The URL can be used to link to this page

20030368.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION PWW NAMEINAME OF BUSINESS PO 0 (4— Hy MAILING ADDRESS -714 1 rf Z 30 + e7r CITY ZIP ITELEPHONE cl �3 NAME ADDRESS CITY ZIP ITELEPHONE - -3b Eb �= -8 1 PERMITEXPIR ES ds E PERMIT ZONE & NUMBERr-P _-� > JOB SUITE/APT# ADDRES&V PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Req - ulted 13 13 Street Use Prrmlt Roq'd tJ EXISTING - PROPOSED Inspection Required 13 sidewalk Required E3 REQUIRED DEDICATION- Fr Unclorgrowd Wiringrequired 13 METER SIZE LINE SITq NO. OF FIXTURES PRV REQUIRED YEs13 NO 13 REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE 11 NAME CB N ENGINEERING REVIEWED BY DATE ADDRESS Iq 551 q t)IH pL pF FIRE REVIEWED BY DATE CITY ZIP _4TELEPHONE LAJ14f_ 010 -rACI I VARIANCE OR CU SHORELINE OR AD1111 INSPECTION REO'D OYES 13NO BOND POSTED s STATE LICENSE NUMBER EXPIRATfON DATE CKE Y SEPA REVIEW COMPLETE EXEMPT EXP I SIGN AREA ALLOWED , PROPOSED HEIGHT ALLOWED , PROPOSED PROPERTY TAX AQCPUNT PARCEL NO 19e :!Z= Apso NEW RESIDENTIAL rl PLUMBING / MECH A COMPLIANCE OR ADDITION COMMERCIAL 1:1 CHANGE OF USE REMODEL MULTIFAMILY 1:3 SIGN GRADING FENCE REPAIR CYDS 1:1 ( _ X _FT) DEMOLISH TANK OTHER GARAGE RETAINING WALL F RE SPRINKLER C ROCKERY FIRE ALARM LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT LIRSIDE REAR PARKING REO'D PROVIDED I LOT AREA I PLANNING REVIEWED BY DATE ---FTHE MARSHAL REMARKS MUST BE PHt:6F-NT FOR �ANK FILL, MEMOVAL, OH GAP (rYPE OF USE, BUS S OR ACTIVWP EXPLAIN: -,'-d 7 -Z, -o CHECKED BY ITYPE OF WNSTRUCTION izw4r= OCCUPANT GROUP Zz MUMBER OF DWELLING j 1 UNITS CRITICAL AREAS I NUMBER SPECIAL INSPECTIOA REQUIRED [] YES AAtA OCCUPANT LOAD .4�4 . DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D DE" kz6ry t-3 21; W, CM f M - 77VKl V : VALUATION $ 1 Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % 1 LOT SLOPE % Building Permit L6: city Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORUES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Iz BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC Grading 23 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPILICATION: 180 DAYS n PERMIT LIMIr 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 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 Landscapelnsp. Total Amt. Due 0 NOR LIMIT IN ANY WAY THE CIIYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Recording Fee Receipt fill 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 Building Official or his/her Deputy: and Fees 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 COMPENSATION INSURANCE AND RCW 18.27. 0 F CAL S URE DATE S;1 SIG U/ (OWNER DATE SIGNED (425) 1, 4 52Y All 1 771-0220 211-46AKeW V zC11 -f A /DATE/ I e 11i Gill Rr REIE R Hy- ATTENTIOd/ t-J Off 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 k z 0 1 0 IT! =i =5 M M 0 —10 0 C: -4 C 3: M M Z 0) 0 -n M M D—O) 0 0 Fn Q 0 Z .I� X z z 0 ITI FINAL PROJECT APPROVAL FORM TO: DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: FIRE DEPARTMENT DATE_�l —ENGINEERING DIVISION DATE — PLANNING DIVISION DATE— PROJ13C Ud -(_ � S -/- S SITE ADDRESS PERMIT ADB# DATE INSPECTED_�E—?-J DESCRIPTION OF WORK TO BE INSPECTED P -)At- R, CL 4A ME k- S-L U/LvLf A fleld inspection was conducted to determine rinal compliance with approved plani. Final approval denotes that there are no objections from the above signed Department to the release of PERF RMANCE BONDS and the granting of Q_ GRANT FINAL PROJECT APPROVAL GRANT PROJECT APPROVAL WITH CONDITIONS NOTED o Copy of CONDITIONS given to owner/contractor by inspector I . FAILED FINAL INSPECTION - OUTSTANDING ISSUES a Copy of CORRECTION NOTICE given to owner/contractor by inspector I . 2. 