ ROCKERY ❑ RENEWALPREMARKS 1 � (p C OWE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: p - f Vt_ 0 -n E OF /NSTRUCTION COgF�.� OROUAN ^NUMBER NUMSER OF CRITICAL///\\J OFDWELUN6 AREAS � AREA OCCUPANT ITl iflOSTORIES UNITS NUMBER LOAD !� t0 DESCRIBE WORK TO BE DONE n S PER UBC 100/FINAL INSPECTION REO'D y CPECTIONS C fn it E d GF7� /1. 1 Z O 7 �� GJl ter! l v Ie / ! _ T A L� 7 > 2 e � c� � � � fiV= VALUATION $ - � 2 yq Description FEE Description FEE _ N Plan Check z SOURCE 6tA21N13 % LOT SLOPE % Building OHEAT ii PLAN CHECK NO: `"Y vssTEO Dare Plumbing m Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTIONONTHEPUBLIC Grading Recording Fee_ ' DOMAIN (CURBS,SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE _ SEPARATEPERMISSION. Engr. Review j City Surcharge PERMITAPPUCAR N: 1NDAYS •^ PERMIT UNIT.I YEAR -PROVIDED WORK I6STARTED WITHIN 150 DAY. SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engc Inspection State Surcharge 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS T BIGi. Plan Chk Deposit IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Review Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE 9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Z NOR LIMIT IN ANV WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Fire inspection Total Amount Due Landscapelnsp. Receipt# THIS APICATION; TT THE INORMATION GIVEN ES CORRECT, AND THAT ACKNOWLEDGE i AMV VTHE OHAE READWNER. ORRLTHE DULY AUTHOR ZEDFAGENT OF APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY Wnit CITY AND STATE LAWS REGULATING CONSTRUC CALL This appiie¢tlanlsnotep.tmit until siSn.dbylhe 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 Su"dina Offidstor his(h.r D.PetY: end Fee. ere p.1,T and FOR INSPECTION t.eelpt is.eknowlodped in.peoe provided WORKMEN'S COMPENSATION INSURANCE AND flCW /8.21. O i . IG TE'/ SIGNATURE NER O AG DATE SID ED •' } ) (425) `- •K/ :% / ✓C-� 771-0220 RELE BY DATE ATTENTION OR OCCUPY STRUCTURE EXT 1333 cj U� IT IS UNLAWFUL TO USE A BUILDING OR UNTIL i71©221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL F E YELLOW INSPECTOR ' CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 • • FAX PINK - OWNER GOLD -ASSESSOR to/01 FINAL+ PROJECT APPROVAL FORM TO: DATE: MEMO TO: PERMrf COORDINATOR BUILDING DIVISION FROM: FIRE DEPARTMENT DATE nrasesox 6x (J- P gRr ENGINEERING DIVISION DATE 2lf 0'Z- �es, PLANNING DIVISION DATE .�euax PROJECT �1 En SITE ADDRESS 1 D301� In of (� �l PIA ct1(/ ye, PERMITT# ,2 —d3 ADB# DATE INSPECTED 5 DESCRIPTION OF WORK TO BE INSPECTED I�00 L L---Ma IQrF l'e 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 releaseof PERFORMANCE BONDS and the granting of : GRAlITT FINAL PROJECT APPROVAL GRANT PROJECT APPROVAL WITH CONDITIONS NOTED o Copy of CONDITIONS given to owner/contractor by inspector is FAILED FINAL INSPECTION - OUTSTANDING ISSUES o Copy of CORRECTION NOTICE given to owner/contractor by inspector L 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date - Sign ocaprvl.docl:temp:bldg:fornu 10101 z 0 0 m om MO -40 00 C mz nz r_ -i n mm oV r 9 co Z n j. x z Z s to 0 i m 1' RECORD OF INSPECTIONS '- - - INSPECTOR DATE APPROVED ' ' - SETBACKS ..................... S FOUNDATION: - - - Footing ..................:... .. 1 Wall .......................... Pier/Porch ................. .. Z. 'r . Retaining Wall. .......... 0 ,. Slab insulation .......... X, PLUMBING: Underground .......... C IT! m " - Commercial Final ....... - S rn' HEATING: m - t .Gas Test ........... � - Gas Piping t- Equipment ::. .. ... ... Commercial Final ....... ITIm_ ' EXTERIOR SHEATHING .. NAILING .......................... C .: �. FRAMING ............ j FIRST FLOOR FRAMING... m: p INSULATION .... Floor Insulation ..........- Z Wall. insulation ........... ' . : 0) Ceiling insulation ....... Z j SHEETROCK NAILING ... SPECIAL INSPECTION ... - O Rt i i MISCELLANEOUS ........:. - -FINAL APPROVAL FOR i OCCUPANCY ..................