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20030512.pdfDATE RECEIVED 17, CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS :4:nj� MAILING ADDRESQJ wo"L CITY E ZIP TELEPHONE L425-- - A %9U),C) 1 PidUr -5-� --i - -7-m NAME ADDRESS CITY ZIP —TTELEPHONE NAME ADDRESS 1%j 77,552— CITY ZIP TELEPHONE SP_C'tL__ cvorrl STATE LICENSE NUMBER EXPIMT1014 PA;FE -4- CHjg "&k a I -� r 6171 C_ L_ 'z/ / 5 /6)5-1 (0 Al e - 7 49d z9l�� 2Z [j NEW RESIDENTIAL (I [3 PLUMBING / MECH ADDITION 0 COMMERCIAL Ej COMPLIANCE OR CHANGE OF USE REMODEL [3 APARTMENT SIGN [3 REPAIR 0 GRADING CYOS [3 FENCE X ( _ _ FT) DEMOLISH TANK 0 OTHER [3 GARAGE CARPORT RETAINING WALL ROCKERY [3 RENEWAL UWE OF USE, BUSINE OR ACTIVIITY) EXPLAIN: 'r(AV%V_ 71mm U J f 1% ;7t MBER -_ NUMBER OF — CRITICALQIW J OF STORIES DWELLING UNITS AREAS NUMBER DESCRIBE WORK TO BE DONE ovitl -f d�-SIQOSCA OV- (I 9 CV-1 oiwA L J S, -T (o; I k I PERMIT EXPIRES al)qw I - USE ZONE PERMIT NUMBER JOB SUITE/APT# ADDRESS 2- 3)12- LA I OC) " A V e- (,) , PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved MY Permtt Required Street Uge Permit RWd EXISTING — PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION— FT Undatirmod Wifingrequired METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I 13 YES13 NO C3 a; REMARKS I OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE 11 ENGINEERING REVIEWED/DATE FIRE REVIEWED BY DATE VARIANCE OR CU SHORELINE OR ADB# INSPECTION BONDd REO'D POSTE I 0466—SNO I BEIRA REVIEW WR4 &HAL HEIGHT COMPM__E_ EXEMPT ALLOWED PROPOSED Mu"'if=NT FQR-�--� zx—p---�- LOT COVEPN� :ftMFj&V P (FT YR ALLOWED p R opeETBACKS SIDE REAR PARKING REO'D I PROVIDED LOT AREA I PjANNING REVWtED BY DATE -r— I — CHECKED BY ITYPE 0 ST ON I �� OCCUPANT GROUP 7 Z k-3 SPECIAL INSPECTOR JAREA OCCUPANT REQUIRED [j YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REO'D 91 VAWATION $ FEE I Description I FEE Plan Check HEAT SOURCE G LOT SLOPE % T 6� Building PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHOREMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading Recording Fee :3 DOMAIN (CURSS, SIDEWALKS, DRfVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review City Surcharge PERMIT APPUCATION: 180DAYS CL PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection State Surcharge SEE BACK OF PINK PERMIT FOR MORE INFORMATION -APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Traffic Mitigation 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 Review 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 Fire Inspection Total Amount Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CRYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Landscapoinsp. Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL A A N '0 pi� GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF P' C T THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRLIC- CALL n 5 not a I This application Is not a permit until signed by the It is pp pe ' u T TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Foes are paid, and dn It 51h oeputy� and Bull g 0"' IN VIOLATIOkOF THE LABOR —CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is spitnowledged in space provided. WORKMEN'"fMPEN !!!!9�NANCE AND RCW 18.27. 