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20030010.pdfDATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS MAILING ADDRESS I CITY ZIP HONE 'TELEP -5 NAME ADDRESS CITY ZIP ITELEPHONE NAME ICBL# ADDRESS PERMIT EXPIRES ±L±1 \j -Z USE PERMIT ZONE NUMBER (J(), JOB IT APT# ADDRESS I 0j nz _Su�l I/ PLAT NAME/S UB DIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required Street Use Permit Raq'd EXISTING — PROPOSED Inspection Required E3 Sidewalk Required [3 REQUIRED DEDICATION— FT Underground 13 Wiling r nuired METER SIZE LINE SIZE NO. OF FIXTURES �RV REQUIRED j YES C3 NO 13 REMARKS z OWNER IN CONTROL/QaA W E of whether the wul,111 01Q%�... I Regardless §,nnkQ Ar 9.30.020 (C) f1lie 1-4 j I it 0 1 1 14 A VI F--- 91 ' 3 1 FIRE F UAT_1z_ LU 0 Zll� �*LEPHONE r" -%^.1 /1. 1 Type B or L vent connectors C+1 - 1:;R3 a :2_�— VARIA, ICnqUirect(mcmaii!DAOAWqgiL#ipltWMI "I B )No STATE LICENSE NUMBER EXPIRATITIN DATE CHECKED JBY unheaLei spaces. Umli:I PC 3TED -Scn d —1 /0 —6, _-1, - (A)19SO I G . >_ 8 1 - HFIrPTI PROPERTY TAX ACCOUNT PARCEL NO. / �,I. C'� ) COMPL1;V_.EVTXEMl`T I ALLOWED , PROPOSED I ALLOWED , PROPOSED EXP NEW RESIDENTIAL LL;��CH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE REAR PROPOSED SETBACKS (FT) FRONT LIR SIDE REAR COMPLIANCE OR P URS ApIT TO ECDC 1 .30.020 z 13 ADDITION COMMERCIAL CHANGE OF USE PARKINcA RECI'D PROVIK,&J,]L!BV- rY'. 'DATE r1N.S"TZ'LED AR REMODEL MULTIFAMILY SIGN REPAIR GRADING FENCE X CYCIS ( FT) I 'rj4p W M.R SHIJTOFF REMARKS DEMOLISH TANK OTHER GARAGE RETAINING WALL F RE SPRINKLER FIRE ALARM CARPORT ROCKERY (TYPE OF USE. BUSINESS OR ACTIV" EXPLAIN: CHECKED BY ITYPE S RUCTION cogrr_-, OCCUPAN GROUP NUMBER OF NUMBER OF DWELLING CRITICAL AREAS SPECIAL INSPECTION JAREA OCCUPANT STORIES UNITS NUMBER REQUIRED [] YES LOAD DESCRIBE WORK TO BE DONE __I__ REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTIO REQ'0 A---, i ru e 0a kWh x Yu r, +-UA U baso VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % I Building Permit City Surcharge t? PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC Grading x DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION . - Engr. Review PERMIT APPUCATION: 180 DAYS PERMIT LIMIT: I YEAR - PROVIDED WORK 15 STAKED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 2 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit �I 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 IALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE Landscape Insp. Total Amt. Due 9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 NOR LIMIT IN ANY WAY THE CRYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION., Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I 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 CONSTRLIC- CALL This application is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED BuildIr"Ificial or his/her Deputy: and Foos are paid, and E I HE STAT IN VIOLATION OF T E OF WASHINGTON RELATING TO FOR INSPECTION rToIpt Is acknowledged in space provided. .;H TI IN *URANCE No RCW 18.27. WORKMEN'S C I N.URANCE T� 6 NATURE D SrITU 111111111il 111111' ill 0NT) DATE SIGNED (425) a o 3 YEEAISEDBY a3771-0220 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- ORIGINAL - FILE - YELLOW - INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK-Ol GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 A 0 M =i 9 1171 C rn 0 -40 0C �c IT! M 0 -n n --I M M 06 0 r- 16') M C Q 0 Z z 3� 1151) z 0 1 5 M ..RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ........................ FOUNDATION: Footing.......... ........... .............. Pier/Porch* ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground ............. Rough -in ................... Commerrial Final ...... HEATING: GasTest .................... 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 Q�TEREC�El CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS MAILING ADDRESS CITY TELEPHONE 92z(,pP0Qb1 -51a- NAME ADDRESS I ZIP I TELEPHONE NAME ADrAEP3 LEPHONE STATE LICENSE NUMBER EKPIRATION ILAI PROPERTY TAX ACCOUNT PARCEL NO. CBL N f IJ PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB SUIT APT# ADDRESS � 15 5/ 0� In, ), ;7. - " -0 PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP APPIZed Rw Permit 8 u"ad street use Permit noq-d EXISTING — PROPOSED Inspection Required [3 Sidewalk Required 0 REQUIRED DEDICATION— FT Underground Wiring required 13 METER SIZE LINE SIZ7 NO. OF FIXTURES PRV REQUIRED YES13 NO 13 REMARKS z z OWNER/CCF DGPIW I- I I is open or dosed, expansion tanks are I - ENGINEERING REVIEWED BY DATE required on fuel -burning np.pl.Q� In - eA VARIANCE DRAbBill [_ INSPECTIOl' BOND CHECKED BAY In"'T"" RFf3,n - I PnqTrnj NEW RESIDENTIAL 1011:11ir I — ��PLUM`BRIN`6`1 MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY SIGN REPAIR GRADING E:] FENCE CYDS ( X FT) DEMOLISH TANK OTHER GARAGE RETAINING WALL F RE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: S NUMBER NUMBER OF RITICAL OF DWELLING I AREAS I NUMBER STORIES UNITS DESCRIBE WORK TO BE DONE HEAT SOURCE GLAZING % I LOT SLOPE % PLAN CHECK NO: I VESTED DATE SEPA REVIEW SIGN AREA 1. HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED, ALLOWED PROPOSED EXP , L LOT COVERAGO 11RAIJAM ALLOWED WDr- SETBACKS (Fr.) SIDE REAR PROFObSTIV APffj1UREPX-_GULAMMR YLA Rj 93 z 1 RN INSXAT I IP z - __ DATE PARKING N§jVjjjW REO'D I PROVIDED REMARKS CHECKED BY ITYPrFM OCCUPANTW CODE, GRO SPECIAL INSPECTION JAREA OCCUPANT REQUIRED LOAD REMARKS PROGRESS INSPECTIONS PER LIBC 108/FINAL INSPECTION REO'D VALUATION JIV119seal: 1 r_u_ $ 1111111111,is a � Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical xy THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t__ BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPUCATION: 180DAYS Engr. Inspection PEIRMrr ILIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS 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 Landscapelnsp. FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE 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.' M Recording Fee I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORREC-P, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRLIC- CALL TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE JAQPA:�C�THE STATE OF WASHINGTON RELATING TO FOR INSPECTION WORKMEN'S C?MP50!E�TlOy INSURANCE IND RCW 18.27. IA-35) 1k WK SJGNATUR OOOfi DATE SIGNED JOE"L� 771-0220 cv"r .410,010 Plan Chk. Deposit Receipt # Total Amt. Due Receipt # APPLICATION APPROVAL This application Is not a permit until signed by the dIng,fifficial or his/her Deputy: and Fees are paid, and filcelpt Is acknowledged In space provided. � S SIGNATURE AT 11 � i, �O 2 kSED BY DATE #111,111 1 1=11 I 111111ijill 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 k z 9 0 ITI =P% M C M 0 10 0 C 5� C M ITI z 0 _n M M a Fa 0 6 Fn C co) C 0 M 0 z z 0) z 0 1 0 M