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20030085.pdfCITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION - ��je TELEPHONE Zip 2L V REMARKS RACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE d - OWNERICONT A-e - W . '*3040 ZIP " ITELEPHONE e2Q :2-0-4, - - 9 I!Z 7 ItCBL # Do SS CC A CIrfi7 zip TELEPHONE 914,-7 /STATE LICENSE NUMBER EXPIRATION OAT CK A/, 0 L A, 0) 9- r- 3 7 9A1- O� , 9 )F;U� , I PROPERTY TAX ACCOUNT PARCEL NO. NEW RESIDENTIAL ADDITION i(COMMERCIAL REMODEL MULTIFAMILY REPAIR 0 GRADING CYDS DEMOLISH 11 TANK oGARAGE CARPORT [3 RETAINING WALL ROCKERY OF I DWEELING STORI�S I UNITS OEI(ChIBE wok To HE DONE /7 1L__1 FIRE REVIEWED BY DATE _7 PERMIT EXPIRES _ 2 1 ' USE PERMIT ZONE Ilia NUMBER, ZCO22 'CV0 iC- r - I� JOB q f Z SUITVAPT# A2a _62�( PLAT NAME/SUBDIVISION NO. LCIf NO. -LID NO. LID FEE S TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Rertuirod Street Use Permit Req'd EXISTING — PROPOSED Inspection Required Sidawatit Required REQUIRED DEDICATION— FT UnderWound witirigrequired METER SIZE LINE7si_zr --- 7NO OF FIXTURES PRV REQUIRE NO 13 15 Z VARIANCE OR CUI SHORELINE OR ADB11 I INSPECTION 1. BOND REO'D POSTED 13YEs 13NO SEPA REVIEW SIGN AREA I HEIGHT COMPLETE - EXEMPT I ALLOWED . PROPOSED ALLOWED . PROPOSED III CC rL LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) POOLU—M OP0 BING / MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE REAR I COMPLIANCE OR 2 CHANGE OF USE I PARKING LOT AR PLANNING REVIEWED BY DATE SIGN REOf PROVIDED I I I E FENCE l ( — X—FT) REMARKS OTHER F RE SPRINKLER FIRE ALARM I A CHECKED BY OF CQNSTRUCTION CO� OCCUPANT ITYPE -r rV e f1r) I AW 7 GROUP B ICAL U _ AREAS SPECIAL INSPECTION AREA OCCUPANT NUMBER REQUIRED [] YES LOAD GLAZING % LOT SLOPE % REMARKS I PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REG'D lm�fi . I A e_jl, $ 1 - Description FEE Description FEE Plan Chec,k State Surcharge t3unuing Permit .— uutf. PLAN CHECK 1:2 ffa VESTED DATE Plumbing. 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 a TC.) WILL REQUIRE DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. E SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 160 DAYS PERMIT LIMM I YEAR -PROVIDED WORK IS STARTED WITHIN 180DAYS 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 Landscapeinsp. Total Amt. Due 9 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.* X. Recording Fee Receipt # I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL - AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF GIVEN IS CORRECT. 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. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. �FIF GNA 8 E (OWNER DATE SI NED 1A039 %-WA65) 771 -02,20 RELEASED BY ATT EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I it 1 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGIN�L�-F E YELLOW !INS4CTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK- NER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING SEEM z 0 IT! M C M 0 C M M ,0 C 0 _n n A rn 0 0 Fn C 9)) C M C) CO) z 0 4 0 M a RECORD 0 F INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ...................... FOUNDATION: Footing...................... .. Wall........................... . Pier/Porch ................. Retaining Wall ........... Slab Insulation ........... PLUMBING: Underground .. ......... ------------------- Rough-in ................... ---------- Commercial Final ...... N6 HEATIN G: 10 Tdst C Z ..................... --Equipment .............. do ni m erqial Final, ca 'EXTERIOR SHEATHING NAILING..... ................... . 'FRAmING ........................ FIRST.,FLO -OR FRAMING_', ATI ..... ! S ON I L N U �Floor Insulation ........ ........... Wall Insulation.' ------------------- Ceiling Ihsulailon ....... 0 S ETROCK NAILING ... HE SPECIAL INSPECTION ... mISCELLANEOUS .......... ------------------- -'03 FINAL AP PROVALFOR OCCUPANCY� .................. ATE REC:EIVE2D,. CITY OF EDMONDS FCONSTRUCTION PERMIT APPLICATION I Me 114: V. WW 000—M. TELEPHONE � Me WOM TELEPHONE CITh .00, ZIP I TELEPHONE A/�; LICENSE NUMBER TAX 1� IPERMITEXPIRES USE PERMIT ZONE _Coo 5"" NUMBER, JOB SUITE1APT#X ADDRESS zgg,_�n PLAT NAME/SUBDIVISION NO. LOf NO. 10 No. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP APP(oved RW Parrilm Requ:fed Street Use Form t Req'd EXISTING — PROPOSED InBpectlon Required Sidewalk Required REQUIRED DEDICATION— FT Undarorvind Wirlrlgrequlmd 13 METER SIZE LINE SIZE NO. OF fjXTURES PRVJEQUIRED 7 YE NO C3 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE 0 NEW [j RESIDENTIAL WLUMBING/MECH ADDITION OMPLIANCE OR WCOMMERCLAL CCHANGE OF USE REMODEL MULTIFAMILY SIGN REPAIR GRADING CYOS FENCE 0 ( x FT) DEMOLISH 1:3 TANK E] OTHER oGARAGE RETAININGWALL FIRE SPRINKLER 0 CARPORT ROCKERY FIRE ALARM USE, L�GINE R A IV !rLAJN: X7, Nume NUMBylk Oft CRITICAL OF OWE ING AREAS STORIES UNITS NUMBER #11BE WO& TO 49 :C.&n see 1h . j — I f ..L— . I -A ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE Id VARIANCE OR CU SHORELINE OR ADIW INSPECTION BOND REO'D I POSTED I 0YEs ONO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP I , I LOT COVERAGE REQUIRED SETBACKS (FT:) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR PARKING REVIEWED LOT ARE97LZ;NING REO'D I PROVIDED I BY IL CHECKED BY ]TYPE OF C NSTRUCTION I A) iFA cc OCCUPANT GROUP SPECIAL INISPECTI DN REQUIRED YES AR A OCCUPANT LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D M1_.Jl I L -A o VALUATION' Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SL I OPE % Building Permit City Surcharge PLAN CHECK N VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORUXS ONLY T14E WORI 'RUIT COVERS WORK TO t BE DONE ON PRIVATE PROPERTY OHLX ANY CONSTRUCTION Old THE PUBLIC 2 Grading DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE :3 INVI SEPARATE PERMISSION. Erigr. Review PFRiMITAPPILICATION: 111210 DAYS PERMIT LIMM I YEAR - PROVIDED WORK 15 STARTED WITHIN 160 DAVS 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 EDMONDS, WASHINGTON,L ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire. Inspec`t!1on%0, Receipt ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY FROMTHE ISSUANCE OF THIS PERMIT ISSUANCE*OF THIS PERMIT 914ALL NOT BE I.And6po IiIsp. Total Amt. Duo DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROY ....... eeWeeee Recording Fee Receipt # 1 HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT; OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL AND THAT I AM THE OWNER. THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a permit unfit signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building OMeW 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 acknovdedged In space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. 0 DAT /1IGN"E (OWNER PR71�Vt DATES[ NED -.0 T j IAO X-25) J�FF WGINA I A --x-. b 771-0220 RELEASED BY DATE ATTENtIdN EXT 1333 4, A Ll. _.1/ .4 L* I IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGIPJAL-FILE YELLOW -'INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINO-O�NER 'GOLD -ASSESSOR 04/02 GREEN - ACCOUNTING PRESS HARD -YOU ARE MAKING 5 COPIES z 0 rn rn C= M 0 C -1 r. rn M 10 z -n E2 r. MITI 0 0 Fn C co) C 0) M 0 z z z 0 M