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20030410.pdfto DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS \41 U-c-s-� (- MAILING ADDRESS 1-1 (71. 4-M TELEPHONE CITY ZIP F-TEL11 :5�� 9 lilt so(--441 NAME Jvo ADDRESS 5,-Z--Z(7 CITY ZIP TELEPHONE 17AME A ICBLN IN C Zip M I TEIPHONE 0 r— f Z I STATE LICENSE NUMBER PROPERTY TAX ACCOUNT PARCEL NO. '91t,12.72 0000no 10a —'P NEW RESIDENTIAL PLUMBING / MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL ICA MULTIFAMILY SIGN REPAIR GRADING CYDS E:] FENCE ( _ X_F1) DEMOLISH TANK OTHER oGARAGE CARPORT RETAINING WALL ROCKERY F RE SPRINKLER FIRE ALARM (TYPE OF USEBUSINESS OR ACTIVITY) EXPLAIN: L) :�- PERMITEXPIRES USE PERMIT ZONE o)41 L__ NUMBER JOB ADDRESS Tq SUITE/APT# e7 PLAT NAME/SUBDIVISION NO. LOT NO. LI 7 I-e LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved AW Permit Required Street Use Permit Roq'd EXISTING - PROPOSED Inspection Required Siftwali, Required REQUIRED DEDICATION- FT Underground Wiring required METER SIZE LINE SIZE i NO. OF FIXTURES I RV REQUIRED I YES13 NO 13 2 NUMBER NUMBER OF RITICAL G OF DWELLIN AREAS UNITS NUMBER STORIES S1 I W DESCRIBE WORK TO BE DONE I HEAT SOURCE I GLAZING % I LOT SLOPE % PLAN CHECK NO: 4,/,/ -- L4 I 1211gjfj� rL&-, THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PLfiMrr 1OVERS WORK TO I BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: ISO DAYS PERMIT UMrP 1 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 N 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 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 THE4��COD NOF THE STATE OF WASHINGTON RELATING TO WORKMEWS�NS I IN CE AND RCW 18.27. DATE SIG ED 7, (R/P;5 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE VARIANCE OR CU SHORELINE OR ADBI I INSPECTION I BOND REO'D __�O_ �T 1APP11 f4 4? 13YES A_O $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT I ALLOWED . PROPOSED I ALLOWED . PROPOSED 0 z 5 z z LOT COVERAGE REQUIRED SETBACKS (FT) PROPOS ED SETBACKS (Fr.) ALLOWE SED D PROPO FRONT SIDE REAR FRONT URSIDE REAR I ----------- z PARKING REO'D PROVIDED LOT AREA I PLANNING REVIEWED BY DATE REMARKS CHECKED BY OF CONSTRUCTION DE OCCUPANT ITYPE V I Nz N 7 GROUP SPECIAL INSPECTION OCCUPANT REQUIRED [] YES JAREA LOAD REMARKS PROGRESS INSPECTIONS PER UBC 11081FINAL INSPECTION REG'. � W9, A WOR Description Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Fire Inspection Landscapelnsp. Recording Fee CALL FOR INSPECTION (425) 771-0220 EXT 1333 dFEE Description FEE State Surcharge City Surcharge Plan Chk.Deposft 0 IV: — Receipt III Total Amt. Due Receipt N D'a I Q I APPLICATION APPROVAL This application Is not a permit until signed by the Building 011icial or his/her Deputy: and Foos are paid, and receipt Is acknowledged in space provided. OFFICIALS SIGNATURE DATE C)_: 0' RELEASED BY DATt I I I A Ii-VI I , -,,� 'N '-) IT 91UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I I L/1- 11,1� j 4XI& I —IV I I L" I A PINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- OR�GINAI_ii FIL - YELLOW - 4PECTt CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 P NK - OV�I`U) - GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING P1.1 z 0 M :i *-fi Vi � Q M C M 0 0 C: �! r. M M z 0 _n n M M D-0 0 r- 0 M 0) M 0 z z z 0 11 0 M I 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 