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20030538.pdfDATE RECEIVE!5 C61()3 �7 1'7"'Lh FPERMIT EXPIRES USE PERMIT -Z CITY OF EDMONDS ZONE NUMBER JOB ITE/APT# CONSTRUCTION PERMIT APPLICATION tADDRESS 0 06LC'tE 0 �' OWNER NAME/NAME OF BUSINESS A 1__.' P T NAJ /SUBDIVISION NO. -& NO. I:IAP_p3hox APC— L&_ LID FEE S MAILING ADDRESS is z z PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING — PROPOSED REQUIRED DEDICATION— FT I FUGr 4proved RW Partnit Requited Street Use perynn RWd Inspection Requited Sidewalk Req Ired undef�d f!�2g r"Wed CITY /zip I TELEPHONE ;55fell — METER SIZE LINE SIZi _f NO. OF/IXTURES PRV REQUIRED YES E3 NO NAME Z.,4, REMARKS CONTROUDRAINAGE OWNERICONTRACTOR RESPONSIBLE FOR EROSION ADDRESS CITY ZIP IWO& TELEPHONE I 1-14-61"3766 NAME CBL# ENGINEERING REVIEWED BY DATE CC ADDRESS 0 70 _IEVY DATE FIRE REV By So su Ir CITY ZIP I LM60 Ve ITELEPHONE 19 2_4 VARIANCE OR CLI SHORELINEORADB# INSPECTION REO'D 13YES JACO BOND POSTED I STATE LICENSE NUMBER EXPIRATION DATE I uffLc& * lmqr 12, SEPA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED PROPERTV TAY ACaQUNF PARCEL NO EXP NEW RESIDENTIAL PLUMBING ECH COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE REMODEL MULTIFAMILY SIGN I LOT COVERAGE ALLOWED PROPOSED e REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (FT.) FRONT URSIDE REAR z I 936 A!! PARKING REOD I.EagYIDEA LOT AREA PLANNIN REVIEWED BY DATE 00, o FENCE REPAIR GRADING CYDS ( _ X_FT) REMARKS DEMOLISH TANK OTHER GARAGE RETAINING WALL FIRE SPRINKLER CARPORT 0 ROCKERY FIRE ALARM (ME OF USE. BUSINESS OR ACTIVITY11 EXPLAIN: A rc At.401k^ll tv"Im r_ CHECKED BY I TYPE OF CONSTRUCT N _rTr I , r OCCUPANT GROUP "_& �'�I_STORIES NUMBER CRITICAL OF DWELU G �REAS ..Mgr-R I S R UNITS — TO BE noNE RE P _Air,> wAtt,!� OAI OAVJ� -of-, 601 L;P1 &7e fovr:'-r� cr- :M r ()AI F HEAT SOURCE % LOT SLOPE % CK NO: 0 VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: ISO DAYS ILJ PERMIT LIMM 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 2 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 9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENt OF ANY CITY ORDINANCE 01 OV - NOR LIMIT IN ANY WAY THE C17YS ABILITY TO ENFORCE ANY ORDINANCE PR I SION. I 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 VIO ION OF THE LABWff"eGU OF THE STATE OF WASHINGTON RELATING TO WOR4M S COMPEN!!2�� aRCW18.2�7 E OWNER 0 G E PNMT) DATE SIGNED 'r . Alrr Ull'IfIkil PFCIAL INSPECTION JAREA OCC I EOUIRED [] YES LOAD MARKS 12 ROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D 9 A- 11-;- 19 Description FEE Description FEE 1an Check State Surcharge luilding Permit City Surcharge Ilumbing Aechanical 3rading :-ngr. Review :-'ngr. Inspection Fire Review Plan Chk. Deposit Fire Inspection A-7h Receipt III Total Amt Due Receipt # Landscapeinsp. Recording Fee APPLICATION APPROVAL CALL This application Is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid, at.. FOR INSPECTION receipt Is acknowledged In space.provided. (425) 0 1 GN JA AATE 771-0220 RELEASED/B D TE IT IS UNLAWFUL TO �A�CUPY A BUILDING OR STRUCTURE UNTIL - - A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - LE YELLOW - IAPEC�01`1 CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OW GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING A FINAL PROJECT APPROVAL FORM z 9 0 m :q rn- vi :0 am c mo 0 80 c --j r. 3: M M Z cl) 0 _n n m M 0 0 0 M (j) ch M 0 Z .4 M --I z __4 M 55 z 0 1 F) m R&INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Signature l:temp:bldg:fomis:ocaprvl 3/25/04 RECORD OF INSPECTIONS INSPECTOR DATE APPROVED �SETBACKS ..................... FOUNDATION: Footing...................... Wall .......................... Pier/Porch ... .............. 4: Retaining Wall ....... 1171� Slab Insulation ... ...q In PLUMBING: M. Underground .............. M Rough -In ............ .. FIRST.FLOOR,FRAMING..,. INSULATI ON . .................... F o6r Insulation ......... Wall Insulation .. Ceiling Insulation . ....... Z, O� SHEETROCK NAILING ... 0. m SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR 4sr, OCCUPANCY ..... ............ The initials RSR are Rick S. Roberts, a temporary contract or the City. itispector f 1k _7 ------ DATE RECEIVE!� f 0 PERMIT EXPIRES USE PERMI ZONE CITY OF EDMONDS NUMBER JOB unVAPT# CONSTRUCTION PERMIT APPLICATION ADDRESS 0 On 0 1 I FOWNER NAMEft"E OF BUSINESS I I n �LE I/ / � I — - I _� - __ — — A NAME/SUBDIVISION NO. I LOT NO. F&D NO. " 14 fkW_-'50r_ )14 je_� e- 1.4, LID FEE S MAILING ADDRESS 1&6 A) - —0 ' J 1 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING — PROPOSED REQUIRED DEDICATION— FT TESCP APPMW Rw PorrrA Mquired street use Perm" RW Inspection Required Sidwalk Required underarcum - WWg required 13. CITY Zip 06 TELEPHONE 04 NAME Agal?&" ra,%l METER SIZE LINE SIZE NO. OF/IXTURES PRV REQUIRED YES 13 NO ADDRESS AR?9,4D1'5& bW9 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE CITY I ZIP tk-owvw�-5 TELEPHONE NAME if//jz-40x' V 6 4 ENGINEERING REVIEWED BY DATE -ICB6 ADDRESS 1--3+ S 70 40F_ 4:5AJ7V FIRE REVIWD BY DATE ul 1 - '?-2-L)3 CITY ZIP TELEPHONE 415 VARIANCE OR CU SHORELINEORADB11 ..... INSPECTION REO'D - 13YES JQI�Q 1. BOND POSTED $ STATE LICENSE NUMBER EXPIRATION DATE 1clI On 12_2�� --,I SEPA REVIEW COMPLETE EXEMPT CV0 SIGN AREA I ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED Ul PROPERTY %Mgr PARCEL NO. 0 NEW RESIDENTIAL LUMBING ECH ADDITION )<COMMERCIAL 0 COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY SIGN LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) F RONT URSIDE REAR I I z PARKING REO'D I PROVI= T LOT AREA PLANNING REVIEWED BY DATE GRADING FENCE 13 REPAIR CYDS 0 x—Fr) REMARKS OTHER [3 DEMOLISH [3 TANK 1:1 3 GARAGE [3 RETAININGWALL [3 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM ME OF USE. BUSINESS OR ACTIVITY) EXPLAIN: Kor-k-60'r Ztnom ir t- iA CHECKED BY ITYPE OF CONSTRUUN�'� OCCUPANT GROUP NUMBER NUMBIER OF CRITICAL OF DWELLING AREAS STORIES UNITS NUMBER SPECIAL INSPECTIO; JAHLA REQUIRED [] YES OCCUPANT Z05)V, LOAD 14W DESC4RUIBEWORITO BE DON' P�x I T=64 . "-V h& AAA? W%A_5 0j\J -ZA7C=l FL s REMARK a PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D 0) AAjD i UhffeEk 9ffS=9A_A5ffi VALUATION LA $ PM _TEW Description FEE Description FEE Plan Check Ir State Surch arge HEAT SOURCE GLAZING % I LOT SLOPE % Building Permit 7 -5'6 City Surcharge PLAN CHECK NO: 0 -3 VESTED DATE Plumbing 1—M, "V- Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Grading IL BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC DOWAN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: ISO DAYS PERMrr ILIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Review Engr. Inspection Fire Review PlanChk.Depop 1??q,:— 'APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS IN INTERE9T, 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 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 CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - Landscapelnsp. Recording Fee Total Amt. Due Receipt # I 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 VIOL�TION 0 F THE LABOR-COQ9 OF THE STATE OF WASHINGTON, RELATING TO WoRrErS COMPENSAT12ANLIQL�AhCk AND RCW 18.27. CALL FOR INSPECTION IA95) APPLICATION APPROVAL OftThis apoication is not a permit until signed by the Bug&pg Official or his/her Deputy: and Fees are paid, and receipt Is acknowledged in space,provided. QFF�JGNAPT �ATE U ILL 0 N.I,)/::; DATE SIGNED rEOWNER iTT fT 01 771-0220 RELEASE D 'TE ATTENTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL- TLE /YELLOW - APEdoR' CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK-OWft1f - GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES e3REEU .,*COUNTING z -04 0 M 74 T, V5 � OM a Rig 80 C E2 z M joi� z 0 _n Irn M a V5 0 0 Fn C9 C MO X z z 9 0 M .r