20020472.pdfDATE RECEIVED
2,
CITY OF EDMONDS
,us'
ZONE
PERMIT
NUMBER Rw -elm
CONSTRUCTION PERMIT APPLICATION
III)TIIAITI
OWN-,rMF
BUSINESS
PLAT NAME/SUBDIVISION NO,
L6 T No
MAILING ADDRE—
Al. /Jo 1/, fo-k,�, 60—v
I
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
IEIP 11�1
of ZIP
�03
ITE11PHON1
7-06 634/ �S-_-o
EXIST NG — PROPOSED—
REOU:REDOEDICATtON—
FT
NAME
CAA () k n --e,< QCID%SOI1 T_YIC, .
METER SIZE I
LINE
IRI REQUIRED
YES 13 No 13 9
ADDRESS
REMARKS
2,0 -30 0 1 CA A-%, t-ve ItA I-
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLJORAINAGE
1EUEPZNB3,j,4
I" I r-.. �Ufl 111,14.4�
ENGINEERING
REVIEWEDIDATE
ADDRESS
H(s
. .....
or, fl�j TELEP"CINE
fe"! III �,5 Z
- 10-01—:29D,
FIRE REVI
=Yc----
— :7�
D TE
.
STATE LICENSE NUMBER EXPIRATION DATE
VARIANCE OR CU
SHORELINE OR ADS* INSPECTION J,IOND
sea, OSTED
8,"fT
!E!\ C3yes
PROPERTY TAX ACCOUNT PAR
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
RE W RESIDENTIAL
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
PLU MBING I MECH
ALLOWED PROPOSED
FRONT SIDE BEAR FRONT URSIDE REAR
COMMERCIAL COMPUAN
[3 ADDITION E OR
CHANGE OF USE
RE MODEL 0 APARTM ENT SIGN
--F-
HE PARKING
T
LOT AREA I P4NNING REVIEWED BY
K-2,
[3 REPAIR GRADING 0 FENCE
CYRS ( _ X Fit
REMARKS
[3 DEMOLISH TANK OTHER
GARAGE RETAININ WALL RINEWAL
CARPORT 0 ROCKERYO
(TYPE OF USE, BUSI
M�/
Ty� C PA';f;�5
'9;, 'G77
—
!!!f7
rccu
. ou
I' , P
M
M ER'o
U BE
NUMBER IN F CRITIO-
OF DWELLING AREAS
SPECIAL INSPECTOR
-To
r
AREA CC11PANT
STORIES UNITS NUMBER��
REQUIRED[:] YES
5 YES
10
LOAD
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC IGO/FINAL INSPECTION REOD
LkL.
VALUATION $
CL%;(
Description
FEE Description FEE
)IPC diA Vjo,-y—, (Se-r,
Plan Check
4
---
BEAT SOURCE GLAZR ME %
IQL* . Gas I
Building
PLAN CHECK NOL
Plumbing
Mechanical
THIS PEDHOUIT AUTHORDES ONLY THE ORKNOTED. T141S PERMIT COVERS WORK TO
Err
; HE of, PH VATIE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
Recording Fee
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, UARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISS1014,
to
Engr. Review
City Surcharge
BE JARrAPPLICATION: INDAYS
PenmiTummiYEAR-PROVI EDWOFIK IS STARTED WITHIN "KI DAYS
Engr. Inspection
State Surcharge
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
—PLIC . ON BEHALF OF 111101 HER SPOUSE, HIMS, ASSIGNS AND S.CCES.Ra
Traffic Mitigation
Plan Chk Deposit
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS WASHINGTON ITS OFFIMALS. EMPLOYEES, .11 AGENTS .. A. AND
Fire Review
0 Receipt #
ALL CLAZ FOR DAMAGEB OFWHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
—
FROM THEISSUA CE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
13EEMED TO MOD' WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Fire Inspection
Total Arn.urrt Due
,
NOR LIMIT IN ANY WAY THE CRYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
La
I HEREBY ACKNOWLE GE THAT I HAVE READ THIS APPLICARON; THAT THE INFORMATION
GIVE" IS CORRECT; AND THAT I AM THE OWNER, 0, THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE DIANE . I AGREE TO COMPLY WITH CITY AND STAT LAWS REGULATING CONSTRUC
CALL
Thi-ppfi-J- 1. — p—i—fil �iqmd by ft
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE L DENOF THE STATE OF WASHINGTON HEWING To
ikilldirt,; OtftW., hNfIV, [N,puly: ard F...— pidd, .d
FOR INSPECTION —1pi ln.p— F—Id.d.
Ne C IIAT
WORKME OMPEN iWM CE AND RCW 18.27�
(425)
DATE
Z:/D 0
771-0220 'Y DAtE
NTION
RI/j,"
W'1333
IT IS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE - YELI.W�1/6SP*ECTR
CATE OF OCCUPANCY HAS BEEN GRANTED. URIC SECTION 109
FAX
PINK -OWNER - GOLD -ASSESSOR
1010,
z
=i 5i
Uj �
0 M
Co
0
80
m
1�
z
O"n
n
ITT m
�i 0)
0
J)
G)
0
z
M
z
z
m
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTNENT DATE
ENGINEERING DIVISION DATE�--
P GDIVISIONDATE,
PROJE1 /319-a- d--
SITE ADDRESS
PERM]T#2�� �L472-�ADB# —DATE INSPECTED�—q'—
SPECTED_462---QS
DESCRIPTION OF WORK TO BE IN
A fleld 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
-----t�!-GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL ATM CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractorby inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to oNvner/contractorby inspector
2.
3.
R&INSPECIED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date_ Sign
ocaprvl.doc.l:tenip:bldg:fonmslO/01
z
9
0
M
OM
co
M 0
80
C:
M
MZ
-4
Z
-4
M
0
n
-4
M M
U Cl)
0 r-
0 M
C (a
9 CD
M 0
Z
z
-1
a;
Cn
z
9
0
M
IT
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing .............
wall ..........
Pier/Porch .................
z
0
Retaining Wall ...........
-4
Stab insulation
PLUMBING:
--I "n
Underground
M
C
171 0
Rough -in ...................
0
Commercial Final
R1
ITI
HEATING:
Gas Test vn�
....................
b
PAS
.,I -b -
Gas Piping
Equipment .................
T1
Commercial Final
M M
EXTERIOR SHEATHING
NAILING .....................
0 Fn
-0z
cm
FRAMING ........................
(a
0
FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation
Wall Insulation
Ceiling Insulation
vv\
SHEFTROCK NAILING
-04
0
SPECIAL INSPECTION
rn
j
MISCELLANEOUS ..........
FINAL APPROVAL FOR
!,a
OCCUPANCY ...........