20020943.pdfx
DATE —RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS
�� M-ed,r-q I Off,"Cle- T;6 Qx,,
73;)-D p-167-H 5+ 5w
0
CITY ZIP TELE HONE
F., r, 0 .,I's 9 q 0'-A 0 1
[----------
PERMIT PIRES
USE
ZONE
PE RMIT
L NUMBER
Jo
AUITETI
ADDRESS,Z�Lp
C" 7-,
/'o
PLAT NAMEISUBDIVISION NO.
LOT NO..
LID N
LID FEE
P SLID RIGHT OF
_I
STREET MAP
A�� U."mmv.
EXISTING_
PROPOSED
cl
atit ... ran —di 13
..'snee'd
—a—eird Ell
REQUIRED DEDICATION— FT
_0F
PRV REQUIRED
770
_FI__111
YES D NO 13
REMARKS
sa
OWNER/CONTRACTOR
RESPONSIBLE FOR EROSION CONTROUDRAINACE
A "
. . I � - I — - . —,
Fed"o F, "—, S2,0" t/
ENGINEERING REVIEWED BY
DATE
ADDRESS
A
_____TT
CITY ZIP
FLEPHONE
A W 0
DATE
STATE LICENSE NUMB R
EXPIRATION 0
VIIANCE OP'Ll HORELINEORA1181
U
IN PECTON ONO
I a
REGG POSTED
FFp r— k Fri— 13 -7
ONES S 13NO S
:1 PROPERTYTAX ACCOUNT PARCEL NO.
SEPA RE HEIGHT
GN AR A ALLOWED
C PLETE EXEM LLOWE PR POSED PROPOSED
OM SID ED
I
EXP
El NEW AESIDENT111
n PLUMBINGIMECH
LOT OVERAGE D SET ACKS (FT.) PROPOSED SETBACKS (Fr.)
E3COMPLIANC
AMMON 3�fCQMME.CIAL
CHANGE OIEUESER
ALLOWEIC PROPOSED FRO SIDE
REAR FAONTT SIDE FEAR
n REMODEL MULTIFAMILY
SIGN
REG PARKING LOT ARIA rNNIN REVIEWED BY DATE
V I PROVIDED
ri F
REPAIR 13 Gmo'NG CYD8 (ENCE X FT)
REMARKS
n DEMOLISH n TANK
13 OTHER
Ei GARAGE RETAINING WA L
FIRE SPRINKLER
CARPORT OCKE
R my
M
E ALARM
(TYPE OF E. BUSINESS OR ACTIVITY) EXPI AIN:
7.
CHECKED BY NSTRTCi]ON
1�v
A7
NUMBE OF
OF DWELLING
I NUMBER
C ITI
R CAL
R S
fAE 4
'gg4
SPECIAL INSPECTION
-0co."P12
Occur PA NT/
0 STORIEW U NITS
NUMBER
JAFIE4
REQUIRED YES
LOAD
DESCRIBE WORK TO BE DONE
RE KS
$
F
Description
FEE Description FEE
Plan Check
State Surcharge
HEAT SOURCE LAZING %
LOT SLOPE %
I
ulkling Permit
City Surcharge
PLANCHECK2L VESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THISPER— ORK To
MIT COVERS W
t: HE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
2
Grading
0 QU ES, ETC.) WILL REQUIRE
SEPAMTEPERMiMAR N. IS
3 OMAIN (CURBS, SIDEWALKS, DRIVEWAYS SSIO
PE MITAPPLICATI M: INDAYS
Engr. Review
PERMIT LIMM I YEAR 0 WORK IS STARTED WITHIN 160DAYS
Engr. Inspection
SEE 13AUCKOiPPIANO'PIDERMIT Fort MORE INFORMATION
'APPIIC , ON 01-11011111 OR HER SPOUSE, H111% AMONG AMD SUCCE11111
Fire Review
Plan Chk. Deposit
IN INTEREST. AGIVEES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
Z EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
LL CLAIMS FOR DAMA ES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
A FFIOM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WA VE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapelnsp,
Total Amt. Due /55
NOR LIMIT IN ANY
se WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE ROVISION.'
Recording Fee
Receipt #
I HERE Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
-
APPLICATION APPROVAL
GIVE IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
T E OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
CALL
Thleapplicafier, 1, net, Parent Until signed by the
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 COMPENSATIO URANCE AND How 18 27.
NWk
Flooding Olbabel or hisphor Dorni y. and Feel to Paid, and
FOR INSPECTION recakel,ask—lodge2lip ... p-1dod.
-
IER ORI�QEI,fff/ DATE SIGNED
(425)
0
(7 11
771.0220 /DATE
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-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORIGINAL -FILE - Ye
FINK -OWNER - GOLD ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
z
0
j
0
ITI
M
0
80
C
MM
IT
W
O"n
IT
ITIM
0 Vi
0 In
C re
9 o)
M 0
;13
z
�2
V)
z
9 1
0
IT!
FINA PROJECT APPROVAL ARM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
DEPARTNIENT DATE 6_0
FROM: —FIRE
ENGINEERING DIVISION DATE —
PLANNING DIVISION DAT9__
PROJEC
4-5,
SITE ADDRESS -)31
Cm
PERMIT#�LOQIo qq3 ADB#____-----DATE INSPECTED_A=LZ-_d_J_
M 0
-40
C.
DESCRIPTION OF WORK TO BE INS PECTED I
M
),4;
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
PERFORMANCE BONDS and the granting of:
O'n
M
GRANT FINAL PROJECT APPROVAIL
m
0
0 Fn
CM
J
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
o Copy of CONDITIONS given to owner/contractor by inspector
z
AMP
z
0
OUTSTANDING ISSUES
FAILED FINAL INSPECTION FILM
-
0
m
o Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE-INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Sign_
ocaprvl.doc,l:tenip:bldg:fbmisIO/OI
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Fooling
wall ..........................
z
Pier/Porch
Retaining Wall ...........
0
Slab Insulation ..........
PLUMBING:
R
am 'v,
C
m C)
Underground .............
0
0
C,
Rough -in ..........
—4 K
x m
Commercial Final
m z
HEATING:
C f
>
r
Gas Test ..............
Gas Piping .................
0 -n
Equipmont
m m
Commercial Final
0
0
EXTERIOR SHEATHING
NAILING ............ .............
C (j)
M 0
FRAMING .................
FIRST FLOOR FRAMING
INSULATION ...................
z
Floor Insulation
Wall Insulation ...........
z
Ceiling Insulation
0
SHEETROCK NAILING
m
SPECIAL INSPECTION
MISCELLANEOUS ..........