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20030331.pdf10 DATE RECEIVED [PERMITEXPIRES 11A'711� _' CITY OF EDMONDS USE PERMIT ZONE NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRESS 9 � 0 OWN�NAMENAME OF BUSINESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. 6-e MAILING ADDRESS 019V T1 1;1r IQ 0 F_�_ LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING — PROPOSED REQUIRED DEDICATION— FT TESCP Approved RW Per 11 Roqu:fed Street Perot 'd U. M I Req Inspection Required C3 SidmalkRequitad [3 Undercrourid Wiring required CI CITY ZIP nok� TELEPHONE NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES E3 NO 13 Z z ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE Orr— 2ON 4- CITY ZIP TELEPHONE NAME Lec-)Aal 1 CBL ENGINEERING REVIEWED BY DATE ADDRESS M280 NG Lknbo Vki cc 0 FIRE REVIEWED BY DATE W M 0 uTe"C)(\� CITY q � QZE,;p S TELEPHONE IN 29) 8(o'G"_LV0`9` VARIANCE OR CU SHORELINE OR ADB# INSPECTION REO'D [3YEs; ONC No PBOOSTED E LICENSE NUMBER EXPIRAT[b DATE L1�6plca 1- 00S71\30 ca CHEC4(E Y SEPA REVIEW COMPLETE , EXEMPT EXP SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED , PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. -z o -q o0l n1 0o NEW RESIDENTIAL PLUMBING / MECH COMPLIANCE OR 1:1 ADDITION E] COMMERCIAL ri CHANGE OF USE LOT COVERAGE ALLOWED PROPOSED I REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT URSIDE REAR I z PARKING LOT RECID I PROVIDED AREA PLANNING REVIEWED BY DATE E] REMODEL MULTIFAMILY SIGN GRADING FENCE E] REPAIR 1:1 CYDS L_j ( X FT) REMARKS OTHP - WA DEMOLISH TANK n z GARAGE RETAINING WALL FIRE SPRINKLER <0 CARPORT ROCKERY FIRE ALARM E (TYPE OF USE, BUSINESS OR ACTIVUM EXPIAN�-7 f Z, 0I ) R A e � ) CHECKED BY I C04,-I-- OCCUPANTR,� GROUP NUMBER OF STORIES NUMBER OF DWELLING UNITS CRITICAL 013, A N SPECIAL INSPECTION AREA REQUIRED [:] YES OCCUPANT LOAD 9 DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REO'D �t?Jb M A&tk�(�n i al9nnA 3 Ai 6 n\ VALUATION o $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Grading It BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPUCATION: 180DAYS Engr. Review Engr. Inspection 916 PERMIT LIMIM 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 Fire Review Plan Chk. Deposit IN INTEREST, AGREES TO INDEMNIFX DEFEND AND HOLD HARMLESS THE CITY OF iY A D EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND E C TL Y ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY OT BE FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE ANCE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 4 'E Fire Inspection Receipt # Landscape Insp. Total Amt. Due 0 ISION - I NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee Receipt # dNF ATION I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION T 0 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 CALL FOR INSPECTION APPLICATION APPROVAL This application is not a permit until signed by the Building Official or his/her Deputy: and Foos arc paid, and receipt is acknowledged in apace provided. WORKMEN'S COMPENSATI��SURANCE AND RCW 18.27. (425) OFFICIALS _§IGNATURF/ DAT9 &BY' SIGNATURE (OWNER OR fENT)) DATE SIGNED S_ 9 -C,3 771-0220 E;SED / /1DATt ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I 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 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING I z 0 4 0 M -4 -n 55 � 0 M C M 0 -10 0 C: � C 1711 M 10 C 0 _n n M M o-0) 0 o Fn C (j) C V) ITI 0 z z z 0 4 0 M RECORD OF INSPECTIONS 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�FJLOOR FRAMING... INSULATION ................... Floor Insulation ......... Wall Insulation ........... Ceiling Insulation ....... SHEETROCK NAILING ... SPECIAL INSPECTION MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. INSPECTOR DATE APPROVED . lco?16103 aw e5ag / 0/ DATE RECEIVED FP ERMIT EXPIRES V CITY OF EDMONDS (ISE PERMIT ZONE �2, — NUMBER L)2,2 Z-_� CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRE OWN�R NAMEINAME OF 13USINESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ (x. C, (, , MAILING ADDRESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Ap- RW Permit R=od &Acta,/ �J� L- . N EXISTING — PROPOSED Street Use Permit Roq'd Inspection Required Sidewalk Requited CITY ZIP TELEPH04E o z N ZS),QG(L. '30ci REQUIRED DEDICATION- FT Underground Wiring required NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES [3 NO [3 ADDRESS REMARKS OWNERMONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE z �0__ 16N CITY ZIP TELEPHONE Lc NAME CBL# Lec-)�\C\ ) ENGINEERING REVIEWED BY DATE co ADDRESS ,icp <i 0 " RC)l _2c) FIRE REVIEWED BY DATE ul IZ M ZIP TELEPHOVE ()S'2 71,0A r,-, q � _�> - IN 2; VARIANCE OR CU SHORELINE OR ADB# INSPECTION REQ'D BOND POSTED I STATE LICENSE NUMBER CHFZKED BY L66A0_,a__\_ Lty�; IQ0 (1 02 M OYES ONO s SEPA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT' ALLOWED PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. -27 09,S(o 0 0 1 - 0 A—,"i , , I EXP NEW ORESIDENTIAL 13 PLUMBING/MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT URSIbE REAR COMPLIANCE OR ADDITION COMMERCIAL 1:1 CHANGE OF USE I z PARKING LOT REOD PROVIDED AREA PLANNING REVIEWED BY DATE REMODEL MULTIFAMILY 1:1 SIGN 116 GRADING FENCE REPAIR CYDS 13 j X FT) REMARKS OTH-1 (�, (yA DEMOLISH TANK Mh GARAGE RETAINING WALL E] FIRE SPRINKLER FIRE ALARM CARPORT ROCKERY (TYPE OF USE, BUSINESS OR ACTlyM E CHECKED 13Y JTY[�El[ fCON A OCCUPANT GROUP L2 less NUMBER OF e2 NUMBER OF DWELLING CRITICAL AREAS SPECIAL INSPECTION AHEA OCCUPANT STORIES NUMBER REQUIRED [] YES LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER LIBC I 08/FINAL INSPECTION REG'D z (*V to AM r%LCTt:n_ \I .0 Ck 6 n VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES 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 Grading Engr. Review SEPARATE PERMISSION. PERMIT APPLICATION: 1150 DAYS . as PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection Fire Review Plan Chk. Deposit '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 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 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.* Landscapeinsp. Total Amt. Duo Recording Fee Receipt # I I CALL FOR INSPECTION 1425) APPLICATION APPROVAL This application Is not a permit until signed by the Building Official or his/her Deputy: and Foos are paid, and receipt Is acknowledged In apace provided. 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 COMPENSATI��SURANCE AND RCW` 18.27. OFFICIALS §IGNATURE1 DAT7 Z/�/// /// 411 �( SIG (OWNER OR tENI)) DATE SIGNED 7TURE �, 4 1 S- 9 -C),Z 771-0220 REtEASED 13Y / /DATE ATTENTION ------- 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 -INSPECT CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD-ASSESSO 04/02 S GREEN - ACCOUNTING PRESS HARD -YOU ARE MAKING 5 COME I z 0 m =i =n- ro � am C ma 0 0 C: � M m m Z 0 -n n M M a V5 0 o Fn C Ch r. 0) M 0 Z .4� X z CD z 0 0 m