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20030279.pdfDATE RECEIVED f —7 LPERMITEXPIRES CITY OF EDMONDS PERMIT ZONE NUMBER, �'l 7. CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRESS _?L j_ OWNER NAMEINAME OF BUSINESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. 1 f'34 LID FEE $ MAILING ADDRESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7ESCP Approved RW Permit Requited 1W6 12-0 EXISTING — PROPOSED Street Use Permit Req inspection Required 13 Sidewalk Required E3 CITY ZIP TELEPHONE 4FIle.-ye-H el,?,;,.- 3 ig- c) z4j REQUIRED DEDICATION— FT — Underground Wiring required E3 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 0 NAME YESM NO 13 2; < Z 1,4 t' �� W ADDRESS z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE loeftoos MID flok CITY ZIP TELEPHONE NAME / 4 4 -ki /11 _jCBLN ENGINEERING REVIEWED BY D - 6 � Lzfs�v DAIE -3 fix] 0 ADDRESS 1716 470 FIRE REVIEWED BY DATE Ix M CITY ZIP TE EPHONE T et-jy_j2_P Lec_1:ff - 7 6"4 r- I VARIANCE OR CU I SHORELINE ORADB11 I INSPECTION REQ;p 0oo, 13YEs ;ko BOND POSTED i$ STATE LICENSE NUMBER Lol-g 1011 ri A9 EXPIRATION DATE BY SEPA REVIEW L;UMrLt: I t: EXEMPT EXP I SIGN AREA ALLOWED PROPOSED I % HEIGHT ALLOWED 1 6', 1 PROPOT �0 PROPERTY TAX ACCOUNT PARCEL NO. ('V _Z52- 127J g 1) 0 / col 0,5- E&-9EW ADDITION grRESIDENTIAL COMMERCIAL 13 PLUMBING / MECH COMPLIANCE OR 1:1 CHANGE OF USE LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE BEAR PROPOSED SETBACKS (Fr.) FRONT URSIDE HEAR 0 PARKING REQ'D PROVIDED LOT AREA PLANNING REVIEWED BY DATE -,7 REMODEL REPAIR MULTIFAMILY GRADING CYDS 1:1 SIGN FE!?f 1:1 X WFI) REMARKS DEMOLISH TANK 1:1 OTHER GARAGE CARPORT RETAINING WALL 0 F RE SPRINKLER ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS R ACTIVITY) EXPLAIN: CHECKED BY ITYPE ION C OCCUPANT ;�Ie GROUP NUMBER OF STORIES , NUM'BLEIR OF DWE L NG UNIT A C RITICAL��JUJ A N SPECIAL INSPECTIONTAREA REQUIRED YES OCCUPANT LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D U VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % I Building Permit T1 City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 2 DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE I= SEPARATE PERMISSION. Engr. Review 2 I PERMIT APPILICATION: ISODAYS CL PERMIT ILIMIr I YEAR - 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 SUCCESORS Fire Review Plan Chk. Deposit N INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # ALL CLAJMS 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 01 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION., Receip t# Recording Fee I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPAOVAL GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF Is p%alon lshn.ol a permit until signed by the 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 CALL Bull 0 . .1 ' hi Dop d Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTIO ece I Is acknowledg in aco provided. WORKMEN'S COMPENSAT19 "IURANCE AND RCW 18.27. 0 Fl LS T RE D SIGN DATE SIGNED ATURE ( WNER 1A9 %425 AORENT) All 771-0220 E)ff 1333 R &EW 9ATF/ �////u ATtENT46N IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL Zc A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- OR�OIN4 I L-Fl),� - YELL0/-INSPE'CTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PNK-b"ER - GOLD -ASSESSOR GREEN - ACCOUNTING 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES k z 0 M =i 9 3: M C M 0 —10 0 C -4 K X M M z 0 n _n —1 3: M M D-0 0 1- 0 M C M 0 z z z 0 4 0 M FINAL PROJECT APPROVAL FORM TO: DATE: — MEMO TO: PERMIT COORDINATOR, BUMDING DIVISION FROM- FIRE DEPARTMENT DATE-.;— yNGINEERINGDIVISIOND 10 PLANNING DIVISION DATE ---..:— SITE ADDRESS___C�q I S;3 Ut" el W PERMIT —ADB# -DATE INSPECTED DESCRIPTION OF WORK TO BE INSPECTED_L_J�j= A field Inspection was conducted to determine final compliance with approved plans. Flual approval 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 'GRA APPROVAL WITH CONDM- ONS NOTED NT PROJECT u . Copy of CONDITIONS given to owner/contractor by inspector FAHM FINAL INSPECTION - OUTSTANDING ISSUES a Copy of CORRECTION NOTICE given to owner/contractor by inspector I . PA 3. RE-INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date— Sip, ocaprvl.doc.l:temp.bldg:formslO/01 z 0 =i =n- M C M 0 0 0 C -4 r. 3: M M Z 10-4 C J) 0 -n n - i 3: M M 0 0 0 M cl) C/) Q 0 Z r— .4w X z --i 3: V) 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: GasTest .................... 