20020654.pdfHr�KDA.Ti RECEIVED%
RL, `,::�75VAC I
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS eajC A Aj D LW R SC-
5" C0F.FjLvP-$ C'140PPIN& P1.47-A
MAILING ADDRESS JVI/Z- ME- 13fJ
CITY ZIP
S,4E/l - C I yj 15 =N�
ICITY ZIP
ITILEPHII E
NAME 7c
??4weo, =wousrgias —
To—
ADDRESS I jq3g7 OiLyMPIC AvE- S.
CITY ZIP
STATE LICE BE NUMBER EXPIRATION DA;
RA-1IJIL&60P j-1-0
;I PROPERTY TAX ACCOUNT PARCEL NO. 006 1340000 0
li
Ew RESIDENTIAL n
ADDITION *..MERC.L COMPLIANCE OR
CHA14GE OF USE
REMODEL [3 MULTIFAMILY SIGN
-1 REPA114 n GRADING ri FENCE
f CYDS L — X—FT)
rl DEMOLISH TANK El 01 -
o GARAGE ri RETAININGWALL 0 F RE SPRINKLER
CARPORT 2OCKERY FIREALARM
PNUMBER NU
-1 -,
I STORIES DUN
I DESCRIBE WORK TO BE DONE
,-0 z (.
[PERMITEXPIRES
USE PERMIT ZCC2,:�
ZONE bN NUMBER
JOB SUITE/APT#
ADDRESS �OLJO,,)- I3oj4vLoj;J WA
L-0 &I WA. q kO2.&
PLAT NAMEISUBDIVISION NO. I LOT NO* LID NO,
LID FEE
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
P-11 ..0
EXISTING — PROPOSED -
P.,
REQUIRED DEDICATION— FT
METER SIZE I LINE .11E [ NO. OF FIXTURES P REQUIRED
YESO NO 0
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
FIRE REVIEWED BY
DATE
.AT.
III
--6Z-IN
EGO
a N.
1)(YER 0
POSTED
Is
SERA REVIEW
SIGN AREA
HEIGHT
OMPLETE I EXEMPT
P X
A�I
1,76$ 1 P1157;
ALLOWED PROPOSED
14' 1/-14'
LOT COVERAGE
REQUIRED SETBACKS (Fr.)
PROPOSED SETBACKS (FT.)
FRONT SIDE BEAR
FRONT UR SIDE BEAR
t7;0/;f7�SED
PAAKING LOT AREA
DATE
OVIDED
E!�4�
_1� _6e,
EMARKS r7e4
UaTAL fbP- '5-CC"-Vz
WMIMA e&Z- ADE�-02--13*-
ICHICIEDITI JTYIEO,1,��IrqCff OCCUPANT
GROUP \-
SPECIAL INIIE-1011 JARIA OCCUPANT
REQUIRED YES LOAD
$
Description
FEE_
Description
FEE
Plan Check
State Surcharge
HEAT SOURCE GLAZING LOT SLOPE I
Building Permit
City Surcharge
PLAN CHECK NO: VESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WO K NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLXANYCONST UCTIONONTHEPUBUC
Grading
.2 0 E
.1 OMAAN (CURBS, SiDEWAMS, DRIVEWAYS MAROU ES. ETC�) WILL REQUIRE
It SEPARATE PERMiSSION.
Engr. Review
PE MITAPPLICATION; INDAYS
PERMIT LIMIB I YEAR - PROVI ED WORK IS STARTED WITHIN too DAYS
Engr. Inspection
SEE 13ACK Of PINK PERMIT FOR MORE INFORMATION
N ON 11 F HIS OR HE SPOUSE, HEIRS, ASSIGNS AND
r —10 R SUCCESOR
Fire Review
Plan Chk. Deposit
IN INTEREST. AGREES TO IND MN11 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
Fire Inspection
Receipt #
FROM THE ISSUA CE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED To MODIFY, WA VE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapeinsp,
Total Amt. Due
Ox NOR LIMIT IN ANY WAY THE C"S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,'
Recording Fee
Receipt IT
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVE IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
T E OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
H
4.nUI�I9n,K1byLP.
CALL
T [ON; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE USDA CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION i Al'%
WORKMEN'S COMPENSATI=NCE AND RCW ILL27�
L SIG
USE
Sj:LUnE (PINNER Oft� DATE SIGNED
(425)
P-1-V-02,
aw
- nn
1 7710220
ATTENTION
')A
Off 1333
(,,,.DATE
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
PAK31NAL
- FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
PINK
-OWNER GOLD-ASSESS08
04102 PRESS HARD -YOU ARE MAKING 5 COPIES
GREEN- ACCOUNTING
IS
z
z
=i9i
C IT
M a
-4 0
0 0
C
-j C
XT
171
0 -4
X
ca
0 -n
In
M ITI
0,0
0
C
M 0
z
4
z
z
9
0
IT!
FINAL PROJECT APPROVAL FORM
T(
DATE:
7-
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE —
ENGINEERING DIVISION DATE —
PLANNING DIVISION DATA—
�PROJECT--q . . .....
SITE ADDRESS�
DATE INSf4CTED—
PERMIT Ak ��ADB#AL
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
MANCE B�NDS and the granting of
P_ERFOR
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractor by ins pector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date— Sigri—
ocaprvi.doc.l:temp-bidg:fomsIO/OI
z
0
d
0
M
0
80
C:
M
M Z
JO
C:
0)
o -n
n
M M
0
0
0 M
C Cn
9 co
Q 0
z
A
M
>
z
z
M
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ............
FOUNDATION:
Footing ...............
Wall ..........................
Pier/Porch
z
Retaining Wall
0
Stab Insulation ..........
M
P LUMBING:
Underground .............
M
Rough -In ................
171
0
--1 0
Commercial Final
Y,
HEATING:
M
ITI
10
Gas Test
C
Gas Piping .............
Equipment .................
0
n
Commercial Final
TR
EXTERIOR SHEATHING
IT!
a
NAILING ..........................
0
Fn
FRAMING ...................
cl)
(4
M 0
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
z
SHEETROCK NAILING
SPECIAL INSPECTION
0
ITI
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ...............