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20020579 (2).pdfDATE RECEIVED '2 [PERMIT EXP "IRES CITY OF EDMONDS BE 2 ZONEU PERMIT &o —NUMBER Jo SUITE/APTO CONSTRUCTION PERMIT APPLICATION ADODRESS OWNER NAMENAME OF BUSINESS PLAT NAME/SUDDFVISION NO. LOT NO. LID NO. a LL= LID FEE S MAILING ADDRESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING — PROPOSED REQUIRED IftDicRuJusmr, IryN_g2C= P_ rl TESCP ApPrOvId RW Porn* nowlired! Strej4 Use Permit Reced ImWdon Required Sidewsbc Required unftwo— WWU required 13 CITY ZIP TELIPHONE 167 NAME METER SIZO T"L9FE TO t I DI10dFErA)Wg 0 PRV REQUIRED R INUIS NO E3 ADDRESS mils-1- HR CAPPED AT OWNERjCCNTRAcR&MP&xBWw9 EROSION CONTROUDRAINAGE 0 WATER METER M PH RPMOUBD G* CITY ZIP TELEPHONE 'IOSLS BIB WITH AVB INSTAUM NAME I)UMP AT APPROVED DUMP SM ()Nly ADDRESS ENGINEERING Ould JJEMOLITION INS 0 CHECKLIST ON BACK OF JOB CARD 3qFIRE REVIEWED BY L�WWTE CITY ZIP TELEPHONE VARIANCE OR CU SHORELINE OR ADD# IWISPECTION REO'D E3 YES [3 NO BOND POSTED STATE LICENSE NUMBER EXPIRATION DATE 0.01 - .0 co b fj acc, 40 CHECKED -BY SEPA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED PROPERTY TAX ACCOUNT PARCELWO. g?01-em EXP , , [3 NEW RESIDENTIAL PLUMBING / MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT UR SIDE REAR COMPLIANCE OR [3ADDITION [j COMMERCIAL CHANGE OF USE [3 REMODEL [3 APARTMENT 0 SIGN PARKING RECrD PROVIDED LOTAREA [PtAlSiNINGREVIEW ED BY DATE [3 GRADING CyoS [3 FENCE X .[3 REPAIR ( — — FT) REMARKS �40EMOLISH [3 TANK [3 OTHER [30ARAGE c3 RETAINING WALL CARPORT ROCKERY RENEWAL (TYPE OF USE. INESS On ACTIVITY1 EXPLAIN: CHECKED BY ITYPII]OF.CONSTRUCTION ct! OCCUPANT GROUP NUMBER OF STORIES N JIMBER OF OUIELLING UNI CRITICA AREAS 1ENt4w SPECIAL INSPECTOR JAREA REQUIRED 0 YES - OCCUPANT LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REO'D _N&_,Mj6 ZA lz R A-01Y VY dffiQL VAWATION $ Description FEE Description FEE Plan Check Building HEAT SOURCE !!:!�!NG % .,LOLSLOPEII �Plumblng PLAN CjK NO: VESTED 13ATE Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: 23 BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC DOIMN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Grading Recording Fee Engr. Review City Surcharge PERMIT APPUCATIOM. 1180DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection State Surcharge SEE BACK OF PINK PERMIT FOR MORE INFORMATION Traffic Mitigation Plan Chk Deposit -APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Receipt # IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 21 NOR LIMIT IN ANY WAY THE CrrirS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Fire Inspection Total Amount Due Landscape Insp. Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- TION; AND IN DOING THE WORK IZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATIONCF-SkE LA843R C F THE STATE OF WASHINGTON RELATING TO APPLICATION APPROVAL This application Is not a permit until signed by the CALL Building Official or his/her Deputy: and Fees are paid. and FOR INSPECTION receipt Is acknoMedged In space provided, WORKMEN PENIATION IN$TCE AND RCW 18.27. OFFICIALSSIGNAJURE ATE 1405) - )ATE SIGNED =*_&iEROP :1111�c . ...... . 1!�,ji :9 1 ( i5zw 771-0220 RgLEASED BY / D*E7 WANTIO EXT 1333 I I UNU UL SE OR OCCUPY A BUILDING OR STRUCTURE UNTIL a�WFU INAL INSZV..S11HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 771-0221 ORIGINAL - FILE - YELLOW - INSPECTOR FAX PINK - OWNER - GOLD - ASSESSOR 10/01 I . I It IIIII I -- I. I k Got It y 1�1. At I 'SI-I Ile Z. 0 I. "t"j, 4' It I 0 4 It 10 I It f I-REC ORDOVINSPECTIONS I to I 1 4. I P. 4 1 1 1 1. 1 1 P I I I I I k I I I I, I I t I LLL 0 DATE APPROVED .,1.14 j I I I I I INSPECTOR SETBACKS Lr 14' 1% 111', ..I'f I dI If If LIS 6k ;I -FOUNDATION:d,; Footin,g age 88 *,11's 6*0000 060 0000 I L I ask k. 0 1. 4wall I It td 4 1 '1, .1 It. I re , I - f III I . 6't too tt; ft It 14, It Ik k Pier/Porch 6 0 Q Go 6 1! A t; ',I I ft, I. - 44 ke J.", Z I. N I I M4 IS staining 7 wi I : I _4 F3 P f I I I I I It I Ift. On I I, It I I It I Slab Insulation iorf� J -IJIP I. I. 1 4 Wt- 1. 1 4 iN' I I I III I I I I I t. I I rd II.Lr 4 1 PLUMBING 14 4 ;1 11% 6 r* r r Of I I Underground I r 1 4 I L I Ikd I 4 0 1 IIt k Roughwin 1 '4' P�: t jr Commercial Final CA r HEATING It I r IM It 0 It 0 0 4 Gas Test I I:I j t I I I I I I I r I tq I I I III Gas.Piping 1 4 - . I I I . I I I I I I I 'd I d� I Equipment I t 1 14 1 Y4 C ommercial Final' G0000t 111 4 t EATHING WERIOR SH NAILING I I P. I FRAMIN I t I I I 1 1. 1 FIRST FLOORIFFIAMING... IX INSULATION k Floor insulation 4 Wall In3ulatlon 4 1 11 14 Coiling Insulation I SHEETROCK NAILING A SPECIAL INSPECTION 4 1 '1 1 1 4 I It MISCELLANEOUS Goo FINAL APPROVAL FOR OCCUPANCY I I 41 1 1 r I L I I Lr I L It tt� I r I 4 It 4 EC 1 0 CITY OFEDIVIONDS USE ZONE PERMI1 NUMBE CONSTRUCTION PERMIT APPLICATION JOB ADDRESS OWNER NAMEJNAME OF BUSINS PLAT NAME/SUBDIVISICIN NO. LOT NO. Ln n 12 fn2 1 MAILING ADDRESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7PDOA- EXISTING PROPOSED CITY zip TTE1 1PHONE r'N 0 /j ;�� = ( ) I :Q > Z REQUIRED DEDICATION— FT NAME METER SIZE LINE SIZE NO. OF I" PRE-INSICTION R ADDRESS REMARKS 0—nn'r CITY ZIP :,(/D / SUITEIAPT# LID NO. UD FEE $ 7EMrA_W_VM RW POFM Requked Bugg U" Pums RW UndKWound g req*sd 'PRV REQUIRED JIYES C3 NO 0 0 SIDE. SEWER MUS I BE CAPPM AT PROPUR3 i L11413 NAME* WATER M R 110 BE. x vvtw %M Ho�qn nin 'wiTHAVB 1N9TA11`-Vn Z, 0 9 ENGINEERING 0 DUMP AT APPROV REVIEWEDIDATE. 3D DUMP SM MT ADDRESS 0,A FIRE REVIEWED BY NEE DEMOLITION CHECKLIS T OR B IN. 6CK OF. CITY ZIP TELEPHONE Loa— VARIANCE OR CU SHORELINE OR ADBO IN Egq�.-� 111E CI YES, LjN*O,' BOND P STE !!