3. RE-INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date— Si ocaM1.doc.1:tmW:b1dg:fbrMS10/01 z 0 q 0 M =i =a M C M 0 0 M M z r') 4 C o -n n M M 0 0 0 M C ci) C V) Q 0 Z X z z 9 0 rn 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 ........... Celling Insulation ....... SHEETROCK NAILING ... SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. so M I ! 0 F_� ERMIT EXPIRES qDATE RECEIVED 7 4g;1,0 el,-� -8- 1 CITY OF EDMONDS 11SE PERMIT ZONE NUMBERA�L,� CONSTRUCTION PERMIT APPLICATION JOB SUITEIAPT# ADDRESS?,,,// 7 Z OWNE NAME/NAME OF BUSINESS PLAT NAME/SUBDIVISION N7 LOT NO. LID NO. LID FEE S P00(4- 15 MAILING ADDRESS 744 17 27 301+ !_S7 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING - PROPOSED REQUIRED DEDICATION- FT TESCP Ap' RW Permit R*Z�11_ .it Street Use Perm I Req'd Inspection Required Sidewalk Required 13 Underground Wiring required 0 CITY ZIP TELEPHONE 4115) -779 36 5b NAME METER SIZE LINESIZEI NO.OFFIXTURES PRV REQUIRED YES 13 NO 13 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE z CITY ZIP TELEPHONE NAME C84N -r ,kOK612,./ gD I Ila ENGINEERING REVIEWED BY DATE ADD jq!5_51 O-R4 pl, pe U 1a0K!5D* FIRE REVIEWED BY DATE Cr IZA. CITY ZIP LjkKe r"-r ?&q , g P,A_q 64010M_0191 TELEPH.QNE VARIANCE OR CU SHORELINE ORADBI1 INSPECTION REO'D OYES ONO BOND POSTED $ STATE LICENSE NUMBER EXPIRATION DATE W1 K-C- fz0bzU05 1EXP SEPA REVIEW COMPLETE , EXEMPT SIGN AREA ALLOWED , PROPOSED HEIGHT ALLOWED , PROPOSED, 9 PROPERTY TAX AQCQUNT PARCEL NO. -07 !!�I- 19v9 eal!�W ME NEW RESIDENTIAL ID PLUMBING / MECH ADDITION COMPLIANCE OR COMMERCIAL 13 CHANGE OF USE LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT L/RSIDE REAR z PARKING LOT REO'D PROVIDED AREA I PLANNING REVIEWED BY DATE REMODEL MULTIFAMILY SIGN CL GRADING FENCE X REPAIR CYDS ( - - FT) REMARKS 113HAL EiBF MA DEMOLISH TANK OTHER MUST BE PRESENT FOR 3 g o GARAGE RETAINING WALL FIRE SPRINKLER CMPORT ROCKERY F RE ALARM TANK FILL, REMOVAL, OR CAP (TYPE OF USE. BUSPqS OR ACTIVTrP EXPLAIN: 25-,�G W CHECKED BY ITY=N ICOM /_ OCCUPANT GROUP NOE NUM EIR OF R A OW L C ITIC L EBL NG AREAS &��,�2 NUMBER SPECIAL INSPECTIO� AhtA REQUIRED [:] YE OCCU Nt LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REG-D AND, 011, TAN Las; MIRA L11 VE I ki I VALUAnON %OVIVII 1610 1 11611111111f $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING I LOT SLOPE % Building Permit City Surcharge ECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT LUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO At Grading t: :1 It: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. PER141TAPPUCATION: 180 DAYS Engr. Review CL PERMIT UMrP 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 x EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND IALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY Fire Inspection Receipt # Landscapeinsp. Total Amt. Due FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE 9 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.' zi Recording Fee Receipt # .7v-- 607 P CALL FOR INSPECTION APPLICATION APPROVAL This application is not a permit until signed by the Building Olficial or histher Deputy: and Fees'arro paid, and receipt Is acknowledged in space provided. 1 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 C17Y 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 F C LS SIGNATURE DATE OT, 1101 aw WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. (425 771-0220 EXT 1333 BIG U (OWNER 01 A4ENT) >t4w� DATE SIGNED RF:l F—� _//�DATE ATTENTIOIV 6,1 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 GREEN - ACCOUNTING 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES ------------ ---- k 4 -n M C M 0 -40 0 M M z o -n n M M a U5 0 0 Fn C 0) C CA M 0 Z z z 0 M