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CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLICATION
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ADDRESS
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SIZE LINE S111
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NAME
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REMARKS
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NAME CSLX I
ENGINEERING REVIEWED By DATE
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CITY 04ME A5 AODVL- F11 E REVIEWED By DATE
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EXPIRATION HAND R SHOReLINEOPIAD IN dTION 80 D
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STATE LICENSE NUMBER IT
-T TO ED, POSTED
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PROPERTY COMPL'EPT'WVS �J; . OIls�,, PROPOSED
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COMPLIANCEOR
ADDITION 0 COMMERCIAL CHANGE OF USE
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PARKING
REMODEL MULTIFAMILY SIGN FRECID I
"'L SPECrION
0 REPAIR 0 GRADING C,GS 0 FENCE
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DEMOLISH [3 TANK rl OTHER MR INSPECTION REQL16i�T��_
GARA-a Ei RETAININGWALL o FIR SPRINKLER
CARPORT ROCKBRY FIREALARM
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
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TYPE OF ONSTRUCTION CUPA�U
N a NUMBER F A 410
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UMBE B An I IS SPECIAL INSPECTION OCCU FIT
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DESCRIBE W06=,,, f,)— (ZIadko�C,,C REMARKS
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PROGRESS INSPECTIONS PER UBC 108/FINAIL INSPECTION RECID
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Description FEE
Description FEE
Plan Check
State Stircharge
NEAT SOURCE GLAZINO qTPE
fiI,r Frzoc 15,
Lek"nIi Par-"
City urcharge
PLAN CHECK NO- 7T.. TE
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Mechanical
TO
THIS PERMIT AUTHORIZES ONLY THE ORK NOTED. THIS PERMIT COVERS WORK TO
0 DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN FCURB$, SIDEWALKS, DRIVEWAYS.MARQUEES, UC.l WILL REQUIRE
_SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: INDAYS
PERMIT JUMIT. I YeAn - PROVID 0 WORK IS STARTED WITHIN 18a DAYS
Engr. Inspection
SEEBACKO PINK PERMIT FOR MORE INFORMATION
'APPLICAW, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTIRRE11, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS' WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
1.
Fire inspection
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, AR SING DIRECTLY On INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY WA E OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapeinsp..
T.1.1 Arnt, Dun
0 NOR LIMIT IN ANY WAY THE CITY1 ABILITY TO ENFORCE ANY ORDINANCE PROVISION..
Recording Fee
-CENP
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
/PPLICATION AP PROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER. OFF THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMP WITH CITY AND STATE LAWS REGULATING CONSTRUC.
"'n signod by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
CALL d
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IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
WORKMEN'S INSU�ANE AND PCW H1,27.
a ,;a?"NSATION
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SJGNAT]��' A�:�
OFF SIGNATURE
(425)
771-0220
�EL .'ASiFD BY
:DATE
ATTENTION
EXT 1333
IT IS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL
� FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
PINK
-OWNER GOLD -ASSESSOR
04102 PRESS HARD -YOU ARE MAKING 5 COPIES
GREEN ACCOUNTING
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ASBESTO-TEST
I N C 0 R P 0 R A T E 0
ASBESTOS SURVEY
Game on1v (a), 22203 96th Ave. W., Edmond& WA 98020
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M#220640
June 26, 2002
FlmtLinelcomtraefion
944 Maple St.
114,
FAmoads, WA 9020
Alto. Frank Licate
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Phillasa- 425-775-6968
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NolexoPSCAA: Tkisisaxanatiockedgerage. The structure is woodfraine on a concrete s1a&6
Tkere were no interior suspect asbestos containing materials locaeat The composidon —flag and
dearded In ofthe
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wood daiag vapor bffffkr juglarlah were smapied Tkere was no asbestos any
is JoeMed ACMp6or to or darft alrawfiAlon (suck as,
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asimpla taken. Ifskere aiv adAWand suiped
bar nor gigaind to, those matcrinia Ustrar on page 3), that — not discovered in Air survey, Ike
inaterld(s) now be PA CM unfew rested a th erwhe by laborwerf onatysIX . ......
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on June 24a', 2002, Asbesto-Test personnel conducted an asbestos survey (per
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U.SjLPAJAJLEY—&- guidelines as designated and specified by Pagd Sound Ckan Air
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Agency and Washington Skule) of she rupture -on& 9e Ave, W. Efteff& Saakandsh
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.Cftq 9#02& This survey purpose is to identify any Asbestos
gffU&,ffaj&in Containing
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Materials that may be present and will require professional renarydprior to demolition or
renovation ofthe structure.
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BASIC CONSTRUCTION (including siding and roofing types) The pragD is one story wood
fiame on a concrete stab. The exterior siding is wood. The wood siding vapor limirier material
was sampled. The composition roofing and underlying materials were also sampled.
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ATTIC/WALL INSULATION: There was no rel ating suspect ACM located.
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PLUMBING SYSTEM: There was no relating suspect ACM located.
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*INTERIOR CONSTRUCTION, FINISHES, AND FLOORINGS: The interior is wood
and concrete. There were no interior suspect asbestos containing materials located.
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CONnNUE TO PAGE 2
8003 11561� ST. SE SNOHOMISH, WA 98296 (425)489-4040 Seattle (206)523-5117 Pager (206)699-4629
Page 3 of 3
June 25, 2002
VV#220640
Asbesfo-TeY4 Inc. (425) 48914040
Lama oy& A 22203 9d* Aw. W., -rdmno%
Snohombk ICO-ug&- WMAIAMM00-
THERE WAS NO ASOESTOS DETECTED RVANY OF INE S"PLES TAKEN
A—NALYSIS ED ASBESTOS/trYM/OUANTM
OTHER MATERML
1-0) composition —fin
NAD Cellulose, tar, fiberglass,
& underbing materials -house,
non -fibrous materials
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2.0) wood siding vapor barrier NAD
cellulose, tar
rp
material beneath wood Wing exterior
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keY ACH
PACM sigaffim�PnwxmdAsbesWCDntoningNataW" to t,
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CAR �pi 'ConcrateAdmdat
dit"ifies -FM time
mildfim-TbarmalSysteminsulabori-
HVAC signifla-HwtingVmtilatingAw-CoWhionine In
No Asbedw Doloctor
NAD silpifics
"Ove pmm is tM USFPA replatory limit far asbeslos in bulk umpk&
PLM bus been known to mim wsbc" in small patam"a ofsome samples, %Na contain wbegm thus neptive PIM results cannot be
pzmftW. Floor blatadwipadwfdbe Wind with SEM mTFMW imumanalytical accu" wim mPmW i"SMWI Pamdes.L
Azinato-TeAl, claim reVinitibilayforsample content only.
H. teider
A i I Chemist, B.Sc.
mllyt
AIHA proficient
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
�s
Footing ......................
wall ...........
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Pier/Porch .................
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Retaining Wall
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Slab Insulation ..........
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PLUMBING:
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Underground .............
M
RoUgh-in ...................
C
Commercial Final
M
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HEATING:
C
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Gas Test ....................
Gas Piping .................
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Equipment .................
M M
Commercial Final
0 —
CA
0
EXTERIOR SHEATHING
0
NAILING .. ...................
C ca,
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FRAMING ...........
FIRST FLOOR FRAMING
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INSULATION ............
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Floor Insulation
Wall Insulation ...........
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Ceiling Insulation
SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS
FINAL APPROVAL FOR
ci 0
OCCUPANCY ..................
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