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20030244.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OF OWNER NAMEINAME 9 USINESS 40 7f__6�1 7— MAILING ADDR7E S il� 5- a 2-047 02qqb . . Vj. CITY Zip TELEPHONE F'o molvo _."p-rw 5"' 13-71 NAME ADDRESS CITY ZIP I TELEPHONE NAME �)—Pm M:FrW4W_1C44t,;:4 I I ADDRESS 1000 jupos—/Py 0 — &I VC CITY -ro K W A- TELEPHONE 2,191a 5"75- 75 STATE LICENSE NUMBER EXPIRATION IDATE _.5r&lz�-Mc I PROP NO. Ino 5 0I)CO/ 6.0 C)�� NEW RESIDENTIAL *-ELUMBING/ MEC ADDITION COMMERCIAL ED COMPLIANCE OR CHANGE OF USE P& REMODEL APARTMENT [3 SIGN o FENCE REPAIR GRADING CYDS ( DEMOLISH [3 TANK OTHER oGARAGE o RETAINING WALL CARPORT ROCKERY _ RENEWAL (TYPE OF USE. BUSINESS OR LAIN: NUMBER NUMBER OF CRITICAL OF DWELLING AREAS I UNITS NUMBER -STORIES _ DESCRIBE WORK TO BE DONE .004 A — — 015 1 rild NOW 2"'M P RMIT EXPIRES USE ZONE PERMIT NUMBER JOB SUITE/APT# ADDRESS 2 26��— '�. A), PLAT NAME/SUBDIVISIO 777 LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required Street Use Permit Roq'd EXISTING — PROPOSED Inspection Required [3 Sidmalk Required E3 REQUIRED DEDICATION— FT 1 Underground 1 wiring required E3 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 0 YES 13 13 No 3 6 REMARKS z z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE a Type B or L vent FIRE REVIEWED BY VA D/DATE DATE W VARIANCE OR CU SHORELINE OR ADB# INSPECTION REOID I PBOND OSTED E3 YES [3 NO SEPA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED EXP , , , IM LOT COVERAGE REQUIRED SETBACKS (FT.) ED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR LJR SIDE REAR z PARKING 0 ITIC DATE S WE IWORP BE IL REQ`D - __ t1gyrn R� Cjjy INSpECInR REMARKS ArrinA111111'rn f%IIAI I &1f%9P CHECKED BY I:MCONSTRUgTION I C CIE OCCUPAN 6_64117 GROUP SPECIAL INSPECTOR JAREA OCCUPANT REQUIRED [] YES LOAD REMARKS fl_�PROGRESq_I_NQP1: I hether the water system Regardless of W 6 ef V,-- 19.30.020 Description FEE Description FEE Plan Check HEAT SOURCE GLAZING % LOT SLOPE % Building PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORUES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPILICATION: ISODAYS IL PERMIT LIMM 1 YEAR - PROVIDED WORK 15 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 SUCCESORS Traffic Mitigation IN INTEREST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND Fire Review ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Fire Inspection DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' x Landscapeinsp. 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 DOIN13 THE W(.jX*WJqjORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF H�E -"PE\OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION WORKMEN'S COM P:E k �INSURAN�E AND RCW 18.27. If - SIGNATURE (OW"L DATE (425) SIED 771-0220 1 ATTENtION M 1333 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 10101 Recording Fee City Surcharge State Surcharge Plan Chk Deposit Receipt # Total Amount Due c15- Receipt # APPLICATION APPROVAL This application Is not a permit until signed by the dina,01ficial or his/her Deputy: and Fees are paid, and Aricelpt is acknowledged in space provided. 