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20030014.pdfW1 h bu) DATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION ER NAME/NAME OF BUSINESS MAILING ADDRESS 16-1f)l 02�lStc(ZN -t-1 t'� CITY ZIP TELEPHONE :�Adft M, 61"Vo Ito - NAME ADDRESS CITY ZIP uz, PERMIT EXPIRES USE pA PERMIT ZONE NUMBE JOB SUITE/APT# N ADDRESS ' L:LIL - I 71 1 LID NO. PLAT NAME/SUBDIVISION NO.' LOT NO. LID FEE S TESCP AP=. PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Street Use Permit Req'd EXISTING - PROPOSED inspection ReQuirod Sidii,walkReWifed REQUIRED DEDICATION- FT Underground Wftg r"ui red METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I I YES [3 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE L±Wrl Z U J�,� VA 1CAj&ahsjI 1 kk==;� ENGINEERING REVIEWED/DATE ADDRESS I icy* DAT E FIRE REVIEWED By cc CITY ZIP TELEPHONE P M a-Aronals (3a&2B e .1l �0.,92fl_ VARIANCE OR CU SHORELINE OR ADB# INSPECTION STATE LICENSE NUMBER EXPI ION DATE /CHEC A _09__ 5C PBONED REO'D OST D XYES C3 NO t,-Jkmgn�u)!� " SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEfNO- COMPLETE EXEMPT ALLOWE PROPOSED ; 1 , ALLOWED PROPOSED 1 .2), I x /0 1.6 tp 6, EXP LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT.) NEW [j RESIDENTIAL PLUMBING MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REAR 0 ADDITION COMMERCIAL o COMPLIANCE OR CHANGE OF USE I I a - PARKING LOT REA IP%;13 ATE 116 E:] REMODEL APARTMENT SIGN REO'D I PROVIDED ___t� I ;Rj"; REPAIR GRADING CYDS FENCE X FT) REMARKS El DEMOLISH [j TANK 0 OTHER o GARAGE RETAINING WALL RENEWAL CARPORT ROOKERY (TYPE OF USE, BUSINESS OR ACTIVITYII EXPLAIN: N flITY) CHECKEDBY ITYPFA*qOPST -�.; I (i KTO M T GROUP NUMBER OF /Ar NUMBER OF DWELLING I CRITICAL AREAS 5 SPECIAL INSPECTOR OCCUPANT LOAD ps Uh NUMBER JAREA REQUIRED [:I YES DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 100/FINAL INSPECTION REG'D ca&�= cam x.-MELI r)v-- n(ANA arz= 1,,\� WIUA)W- VALLIATION $ bmtDescription FEE Description FEE Plan Check H FAT. HOURCE GLA23NG % LOT SLOPE % I___ PLAN t:HECK NO: vEsTEDIGATE Plumbing 12� Mechanical THIS PERMIT AUTHORGMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLY. AM CONSTRUCTION ON THE PUBLIC Grading Recording Fee VAYS, MARQUEES. ETC.) WILL REQUIRE 3 DOMAIN (CURBS, SIDEWALKS,DRIVE t SEPARATEPERUISSION. Engr. Review City Surcharge PERMIT APPLICATION: ISODAYS L PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engir.Inspection State Surcharge SEE BACK OF PINK PERMIT FOR MORE INFORMATION *ApPucANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Traffic Mitigation Plan Chk Deposit IN INTEREST AGREES TO INDEMNIFX DEFEND AND HOLD HARMLESS THE CITY OF Receipt # EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND Fire Review ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE Fire Inspection Total Amount Due DEEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Landscapelnsp. Receipt # I HERESY 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 CONSTRUC CALL This appliCation Is not a permit until signed by the Foes and TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LAU0A_GQQE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building Official or hitiftier Deputy: and are paid, receipt Is acknowledged In space provided. WOR2zj!2t:2!L5�--E AND RCW 18.27. 