20020446.pdfCATE NBC PERMIT EXPIRES
6s' B PE
ZON 'RMIT'
CITY OF EDMONDS N M, 'Lo_C)t
CONSTRUCTION PERMIT APPLICATION ADDRESS SUITEIAPTN
BUSINESS
I pzwu�' PLAT NAMEISUBDIVISION NO. LOT NO L�D N .
MAILING ADDRESS L D EEE $
TS
S—AP11—
t5 'Fo t;m 16�15 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP P" R'
ZIR
CITY EXISTING __ PROPOSED
E.UlF�.IDEGICAR.N_ IT
NAME METER SIZE I LINE SIZE I NO. .1 FIXTURES FRY REOUIRED
YES 0 No 0
ADDRESS R MARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROIJORAINAGE
a 2�. /?E&lb . C F �L_
CITY ZIP TELEPHONE f6C7-LA__
- ' 1 11 1 1— —
ENGINEERiNG REVIEWEDIDATE
IF ADDRESS
S, _)U\7r
-rr -
b. (it L-8 s.1-7-4o
FIRE REVIEWED Y DATE
CITY NI
0 ,�
STATE LICENSE NUMBER
Z):T6
�;V
I
VARIANCEO CU
SHORELINE OR ACKIA
7+
NSPIC�ION
BE..
XYES E3NO
PROPERTY TAX RC4 NOL
SERA REVIEW
uum
COMPLETE EXEMPT
SIGN AREA
HEIGHT
A�W
232 _00(�n
EXP
NEW 0RESIDENTIAL C] PLUMBING i MECH
LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SETBACK$ (FT)
FRONT SIDE REAR
PROPOSED SETBAC
PET
COMPLIANCE On
ADDITION COMMERCIAL CHANGEOPUSE
q� 0 a
I AN. X",
-
PARKINGO
LOT AFiEA
I DATE
REMODEL C] APARTMENT 0 SIGN
BEET'
io PROVI
0, r5zl
&N
REPAIR Cl !:2�k CYDS 0 (PENCE X FT)
-�WIPA
jr) IN-LIF-L)
DEMOLISH TANK
PA*_V_q_t& 4,M0 t-16 )kt)j>M6MAL
GARAGE F-1 RETAIN WALL. C] RENEWAL
CARPORT E-T ROCKE
PAP-y-At4G, P-m-dwit2rao VbF- Dac*-',
(TYPE OF USE� B OR ACTIVITY) EXPLAIN:
'; -
7,--
'HEC'mSY
CURANT
,l-1MQN7
r
_0' - *
JTY��OTTRUCTJON
I
NUMBER
NU5sgR
CRFTICAL�
OF
DWELLING _a_
NT I
AREAS,
NUMBS
SPECIAL INSPECTOR JAREA
REQUIRED 0 y�S
IL
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER BED 1081FINAL INSPECTION
VALUATION
FEE
PLAN CHECK FEE
q/
HE!T�SO PIC GILA LOT SLOPE
BUILDING
/0
A&ATE
CV TED
CH6
FlUMPTING
MECHANICAL
THISPERMITAUTHO $ZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
IT u LIC
SEDONEO PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON T EP 0
OMAIN (CURBS, SIDEWALKS, DRIVEWAYS�MAROUSCS. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
STATE SURCHARGE
IT APPLICATION! 100 DAYS
PERMIT LIMIT, I YEARRPFTOVIDED WORK IS STARTED WITHIN 180 DAYS
ENG EVIEWIEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPUCANTONIBEH4 0, $OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
ENG INSPECTION FEE
IN INTEREST. AGREE TOT DEMNIF� DEFEND AND 14OLD HARMLESS THE CHY OF
LANDSCAPING
2 EDMONDS WASHtNGT N. ITSOFFICIALS, EMPLOYEES, AND AGENTS FROM ANYAND
c ALLCLAIMSFORDAM GESCEWHATEVER NATURE ARISINGOIRECT—FITIDIAECTly
INSPECTiOn FEE
X FROM THE ISSUANC OF THIS PERM17 ISSUANCE OF THIS PERMIT SHALL NOT RE
DEEMED TO MODIFY, AtVEORREDUC ANY RIEQUINEMENT Or ANY CU� ORDINANCE
PLAN CHECK DEPOSIT
2-07
NOR LIMIT IN ANY WA THE CITY S ABILITY TO ENFORCE A YORDINANCEPROVISiON-
"'C
TOIALA-1111 DNI
I HERE D E AT: 'AVT.REAO 11EIRS Al;FLWA ION THAI THE INFONVATION
GIVEN IS =L7' I AT AM F WN . THE DUTY AUTHONIZED AGENT OF
APPLICATION 'APPROVAL
NIP
THEOWNEA IAGREE M LY WITH CITY AND STATE IAWSFIEGUIAT�NG
R
I ION AND IN DOING V RKAUTHORIZEOT IIFHEBY NO �E.SCN
CALL
IN VIOLATION Or Tf 6 R CODE 0 THE STATE F WA5111NG I LATING TO
0
FOR INSPECTION
WORKMEN C N��GFTANCE AND HCW 18.
