20030467.pdf-A
DATE RECEIVED IT EXPIRES
[PERm
us PERMIT 2
ZONE b) C- -1 -a
CITY OF EDMONDS r-% NUMBER
JOB SUITE/APT#
CONSTRUCTION PERMIT APPLICATION ADDRESS 001 76-11, pive Q)
OWN
,�AMEINAME BUSINESS
PLAT NAME/SUBDIVISION NO. LOT NO. LID NO.
MWG ADDRESS -rjj Q Hci:,6L�� 4&-5 c�2_ LID FEE S
ti4 <S, TESCP APPf0V*d
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Palmll Requked
Sifeel Use PermK R4q'd
CITY EXISTING — PROPOSED Inspecuo ' Requited
ZIP ITELEPHONE Sidewalkliecluked
2Z (D Ro 1 2 Z4., REQUIRED DEDICATION— FT undsrWouund
WOO Wirtngreq ired Ell
NAME METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED
(Se"r!� I YES 13 13
ADDRESS NJ REMARKS
WNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
IDT
Ic 4�� 1�sklnp As
f1w. ZIP TELEPHONE
KiAktrwi wo - Ifi" U-1 j 12,AA
N ASO C'L 6,1_4 1 V�
JCBLN
ADDRESS 00 TNGINEERING REVIEWED BY DAIrE - -3
?0 t�_ /,q Ues - L 6(ulaL � fl 40
FIRE REVIEWED BY z
CITY TELqO lZ 0
Zip �R
VARIANCE OR cu SHORELINE OR ADBN INSPECTION 1$ BOND 0
Sj%TU I lrFN.qg: NO 940cn YPIRAT DATE REQLD POSTED m
_W� I 113YES .1FO ---- I
SEPA REVIEW S I HEIGHT =i 9
�L2�QV"_M.ssej 1i IGN AREA
PROPERTY T ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
02 47 '0 1
Z-61219-0060-00- 3 EXP 1 ---7-- am
NEW RESIDENTIAL PLUMBING MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) C a
)K 0 ALLOWED PROPOSED FRONT SIDE REAR FRONT LJRSIDE REAR 2 m 0
OMM I COMPLIANCE OR 0 1 ALI, 5, 1 1,3 2 0
ADDITION COMMERCIAL CHANGE OF USE '35Y-0 -20 C
PARKING LOT AREA PLANNING REVIEWED BY DATE 9
REMODEL MULTIFAMILY SIGN REOD PROVIDED m
L--; m
0 10
G C E3 FENCE I �i
REPAIR 40 CYDS ( X Fr) REMARKS z
DEMOLISH TANK OTHER
GARAGE RETAINING WALL F RE SPRINKLER
CARPORT 0 ROCKERY FIRE ALARM 0
(TYPE OF USE, BUSINESS OR ACT n
CHECKED By TYPE OF -CONSTRUCTION CqE OCCUPANT
71297r_� GROUP L7-A
NUMBER IUMBER OF CRITICAL L-L&J L 5 I=s. -7 1-% a, m m
SPECIAL INSPECTION JAREA OCCUPANT
OF )WELLING AREAS a003-wi* LOAD
-STORIES PE)NITS NUMBER REQUIRED [] YES I
DESCRIBE WORK TO BE DONE fiEla Fn
N. e-W S.F. REMARKS 0)
PROGRESS INSPECTIONS PER UBC 1108MINAL INSPECTION REG-D, 0)
A M 0
111"_j z
r4=1 U - �61
Irl Tr-4
an :).q 00 9 7/---nl Aw A AAP X
C I �__ a3
U0 t VALUATION
-79 $ 7 q, 4�� z
Description FEE Description FEE
FL= 1:?2 A
OCH-e 5 =_ -_7 2- 14 LP Plan Check 17to'-9' State Surcharge z
Hn SOURCE I JAZING % LOT 8LQPE % 9
dt UJA '% Building Permit City Surcharge 0
<— VE TE E
PLAN CHECK NO: A5 Plumbing 2,
Mechanical '70
THIS PERMIT AUTHORIZES ONLY THE WORK NOTEn THII COVERS WORK TO
t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PLIBILIC Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION. Engr. Review .. . ..... V,
PERMIT APPILICATION: ISO DAYS
CL PERMIT 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
2 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
!3 DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due
2 NOR LIMIT IN ANY WAY THE C17YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Recording Fee Receipt # L
I HERE13Y 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 APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application Is not a permit unfit signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL 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 COMPENSATI"URANCE AND RCW 18.27. DATE
OF GNAT
I
E
SI E (OWNE' OR DATE SIGNED (425)
GN&T4*
771-02'20
r RELE E 6ATE
A17ENTION M 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL IV I Il
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 ' %
APPROVED BY PLAWmiNG
00
U)
LU
4E
EROSION
1114 , :> �rec-'- cararoK 0 ro
�50 -!�OL-Lk fe-t '11-9
�oA Rrea.'.' 4
I to
1 10
190
16m, SO
0
M $20
0 WATER & SEWER
mf co
05 INSPECTIONS REOD -10,
6__,
m
0) 15 ('Al I ags;.771.(1220 aff. 1326 lk -.nV Ns" 01
0 1 105
707 i05-2103 04
100
LOT 2 TEMPORA.71","-*'.',*,:,'"'�,i'tiUUyfdXI4&HT C-ALC,.
