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20020911 (2).pdfiDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMENAME OF BUSINESS MAILING ADDRESS CITY ZIP TELEPHONE NAME ADDRESS CITY ZIP PERMIT EXPIRES USE PERMIT ZONE 1 I' I � ; ' .' NUMBER JOB ADDRESS SUITE/APT# U PLAT NAME/SUBDIVISION NO. P LA T NA M E 'S LOT NO. LID NO. LID FEE $ TESCP APPf PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP PU 13 LIC R I G T 0 AW Permit R=ad Street Use Permit Roq'd EXISTING PROPOSED inspection Required E3 Sidewalk Requited 0 REQUIRED DEDICATION— FT tEMA:RKS Underground Wiring required Sl METER SIZE M T Z LINE SIZE NO, OF FIXTURES PRV REQUIRED YES 13 NO 13 3 5 z R M R S z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE JCO T OW P NAME CBL$ ADDRESS CITY ZIP TELEPHONE STATE LICENSE NUMBER EXPIRATION DATE CHECKED-D'Y',, `43 PRQPERTY.TAX,,-,AC�OUNT-,PARCELINOt' NEW 0 RESIDENTIAL MECH ADDITION [] COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY E3 SIGN REPAIR GRADING CYDS FENCE ( x FT) DEMOLISH TANK OTHER GARAGE RETAINING WALL F RE SPRINKLER E3 FIRE ALARM CARPORT ROCKERY (TYPE OF USE. BUSINESS OR ACTIVITY11 EXPLAIN: NUMBER 0 T F NUMBER OF DWELLING CRITICAL AREAS '' STORIES U ZTS NUMBER DESCRIBE WORK TO BE DONE HEAT' —SOURCE F—GLAZING % LOT SLOPE % PLAN CHECK NO: I VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I E DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC I I DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQU RE SEPARATE PERMISSION. PERMrrAPPUCATION: 180 DAYS PERMIT ILIMIM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY Or EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, AFUSING 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 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* 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 AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. DATE SIGNED SIGNATURE (OWNER OR AGENT) ATTEN ION 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. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING I ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE W M ra VARIANCE OR Cu SHORELINE ORAD1111 INSPECTION BOND REO'D I POSTED 1. OYES ONO SEPA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIG ALLOWED , PROPOSED EXP I , LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR z PARKING I LOT AREA I PLANNING REVIEWED BY DATE REO'D I PROVIDED REMARKS CHECKED BY OF CONSTRUCTION OCCUPANT ITYPE GROUP SPECIAL INspCTION AREA OCCUPANT LOAD REQUIRED YES REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION nriu'!�A g 121 Description Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection FEE Description FEE state Surcharge City Surcharge Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp, Total Amt. Due Recording Fee Receipt # APPLICATION APPROVAL CALL FOR INSPECTION This application is not a permit until signed by the Building official or his/her Deputy: and Fees are paid, and .. receipt Is acknowledged In space provided. OFFICIAL,S'S'IGNATURE PATE (425) 771-0220 RELEASED BY DATE EXT 1333 z 0 11 0 M :; 9 us � M M 0 —10 0 C: 3� r. M M 10 � z 0 _11111 '�'n 9 M M a Vi 0 Fn cl) Ca M C) z X z z 0 q 0 ITI -�"4 C. i sq, CITY OF EDMONDS 121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221 Website: www-ci.edmondsma.us DEVELOPMENT SERVICES DEPARTMENT Planning - Building - Engineering Mr. Gerod Floyd Fischer Reline and Repipe, LLC I 115 Northwest 5 1 " Street Seattle, WA 98107 RE: Curaflo Epoxy Pipe Lining Dear Mr. Floyd: GARY HAAKENSON MAYOR October 21, 2002 This letter is in response to your letter dated October 17, 2002. As stated in my letter dated October 16, 2002, a plumbing permit is required for the plumbing repair method of epoxy pipe lining, including installation of isolation valves. This permit can be issued over the counter, provided there is a complete description of work, including number of valves that must be installed. Sincerely, Jeannine L. Graf Building Official, C.B.0 Incorporated August 11, 1890 Sister Citv - HPIkin-an. Janan I RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... Wall .......................... Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground ............. Rough -in ................... Commercial Final ...... HEATING: Gas Test .................... Gas Piping ................. Equipment .................. Commercial Final ....... EXTERIOR SHEATHING NAILING .......................... FRAMING ........................ FIRST FLOOR FRAMING ... '6N INSuLAT1 ................... Floor Insulation ......... Wall Insulation ........... Ceiling Insulation ....... SHEETROCK NAILING ... SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. 0 z 0 1 0 M V) DIM a . I MID 0 0 0 C ITI 11711 CO) 0 _n n ITIM 0 0 o Fn C mo� z 0 1 0 IT! 0*4 QbATE RE,,CE bATE RECEIVED PERMIT EX Al"Pi" - ". f , PIRES j � li CITY OF EDMONDS USE PERMIT ZONE NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRESS OWNER NAMEINAME OF BUSINESS PLAT NAME/SUBDIVI SION NO. LOT NO. LID NO. LID FEE $ " v I --., _-(, (�') L &f 0 MAILING ADDRESS 0 F7 7 t PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING — PROPOSED REQUIRED DEDICATION— FT TESCP Approved RW Permit Required Street Use Permit Req 'd inspection Required [3 Sidewalk Required [3 Underground Wiring required CITY ZIP TTELEPHONE '71- F NAME METER SIZE LINE SIZE 1 0. OF FIXTURES PRV REQUIRED YEsI3 NO 13 C5 3 U z ADDRESS REMA:IRKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE z CITY ZIP TELEPHONE NAME C! f A,/'L --1 (.7 ENGI' NEERING REVIEWED BY DATE ADDRESS 5- cc 0 FIRE REVIEWED BY DATE M rL 0 city ZIP �' C_ i� L) —� - L I I TELEPHONE ') (" / 1r, � , ..' / — -_ 4. ) L VARIANCE OR CU I SHORELINE OR ADBJ1 INSPECTION REQ'D 13YEs 13NO BOND POSTED $ STATE LICENSE NUMBER EXPIRATION DATE <�C -(/ (,, (I ECKE" I rn-u SEPA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED 103, EXP , , , NEW RESIDENTIAL [�ro�L�UMBI�N/ MECH COMPLIANCE OR ADDITION COMMERCIAL 1:1 CHANGE OF USE LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE REAR PROPOSED SETBACKS (FT) FRONT URSIDE REAR z PARKING REO'D I PROVIDED LOT AREA PLANNING REVIEWED BY DATE REMODEL MULTIFAMILY [:1 SIGN CL GRADING [3 FENCE Q"REPAIR CYDS Ix — FT) REMARKS DEMOLISH TANK OTHER GARAGE RETAINING WALL F RE S RINKLER CARPORT ROCKERY FIRE APLARM (rYPE OF USE, BUSINESS OR ACTIV" EXPLAIN: 6".0A1.6 0 CHECKED BY ITYPE OF CONSTRUCTION CODE 1 OCCUPANT GROUP NUMBER OF TORIES 0 NUMBER OF DWELLING �7, UNITS 0 CRITICAL AREAS NUMBER SPECIAL INSPECTIO7NAREA REQUIRED [:] YES OCCUPANT LOAD a DESCRIBE WORK TO BE DONE Vv A 7—L REMARKS PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REG'D A I Bowl H W) r, k A 0 (t x y L.-f k/ IN .7 -'-Y W�M vAwAnON IVIIII I 1111111W flAIC L 1,? J� (�j $ �tj L__A -n C, tt�J VA E" C'V -0. Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE T GLAZING % LOT SLOPE % Building Permit City Surcharge )5 HECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Grading t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPILICATION: ISO DAYS Engr. Review CL PERMIT ILIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit 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 Fire Inspection Receipt # Landscapelnsp. Total Amt. Due 0 z NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION., Recording Fee 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 AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLAT ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO CALL FOR INSPECTION APPLICATION APPROVAL This application Is not a permit until signed by the Building Official of his/her Deputy: and Fees are paid, and _."r%E±t Is acknowledged In space provided. WORKMEN!S COMPENSATION INSURANCE AND RCW 18.27. OF161A IGI�ATURE ATE t JAI WUNAI Uht: IUVVNtH Un C olu".w r r I __ (7 _� 7 1 i Aj� v 771-0220 _DATE__' RIFLE �SEb BY ATTENtION Off 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. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR 04/02 S GREEN - ACCOUNTING PRESS HARD -YOU ARE MAKING 5 COME i z 0 IT! 3: M C M 0 0 C 4 r. X M M 0 _n n M ITI 0 C-1) 0 f- 0 M 0) CO) M 0 Z z 0) z 0 1 0 M