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20030255.pdfI --- --I , '-- Of 2UL DATE RECEIVEDq/ q, I �� I PERMIT EXPIRES USE PERM T CITY OF EDMONDS ZONE NURMBIER7!��/,Og JOB CONSTRUCTION PERMIT APPLICATION ADDRESS _T3 2— -7 Z q_rL 's" rlzc OWNER NAMEIN7E OF BUSINESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. '�j ( 'j /Y MAILING ADDRESS 177Y;7 CITY �� J" I C h iv r-A NAME ADDRESS Al Al ex/ ZIP TELEPHONE 90 9'/ 7 7142 0.4- CITY ZIP I TELEPHONE LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7ESCP Approved AW Permit Required EXISTING - PROPOSED Street Use Permit Roq'd Inspection Required SidmalkRequired SXd3 REQUIRED DEDICATION- FT Underground Wiringrequired METER SIZE LINE SIZE NO. OF FIXTURES I PRV REQUIRED I YES C3 NO 13 NAME JCBLN 'Ve, 'je ADDRESS *7,7 / A/ ;7 CITY ZIP TELEPHONE 6' x3rz STATE LICENSE NUMBER EXPIRATION DATE Ok,AUt WcMe7h;��4 CHECKED BY PROPERTY TAX ACCOUNT PARCEL NO. 7 e �z zq NEW RESIDENTIAL PLUMBING I MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL 1:1 MULTIFAMILY 0 SIGN REPAIR GRADING FENCE X 1:1 CYDS ( FT) DEMOLISH 1:1 TANK OTHER oGARAGE CARPORT RETAININGWALL F RE SPRINKLER 0 ROCKERY FIRE ALARM (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: 0 NUMBER NUMBER OF il I CRITICAL OF DWELLING A STORIES UNITS N DESCRIBE WORK TO BE DONE HEAT SOURCE GLAZING % LOT SLOPE % PLAJN CHECK NO: VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 13E DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 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 CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION., 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 U.WS REGULATING CONSTRUC- TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF W LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKIME141-GeMKI411ATION INSURANCE AND RCW 10.27. A DATE SIGNED 16/-_ /-& REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE o6u1'1dj41jV fi� (10'.1.1jaryffil...7 REVIEWED BY DATE FIRE REVIEWED BY DATE W W VARIANCE OR CU SHORELINE OR ADB11 INSPECTION BOND REO'D I POSTED i OYES ONO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , , I LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR z PARKING LOT AREA PLANNING REVIEWED BY DATE RECVD I PROVIDED I I I . REMARKS CHECKED BY TYPE OF Cf*;WYA jcO U tinj OCC PANT I GROUP SPECIAL INSPECTION JAAEA OCCUPANT REQUIRED [] YES LOAD REMARKS z PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REQ'D 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 125' Receipt N s. CALL FOR INSPECTION (425) 771-0220 APPLICATION APPROVAL This application is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid, and receipt Is acknowledged in space provided. OFFICIALS SPNATURE DATE rm) 'V/qk� DATE AWTENTION E X T 1 3 3 r111,R 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 -'(NSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 M M M 0 —40 0 C: 3� K M 10 0 _n M M 0 —0) 0 r- 0 M C V) C 0) M 0 Z r- z _11 3: 0) z 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 .......... \ol S. FINAL APPROVAL FOR OCCUPANCY .................. 200� M q DATE r [PERIMIT EXPIRES CITY OF EDMONDS USE PERMIT Z ONE NUMBEI`t-7��/Vg JOB ��7.5 ADDRESS 7 ( (I'L S, CONSTRUCTION PERMIT APPLICATION OWNER NAME/ E OF BUSINESS t7PLAT 'I NAMEISUDDIVISION NO. LOT NO. LID NO. LID FEE S MAILING ADDRESS I ESCP AP 177AI? PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Pvfm11_R;V116d EXISTING - PROPOSED- Street Use Peffnij Req Inspection Required 13 s1dawatk Required 13 CITY ZIP TELEPHONE '!�i a REQUIRED DEDICATION- Fr Undergiround Wiringrequited El NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YESM NO C3 z ADDRESS REMARKS OWNER/CONIRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE z \Aij _' _0 -0:!nj"ff&L CITY ZIP TELEPHONE NAME jCBL# ENGINEERING REVIEWED BY DATE ADDRESS I 77,Y 7 /7 ",�IRE R EVIEWED 13Y DATE US M CITY ZIP TELEPHONE I 1 VARIANCE OR CU "I'SHO.RELINEORADBN INSPECTION REO'D BOND POSTED 4& STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY 7. OYES EINO $ Wif mjjhL� SEPARtVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. 0 qA. ;?.? 0,0 , , 74 .0 "P ;?'40 EXP NEW rl RESIDENTIAL El PLUMBING / MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SkWCKS (FT) FRONT LIFISIDE REAR COMPLIANCE OR ADDITION COMMERCIAL E] CHANGE OF USE z z PARKING LOT AREA PLANNING REVIEWED BY DATE REMODEL MULTIFAMILY SIGN REQ'D I PROVIDED GRADING FENCE X REPAIR CYDS I Fr) REMARKS OTHER DEMOLISH El TANK GARAGE FIETAININGWALL FIRE SPRINKLER CARPORT ROCKERY -FIRE ALARM a (TYPE OF USE. BUSINESS OR ACTIV" EXPLAIN: CHECKED BY TYPE OF OCCUPANT 1COg? GROUP :z_ NUMBER OF N BER OF DWI LLING V,4 CRITICAL A I SPECIAL INSPE CTION OCCUPANT STORIES Uum NI' N JAREA REQUIRED [3 YES LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ-0 VALUATION $ 1JU 1111116 LE I IN W I 'op, � - - Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % IBuilding Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORRES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. 1=1 En"view PERMIT APPUCA�f& I DAYS Inspection PERMIT LIMrP I YEAR - PROVIDED WORK IS ITHIN 180 Engr.. SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF a EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection 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 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." x I NOR LIMIT IN ANY WAY Recording Fee Receipt # 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 IN VIOLATION OF Tkif LABOR CODE OF THE STATE OF WASHINGTON RELATING TO Building Official or his/her Deputy: and Fees are paid, and FOR INSPECTION receipt Is acknoydodged In space provided. WORKMEN;4AHMWENIATION INSURANCE AND RCW 18.27. OFFICIALS SjQIk*TURE DATE GNA: WNE A:GELL DATE SIGNED 1425) 771-0220 A SED Y DATE AftENTION EXr 1333 UNTIL IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL-FIIE YF'IOVV--(NrPr:CTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 0 M C ma 0 -10 0 C � C 171 M z 10-1 Cl) o -n ,n M a 0 0 M C M 0 Z r- .iW W z --I x 55 z 0 0 ITI