20030443.pdfPERMIT EXPIRES
DATE RECEIVED
CITY OF EDMONDS
USE
ZONE
PERMIT
NUMBER&V_L�Y3
—CONSTRUCTION PERMIT APPLICATION
JOB
ADDRESS
E APT#
Sz 11C
OWNER NAMEINAME OF BUSINESS
PLAT NAM EIS UBDIVI SION NO.
LOT NO. LID NO.
W MAILING ADDRESS
LID FEE $
aolirc)
PUBLIC RIGHT
OF WAY PER OFFICIAL
TESCP Approved
STREET MAP RW Permit Required
0
13
0
Street Use Permit Req'd
0
CITY ZIP TfLEPHQNE
EXISTING
— PROPOSED Inspection Required
Sidewalk Requited
0
0
77 q-9V-74o
REQUIRED DEDICATION—
FT Underground
Wiring required
0
NAME
METER SIZE
INE SIZE
NO. OF FIXTURES PFIV REQUIRED
7�
YES C) NO EI
ADDRESS
REMAR sJL
—1 YR
or V(P 0
0AEA&RMWDRAINAGE
OWNE C
122 TnaOR
ESP09SIBLE
VSN446
tim
appliances In
z
W
CITY ZIP TELEPHONE
slembealmd
snnt,
—
NAME I a
ENGINEERING PIEVIEWED/DATE
M ADDRESS IV r LOW
Rr 2
4 76� W005, A-W Y3 FIRE RE by IJAH: vu
CITY ZIP ELEPHONE
0 Regardless of whether the water system
Moves
VARII We BOND
STATE LICENSE NUMBER EXPIRAMN DATE HECKELIQV� d cn all hot water-'tankZCWQ'D POSTED
C r u I
.0 [:1 NO
F�e
O;gul
r09 P
. t L
;Pod A Elemot".020 ( t__
SE*MViF 0, - HEIGH r
PROPERTY TAX ACCOUNT PARCEL NO. COMPIL RROPOSED
0 6 17 40boioo &01D� EXP
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
NEW RESIDENTIAL VPLUMBING MECH ALLOWED PROPOSED FRONT SIDE REAR FRON1+1`1 SIDE REAR
:y
COMPLIANCE OR
C] ADDITION COMMERCIAL
CHANGE OF USE
PARKING LOT AREA PLANNING REVIEWED'bV DATE
REMODEL APARTMENT SIGN REO'D PROVIDED
C] REPAIR C] GRADING FENCE
CYDS X FT) REMARKS
DEMOLISH C] TANK OTHER
c3 GARAGE 0 RETAINING WALL
CARPORT SOCKFRY C] RENEWAL
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN
CHECKEDBY jTYl1fj=FrION CAqQ
OCCUPANTr
tq,,7
GROUP
UJI NUMBER NUMBER OF CRITICAL
a WELLING AREAS SPECIAL INSPECTOR JAREA OCCUPANT
M OF 0
o STORIES UNITS NUMBER Nil) Pf REQUIRED[] YES LOAD
DESCRIBE WORK TO BE DONE I
REMARKS
z
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D 5
404 cte-y) 4504r
16 C
t 6140-!z�
LAU FEE
VALUATION
PLAN CHECK FEE
HEAT SOURCE GT.AZlf4G % LOT SLOISE % _vr)
BUILDING
PLAN CHECK NO: VESTED DATE PLUMBING
100 �10
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/FILL
DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
STATE SURCHARGE
PERMIT APPLICATION: 180 DAYS
a. PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENG. INSPECTION FEE
U) 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
0
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING
2 EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND INSPECTION FEE
0 ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY RECEIPT
I FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 RECEIPT
NOR LIMIT IN ANY WAYTHE CITY'S ABILITY TO ENFORCE ANYORDINANCE PROVISION. -
TOTAL AMOUNT DUE 0&2
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 'AISPLICATION APPROVAL
.?AE 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 COMPENSATIV4
_WRANCE AND RCW 16.27. OFFICIA ION TURE
