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20030533.pdf13 DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNE9 NAMEMME OF BUSINESS A-K) A " D MAILING ADDRESS 02 If 0 S 40 CITY ZIP TELEPHONE CO~OS �L09LCJ NAME ADDRESS CITY ZIP ITELEPHONE NAME 0 ,�.k C- tj 4 j4 )q (LP, S t IOU ADDRESS I if � 2 g4, /0 #00r (Aj CITY Zip TELEPHONE 56-An7_6 9 �2'0 6,9vic 6 go- ST6TE LICENS§ NUMBER EXfIRATIPN E ONECKED 8 'ROPERTY TAX ACC 010 11 PARCEL NO. ;z aa W—L-0-1 I NEW 0 RESIDENTIAL PLUMBING/MECH 0 ADDITION COMMERCIAL COMPLIANCE OR 0 CHANGE OF USE 11 REMODEL 0 MULTIFAMILY SIGN 0 REPAIR GRADING 1:1 CYDS FENCE 13 t X FT) DEMOLISH 11 TANK [:] OTHER GARAGE CARPORT -1 RETAINING WALL 0 ROCKERY 0 F RE SPRINKLER FIRE ALARM I[TYPE OF USE. BUSIbWSS OR ACTIVITY) EXPLAJ14: - PERMIT EXPIRES USE PERMIT-? ZONE NUMBER� JOB SUITE/APT# ADDRESS le /fil , PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TE CP Approved RW Perm I R:r ulted I q Street Use P milt Rsq'd EXISTING PROPOSED inspection Required Sidewatit Required REQUIRED DEDICATION— FT UnddWound Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES13 NO 13 25 1 REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE Q NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES UNITS NUMBER IVA_� I JO DESCRIBE WORK TO BE DOME I TW(3 t6-txg t Pg,Hjdjjy uxib&t. t"_ V 4- 3"IfVt.1" Imerm..;,orm It),, HEAT SOURCE GLAZING % I LOT SLOPE % PLAN CHECK NO: Z2!�� VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 160 DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WffHIN 180 DAYS SEE BACK OF PIHIK PERMIT FOR MORE INFORMATION APPUCANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS N 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, AFUSING 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 C17YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* 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 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 THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN!S CQNPENSATION INSURANCE AND RCW 18.27. DATE SIGNED r7 -1 - 43 Affilf(A]ILMA UVVVWl =NGINEERING REVIEWED BY DATE —1 W(ffiflel -7// te t FIRE REVIEWED BY DATE Lu cc VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND I REO'D 1$ POSTED WyEs 13NO — SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOW! PROPOSED ALLOWED PROPOSED , C'%- 10. f%.0 4)� 4 :_XP LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR z DA�;/ PARKING REO'D I PROVIDED I LOT AREA 0 REVIEWED ;a: r')_ BY _'.' - I E�Z �nL 2 REMARKS CHECKED BY ITYP ION OCCUPANT I MW 1 GROUP SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [3 YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D VAILUATION 1 $ _j Description FEE ev f I fV). '-- LA-11 Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing 6 P4, I clo 0C .4 Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION IA13 %425) 771-0220 EXT 1333 APPLICATION APPR L This application is not a permit until signed by the Building Offlcial or his/her Deputy: and Fees are paid. and receipt Is acknowledged In space provided. OFF ALS SIGN URE DATE REtEA§EO BY DAAE — 1/) 7 n - J 7 1 , /I I C-1 IT-fS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 1 1 4 144 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES FILEj- YELLOW -!INSPECTC NEFV - GOLD -ASSESSOR 4EtN - ACCOUNTING z 0 M M C M __40 0 C M M 10 0 171 M M 0 0. Fn M C) z M FINAL PROJECT APPROVAL FORM z 9 0 m "4 =a m c rn 0 0 c M m 10 0 n m M a 0 0 M C cl) c co) M 0 Z X z z 0 m RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Si ocaprvl.doc.l:temp:bldg:form�10/01 z 0 4 0 m =4 --H 55 :� OM c MO 0 40 C= MM MZ 10-4 V) 0 -n n m M a Fa or - OM C cl) K (1) M 0 Z X z 3� 0) z 9 0 m RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing...................... Wall .................... ... PleriPorch .... Retaining Wall' ........... -Slab Insulation .... . YLUMBING:�L'�L Underbround ........ Rough -in ................... Commercial Final,...*... N HEATI G' Gas.Test ...................... -Gas ping. . ............. Epment .................... qui Comrnarcial Final EXTERIOR SHEATHING NAILING............. ............. FRAMING ......... ................ FIRST FLOOR FRAMING ... NSU ..................... Fioior"In's'u'lition ......... Wall Insulation .. ....... Ceiling Insulation... SHEETROCK NAILING ... SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY ............... "Oe 9 zi f Zj� 4" 0 rn. m M Fn c C), ;r ,AT ATE RECEIVED PERMIT EXPIRES USE PERMIT ZONE CITY OF EDMONDS NUMBER ON JOB SUITE/APT# CONSTRUCTION PERMIT APPLICATI ADDRESS Ah// 1!:::1 OWNANAMEINAME OF BUSINESS KA C, L Awx�r� PLAT NAMEISUBDIVISION NO. LOT NO. LID NO MAILING ADDRESS CITY tj 0 's o(d -/w TELEPHONE zip 6 3s- 3c) PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP __-.01 EXISTING — PROPOSED REQUIRED DEDICATION— FT LID FEE $ TlibUr Approved AW Permit Required Street Us* Permit Raqd,� lnspftWn Required #0 Sidewalk Required Undwwound WkingrequIred PRV REQUIRED NAME METER SIZE �INE SIZE NO. OF: FIXTURES ADDRESS YES 13 NO 13 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE 0 z CITY ZIP TELEPHONE tlw- IW&Isr-S& JU VLAL41% WISMI 1&JNtjLkM - I O)AM SIARkaaffa a+ 0- NAME CBL # 1W W1 Cali& ffiffl)(L. M C- tj A A Iq (-I tA P-C- 62 ENGINEERING REVIEWED BY - DATE ADDRESS L&A -71API= I if S 2 CAJ 'I FIRE REVIEWED BY DATE us at CITY ZIP 4E ;?4 STTE LICENS NUMBER EXFIRATI IN DATE 011ECKE VARIANCE ORAft m %Apw�_ tNSPECTION BOND 7!""AQ-D� POSTED MAI yj gill M 0 1 - �, . I ONO $ . SEPA RIEW AIPN ARE A ' "-'I HEIGHT VAV PROPERTY TAX ACCO PARCEL NO. EXEMPT �1_1�91 ED? COMPLETE V? PROP OSED ALLOWED PROPOSED , -3 %4 I EXP 1 [3 NEW RESIDENTIAL PLUMBING/MECH LOT COVERAGEj.,�' --REQUIRED SETBACKS (FT)' PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR COMPL ANCE OR P ADDITION COMMERCIAL CHANGE OF USE z REMODEL 13 MULTIFAMILY SIGN PARKING LOT AREA RECYD I PROVIDED PLANNING REVIEWED BY DATE GRADING o FENCE REPAJR CYDS X FT) REMARKS T vZix *� OTHER DEMOLISH TANK .[:],GARAGE RETAINING WALL FIRE SPRINKIIER --CARPORT ROCKERY,' FIRE ALARM' (TYPE OF USE. BUSIy§SS OR ACTIVITY) EXPLAIN: T CHECKE 'P' 0 ST D BY 0 RU ON OCCUPANT GROUP NUMBER NUMBER OF CRITICAL OF DWELLING AREAS NA-1-NUMBER A '54 SPECIAL. INSPE IDNAREA OCCUPANT LOAD STORIES S REQUIRI S DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D Ajj6 o S 16-0 tt (1") Pa _2 L( S'; L! AA Y r__ utio 45 AV C_ -516-ti — VALUAnON 44-o &" Lkrine, an $ Description FEE Description FEE Plan Check 00. _001 State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % -1 Building Permit in 1 .01, City Surcharge PLAN CHECK NO: VESTED DATE Q ;3, 4�i Plumbing 100' MONSOON Mechanical THIS PERMIT AUTHOR[ZEB ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DOME ON PRIVATE PROPERTY ONLY. ANY CONMUCTION ON THE PUBLIC Grading a DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) IWILIL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPLICATION: 180 DAYS PERMIT LIMM I MR - PROVIDED WORK IS ISTARIVED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION I . 'APPLICANT. ON EEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit /7 "7 C 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 ]Depor.ft 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 Landscapelnsp. Due Total Amt. Due Ot T N OR UMrr IN ANY WAY THE CnYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' F Recording Fee o I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN 18 COME" 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 to not a permit Until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED 71 IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO IF BuUdng FOR INSPECTION OMcW or tdothor D"uty: and Fees are paid, and receipt to acknoydodgod In space provided. WORKMENS C SATION INSURANCE AND RCW 16.27. SIGNA URE DATE IG rj=- R An�� Ll E SIGNED S E ER OAT 7FFIALS RELEASED 13Y Ap, tNftN Off 1333 7/l/. I" UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- VeR I G ILK FILE YEIa�W -/INSPEdTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PIN tNE GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES N - ACCOUNTING P