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20030236.pdfI i DATE RECEIVEWD CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS CH MAILING ADDRESS ze� CITY ZIP ITELEPHONE NAME ADDRESS CITY ZIP ITELEPHONE NAME CBLN C-C-1 kj C_ ADDRESS U C 5 � ,- CITY ZIP ITE EPHQ�E Lv!j 1\jVjcV) q Ec:�61 ( 11S) STATE LICENSE NUMBER EXPIRATION DATE CKEq JJY 7� V10 k, 41 PROPERTY TAX ACCOUNT PARCEL NO. a L 00 L'i C\ I I C C, CY---,-\ 10 13 NEW [:] RESIDENTIAL PLUMBING I MECH ADDITION 01 COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL 1:1 MULTIFAMILY SIGN REPAIR GRADING 0 CYDS FENCE x FT) ( DEMOLISH ri TANK OTHER oGARAGE CARPO RETAINING WALL 1:1 ROC RY F RE SPRINKLER FIRE ALARM I[TYPE OF USE, BUSINESq OR ACTiviTY) EXPLAIN: C 4 U P�ICR NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE F-,EFLA-C�EKrr IQ KWr-2, Or- EVA-C_ U 1\) 17S , _'SEF 4;,IJ -EYL: HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO;,A, I VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUSUC DOMAIN (CURSS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: ISO DAYS PERMIT ILIMM 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 HE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE C17YS 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 THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. SIGNATPU �(W to -j,,)11DATE SIGNI�D 1A ATTENTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL \1 --- - 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 04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING PERMIT EXPIRES USE PERMIT 2(1-3 ZONE je N NUMBER JOB SUITE/APT# ADDRESS ...,7o61c0_7Z) PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ TIESCIR Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit R Req. Street Use P:qu:tfod of nn EXISTING - PROPOSED Inspection Requited Sidewalk Requited 13 REQUIRED DEDICATION- FT Underground E3 r I "a"I5 METER SIZE LINE SIZE NO. OF FIXTURES w'YEPTV REQUIRED .S [3 YES Cl NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE VARIANCE OR CU SHORELINE OR ADB# I INSPECTION BOND 1REO'D POSTED 13YES 03�0 IS SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT ALLOWED . PROPOSED I ALLOWED . PROPOSED 0 W cc rL LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAW FRONT UR SIDE REAR z PARKING LOT AREA PLANNING REVIEWED BY DATE REO'D I PROVIDED J6. REMARKS CHECKED BY SPECIAL INSPECTION JAREA REQUIRED [3 YES I OCCUPANT LOAD REMARKS i PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D 1 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 5 Recording Fee Receipt # N APPLICATION APPROVAL CALL This application Is not a permit until signed by the Building official or his/her Deputy: an eas to paid, and FOR INSPECTION receipt Is acknowledged In spacelpr Idod. OFFICIALS SIGNATURE Lj (425) 771-0220 RELE (_ D&E EXT 1333 .Cj;� l(/ el h . t z 0 M -i -n 55 � 0 M C M 0 -40 0 C --I z 3: M M z IC) -1 C _z 0 _Tl n M ITI 0 50) 0 o Fn Co C C0 M 0 z z 0) z 0 A 0 M 7, RECORD OF INSPECTIONS INSPECTOR SETBACKS ..................... FOUNDATION: Footing ...................... Wall .......................... Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground ............. Rough -in ................... Commercial Final ...... HEATING: Gas Test .................... Gas Piping ................. 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 .................. 40ft ov DATE APPROVED RECORD OF INSPECTIONS INSPECTOR SETBACKS ..................... FOUNDATION: Footing ...................... Wall .......................... Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground ............. Rough -in ................... Commercial Final ...... HEATING: Gas Test .................... Gas Piping ................. 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 .................. 40ft ov DATE APPROVED 0 : DATE RECEIVED/ CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS 5FA=L.1-= MAILING ADDRESS ZI`4-Z25 \A/ CITY ZIP ITE�EPHIQN12 EbM00t6l 01530Z9 1(4ZS) -,7_7 2-90 1%.-w NAME ADDRESS CITY ZIP I TELEPHONE NAME CBL 0 Lob,ESTP�P�, ADDRESS -ZO51— SW CITY ZIP TEjEPHGkVE Ly0Q\)j0o)), %Z61 (425) iK STATE LJCENSE NUMBER I EXPIRAT ON DATE Lob&590 *7q KO 7/o3 PROPERTY TAX ACCOUNT PARCEL NO. co �ok I 10000 10 13 0 NEW 0 RESIDENTIAL PLUMBING MECH IADDITION COMMERCIAL COMPLIANCE OR 3 z CHANGE OF USE 1:1 REMODEL MULTIFAMILY SIGN E] REPAIR E] GRADING FENCE X CYDS ( FT) DEMOLISH TANK OTHER GARAGE o RETAINING WALL F:RE SPRINKLER CARPORT ROCKERY F RE ALARM (TYPE OF USE, BUSINES OR ACTIV" EXPLAIN: C RC) NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES UNITS vz* NUMBER lVjIYI�t DESCRIBE WORK TO BE DONE I" VIMb /(IWOP ERMIT EXPIRES USE PERMIT ZONE IV NUMBER Z��2__V JOB SUITE/APT# ADDRESS. 26Lze ig PLAT NAME/SUBDIVISION NO.tLOTt. L�D NO. L D FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Porm Requirod Street Us: Permit Req'd EXISTING - PROPOSED inspection Required 0 Sidewalk Required 13 REQUIRED DEDICATION- FT Underground Wiring required 0 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 1 YES E3 No 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE U3 cc 9: VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND REQ'D 10YES I POSTED ------- 0�1_0. S SEPA REVIEW SIGN AREA HEIGHT COMPLETE E5XZm ALLOWED PROPOSED ALLOWED PROPOSED I _T EXP LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR PARKING REO'D VIDED LOT AREA PLANNING REVIEWED BY DATE REMARKS -7z r I F3kCK)\GE1 4�11GIF CDPz5 11"' KFECOMOGI= -ro :_�()SM �J6 bUCTWOP441 3p"s P1 M, HEAT SOURCE I GLAZING % LOT SLOPE % PLAN CHECK NO;^ , i. n . I VESTED C,/ -�J` :.4Z 47' 1 THIS PERMIT AUTHOR17ES 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 SEPARATE PERMISSION. PERMIT APPILICATION: 180 DAYS PERMIT LIMIT! I 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 CITY'S 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 VIOLAT ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN!S COMPENSATION INSURANCE AND RCW 18.27. CHECKED BY ITYPE=N I C OCCUPANT GROUP SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REP 2 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 # Landscapeinsp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION APPLICATION APPROVAL This application Is not a permit until signed by the Building Official or his/her Deputy: and Feetla'de.paid ' and receipt Is acknowledged In specolp... .PlAl Q 01nKIAT... Ll DA+ (425) -S, I) I - " 11 1) /0,;) 771-0220 RELE GFJ): L_/ / DATE ATTENTION EXT 1 33 1 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 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES OR ORIGINAL -FILE YELLOW -INSPECTOR PINK -OWNER GOLD -ASSESSOR GREEN - ACCOUNTING z 0 i 0 M -4 -n (j) M M 0 -10 0 C -4 C X M M z g) --I C 011 0 n _n � M M M 0 0 0 Fn C cl) C 0 M 0 Z I 0 0 rA, —I 3: 5 z 0 M