20030583.pdf4
DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS
DoAjljA EA2,vs7-
MAILING ADDRESS
153D C?�414ue_
CITY ZIP TELEPHONE
E,1>A401,10S C?86eD Z-5-774-4839
NAME
/1?0/1/
ADDRESS
4 02 A LIc A
CITY ZIP TELEPHONE
L!1/622 9B290 1-160-56-3-0849
NAME CBLN
44C
ADDRESS
7,33 Awe- 57—
CITY ZIP TELEPHONE
dQL>1401,1Las 9c9o20j,4Z_S-7;71-546_5
STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY
z 11414JE76.1 061 k _T 2_j 1—"H
PROPERTY TAX ACCOUNT PARCEL NO.
NEW
RESIDENTIAL
PLUMBING / MECH
ADDITION
COMMERCIAL
COMPLIANCE OR
CHANGE OF USE
REMODEL
MULTIFAMILY
SIGN
REPAIR
GRAQIN9-
CYDS
FENCE
( X Fri
DEMOLISH
—Aa..T—
TANK
13 OTHER
GARAGE
FIETAININGWALL
FIRE SPRINKLER
CARPORT
ROCKERY
FIRE ALARM
I[TYPE OF USE. BUS OR ACTIVIITY) EYPLAIN:
TIAZ_
NUMBER NUMBER -OF CRITICAL
OF DWELLING AREAS
STORIES UNITS NUMBER
DESCRIBE WORK TO BE DONE
1n)17e 1)eIAJ ele. 1(2z A r, e
do4a '. 140 D1.46- E-�C, �o,f t'ourd- 4Shl 0
HEAT SOURCE GLAZINQ % LOT SLOPE
11%64 1- __ A64 �J_ < TP
PLAN CHECKAO: At r) , j Z I VESTED DATE
(Z - �2 —24.=.9Z I
THIS PERMIT AUT14ORIZES ONLY THE WORK NOTED. THIS PERUrT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DONLIUN (CURBS, SIDEWALKS, DRIVEWAYS, IIIIARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: 180DAYS
PERMIT LIMM I YEAR - PROVIDED WORK is STARTED WITHIN 180 DAYS
SEE 13ACK 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
LNOR LIMIT IN ANY WAY THE CITY$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION.*
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-
3";.AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLA�!ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'R C01WR
BSN11O"SUQANCE AND RCW 18.27.
I DATE SICPED le
ATTENT(Q-A
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 PRESS HARD -YOU ARE MAKING 5 COPIES
PERMIT EXPIRES 1,0
USE PERMIT
ZONE
NUMBER
JOB SUITE/APT#
ADDRESS 153C) 9t4AL/e Al.
PLAT NAME/SUBDIVISION NO.
L�D NO.
L D FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
THCP APPI—
RW Req.k.
---t
80061 Use Permit Rac(d
EXISTING PROPOSED
Inspection Required
Sidewalk Required
REQUIRED DEDICATION Fir
wiring required
METER SIZE
NO. OF FIXTURES
PRV REQUIRED
YESD NO 13
REMARKS
OWNEWCONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
:ERING REVIEWED 97
FIRE REVIEWED BY
;I
ul
VARIANCE OR CU
SHORELINE OR ADB#
INSPECTION
BOND
R
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POSTED
13YEE No
$
SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE EX;EMPT
ALLOWED PROPOSED
ALLOW PROPOSED
,
15 //.,0"
__XP
LOT COVERAGE
REQUIRED SETBACKS
PROPOSED SETBACKS (Fr.)
ALLOWED D
FRONT SIDE REA
FRONT UR StE REAR
C3
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1
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P�ANNING REVIEA ED BY 'DATE'
CL
REQ`D I PROVIDED
'2- -2� [,LOT
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delz" 9d ga���
exce e-4 _&00
CHECKED BY TYPE q7;VCTION C OCCUPAbjT
211� GROUP&I
F I 1 0. _C_
SPECIAL INSPECTION JAREA OCCUPANT
REQUIRED[]YES 1 '1"904 LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC IGO/FINAL INSPECTION REO'D
Description
Plan Check
Building Permit
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
FEE Description FEE
StateSurcharge
City Surcharge j
.�l 'A I 4:2f�p_ -
Fire Review
Plan Chk. Deposit
J
Fire Inspection
Receipt #
Landscape Insp.
Total Amt. Due
Recording Fee
Receipt #
APPLICATION APPROVAL
CALL
This application Is not a permit until signed by the
FOR INSPECTION
Building Official or histher Deputy: and Fees are paid, and
receipt Is acknowledged In space provided.
OFFICIALS SIGNATURE 0 E
ALEAdW
771-0220
EXT 1333
BY DYE
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GOLD -ASSESSOR
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PERMIT#: �zx 3
EXPIRES:
ISSU D: A M n)4
'114�� City of Edmonds I /
THIS CARD MUST BE POSTED ON SITE AND AVAILABLE TO THE INSPECTOR
Owner: 4,7KIV3 7
Site Address:. /S-3o Al
Project: 1)ekckd
Setbacks for
Zone
Front
Rear;,.-Q?,6 /
Side:
Height: 15
Variance #:
Inspections
Approved I
Date
Notes
#1 ENGINEERING
MOBILIZATION AND EROSION CONTROL INSTALLATION MUST BE APPROVED
PRIOR TO COMMENCEMENT OF ADDITIONAL WORK.
(425) 771-0220 x1326 Mobflizafion / Erosion Control
—7jightline
Detention
Forms (sidewalk, driveway)
Water Service
------------------------
17A
Permit # Side Sewer
Permit # Right -of -Way
Ls./.W, 2�&, paving)
#2 SITE/DEMOLITION Pre -Demolition
Asbestos SAPCA Permit
Sewer Cap
Cleaned Site/]Final
- - - - - - - - - - - - - - - - - - - - - -
#3 FOUNDATION Setbacks
Footings
Foundation Wall
Piers
Retaining Wall
Slab Insulation
MS
0
- - - - - - - - - - - - - - - - - - - - - - - -
07
- - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - -
6-5
M S
#4 PLUMBING Ground Work
Permit # —RoughIn
Grease Fixture
- - - - - - - - - - - - - - - - - - - - - - -
— --------
#5 PUBLIC WORKS Cross Connection Control
J425) 771-0235
#6MECH/HVAC Gas Test/Pipe
Permit # Eguigment
------------------------
—
#7 FRAMING Exterior S�eathing
Shear Nailing
First Floor Framing
Framing
2t— Height Check
77— 1
�F
- --------------------
----------------------
----------------------
01's--T14-al
M3
PEE4
#8 INSULATE / CAULK Wall
Floor—
'Ceilina
-----------------------
-- ---------------------
—
g2 S11F4FapAQQJ DJAIL
#10 FIRE Hydrant
(425) 771-0215 FQC
Fire Protection System
Extinguishers
Addressing Visibility
------------------------
-----------------------
------------------------
-----------------------
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FINAL PROJECT APPROVALS ***
VA*t7t,—,,w;! -, M , -) i I
RM I --- I I
h%- FINAL OCCUPANCY APPROVAL
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USE PERMIT
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CONSTRUCTION PERMIT APPLICATION"
JOB SUITE/AFT#
!Ale 1J,
ADDRESS
WN �ft"E OF BUSINESS
Z)oAjqA EA?/,/,sr
PI.AT NAME/SUBDIViSION NO.
LOT NO. LI: N
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MAILING ADDRESS I
/53o & A/I
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PUBLIC RIGHT OF WA UPER!F - ii Of
Permft
Ldred
73—ITY
ZIP ITELEPHONE
E1L>14oA10S ZO . 142.5-774-4838
EXISTING W-Will am
REQUIRED DEDICATION— Fr
Q
PRV RE QUIRED
ETER SIZE
LINE SIZE
NO. OF FIXTURES
NAME
YES 13 NO 13 z
ADDRESS
REMARKS LE FOR EROSION CONTROL[DRAINAGE
OWNER/CONTRACTOR RESPONSIB
400 A LIC ZA
CITY ZIP(. 0
0.0290
P NE
5; Ik 4 S re 0 4_6 1/6 W f Af
CBL#
NAME
00' jW
EN EWEUt)Y D
RE.�L
_MNEERING
1-0,
cc
ADDRESS
733 t0no,16'
FIRE REVIEWED BY DA* W
cc
CITY ZIP TELEPHONE
qcqozo jzs-7;r1-546
VARIANCE OR CU
SHORELINEORADBIJ
INSPECTION
13OND
STATE LICENSE NUMBER EXPIRAHON DArE I CHECKED BY
RECjD_
(3YES,^NO
POSTED
S
z /.,w 6'6, 1 061 k 6� 51jz14 f!21
AREA HEIGHT
SEPA REVIEW SIGN AREA
COMPLETE EXEMPT ALLO WEDPROPOSED ALLOWE PROPOSED : I
PROPERTY TAX ACCOUNT PARCEL NO.
15
,f
Jf i�
L L_ ,
2Q.11449
— —
EXP j
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LOT COVERAGE REQUIRED SETBACKS
SI; E REAR
ALLOWED OPOSED FRONT SIDE / �REA FRONT 1.10 SIP
PR 1 - X/ I
1 Of
Iss
NEW RESIDENTIAL PLUMBINGIMECH
;9
COMPLIANCE OR
0
IS. . 'er E
ADDITION COMMERCIAL CHANGE OF USE
17� __T
FrARY
LOT AR A
p 4NING REVIEWED BY -DATE
REMODEL 13 MULTIFAMILY SIGN
RECtD \1
P VIDED
111,0
It
1/0-
FENCE
GRAg FT)
0 REPAIR CYDS 13 x
K e- -e - d
OTHER
[3 DEMOLISH TANK 0
-IV
ETA F RE SPRINKLER
GARAGE R ININGWALL
ROCKERY
10 CARPORT 11 FIRE ALARM
e e of
P
MPE OF USE, BUSINEPS OR ACTIVITY) EX LAIN
CHEMWD ly ITYPE 07XI CTI?N
CO-DJE— 0
GROUP
*UMBER
OF 7/ 714
NUM13ER OF
DWKLING
CRITICAL
AREAS
REAS
R
UM I
NUMBE
f,V -A/ G, Ibcdo 0AW
LO�p
STORIES
UNITS
yEd.
;F- P
Ks Ktazu
DESCRIBE WORK TO BE DONE
lj�ff ECYJGU"EKUBC j.0d1F(9ALA�0dCTION
40 A e, a
zmj
VATIO N
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20 X 30
E- Description FEE
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HEAT SOURCE Lor SLOPE % Buildina Permit !9,11;' City Surcharge
141A
VESTED DATE Plumbing
PLAN CH20, -0 5
Mechanical —
THIS PERMIT AUTHORIZES ONLY THE WORK WnED. THIS PERMIT COVERS WORK TO
t-1 BE DOME On PRIVATE PROPERTY ONLNt ANY CONSTRUCTION ON THE PUBLIC Grading
X IDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE
DOMAIN (CURBS. 6 SEPARATE !LR;MISSION-
Erffl.rRyiew
PERMITAPPLICATION.
PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 160 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR UORE INFORMATION
Plan Chk. Deposit
;A _ N BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review.
PPU '0 1
N INT=T. AGREES TO INDEMNIFY, DEFEND AND HO�I) HARMLESS THE CITY OF Fire Inspection Receipt # 45�
EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES. ME AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARIS N DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMM ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Tot;:il Amt Due
DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Receipt #
0 NOR LIMIT IN
Recording �ee
TA APPLICATI
I HEREBY ACKNOWLEDGE THAT I HAVE READ , �RLICATIO�; THAT THE INFORMATION ON APPROVAL
GIVEN IS CORRECT6 ANDTHATIAMTHE OWN OR THE DULY AUTHORIZED AGENT OF This application Is not a permit until signed by the
THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL d Fees are paid, and
No IN ING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building otticiall or his/her Deputy: an
0 AON OF THE L.ABQR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged in space provided.
IN VI NCE AND RCW 18.27. OFFICIALS SIGNATURE D E
WORKMEN`S,,CO
R AGE DATE SIG , ED IA91;
7G�NA:TU:R �( V�% - - �?
771-0220 D E
LEA By
EXT 1333
ATTENT"
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE U�� ly
AL LE YELLOW P
ROVAL OR A CEA IFI j GOLD - ASSE Son
,fJ154
A FINAL INSPECTION HAS BEEN MADE AND APP 0 N ER
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 ti - P GREEN - ACCOUNTING
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES