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20030128.pdfCITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION ER-NAME/NAME OF BUSINESS.^-- NAME 7 D RESS —D cl NAME (11) ADDRESS CITY STATE LICENSE NUMBER Isk/ .EPHONE ZIP ITELEPHONE CBL N a -��> sseej USE ZONE JOB 7y ADDRESS F /& PLAT NAME/SUBDIVISION NO. PERMIT EXPIRES Z CZ�, PERMIT NUMBER SU TE/APT# LOT NO. LID NO. LID FEE S TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required Sit ot Use Permit Roq'd EXISTING PROi'OSED 1ns;LtJon Required [3 sidewalk Required E3 REO F1 wiring required C3 MET R UIPC L RUS-16--vintdc-i PRV RE( UIRED requi ed on Tuel-P jr.-Ang applIE neadn NO 13 ul REMA IKINnhCate(I SpaCeS. UMC 815.1'7-- z OWNE I/CONTRACTOR RESFONSIBLE FOR EROSION CONT��L/DRAINAGE , =3r— ENGINEERING V " __ ATC RegWiless of whether the water syster elv FIRE REVIEW. . Or I ' 115991, expansion taw are ZIP TEL PHONE I required on all hot water tanks per I AiNo Am 4 r.Fjpl IQ I A a A - q - VARIANCE ORPT--; rADMAP&MOrOAK-0 EXPIRATION DATE CHECKED 13Y SEPA REVIEW I SIGN AREA JUYES UNOj$ HEIGHT — NO. COMPLETE , EXEMPT I ALLOWED . PROPOSED I ALLOWED . PROPOSED 1:1 NEW TErRESIDENTIAL 1:1 ADDITION [:] COMMERCIAL 17 REMODEL 13 MULTIFAMILY 1:1 REPAIR 13 GRADING CYDS 1:1 DEMOLISH 1:1 TANK GARAGE CARPORT rl RETAINING WALL _ ROCKERY (TYPE OF USE. BUSINESS OR NUMBER NUMBER OF OF DWELLING STORI UNITS DESCRIBE WORK TO BE DONE M-ftnBING / MECH LOT COVERAGE ALLOWED PROPO 1:1 COMPLIANCE OR CHANGE OF USE [:1 PAR C�' SIGN REOD I R(g [3 FENCE I ( _ X FT) REMARKS1 13 OTHER F RE SPRINKLER F:RE ALARM CHECKED BY ITYPE CRITICAL _j AREAS SPECIAL INSPECTION NUMBE REQUIRED [3 YES f V '7 dd Z/ItZ f7li)ih.— , Z1,,114A 1",X uj W rL REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr.) _TI-3117f REAR AW ffFF -- Am a 0 t frm 1 4EUe turn] z 'TREA P'.ANNfnGNIV'E Y DATI . Sj1E D. 2W & LIS R& OCCUPANT GROUP j OCCUPANT LOAD VALUATION IWO. I IL W5.11 I I.W $ 1 Description FEE Description Plan Check State Surcharge REE0q"D 9 FEE HEAT SOURCE GLAZING % LOT SLOPE % I Building Permit City Surcharge c5. PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 1= a BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading t: SEPARATE PERMISSION. PERMIT Engr. Review APPLICATION., 180 DAYS PERMIT ILIMIM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK Engr. Inspection 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 ALL Fire Inspection Receipt # 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 Landscapelnsp. Total Amt. Due NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Recording Fee Receipt # I HERE13Y 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 APPLICATION APPROVAL 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 CALL This application Is not a permit until signed by the IN VIOLATI OF E LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building Official or his/her Deputy: and Fees are paid, and receipt Is acknowledged In space provided. 1. E TION INSURANfE AND RCW 18.27. 1A 5) 0 F;. D MINV TE /f DATE SIGNED ,It-, 1-12 10 771-022 / /1�" 7A #DA*TE RE EASED BY 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- ISPECAR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 OR�GINA E YELLOW - P NK NEn GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 q 0 IT! OM C M 0 -40 0 C --I C 3: rn M z g) -4 C _z Cn 0 _n n M M a 0 0 rn C 0) C 0) Q 0 Z X z -4 x 75 z 0 1 0 M RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing...................... wall........................... z Pier/Porch .................. Retaining Wall ........... Slab Insulation .......... PLUMBING: M Underground . ............. rn.0 __110 0 0 C Rough -In ................... Commer6ial Fln'al ...... M M HEATING: GasTest 10 z .................... e" - (7,3 CA Gas Piping ................. Equipment ................. IT! IT! Commercial Final ....... 