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20030530.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS MAILING ADDRESS 080�, CITY ZIP TELEPHONE EAV%A &i r-Ac- WOZi� 142_S-*77q-94-' NAME ADDRESS CITY ZIP ITELEPHONE NAME CBL PERMITEXPIRES 4'Z�LI17 4 USE PERMIT ZONE NUMBER JOB ADDRESS SUITE/APT# PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP APP(Ov6d RW Permit Roqu:rod street Use Perm 80,.d EXISTING - PROPOSED inspection Required E3 sidewalk Required E3 REQUIRED DEDICATION� FT underg- Wifingroquited E3 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES C3 NO 13 REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE a 5 ENGINEERING REVIEWED BY DATE ,56oS' CITY ZIP TELEPHONE FIRE REVIEWED BY DATE W W rL .i& VARIANCE OR CU SHORELINE ORADE111 INSPECTION BOND NUMBER EXPIRATItN DATE CHECKED BY REO'D POSTED I is 141-yok,3 1 -2-14 7_/04 OYES ONO SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PR POSED , , EXP 1:1 NEW 9�RESIDENTIAL E(PLUMBING / MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) FRONT SIDE REAR FRONT UR SIDE REAR COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE z PARKING LOT AREA PLANNING REVIEWED BY DATE a. I REMODEL 11 MULTIFAMILY SIGN REQ'D PROVIDED I I E00'REPAIR 0 GRADING FENCE I CYDS ( FT) X REMARKS DEMOLISH 1:1 TANK OTHER oGARAGE -1 RETAINING WALL F RE SPRINKLER 11 ALARM CARPORT ROCKERY FIRE i2 (TYF.VF USE, BUSINESS OR CTIVITY) EXPLAIN: CHECKED BY TYP CTION CO?,E OCCUPANTP GROUP NUMBER NUMBER OF CRITICAL OF DWELLING FAREAS SPECIAL INSPECTION AREA OCCUPANT STORIES UNITS NUMBER REQUIRED [] YES LOAD DESCRIBEPORKT BE E 4L 4 1% REMARKS 02 PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REO'D VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit 7th, City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO h BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE I=- SEPARATE PERMISSION. Engr. Review PERMIT APPILICATION: 180 DAYS IL PERMIT ILIMIT: I YEAR - PROVIDED WORK IS STARTED WITHIN 100 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 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 FROM THE ISSUANCE OF THIS PERMi7. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapeinsp. Total Amt. Due Fif DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE L 0 0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* 2 X1 Receipt # Recording Fee I HERE13Y ACKNOWLEDGE *THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION 1 HI APPLICATION APPROVAL IG'APPLICANT GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF IV THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- THI CALL This application is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED TIC Building Official or his/her Deputy: and Foes are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO IN FOR INSPECTION receipt Is ecknowledged In space provided. WORKMEN'S COMPENSATICI��RANCE AND RCW 18.27. OFFICIALS SIGNATURE DATE SIG�N�E DATE S 3NED (425) 771-0220 R SED BY DATE ATTENTON EXT 1333 1 P'z;;�4 - -a IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL -1 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW. INSPI!CTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING k z 0 ITI rn C rf, 0 0 0 C --I K X rn M Z Cl) 0 'n M M 0 50) 0 f- 0 M C M 0 Z X z (1) z 0 0 M I ........ . .. RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... Wall .......................... z Pier/Porch ................. Retaining Wall ........... M Slab fni , ulation . ......... PLUMBING: C4 M C Underground ............. M ds —40 Rough -In ................... 0 C M Commercial Final ...... M I0 HEATING: z GasTest .................... 