20030455.pdf13
DATE RECEI�
A A ____ I
PERMIT EXPIRES te"ll 7—S
USE PERMIT
ZONE
CITY OF E;MONDS
NUMBER
CONSTRUCTION PERMIT APPLICATION
JOB
ADDRESS
zz
OWNER NAME/NAME OF BUSINESS
l4w&wativ
PLAT NAME/SUBDIVISION7
LOT NO. LID NO.
MAILING ADDRESS
I-Voo v6A
LID FEE S
TESCP Approved
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP AW Pernift Required
Street Use Permit R&Wd
CITY ZIP LEPHONE
EXISTING —_ PROPOSED Inspection Required
Sidewalk Required
13 -&W - ?5 1 i,:_2
REQUIRED DEDICATION—
T-7.
FT Undergmund
Wiring required
NAME
METER SIZE LINE SI�E
OF FI XTURES PRV REQUIRED
Q��e_I
4
I YES13 NO 13
z_
%
ADDRESS
P-0
12,
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
z
162-010 21 f�'.
CITY TELEPHONE
70, 1 '37 APG-74G --32-10
L21(kvl" 9 100z'P I
NAME ICBL#
-P'k, L/ VJI kX/L--* X/I I I (U�4 C-c-' L ENGINEERING REVIEWED BY DATE
W
01
ADDRESS
FIRE REVIEWED BY DATE
Lu
CITY EPHnNE I
a
'a
da 11
VARIANCE OR CU SHORELINE OR ADB# I- INSPECTION BOND
STATE LICENSE NUMBER EXPIRATION DATE CHECK D BY REO'D POSTED
I
OyEs 13NO
I
SEPA REVIEW SIGN AREA HEIGHT
PROPERTY TAX ACCO PABC NO. COMPLETE EXEMPT ALLOWED PROPOSED AL LOWED PROPOSED
a`761 1 00 15400D , ,
,
EXP
NEW RESIDENTIAL PLUMBING/MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE REAR
COMPLIANCE OR
ADDITION COMMERCIAL 0 CHANGE OF USE
0
z
PAR DATE
KING LOT AREA PLANNING REVIEWED BY
REMODEL MULTIFAMILY SIGN REQ`D PROVIDED
GRADING FENCE
0 REPAIR CYDS I X FT) REMARKS
DEMOLISH TANK OTHER
GARAGE RETAJNINGWALL FIRE SPRINKLER
0 PRE ALARM
CARPOE ROCKERY
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN. CHECKED BY OF CONSTRUPTI OCCUPANT
/
ITYPE
j2'j'--::WjAM mlaw, fLeA-oL_, GROUP47
NUMBER NUMBER OF CRITICAL
OF OCCUPANT
A/A IDWELLING A/A I AREAS /VA SPECIAL INSPECTION LOAD
STORIES UNITS NUMBER REQUIRED [:] YES /35k 2
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REO'D
lAb=lul 4n
41
VALUATION
1A &76
Description
FEE
Description
FEE
Plan Check
/9,5
state surcharge
HEAT SOURCE GLAZING % LOT 11LOPE % Building Permit city Surcharge 16-
/VA- /V/Of-
— —
VESTED DATE Plumbing
PLAN CHECK NO: 0�)
r9
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
I: BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading
23 OOMAIIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION. Engr. Review
PERMIT APPLICATION: 150DAYS
IL PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WTTHIN 180 DAYS Engr. Inspection N
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANr, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit 05
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
a EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
IALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY _
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscape Insp. Total Amt. Due
9 DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
2 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
33
Recording Fee Receipt # L
I HERESY 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 WOR 0 1 THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and
LAB !tS�� )R ZED receipt Is acknovAodged In space provided.
IN VIOLAMON OF THE 0 OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION
��W �OMPENS;�� AND RCW 18.27. - OFFICIALS SIGNATURE PATE
IG14ATURE NER R AGE DATE SIGNED IA-95) 1,7
%-Ta- //9Az3__
0,3 771-0220 DATE
mj
ATTEN ION t:x I 1JU
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL LU-- (4-1 / Z__ / 0
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
FINAL PROJECT APPROVAL FORM
t
RE-INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Sign,
ocaprvl.dGc.l:tcnip:bldg:fonnsIO/OI
z
9
0
M
:;:R
ai;l
am
c
Ma
0
80
c
-4 C
MM
mz
jo --I
CE
0 -n
n
m M
065
0 r-
0 M
C ch
M 0)
M 0
Z
z
--I
X
U5
z
0
m
a
RECORD 0 F INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS . .....................
FOUNDATION:
Footing......................
Wall...........................
ZI
pier/Porch .................
Retaining Wall ...........
Slab Insulation ......
PLUMBING:'.
Underground ..........