0 Fn EXTERIOR SHEAT HING C NAILING .............. I .......... 0, RAM[NG ................ * ....... 'fIRST'FLdOR FAAMINd... ... . ........... Floor Insulation ......... Wall Insulation ........... z Ceiling Insulation ....... SHEETROCK NAILING ... IT! SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. V sop lolt4 M RECEIVED 1�;? CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNE"AME/NAME OF BUS!Mm�)_�,-- MA[iJNG ADDRESS CITY �LEPHONE TDIWOf2 NAME ADDRESS U CITY ZIP TELEPHONE NAME IOA&lge &rcll ADDRESS _�Wtlpv IM CITY ZIP TELEPHONE 0 STATE LICENSE NUMBER EX IRATION CBL N PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB ADDRESS E/APT# PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Id � EXISTI fm—B PF8jOrD Vent conn dV I Is- Inspection Required ON Required [3 13 E's*13_ REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ENGINEEF FIRE RE% Regardless of whather tile. wailief Isystww D g dosed, expapAign n"AT re requked on all hot water tanks pqr `bp Qp+q P`__,10 PWECFBY- DATE DATE I CHECKED BY i VARIANCE OR CU SHORELINE OR ADBO INSPECTION BOND REO'D POSTED 13YES ONO is SIGM A93CA HEIGHT WE PROPOSED ALLO PROPOSED t Ir i�,A Pe;; W LOI C&ON%W -IL'a, IR&SIjb)d8ftr �efflPOSED SE 'BACKS (Fr) Ek_gop JOSEI� C NEW 2rRESIDENTIAL ftl..P�BING / MECH ALLOW FRONT SIDE REAR ONT L/R! IDE REAR -W % z ADDITION [3 COMMERCIAL COMPLIANCE OR F1 1:1 CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE I [] REMODEL 1:1 MULTIFAMILY 1:1 SIGN REO'D I PROVIDED 11 REPAIR E] GRADING CYDS [3 FENCE ( FT) REMARKS DEMOLISH 1:1 TANK 1:1 OTHER GARAGE RETAININGWALL ci F RE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS 0 N: gsl.�rlf CHECKED BY TYPMM�� C47 OCCUPANX,� Ile GROUP NUMBER OF N BER F UM LL 0 DWE NG CRITICAL AREAS SPECIAL INSPECTION AREA OCCUPANT LOAD STORIES UNIT NUMBER REQUIRED [:] YES DESCRIBE WORK TO BE DONE PIPE TES 13 -S 'PRO T MWIM 1 fill I 9 INSPECTION REQ'D 9 in 5 (004 )a IAII (215 / f)IJ01''hic - kom WM V) C/ -_ ... VALUATION $ Description . - 11 CLI FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge CHECK NO: VESTED DATE Plumbing q 0. 4, Mechanical A), THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO h BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC Grading OMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPILICATION: ISO DAYS IL 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, A13REES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF 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 Landscapelnsp- Total Amt. Due 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., Receipt # Recording Fee 1 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 This application Is not a permit until signed by the THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC CALL Building Official or his/her Deputy: and Fees are paid, and TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLAT LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged In space provided. WORKME;�ATION INSURANfE AND RCW 18.27. OFY-191 61_6NAT DATE SIGNAT I WNER R AGEmK DATE SIGNED IA95) %_r1_ 771-0220 'RETEASED BY / DATE/ A717TENTION V Off 11333 _4� 1 "i IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL-�VLE YELLOW-4SPECi0R CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK-eftER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 1711 M C: M 0 0 C: � C 1711 1711 z ca 0 -n A M M 0 vi 0 0 Fn a (j) M co M 0 z z z 0 ITI