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20030126.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS PERMIT EXPIRES USE PERMIT ZONE 2 NUMBER _av JOB SUITE ADDRESS so v� nf�on PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS LID FEE$ TESCY Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Rw pertnit Required 6,c� Street Use Parrrnft Rsq'd CITY ZIP TELEPHONE EXISTING — PROPOSED inspection Required squired UndorWound REQUIRED DEDICATION— FT Wiringrequil(od 13 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES C3 NO 13 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE —F-LEPHONE CITY ZIP NAME CBL# n k,5 1,A/ 0�t I to 5 ENGINEERING REVIEWED BY DATE jl, a ADDRESS f q0-601 F, —1 FIRE REVIEWE DATE MUST BE PRESENT FOR 91.1 W TELEPHONE SEM(Wal - OR CAP ME VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND STAYE'UCENSE NUMBER JF EXIIRATVDN DATE CH REQ'D POSTED 10YES 13NO K (5 W05 co SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCO PARCEL NO. 'TE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED I , , EXP LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) NEW RESIDENTIAL PLUM13ING I MECH ALLOWED PROPOSED A FRONT SIDE REAR FRONT LIRSIDE REAR COMPL ANCE OR ID ADDITION COMMERCIAL El CHANGE OF USE PARKING LOT AREA PLANNING REVIEW ED By DATE REMODEL MULTIFAMILY SIGN REO'D PROVIDED REPAIR GRADING Ei FENCE CYDS X FT) REMARKS DEMOLISH TANK OTHER A GARAGE RETAINING WALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: 51��'OCCUPANT CHECKED BY ITYPE ges icte GROUP NUMBER NUMBER OF CRITICAL SPECIAL INSPECTI OCCUPANT OF DWELLING AREAS ON'JAREA &* U LOAD STORIES Z NITS NUMBER REQUIRED [] YES DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC IGO/FINAL INSPECTION REO'D e4 00-19 VALUATION gm14 $ V Description FEE Description FEE Plan Check State Surcharge p I HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORGMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. AM CONSTRUCTION ON THE PUBLIC Grading X DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: ISO DAYS PERMIT LIMM 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 a EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # ALL 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 DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE E2c NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' .1eil-111 Recording Fee�l Receipt # :�&ZQLL I HERE13Y ACKNOWLEDGE THAT I HAVE READ rlIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN 13 CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CnY 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 L6404_CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided. WORKMEN'S COMPENSffM. IN)URANCE AND RCW 18.27. OFf&IA . S)GNA)IJR TE NATURE (OWNER AGE ED 03 (425) 71 wim ITSI 02 AM 771 -042,20 RELEASED BY DATE' ATTENTION M 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 FINAL PROJECT APPROVAL FORM TO: DATE: MEMOTO: PER.Wr COORDINATOR, BUILDING DIVISION FIRE DEPARTNMNT D FROM KRAnsom 0 z 9 0 m =i =n- m m 0 0 80 c M m 14 z 0 -Ti n � � ic m m 0 vi 0 o Fn C (n ic co) M 0 Z .q� M z co z 0 m RECORD OF INSPECTIONS M q m m Pv ......'Wall Insulation ........... . 'Ceiling Insulation ....... SHEETROCK NAILING SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR -76210 "10 OCCUPANCY .................. 4 ... ..... ... 7 RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS The r soV)n,<:-an MAILING ADDRESS oz-11-3 CITY TELEPHONE NAME ADDRESS CITY ZIP NAME I CBL ADDRESS 08 19,9::61 q0`6, 01 CITY ZIP TELEPHONE So I 1"A (��t -el M W STANE'LICENSE NUM13ER Eljl�r65E -Iar,�s,o-vco I KjF 5 NEW t A RESIDENTIAL PLUMBING / MECH ADDITION COMMERCIAL COMPLIANCE OR CHANCE OF USE REMODEL MULTIFAMILY SIGN 0 REPAIR GRADING CyDr FENCE X FT) DEMOLISH TANK OTHER GARAGE RETAJNINGWALL FIRE SPRINKLER 0 CARPORT ROCKERY FIREALARM UWE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: ges icte k, +1 k"e NUMBER NUMBER OF CRITICAL 0 OF DWELLING AREAS ILA_ STORIES LIN ITS NUMBER DESCRIBE WORK TO BE DONE 71 HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: VESTED DATE ....... sess" THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMffAPPUCATION. ISO DAYS PERMIT UMrr I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE 13ACK 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 MATURE, 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 I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORREC-11 AND THAT I AM TH4 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 L&BGQkCODE OF THE STATE OF WASHINGTON RELATING TO WORKMENS COMPEN 111!�URANCE AND RCW 18.27. SI W�IEARAG!W RE (0% DATE SV3NED 111 102, PERMIT EXPIRES USE PERMIT ZONE a4w NUMBER JOB sunfjAPT# AD DRESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP I Lbtor APR; -- RW Permit Required Street Use Permit Raqd EXISTING — PROPOSED inspection Required Sidewa* Required REQUIRED DEDICATION— FT Underground w—U. ed CI METER SIZE LINE SlZi NO, OF FIXTURES PRV REQUIRED YES 1:1 NO 13 z REMARKS I OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE 11 ENGINEERING REVIEW Y ...' " 'w' If As- DATE TvMST BE PRESENT FOR FIRE REVIEWED BY VARIANCE OR CLI SHORELINE ORADB11 INSPECTION BOND REO'D I POSTED 13YEs 13NO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMP T ALLOWED PROPOSED I I ALLOWED PROPOSED EXP , i , LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR BY DATE PARKING LOT AREA PLANNING REVIEWED 9L REQ`D I REMARKS CHECKED BY SPECIAL INSPECTION REQUIRED [] YES OCCUPANT GROUP OCCUPANT LOAD REMARKS 12 PROGRESS INSPECTIONS PER UBC IGO/FINAL INSPECTION REG'D $ 1 - 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 # Landscapielnsp. Total Amt. Due Recording Fee T_ lRecelpt # CALL FOR INSPECTION 1AID APPLICATION APPROVAL This application Is not a pennit un6I signed by the Buliding Omcial or Woor Deputy: and Fees are paid, and receipt is acknowledged in space provided. 0 [A .ERQ7 ;;�ATE � 7GR - �' I.L-Q � .1 - 1) () 1) -) 1-022U -RELEASED BY ATT NTION EXT 1333 IT IS UNLAWFUL�TO USE OR OCCUPY A BUILDho�3,OR aTRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES - ---------- ORIGINAL-FILE YELLOW -INSPECTOR PINK -OWNER GOLD -ASSESSOR GREEN - ACCOUNTING z M M N' 0 C :1 C M M 0 n 5� 1 M M 0 0 0 M IT11 01 z 9 0 M