Rough -In ................... -----------------
rornmercl al Final . . . . . . .
�:,HEATING��,
Z'
GasTest, .................... ............... ...
Gas Piping .................
Equipme nt ....... ......
m
COMM6 1 '10
co
EXTERIOti SHEATHING,
NAILING ..........................
C
FRAMING .................... 9
FIRST FLOORF RAMING..
:4
bATE RECEII-f-
A
PERMIT EXPIRES
5
-A
USE PERMIT
ZONE
CITY OF EDMONDS
NUMBER
CONSTRUCTION PERMIT APPLICATION
J0
ADODRESS "35CO
zo 0-t, SUITF., �#
OWNER NAME/NAME OF BUSINESS
/MR161-woo /4-95 C:-PflM0!5 56+1W, VltT,.
PLAT NAME/SUBDIVISION NO.
LOT NO. LID NO.
T
MAILING ADDRESS 14
LID FEE S
TIEUCIF APP(O"d
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required
49T. W
Street Use Permit RKd
ZIP lLEPHONE
EXISTING — PROPOSED
InspocUon Requited
Sidewalk RaWked
qbj�)Z& 1z) 5
REQUIRED DEDICATION—
FT Undergmund
13
NAME
METER SIZE LINE SIZE
I NO. OF FIXTURES PRV REQUIRED
W/t�6w
- YF:q 13 NO 13
ADDRESS
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY ZIP TELEPHONE
L�hvl"0_0 eq,0037 142G--74S
NAME CBLN
(pwfv.,
"A
-k
REVIEWED BY
DATE
ENGINEERING
ADDRESS
FIRE REVIEWED BY
DATE
C(,ry TELEPHONE
STATE LICENSE NUMBER EXPIRATION CKED
VARIANCE OR cu SHORELINE OR ADB# INSPECTION BOND
REQ'D POSTED
I 10YEs
. ONO $
SEPA REVIEW
SIGN AREA HEIGHT
PROPERTY TAX ACCO C E 6N 0;5.
COMPLETE EXEMPT tALLOWED PROPOSED ALLOWED PROPOSED
EXP ,
,
EW PLUMBING/MECH
N RESIDENTIAL
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.)
ALLOWED PROPOS*ED FRONT SIDE REAR FRONT URSIDE REAR
COMPLIANCE OR
ADDITION COMMERCIAL 0 CHANGE OF USE
A
RE ODEL muLnFAmwy SIGN
PARKI L06T AREA PLANNING REVIEWED BY DATE�
No
REO'D I PROVIDED
IL
1:3 W GRADING o FENCE
REPAIR CYDS X FT)
REMARKS
'40
1
OTHER
DEMOLISH TANK
DGARAGE , REIAININGWALL FIRE SPRINKLER
CARPORT. 0 ROCKERY FIREALARM
(TYPE OF USE, BUSINESS OR ACTIVITY), EXPLAIN:
CHECKED BY OCCUPAN 1
TYPE OF CONSTR
'F GROUP
M __r
'NUMBER NUMBER OF RITICAL
AREAS
WELL NG C
OF I
IVA
ssx�
SPE MEA
SPECIAL IN CTION JA
OCCUPANT
LOAD . 2.
'AIA
��STOFUES UNITS NUMBER
REQUIRED 13 YES t
DE&MBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REIWD
A 4 plul
At
VALUATION
$
7t05 -I
Description
FEE
Description
FEE
Plan Chock
State Surcharge
State:
HEAT SOURCE GLAZING % %
-)U 4)67 IVA-
�W
Building Permit 1A
ID'as'
City S
city
4 Surcharge /6
PLAN CHECK NO: _VESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHOR[ZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION Oft THE PUBLIC
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MAIIIQUEES. FTC.) WILL REQUIRE
SEPARATE PERMISSION.
t:
Engr. Review
PERMIT APPLICATION: 180 DAYS . .. I
PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN106DAYS
Engr'. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
1APPLICAUr, 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
BE
FROM THE ISSUANCE OF THIS PERMM ISSUANCE OF THIS PERMIT SHALL NOT
Landscapeinsp.
Total Amt. Due 13.
, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
DEEMED TO MODIFY
NOR LIMIT IN ANY VfAY THE CffVS A131UTY TO ENFORCE ANY ORDINANCE PROVISION.-
Recording Fee
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECM AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPIY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
This application Is not a permit until signed by the
TION; AND IN DOING THE WOR&ALATHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LAW1,1"COUE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Building Offtlall or his/her Deputy: and Fees are paid, and
receipt Is acknovAedgod in space provWed.
r�MPENSY��AND RCW 18.27.
URE IPATE
IGOATURE ( Vhiq���� DATE SIGNED
1A9
%425)
2W hAfk�
0
771-0220
'KE DATE
-ON
EXT 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
04/62 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING