20020910.pdf_Iq a
PERMIT
CITY OF EDMONDS CC LIM ER _e9
2 . N B
CONSTRUCTION PERMIT APPLICATION JOB C1111 TE/APT#
O�70 UNArICN71E OF BUSIN as ADDRESS jL11 —
— _ ) n1c #JC FLAT NAM1111,11DIIIIIIIN 10, 1�1) NO,
Mj��Ag�1/111 , DIESS
PUBLIC RIGHT OF WAY PER OFFICIAL STREET IUAP ne— ro
W
...... I esetess
0 ,Me Isn,ne
CITY SXISTtNG — PROPOSED— ou—n. ase-111-d
zip TEIEP r,F.,rr.d
0( -77V 5W E IRE EDCA1ION_ ye,rann.l.
REQUIRED DEDICATION— FT — Insfunneed
04(1 No O"_E_
NAME MC-� Pj METER SIZE LINE SIZE NO, 01 FUTURES REQUIRED
/"d PRV
13 YES 13 NO 1 3
R
ADS. REMARKS
E
1 �� R Q'GR ESSPONS' '0
OWN p'GONT A LE R EROSION C.NTI
WNES/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLADRAINAGE
71?'Vo 1\,)c- �?-3 1--f V t)/ 7t-_-� V--�'2-
ZIP
NAME I.BLe_
91 1/4ff2 z
�W_59vww
STATE LICENSE NUMBER EXPIRATIO CHECKED BY
M, 4 TF —) e, . z: Z. " g "i L' _-, VO4] ON
PROPERTY TAX ACCOUNT PARCEL
ri��
2—b 7 �9� �2
ZZ
FIRE REVIEWED BY DATE
VARIANCEORCU I SHORIUNIORADII INIPECTI N BOND
BE 'D POSTED
SEPIA REVIEW SIGN AREA ONES ON HEIGHT
:OMP11TE EIEMPT ALLOWED , PROPOSED ALLOWED , PROPOSED
NEW RESIDE IAL PLUMBING I MFCH
LOT C VERAGE REQUIRED SMACKS PROPOSED SETBACKS IFT)
AL OWED 0 PROPOSED FRONT SIDE REAR FRONT LJRSIDE HEAR
ADDITION
C MPLIANCE OR
/C .. s...' CHANGEOFJUSE
r-1 REMODEL
0 MULTIFAMILY SIGN
NEG' PARKING LOT AREA Is NNING REVIEWED aY DATE
0 1 PROVIDED
REPAIR
GRADING cycs C] PENCE
I X
Fn
REMARKS
a.
OTHER
TANK
GARAGE
C fl
A PORT
RETAINING WALL FIRE SPRINKLER
a LA]
DICKERY FIREA Fum
(TYPE OF USE, BUSINE OR mme
0 GO PAN
BY ITYIE=
GROUP
NUMBER
Is OF
jtN BER OF CRITICAL
UM
DWELLING AREAS
�CHECKED
r E AL 0
FLOCC-U_
STORIES
ON ITS NUMBER
..' E
I R
DESCRIBE WORK TO BE
DONE
REMARKS
ROGRESS INSPECTIONS PER UBC 11031FINAL INSPECTION REO'D
1
$
er on
Description
D Sit C
FEE
Description
FEE
in k
Plan Check
P I a G C
State Surcharge
OT SLOPE
HEAT SOURCE G�ING % LOT SLOPE %
- - enrut
Building Permit
I 'ding P
City Surcharge
BTs. DATE
TOP
Mechanical
-achanca'
C."... W .. it.
THIS PERMIT AUTHORIZES OIJILV THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
i"'. ON 'He PUBLIC
Grading
Grading
2 MARGO ES, ETC.) WILLREQUIRE
OMAIN (CURE1% SIDMALKS.DAIVEWAYS;SSION. E M I "L REQUIRE
SEPARATEPERM
P
E 'a
PERMIT LIMM, I YEAR. PMtRTOAVIPOPUDCWATOIROKN:ISIS.TAORAYMSD WITHIN ISO DAYS
Engr. Inspection
SEE 04CK OF PINK PERMIT FOR MORE INFORMATION
-APPLICANT� ON BEHAL OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Revim
PlanChk.Deposft
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY
M EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
I Receipt #
re CTLY
ALL CLAXMS TO DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
I
FROM THE I SUANCE OF THIS PERMIT, ISSUANCE F THIS PERMIT SHALL NOT BE
9 DEEMED TO MODIFY, WAIVE OR REDO I. ANY REQUIREMENT OF ANY CITY ORDINA CE
Landscapeinsp,
a
a 'OR LIMIT IN ANY WAY THE CIWS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,
I Receipt # A"Z:�L
I HERESY ACKNOWLED E THAT I HAVE READ THIS APPLICATION; THAT THE INFORMA1 ION
APPLICATION APPROVAL
GIVEN 16 CORRECT, AND THAT I AM THE OWNER, OR TH DUtY AUTHORIZED AGENT OF
THE OWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONISTRUC.
CALL
This application Is not a prepelt Until signed by the,
Deputy: Fees
TION; AND NIDOIN K AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATIO1.01 THEX-ItODE OF THE $TAT OF WASHINGTON RELATING TO
Building Crucial or hilften and are Pard, and
FOR INSPECTION unrope I—Ion—hulIpul—up.c. prInki
His
WORKMEN'S PENS V CE AND HOW 15,Z7.
'J�s N
G RE DATE
ER A AGENT)' ED
SIGNATIRTE "'T" SIGN
(425)
"
7/5" 0
771-0220
4�
RELEASED BY
ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL 08 A CERTIFI-
08 GiNAL � FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK -OWNER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING
z
0
m
m
M 0
0
0
in
'01
C 2
o
n
-4
m M
13
0
0 M
C (j)
9 cy,
IT 0
Z r-
z
&0
z
0
in
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATIOW
Footing ..............
wall
Pier/Porch .................
Retaining Wall
Stab Insulation
PLUMBING:
-i -n
Underground .............
M
Rough -In ...................
Commercial Final
0
C
HEATING:
IT!
171
Gas Test ..................
F
Gas Piping
C4
Equipment ...............
0 'n
Commercial Final
M
EXTERIOR SHEATHING
NAILING ..........................
0
.0
FRAMING ........................
C cf)
r. 0)
FIRST FLOOR FRAMING
rn 0
INSULATION ...................
Floor Insulation
Wall Insulation
z
Ceiling Insulation
SHEETROCK NAILING
z
SPECIAL INSPECTION
0
IT!
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..........
Of/0