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20030052 (2).pdfDATE RECEIVED /A// CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS MAILING ADDRESS CITY ZIP TELEPHONE R)tAolibs, `1502K 1(��6 �<7q- NAME ADDRESS CITY ZIP I TELEPHONE I I PERMIT EXPIRES USE PERMIT ZONE -0052-,, "6,4/ NUMBER ;?x 0, 3 JOB - SUITE/APT# ADDRESS Az (5r PLAT NAME/SUBDIVISION NO. LOT NO. L�D NO. L D FEE $ 7ESCP Approve PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Roqu:lfod Street Use Parrit Req'd EXISTING PROPOSED inspection Required E3 Sidewalk Required E3 REQUIRED DEDICATION— FT Underground wiring required [3 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES 13 NO 13 REMARKS z z OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE 0 NAME L-ObEST-Pit-91 Coll ADDRESS 2-00 STI CITY ZIP TE�EPHONE LywWoobo aj�p� STATE LICENSE NUMBER Lo 1) E-S RCI A KO 61_31o7, PROURTY TAX ACCOUNT PARCEL NO. SkAl �7(:)—Iqlz CHECI�ED BY ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE . VARIANCE OR Cu SHORELINE OR ADB# INSPECTION BOND REO'D POSTED SEPA REVIEW SIGN AREA 1[3YES ONO $ HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED Lu , X_ [3 NEW RESIDENTIAL PLUMBINO�M�ECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LJRSIDE REAR ADDITION COMMERCIAL Fht. COMPLIANCE OR CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE REMODEL MULTIFAMILY SIGN REO'D PROVIDED I I I GRADING REPAIR CYDS FENCE ( — X —FT) REMARKS DEMOLISH TANK OTHER GARAGE RETAINING WALL 0 F RE SPRINKLER FIRE ALARM CARPORT ROCKERY (TYPE OF USE, BUSINESS OR ACTIVITY) P(PLAIN' re CHECKED BY ITYPE. F CONSTRUCTION OCCUPANX GROUV 15 �rNUMBER 0 M NUMBER OF OF DWELLING 01 CRITICAL AREA SPECIAL INSPECTION JAREA OCCUPANT LOAD ci STORIES UNITS NUMBSER REQUIRED DESCRIBE WORK TO BE DONE 9 Q C7W 024< REMARKS PROGRESS INSPECTIONS PER UBC ioa/FINAL INSPECTION REO'D G9JLLV=5 A-5 kn;r=ba. VALUATION '21Vr $ Description FEE DescAption FEE Plan Check State Surcharge HF,41,SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHEC fjK)N, Plumbing % VESTED DATE — �Z� egg, 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 I DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 0 SEPARATE PERMISSION. t: Engr. Review PERMIT APPLICATION: 180DAYS, PERMIT UMM 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 2 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 Landscapelnsp. Total Amt. Due S55 9 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.' MI 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 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 Official or his/her Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged in space provided. WORKM�N'S COMPENSAT)ON INSYRANCEAND RCW 18.27. A OFjg1ANA DATE SIGN WN E DATE SIGN (4215) 1 7 1Z z,74 2 fZ 07- x 771-0220 _ -REL6-ASiED DAE BY ATtENT16N- EXT 1333 'r IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINA�/ILE YfLLCW - 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 --i -n 3: M C M 0 40 0 C --I C X M M Z JO -4 C 0 -n n M M 0 0 OR C (j) C V) ITI 0 Z X z -4 3: C0 z 0 q 0 M RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... Wall.......................... --------------- Pler/porch ................. RetainingWall ........... ----------------- Slab Insulation .......... PLUMBING: Underground ............. Rough -In ................... . Commercial Final ..... HEATING: Gas Test .................... Gas Piping ................. t3,6 Equipment ................. Commercial Final ....... ----------------- EXTERIOR SHEATHING -------------- NAILING.......................... FRAMING........................ - --------------- FIRST FLOOR FRAMING ... --------------- INSULATION ................... Floor Insulation ......... WallInsulation ........... ------------------ --------------- Ceiling Insulation ....... ------------------ --------------- SHEETROCK NAILING ... ------------------ SPECIAL INSPECTION ... ------------- MISCELLANEOUS .......... FINhL APPROVAL FOR OCCUPANCY .................. 006 A.& CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS SE_&�LT__ ��V_MST CK MAILING ADDRESS A Vy, CITY ZIP TELEPHONE J=t�noobS _ 7Z NAME 'ADDRESS NAME - t-0 ADDRESS __K�0,5_ 2 CITY L�IMM\A/001> STATE LICENSE NUMBER LOIDL-5 FIC-1 ZIP TELEPHONE JCBL CO. s ZIP I TELEPHONE NEW 1:1 RESIDENTIAL ADDITION %L COMMERCIAL REMODEL MULTIFAMILY REPAIR C] GRADING CYDS DEMOLISH 0 TANK EGARAGE ] RETAINING WALL CARPORT _11 ROCKERY (TYPE OF US= BUSINESS OR ACTIVITY) UPLAIN: r, -"57 1 NUMBER U' NUM ER OF OF WI TDWEBLING STORIES UNI .rA PLUMBINGQECH COMPLIANCE OR CHANGE OF USE E] SIGN EFENCE ( — X—FT) OTHER F RE SPRINKLER FIRE ALARM PERMIT EXPIRES USE ZONE PERMIT 0('52 NUMBER JOB 1;111TEIAPT# ADDRE.-S PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE$ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP AP -W cquk. S.;;F. Permit Raq'd EXISTING - PROPOSED n inap n Required E3 Sidewalk Required 13 REQUIRED DEDICATION- FT Undo'ground Wiring required 13 METER SIZE LINE SIZE-1 NO. OF FIXTURES PRV REQUIRED YES 13 No z REMARKS z OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE Il VARIANCE OR CU SHORELINE OR AD1111 INSPECTION BOND REO'D I POSTED I OYES ONO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP I I , LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR z PARKING BY DATE I LOT AREA REO'D I ELROVWEDI m rm at I PLANNING REVIEWED CL CHECKED 13Y OE CPNSTRUCTION CODE OCCUPAVY &I ITYPE q7 GROL" r,;;:�l CRITICAL AREAS SPECIAL INSPECTION —_ OCCUPANT .NUMBER JAREA REQUIRED [] YES LOAD > L) C7W REMARKS z PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION, REO'D A., A _5=10tj5 K's NEEb-L-1311 - , .1 k: 07)`3411 bjEEjk�� yl GOU-TE5 NS UEEbM, VALUATION Description FEE DescAption FEE Plan Check State Surcharge HENAOURCE GLAZING % LOT SLOPE % Building Permit city Surcharge PLAN CHECILNCI* VESTED DATE Ce, Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I 1= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC Grading a a 3 DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 1=1 SEPARATE PERMISSION. Engr. Review 2 PERMIT APPILICATION: 180 DAYS —..—.r umir i YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS I Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT; ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND 60CC6ORS Fire Review Plan Chk. Deposit IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS T)HE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTSPROM ANY AN� OF WHATEVER DIRECTLY OR INDIREOTC Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES NATURE, ARISING FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITYORDINANCE Landscape Insp. Total Amt. Due XO NOR LIMIT IN ANY WAY THE C17YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' 17 Recording Fee I Receipt # �2 [L,? I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECr, 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 TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building Official or histher Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided. WORKMYN'S COMPENSAJON INSERANCEIIAND RCW 18.27. A OFFICMIAGNA DATE/ SIG E WN EN DATE SIGN 71rZ /I (425) A�RE;7LEAS_E'13 7 0C 771-0220 BY DATE ATTENTON Off 1333 > 17 IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR S TRUPTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL O� A CERTIFI- ORIGINAL�-�ILE Y/ELLOW-I�SPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION',109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING t z 0 4 0 M =i:R M C M 0 0 C �c M ITI z jo Cl) 0 -n n IT! IT! 065 0 r_ 0 M C cl) K 0) FTI 0 Z z --I x 0) z 0 ITI