20030007.pdfDATE RECEIVEI) L
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USE
CITY OF EDMONDS ZONE
JOB
CONSTRUCTION PERMIT APPLICATION71ADDRESS
OWNER NAME/NAME OF BUSINESS
PLAT NAME/SUBDIVISION NO.
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MAILING ADDRESS
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ct'ry ZIP TELEPHONE
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NAME
ADDRESS
CITY ZIP TELEPHONE
252 -o�
NAME 1CBLN
ADDRESS
31
PERMIT EXPIRES
PERMIT 'ZCX_) 7 - Cj��l
NUMBER
vd _qWTEIAPT#
7 NO. L�D NO.
L D FEE $
7ESCP APP(OV90
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
RW Permit Required
Street Use Permit Req 'd
EXISTING - PROPOSED
Inspection Required
13
Sidewalk Required
REQUIRED DEDICATION- FT
Underground
1 wiring raquaed
E3
METER SIZE
LINE SIZE
NO. OF FIXTURES
V REQUIRED
V
FYEPSRE3 NO 13
3
REMARKS
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OWNER/CONTRAM EROSION CONTROUDRAINAGE
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REVIEWED BY
DATE
_7EPHONE
FIRE REVIEWED BY
DATE
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CITY ZIP
11:
VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND
STATE LICENSE NUMBER EXPIRATION CHECKED BY
REO'D POSTED
I 1$
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SEPA REVIEW SIGN AREA HEIGHT
PROPERTY TAX AqCCO
COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
EXP ,
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13 NEW RESIDENTIAL PLUMBING / MECH
LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR F3
COMPLIANCE OR
13 ADDITION COMMERCIAL CHANGE OF USE
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PARKING LOT AREA
PLANNING REVIEWED BY DATE
1:1 REMODEL MULTIFAMILY SIGN
REO'D PROVIDED
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GRADING Ei FENCE X
E] REPAIR CYDS I FT)
REMARKS
—
DEMOLISH �PIANK 13 OTHER
GARAGE RETAININGWALL F RE SPRINKLER
13
CARPORT ROCKERY FIRE ALARM
(TYPE OF USE. BUSINESS OR ACTIV" EXPLAIN:
17) hz-- 4
CHECKED BY JTY�
IE OCCUPANT
GROUP
NUMBER NUMBER OF CRITICAL
OF DWELLING AR EAS
1
__JAREA
SPECIAL INSPECTION
OCCUPANT
STORIES .2 UNITS NUMBER
REQUIRED [] YES
LOA��
DESCRIBE WORK TO BE DONE
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REMARKS z
PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D
-LJC- jjeA'F1 A) b r)LC— 7AA/1C FaV7—
VAWATION
$
Description FEE
Descriptioln FEE
Plan Check
irg
State Surcharge
HEAT SOURCE GLAZING % LOT SLOPE %
T
Building Permit
City Surcharge
ge
PLAN CHECK NO: VESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
I= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: ISO DAYS
PERMIT LIMM I 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 SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
a EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
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Total Amt. Due
9 DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
./A)
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
x
Recording Fee
Receipt # I Z // S 3
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
-APPI IC ION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIXED AGENT OF
r�js a7ppli ation Is not a permit until signed by the
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL d7in
oti. a! Deputy: and Fees are paid, and
Offipal or his/her
TION; AND IN DING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
D
IN VIOLAT19N--QF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
0 t is acknowledged In space ovi ad.
, , P, .
WORKMENP COMINSATION INSURANCE AND RCW 18.27.
5 11
NATURE DATE
., '14,
SIGNAT (OWNE '�R DATE SIGNED
—7
(425)
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771-0220
DATE
-:=
kftENTION
E)ff 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 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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MICHAEL MITCHELL
HEIGHT CALCULATIONS
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(MF!AqN 0 J�E CONSTRZTIGN GRADES)
MAI
REDMOND, U14. WM2
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(425)141-5ft
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A-1 MZWTI
A-? KAN FLOOR PLAN 4 Wt= SCHEDULE
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A-3 UPPER FLOOR PLAN I DETAILS
M E WIWT AAqW
A-4 BASEMENTPLAN
B
S-U STRUCTURAL NOTES, SCHEDULE$ 4 DETAIL$
5 4080
5-12 STRUCTUIRAL, DETAILS
6 Alows,
1 4"
BUILDING IBI & 10
8 4050
A-5 SWILDINOW ELEVATIONS
-W—
3ON-f- 4 - AWL GRADE 40156'
A -6 WLDWj V ELEYATIM
MAX RIDGE NEW 40156'& 3V a 43156'
A-1 WLDWs 13'MAIN FLOOR PLAN
�_ �RDGE WEW�435Y I
A-I3 BUILDINGiV KAIN FLOOR PLAN
A-13 MLOWs 15' 4 V UPPER FLOOR PLAN
BUILDING 'Cl
A-10 13JLDWj 13* 4 V BASEMENT PLAN
405.15'
A-11 WLDING; 13' 4 V FOUNDATION PLAN
W 40325'
A-12 BUILDWs 13' 4 V ROM AND
Ul I FLOOR FRAIMM PLAN
K 402&
12 4040
A-0 TYPICAL WALL SECTIONS
'ZWW 4 - AM GRADE 403.15'
A-0 GENERAL AND ENERGY NOTES
MAX RIDGE WE6'� 403.W 4 30 433.75-
5-1 STRUCTURAL NOTES AND SCHEDULES
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5-2 STRUCTURAL DETAILS
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5-3 STRUCTURAL DETAILS
UNIT AREA SUhV"RY
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CONSTRUCTION DATA (PA. BLDG.)
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LOT COVERAGE CALC
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PERMIT COUNTER
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MEMO TO:
FROM:
FINAL PROJECT ATPROVAL FORM
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TO: L-CL �'e�
DATE:bjl-,� 103
BUILDING DIVISION
DEPARI'MENTI)ATE
DIVISION DATE .
PLANNING DIVISION DATE—,
PROJECT
SITE ADDRES
PERMIT # 0 -3 — 00 -7 ADB#__________PATE INSPECTED —
DESCRIPTION OF WORK TO BE INSPECTFD_—fb--F—L-r��ie"c��-x',
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
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
I .
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
o' Copy of CORRECTION NOTICE given to owner/contractor by inspector
1 .
2.
0
REMNSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date. S i
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footlng......................
Wali. ...........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
-In ...................
Rough
Commercial Final ......
HEATING:
Gas Test ....................
Gas Piping .................
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
or
RECEIVEI) I G
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
(_C,,,A,,r_jjZv C7 1 c
5 MAILING ADDRESS
CITY ZIP TELEPHONE
"�Vj 0 _7� -7
NAME
Ace tie 7'&- t �,4 A el, L j) t' 1U E �1_6
ADDRESS
ZIP TELEPHONE
25� -c,4(;,1
NAME (Z) IC13L#
ocl ADDRESS
I; CITY ZIP TELEPHONE
0
STATE LICENSE NUMBER EXPIRATION DATE
;J1 PROPERTY TAX ACCOUNT PARCEL NO.
NEW 0 RESIDENTIAL
ADDITION
COMME
REMODEL
MULTIFAMILY
REPAIR
GRADING CYDS
DEMOLISH
15PIANK
0 GARAGE
RETAININGWALL
CARPORT
ROCKERY
(rYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
3 hz— —
NUMBER
NUMBER OF
OF
DWELLING
STORIES -2
UNITS
DESCRIBE WORK TO BE DONE
17 C—_ " _ L) &:
JAL= tj 7j— 1 A)
A -,�,A tki t2 z/^j m,� YU'7-
-71
FPERMIT EXPIRES LIP (9:5-
USE PERMIT
ZONE
Gos
NUMBER
JOB
ADDRESS 7(4-
2,
UITE/Aff# _-)i
-1
PLAT NAMEISUBDIVI SION NO.
LOT NO.
L�D NO.
L D FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved
SW Permit Required
Street Use Permit Roq'd
EXISTING — PROPOSED
Inspection Required 13
Sidewalk Required 13
REQUIRED DEDICATION— FT
Underground
Witingrequired CI
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
NO 13
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
fn� LI&MMMITH.1111 101
M�.=LA amffa=
FIRE REVIEWED BY
DATE
....... NEORADBN I INSPECTION BOND
0 $
CHECKED BY REO'D POSTED
OYES 13NO $
^enA nm- SIGN AREA HEIGHT
fIEW
COMPLETE . EXEMPT ALLOWED , PROPOSED At I OWED PROPOSED
LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.)
PLUMBING / MECH
ALLOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE REAR
COMPLIANCE OR
CHANGE OF USE
E] SIGN
PARKING LOT AREA PLANNING REVIEWED BY DATE
REQ'D PROVIDED
I
FENCE
I
( — X —FT)
REMARKS
OTHER
FIRE SPRINKLER
FIRE ALARM
CHECKED BY I TYP
Go, STHLIUTIUN
GROUP
L4 L'
CRITICAL
AREAS
SPECIAL INSPECTION
JAREA
OCCUPANT
LOAD
NUMBER
REQUIRED rl YES
REMARKS
PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REO'D
VALUATION
$
Description
FEE
Plan Check
HEAT SOURCE GLAZING % LOT SLOPE %
Building Permit
PLAN CHECK NO: VESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
III: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
2 1
3 DOMAIN (CURBI5, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQU RE
t: SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: IGO DAYS
ILIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Insp'ection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
*APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS. WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Landscapelnsp.
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
Recording Fee
I HERE13Y 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
CALL
TIO.4; AND IN DOING THE WC RK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION -OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION I
WORKMENP COMPtNSATION INSURANCE AND RCW 18.27.
SIGNA;Tt�'(JOWNE OR AGENT) DATE SIGN D
11425)
771 -0220
R I,
AfTENTION
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-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES
IDescription FEE
State Surcharge
City Surcharge
Plan Chk. Deposit
Receipt #
Total Amt. Due /A__
Receipt # 3
Z // St
ICATION APPROVAL
�tlon is not a permit until signed by the
it or his/her Deputy: and Foes are paid, and
Is acknowledged In space Wovidod.
1, Ou
BY DATE
ORIGINAL - FILE - YELLOW - INSPECTOR01 urj 3
PINK - OWNER - GOLD - ASSESSOR rao
GREEN - ACCOUNTING 7
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