t OCCUPANCY .................. z 0 1 0 M M, C= M 0 10 0 C: � C M M z 0 _n ITIM co o Fn C: (A r, co 0 M z z 0 M DATE RECEI CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS MAILING ADDRESS -2-161 t 44iS. CITY ZIP TELEPHONE ::5�� 44 NAME __VkA� ADDRESS 'CITY ZIP TELEPHONE ,NAME CBL# ZIP PERMITEXPIRES USE PERMIT ' ZONE NUMBER Zo?) (jkj I JOB ADDRESS sulriiiA ;j C"PT" PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE $ TESCP Ap 'r�V PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Aw ParmhpR Ir.1 street Use Pannit Roqd EXISTING - PROPOSED inspection Required 13 Sidewalk Required 13 REQUIRED DEDICATION- Fr UnderWound Wiring required 0 METER SIZE LINT;�� NO. OF FIXTURES PRV REQUIRED YESE3 NO 13 REMARKS z z WNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE 2 ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE 1--�11Lx_. Llibil-Irli�(-ULO-4-;6*-O)'/It-� VARIANCE OR Cu 1AVhjH SHORELINE OR ADB# I 4?113YES�&O INSPECTION REO'D BOND PO $ STATE LICENSE NUMBER EXPIRATION D TE Y Lg]oROU7r, SEPA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIG ALLOWED PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. C> 0C)C30 IOU Sot::? A76.1219 0 EXP , X, NEW RESIDENTIAL PLUMBING MECH COIPLIANIE OR ADDITION 0 COMMERCIA�L� CHANGE OF USE LOT COVERAGE ALLOWED PROPOSED ------------ REQUIRED SETBACKS (Fr.) FRONT SIDE REAR I PROPOSED SETBACKS (Fr.) FRONT UR SIDE REAR I I z PARKING REOID PROVIDED LOT AREA I PLANNING REVIEWED BY DATE CL REMODEL MULTIFAMILY SIGN REPAIR GRADING FENCE X CYDS FT) REMARKS DEMOLISH TANK 0 OTHER GARAGE RETAINING WALL E] FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM 9% Ot FA M Ift 2 m-= TT vft L" R (TYPE OF USE, QWINtSS OR ACTIVITY) EXPLAIN: it CHECKED BY ITYPE OF CONSTRUCTION - DE 7 - OCCUPANT GROUP, NUMBER OF STORIES NUMBER OF DWELLING UNITS CRITICAL AREAS NUMBER SPECIAL INSPECTION JAREA REQUIRED [I YES OCCUPANT LOAD DESCRIBE WORK TO BE DONE REMARKS I PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: 12 2 1 1 Plumbing —Aysr-C, U Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTF:n Tit WORKTO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading Engr. Review SEPARATE PERMISSION. PERMIT APPUCATION: 180DAYS PERL41T UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection I Fire Review Plan Chk. Deposit, K2. 'APPLICANT; ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIFX 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.' Fire Inspection Receipt # Z2-01 L9 Landscapelnsp. Total Amt. Due I - Recording Fee Receipt # CALL FOR INSPECTION (425) 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. 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 CITY AND STATE LAWS REGULATING CONSTRUC- TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE OF THE STATE OF WASHINGTON RELATING TO )?I'N S;;N C E �AN D R C W 18. 2 7. WORKMEq,-S,,CO"NSr1P OFFICIALS SIGNATURE DATE na SIG�URE (OW �R 11 1 � 1 DATE SIG ED asses 771-02:20 EXT 1333 RELEASED BY DATE " i I 111-)4 lc�4 i ti 1-111 kTTEhTI0N IT IS/UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAILZFI�LE YELLOW-APEC4 CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWN GOLD -ASSESSOR 04/02 GREEN - ACCOUNTING PRESS HARD -YOU ARE MAKING 5 COPIES I z 0 IT! -I -n M M 0 0 C: � C IT11 M Z g) --I C _z 0 _n n M M a 0 0 M C cl) C CO) M 0 z X z (0) z 0 1 0 M