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20030165.pdfCITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEMAME OF BUSINESS fP1.46 A./PS � Con 1- 4 C MAILING ADDRESS -P.0 Zcix,16-43 CITY "P '69MOND.5 Q % 6 NAME I CIL )7.d�- IAIC %*?Vl PERMIT EXPIRES USE PERMIT ZONE NUMBER e� 003 — 0 ( (0� JOB SUPTIAPTO ADDRESS.3o7 3a NAMVSUBDWISION NO� LOT NO. LID NO, 11. FEE API —I PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING — PROPOSED REQUIRED DEDICATION— FT METER SIZE I LINE Sl�� PRV REQUIRED YES E3 No 13 ARKS --l—T..— .111ONSIBLE FOR EROSION CONTROUDRAINAGE FIRE REVIEWF D By DATE CITY ZIP AA IT To//,> ITELEP"ONE VARIANCE OR C RE7 j 61 N S P ED 0 N YES D H 0 R E L1 :�O A :�D ONG BOND POSTED IS STATE LICENSE NU1JXR EXPIRATION DATE y M.r-m' L SEPA RW COMPLETE EXEMPT rS# N A� ALI, I OWED , PROPOSED HEIGHT ALLOWED PROPOSED IRCCUTry/ACCO PARCEL NO. I'll 1Z EXP NEvv RESIDENTIAL PLUMBING MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR ED S ETBACKS (FT) PROPOS LIR SIDE FEAR FRONT AOPITION COMMERCIAL C MPLIANCEOR CHANGE OF USE *LANNINGREVIEWEDBY PA KING LOTAREA DATE RECro PROVIDED F&ODSL MULTIFAMILY SIGN REPAIR ORADING CYBS ( X FT)) EMARK$ DEMOLISH TANK OTHER 1:1 — 03"GARAGE RETAININGWALL [3 F RE SPRINKLER CARPORT. POCKERY FIRE ALARM -FWE —OF US&13USINESS OR ACTIVITY) EXPI.Aft 'I-ECKEb By TYPE 0 C C OCCUFANT T;? M L ORO Up -NUMBER UMBER OF I CRITI 'AL AREAS S'ECT'7-� AREA ccUlAMI OF DWELLING U STORIES MITS NUMBER ECUIHLD Y. LOAD W 7C9a",440R40f?Eij1E4L SIPP di!5 7-2 &4:� ARKS ROGRESS INSOEC C 1081FINAL INSPECTION REOT TIONS PER U13 ka 4C., VfAl-r AAA!�Nq) , rvA'i?12t j ,,rAZA4CFYi1Ac1:5'� $ 1 1 Delcription F . EE Descirlptlon FEE a C l State Surcharge LOT SLOPE ui'QiP' Permit City Surcharge vor PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS pE,eUT AUMOFIktE8 ONLY ME WORK NOTED. MIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PIT OPERTY ONLY. ANY CoNSTRUCTION ON THE PUBLIC Grading 00"N (CURBS, SIDEWALKS, DRIVEWAYS "ROUETS, UTC4 Yfl� REQUIRE SEPAFMT.PERM;SStONI. PERMITAPPLICATION: IWOAYS PER3JUTUMTTiYEkR-PROV1 EDWOMKISISTARTITCOWDIHIN IBODAYS SEE BACK OF PINK PERMIT FOR MORE INFORM ATION Engf. Inspection File Revi— Plan Chk. Deposit CANT�� ON BEHALF F HI OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS �APPLI S IN INTEREST AGREES TO NDIMNIFY. DEFEND AMD HOLD HAR LEIS T E CITY OF Inspection Receipt # EDMONDS, WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS MO. ANY AND ALL CLAIMS FOR DAMAGES OFWHATEVER NATURE. ARISING DIRECTVYOR INDIRECTLY Fire FROM THE ISSUANCE OFTH11 PERMIT. IIIIIAHCIOFTHIIPER TIWALLNOT BE M'C SH Landscape Insp. Tota DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ORDINANCE NOR LIMIT IN AM WAY THE CIWS ABILITY TO ENFORCE ANY ORDINANCE F.— — —E�EE�� # Recording Fee Receipt I HEREBY ACKNOWLEDGE THAT MAY READ TH S APPLICATION� THAT THE INFORMATION APPLICATION APPROVAL OW GWEN 19 CORRECT. AND THAT AM THE ME OR THE DULY AUTHORIZED AGENT OF � Thl-pplic,tion 1, mli unfil sIgned by THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- EMPLOYED CALL 1,11d1,,g_*'P I.. hjfhD.p,,,y.wdF .. ... p.1d, 'rId P TION: AND IN DOING THE WORK AUTHORIZED THEREBY. NO ERSON WILL BE THE STATE OF WASHINGTON RE,_ATING TO P_d. d It. 1, � FOR INSPEC ON PH'. Ott IN VJOI-ATION OF THE I-ABOR CODE OF WORKMENS COMPEN:;!=NC 2 No RC 18 27. Olt(ICIALS SIGNAt DATE DATE SIGNED -bS 1 771-0220 RELEAS DATE A-rTENTIOIQ EXr 1333 -5"� IT IS UNLAWFUL TOL USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERT0� 0 CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK.OVNER - GOLD -ASSESSOR .CC Wann.Vnii I Apr AAAlelMr r.nojr gor DREEN-ACCOUNMING 04/02 M IT 0 0 M M 0 IT M M C) 0 0 C M 0 z M rj) z 0 0 IT! 'M RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... Wall.......................... Pier/Porch ................. 3, Retaining Wall ........... Slab Insulation .......... M P LUMBING: M Underground ............. Rough -in ................... IT! Commercial Final R C z HEATING: GasTest ..................... Gas Piping ................. Equipment ............ Commercial Final EXTERIOR SHEATHING NAILING .......................... C, FRAMING ...................... FIRST FLOOR FRAMING INSULATION ................... 71 Floor Insulation Wall Insulation ........... z Coiling Insulation ITI K SNEETROCK NAILING SPECIAL INSPECTION if MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .............. ,j I ();� I N,,,x I PERMIT EXPIRES "U" ERM T CITY OF EDMONDS ZONE NUMBER,�00,�? -1 —01( CONSTRUCTION PERMIT APPLICATION jo SUMAPT# 1111E11_307 I�INISI .3E/ FLAT NAMEJSUBDNISION NO, LOT NO, 110 NO, 00,0 MAILING ADDRES LID FEE S PUBLIC RIGHT OF WAY PER B11ICIL STREET MAP 3 ------ CITY EXISTING — PROPOSED - :;-ZIP [TELEPHONE REQUIRED DEDICATION— FT — 9 NAME METER SIZE LINE IIZI 10, 01 FIXTU111 PHI REQUIRED I YES 13 NO E3 REMARKS WNERICONTRACTOR RESPONSIBLE TO. EROSION CONTROLIDRAINAGE CITY ZIP ITE-PHONI NAME A4C--r,44_<+fj-rd�' JAIC jCBL Iq RGINEEBIN.RE.�- D BY IATE AD;E11 1.7"'/ 57 FIRE REVIEWED By DATE CITY ZIP TELEPHONE Q AA 4-r C/ ? 0 4->, ow., - '��'z -_3 N WIND STATE LICENSE NUXTR EXPIRATION DATE -RIANCE OR CU HORELINE OR ACBM INSPEC'n HE v I POSTED 7 _ -r,4 xwl' Vler _'S. <I 'S — [1yES EINOL - HEIGHT , 'r g 4 PR(V."TlrrA//ACCO NT PARCEL NO. 0 SEPA REVIEW COMPLETE EXEMPT BICH AREA AILO WED PROPOSED ALLOWED PROPOSED I LOT /2, dl,3 V00 ��O /-Z 04 0 EXP RESIDEIMAL [2rpLUIABINGIMSCH LOT COVE E ALL ED PRAGOSED Nor REQ ISED SETBACKS (FT) PROPOSED FRONT SIDE REAR FRONT SETBACKS (Fr.) IJRSrDE NEAR ACqiBON COMMERCIAL C MPLIANCE OR CHANGE OF USE N_0AODEL gr MULrIF"Iuy SIGN PARKING LOT EA LANNING REVIEWED REUD I PROVIDED GRADING CYCS o FENCE 0 REPAIR x Fri REMARKS 111ow r.Tr:n 0 DEMOLISH TANK OTHER LIJ [jfG&RAGE RIETAINING WALL o .3 SPRINKLER CARPOPrr. "'C�' AEALARM (TYPE OF US&13USINESS OR ACTIVITY) EXPILAIN: CHIECKEDBY ITYPEJj�!r1ION OCCUPANT I GROUP NUMBER NUMBER OF cI OF .E11IN. <3 AREAS 'RmCAL ECIALIIIIECT.N [AREA � STORIES UNITS / HUM E APEOURRED [:]YES 21 REaD FA <54 AS -0 FU N-A/4 CFY, $ Description FEE Description FEE Plan Check State Surcharge GLAZING % LOT SLOPE Building Permit city Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical 'THIS PERMIT ALTRORMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t- BE DONE ON PRIVATE PROPERTY OHM ANY CONSTRUCTU314 ON THE PUBLIC Grading 2 00 GUIRE 3 MAIN (CURDS, SIDEWAtK(S. DRIVEWAYS, MARQUEES, ETC.) WILL BE t: SEPARATE PERMISSION. Engr. ReView 2— PmurrupucAnON: 1WOAYS PERMIT LIMIT. I YEAR - PRO%nDED WORK IS STARTED WITHIN 1W DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORIANNON NBENA11, F HIS OR HER SPOUSE. HEIM. ASSIGNS AND SUCCESORS `APPLICANT' ON DEHAL" RIG Revim Plan Chk. Deposit IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF ITS OFFICIALS, EMPLOYEES. AND AGENTS MOM ANY AND Fire Inspection Receipt EDMONDS, WASHINGTON ' ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMff. ISSUANCE OF THIS PERIAff SHALL NOT BE Landscape Insp. To,., .1 DEEMED TO MODIFX WAPVE OR REDUCE ANY REQUIREMENT OF ANy CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE '--- Recording Fee Receipt It 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPUCATION; THAT THE INFORMATION APPLICATION APPROVAL GIVE 0 CORRECT, AND THAT I AM THE OWNER. ORTHE DULY ALTNONIZ'EDAGENT OF C C_ ONSTRU "d u THE OWNER. I ACRE TO COMPLY WI ULAT E I Ay— NO PERSON WILL BE EMP CALL .�'Thi.I,pplkauo WIng OffidI .,.d*. d TION; AND IN DING WORK AUTHORIZED THEREBY. B IH�BOR CODE OF THE STATE OF IN VIOLATION OF THE E WASHINGTON RELATING TO ON .. IPI 1. FOR INSPErC WORKMEN�S COMPENSr�=CZD NOW H1.27. 7. 0 IA SIG A UR), ATE SIGNED (425 I 771-0220 R I As DATE ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING 08 STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 Fm� - OWNER Go -ASSESSOR 04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING z 0 0 M ITI 0 4 C.) 0 C J& IT1 m 10 � 0 _n IT In 0 0 0 Fn M 0 Cf) z 0 _j 0 ITI