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20030210.pdfDATE RECEIVED CITY OF EDMONDS -' ' CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS MAILING ADDRESS rk CITY ZIP TELEPHONE 2, 7 NAME ADDRESS CITY ZIP ITELEPHONE NAME _�/ 1_1� 1 f . :z,/.,-. . J CBL 0 Z /77q ADDRESS ?0,1) CITY ZIP T�LEPHONE STATE LICENSE NUMBER EXPIRATI ON DATE C CKED BY / & / e-, -b L10 �46) 211� PROPEFkTY TAX ACCOUNT PARCEL NO. 40 �_' 41 zz d 4= Z._� 2 NEW RESIDENTIAL PLUM13ING / MECH ADDITION COMMERCIAL COMPLIANCE OR A CHANGE OF USE REMODEL MULTIFAMILY SIGN GRADING FENCE REPAIR CYDS E] ( — X—FT) DEMOLISH TANK OTHER GARAGE C-31 RETAINING WALL IRE SPRINKLER 1E_:SA �LA fFI CARPORT ROCKERY R R M (TYPE OF USE, BUSINESS OR ACTIV" EXPLAIN: NUMBER OF 2, NUMBER OF DWELLING /1//Al CRITICA AREAS WA UNIT NUMBER -STORIES DESCRIBE WORK TO BE DONE "41 IeA�l A/' HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECEO' VESTED DATE a — THIS PERMIT AUTHORIZES ONLY THE WORI RMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPUCATION: IBODAYS PERMIT LIMIT 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 N 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 C11YS 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 C17Y AND STATE LAWS REGULATING CONSTRUC- 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 WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. DATE SIG>ED PERMIT EXPIRES ZONE USE PERMIT 0?A0 NUMBER JOB SUITE/APT# ADDRESS PLAT NAME/SUBDIVISION NO. LOT NO. L�D NO. L D FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP I ESCP Approved Aw Permit Required Street Use Permit Req'd EXISTING — PROPOSED Inspection Required Sidewalk Required L1 13 REQUIRED DEDICATION— FT �,,—n ... . .. g required METER SIZE NO. OF FIXTURES PRV REQUIRED YES13 NO 13 z REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE III cc VARIANCE OR CU SHORELINE OR ADB11 INSPECTION B D REQ'D POSTED DYES 13NO S SEPA REVIEW SIGN AREA HEIGHT COMPLETE I EXEMPT ALLOWED , PROPOSED ALLOWED PROPOSED EXP I LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR PARKING LOT AREA PLANNING REVIEWED BY DATE REQ'D I PROVIDED I I REMARKS CHECKED BY 0CUPANT 0 'F1 ITYPLO YNSTRUCTION yjib�5y1977 G 0 U P SPECIAL INSPECTION OCCUPANT REQUIRED JARtA LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D VALUATION $ Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review PlanChk.Deposft Fire Inspection Receipt # Landscapeinsp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION (425) 771-0220 EXT 1333 APPtICATION APPRO"VAL This application Is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid, and i(�.Calpt-iseckno#ledgedinspacoprolded. 0 C III QA11E �4 RELEASEkV _,J, in r� DATE IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- INAL-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 k z 0 4 0 M rn M 0 0 C: -4 C X M M z E: 0 -n n —4 3: M M 06 0 0 C Q 0 Z X z -4 3: 5 z 0 M MEMO TO: FROM: FINAL PROJECT APPROVAL FORM TO: DATE: )IVISION DEPARTNIENT DATE o —L2AL_T — - nimsm JINGINEERING DIVISION DATE� PLANNING DIVISION DATE nz=sm PROJECT. 5_i54TrLEF 5A?7-7 C 7- SITE ADDRESS -7 S T--.s-,J PERmrr # 0`2 ADBk -DATE INSPECTED_712,s-/C),� DESCRIPTION OF WORK TO BE INSPECTED A field inspection was conducted to determine final compliance with approved plans. Final a' roval pp denotes that there are no objections from the above signed Department to the release' of PERFORMANCE BONDS and the granting of: GRANT FINAL PROJECT APPROVAL GRAM PROJECT APPROVAL WITH CONDITIONS NOTED u. Copy of CONDITIONS given to owner/contractor by inspector FAILED FINAL INSPECTION - OUTSTANDING ISSUES u Copy of CORRECTION NOTICE given to owner/contractor by inspector I . 