�9& am ca m 0C m z 0 In 'r m M, 13 Fn M C) EX STATE LICENSE NUMBER PIRATION DATE CHECKED -BY SEPA REVIEW COMPLETE EXEMPT EXP -SIGN AREA ALLOWED PROPOSE -D HEIGHT OWED PROPOSED f.'. ALL .1 .- d PROPERTY TAX, ACCOUNT PARCEL NO. EW RESIDENTIAL -13 N [3 PLUMBING MECH .[3 ADD COMPLIANCE OR MON [3 COMMERCIAL 13 CHANGE OF USE 0 REIIIOD'EL [3 APARTMENT SIGN GRADING E3 FENCE :'[3. REPAIR 08 X FT) CY DEMOLISH 1 [3'TANK [3 OTHER .[3GARAGE, RETAINING WALL CARPORT:. ROCKERY jj RENEWAL LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS'�Fr.) FRONT SIDE REJ PROPOSED* SETBACKS (I`T)� FRONT LIR SIDE REAR PARKING RECrD I PROVIDED LOT AREA PLANNING RI:D'BY DATE REMARKS CHECKED BY sTr ITY�� .. .... 1-27 .0 ccuPANt GROUP k ITYPIE OF. WZi,NESS Oil JACTN", EXPLAIN: —1 t A m 'NUMBER'' :.8T OR . JE 8 NUMSER'OF DWELLING UNITS CRITIC 'R SPECIAL INSPECTOR', JAREA REQUI RED [3YES REMARKS PROGRESS INSPECTIONS PER UBC 11�FINAL OCCUPANT',--, INSPECTION R EQ6 DESCRIBE WORK TO BE DOME Ask* Adik-= nRIU1*41i CA V111t maw VAWATION $ Desdription FEE bescription FEE; z 0 Plan Check HEAT SOURCE % to Building ILJII -.x M. Plumbing 4": PLAN CITA: VESTED DATE Mechanical THMPERWAUTHOI 79M TWS PERMIT COVERS WORK TO Grading Re cording Fee BE DOME ON PRIVATE PROPERTY ONLY. MY CONSTRUCTION ON THE PUBLIC DOUM (CURIBS, SIDEWALKS, DRIVIEVAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATEPERMISSION. PEFIMIT APPILICATIOMA00 DAYS Engr. Review City Surcharge PERMIT LIMM I YEAR - PROVIDW WORK 18 STAR= WITHIN 180 DAYS 11111111 L4CK OF P111115 PWWff FOR MORE INFORMATION Engr. Inspection 8 to Surcharge Traffic Mitigation Pi n C'hk Deposit I r `APPUCANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review R elpt # 'C Tb� Amount Due IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE, APj&NG DIRECTLY OR INDIRECTLY FROM THE ISSUA14CE OF THIS PEFimrr. 18SUAKE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Fire Inspection NOR LIMIT IN ANY WAY THE C"Y8 ABILITY TO ENFORCE ANY ORDINA14CE PROVISION.' Landscapelfisp., Rc colot # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. THAT THE INFORMATION GIVEN 18 CORRE" AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- TIOW. AND *11 DOING THE WORKg ED THEREBY NO PERSON WILL BE EMPLOYED IN VIOLATIONAF 3 CO rF E STATE OF WASHINGTON RELATING TO TqE LAEW R T T IN WORKMENS AND RCW `111.27. ,,COMPENIIATION IN APPLICATION APPROVAL TWs applicatlo i Is not a perrrJt until signed by the CALL suit ding Orticial or Welher Deputy: and Fees are paid, and FOR INSPECTION reoeipt is ai knovAeftod In space provided. OFFICIALS aIGNAPRE ATE IA13 025) 771-0220 RELEASED BY DANE DATE SIGNED EXT 1333 -------- U N R OCCUPY A BUILDING OR STRUCTURE UNTIL rINA BEEN MADE AND APPROVAL OR A CERTIFI. CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 771-0221 ORIGINAL FILE - YELLOW- INSPECTOR FM PINK- WNER - GOLD -ASSESSOR 10/01