0 1 LS ATURE DATE SIGVfiAEXOW4§f%0E DATE RIGNED 1A25) %-V&- MY91 1114- a2 j 771-0220 Y ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-022 1 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - IASPE0fOR CATE OF OCCUPANCY HAS BEEN WNTED. UBC SECTION 109 FAJ�_ 10/01 PINK - OWNER GOLD - ASSESSOR z 0 4 0 M M C PIS ;q, 0 C M M z CO) 0 M M 0 C C0 0) 0i z z 0 M FINAL PROJECT APPROVAL FORM TO:. D A T E: '5: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: —YIRE DEPARTMENT DATE— nffAn SM ENGINEERING DIVISION DATE- z 0 nnoo,__PLANNINGDWISIONDATE.�—�0>-O-�) M MAMMON =n PROJECT— C M M0 SITE ADDRES S 402Z c� 80 PERMIT A DATE INSPECTED C M M DESCRIMON OF WORK TO BE INSPECTEDW"4&"4a4::�n2 z A field inspection was conducted to determine, final compliance with approved plans.' Final approval CO) 0 -n no objections from the above ped Department to the' release, of denotes, that there are Si n P—ERFQRMM4 BONDS and the granting.of: MM 0 C GRANT FINAL PROJECT APPROVAL MO z M z GRANT PROJECT APPROVAL WnH CONDITIONS NOTED a COPY of CONDMONS given to owner/contractor by inspector z M FAILED FINAL INSPECTION - OUTSTANDING ISSUES (3 Copy of CORRECTION NOTICE given to owner/contractor by inspector 2. 3. RE_INSpECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL Date Si ocaprvl.doc.l:taV:bldg:formsIO/O1 I eel P'.. -1 " 41"--�, VJI, CP I t I I .4 1 RECORD OF INSPECTIONS 'Le Lie I.ip It It It It INSPECTOR DATE APPROVED SETBACKS FOUNDATION* I it It 1 4 Footing 090809 1 1 1 1 1 1 1 11 1 1 1 0 1 1 1 . - I I I - I - I Wall It I Pier/Porch ot I L III I l I- fTI t Retaining Wall .4. iL I:z sell Slab Insulation I 1 4 1. PLUMBING* I. I L I I :d I I I".. -I- I, I I Underground kouOh4n JI 1, It mmerblal Final M I tI I I I I' P I I I P I I.-HEATINGe t i I � I I I I I zl It Itt el Irk .1 It �-�ilmIIII Gas Test 'r I I 03 j IA Gas Piping rr I I I. I 4' '1 1 - - - - I I I - , . I , t I I I I I Equipment I Itr wI tI It t 0 ed I I. L Ir Commercial Final I IL 1 1. 1, 1 1 d I I I I rl 1 4 +N I e 10 1 eke I: % It d, Ir It EXTERIOR SH EATHING It I 1 1. 1 1 1 ' I I I " I 1 9 , I t lt. I III f 1 0 4 C: It I r I I It 1� 1 .1 1 4 1 1 1 1 1, 1 1. k-f I I d C.. I It' 4, 11'.. At�, "I I NAILING I Af I I, l 4 1 1 .1 1 (L I I, I I 1 4 1 1 1 1 1 1 14 1 1 1 0 1 r; 0 1 1 1 % I � : ' I I I , I , I � I , I It 1 1 et � I III - I 'I I I I t It III FRAMING t I I I. I I , I I. :.tee 4 1 1 d I I r I I I F RST FLOOR FRAMING94* It It I ltet, I �Lte. INSUIATION I% J. 14 �10 It It I I I I z Floor Insulation t,�. Its Wall Insulation, 4, It I' t I C It k eiling nsu ation It A 1 9 $ L, I I I I 0 SHEETROCK NAILING M 1 14 1 l I I I I I I I I I 1 4 1 l I. I I I I I SPECIAL INSPECTION... MISCELLANEOUS 4 6* 9 6 0 &a I I FINAL APPROVAL FOR OCCUPANCY d Ze I k It It It I IT, I I 4 44, P 6 li ATE RECE111 07 2 PERMIT EXPIRES USE PERMI CITY OF hOMONDS ZONE NUMB��-1�0� CONSTRUCTION PERMIT APPLICATION JOB BUIMAPT# ADDRESS 0 1 E, OWNER NAME/NAME OF BUSINESS 1 �4 0 � ( � rr f ( - �) � C C V, f �� t C PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. _-�"712 2 [ MAILING ADDRESS LID FEE S ZAY) :-,Lr-�Ai _"r PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7ESCP Approved FVW permit Required ;?j CITY ZIP ITELEPHONE EXISTING - PROPOSED Street U" Pom* RW