20020884.pdfDATE �RECEWED�,
/&��
I
PERMIT EXPIRES
CITY OF EDMONDS
USE ERMIT
ZONE P
ea
CONSTRUCTION PERMIT APPLICATION
777
— .. NUMBER
SUiTEIA #
ADDRESS
0- MEOF 8 USIN SS
ez
9R A vIE)(4 �w I
FLAT NAMEISUBDIVISION NO
&T NO-,__
_L�D 110,
MAILING ADDRESS
I
L DFEE$
CNIZI 0,1 A 0
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
UACP
sh.s U. P.- a., a
Illy ZIP ITELEPHONE
1 �7:5_ q Z 7
EXISTING -
S'q.I'W E3
&A at
yopop
U
REQUIREAEDPAPA. �QU'RED
,IQ
U-stnuad
7A�ME-
AU
`dNfi.lid0AY6RJ)f
..a a
DFAMoLUREo
V
MUST BE
NO C3
to
as
hisd
REMARKS PROPERTY LINE
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONITAOUDRAI
----*--WATER
CITY
METER 70 BE itsmovill
LEPHONE
------- AD
13TIMP
NAME
AX A
ENGINEERI
ADDRESS
Rjwr4NIG6lT-IQN
LIST ON BACK OF JOB MW
FOR -INSPECTION REQUIREMENTS
CITY ZIP
TEA1
P
FIRE REVIEWED Ry DATE
%��s
W-12
r
9
5 FATE U ENSE NUMBER
EXPIRATION "DATE-_
BY
CHECKED BY
VARIANCE OR CU
1HORILINIOR ADO'
INIPECTION
OND
0
f z2Oq
RE 0
I 13 YES JjN.
POSTED
1.
TAX ACCOUNT PARCEL NO.
M77)
SEPA REVIEW
C 0 M
COMPLETE
L ... Me T
SIGN AREA
ALLOWED P ALLOWED
EIGHT
PROPOSED
0 -G4 4& o 0000 GG) CD
I X
�ED
N/A 1 �7
E
EXP
X P
NEW
RESIDENTIAL
PLUMBING/MECH
L
LOT C VERAGE
A L L
ALLOWED
REQUIRED SETBACKS (FT.) PROPOSED
FRONT
SETBACKS (FT)
M
C:
COMPLIANCE OR
PROPOSED
SIDE BEAR FRONT
UR SIDE HEAR
a
M
ADDITION
0
COMMERCIAL
CHANGE OF USE
sa
0
0
REMODEL
MULTIFAMILY
SIGN
P
PARKING
E 'D'
REDD PROVIDE�D
LOT AREA
��P�1(1
REV
C:
I
X ITI
0 REPAIR GRADING FENCE
CYOS
I
z
X FT)
7)
'5CDEMOUSH TANK 0 OTHER
REMARKS
-i
2
[:] GARAGE RETAINNGWALL E] F RE SPRINKLER
CARPORT ROCKERY FIREALARM
C4
a
__..
(TYPE UP Ubk. Uub[NtVs OR ACTAT[Y) EXPLAIN:
to
0
-n
CHECKED BY
TYPE STRUCTION
OCCUPANT
U
U.
:.F
OF RE
E�.
R
.0 .. -`�
Slip
C 041,;S?p
FND-Affjl//Z�h*�_,
r"Tr
�A.
_T
Ica
GROUP
A .�
ST..
'T.IR:: /
..U.-L.
-.LLI.G
INGO
IS
ITS
AREAS
A.
US
NU at: _
Y/
-PEC
SPECIAL INSPECTION
"At
.OU PANt
M
DESCRIBE WORK TO BE
l
8 jAaEA.
RECIUM ED YES
I
LOAD
DONE
0 r-
REMARKS
0 IT
PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION RrzQ'D
V)
co
as
VALUATION
$
z
DeSCrIption
FEE
Description
FEE
Plan Check
State Surcharge
H-I IS LAIINO
LOT SLOPE %
I
Building Permit
D
City Surcharge
5
-
PLAN CHECK NO-
�ST�ED_ �
Plumbing
0
IT!
