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20030080.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS MAILING ADDRESS I 01(jC(s CITY ZIP TELEPHONE EDWMD6 1 "425- 3q7o�Sc IIT27j; ADDRESS CITY ZIP [TELEPHONE NAME ADDRESS PLO Po c) X -F-, 112 2Q6_ CITY ZIP I TELEPHONE 07 PERMIT EXPIRES USE ZONE PERMIT NUMBER JOB SUITE/APT# ADDRESS <��tj 4S-X_,A3 PLAT NAME/SUBDIVISION NO. LOT No. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW P it Required 'arm t Sireat Use Permit Req'd EXISTING - PROPOSED InspocUonRoqui,red S Idmark Required REQUIRED DEDICATION- FT Undergmund I Widng required METER SIZE LINE SIZE I NO. OF FIXTURES I RV REQUIRED I YEPs 13 NO 13 .9aA 54_1 -5N *7 , ru- C063 12& E_ - STATE LICENSE NUMBER EXPIRATION DATE I CW.GVXQ BY FIVEOCA d12i6e,1,t Iva TAX ACCOUNT PARCEL NO. 1:3 NEW VRESIDENTIAL PLUMBING / MECH IADDITION 3 COMMERCIAL COMPLIANCE OR CHANGE OF USE 1:1 REMODEL MULTIFAMILY SIGN REPAIR GRADING CYDS FENCE X ( FT) 13 DEMOLISH W-IA'N—K E] OTHER 0 GARAGE o RETAININGWALL F RE SPRINKLER CARPORT ROCKERY FIRE ALARM ITYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: 60— :2!L*M NUMBER NUMBER OF CRITICAL OF DWELLING L AREAS STORIES UNITS NUMBER DESCRIBE WOR&TO BUONE � - — * f\i --A III A.A REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING REVIEWED BY DATE 13 z 15 z z FIRE REVIEWED BY DATE W cc I M VARIANCEORCU INSPECTION BOND JSHORELINEORADBN 113YEs REO'D POSTED I ONO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP ] , , LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR P16r- hA,&R_QWAI z PA KING REO'D I PR TA I Mk' I fiti en�r- BY DATE Sa f M N R OAP Is. REMARKS CHECKED BY COPg OCCUPANT GROUP 7- SPECIAL INSPECTION JAREA OCCUPANT REQUIRED LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'u I HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 180 DAYS PERMIT LIMIT 1 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 IN INTEREST, AGREES TO INDEMNIFY. 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 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., I HEREBY 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- TION: AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENS=URANCE AND RCW 18,27. .jIGNAkTURE (OWNER 04tGiENT1 I A I DATE SIGNEID VALUATION $ DescrIption FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION (425) 771-0220 APPLICATION APPROVAL This application is not a permit until signed by the Building diticial or his/her Dopuly: and Fees are paid, and receipt Is acknowledged In space provided. OFFICIA S I NATORE DATY 41 R LEAS 5D BY / f DATE ATTENTION EXI 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 t z 0 4 0 ITI -I -n ro � 0 M C M 10 0 -10 0 C -4 C X M ITI Z K) --I C —Z 0 -n n ITI ITI a —0) 0 r- 0 M C 0) C 0) M 0 z X z z 0 4 0 IT! 4 FINAL PROJECT APPROVAL FORM TO: DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: -FIRE DEPARTMENT DAT MMMMSM ENGINEERING DIVISION DATE — PLANNING DIVISION DATE— nzmsm PROJEC W 7 SITE ADDRESSA'�4 4n". 2,_ Z PERMIT ADB# INSPECTED '2-3 DESCRIPTION OF WORK TO BE INSPECTED_�2,��A�,31C 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: . X 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 ci Copy of CORRECTION NOTICE given to owner/contractor by inspector I . 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date— Si ocaprvl.doc.l:temp:bldg:formsIO/OI z 0 i 0 M =i =5 65 M 0 0 0 0 C —1 M MM M Z 0) 0 -n n i x M M 0 0 0 M C Cn C CA M 0 Z .'T X z z 0 M RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing...................... Wall.......................... Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground ............. Rough-lp ........... 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 .............. 4&vg am 40A0 ed & / DATE RECEIVED )FT 0 PERMIT EXPIRES ", CITY OF EDMONDS USE PERMIT ZONE )0 NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRESS v SA_'�. OWNER NAME/NAME OF BUSINESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S MAILING ADDRESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP AP RW Permitp.,=." 0 1 Dina 0 _A &T '�w EXISTING — PROPOSED Street Use Permit Req'd Inspect] n Required 13 CITY ZIP TELEPHONE REQUIRED DEDICATION— Fr Sidawalok Required 13 Underground Wiring required 13 NAME METER SIZE LINE SIZE NO. OF FIXTURES RV REQUIRED YES 13 NO 13 ADDRESS REMARKS z z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE F3 rITY. ZIP ITELEPHONE NAME CB L ENGINEERING REVIEWED BY DATE ADDRESS PjA ?—j 22_9 CC FIRE REVIEWED BY DATE CC 11: 0 CITY ZIP C�� IDA7nk- 1 /(; TELEPHONE 120-.o- -IRSL -7 VARIANCEOPICU SHORELINEORAD111 INSPECTION EQ'D 13YES' ONO PBOND OSTED S _L STATE LICENSE NUMBER EXPIRATION DATE FILCM 6 916EM . CUWAQ BY SEPA REVIEW COMPLETE I EXEMPT EXP' SIGN AREA ALLOWED , PROPOSED HEIGHT ALLOWED , PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. 19 417671) fil)1-2 IIVA14111? NEW VRESIDENTIAL PLUMBING / MECH COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE REMODEL MULTIFAMILY El SIGN LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR t;. . I il-11 PROPOSED SETBACKS (Fr.) FRONT L/R SIDE REAR z PARKING REO'D I PROVIDED L DATE A !T% FENCE REPAIR GRADING CYDS — X —FT) 0 REMARKS RE Uf OTHER DEMOLISH [Z�NK Pit, wry VAP GARAGE ci RETAININGWALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: C) t-c-cs M rig It /o k)l ki (0 NUMBER N CRITICAL UMBER OF ' OF WELLING AREAS %TORIES UNITS NUMBER CHECKED BY TYPE OF CONSTRUCTION CODE (72" OCCUPANT GROUP A — SPECIAL INSPECTION JAREA REQUIRED [:] YES OCCUPANT LOAD z DESCRIBE wbRK T ONE )OAQ _�Sln 4- REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION nru-u __Jac 1 bk(AIC7 Ak Aft 0 a WA V M-0h tA,ii_A-rkou (AL Z&N.K/ VALUATION IVII I 111111111kill" $ Descirlption FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE% Building permit city Surcharge Iq ECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Grading t: t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMITAPPILICATION: ISODAYS Engr. Review Engr. Inspection PERMIT LIMM 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 Plan 6h-k,*. Deposit IN INTEREST. AGREES TO INDEMNIFY, 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 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.- Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Recording Fee Receipt # I HEREBY 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 ' TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION -OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO CALL FOR INSPECTION APPLICATION APPROVAII This application Is not a permit until 5ignod by the Building Official or his/her Deputy: and Foos are paid, and receipt Is acknowledged In space provided. RANCE AND RCW 18.27. (4225) OFFICIALS SIGNAT)JRE DATE / 12, , IGN�TURE (OWNER O�G�N Ak kil, A , DATE S IGNEP I elm RfttA&D BY /DATE ATTENTION 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- 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 0 1 0 M --I -n 3: M M 0 -10 0 C: -4 C X M M Z 0 _TI n M M a V5 0 r- 0 M C (j) r. (1) Q 0 Z 7-1 X z CA z 0 1 0 M