3'A S SIGNAT1.15 ATE .YEASED BY DATE ORIGINAL - FILE - YELLOW - JNSPECT-JR PINK - OWNER - GOLD - ASSESSOA z 0 4 0 IT! =i =5 M M 0 0 0 0 C: --I C X M M Z ,C) 0 -n n M M 0 —0) 0 11-1 0 M C V) C 0) Q 0 Z X z z 0 A 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: 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 .................. '0 0 &0000 M. M 0 ITI M z CA 0 _rl .h M M 0) 0 0 Fn 0 X z z 0 1 0 IT11 ATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF 2USINESS r-7 MAILING ADDRE 7�'2_-aq CITY 0 fV 1) S ZIP TELEPHONE e& 26') & NAME ADDRESS CITY ZIP ITELEPHONE NAME -# C' W, K, LINO ADDRESS &0 1517 I V CITY ZIP TELEPHONE _F0 K W I L 2 06 5`71,;- STATE LICENSE NUMBER EXPIRATION .5TA -TEn -10 C 7 C1 NEW RESIDENTIAL ADDITION COMMERCIAL REMODEL APARTMENT REPAIR GRADING CYOS [3 DEMOLISH TANK GARAGE RETAINING WALL CARPORT ROCKERY BE. (TYPE OF U BUSINESS 0 = N: o COMPLIANCE OR CHANGE OF USE 0 SIGN [3 FENCE ( _ _ FY) OTHER [j RENEWAL NUMBER OF CRITICAL UNUMBER OF 0 S-ORIES DWELLING UNITS AREAS NUMBER DESCRIBE WORK TO BE DONE A/,(L), �Lw/[ A IWiln Floor I mriln A HFAT SOURCE PLAN CHECK NO: IF, 0 ej V, LOT SLOPE % VESTED DATE 02) I I , PERMIT EXPIRES "x I —mom� - U USE ZONE Z I PERMIT / V .3 NU J JOB _7q2l ADDRESS 411 ;7.7 SUITE/APTO S_ !�' b A) PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE S JAI PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCIR APW RW lt&d Permit R:V Street Use Permit Rtsq'd EXISTING PROPOSED inspection Required Sidewalk Required REQUIRED DEDICATION- FT Undwaround wmg required [3 .METER SIZE LINE SIZE PO. OF FIXTURES PRV REQUIRED YES13 NO 13 REMARKS z 0 C WNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE ENGINEERING BE ACCEffEU FIRE REVIEWED BY DATE VARIANCE OR CU SHORELINE OR ADB# INSPECTION I PBOND REOM OSTED [3 YES (3 NO t' � A ffew t - M SEPA REVIEW 'GHT COMPLETE I EXEMPT E j L PROPOSED EXP LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR I PARKING =7�� rs�DATE RE f"VIND jr L ve t connecto R4EMI-11 ed ull "Durr1ing'sPAweesin CHECKEDBY jTXrCONSTRU TION T CIP OCCUPANT GROUP ( C SPECIAL INSPECTOR OCCUPANT REQUIRED [] YES JAREA LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD Regardess of whe "en or dosed, Plan Check Building q 0 Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC Grading DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPUCATION: 180DAYS L IL PERMIT LIMM I YEAR - PROVIDED WORK 15 STARTED WITHIN 180 DAYS Engr. Inspectioni SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Traffic Mitigation IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS 1 HE G1 I T OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Review ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Fire Inspection 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.- Landscapoinsp. I HERE13Y 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 W9j ORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE gi=00 IF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION U INSU WORKMENS COMP 90W INSJ�CCJIE AND RCW 18.27. SIGNATURE (OWI? GE DATE SI 51�F D/' (425) , !:1 o o 771-0220 ATTENTION Off 1333 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 10101 FEE Recording Fee City Surcharge State Surch arge Plan Chk Deposit Receipt # Total Amount Due `)5 - Receipt # T.� APPLICATION APPROVAL This applicaUon Is not a permit until signed by the ;iina pmclal or his/her Deputy: and Fees are paid, and '� rfz�jlj�t!n rrknrwiladged In space provided, 146 SIGNAT "'.'TTE M" - 1 141 _N -'�. R bATE '_�'EASED BY ORIGINAL - FILE - YELLOW - INSPECTOR PINK - OWNER - GOLD - ASSESSOR 4 z 9 0 M --I -n M rn 0 80 X M 1711 z Ca o -n n M M 0 0 0 M 0 ca M 0 Z� z C0 z 0 q 0 M