4 GIN QF� N E DATE SIGNATUR$ (O#NER OR G DATE SIGNED (425) -71%11V 771-0220 RELEASED B I DAlt ATTENTION EXT 1333 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- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX ORIGINAL - FILE - YELLOW - INSPECTOR PINK - OWNER - GOLD - ASSESSOR 10/01 z 0 4 0 M z 0 1 0 m q ii U5 � Q M c MO 0 40 c �m m M4 z 0 -n m M a 7w 0 0 Fn C 0) m co M 0 Z r, M z z 9 0 m 2. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Si ocaprvi.doc.l:temp-bldg:formsio/oI t Jan 09 04 02:54p P.2 ho,j) BUDGET TANK REMOVAL,, & ENVIRONMENTAL SERVICES97"LLC P.O. Box 775�2 Seattle� WA 98171�0552 206-306-9061 Fai: 206-306-9091 6ntractors LicensbNoo- BUIPGETR973CL RE-. 'DECOID&SSION UNDERGROUND BEATING 0H,STQRAGE TANK 4T: 23124 10& Ave W2 Edm6fids, *A 98020 This is to certify that BUDGET TANK REMOVAL & ENVIRONA4ENTAL SERVICES, LLC, decommissioned one 300 gallon uriderground. heating Oil storage tank located . at the above address on July 15, 2003. The tank was removed and pfferly decommissioneds, pursuant to the codes,,' � rules and giddelines established by local and state law. Upon removal of the'tank, it was noted that -an undisclosed amount of heating, oil had leaked into the surroundinp,. soil area, and soil samples revealed -tevels at 12,000 ppm. Dated: July 31,2003 BU-1).QET TANK REMOVAL & ENVIRONMENTAL SERVICES, LLC Wiliffil. Matthew P. Veeder — Project Coordinator P.O. Box 77552 Seattle, WA 98177-0552 It A_ W W 0 ro). 0 'XI LaboraterY ID 1 d 307148-01 Method Blank diluted- d The sample was Digakel Extm&d (CIO -CH) 12,000 Mill I Surrog-a-Ate (LAmit 45-163) 123 PDA P. 3 i I v INSPECTOR DATE APPROVED I P. I SETBACKS 090606 &**owes@ a so PAO* TOUNDATION: Footing a see 840*60 ..Wall Pier/Porch Retaining Wall Slab Insulation I d Ld PLUMBING: I d Underground L % 11, r, �d I IWL Roughmin I � f ' L 4 it, p I d I.� I p I I I I I , (.4 � . I k I - t I . Commercial, Final I p f F HEATING. I I. t' q I p I 'Gas Test i� I I 'I.. ep" I p L I p .,t '1 4 1 .... Gas'PlOing.. L p I L . I L I I . L I d I t P Itp I N .101 1. p 1; e L't Equipment 1 d I d I P. I k 1 % Commercial Final lot 14 01 EXTERIOR SHEATHING I I I_ �L f Z t I I L d L NAILING *sees k 11 I I I I, I k FRAMING' i a I *googol It 111 -11 d �w P r dL 'L. L�. FIRST, FLOOR. FRAMING.,. steel 1 4 . k INSULATION 0 d I . L I ,Floor Insulation kL tp L N't' :L� L, -insulation L- I Wall Ceiling tI nd'sulation .1, .1 'W' 4 '1 r 4 L I I :I L r p L L d I L L r I SHEETROCK NAILING 1 4 1 p . I SPECIAL INSPECTION 'L .0 1 11 Nestle MISCELLANEOUS .... &@lose 1p L FOR FINAL APPROVA 4 1 I I L r V rL r I I, I t I Ill' 4p �OCCUPANCY 0 I I 1 1% wl I t I L k J"�L k `IIt f T d � : j 4 '[1 A ddow VISION z I I 6 I DATE RECEIVED -71 PERMIT EXPIRES CITY OF MONDS USE ZONE PERMIT NUMBER CONSTRUCTION PERMIT APPLICATION JOB ADDRESS 2 311L4 ................... SUIMAPTO Aqr- lcol w. OWNER NAMEINAME OF BUSINESS PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS.; I UD FEE S I-LL4 mot� PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP YESCP Appm"d CITY ZIP ITELEPHONE 14-415-- EXISTING - PROPOSED StMM U" PwwJt ROO k0p6edon FAQ!