SIGNATU . RE� ROR UGENT), DATE SIGNED
I ___ —is RELEASED BY
AfrENTION EXT 333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER - GOLD - ASSESSOR
5/98
r
p
I I I I I , I � . . � 4�: I: k , try j r
0 "retr
F
-RECORD OF INSPECTIONS
1- 11 rp I "I I
0:
4
4'-p o'. INSPECTOR DATE APPROVED
1 4 1
6 It r
4 It 1-1 SETIBACKSi........69606 I
f
et 61 FOUNDATIONS* Art
61
%
Foopng
r 4 *me& *Osseo@ 0 4 0 8 9 0 0 a 0 6 0
4 4 14 r
1
. I
wasofood sefeases 0050000046 1
0 1 r4
0
14 It I
N., . rair . - I � . 1— 4 1 1 1 1 1. 1 1
r-'rtf ' Lt' ; I 1 0
plirdpor6h 'I Or r r r r
It:r,
Ot 4
1, p ' I P"
M1 4 6
0
It It irt Lit �,Retalning Wall" r L I
0 L
I It 1 1. r r L,
r 0 14 r r L it' Ir. I r, r r r r It 4;' r 0 1. L an
I
r S4ab L r I
Insulation 'L
p L I
I L "I
, . I I , 4, tl I A 'I
It
tit
Or F
L;; I PLUMBING r I I
r r I I I ILI I I r
r r ty
r r L r dergrounl
'L I .,L; I r I- L L UP)
it Or- 1 14 'L I � I I'�L I L #A/0
I It. f 1.*
I I L 1 1 4 11 111
0 1
I I I _p I I I I I r I 1 .1 r I I I r rL I r
I L 11 1 1, 1 1 L I 1 1, 1 1 1 1 1 1 1 1 1
Roughftln 001�
10 er
it III ... ... I 'L
it
L L Commercial Final Osseo* t
P'
IL L OSSEO L L 9A
Z
I I 1 4 :4
HEATING: L' L
) It , : I I i I I I
L ..r. I Ott 1 1. Or � I I r . I r I I L I
III` Or L L 'L r L
I Ir
rt qkT
r r I r Or Or st .1 r r L L
L Gas Te
I I
Go r
r' r to t r L L I I r r r
r I I I it I I- 'r L I I r L 1.
Ir. It I irr Or
r G A PI In r 'r I
P. 9
4 1 1. P, rt I L I I I ...... I I L r ........ I I. tIrr
L L L L, It I I It I L L
It
I rd I I I
rt,rr
re r k44 dL % r",I fv, I
L4 I r 'L_;p_. I., r.., I., I I. L it L quioment r 'L r
L L, r r I Or L' L L I L
L I I L
Lt.
tr , rrr� .1
L Irk. I
IL�
L I L ir 'L I I I It 4 L I I I I I LJ.
I k I . I I I I
� 'r... 'Ir " I I Cdrnmerclal Final
-'t,' 1, Irk I I I P, 'it 1" -.141, .-11 1 r L *Sao$** k
p"
4 . - t . I I I I
r r' Ir r Lit I
tI 1 0 t t,
It 1.
I Or
EXTERIOR SHEATHING I 'r Or ft., "r,., r Cz r
Ir I
Ir 1 .1 1 L It It I
r NAILING r I r
I'tt' I
I .. I L.�
I Ir L I r 4 r I I r r r I
I d I t I I I
I t" It I I I r I r
ri 'It." FRAMING r I r
4' 1 1 1 t
�,O
p
r. I FIRST FLOOR FRAMING t j Ir r r
4
Or L I I
r r 4 INSULATION a a 0 0 a 0 0 a a 4 a a 6 o 0 a r I r
44
I r i I I
Floor Insulation
:OttrIL , i I Or:
It I 'A Ir
VIr, I I I
I d t 4, 1 1 L
.4 1
It
Lit L: 'L 1p Wall Insulation L
1 0
0
r Ceiling Insulation L r I
r 'r I I r I r Op
r r r pa I
SHEETROCK+,NAILING r
I S� r
41, r I SPECIAL INSPECTION
4
-SIMMONS
MISCELLANEOUS r I I
r Orl!
FINAL APPROVAL FOR
OCCUPANCY m� MISSOURI
& r 4
#q3
Or. I r I 1' 1, .1 1 1 1 1 4 r I
4 1 1 )003 Oro
Jv f
4
t I
Or
'r,
It IIJ
p I
t
DATE RECEIVED
1 I'q PE
�9 RMIT EXPIRES Z2
C)TY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS
4J / Z_ "<Id-S,
MAILING ADDRESS
CITY ZIP _,,ITPLEPHQNE
29 0. ILAS)
NAME
I: ADDRESS
cc
CITY ZIP ELEPHONE
T
NAME
ADDRESS f V
L L
ISE PERMIT
ZONE
NUMBERMOLt�3_
JOB SUTFJAPT#
ADDRESS 0 n, U)t) (_,(D
PLAT NAME/SUBDIVISION NO.
LOT NO.
L�D NO.
