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20030421.pdfE 1 DATE RECEIVED & CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEMAME OF BUSINESS k1n. 1)"p-IIt-ttj IS Z 3 1��r �5 L2 CITY ZIP ELEPHONE NAME ADDRESS CITY ZIP I TELEPHONE PERMIT EXPIRES .4 USE PERMIT ZONE NUMBER JOB SUITEIAPT# ADDRESS 9 � ? - PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP APPfcvOd RW Permit Required street Use Permit Req 'd EXISTING - PROPOSED Inspection Required 0 Sid"alk Required 13 REQUIRED DEDICATION- FT underground wiring required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE NAME CS N 3 �,q V, e- Po,y'44e- PLP— ( 1 19 S �e Zl_ a) ENGINEERING REVIEWED BY 105b.020 ADDRESS PURSUANT TO ECDC 613 3. ATDR YAM (M -5 FIRE REVIEWED BY SHALL BE I IMAR ul CITY IP TELEPHONE JE WAkSITALLEDD Tf , R cc rL Y'r M 9 L;125'- q9 6 7500 iSHUTOFF STATE LICENSE NUMBER EXPIRATION DATE C K FY VARIANCE OR CU I SHORELINE OR ADBN IMPECTION BOND REO'D POSTED 1[3yEs e's ndi Z01 M_ q [3NO1s SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPI ALLOWED PROPOSED ALLOWED PROPOSED 010 &P 000 (12-1z , I , EXP 1:1 NEW 13 RESIDENTIAL 13 PLUMBING / MECH LOT COVERAGE ALLOWED REQUIREDJ� fIMTBACKS (Fr.) F CtM DE REAR PROPOSED COMPLIANCE OR 0 ADDITION COMMERCIAL AWATM SERVICE S I CHANGE OF USE 1:1 REMODEL MULTIFAMILY SIGN PARKING L(0""P&%IW*dAff&'5W REO'D I PROVIDED I "JI'4 DJk LME Af rr ENTM THE BUH I'M GRADING Ei FENCE X REPAIR CYDS I Fr) REMARKS DEMOLISH TANK OTHER GARAGE RETAINING WALL F RE SPRINKLER FIRE ALARM CARPORT ROCKERY (TYPE OF USE, BUSINESS 09M: CHECKED BY TYPEa Iq RUCTION OCCUPANT C 1C GROUP NUMBER NUMBER OF CRITICAL OF DWELLING AREAS SPECIAL INSPECTION OCCUPANT LOAD STORIES UNITS NUMBER JAIREA REQUIRED 0 YES DESCRIBE WORK TO BE DONE REMARKS 't-0- PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D )A -IL Cie— 1j.? t/ i 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 Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 180DAYS PERMIT LIMM 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 N ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Total Amt. Due 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., Recording Fee I 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- 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 Foos are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided. WORKMEN'S COMPENSAT!PW ',�UURANCE AND RCW 18.27. OFFICIALS/SIGNAYURE DATE SIGNATURE (OWNER 0 DATE SIGNED (425) . -`-/ /00 -/ U%W1 - '--) -0-3 771-0220 , '�_ �2_ RE[_EAU6_B_Y_ D ATTENTION '--r 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 04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 3: rn M 0 -40 0 C 3� r. M M z 10--f z co 0 z MM 055 0 o Fn M 0 Z r- z -4 z 0 M FINAL PROMECT APPROVAL FORM RECEIvE[) TO:(Jk DEC 3 0 2003 DATE: ENGINEERING DIVISION MEMO TO: PERMIT CooRDINATOR, BUILDING DIVISION FROM: FIRE DEPARTMENT DATE---- FLYASE SIGN 11tv !Wa4 b3 Im D bither —ENGMEPJNG DIVISION DATE__LL__________� PLANNING DIVISION DATE-, FLZASH SIGN PROJECT SITE ADDRESS— ��/ADB# tele41M03 PERAMUrr ________PATE INSPECTED DESCRIPTION OF WORK TO BE INSPECTED Hance with approved plans. Final approval A field inspection was conducted to determine final comp ve signed Department to the release of denotes that there are no objections from the abo PERFORMANCE BONDS and the granting of: GRANT FINAL PROJECT APPROVAL GRAM PROJECT APPROVAL WITH CONDITIONS NOTED u Copy of CONDITIONS given to owner/contractor by inspector I . FAILED FINAL INSPECTION - OUTSTANDING ISSUES u Copy of CORRECTION NOTICE given to owner/contractor by ins . pector I . 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Dat Si- ocaprvl.doc.l:tenip:bldg:fonnsIO/OI z 0 :; 9 U5 --I 0 M C= rn 0 0 -40 0 C M M z Cn 0 -n n M M 0 U5 01- 0 M C C/) M C/) Q 0 Z .q� X z z 0 A 0 M I RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ................ Wall ........................ Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: U pde.rgr.ound ............... HEATING - Gas Test .................... Gas.Plping ................. 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 v YJ OCCUPANCY .................. L 4,9615 . - 400�1` / k1 I k�, DATE RECEIVED "J h [PERMIT EXPIRES I se - CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEfNAME OF BUSINESS k1n () to 44 W MAILING ADDRESS LT � 2 -7-1 z P L- 5 (--2 CITY ZIP TELEPHONE NAME ADDRESS CITY ZIP ITELEPHONE ZONE 1 -.0 NUMBER J013 SUITE/APT# ADDRESS �Z Z77 U-). PLAT NAME/SUBDIVISION NO. 7 LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required Street Use Pennit Rq'd EXISTING - PROPOSED Inspection Required Sidewalk Required 13 REQUIRED DEDICATION- FT Underground Wiring required 13 METER SIZE LINE SIZE ES PRV REQUIRED YES[3 NO 13 REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE W 01 NAME J,A N4, e P0 ej P ADDRESS 1-3 /V 04-�� CITY ZIP kt A, Vic-e- 9 STATE LICENSE NUMBER L- OM 'A- (7-e e.5 j4DO"? M Lt PROPERTY TAX ACCOUNT PARCEL NO. C 13 1. N e 4- 1) TELEPHONE Y?.5-qg t 7500 EXPIRATION DATE CKINKEb%BY -7- 17 -0� ENGINEERING REVIEWED BY DATE PURSUANT'ID F CDC 19.30-020 FIRE "DATE SMALL BE IN STMIXD NEAR Ttm IAIA��, .ARIANCE OR CU SHORELINE OR ADB# INSPECTION 13OND REO'D POSTED SEPA REVIEW SIGN AREA OyEs ONO HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED I 4 09 711.019 /-)cr IxW Ql-e) EXP , , NEW RESIDENTIAL PLUMBING MECH I LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ,ED -31PE -REAR ONT LIRSIDE REAR ALLOWED PROPOSED FRO U�F TO ADDITION COMMERCIAL El COMPLIANCE OR CHANGE OF USE -PC P A %"&UP k am. A, IN (worm DATE PARKING E, 016 REMODEL MULTIFAMILY F] SIGN REO'D C;W�� TMBUMDOM I TWJB 13M ff 1; ff REPAIR GRADING [3 FENCE X CYDS ( _ _FT) REMARKS DEMOLISH TANK 1:1 OTHER GARAGE RETAINING WALL [3 F RE SPRINKLER FIRE ALARM CARPORT ROCKERY (TYPE OF USE, BUSINESS OR Ar-T CHECKED BY TYPE RUCTION OCCUPANT I Cx ��!)�rN: GROUP I I NUMBER OF NUMBER OF DWELLING CRITICA AREAS I /�#— SPECIAL INSPECTION jAffEA OCCUPANT LOAD STORIES ji� UNITS NUMBER REQUIRED F] YES DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ z Sex- 4.,,, ",jucelr— rL 4e,4. J4 $ 1 - Description FEE Description FEE Plan Check I State Surcharge HEAT SOURCE GLAZING 11 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 t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 23 DOMAIN (CURas, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPLICATION: ISO DAYS UMM 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, IT$ OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND File 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 Landscapelnsp. Total Amt. Due lali. 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.' Receipt # Z/n tp Recording Fee 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 IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION BuildIng official or his/her Deputy: and Fees are paid, and recelpt is acknowledged In space provided. WORKMEN*S COMPENSAT!PW 18.27. ,NkRANCE AND RCW OFFICIALS ISIG,7NARE DATE SIGNATURE (OWNER 0 DATE SIGNED (4215) L & 771-0220 DATE RELEA5ED UY cv"r .1 1212Q 1111111111U11 Ik I I Cn lulm IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL L A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW- INSPECTOR PINK -OWNER GOLD-ASS;ESSOR NO CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 GREEN - ACCOUNTING 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES xkj, t z 0 4 0 M M M 0 0 0 C: -4 C X M M Z 0 -n n M M OV—) 0 r- 0 1171 C ITI 0 -Z 17n ii; z z 0 1 0 1171