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Si ocaprvl.doc.l:temp:bldg:formsIO/OI z 0 M 'A --fi M C MO 0 80 C 4 K MM M Z 10-1 �z -1 3: C1) 0 -n n --I 3:9 M M 0 0 0 M C Cj) M CY) M 0 Z r- X z -i 3: Cl) z 0 i 0 M RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... Wall.......................... Pier/Porch ................. Retaining Wall ........... 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 .................. 70vw sow It DATE RECEIVED CITY OF EDMONDS ' " ' CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS 5-4*77t4f MAILING ADDRESS .xe12_ CITY ZIP TELEPHONE Zx2>,�g^_/4).5 �12j-_771-1- 12-yo NAME ADDRESS CITY ZIP ITELEPHONE NAME CBL I 'Ic— I y lolq ADDRESS t0i CITY ZIP TTEI EPHONE -7 _:5KA- S- > .9 ?7/ 2, sis STATE LICENSE NUMBER EXPIRATION DATE C%CKED BY �'ROPEMY TAX ACCOUNT PARCEL NO. 40 14/ �? z/ e e z 1�/A P __5 0 NEW RESIDENTIAL PLUMBING/MECH 3 ADDITION 60MMERCIAL COMPLIANCE OR A CHANGE OF USE [—] REMODEL MULTIFAMILY SIGN 0 REPAIR GRADING CYDS FENCE X ( FT) DEMOLISH TANK OTHER GARAGE CARPO RETAINING WALL 1:1 ROCKERY R"FIRIE IF E PF NKLER SELAIRZ (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: ,, F 4'0f-5.s '"--fr - — NUMBER NUMBER OF '4 1 CRITICAL OF 2, WELLING AREAS STORIES UNITS NUMBER .1 DESCRIBE WORK TO BE DONE jf�ti' 'Ov�� /,v eAli""L4AI' 0 PERMIT EXPIRES MWP� USE PERMIT ZONE NUMBER -200 02, JOB SUITE/APT# ADDRESS lad IL? 14 4/ — ass PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7ESCP AP RW Pormll"RID.V171'ed Street Use Permit Roq'd EXISTING - PROPOSED lnspft'llon Required Sidewalk Required 13 REQUIRED DEDICATION- FT Undergmurld Wiring required METER SIZE LINE SIZE OF FIXTURES PRV REQUIRED YES13 NO 13 REMARKS z z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE c2) -7 spEcTION BOND VARIANCE OR CU j SHORELINE OR ADB# I N REO'D POSTED OYES 13NO is SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT I ALLOWED . PROPOSED I ALLOWED , PROPOSED LOT COVERAGE REQUIRED SETBACKS (Fr.) I PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR E REAR 13 z 1 2 PARKING LOT AREA LANNING REVIEWED BY DATE P 06 REO'D I PROVIDED REMARKS 1 -1 it CHECKED BY I TYPE AF INSTRUCTION �� OCCUPANT _1QU "ClAt GROUP 4!::,— SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [] YES LOAD REMARKS z PROGRESS INSPECTIONS PER LIBC I 08/FINAL INSPECTION REO'D I § VALUATION $ Description FEE DescriptIon FEE Plan Check State Surcharge HEAT SOURC= GLAZING % LOT SLOPE % Building Permit City Surcharge 67 PLAN CHECKNQL 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 PUBUC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE I SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 180 DAYS PERMIT LIMM 1 VEAR - 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 SUCCESOR§' Fire Review PlanChk.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 /)Zg 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 I 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 .* Recording Fee Receipt # R?7_ 4� 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 Building Official or histhor Deputy: and Fees are paid, and IN VIOLAT ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION recelp�is acknoXodged in space pr"dod. WORKMEN�S COMPENSATION INSURANCE AND RCW 18.27. OTF611 AT. BIG E (0� E =RG E DATE SIG >ED (425) 1 '/Z2 = --- 771-0220 IL %TIMWTIO—N Off 1333 RELEASE?'V .I (.,I, Irl t", -,) DATE K-4 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 k z 0 4 0 M 11 -n V5 � 0 M C M 0 —10 0 C ITI z C _z 0 _Tl T11 M M a 6) 0 o Fn C 0) C C0 M 0 Z .11� X z (j) z 0 IT11