5
SIGNAT. WNER
(425)
1113AIIS�l�
IlAlr
I
/L
7
1�
ATTERTION
EXT 1333
cl
IT IS UNLAWFUL��OUSE OR OCCUPY A BUILDING 0 STRLTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
OTFUINAI FILL
YELLOW INEPECtOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
111X OWNER
.010 A SSCSSOII
z
?5
m
m
0
80
c
--I C
z X m
M Z
O"n
m M
GIG
6
0 M
C ca
C CA
M 0
z
z
co
z
m
MvIt"',
Cop.v
JW
PARKING SPACES REM
APPROVED AS 140TED
BY ENGINEERING
P0.
'51',CES PROPOSED:
0;;
BAM-�
K,R:T.'G SRTES:
Dat.:
ai
M,
M 0
0.
(206) B&M
t1i 27,2=
TM
F-
zi
904 I'Ah Aveme 5.
r
M m
Arm
UmaO�, WA 96020
0"
09,
C
c
m
AAW Vck 208e
;u
-tT
0
cc
z
g*
0
OWNERMONTRACTOR
IS REMSIM
FOR
m
EROSION CONT(N.
AND DRAINAGE
Flower %,p
M 619.95'
r=SIVEL
APR 2 1 M?
FINAL PROJECT APPROVAL FORM
TOAII'IwX14�,
DATE:
1�ffi I MO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIR DEPARTNIENT DATE —
ENGINEERING D' IVISION DATE —
PLANNING DIVISION DATE�--7--21--69-,
PROJECT
SITE ADDRESS 54��- 4g6t"
�DATE INSPECTED-.�Z— -6 —102--
PERMIT #,= ADB#-Ag:��
DESCRIPTION OF WORK TO BE INSPECTED
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 WrM CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u 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:fonrisIO/OI
z
0
i
0
M
C M
M 0
0
80
C
M
M Z
0-4
0 -n
MM
U
0
0
CM0
Q)
M 0
z
z
-4
3:
0)
z
0
4
0
M
FINAL PROJECT APPROVAL FORM
TO:94aiox
DATE: 4/�
MEMO TO: PER)M COORDINATOR, 13UILDING DIVISION
FROM: FIRE DEPARTMENT DATE
I LK --ENGINEERING DIVISION DATE
PLANNING DIVISION DATE—
PROJECT--,_ -:,ul
SrrEADDRFSS—ffZ4
U&Z
PERmrr#c0e�g-/9!�/�ADB#-,::� �- ---- PATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED
A field inspection was conducted to determine final compliance with approved plans. Flnal approval
denotes that there are no objections from the above signed Department to the release of
PEREORMANCE BONDS and the granting of:
-X-GRANT FINAL PROJECT APPROVAL
RECEIVED
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractor by inspector JUL 2 - 2002
ENGINEERING DIVISION
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 Si
ocaprv1.doc.1:temp:b1dg:fbrms 10/01
z
C
MO
0
0
Z
'0-4
�z
E::
0 n
n
� 9
M M
0 V5
0 'M
C')
(J)
M0
z
;U
z
z
rn
FWAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE—
11 �01-
AA((K\R ENGINEERING DIVISION DATE��-�J
z
PLANNING DIVISION DATE—
0
PROJECT
a M
—
SITE ADDRESS
mo
40
PERMIT 0 ��ADB# INSPECTED
OC
4 K
MM
-------DATE
n1z
DESCRIPTION OF WORK TO BE INSPECTED
C 2
>
A field inspection was conducted to determine final compliance with approved plans. Final approval
Cn
denotes that there are no objections from the above signed Department to the release of
0 -n
-i
PERFORMANCE and the granting of
3: K
M M
055
0
GRANT FINAL PROJECT APPROVAL
0
C IM
K CD
A 0
z
GRANT PROJECT APPROVAL WITH COND]TIONS NOTED
z
u Copy of CONDITIONS given to owner/contractor by inspector
z
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
M
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Sign_
ocaprvi.doc.l:tenip:bldg:fonnsIO/OI
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .................
FOUNDATION:
Footing ..............
Wall ..........................
4;,
WY5
Pier/Porch
Retaining Wall ...........
Slab Insulation
M
C
PLUMBING:
rn
0
Underground
0
C=
Rough -in ..........
rn
j
Q
Commercial Final
HEATING:
Test
Gas ...........
vyll
0,n
-n
Gas,PIpIng ... ..............
IT1 rri
Equipment ...........
Commercial Final
EXTERIOR SHEATHING
C
C Cl)
M 0
NAILING ..........................
-Z,
FRAMING ............
;U
FIRST FLOOR FRAMING
INSULATION ...................
z
Floor Insulation
Z
Wall Insulation ...........
Coiling Insulation
0
ITI
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ...............