A 104.2
2.40061 076TH A%MPJftE REQUIREDB 106.2
C 105.2
D 102.0
TOTAL 417.6 X 4 = 104.4
rL40 17,q, JA
ove4n 's
201
0 �.a
APPROVEI) AS NOTEO
ro 0 Awk r r vu
ICA-e5 � f'j'. aq qvk* � - G 'stLLATZ
BY ENGINEERING
view (C-pr:-p -T- s x 00
VVL Dab: UT-
Q- 1+
iti, JiSIKE"
AN, -;t-f--,NAGE
ACCEPTABLE TIGHTLINE
MATERIAL
SDR 35
SCH 40
N-12
211t COR
. Height Calculation Worksheet
C%140-) ---? U �-
Vvi
Datum Point: IA1%
2.
Datum Point Elevation: L% -J-0
3.
Average Grade:
owed +2
Elevation All giade)
Maximum 1�4.-�Averagb 5 cv
.4.
5.
Reference Point Elevation Shot to House:
A
(datum elevad + —rade to transit level Hue *shot to house)
n)
71 0"
6.
rom line shot onto house to roof ridge:
Measurments f
z
L
FINAL -PROJECT APPROVAL F RM
TO:
DATE:
z
0
m
=i 9
am
c
MO
0
80
c
MM
MZ
g) --I
cy
E:
0
M M
0
0
0 M
C (j)
c cl)
M 0
Z r-
.IT
M
z
(j)
z
0
m
2.
3.
R I E-INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Si
ocaprvLdoc.l:t=V:bldg-formsIO/OI
1b
C.,
RECORD OF INSPECTIONS
FRAMING ........................
G...
FIRST FLOOR FRAMIN
INSULATION ..................
loor
Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING
SPECIAL INSPECTION ...
.9"
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
q WV005troo7vSkle Sewer ft
p,
The initials RSR are Rick S. AmoUt PAW
1A
Roberts, a temporary contract Datelssued
inspector for the City.
water Meters., -
A
mount Pctu
]Date Purd.=",
Z
0
0
M
M
M
z
0
"n
MITI,
C)!
Z.
0
5:
M
DATE
DATE RECEIVED
0
[PERMIT EXPIRES
CITY OF EDMONDS
USE R,5,g PERMIT
ZONE NUMBER
CONSTRUCTION PERMIT APPLICATION
JOB SUMAPT#
ADDRESS AJC)0� f_7(v_Tf1 RA LO
OWN!rEINAME BUSINESS - i
0 1
LA%7Vf0Uj Howzbl.A /AC5 71,
—
PLAT NAME/SUBDIVISION NO.
L9T NO.
LID NO.
11 f.
45 03 T
"2
C>
LID FEE $
MA9,ING ADDRESS.
OR 6
_
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved
RW Permit Required
T
Street Use Permit Roq*d
CITY
ZIP
TELEPHONE
'S--
EXISTING — PROPOSED
REQUIRED DEDICATION— FT
Inspection Required 13
Sidewalk Required 93
undarwound
"10 t"L
2
Rol
2ZO
i)
Wiring required 13
NAME
6 451112
06"Gin
METER SIZE
LINE SIZE ]:!,OF
I
FIXTURES
PRV REQUIRED
YEs13 No 0
- L16.—
ADDRESS
NJ *
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
ZIP
TELEPHONE
— 0r_N1-LVnAkA
OSftb-900S
CBL N
-7
V V., Koz _ffNGINEERING REVIEWED BY DATE
-3
ADDRESS
FIRE REVIEWED BY DA
CITY 71P ITELEPHONE_
4
zf;t5- &
VARIANCE OR CUI SHORELINE OR ADBN INSPECTION BOND
DATE 'D POSTED
REP
$
13YES ;W9
SIGN AREA HEIGHT
aL BEIRA REVIEW
PROPERTY TAX —ACCOUNT PARCEL NO. COMPLETE , EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
00C
!1 0 0, oco EXP
I
LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FE)4
RESIDENTIAL PLUIMBING/MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR
25%, - I At_t, e I
0 ADDITION 0 60MMEACIAL COMPLIANCE OR -3.5YP -2_1YV "I. S; 9.;;X`2*f9
CHANGE OF USE n & x- S 1 ;7-0.