*W 8W@w**A*quk@d 01 EAMOV,A5 '902-01 REQUIRED DEDICATION- Fr Ur4ororcund vvmg Mq PJAUF METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED ADDRESS CITY NAME ZIP ITELEPHONE ADDRESS ri C ZIP STATE LICENSE NUMBER ?�- C, -t � r C1 -) S C- I- L_ -_ Z 6_22 [3 NEW RESIDENTIAL ADDITION 1:3 COMMERCIAL [3 REMODEL [j APARTMENT [3 REPAIR [3 GRADING CYOS [3 DEMOLISH TANK IROCKERY o GARAGE RETAINING WALL CARPORT M?E OF USE. BUISIN k. 17, OR ACTIVTM PLAIN: (it ::T C-W-O U _T NUMBER NUMBER OF OF STORIES DWELLING UNITS DESCRIBE WORK TO BE DONE buld 't Ais.00sed YES 13 NO 13 REMARKS OWNERICONTRACTOR RE8PONSIBL E F OR JkRO�Sa CONTROLIDRAINAGE IENGINEERING F FIRE REVIEWED BY DATE IRE I Inc VARIANCE OR CU SHORELINE OR ADBO INSPECTION BOND E CH By REO'D POSTED M*EO--BNO SEPA REVIEW SIGN AREA HEIGHT C COMP OMPLETE . EXEMPT ALLOWED . PROPOSED ALLOWED . PROPOSED PLUMBING I MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Ft) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIFISIDE REAR I COMPLIANCE OR -------- CHANGE OF USE PARKING LOT AREA I PjANNING REVIEWED BY DATE [3 SIGN [3 FENCE ( Fri REM _ _ E2 - OTHER 0(A 0& En?= J2 t_*-A -r :Aj L - [3 RENEWAL bl� CHECKED BY OCCUPANT 1=14 GROUP CRiTICA%,I- W A &1'03-C6 SPECIAL INSPECTOR REQUIRED AREA OCCUPANT LOAD N [3YES REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RE= 121 ( I ) 911A & IN1111 VAWATION $ I I 111MIE" 1_ �! Description FEE "EX RTI: -7 Plan Check HEAT SOURCE GLAZING % LOT SLOPE % Building PLAN CHECK NO: VESTED DATE PI umbing Mechanical TWS PERNrr AUTHORms OMY THE WORK NOTED. THIIS PERMIrf COVERS WORK TO FEE C BE DM ON PPJVATE PROPERMY ONIX AM commucirton ON THE PUBLIC Grading Recording Fee 3 DOUAIN (CURBS, SIDEWAUCIII, DRIMEWAVS, MAP4UEES, ETC.) WILL REQUIRE M SEPARATE PERIIAMISION. I Engr. Review City Surcharge 15 PMMITAPPUCATHft 100 DAYS IL PERMff LIUM I YEM - PROVIDED WORK 18 STARTED WrTHIIN 100 DAYS Engr. Inspection State Surcharge SEE BACK OF PINK PEMrr FOR MORE INFORMATION ;APPLICANT, ON BEHALF OF HIS OR HER SPOUSE HEIRS ASSIGNS AND SUCCESORS N INTEREST, AGREES TO INDEMNIFY, DEFEND ;�il) H61� HARMLESS THE CITY OF Traffic Mitigation Plan Chk Deposit EDWNDS, WASHINGTON., ITS OFFICIALS. EMPLOYEES.,%ND AGEWS FROM ANY AND Fire Revievy Receipt # ALL CLANS FOR DAMAGES OF WHATEVER MATURE. ARNG DIRECTLY OR INDIRECTLY OF I FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF 108 PERMIT SHALL NOT BE Fire Inspection Total Amount Due DEEMED M MODIFY. WAIVE OR REDUCE ANN REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAYTHE CITYS ABILIITY TO ENFORCE ANN ORDINAME PROVISION.' Landscape Insp. Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE REM THIS APIPLICATION; THAT THE INFORMATION 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 OMeW or hlsftr Deputy: and Fees are paid, and IN VIOLATIO&OF THE LABOaXODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is �pknovvlodgvd In spaeo provided. WORKMEN"PEN AM RCW 10.27. licisiol CON *TE SIGNATU ER EA: DATE SIGNED (42-01 3- I ru; ILL 771-0220 D RELEASED BY ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 1 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FM PINK - OWNER - GOLD - ASSESSOR 10/01 ......... .. ---------