40 Gas Piping ................. o -n. Equipment ................. M IT! Commercial Final 00) 0 EXTERIOR SHEATHING 0 Fn NAILING .......................... C: FRAMING ........................ 01 FIRST FLOOR FRAMING... INSULATION ................... z Floor Insulation ......... Wall Insulation ........... co z Ceiling Insulation ....... 0 SHEETROCK NAILING ... 0 IT! SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. V — 1W_ QDATE RECEIVED -7 " )I PERMIT EXPIRES CITY OF EDMONDS USE PERMIT ZONE V NUMBER CONSTRUCTION PERMIT APPLICATION JOB ADDRESS X) SUITE/APT# ja OWNER NAMEINAME OF BUSINESS - 'T— 412— PLAT NAME/SUBDIVISION NO. LOT NO. L�D NO. MAILING ADDRESS so(,. PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP L D FEE $ TES 'F APP(OVId RW Cftmit Required 2-4-2-y--j s,ui I Streei I In Permit Req'd CITY ZIP TE EPHONE EXISTING — PROPOSED Inspacition Required 13 Sidewalk Required 13 91?0 7-6 SA-1 REQUIRED DEDICATION— FT Undorground Wiring required 13 NAME ---- METER SIZE LINE S17E-1 NO. OF FIXTURES PFIV REQUIRED 0 YES E3 NO 13 1 ADDRESS REMARKS z 3 WNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE CITY ZIP TELEPHONE NAME CSL# t-A c ENGINEERING REVIEWED B DATE ADDRESS 560!�_ 31-j FIRE REVIEWED BY E Lu cc CITY zip TELEPHONE Ic C VARIANCE OR CU SHORELINE OR AD1111 INSPECTION BOND NUMBER EXPIRATIhN DATE CHECKED BY REO'D POSTED MCYN I WyOt.3'1 2- 04 �L 13 YES 13NO $ 1 .2&1 � SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX A COUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED .04G2c302_6002_,l EXP I , , 11 NEW 211RESIDENTIAL E(PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) LIRSIDE REAR ALLOWED PROPOSED FRONT SIDE REAR FRONT COMPLIANCE OR ADDITION COMMERCIAL z CHANGE OF USE REMODEL MULTIFAMILY'. 0 SIGN PARKING REO'D PROVIDED LOT AREA PLANNING REVIEWED BY DATE IL Ea/REPAIR GRADING FENCE _:::i CYDS ( X REMARKS —M TANK OTHER [3 GARAGE [3 RETAINING WALL F RE SPRINKLER FIRE ALARM CARPORT ROCYERY F USE, BUSINESS OR ACTIVITY) EXPLAIN: rE CHECKED BY IST LICTION E . OCCUPANT -_2 07- ITYP GROUP 2M NUMBER NUMBER OF CRITICAL a OF DWELLING AREAS SPECIAL INSPECTION AREA OCCUPANT STORIES I. UNITS NUMBER REQUIRED LOAD DESCRIBE WORK TO BE D,5NE F1 'r10 "'; LAIN' REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D ilys QrA IIII - �nlr unln&g C_ WoAej (�,Cesleh �2 SE VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % I Building Permit city S urcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, E-rc.) WILL nEGUIRE t: SEPARATE PERMISSION. Engr. Review 5 PERMIT APPLICATION: ISO DAYS 1116 PERMIT UMM I YEAR ' PROVIDED WORK IS STARTED WITHIN ISODAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICA1`9 ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit IN INTEREST, AGREES TO INDEMN(FY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt N ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. AFILISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Total Amt. Due DEEMED TO MODIP� WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,' x I - Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATI011N 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 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 9: 13 1PjQPFrT1 N receipt is acknowledged In space provided. WORKMEN'S COMPENSATION RANCE AND RCW 18.27. OFFICIALS SIGNATURE DATE S7 DATE S GNED/ (425) M.Q_,r-yjdL 03 771-0220 RWASED BY DATE ATTENTON EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL Ll 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 GREEN - 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES ACCOUNTING z 0 1 0 m =i 9 ra � am C mo 0 -40 0 C: -1 r. 3 m M Z z CA 0 -n TI m m 0 F) 0 r_ 0 M (j) Cft M 0 Z z W z 0 1 0 m