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
I=
Mechanical
HE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE pUBU
n C
OMAIN (CURN, SIDEWALKS, DRIVEWAYS, MARClUEE1 ..) WILL REQUIRE
Grading
IC IsEPARATEPERMUla'.N.
Engr, Revieur
PERMITUMITI OERNUTAPPUCATION: INDAYS
YEAR -PROVIDED WORK IS STARTED WITHIN 160DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
'APPLICANT, ON BEHALF OF HI OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
j IN INTEREST, AGREES To tNDSMNIFY DEFEND AND HOLD HARMLESS I HE CITY OF
Fire Review
Plan
Ctik, Deposit
2 EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMA ES OF EVER NATURE. ARISING
GOF
Fire Inspection
Receipt
N
DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY.
WA VE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE DRYS
Landscapoinsp.
Total
Amt. Due
ABILITY TO ENFORCE ANY ORDINANCE PROVISION,'
-
Recording Fee
Receipt
#
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE
GIVEN CORRECT. AND THAT I AM THE OW INFORMATION
AS HER, OR DIE DULY AUR tORIZED AGENT OF
APPLICATION
APPROVAL
THE 0 E I AGREE TO COMPLY WITH CITY AND STATE LAWS IRGULATIN G CONSTRUC.
TION; AND N DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
CALL
This application is not a ponalt until signed by the
IN VIOLATI ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Bull ding Off Of Deputy: and False 'to Paid, and
uncolchal 0, his
Is..kh1.hwI.d,rnd
WORKMENS,qq,M;kNSATION INSURANCE AND ACW 18.27.
on I..p ... p-taftlel
_,OAT1
I
T HE
1"u, J
A�j SIGNED
(425)
ALS
:,�: 76:11 Ll-
L71-16- 2 cie, 7-
771-0220
&IIATURE,
L
AEL�A'
ATTENTION
EXT 1333
as BY TE
IT IS UNLAWFUL TO USE OR OCCUPY A 13UILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
OFIGNAL-FILE YELLOW. INSPECTOR
04102 PZK'-OWNER GOLD -ASSESSOR
PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
FINAL PROJECT APPROVAL FORM
TO:—
DATE: —
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: —FIRE DEPARTMENT DATE-
-t>- r4tu-,C_� -ENGINEERING DIVISION DATE—L[409,
PLANNING DIVISION DATE—
PROJECT___!��
gMk pf-w
SITE ADDRESS
PERmrr # goo 1)— 09 ��+-___ADB#_________DATF INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED_10_�..��
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
'PE U_qANCEBONDS and the granting of:
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
c, Copy of CORRECTION NOTICE given to owner/contractor by inspector
I
2.
3.
RE_INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date_ Sign_
ocaprvl.doc.l:tenV-.bldg:formsio/oI
z
9
0
M
-4
M
M V
0
0
M
C/)
0 -n
n
M M
0 V;
0 r-
0 M
C co
9 (A
M 0
Z
X
z
--i
3-
co
z
M
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS . ......................
FOUNDATION:
Footing.. ....................
watt ...........
Pier/Porch ...........
z
Retaining Wall ...........
0
Stab Insulation
PLUMBING:
Underground
M
a "I
M
0
Rough -in ...........
0
Commercial Final
M Z
HEATING:
g) —1
Gas Test ....................
>
Gas Piping .................
Equipment
31
Commercial Final
EXTERIOR SHEATHING
0
NAILING ............... ..........
0
C
FRAMING ..................
M 0
FIRST FLOOR FRAMING
z
-I
;U
INSULATION ...................
Floor Insulation
z
Wall Insulation ...........
Ceiling Insulation
z
0
SHEETROCK NAILING
-4
0
ITI
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FO
OCCUPANCY ..................
"A
CIO -IN