PARKING OT AREA PLANNING REVIEWED BY DATE
muLnFAmiLY SIGN 6 0— 1
0 REMODEL REOD I PR�VIDED
G Ei FENCE
9
R PAIR
E CYDS x FT) REMARKS
OTHER
DEMOLISH 0 TANK
Ukli lmkf
GARAGE o RETAINING WALL FIRE SPRINKLER
CARPORT ROCKERY FIRE ALARM
"E'OF USE. BUSINESS OR ACTIV PLAJJ��
CHECKED BY TYPE OF-ONSTRUCTION OCCUPANT
GROUP
NUMBER NUMBER OF ACRRIETICALX03 SPECIAL INSP�gr[ON JAREA OCCUPANT
OF DWELLING As LOAD
STORIES UNITS NUMBER REQUIRED [] YES
j
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REIVO
-)qo09 -T Ave
an A. -
WE
A
-7
A^ I L-q Le
VALUATION
V
$ m I
Ila
19 -7!�
F EE Description FEE
-FL L Description
/71
C—ov 'i�b P—C IF 5 Lt 4 Plan Check -o State Surcharge 1_/1
HET SOURCE MA -ZING Building Permit 8-n City Surcharge
loy�a
2 IW' VE4TE9 DATE -2,
PLAN CHECK NO: Plumbing
2, Mechanical
THIS PERM1TAUTHO-rw9:LyTNswoRK NOTED THIS PERfirr COVERS WORK TO -7fl
h BE DONE ON PRIIVATE PROPERTY ONLI ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 1)
t: SEPARATE PERMISSION. Engr. Review
PERMIT APFUCATIOM 100 DAYS
CL PERMIT LIMM I YEAR - PROVIDED WORK 18 STARTED WITHIN 160 DAYS
Engr. Inspection
SEE B=K 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 THJE CITY OF
EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM AW AND Fire Inspection Receipt # gjq,
ALL CLAIMS FOR CLAMAGES OF WHATEVER NATURE, AFUSING DIRECTLY OR INDIREdrILY)
FROMTHE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL"NOT E' Total Amt. Due
a Landscape lfi:s�.
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR UMrr IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recordl�g Fee
Receipt #
I HEREBY 1. ACKNOWLE I DGE THAT I HAVE qE
APPLICATION: THAT THE INFORMATION
OWEN IS CORRECT, AND THAT�ILAM NCR. OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
-THE OWNER. I AGREE TO coM Y W;M%nYkAND STATE LAWS REGULATING CONSTRUC- This application Is not a permit until signed by the
TION; jtjl?�. 1.1p WORK AUTHORafikWRE,8�, NO PERSON WILL BE EMPLOYED CALL Building Offlclal or his/her Deputy: and Fees are paid, and
I IN YIC eon CODE OF THF4�ATk,dl� WASHINGTON RELATING TO FOR INSPECTION F0001PI 13 acknowledged in space provided.
,GF
MIP WORKMEN C MP 0 URANCE AND RM 10.27.
OF 0 NAT DATE
L
M
D4ue5
1A9
OWNER OR L% DATE SIGNED 1,425)
A"? 14?;16
771-0220 1AELEA E LATE
ATMNTION Off 1333
IT IS UNLAWF
WIN OR STRUCTURE UNTIL
UL (T E R(IOCCU Nil"'
A FINAL INSPECTION HAS BEE ID ROVAL ORTA' CERTIFI- -,,ORIGINAL'FILE -'YELLOW. INSPECTOR
CATE OF OCCUPANCY AS BEEN GRANTED. UBC SECTION 109 PINK - OWNER - 'GOLD - ASSESSOR
04102 PRESS HARD -YO��MAKING 5 COPIES GREEN - ACCOUNTING
z
0
0
M