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20030190.pdf_1____ s / 1, CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEMAME OF BUSINESS 0" —1A \1, � MAILING ADDRESS C1j,j 1 -1 - P 3:W -A' 4;" CITY ZIP TELEPHONE NAME ADDRESS CITY NAME ADDRESS CITY STATE LICENSE NUMBER PROPERTY TPX ACCOUNT ao" �;?,? ZIP TELEPHONE CBL # &14- ZIP TELEPHONE mo EXPIRATION DATE I CHECKED BY NEW W—RESIDENTIAL ADDITION [:] COMMERCIAL REMODEL 0 MULTIFAMILY REPAIR [] GRADING CYDS DEMOLISH WTANK ri GARAGE rARPORT RETAINING WALL 13 ROCKERY (TYPE OF USE. BUSINESS OR �rr )34.D�"N: PLUMBING / MECH COMPLIANCE OR 0 CHANGE OF USE [:1 SIGN 1 FENCE 3 ( x FT) OTHER FIRE SPRINKLER FIRE ALARM NUMBER NUMBER OF CRITICAL OF I DWELLING AREAS STORIES I UNITS NUMBER DESCRIBE WORK TO BE PONE Rt M12 ou + V-eci et (,t4 I Keg 41 o I I 4+V4 LAE HEAT SOURCE GLAZING % LOT SLOPE % 'CK NO: VESTED DATE PLAN CHE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 180 DAYS PERMIT LIMM 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK 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 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 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* I — I HEREBY 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 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 OUHE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S GOMElItSATION INSURANCE AND RCW 18.27. a /6 1�41)�� _I I PERMIT EXPIRES UhE PERMIT ZONE NUMBER JOB SUITE/APT# ADDRESS PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE $ TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required Sir ot Use Permit Roq'd EXISTING — PROPOSED Ins;ctlon Required SIdewalk Required REQUIRED DEDICATION— FT I Underground I vviring requirod METER SIZE LINE SIZE NO, OF FIXTURES I PRV REQUIRED I I YES C3 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE L� z 6 ENGINEERING RE�I�WED'fff- 1ANK r-ILL, 9E��_7A'L','6R% CEAP FIRE REVIEWED BY DATE cc ILL. VARIANCE OR CU SHORELINE 08 ADBO� I INSPECTION BOND POSTED iREO'D 13YEs- 13NO 1$ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP I , , LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR z PARKING LOT AREA PLANNING REVIEWED BY DATE REQ'D I PROVIDED I REMARKS CHECKEDBY ITYWPEONECTION OCCUPANT I GRO IV 77 SPECIAL INSPECTION JAREA OCCUPANT REQUIRED 0 YES LOAD 13 REMARKS z PROGRESS INSPECTIONS PER UBC 101111MINAL INSPECTION REaDj 9 VALUATION 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 # Landscapelnsp. Total Amt. Due Recording Fee Receipt III CALL FOR INSPECTION (425) 771-0220 EXT 1333 APPLICATION APPROVAL This application is not a permit until signed by the Building Official or his/her Deputy: and Foos are paid, and receipt Is acknowledged in space provided. OFFI LS 6IGNAbTUE DATE E6 By 'DATE' F� 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 2 t z 0 q 0 M 3: C rTI 0 0 0 C: M z 0 n —1 x M M a-0) 0 0 Fn C 0) 0 z X z —I x 0) z 0 q 0 171 mg,10M.111 ".1wal.31 DION winTIM., "amanol TO: -DATE: MEMO TO: PERMIT' BUILDING DIVISION FROM: - 7 M-�� 14S,4103 1211 NON —FIRE DEPARTMENT DATE- GINEERING DIVISION DAT PLANNING DIVISION DATE I PROJECT UA SITE ADDRESS 7 PERMIT # —ADB# _DATE INSPECTED 9 DESCRIPTION OF WORK TO BE INSPECTED U Sr - A field inspection was conducted to determine compliance with approved plans. Final approval denotes that there are no ob'ections from the above signed Department to the granting of Final approval of the described work I . I . 2. 3. Performance Bonds associated with the project may be released GRANT FINAL PROJECT APPROVAL GRANT FINAL PROJECT APPROVAL WITH CONDITIONS ___FAILED FINAL INSPECTION - OUTSTANDING ISSUES —RE-INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL ocaprvl.doc.l:tenip:bldg:forms6/98 z 0 :; =5 M M 0 0 0 0 C —1 r. X M M Z 10--i cl) 0 71 MM 0 0 0 M ci) M 0 Z z 0) z 9 0 M I RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing...................... Wall.... ................ :7, Plei/Porch .................. Slab Insulation .......... PLUMBING: Underground .............. Rough -in ................... Commercial Final ...... HEATING: GasTest .................... GasPiping ................. Equipment .................. Commercial Final ....... EXTERIOR SHEATHING NAILING .......................... FRAMING ........................ FIRST FLOOR FRAMING... INSULATION ................... Floor Insulation ......... Wall Insulation ........... Ceiling Insulation ....... SHEETROCK NAILING ... SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .............. :fYDATE RECEIVED. CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS t)ew -Ipt \J. Kinj 0 Wr�J vwl(, MAILING ADDRESS j 911-1 - 9 3:40, /54 CITY ZIP TELEPHONE NAME ADDRESS CITY ZIP ITELEPHONE NAME CBL# &&L", A2i I — ADDRESS , I /,- j- CITY ZIP I TELEPHONE STATE LICENSE NUMBER EXPIRATION DATE I CHECKED BY PROPERTY TAX ACCO PARCqL NO. ad . y �00 NEW k—RESIDENTIAL PLUMBING / MECH ADDITION COMMERCIAL 13 COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY SIGN REPAIR 0 - GRADING CYDS [3 FENCE ( x FT) DEMOLISH TANK OTHER GARAGE CARPORT RETAININGWALL ROCKERY F RE SPRINKLER FIRE ALARM (TYPE OF USE, BUSINESS OR 6GT1VTaEX"N: NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE PONE flr( OA L) Ott* V",-9 ett,44 �v a 410(1 ol .1 V-2onc,a,t U5,T HEAT SOURCE GLAZING % LOT SLOPE % PILM CHECK NO VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMITAPPLJCATION: ISO DAYS PERMIT UMM I YEAR -PROVIDED WORK IS STARTED WTTHIN 1180DAYS SEE BACK 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 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 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' I HEREBY 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 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_LHE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S CWPETOATION INSURANCE AND RCW 18.27. a /6 -7- ,F , J7 PERMITEXPIRES ae UTE PERMIT ZONE NUMBER JOB SUITE/APT# ADDRESS PLAT NAME/SUBDIVIS 777 LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP ApProved RW Permit Required Street Use Peffnit Roq'd EXISTING — PROPOSED inspection Required [3 Sidewalk Required 13 REQUIRED DEDICATION— FT Underground Wiring required 0 METER SIZE LINE SIZE OF FIXTURES PRV REQUIRED FNO. YES13 NO 13 z 5 z REMARKS z rOWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ------ FIRE MARSHAL REVIEWED BY MUST BE PRESENT FIRE REVIEWED BY DATE VARIANCEORC�—rRELINEORADBI I INSPECTION I BOND REO'D POSTED [3YEs 13NO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE , EXEMPT ALLOWED I PROPOSED ALLOWED , PROPOSED EXP LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR z PARKING LOT AREA I PLANNING REVIEWED BY DATE REQ`D I PROVIDED REMARKS CHECKED BY ITY CTION c9p OCCUPANT GROU 77— L SPECIAL INSPECTION JAREA OCCUPANT a Cl ll' LOAD R R UIR EQUIRED YES 0 — M S rREMARKS 2 P 0 PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REO'D 9 VALUATION Description_ Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection FEE Description FEE State Surcharge City Surcharge 5 — 74fo /t 4 V. 9 Fire Review Plan Chit. Deposit Fire Inspection Receipt # LandscapeInsp. Total Amt. Due -//1 Recording Fee Receipt # IT APPLICATION APPROVAL CALL This application is not a permit until signed by the Building diticial or his/her Deputy: and Fees are paid, and FOR INSPECTION receipt Is acknowledged In space provided. OFFICIALS IGNAT E DATE (425)' T, 771-0220 RELEASED BY --FIT DATE' 'EXT 1333 IT IS LIN FUL 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 i z 0 M rn 0 -40 0 C: M M z 0 -n IT! M 0 0 6 Fn C (j) C (A M 0 Z X z 0) z 0 1 0 171