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20030220.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS CITY r6m NAME ADDRESS CITY N NA E A VE ADDRESS 1 g 0- 7p, p4 4 CITY ST T STATE LICENSE NUMBER TELEPHONE ZIP [TELEPHONE ZIP TELEPHONE -15- CBL # ;.V AM PARCIL NO. ROPERTY iAX ACCO NEW PLUMBING I MECH ADDITION JVf-COMMERCIAL 0 W_ COMPLIANCE OR CHANGE OF USE ULn MIL 11 REMODEL FA Y SIGN 1:1 REPAIR GRADING CYDS FENCE C1 ( — X—FT) 0 DEMOLISH TANK ci OTHER GARAGE RETAININGWALL 13 CARPORT 0 ROCKERY FIRE SPRINKLES )d FIRE ALARM — (TYPE OF USE. BUSINE55 OR ACTIVIM EMLAIN: NUMBER NUMBER OF DWELLING I CH111CAL AREAS I OF �� STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE PERMIT EXPIRES USE PERMIT ZONE NUMBER joB SUITE/APT# ADDRESS PLAT NAME/SUBDIVISION NO. LOT NV LID NO. LID FEE $ TESCIR Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Pefffm Required S"', Use Peffnit Req'd Inspectio" Requited EXISTING — PROPOSED Sidewalk Required REQUIRED DEDICATION� FT underW=W Wiring required 131 METER SIZE LIN NO. OF FIXTUR PRV REQUIRED IV QUI YES =C3NO 13 FRE z MARKSO OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE BY DATE FIRE REVIEWED BY DATE cl_-o ? I �,� e -?—/ 11� OR CLI SHORELINE UK AUt3ff INSPECTION BOND REO'D POSTED 7JKRIANCE 13YES ONO $ SEPA REVIEW At SIGN AREA , HEIGHT ALLOWED PROPOSE D AL LOWED PROPOSED COMPLETE MPT EXEMPT EXP LOT COVERAGE REQUIRED SETBA S (FT.) PROPOSED SETBACKS (FT) URSIDE REAR ALLOWED PROPOSED FRONT SIDE REAR FRONT PARKING REVI ED By DAT E �AREAPLANNING EW REO'D I PROVIDEDTILOT \1. HEAT SOURCE GLAZING % LOT SLOPE % ff VESTED DATE pLAN CHECK NO: 1_23�Z4 THIS PERMIT AUTHORIZES ONLY THE WORK NOTED- THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURSS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION. 180 DAYS PERMIT UMM I YEAR - PROVIDED WORK 18 STARTED WITHIN 160 DAYS SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND S CCESORS 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, WAPfE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CnYS 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 kl._�TION OFn LA89R`CMK OF THE STATE OF WASHINGTON RELATING TO "'r"LIRAWCE AND RCW 18.27. DATE SIGNED CHECKED BY TYPE OFPCP �A2-7 Ou VfST 6R P TION REaD OCCUPANT SPECIAL INSPECTION AREA LOAD REQUIRED [3YEtS REMARKS 4 Cn NSpERU PROGRESS INSPECTIO 7 BC 1078/FINAL INSPECTION REaD $ M DescriptiOn FEE Description FEE Plan Check State Surcharge Building Permit city Surcharge C�� Plumbing Mechanical Grading Engr. Review Engr. inspection Fire Review Plan Chk. DePOS* Fire Inspection elpt# Landscapelnsp. Recording Fee Receipt # AP CATION APPROVAL CALL Thl application Is not a permit until signed by the BuIldin95 official or histher Dcputy: and Fees are paid, and FOR INSPECTION receipt Is acknowledged In space provided. OFF!P"IGNATURE DATE (425) -2-1-03 771-0220 DATE EXT 1333 rLSAMLM'1�5;j h-A ml 17=10"a USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL -_ '-7 7 IT IS FUL TO ORIGINAL - FZE -_`YELLT - INSPECTO A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- PINK - OWNER - GOLD - ASSESSOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 GREEN - ACCOUNTING 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES z 0 4 0 =i5i M N 0 C �� X. M M jo 0 _Tl "n M a 0 6 Fn C co) ic Cf) 0, z co), z 0 0 M FINAL PROJECT APPROVAL FORM a 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Sign, ocaprvi.doc.l:temp:bldg:formsIO/OI z 9 0 m 719 m Ma 0 80 c 4c MM MZ co 0 -n n m m a 0 0 M C (j) c 0) M 0 Z M z z 0 m Irl z 47w. . ..... � J a RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing...................... Wall. ....................... Pler/Porch ........ R et'ainl'hg Wall .... Slab Insulation .......... PLUMBING: ronderg und ............. Rough -In . ................... CoMmercial Final ...... EATING: Gas' Test .... ................ Gas Piping ...... .......... Equiprnent . . ................. Commercial Final ........ EXTERIOR SHEATHING NAILING . .................. ....... FRAMING ............................. FIRST FLOOR'FRAMING.'.. INSULATION ....... 0 ........... 11 -1V Floor Insulation ......... -Wall Insulation ........... Ceiling" Insulation' ....... SHEETROCK NAILING ... SPECIAL INSPECTION MISCELLANEOUS ........... FINAL APPROVAL FOR OCCUPANCY .................. I I DATE RECEIVED -F ERMIT EXPIRES USE PERMIT CITY OF EDMONDS ZONE NUMBER I CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS CITY [zip TELEPHONE NAME ADDRESS CITY ZIP TELEPHONE NAME =CBLN &YZ 4,r- CITY ZIP I 7T:EL �EP H �ON E STATE LICENSE NUMBER PROPERTY TAX ACCO PARFAI. NO. q 0 6/ NEW RESIDENTIAL ADDITION Ig-COMMERCiAL 0 REMODEL MULTIFAMILY REPAIR GRADING CYDS DEMOLISH' TANK oGARAGE CARPORT o RETAJNINGWALL ROCKERY (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: i4*e NUMBER OF STORIES NUMBER OF DWELLING UNITS DESCRIBE WORK TO BE DONE 0.10. . 7 PLUM13ING / MEC H COMPLIANCE 00 CHANGE OF USE SIGN FENCE ( X Fr) OTHER FIREPPRINK I LER FIRE P4ARW, JOB ADDRESS Z)om�ql SUITE/APT# = X:1' —, PLAT NAMEISUBDIVISION NO. LOT Ne LID NO. LID FEE It PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP APPMW LA RW Penffl As"Ifed Sum Use FormN Rotfd EXISTING — PROPOSED Inspocuon PAqukw Sidrors* 11squked REQUIRED DEDICATION— Fr UndsrWouM WWgrequited METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES13 NO 13 z REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE REVIEWED BY DATE FIRE REVIEWED BY DATE W cc M JQMRIANC OR Cu SHORELINE OR ADB# INSPECTION BOND REO'D POSTED 113YEs 13NO is $EPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT ALLOWED . PROPOSED I At LOWED . PRO LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LJRSIDE :REAR I I z PARKING LOT AREA I PLANNING REVIEWED BY DATE REO'D I PROVIDED I CHECKEDBY I TYPE OF, CQNSTqUqI 14 CgRtV ULA;UrArV=X CRITICAL GROUP AREAS SPECIAL INSPECTION JAREA OCCUPANT, NUMBER REQUIRED [:] YES LOAD REMARKS ON REaD PROGRESS INSPECTIONS PER UBC 11081FINAL INSPECTI 4W.6 / 40 ido I Description FEE Description FEE\ Plan Check .00- State Surcharge 1450� HEAT SOURCE GLAZING % LOT SLOPE % Building Permit P City Surcharge Plumbing s e PLAN CHECKiio: VESTED DATE 1, � �3 - —0 Mechanical if — THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERIMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLM ANY CONSTRUCTION ON THE PUBLIC DONIAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading Engr. Review SEPARATE PERMISSION. PERMITAPPILICATION. IGO DAYS PERMIT UMM I YEAR - PROVIDED WORK 18 STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection Fire Review -50 Plan Chk. De �od OAPPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESCIRS 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 Fire Inspection 0 0 Pei,-p:t# &5C Landscapeinsp. �,Tbtal*Arnt. 71 11A 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 UMrr IN ANY WAY THE C"S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee Receipt # 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 RIZED THEREBY. NO PERSON WILL BE EMPLOYED LA OF THE STATE OF WASHINGTON RELAT IN V19)ATION OF WOR 0, ING TO WOF"ENS COM ,fE r' CE AND RCW 10.27. CALL FOR INSPECTION 1A9 %-Wam) APPUCATION APPROVAL This application Is not a pernr9t Until signed by the Building 0111cial or his/her Deput�: and Fees are paid, and receipt Is acknovAedged In space provided. OFFAPKMIIGNATURE DATE 3-1 ?, 1-03 S I E rA 0 DATE SIGNED 4GR 771-0220 EXT 1333 I"- - DATE TION IT IS WLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FIE YELL&W '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