20030524.pdfCITY OF EDIVION
CONSTRUCTION PERMIT AP
OWN N4ME/NAME OF BUSINESS
1/. If / ;A/,A.& A /
MAILING ADDRESS
7 7/0 - �Z-43!!�,Pla at- S Iry
CITY ZIP 0 ITELEPHONE t-.20[o'
9,?62 S13-3
NAME
ho+ CLPP L; cj,.Le
ADDRESS
CITY
ZIP I TELEPHONE
NAME __jCBL,1
hioT oppUccL4
ADDRESS
CITY \ )up I TELEPHONE
STATE LICENSI%�MBER EXPIRATION DATE N�CKED BY
ROPEM
,JAX ;'AONAW
SP_
NEW
9 RESIDENTIAL
[] PLUMBING if MECH
ADDITION
[3 COMMERCIAL
E3 COMPLIANCE OR
CHANGE OF USE
REMODEL
MULTIFAMILY
El SIGN
REPAIR
GRADING
FENCE
CYDS
( X - Fr,
E] DEMOLISH
El TANK
OTHER
E:iGARAGE
o RETAINING WALL
E] FIRE SPRINKLER
CARPORT
ROCKERY
F RE ALARM
(TYPE OF USE. BUSINESS OR ACTIV" EXPLAIN:
_ Roah,
hobb),es
SIPAeC
NUMBER
OF -7,
NUMBER OF
IDWELLING
j
CRITICAL
I
STORIES
UNITS 11?/V If-
A
- - �
A -
DESCRIBE WORK TO BE DONE
HEAT SOURCE GLAZING % LOT SLOPE %
PLAN CHECK NO: I VESTED DATE
:,/ � LI-1
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT: I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABIL17Y TO ENFORCE ANY ORDINANCE PROVISION.*
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
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLAT ON OF TUE. LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN!S CQMPENShTION INSURANCE AND RCW 18.27.
DATE RECEIV 7
USE
DSZONE
3LICATION JOB
ADDRESS C11- I D
eir-,KYA I PLAT NAME/SUBDIVISION NO.
L! ERMIT EXPIRES
PERMIT
NUMBER
SUITE APT#
),(4_j2rd 1', � L)-
-1 LOT NO. LID NO.
LID FEE S
IESCP Approved
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Rw Permit Required
Street Use Permit Roq'd
EXISTING - PROPOSED Inspection Required
S kimalk Required
REQUIRED DEDICATION- FT Un&rgrowd
Wiring required
METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
I I YES 13 NO 13
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
ENGINEERING REVIEWED BY DATE
FIRE REVIEWED BY DATE
15
5
W
cc
rL
VARIANCE OR CU
SHORELINE OR ADB11
I INSPECTION
REO'D
13YES ONO
PBOND
OSTED
$
SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWED PROPOSED
EXP
,
,
LOT COVERAGE
REQUIRED SETBACKS (Fr.)
PROPOSED SETBACKS (Fr.)
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT L/RSIDE REAR
z
PARKING
I
LOT AREA
PLANNING REVIEW ED BY DATE
I
REQ'D I PROVIDED
REMARKS
CHECKERT BY
TYPE OF
CONSTRUCTION
11
OCCUPANT
-GROUP
V_A/
SPECIAL INSPECTION
OCCUPANT
JAREA
REQUIRED [:] YES
1//0
LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D
SIGNAT (OWN , VRA.,EN]2 DATE SIGNED
106--c 63. 1
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
04/02 1171111TIM00 UAMr% VnH AD
VALUATION
$ g -�&
Description FEE Description FEE
Plan Check State Suicharge
: rge
Building Permit City Surcharge
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Plan Chk. Deposit
Fire Inspection
Receipt #
Landscapeinsp.
Total Amt. Due
JC40
Recording Fee
Receipt #
APPLICATION APPROVAL
CALL
This application Is not a permit until signed by the
Building Official or his/her Deputy: and Fees are paid, and
FOR INSPECTION
receipt is acknowledged In space provided.
OFFICIALS SIGNATURE DATE
(AD
,425)
771-0220 �
"'RE
LEAS DATE
EXT 1333
OR�GINAIL - FILE YELLOW - INSPECTOR
P NK - OWNER GOLD - ASSESSOR
C RAAVlklt'%- r- &%nD1CQ
GREEN - ACCOUNTING
t
z
0
4
0
ITI
M
ma
0
—40
0 C:
�c
M M
0�
_z
CO)
0 -n
A
M M
0
0
0 Fn
C V)
C V)
M 0
z
X
z
z
0
q
0
M
i- v &1`4
ing Official tor'tfii
By order of the Build
City of Edmonds
I?,
All Persoine- Are Ordered to
AR&
iVW
..........
R 1!
"V.
0-NC
d
Tu
rsuant to: Section. 202( of the Uniform Building,,Qode the Building
City. of Edmonds hereby orders all work to. STOP. at the site listed
Address:
For.. the following reason(s):
AIJJkA,JAIA
'Posted this day of
at am/pm
Building C
WA
A 0�1
The failure
resuming of work
sion from the 8�
or the rettioval'
concealment -of
punishable by fMe
�'I F.
z
0
i
0
M
0 M
C
M 0
0
-40
0 C:
--j K
M M
M Z
10-1
-Z
M
C/)
o -n
n m
>
M M
0
0
0 M
C C/)
9 C/)
M 0
Z r-
M
z
-4
M
(n
z
0
i
0
M
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
Commercial Final ......
