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20030009.pdfDATE RECEIVED I CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS ah_QA 0 1 \_ e_C_,ttTA MAILING ADDRESS �_j Qca 2 L CITY ZIP TELEPHONE f__11*_1 A.- r,% in F, --i I A nf-- NAME ADDRESS CITY NAME ADDRESS ZIP ITELEPHONE U944 CBL # STATE LICENSE NUMBER EXPIKATIUN WAI I: OA tc, i k)PL<__44 I M I PROPERTY TAX ACCOUNT PARCEL NO. I L2--("( I Nl_ma� ail C'� r)n .) Qc) E RESIDENTIAL LUMBING / MECH ep?�EW DITION COMMERCIAL COMPLIANCE OR c 0 CHANGE OF USE REMODEL MULTIFAMILY 0 SIGN REPAIR 0 GRADING CYDS FENCE X ( _ Fr) 1:1 DEMOLISH 0 TANK OTHER oGARAGE [] RETAINING WALL F RE SPRINKLER CARPORT ROCKERY FIRE ALARM CrYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: 5F__ ?� NUMBER NUMBER OF CRITICAL OF DWELLING I AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE PERMIT EXPIF1 USE ZONE PERMIT NUMBER OZX) JOB ADDRESS PLAT NAMEISUBDIVISION NO. LOT NO. PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING — PROPOSED REQUIRED DEDICATION— Fr RES METER SIZE LINE SIZE NO. OF FIXTU REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CON '007 � I f It GAS PIPE TEST ft ENGINE(Ag By CITY INS arrInRill ItIng FIRE REVIEW&V "' " - BE ACCEPTED VARIANCE OR CU SHORELINE OR AD87N PURSUJkNT'f.j0 ECDC I COMPLETE I THE WATER PHUTOFF OWED POSEIL FRnOf ' eftS Type T or Ve coa CHECKED BY ITYPE i_0 SPECIAL INSPECTION REQUIRED [3 YES is open or C=;I(" I -I— $ nwin Description FEE PlanCheck 'd ze, 9 / Me A r, V&V ZZ"PI—A Y-9 Building Permit PLAN CHECK NO: VEtTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO h BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, IIIIARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: ISODAYS PERIAIT LIMIT: 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 IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF 2 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY NOT FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL BE Landscapelnsp. DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 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 APP GIVEN IS CORRECT AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF This appl THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Buildin IN VIOLATION OF THE BOR C OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION 16101F WORKMEN'S C MPENSA�TIO RA14 E AND RCW 18.27. SIGNATURE GENT) DATE SIGNED -1 AO% -12.5) -�ILLWMJ 771-0220 M ATT NTION EXT 1333 State city E cujq — SLIITELAPT# LID NO. LID FEE $ ESCP Approved 1W Permit Required ;treat Use Permit Req'd ispection Required 13 11dawalk Roquited 13 Inderground ViringtaquIred 11 PRV REQUIRED 115 YES 13 NO 13 z z z JDRAINAGE DATE DATE W BOND POSTED HEIGHT )WED I PROPOSED OSED ETBACKS (Fr.) 4T SIDL REAR z OCCUPANT GROUP OCCUPANT LOAD FEE Plan Chk, Depositl Receipt # Total Amt. Due Receipt # JCATIO APPROVA 311onlsnola ormit until signed by the I or his/her D7puty: and Fees are paid, and 3 acknowled6od in space pr�pvjood. 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 z 0 4 0 M ca M rn 0 -40 0 r M M 0 _n "n M M C 0 0 Fn a C) z z 0 RECORD OF INSPECTIONS INSPECTOR DATE APPROVED �E �K ............. FOUNDAtION.' All Footing. ................. Wall ..... . Pier/Porch ........... . ...... Retaining.W611 ............ Slab. Insulation .......... PLUMBING: m C p Rough -In . 1C ................... J't 10 Commerclal'Flhal ...... Z HEATING: Gas Test ................... Gas Piping ............ EquipTen, t .............. . ..... ca, lai Final Commerc ....... Fn ca EXTERIOR SHEATHING_ NAILING... . .... ....................... FRAMING .......................... FIRST FLOOR FRAMING.." . INSULATION ................... Fiboit lnsulation� ........ z Wall Insulation ........... Ceiling Insulation ....... 0 m SHEETROCK NAILING ... SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR CIO OCCUPANCY .................. RECEIVED I CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER 7EINAME OF BUSINESS _,� _, h4X (A MAILING ADDRESS _j —1-11 c) —n ZIP ITELEPHONE by -as NAME ADDRESS CITY ZIP ITELEPHONE PERMIT EXPIRES USE ZONE PERMIT 77- NUMBER CX6 ()00151 JOB SUIT t__1L ADDRESS zdpd, 7 I-) PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7ESCP ApprO-d RW Permit Required EXISTING — PROPOSED Street Use Permit RWd inspection Required Sidewalk Required REQUIRED DEDICATION— FT Underwound wimmim, 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 1 1 YES E3 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE 147— . I— t - j — - .% — NAME CBL wwlwmmv--- — - __ - - irmnm 1191 ENGINEERING R911REUMV I I DATE Wesco ADDRESS BE ACCEPTED_ '�-�rndwb, *-, DATE FIRE REVIEWED BY CBL�, EN rNE F N 1 " C G' r FIRE REVIEV ZIP Jj TELEPHONE PURSUANT TO ECDC 19.30.020 Q 161 1 e;2(j_V - :, - 01 1 VARIANCE OAtv BOND STATE LICENSE NUMBER EXPIRATION DATE 1,�ECK Av SWL i-i"liNSTAL $ POSTED IrtTP WAq-t- �op L<244 0S, 41). $EPA REVIEW A HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COM ETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED PL EXP 1 -----4 PEW 51 RESIDENTIAL [:3 ADDITION [3 COMMERCIAL 0 REMODEL [:] MULTIFAMILY [:] REPAIR 0 GRADING CYDS [3 DEMOLISH 13 TANK oGARAGE [3 RETAININGWALL CARPORT ROCKERY (TYPE OF USE. BUSINESS OR AC71VITY11 EXPLAIN: NUMBER NUMBER OF OF DWELL NG STORIES UNITS DESCRIBE WORK TO BE DONE / MECH //"VLUMBING COMPLIANCE OR 0 CHANGr OF USE LLO ALLO 0 E 0" E "Uh mquhrei q 7 0 SIGN REO` I PROVIDED FENCE 1:3 X_F7) REMARKS 0 OTHER . . &or wl FIRE SPRINKLER 11 FIRE ALARM 4,0'r,04, WA4,0,r,0iA )s CKS (Fr.) S E REAR D AT CHECKED BY :WPE)CMWe OCCUPANT If/ J) GROUP CRITICAL AREAS SPECIAL INSPECTION JAREA SPECIAL INSPFC OCCUPANT NUMBER REQUIRED 0 YES LOAD REMA ION REaDj P P 0 ROgw�*1whowem I13 oel is open or dosed, expansion tanks jare 2 r -I ns,04— I 194u" _ au Will 9 hot Is Watei tanks per r Description Plan Check Building Permit FEE Description FEE state Surcharge lCitySurcharge 1 PLAN CHECK NO: I VMED 13ATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURSS. SIDEWALKS. DRIVIEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPLICA410N. 180 DAYS PERMIT UMIr I YEAR - PROVIDED WORK 19 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 IN INTEREST, AGREES TO INDEMNIFX 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 Fire Inspection FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT HE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' --M— Recording Fee I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT� AND THAT I AM THE OWNER, ORTHE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CjQM,0F THE STATE OF WASHINGTON RELATING TO FOR INSPECTION WORMERS CVMPENSAT150IM14RANIE AND RCW 18.2 . A SIGNATURE GENT) DATE SIGNED tAO 1,42.5) QVT��L I 1 1, - 771-0220 Plan Chl, Deposit ec Receipt # T T I eip I ue Dial Amt. Due 0al c to Recelpt N APPLICATION APPROVAL This application is not a permit until signed by the diqgJ I or histher Deputy: and Foes are paid. and re olot a acknovirledged in space prpvjded. ATTENTION r.A 1 1 a I 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 PIES 04/02 PRESS HARD -YOU ARE MAKING 5 CO ED BY UAIC ORIGINAL -FILE YELLOW -INSPECTOR PINK -OWNER GOLD -ASSESSOR GREEN - ACCOUNTING L