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20030346.pdfA DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEMAME OF BUSINE S S L .15 MAILING ADDRESS L CITY ZIP TELEPHONE lIE�tM)r)j,j( C 4 NAME ADDRESS CITY ZIP TELEPHONE NAME -, ICB7# I; CITY ZIP TELEPHONE 0 STATE LICENSE NUMBER EXPIRATION TAX ACCOUNT PARCEL NO. [] NEW ADDITION REMODEL REPAIR DEMOLISH E:iGARAGE CARPORT (TYPE OF USE. I NUMBER OF STORIES I 1PERMITEXPIRES jql#L�e_ USE PERMIT ZONE N U M B E R -_7 JOB S ITE/APT# ADDRESS res PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7 ESCP Approved RW Permit Requ 'ad 13 street use Peffn:, RI'l EXISTING — PROPOSED Inspection Required 13 Sidewalk Required [3 REQUIRED DEDICATION— FT Undergmund Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 13 NO 13 REMARKS z z OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE 45 T MUST BE HINSPECTOR ENGINEERING FIRE REVIEWED BY DATE us W M I B No 1$ POSTED 1[3`YEs ONO CHECKED BY I I OCDA MM11CW QW-IM &MCA 7.1-11T COM PLETE EXEMPT 1 ALLOWED PROPOSED i ALLOWED"r. PROPOSED LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) 0 RESIDENTIAL LUMBING / MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR ?<4COMPLIANCE OR z 0 COMMERCIAL z 0 CHANGE OF USE z PARKLqp ... ANNINQ Al:VlFWEQ.9X____DAj9 MULTIFAMILY L_j SIGN GRADING CYDS 13 FENCE ( x Fr) REMARKS TANK El OTHER I RETAININGWALL ROCKERY F RE SPRINKLER FIRE ALARM R ACTIV" EXPLAIN: B or 4 vent connectors ,ed on fuel -burning applis ted spwm UMC 815.1. In CHECKED BY REONSTRUCTI CO2y_ OCCUPANT 1-`)r-z4&2b7R-/ ITYP GROUP NUMBER OF DWELLING UNITS CRITICAL AREAS NUMBER VIA SPECIAL INSPECTION REQUIRED [:] YES JAREA OCCUPANT LOAD TO ED NE t REMARKS z PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D I � (A j-) V,5r�bAb. J, ,7— $ F_ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE% Building Permit City Surcharge 15 PLAN CHECK NO: VESTEDPATE -; Plumbing "y) _�_ 7ZI ,O ,Zh . Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT C&ERS WORK TO 1= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 180 DAYS PERMIT UMIR I YEAR - PROVIDED WORK IS STARTED WITHIN 100 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 IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EUMONDS. 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 Landscape Insp. Total Amt. Due l!9 0 0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* 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 M 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 Building Official or his/her Deputy: and Foes are paid, and IN VIOLAT ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided. WORKMEN!S 59#211�kSATION INSURANCE AND RCW 10.27. OF ALS SIGNATURE DATE 9 R AGPA)-j DATE SIGNED (425) (%TUR((OWNEA LtL S I 771 -022M Agsr RELEASED BY UATt: % I AT'itNTION E)ff 1333 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 - 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 z 0 0 M C MO 0 -40 0 C M M Z 0 -n n M M a V; or- 0 M C (j) C ca Q 0 Z X z 0) z 0 A M RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS FOUP'DAT10k..: Footing ......... ........... Wall............................ Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground ............. Rough -in ................... Commercial Final ...... HEATING: Gas Test ...................... Is -pf Gas Piping .................. Equipment ................. r Commercial Final ....... EXTERIOR SHEATHING NAILING .......................... AMING . ................ PiRST-MOOR FRAMING ... INSULATION ................... Floor Insulation ......... Wall Insulation ........... Ceiling Insulation ....... SHEETROCK NAILING ... SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. &60 gram 0084016 v DATE RECEIVED PERMIT EXPIRES USE PERMIT ZONE CITY OF EDMONDS - NUMBER C,�&S 6)';� CONSTRUCTION PERMIT APPLICATION 'OB SUITE/APT# ADDRESS OWNER NAME/NAME OF BUSINESS PLAT NAMEISUBDIYISION NO. LOT NO. LID NO. LID FEE $ MAILING ADDRESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Ap 'ZV RW PermitpR ked JIA"?o EXISTING - PROPOSED Street Use Permit Req'd Inspection Required 13 Sidewalk Required 13 CITY ZIP IT! LEPHONE REQUIRED DEDICATION- Fr _TNO. Underground Wiring required 13 NAME L METER SIZE LINE SIZE OF FIXTURES PRV REQUIRED 0 YES [3 NO 13 2; ADDRESS z REMARKS z OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE I GAS PIPIE TEST MUST BF J CITY ZIP ITELEPHONE NAME CBL 0 ENGINEERING REVIEWED BY BE ACCEFrED FIRE REVIEWED BY DATE ul CITY ZIP LEPHONE T VARIANCE OR CU SHORELINE OR ADIIII I INSPECTION REO'D OYES 13NO I $ B9ND POSTED STATE LICENSE NUMBER EXPIRATION DATE I CHECKED BY I SEPA REVIEW COMPLETE , EXEMPT EXP SIGN AREA ALLOWED , PROPOSED HEIGHT ALLOWED , PROPOSED 4 PROPRTY TAX ACCOUNT PARCEL NO. 0616Z4�1� L�0 --- NEW RESIDENTIAL LUMBING if MECH ADDITION COMMERCIAL o COMPLIANCE OR CHANGE OF USE LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT LJRSIDE REAR z PARKINP PLANNING REVIEWED BY DATE I LOT AREA REQ'D I _ --- Tj;� REMODEL MULTIFAMILY SIGN REPAIR GRADING FENCE CYDS ( - X-FT) Ift-_ Ar I went eenneefts REMARKS required on fuel-hulming app DEMOLISH TANK 0 OTHER unheated spum UMC 81S,1_7 GARAGE RETAININGWALL F RE SPRINKLER CARPORT 0 ROCKERY 1:1 FIRE ALARM (TYPE OF USE, BUSIN R ACTIVITY) EXPLAIN: 52: / CHECKED BY ITYP",PONSTRUC 10 COQV_ OCCUPANT T ?GROUP M I �_l NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES UNITS NUMBER SPECIAL INSPECTION JAREA REQUIRED [3YES __0 OCCUPANT LOAD DESCRIBE WORK TO QE Do% A-b "_AAfJ -t"-N REMARKS T1 PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ Ada, MUM FRIF91 -VALUATION 1 %0%11111 U $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge 15 Plumbing PLAN CHECK NO: VESTED PATE Fg�� Mechanical &/) . foL'? THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT C6VERS WORK TO Grading I= t: 2 I BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 180DAYS Engr. Review CL PERMIT LIMM I YEAR ' PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION I Engr. Inspection Fire Review Plan Chk. Deposit 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS a 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 Fire Inspection Receipt N Landscapelnsp. Total Amt. Due 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 Recording Fee Receipt # NOR LIMIT IN ANY WAY THE CITYS 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 CALL FOR INSPECTION APPLICATION APPROVAL This applicalIon Is not a permit until signed by the Building Olficial or his/her Deputy: and Foos are paid, and receipt Is acknowledged In space provided. OF IqALS SIGNATURE DATE WORKMEN'S �W.I�,4SATION INSURANCE AND RCW 18.27. 1"A 2 5) LI (OWNER R AGENT]i- V DATE SIGNED RELEASED BY ATitNTIOW EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AN.0 APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR GREEN - ACCOUNTING 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES I z 0 i 0 M C M 0 —to 0 C --I C X M M 10 S z ca 0 -n M M a -0) 0 r- 0 M C M 0 Z ri z z 0 4 0 M