L D FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved 13
RW Pamill Required 0
Street Use permit Rsq'd 0
EXISTING — PROPOSED
Inspection Atiquired (3
Sidewalk Required 0
REQUIRED DEDICATION— FT
Underground
vvrnng,.quq.d 13
MET
NO, OF FIXTURES
PRV REQUIRED
TM
or L y
It coxwee ps
YES 0" NO 0
—
jREM
OWN Fr E
Unh UfA 8
ri
4.
ENGINEERING REVIEWED/DATE NA
FIRE 38 Of whether the warier sysfil'A
CITY ZIP TELEPHONE
Is open � Or dosed,
9 C.A
io.
n
gan&
STATE LICENSE NUMBER EXPIRA60N
DATE CHECKE
Suan I We~ SPECTIC
REO'D
My Codes
D.
Do i 9.3o. 13YES 0
acrn 1 H
PROPERTY TAX'ACCOUNT PARCEL NO.
ASO 7
0
COMPLETE EXEMPT 't ALLOWED PACIPOSE1 MLL
U1
6
EXP
NEW VRESIDENTIAL
IVPLUMBING MECH
LOTCOVERAGE REQUIRED SETBACKS (FT.) PROPOSEDS
ALLOWED PROPOSED FRONT SIDE REAR FRONT UR
C]: ADDITION; '0 COMMERCIAL
o COMPLIANCE OR
CHANGE OF USE
NING REVIEWED'BY
PARKING LOT APSA PLAN E
C] REMODEL 0 APARTMENT
SIGN
REO'D JPROVIDEI�
0 REPAIR, 0 GRADING CYDS
FENCE
X FT)
EMARKS
IT
PROPOSED
BACKS (FT,)
DE� REAR
rE �:.
uj
0 OTHER
DEMOLISH TANK
GARAGE 0 RETAINING WALL 0 RENEWAL F�
z
-CARPORT ROCKERY Pl. I
ACTIV ITY y
--,(T.YPE)OP.;USE. BuSINE4071 li�,
�N' ry CHECKED BY TY F OCCUPANT
fj WN GROUP ()17,
NUMBER NUMBER OF CRITICAL
OF. DWELLING AREAS SPECIAL INSPECTOR OCCUPANI`
0
JAREA
�STORIES UNITS NUMBER REQUIRED 0 YES LOAD
DESCRIBE WORK TO BE DONE
. C3
7'
6
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D
VALUATION I FEE
/U40 /VF-& 620�5' /-// ry / U
PLAN CHECK FEE
HEAT SOURCE tLA2. ING %
LOT SL45PE %
BUILDING
ca-e t�_.
—:T7
PLAN CHECK NO*
VESTED DATE
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK POTED. THIS PERMIT COVERS WORK TO
j BE DONE. ON PRIVATE, PROPERTY ONLY. ANY -,CONSTRUCTION Ori-THE PUBLIC
GR�DING/FILL
:3
DOMAIN (CURBS. SIDEWACKS. DRIVEWAYS, MARQUEES, ETC.) WILCREQUIRt
SEPARATE PERMISSION.
STATE SURCHARGE
PERMIT APPLICATION: 180 DAYS
06
PERMIT LIMIT: I YEAR - PROVIDED W0.RK 15 STARTED WITHIN 140 DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION ,
0
'APPLICANT ON 13EHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
ENG. INSPECTION FEE
IN INTEREST. AGREES TO INDEMNIFN� DEFEND AND HOLD HARMLESS THE CITY OF
- LANDSCAPING
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
INSPECTION FEE
ALL CLAIMS FOR DA"GES OFWHATEVEPI NATURE, ARISING DIRECTLY OR INDIRECTLY
.
RECEIPT
FROM THE ISSUANC E'OF THIS PERMIT. ISSUANCE�OP THIS PERMIT SHALL NOT 13E
PLAN CHECK DEPOSIT
DEEMED T6 MODIFY,'WAIVE OR REDUCE ANY REQUIREMENTOF ANY 61TY ORDINANCE
0 NOR LIMIT IN ANYWAY THE CITY't ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
RECEII T
TOTAL AMOUNT DUE
1 '0
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
%FrPLICATIbN APIPROVAL
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 VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
receipt Is acknowledged In space provided.
WORKMEN'S COMPENSf5MURANCE AND RCW 18.27.
OFFICIALS §IGNATURE 1. DATE/
SIGNATU�RE
�07[R OF(AGENT)
2j
DATE SIGNED
(425)
T
771-02.20
RELEASED BY 16ATE
AftENTION",- ILI/
EXT 333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER GOLD - ASSESSOR
5198
f
z
0
0
M
=j :R
M
C
M
0 C
M
10
C
"n
M1
Fn
C
z
0
M