20030145.pdfDATE
131, PERMIT EXPIRES
USE PERMIT
CITY OF EDMONDS ZONE NUMBER ZtL.,y2—()j Ltt3_
JOB SUITEIAPT#
CONSTRUCTION PERMIT APPLICATION ADDRESS 595 79 A W.
iR NAMEMIAME OF BU1131NESS '2e
MAILING ADDRESS
e
CITY
'""m OAJDS 2
NAME
ADDRESS
CITY
NAMrlp'4
ADDhESS
CITY
STATE LICENSE NUMBER
ZIP ITELEPI
ZIP
ZIP I TELEPHONE
NO.
PLAT NAME/SUBDIVISION NO.
LOT NO.
LID NO.
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Ap
11w Psrmft=od
lusat Use Permit Req'd
EXIST:NG — PROPOSED
Inspection Required
Sidewalk Required
REOU RED DEDICATION— FT
Undsrground
c773T
Whing requhrad
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
I
I
YES 13 NO C]
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE
CBL 0
CHECKED BY
NEW
�CFRIE SIDENTIAL
—". MECH
et
ADDITION
COMMERCIAL
COMPLIANCE OR
OF
�<REMODEL
MULTIFAMILY
CHANGE USE
0 SIGN
REPAIR
GRADING CYDS
[] FENCE
FT)
DEMOLISH
TANK
OTHER
[3 GARAGE
RETAINING WALL
0
FIRE SPRINKLER
FIRE ALARM
CARPORT
ROCKERY
(TYPE OF USE. BUSINESS OR ACTIVITXL
jM
---I
NUMBER
OF
NUMBER OF
DWELILING
CRITICAL
AREAS
STORIES 4""
UNITS
NUMBER
DUCHISE WORK TO
BE DONE
01 1A MJ&fJ4
LOT SLOPE %
BY DATE
FIRE REVIEWED BY DATE
I Log:
VARIANCE OR CU
SHORELINEORADB11,
INSPECTION
BOND
REO'D
I I
POSTED
13YEs 13NO $
SEPA REVIEW
-SIGN AREA
HEIGHT
COMPLETE
EXEMPT
ALLOWED
PROPOS ED
ALLOWED
PROPOSED
EXP
I
I
I
,
LOT COVERAGE
REQUIRED SETBACKS (Fr.)
PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT
LIRSIDE REAR
PARKING
REO'D I PROVIDED I
LOT AREA
I PLANNING REV=6ED BY
DATE
1116
I
40-111K,
CHECKED BY
TYPE OF CONSTR Cr#ON
Ogk
JC�f
OCCUPANT
GROUP
_'�
SPECIAL INSPECTION
OCCUPANT
REQUIRED
JAREA
LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC 1109/FINAL INSPECTION REaD
1AIA0 P1'4Aftf'0_ An JOU jln L Aoo 4.o AJ_ i e zo . -it^ 11,g 9
$ "Wo
Description FEE
Plan Check
Building Permit
Description
FEE
State Surcharge
Al. SV
City Surcharge
_G" 44P
PLAN CHECK NO��._&S
VESTED DATE
Plumbing
5V
I
Mechanical
sp
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
!74P'W
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC
Grading
DOMAIN (CURBS, SIDEWALKS, ORNMAYS, MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPILICATIOW. 180 DAYS
PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 100 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
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
I
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMrr. ISSUANCE OF THIS PERMIT SHALL NOT BE
Landscape Insp.
Total Amt. Due
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
kNCE
.064,
NOR LlMrr IN ANY WAY THE Crr1rS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
-1
— —
Recording Fee
Receipt At
I HERESY 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 histher Deputy: and Fees are paid, and
IN VIOLATION OF THE LA13OR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
receipt Is acknowledged In space provided.
WORKMEN-�,�SATIOYINSUR*,�CE AND RCW 18.27.
OFFICIA���E DATE
SIG �rR��
DATE Sit
WWNEIRI
7-;-
�N;ED
�;Mj
771 -0220
'fiE
DATE
rlzw
ATTENTION
M 13133
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
04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
z
0
4
0
am
C
ms
Z-1
30
C
m
m
10
a
0 _1rl
5n! I
M m
C
r. 9
M C)
z
i!
Vi
z
0
m
CITY OF EDMONDS
121 5TH AVENUE NORTH -EDMONDS. WA98020 - (425) 771-OM -FAX (425) 771-mi
Website: wwdedmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
DI nnin 9 A"Urfin a Pnnineerinn
C. 189", Q to to
Janu ary 7, 2003
Alan Hardwick
20525 78th PI W
Edmonds, WA 98026
Dear Mr. Hardwick,
GARY HAAKENSON
MAYOR
This letter is to inform you that we s n d plans submitted with yo pe t
till ee ur r1ni
ew
th
and approve your remodel project at e above
order to revi
application in
address. Please see the enclosed list of requirements needed to submit. If you
have any questions, please feel free to call me at 425.771.0220 o eannine Graf,
If we do not
Building Official. Please submit all required materials by,�,(
lete application by this date unfortunately I will have to turn this
receive a comp
enience that
over to code enforcement for resolution. I am sorry for any inconv
"d
this may cause you but we must adhere to the same code standards for all to
ensure fair and equal treatment of all citizens.
