20020946.pdfDATE RECEIVED
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EXPIRES
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CITY OF EDMONDS ZONE AA1 21'v2-c"Ij�
CONSTRUCTION PERMIT APPLICATION JOB SUITEiAPT#
FO-N'r
ADDRESS
A NAMSINAME OF BUSINESS 23028 100th Ave. West
_2.7� LID NO.
Bartell Drugs PLAT NAME/SUBDIVISION NO. 71
M MIND ADDRESS LID FEE
4727 Denver Ave. South PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
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CITY P ITELEP ONE EXISTING — PROPOSED— 93
Seattle, Wa. 98134 1206-763-2626 REQUIRED DEDICATION— Fr — CI
NAME METER SIZE LINE .1Z. No .1 11.11FIES IFIV IIECIUI1E1 or
yes C3 NO E3
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U CDA Architects
ADD EBB REMARKS
P.O. Box 35429 OWNERJCONTRACTOR RESPONSIBLE FOR EROSION CONTROLMRAINAGE
CITY
Seattle, Wa. i8-9668
NAME lk-11
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Smith Fire Systems ENGINEERING REVIEWEDIDATE
ADDRESS
3813 168th St. N.E., Suite 1
FIRE REVIEWED BY DATE
ZIP I TELEPHONE
or- "I M
Arlington, W .98223 1360-651-7701 "y— 0 -r—
VARIANCE 08 CU SHORELINE OR ADB# INSPECTION BOND
STATE LICENSE NUMBER EXPIRATION DATE BY POSTED
00 JECKID 'SEGO I
Es 13NII
SMITHFS1360T 11-02-2 2 mu-
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SERA REVIEW SIGN AREA HEIGHT
PIQ�EE7 TIAX AICCI PAR EL NO. COMPLETE 111111T ALLOWED PROPOSED Lo
EXP ,
LO COVERAGE REQUIRED SET ACKS (FT PROPOSED SETBACKS (Fr.)
R1 NEW 0 RESIDER IAL 1:3 PLUMBING I MECH ALLOWED PROPOSED FRONT SID: REAR FRONT UR SIDE REAR
ADDITION COMMERCIAL C MPUANCE OR
CHANGE OF USE
PARKING I LOT AREA PLANNING REVIEWED BY DATE
0 REMODEL APARTMENT 0 SIGN REDD I PROVIDED
0 REPAIR GRADING FENCE
CYDS X Fr) REMARKS
DEMOLISH n TANK
[:j GARAGE o RETAINING WALL
CARPORT ROOKERY
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
ECKED BY 2E OCCUPANT/
Retail SOUP
.. IER NO"'" OF '/ 11 CRITICAL
OF WELL N AREAS SPECIAL SPECTOR OCu:��
JASEA
E NITe' NUMBER E IREINC] YES LOAD
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DESCRIBE WORK TO BE DON.
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SIR INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D
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PLAN CHECK Nr STED DATE
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THIS PERMITAUTHOFUZE-S ONUIHE ORK NOTED. THIS PERMIT COVERS WORKTO
I: BE DONE ON PRIVATE PROPER" ONLY. ANY CONSTRUCTION ON THE PUBLIC
tadr.g
Grading
Recording Fee
a DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATEPERMISSION.
Engr. Review
City Surcharge
PER ITAPPLIrATION: IN DAYS
L5
PERMIT LIMIT I YEAR D WORK IS STARTED WITHIN 10 DAYS
"A'S
DINE BACK i PINKIPIDERMIT FOR MO RE I N FORMATION
Engr. Inspection
State Surcharge 5-0
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S ESOS
'APPLICANT ON BEHALF OF HIS 01 HER 11OU11. HEIIS, ASSIGNS AND SUCCE101S
Traffic Mitigation
Plan Chit Deposit
T HE CITY OF
IN INTER'BrAGS"' To INDEMNIFY, B.IENG AN. I-I.I. ...LE.S THE CITY .1
Receipt #
S NY AND
E ... N.S. WASHINGTON. IT OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
RE TLY
ALL CLAIMS FOR DAMAGES OFWHATEVER NATURE ARISING DIRECTLY On INDIRECTLY
Fire Review
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FROM THE ISSUANCE 01 THIS PERMIT ISSUANCi OF THIS PERMIT SHALL G NOT BE
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DEEMED TO MODIFY. WA OR REDUCE ANY REQUIREMENT OF YCRYORDINANCE
Fire Inspection
Total Amount Due
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NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
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Receipt #
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT E INFORMATION
APPLICATION APPROVAL
GIVE IS CORRECT, AND THAT I ALI THE OWNER, OR THE DULY AUTHOR ZED AGENT OF
T E OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSMUC-
CALL
Is no" permit until signed by the
TION. AND IN DOING TH; SUTH.FFI�TEH.ET.EARTE' NO PERSON WILL BE EMPLOYED
IN ON OF THE ';o ST �btf WASHINGTON BEITINIG TO
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FOR INSPECTION
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OVS Official or his/her Dopey: and Fees are paid, and
..lot ism,ke-I.died Inspect, p—Idd.
WORKMENS COMPENS90WIWU NCE AND RCW 18.27,
OFFI R DATE
DATE SIGNED
SIGNATURE (OWNE:L::L
(425)
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11
10
771-0220
SEL
ATTENTION
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
—
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE YELLOW -INSPECTjR
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
FAX
PINK - OWNER GOLD - ASSESSOR
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MEMO TO: PERNM C.?TDIN ING DIVISION
FROM: ®r-A �nr.YIRE DEPARTNENT DATE___���40
ENGINEERING DIVISION DATE—
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A field inspection was conducted to determine flual compliance with approved plans. Final approval
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RE -INSPECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
Date— Sign_
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FIN a,"ISMS01APPROVAL FD*M
TO:
-DATE:
MEMO TO: P77F UILDING DIVISION
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FROM: FIRE DEPARTMENT DATE—Af�a—f 3
.—ENGINEERING DIVISION DATE
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'PERMIT 2 1 ADB#—DATE INSPECTED _-2,
DESCRIPTION OF WORK TO BE INSPECTED ..... .. . .... . .
A field inspection was conducted to determine compliance with approved plans. Final approval denotes that
there are no objections from the above signed Department to the granting of
-,-_Final approval of the described work
erformance Bonds associated with the project may be released
FINAL PROJECT APPROVAL
—_GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
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FINAL INSPECTION - OUTSTANDING ISSUES
2.
3.
______RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ............
wall ............
Pier/Porch
Retaining Wall ...........
0
Slab Insulation ..........
PLUMBING:
Underground .............
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Rough -in . ..................
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Commercial Final
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HEATING:
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Gas Test ...........
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Gas Piping ...............
Equipment ................
Commercial Final
M IT!
EXTERIOR SHEATHING
0
0
NAILING ................
0
FRAMING ......................
M 0
FIRST FLOOR FRAMING...
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INSULATION ...................
Floor Insulation
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Wall Insulation ...........
Ceiling Insulation
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SHEETROCK NAILING
SPECIAL INSPECTION
ITI
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ............. ...