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 .................. DATE RECEMD C11Y OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS / L,1�4(-Obl 6�4 MAILING ADDRESS CITY ZIP TELEPHONE Fitll v,- NAME 4, A/C kel ADDRESS CITY ZIP TELEPHONE NAME CBLN 5�_Z o , I 0.[;;E7RMIT EXPIRES 6SE PERMIT ZONE NUMBER JOB SUITE/APT# ADDRESS qqls-- PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE $ TESCP APPrOV60 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Requited Street Use Partnit Roq'd EXISTING - PROPOSED Inspection Required E3 Sidewalk Required Underground REQUIRED DEDICATION- FT Wiring requited E3 METER SIZE.* NO. OF FIXTURES PRV REQUIRED LINE SIZE YES[3 NO 13 z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE , L1 Smn oo S? n, I D 1 01 f=(OA L.- dL,U, e,-, /0 4`9/ 4 (J(AY ENGINEERING REVIEWED BY D�TE 1) Lgsz� -31 �6 5 1 CC ADDRESS 0 c 1.7c; FIRE REVIEWED BY DATE W M CITY ZIP TELEPHONE 0 VARIANCE OR CU SHORELINE ORADBI I INSPECTION 13YES' 0 E3< BOND POSTED $ STATE LICENSE NUMBER EXPIRATION DATE 1zTj4j:�C-,,- 10�12612 1�` r, 3 1MY SEPA REVIEW COMPLETE I EXEMPT EXP_ SIGN AREA ALLOWED I PROPOSED HEIGHT ALLOWE 6 % I PROPOS�D -PARCEL ;11,PROPERTY TAX ACCOUNT NO. 00/ 0 0,5 g & RESIDENTIAL PLUM13ING / MECH AC�DTiolsl COMMERCIAL COMPLIANCE OR CHANGE OF USE LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT URSIDE REAR z PARKING REO'D I PROVIDED LOT AREA PLANNING REVIEWED BY DATE REMODEL MULTIFAMILY SIGN GRADING FENg/ REPAIR CYDS XkFr) REMARKS COO, OTHER DEMOLISH TANK GARAGE RETAININGWALL FIRE SPRINKLER CARPORT 13-ROCKERY FIRE ALARM &PE OF USE, BUSINEIPR A rriv" EXPLAIN: N CAECKED BY TYPMION CV. OCCUPAN& GROUP NUMBER NUMBER OF CRI I AL OF DWELLING AR S STORIES 14 UNITS NU BEM&21 SPECIAL INSPECTION JAREA REQUIRED [:] YES OCCUPANT LOAD DESCRIBE WORK TO BE DONE I REMARKS i; FROURr-tbis INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D J(�k lifn C/ I Olin &JI AN I bE VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit city Surcharge ECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading x DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. I: Engr. Review PERMIT APPLICATION: ISO DAYS EL PERMIT UMM 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection I 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 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 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' X. Receipt # Recording Fee I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPFIOVAL GIVEN IS CORRECn 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 IS pili 110 n sno t a permit until signed by the a a, TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LA13OR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTIO u I 4ir A-O -Pc a r hils/her Dep>*."nd Foes are paid, and t is acknowledg d In aco provided. WORKMENS COMPENSATION INSURANCE AND RCW 18.27. /0 F LS G �T RE DAYE SIGNATURE (OWNER OR AGENT) DATE SIGNED 1A0 0,25) W 15 l(MIT 771-0220 LOAblEdLB ATV ENTION EXT 1333 C/ -12 /C UNTIL IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW- INSP6CTOP1 CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK-�OWhER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 11 0 om a ma 0 -40 0 C -4 r. MITI M 10 Z io -n n M M 0 C-1) 0 r- 0 M C 0) C V) M 0 X z z 0 11 0 M