HEATING:
Gas Test ....................
Gas Piping .................
Equipment .................
Commercial Final .......
EXTERIOR SHEATHING
NAILING ..........................
-7,
FRAMING ........................
FIRST FLOOR FRAMING...
S,—UT
INSULATION ...................
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
�._ANO
OCCUPANCY ..................
- wo*A,2.fO al oo r
rn
DATE RECEIV
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS
V, L. 9040(31V,4
MAILING ADDRESS
-7 7/0 - ;�4 3
0
CITY ZIP TELEPHONE
Ebl" 0"/)s 90.2 C) S 3 -3 - 16
NAME
ADDRESS
ZIP TELEPHONE
NAME CBL#
----noT
'ADDRESS
CITY \ NP I TELEPHONE
7-)
PERMIT EXPIRES
USE
ZONE
PERMIT
NUMBER 0(�;zq
�
lu
JOB
ADDRESS
D fj CUITEMPT
2
PLAT NAME/SUBDIVISION
NO.
LOT NO.
L�D NO.
L D FEE $
PUBLIC RIGHT OF
EXISTING -
7ESCP Approved
WAY PER OFFICIAL STREET MAP RW PUMA Required
StMt Uss Permh Req'd
PROPOSED InsPection Required
Sidmalk Required
REQUIRED DEDICATION- FT Underground
13
Wiring requIred
0
METER SIZE
LINE SIZE NO. OF FIXTURES PRV REQUIRED
I
YES13 NO E3
_F
15
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
REVIEWED BY DATE
FIRE REVIEWED BY DATE W
W
Ic
STATE LICENSI�MBER XPIRATION DATE
ILHECKED BY
VARIANCE OR CU
SHOREIINEORADBII
I INSPECTION
EO'D
I BOND
POSTED
13YEs' ONO
is
PROPERTY,j,AX ACCOL
NT PARCEL NO.
SEPA REVIEW
COMPLETE EXEMPT
SIGN AREA
ALLOWED PROPOSED
HEIG
ALLOWED PROPOSED
'X
EXP I
I
I
LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SETBACKS (Fr.)
FRONT SIDE REAR
PROPOSED SETBACKS (Fr.)
FRONT URSIDE REAR
NEW
ri ADDITION
REMODEL
RESIDENTIAL
COMMERCIAL
MULTIFAMILY
PLUMBING / MECH
COMPLIANCE OR
CHANGE OF USE
SIGN
z
9
I I
IL
PARKING
REQ`D PROVIDED
LOT ARE
PLANNING REVIEWED BY DATE
I __ I
REPAIR GRADING FENCE
CYDS El ( _ X _ FT) REMARKS
DEMOLISH TANK OTHER
ri GARAGE
1771 RETAININGWALL FIRE SPRINKLER Ann
k
CARPO ROCKERY FIFIE ALARM III 11047p x PW
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
SPAIZE /RoOm fstwmj � hobbics CHECKEDBY ITYPEOFPO
VVSTRUCTION Cel-j_ OCCUPANT
GROUP
NUMBER NUMBER OF CRITICAL _/V
OF DWELLING A SPECIAL INSPECTION JAREA OCCUPANT
STORIES UNITS 191vilin. Nffff R REQUIRED [3 YES LOAD
DESCRIBE WORK TO BE DONE ad //0
1_�-,4 /,--
HEAT SOURCE
PLAN CHECK NO:
REMARKS I
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RE0'0
VALUATION
Descirlptlon
Plan Check
GLAZING % LOT SLOPE %
Building Permit
L
;7
ESTED DATE
FEE DescrIptlon FEE
State Surcharge
City Surcharge :F
Mechanical
,%A I &^_1 or
I
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE
Grading
SEPARATE PERMISSION.
Engr. Review
PERMIT APPUCATION: 180DAYS
Engr. Inspection
PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICAK ON BEHALF OF HIS OR HER SPOUSF, HEIRS. ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
Fire Inspection
Receipt #
EDMONDS, WASHINGTONj ITS.OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFX'WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapelnsp.
Total Amt. Due
IPL
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
Recording Fee
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS COARECT; 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-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
CALL
This applIcation Is not a permit until signed by the
Building Official or his/her Deputy: and Foos are paid, and
IN VIOLATION OF THkLABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S �9MPENSIYION INSURANCE AND RCW 18.27.
FOR INSPECTION
receipt Is acknowledged In space provided.
OFFICIALS SIGNATURE DATE
_1� r
(425)
SIGNAT4d . (OWNIPI�R AQENU
DATE SIGNED
;Id� 1
a�,
06 - C2 6 3
77.1 nfjol
40W 3;1_/S_0_3
ELEASI�D4t"� DATE
ATTENTION M 1333
f., 1 1-1 � ,I cI
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
...04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
M
z
0
4
0
M
=i =n-
ca �
M
M
0
0 C:
4 r.
3: rn
M
z
0 -n
n
0
0 Fn
C cl)
C CO)
M 0
z
z
0
I
0
M