20030413.pdf13
[PERI
PERMIT EXPIRES
DATE RECEIVED
1�e
CITY OF EDMONDS
use
ZONE jC
PERMIT
NUMBER
CONSTRUCTION PERMIT APPLICATION
JOB
SUITEIAPT#
ADDRMtq[0
OWNEFIAAME/NAME QF BUSINESS
PLAT NAME/SUBDIVISION NO. L�D NO.
MAILING ADDRESS 1
L D FEE$
2A6 16 -7 6 444 prv-c
TESCP Appf:Vked
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP R Permit R
Mrset
Use Permit Req'd
CITY ZIP TELEPHONE
EXISTING —
PROPOSED Inspection Requited 13
Sidewalk Required
3(iLi G
REQUIRED DEDICATION— FT Underground
Wiring required 13
NAME
METER SIZE
LINE SIZE NO. OF FIXTURES PRV REQUIRED
LC
6oum,lk 6V '")
I
YES 13 NO JW
I
z
ADDRESS I U I
REMARKS
z
Lf 4k Av4 U-)
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY ZIP
ITELEPHONE
ftwk,-rew -10�s L4 2.5. _ 4 70-670(a
NAME
ENGINEERING REVIEWED BY DATE
ADDRESS
22Z242W
FIRE REVIEWED BY
DATE
CITY ZIP TELEPHONE
1��
(0 — q— 6 -7
10
VARIANCE On cu SHORELINE OR ADJB# INSPECTION BOND
STATE LICENSE NUMBER EXPJRATION CHECKED BY REO'D POSTED
13YES 13NOI$
SEPA REVIEW
SIGN AREA HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO.
COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
L1 (0 1 — 2-ft 1 0 1
EXP
1:1 NEW 1:3 RESIDENTIAL MECH
gEiD
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKIS (Fr.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR
3 ADDITION COMMERCIAL COMPLIANCE OR
Im 11
CHANGE OF USE
REMODEL MULTIFAMILY 1:1 SIGN
PARKING
REQ`D PROVIDED
LOT AREA PLANNING REVIEWED BY DATE
REPAIR GRADING FENCE
0
CYDS ( — x—Fr)
REMARKS
1:3 DEMOLISH TANK
o GARAGE RETAININGWALL FIRE SPRINKLER
PORT -ROCKERY FIRE ALARM
UWE OF USE,.BUS114ESS OR CTfVrM EXPLAIN:
XtL
CHECKED BY COELE. OCCUPAtjL_
o&wk-a
ITYPE
I
!MUCTION
GROUP J�
Tz
NUMBER NUMBER OF CRITICAL
OF DWELIUNG AREAS
61A
SPECIAL INSPECTION
All] 4+0 OCCUPANT
LOAD
STORIES UNITS NUMBER
REQUIRED KyES
I
DESCRIBE WORK TO J31E DONE I
JA0_rftM__
VLIAA�- C"!�,�
9VV,6!M eKAVAAA,(.t
REMARKS
PECTIONS PER UBC IPO/FINAL INSPECTION REQ'D
Ole
A-
ffflf 5 W4�4 U C I
VALUATION
11
ikl�lllak"A 1C, j4DLA+_7-7j2n2j- MGZDj
$ 2&q-
i
714- ri-4 ��C
Description
FEE Description FEE
1411111.1 if ab�t�,
Plan Check
State Surcharge
.
HEAT SOU C9 G LOT SLOPE %
4� ,4Zt�PNG %
'WT I f
Building Permit
City surcharge
PLAN CHECK N VESTED DATE
Plumbing
2L— 1
_6
Mechanical
THIS PERMIT AUTHORE"S ONLY THdWORK NOTED. THIS PERMr'T COVAS WC
HE DONE ON PRIVATE PROPERTY ONIX ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMITAPPILICATION: 150DAYS
PERMIT ILIMM I YEAR - PROVIDED WORK IS STARTED WIITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICAN7; 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
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
Landscapeinsp.
Total Amt. Due
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CIIYS ABILITY M ENFORCE ANY ORDINANCE PROVISION.'
Recording Fee
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
__L
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 o. his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION wr!p4ls acknoModgod in space provided,
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
FFI IA S ATU DATE
SIGNATURE =AGE - I DATE 13IGNED
(z,
(42my
M�4 4 6 A/z -5
L(NER
771-0220
—f -
RELEASED ly DATE
ATTENTION Off 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL L MO/M &MIZ-12
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - YELLOW 4SPE`CTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OW GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
NINE
L.. .
z
0
1
0
m
:; 9
M
m
—10
0
0 C=
4 c
= M
M Z
10-1
0 -n
n
m M
065
0
0 Fn
C (j)
c ch
M 0
Z
z
(j)
z
9
0
m
2.
3.
RE-INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Si
ocaprvl.doc.l:temp:bldg:formsIO/OI
hL
NG
'ITMIENTOFBUILDI S--
A.PER UNIFORM BUILDING CODE SECTION 100,
:1810 7e Avenue W. Edm6hds WA —Building 0ji4hit X: 2003-0413
Occupancy established by this
B
Maximum Occupant Load.
Room...capacify signs,
IF
Units: **W* No. Stories: I
struction: VN Basement: No
List remain posted at a# times.
1002)
L�l -- I
Owner of Building: Dr. Steve Mackay 5,,, Addr9" FMA VVP% WGUA90
'*ING WITH THE REQUIREMENTS OF THE 1"7
THE Dr. S%ve Macke Dental Offl D it �.$iWN7`INSPt&1*WAWj*. jtgl=� JAPL
DIVISION OF OCCUPANCY AND THE USE FOR
EDITION OF THE UNIFORM BUILDING CODE D BY Cfw*'-�' --..T.HE
WHICH THE PROPOSED OCCUPANCY IS CLASSI
Issued this AU 2003
CHIEF BUILDING OFFICIAL
INs cefflicalle be poolled in a ws*um pt"c ares arw not be m-novW. inublated or obwxed wW OW be minlained In legible oondbon at aN firnes. Any change of occupancy or use Muires a bdlckng parrrit and a now
Car0kate of OocLgwlcy Mued by On Oty d Edmonds EkAking Oftiel -
11
RECORD OF INSPECTIONS
01DATE'
IDATE REREIVED
PEPMIT EXPIRES
-IMF=
CITY OF EDMONDS
USE
ZONE PERMIT
NUMBER 6'
CONSTRUCTION PERMIT APPLICATION
JOB SUITE/APT#
ADDREY -7(p444
OWNE"E/NAM BUSINESS
BT
PLAT NAME/SUBDIVISION NO. L&Ao. LID NO.
MAILING ADDRESS
szk LID FEE $
6 16 '7 6 1-11 *10 1
TESCP Approved
PUBLIC RIGHT OF WAY PER.OFFICIAL STREET MAP AW Pofnvt Required
Street Use Patmil R44d
CITY ZIP TELEPHONE
EXISTING - PROPOSED Impaction Required
Sidewalk Required
11 Li
UnderWound
REQUIRED DEDICATION- FT Wiring required
NAME
METER SIZE LINE SIZE NO. OF -FIXTURES PRV REQUIRED
V
YES 13 NO
ADDRESS
L(-kA Avv UJ
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE
7- 7.,ovV
CITY zip TELEPHONE
NAME CBL 0 - -
VU
ENGINEERING REVIEWED BY DATE
ADDRESS
FIRE REVIEWED BY DATE
&U
z
0
CITY ZIP TELEPHONE
C-(-
0
EXPIRATION D
STATE LICENSE NUMBER CHECKED�BY,.,
BOND
VARIANCE OR CLI SHORELINEORADS# INSPECTION POSTED
REQ'D
[3YEs 13NO $
PROPERTY TAX ACCOUNT PARCEL NO.
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
C
N L) 6 0-0 - ) 00 1 0
,
M
NEW RESIDENTIAL k�U M
�BINECH
EXP
LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR
M
11
00
ADDITION COMMERCIAL COMPLIANCE OR
CHANGE OF USE
Eb-REMODEL MULTIFAMILY SIGN
PARKING LOT AREA PLANNING REVIEWED BY DATE
ED
REO'D I PROVID'
M
M
0 REPAJR 0 GRADING FENCE FT)
CYDS 0 X
REMARK HIM:,
S
z
DEMOLISH 13 TANK I
GARAGE RETAININGWALL, FIRE SPRINKLER
1:3
0
cARPoFrr ROCKERY FIRE ALARM
(TYPE OF USE,.SUS"ESS OR ISOTIV" EXPLAIN:
-'611
0 rx
CHECKED BY TYPE 0!
'=UCTION OCCU
N
GROUP
M M
NUMBER NUMBER OF CRITICA
OF�,:� DWELLING AREAS
SPECIAL INSPECTION JARE occu
LOAD PANT,
0
U
STORIES NITS NUMBER
1�11A
REQUIRED ES
K-Y
OR
DESCRIBE WOFIK I TO PE DONE
dk- 07) yLl't
REMARKS
C2
C" S i
P RESS INSPECTIONS PER UBC 1p8/FI NSPECTION RECtD
0
0 ri -eKAyAAAu
q
94�,j (_LAfMMA_.'
VALUAPON
Description FEE Description FEE
co
Plan Check state surcharge
z
HE& SOU GIIAZING % LOT SLOPE %
t :>
[PLAN
Building Permit City Surcharge
0
M
CHECK NO: VESTED DATE
Plumbing
/v
wai
Mechanical
THIS PEmrr AUTHORIMS ONLY THE'WORK NOTED. THIS PERMr'T COVL06S WORK TO
1: BE DOME ON PRIVATE PROPERITY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
2 DOMAIN (CURBS, SIDkWALK8, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
:3
SEPARATE PERMISSION.
Engr. Review
PIERMITAPPLICATIOW. 1180DAYS
PERMIT LIMM I YEM - PRO�IDEO WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection,
SEE BACK OF PINK PEnMff FOR MORE INFORMATION
'APPLICAW. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review 6P Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFX 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
_X,7V
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Landscapalnsp. Total Amt. Due
DEEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY$ 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 TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
This application Is not a pelralitis,
CALIL.
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
onlid.bpWddle
Building Official or his/her Deputy: . and
Idad.-_
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION regoiMsacknoAtidgedinspacop!
WORKMENS COMPENSATION INSURANCE AND RCW 18.27.
FF1 ATU DATE
BIG DATE SIGNED
NATURE (GINNER OH'A-CGEPM
771-0220 DATE
AT;906N EXT 1333
IT IS NLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
is
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - YELL SPECTOR
��/
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PIM GOLD -ASSESSOR
GREEN - ACCOUNTING
04/02 PRESS HARD -YOU ARE MAKIN.G 5 COPIES