kopoedon Reqtdred Sidewalk Recitsired �6dctm REQUIRED DEDICATION- FT urlderwourld "emirequired g NAME METER SIZE LINE SIZE I NO. OF FIXTURES 17813 V PRV REQUIRED 8 NO 13 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUT)RAINAGE CITY ZIP TELEPHONE NAME 0a\tu a�� ENGINEERING REVIEWED/DATE ADDRESS 1q, FIRE REVIEWED BY DATE CITY ZIP TELEPHONE STATE LICENSE NUMBER P � UAI?Z� PROPERTY TAX ACCOUNT PARCEL L k�' VARIANCE OR CU SHORELINE OR ADBO INSPECTION I PBOND EXPIRATION DATE I /UEC REQ'O OSTED 4 C1. /f � I DB —,).Z— S& [3NO � 04 OfnU ACCA HEIGHT 13NEW RESIDENTIAL [3 ADDITION COMMERCIAL I-] REMODEL APARTMENT [3 REPAIR E3 GRADING CYDS DEMOLISH [3 TANK E GARAGE 3 RETAINING WALL CARPORT ROCKERY (TYPE OF USE. BUISINER OR ACTIVITY) N: CLI;_ NUMBER OF NUMBER OF DWELLING $Topics UNITS DESCRIBE WORK TO BE DONE HEAT,SOURCE I GLAZING % 2- ac 1CW COMPLETE EXEMPT EXP x AL R I PROPOSED i I a t� ALLOWED I P'Opf BED (01 S PLUMBING / MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT LIRSIDE REAR COMPLIANCE OR CHANGE OF USE SIGN R PARKING ED =7PF P- LOT AREA I P�"G R" DATE FENCE X - Fr) REMARKS P542— [3 OTHER [:] RENEWAL CHECKEDBY conE -pluuum ral jTY`PEffFrGTqUCfrON N GROUP r I �' CRITICAL AREAS SPECIAL INSPECTOR OCCUPANT NUMBER REQUIRED [:] YES JAREA LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1108/1FINAL INSPECTION RECtD (,\\ki- 7T 7-T V3 l:qfr'%N VALLIATION $ Plan Check SLOPE % Building 'E Plumbing FEE I Description I FEE I I I �L :.2 1 L42 �1� Mechanical THis Pownr AuTHoRmEs ONLY THS woRK umm THIS PERMIT COVERS WORK TO h BE DONS ON PRIVATE PROPEM ONLX ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SLDMALKS, DRIVEWAYS, MARQUEES, ETC.) VfiLL REQUIRE Grading Recording Fee SEPARATE PERMISSICOL Engr. Review City Surcharge PEMIT APPILICATIOW. 180 DAYS PERMIT ILIMM I YEAR - PROVIDED WORK 18 STARTED WITHIN 180 DAYS Engr. Inspection State Surcharge SEE BACK OF PINK PERMIT FOR MORE INFORMATION -APPLICANT. ON BEHALF OF HIS Oft HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Traffic Mitigation Plan Chk Deposit IN INTEREST, AGREES TO INDEMNIFY: DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, 98 OFFICIALS. EMPLOYEES, AND AGENTS FROM AW AND Fire Review Receipt # ALL CLANS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Fire Inspection Total Amount Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANN WAY THE CITYS ABILITY TO ENFORCE AW ORDINANCE PROVISION.- Landscapainsp. Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN 18 CORRECr AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CrTY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building 01111cial or W/hor Deputy: and Foes are paid, an IN VIOLATION OF THE LAWN"GQg OF THE STATE OF WASHINGTON RELATING TO IFOR INSPECTION receipt Is acknowledged In epace provided. WORKMEIT$ Com WIN E AND RCW 18.27. 0 URE, DATE ZSIGY* 0"AZO:&Nrn�/ DATE IGNED 77 (425) 1�_AAA 771 -0220 iiiiiiiisii E ED BY 7 /bATE ATTEqrION W 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR'STRUOTURE UNTIL 771-0221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE - YELLOW -'-.qPF:--OR CATE OF OCCUPANCY HAS BEEN RANTZEDU C SECTION 109 10101 2 77 A FAX,. PINK - OWNER - GOLD - ASSESSOR _op L L d z 0 0 ITI --n M I i6: 171 C M ITI 0 ,n M M ci Fn C M0 z 0 0 ITI