Sincerely,
Lara Palma Pr
Development Services Division
City of Edmonds
425.771-0220 ph
425.771.0221 f
Incorporated August 11, 1890
Sistpr 0tu - HpkinAn Ipinan
. % I - . , , .- , , '. .! - , "Id?.
-j*4
A
RECORD
OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
.......... .
FOUNDATION:
Footing ....................
Wall.....................
Pier/Porch .................
Retaining Wall. ...........
Slab Insulation
..........
PLUMBING:
Underground .............
Rough -In ......... ..........
Commercial Final, ...
HEATING:
Test
Gas . ....................
%Gas Piping .................
Equipment .................
na ......
Commercial FI I'
EXTERIOR SHEATHING
NAILING.........................
w
FRAMING ... ...............
;.f.
F S OR FRAMING...'
IR T FLO
INSULATIOA�� .................... ..
Floor Insulation .. .........
I s Idtlon ...........
Wall 4n u
.,calling Insulation .......
SHEETROCK NAILING
SPECIAL INSPECTION ...
mi;�C.ELLANEOUS ..........
FINAL.A PPROVALFOR
OCCUPANCY ...................
..........
I
DATE RECEIVfD
101 PIRES
asa,�J�/. Q I PERMIT EX
USE PERMIT _7
ZONE
-C11Y OF EDMONDS NUMBER
JOB SUITE/APT#
OW CONSTRUCTION PERMIT APPLICATION ADDRESS t:9.5 7 �? 10L
,4R NAMEINAME OF BUPINESS
/ L I i / /A /) X. / I .- , / PLAT NAMEISUBDIVISION NO. 0. LID NO.
&_/t/
MAILING ADDRESS
t196,
CITY ZIP TELEPHONE
LOMOA/40 S 170 , D/
NAME
ADDRES.S
CITY
41.,
ADD
CITY
STATE LICENSE NUMBER
ZIP ITELEPHONE
ZIP I TELEPHONE
NO.
NEW
�CRESIDENTIAL
ADDITION
COMMERCIAL
�CRIEMODEL
ri MULTIFAMILY
REI�AIR
GRADING
CYOS
PEM.OLISH
TANK
0 GARAGE
RETAININGWALL
0
CARPORT
ROCKERY
UWE OF USE, BUSINESSOR ACTiV"
NUMBER
NUMBER OF
OF
'STORIES
DWELLING
UNITS
DfPCRIBE WORK TO BE DONE
rzz:�7 - 11VA �* dz� r -y' I - I A < Lj —
Ac. r, P�f'v� &NA (Mf)At-
HEAT SOURCE GLAZING %
PLAN CHECK NO'
THIS PERINSIT AIMAORMS ONW THE WORK N
CBL 0
DATE I CHECKED BY
tw_�� �Bl MECH
COMPLIANCE OR
CHANGE OF USE
SIGN
FENCE
( X FT)
OTHER
EF RE SPRINKLER
] FIRE ALARM
I
LID FEE $
PUBLIC I
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TeSCP Approved
RW Pamilt Required
Street Use Peffnit Rocfd
XISTI
EXISTING — PROPOSED
Inspecdon Required
Sidewalk Required
REQUIRED DEDICATION— FT
OU E
rREMARKS"
Underground
I vvmng reqw—
ETER SIZE
M M R
T
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED 13
I
YESE3 NO 13 9
M
Z
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE
OW IC
REVIEWED BY DATE
FIRE REVIEWED BY DATE I 101"C'
VARIANCE OR CU
SHORELINE Oil ADB,1
INSPECTIO? '
D
REO'D
I
I PBOOSNTED
OyEs 13NO
S
SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE EXEMPT
^W)NED PROPOSED
ALLOWED PROPOSED
:_XP ,
,
,
LOT COVERAbE
REQUIRED SETBACKS (Fr.)
PROPOSED SETBACKS (Fr.)
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT LIR SIDE REAR
BY DATE
PARKING
1
LOT AREA
PLANNING REVIEWED 06
REO'D I PROVIDED
REMARKS
CHECKED BY TYPE OF CONSTRYCTION Co �,.00CUPANT
GROUP ry 2-
CRITICAL j I ft - . 1/1-7%/ 4
AREAS SPECIAL INSPECTION JAREA OCCUPANT
NUMBER REQUIRED YES," LOAD
JA I A ki b" REMARKS
t PRO63RII56 INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D
R A 4_-r 4o f - dw,
VALUAnON
A in I
06scription
ADATE
FEE
Description
FEE
Plan C
State Surcharge
LOT SLOPE % Building P , armit
VESTED DhImininn
Cit� Surcharge
-!91. 00
I -
I '
Mechanical
OTED. THIS PERMIT COVERS WORK TO
BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURBS, SIDEWALICS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: ISO DAYS
PERMIT LiMir I YEAR - PROVIDED WORK 16 STAMED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICAW, 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, 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 C17Y ORDINANCE
NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.,
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
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Building Official or his/her Deputy: and Foos are paid, and
receipt Is acknowledged in space provided.
WORKMENIS,�SATIOYINSU�CE AND RCW 18.27.
A S "E DATE
OFFICI LS
S107 WNER,"R GE
DATE S15NED
14-25)
1 "-. _*1 n
_;;, �Ir
771-0220
tk fiv Z DATE
PSED
MENTION
EXT * 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A'FINAIL 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
z
0
4
0
M
M
C
M8
-40
0 C
�17111
IT11
0 _n
M M
F,
C ca
IT! 0
z
0
IT!