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20020914.pdfDATE RECEIVED ERMIT CITY ®F®M®N®e7, ioraE NUMBER CONSTRUCTION PERMIT APPLICATION JOB u1TE/npTM ADDRESS OWNER j1U Ebe,�BURINESS� e SUB G �Cj "J'{' PLAT NAME(SUBDIVISION NO. LO N0. L N0. 5 MAILING ADDRESS LID FEE I O i4 ) t (// WV .10rt Ze PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP qw pe�mil gequlia# (.� Svocl Use Pa,mit goq'e CITY EXISTING PROPOSEDme ecoan goputree �j ZIP TELEPHONE SaoveiM Penuxee I_ 1/k1 - 77Y -`� � /_ g REQUIRED DEDICATION FT III ngId NAME rr( /(iL� (l I 'E' METER SIZE I LINE SRE N0. OF FIXTURES W PRV REQUIRED YES ❑ NO ❑ ADDRESS REMARKS P OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE IN it, V�� 1.1 I, vLI IJ-U If X I d, ENGINEERING REVIEWED BY DATE ADDRESS FlRE REVIEWED BY DATE O21P u TELEPHONE ,' f �Za U• Z VARIANCE OR CU SHORELINE OR ADS# INSPECTION BOND STATE LIC NSE NUMB R EX R ION DATE 7 ❑YES 0—REO'D POSTED S � HEIGHT a POOP RN TA% ACCOUNT PARC NO. SEPA REVIEW SIGN AREA COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED O EXP rl NEW RESIDENTIAL PLUMBING(MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REAR 11 ADDITION COMMERCIAL COMPLIANCEOR ❑ CHANGE OF USE 0 REMODEL El MULTIFAMILY SIGN PARKING LOT AREA PLANNING REVIEWED BY DATE REa PROVIDED D REPAIR G CYDS ;ENCE X��FT) REMARKS �GIADN DEMOLISH TANK OTHER GARAGE RETACARPORT ROOKIERY WALL ❑ FIRE APLARN�LER (TYPE OF USE, USINES6 OR AGTATM EXQLAIN: OCCUPANT ' u 5e a _ /-/r / [JfG! 77A7'T. CHECKED BY TYPE Of CONSTRU ION GODS GROUP nNUMBER ( NUMBER OF OF DWELLING t CRITICAL AREAS SPECIAL INSPECTION AREA OCCUPANT O STORIES UNITS NUMBER REQUIRED ❑ YES LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D 12-0 an s r. $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit -+ City Surcharge P HECK NO• ^ vesreD DATE Plumbing G/ Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS COVERS WORK TO CTOR t DE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading ? DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC,) WILL REGULRE SEPARATE PERMISSION. � Engr. Review PER MITAPPLICATION: IIWDAYS PERMIT LIMIT. 1 YEAR• PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION •APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESOHS 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 Fire Inspection Receipt N 15,� ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, AS SING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE 9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. — Total Amt. Due Z N00. LIMIT IN ANY WAY THE CINS ABILITYTO ENFORCE ANY ORDINANCE PROVISION.• Recording Fee Receipt It 1 HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL 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 CALL sap allan is no I. pOrmllumil nigned by No 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 B ding OIn r his(bor Dopury; Aqd Foos Aro poid, and FOR INSPECTION o1 11 ncknowlodged inapacoprovidod. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.2T. F I S SIG RE E 1 ( SIGNAT R t0 N OR gGENT) SIGNED (42(�5) v DATE 771-0220 l Y REIEA D WY DATE ATTENTI N 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 YELLM- INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 ZKN .OWNER GOLD -ASSESSOR 04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING O m V1"I Cm M ID —I n O C rnZ 'i C Z r �{ O mm ON r mw zr mn X D Z CO O 1 n m l FINAL PROJECT APPROVAL FORM TO: DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION } FIRE DEPARTMENT DATE_/2- --C) 2 FROM: ENGINEERING DIVISION DATE .�+ PLANNING DIVISION DATE # m PROJECT . S G C 1aG j` : 4 m 4 vi-q O m SITE ADDRESS R%(� /�1/ D t mo PERMIT #2d ! 2. ` ©9 / �-( ADB# DATE INSPECTED 2:::L o '0 c Tin DESCRIPTION OF WORK TO BE INSPECTED/ to C> 'i—A i1G ��S%/ ( LL p i A field inspection was conducted to determine final compliance with approved plans. Final approval cz -4 _ F denotes than there are no objections from the above signed Department 4o the release of PERFORMANCE BONDS and the granting of: om min GRANT FINAL PROJECT APPROVAL 0 _ O0 r M m C CD m co 1� GRANT PROJECT APPROVAL WITH CONDITIONS NOTED 1 y o Copy of CONDITIONS given to owner/contractor by inspector z s 1. z 0 FAILED FINAL INSPECTION - OUTSTANDING ISSUES m t3 Copy of CORRECTION NOTICE given to owner/contractor by inspector 1. 2. 3. . RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Sign ocaprvl.doc.l:tm*:bldg:formsI O/OI RECORD OF INSPECTIONS INSPECTOR DATE APPROVED 4 - .. .. SETBACKS ..................... I.. t ' FOUNDATION: .... .. . Footing ....................... . Wall ........................... . PierlPorch ................. y Z '. O l Retaining Wall ......... Slab Insulation .......... m . " - -PLUMBING: Underground _ g to i. S Rough -in CCTI m ................... O O Commercial Final ...... Q C " 1 HEATING: m. mz " ( Gas Test .......... A '1 C� Gas Piping -4 ,... ......... . N Equipment .......... O�' Commercial Final ....... _n m EXTERIOR SHEATHING m NAILING .......................... j FRAMING ........................ C tto FIRST FLOOR FRAMING .. Z 0 i INSULATION ................... - Floor Insulation ......... Wall Insulation ........... z - Ceiling insulation ....... �. N - SHEETROCK NAILING ... z O 0 SPECIAL INSPECTION ... O m " - MISCELLANEOUS .......... j " ( FINAL APPROVAL FOR 1Ll1'/�.�_ ,. OCCUPANCY .................