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20030208.pdfa . DATE RECEIVW if :2 LPERMIT EXPIRES CITY OF EDMONDS USE ZONE PERMIT NUMBER O]ION CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# 1� ADDRESS Z / 9163 ,?0 IJ OWNE"AMEINAME OF BUSINESS C3 e.0/i54C � " � � # /_;I, ') rm, PLAT NAME/SUBDIVISION NO. -1 LOT NO. LID NO. Cc MAILING ADDRESS W 3 /c, '�b LID FEE $ TESCP Approved 0 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP AW Permit Atiquifed 0 Permit Rfq CITY ZIP TELEPHONE Street Use d inspection Required EXISTING — PROPOSED Sidewalk Required 0 0 0 ­11 91, Dk 1 ::1 4/ vo -!� REQUIRED DEDICATION� FT Underground — Wiring requited 0 NAME METER SIZE - I- LINE SIW OF FIXTURES PRV REQUIRED YES 0 NO 0 I ADDRESS CITY NAME Ac' ZIP I TELEPHONE ADDRESS / W,6 113 CITY ZIP LEPHONE I IQ jg_ 7g6 STATE LICENSE NUMBER E: Iq C"' 400 fie Wall DROPERTY TAX ACCOUNT PARCEL NO. Q 6) ao 06 0( 0 NEW &�.AESIDENTIAL ADDITION [:] COMMERCIAL <'EMODEL 0 APARTMENT REPAIR C:] GRADING CYDS 0 DEMOLISH 0 TANK c3 GARAGE 0 RETAINING WALL CARPORT or%r%iecmv (TYPE OF USE, BUSINESS OR AC4N3Zr&frV)LAIN: NUMBER NUMBER OF OF DWELLING STORIES UNITS - DESCRIBE WORK TO BE DONE le-1 W59 C?00'P`LUMBING / MECH COMPLIANCE 08 CHANGE OF USE SIGN 0 FENCE ( _X FTJ rl OTHER 0 RENEWAL CRITICAL AREAS NUMBER � .0!2 . i . " '01 1) j 0 C)38-rl required on all hot water tanks per FIRE REVIEWED BY Ifl OF ACCEPTED �..SHDS,ELINE OR ADS# DATE INSPECTION __PXQM—� ]YES 0 NO Is HEIGHT EXP 1 uju'Valea spacts. jjj*�/AC 815.1.7 F I.CrrMrMM�— A PROPOSED SETB� ALLOWED PROPOSED PARKING LOT AREA I PLANNING REVIEWED BY 7ATE REO'D I PROVIDED I CHECKEDBY ITYPE a z i-x LU W BOND POSTED KS (FT.) I z SPECIAL INSPECTOR 'JAREA OCCUPANT REQUIRED C3 LOAD REMARKS z PROGRESS INSPECTIONS PER UBC 1 08/FINAL INSPECTION REdaD a PLAN CHECK FEE HEY SOUR GLAZING % LOT SLOPE % / - . I( 6_119's BUILDING — Lf PLAN CHECK NO: VESTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADING/FILL DOMAIN (CURDS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. STATE SURCHARGE PERMIT APPLICATION: ISO DAYS PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS ENG. INSPECTION FEE IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING I EDMONDS, WASHINGTON. ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND INSPECTION FEE ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY R FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT DEEMEDTO MODIFY, WAIVE OR REDUCE ANY REQUIREMENTOF ANY CITY ORDINANCE NOR LIMIT IN ANYWAYTHE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- R TOTAL AMOUNT DUE 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- CALL TION; AND IN DOING THE RIZED THEREBY, NO PERSON WILL BE EMPLOYED WO it� F IN VIOLATION OF THE LAE '�' COD' THE STATE OF WASHINGTON RELATING TO FOR INSPECTION WORKMEN'S COMPENi;� ENSURAN)E AND RCW 18.27. SIGNATURE10 ER R:LAGENLT DATE SIGNED (425) / Z_ 12a ( I i _�- / 3 771-0220 WfTENTION EXT 333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX MIL-1 VALUATION FEE — 4101z (91 APPLICATION APPROVAL 115 . ation is not a permit until signed by the 11KIII),cli I or his/her Deputy: and Foos are paid. and oi is acknowledged in spaco,providod. ei`7T 65 -kL&4KD BY 'UAII: ORIGINAL - FILE - YELLOW - INSPECTOR PINK - OWNER - GOLD - ASSESSOR I z 0 0 m =i:% 55� m 0 C: j! rb m m 0 m m o Fn MO z 0 0 m k_ 0 1 RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SET0f4CKq ............... FOON6WhOW Footing...................... Wall.......................... Pier/Porch ................. Retainirig WA I ... Slalli Ins ulatibn PLUMBING: .............. 'Underground �'Comm ...... etc ;,"EATING. 0--i .................... Gas Pipin 91 .............. Equipment................. Commercial Final ....... EXTERIOR SHEATHING. NAILING .......................... FRAMING, ......................... FIRST FLOOR FRAMING... 'INSULATION .......... Floor Insulation ......... Wall Insulation ........... Calling Insulation ....... SHEETROCK NAILING SPECIAL INSPECTION MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. . � j r ryT ATE RECE,V!�,/ PER IT EXPIRES CITY OF EDMONDS CONSTRUCTION PER.MIT APPLICATION OWNE AME/NAME OF BUSINESS MAILING'ADDRESS /P /03 A CITY ZIP TELEPHONE P NAME ADDRESS USE PERMIT ZONE NUMBER JOB SUITE/APT# ADDRESS/ Y163 _3 tq(11111:� oessesse PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ Th5UP APPfUV@d PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required Street Us* Pernig Rfq'd EXISTING — PROPOSED inspecilon R*quir d Sidewalk RequWal REQUIRED DEDICATION_ FT Underground Witing required METER SIZE LINE SIZE I NO. OF FIXTURES I RV REQUIRED YES C3 NO 13 ­V---esse 'I" w AMA CITY ZIP TELEPHONE 99 110" se NAME ENG cc 10- ADDRESS CV'l (A La 1) FIRE REVIEWED BY TELE CITY--"' ZIP PH E VARIANC 01 STATE- LICENSE NUMBEIR* EXPIRATIO1 TATEOI TM (I --ro CTAJ 1—b ID 73 P10111 SE R COUNT PARCEL NO. COMPLETE PROPERTY TAX AC -L .j e, a . 6 0 -5 EXP LOT COVERAGE 0 NEW AESIDENTIAL Cal"PLUMBING MECH. ALLOWED PROPOSED T o COMPLIANCE 08 C:] AUDITION 0 COMMERCIAL CHANGE OF USE A PARKING . U EMODEL 0 APARTMENT 0 S16N REOI I PROVIDED T9A FENCE 0 GRADING X FT) MARKS REPAIR CYDS OTHER MOLISH 0 TANK GARAGE 0 RETAINING WALL C3 RENEWAL )RT ROCKERY z (TYPEO USE, BUSINESS Oj-AC4kt1T eArft CHECKED 13Y 'JTYPEOJ(16� Vie water a* 0 Z cc UJI z z CAAJ WApansiow WE are, ULM&— A--Il J - 0— 1 OhEVIEWED/DAJTE DATE w SHORELINE OMTjB# ED or L vi 6-4Z`r""N`Q­T q0S , I D SETBACKS PR:OPOK;:n 3EI OURV11F 1.) SIDE REAR "jWFRPONT, U5 SIDE REAR:� G XTE IN NS 0 Lit 0 - - CRITICAL CCCU0ANT-.i--- NUMBER NUMBER OF INSPECTOR AREA. D AREAS SPECIAL WELLING LOAD, 0 0 OF S NUMBER RED C3 S STORIES UNITS REOU . I -:DESCRIBE WO9K­T0 BE DC14E. z j REMARKS. FlIOGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION PEQ'D 0C iye�j- 609 HE�ItSOURC GLAZING % ,y S79 /197tp PLAN CHECK NO: LOT SLOPE.% DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE M, SEPARATE PERMISSION. PERMIT APPLICATION: 180 DAYS ERMIT LIMIT- I V�EAR - PROVIDED WORK IS STARTED WITHIN ISO 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, :5 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES. ANDAGENTS FROM' ANY AND ALLCLAIMS ORDAMA ' QESOFWHATEVER 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 0 NOR CIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE AOY ORDINANCE PROVISION, I HER . EBY ACKNOWLEDGENHAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT, ANDTHAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO eOMPLY WITH CITYAND STATE LAWS REGULATING CONSTRUC- TION: AND IN DOING THE WO C FIFIZTEHETHEREBY. NO PERSON WILL BE EMPLOYED 4M ODE IN VIOLATION OF THE LARf CODE STATE OF WASHINGTON RELATING TO I SURAN WORKMEN'S COMPEN 4% AN E AND RCW 18.27. I SUR DATE SIGNED i SIGNATURE (0 ER R AGENT'� ION 6MTI IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 519B VALUATION PLAN CHECK FEE BUILDING PLUMBING MECHANICAL GRADING/FILL STATE SURCHARGE ENG, REVIEW FEES ENO. INSPECTION FEE LANDSCAPING, INSPI FEE RECEIPT PLAN CHECK DEPOSIT RECEIPT TOTALAMOUNT DUE CALL FOR INSPECTION (425) 711-0220 EXT 333 771-0221 FAX APPLICATION APPROVAL This ffici ation is no a permit until signed by the "I or histhor Deputy: and Foos are paid, d V oi isacknowlodgod in space provided, IG URE DAT 76 :D BY fDATE ORIGINAL - FILE - YELLOW - INSPECTOR PINK - OWNER - GOLD - ASSESSOR z 0 1 0 M =i --fi 5i � a M C M 40 0 M CA E02 M M a -0) 0 0 C 0� z 0 M