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20030610A.pdfDATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS %-TI." ("1C_)ry\(yWxf I I 14 L MAILING ADDRESS I c.) "-, 'A'C) t. -7 " - �' -�'- -, , '-) CITY ZIP TELEPHONE L NAME ADDRESS CITY ZIP ITELEPHONE INAME CBL N I M /V'7t P �- 164- 1 147A­771 N G_ I I L ADDRESS CITY ZIP TELEPHONE =()M -I.-- . -1 STATE LICENSE NUMBER EXPIF I" P, —1 0 �:> 4 0 PROPERTY TAX ACCOUNT PARCEL NO. 13 NEW 1:1 RESIDENTIAL 0 ADDITION 0 COMMERCIAL 1:1 REMODEL 1:1 MULTIFAMILY REPAIR 1:1 GRADING ryps DEMOLISH 1:1 TANK EiGARAGE RETAINING WALL CARPORT ROCKERY (TYPE OF USE, BUSINESS OR ACTIV" EXPLAJN: NUMBER NUMBER OF OF DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE e , I -'� I I d '-'� n HEAT SOURCE GLAZING % Co- & I PLAN CHECK NO: 1 1PERMIT EXPIRES USE ZONE PERMIT I Q� NUMBER JOB ADDRESS 11WI*E1 T# 7 t PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved El RW PerMil Required 13 EXISTING - PROPOSED Street Use Peffnit Req'd 13 Inspection Required [3 S Idewalk Required 13 REQUIRED DEDICATION- FT Underground Widng required [3 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YESO NO 13 ,REMARKS z 2; OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE 0 5 all hot water tanks per DATE FIRE FMIFWFn FIX ul cc VAFIIANCEORCU _4SHORELINEORADB# INSPECTION BOND ie� REQ'D POSTED :W-1 ___�__JOYEs ONO IS -1 --Ce PAFOWNWIS 0 j 1[fOAWj26Q=t "EIG9 COM Fe CAEMPT . A )p%LOWED OPOSED oc:) ed e, rue1-b4j-n1,,g,p,,I_ I I EXP jancec <LUMBING/MECH L COVERAGE 44010 hmD suralo D T �TSE CKS (Fr.) 0� ALLO FRONT SIDE REAR LISESI REAR t COMPLIANCE OR USE z CHANGE OF PARKING LOT AREA PLANNING REVIEWED BY DATE Lj SIGN REO'D I PROVIDED FENCE -A na Dr x -FT) REMARKS Fill f- ST BE OTHER U 1 1. F SPRINKLER FIRE ALARM OrIALL NUT CRITICAL AREAS NUMBER LOT SLOPE % VESTED DATE CHECKED BY ITYPE OrnSTRUclic)" I I- UUUU XdN 14 2� GROU SPECIAL INSPECTION [AREA OCCUPANT REQUIRED YES LOAD 43 REMARKS z PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RE VALUATION $ Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PU13UC Grading 3 3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPILICATION: 180 DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF a EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscape Insp. DEEMED TO MODIF4 WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION., Recording Fee 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 C21 IlY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL T '�N TION; AND IN DOING THF_* R -'HORIZEC THEREBY, NO PERSON WILL BE EMPLOYED ldl Bul r IN VIOLATION OF THI COUP OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION WORKMEN'S COMPE� �ION I SU9fNCE AND RCW 18.27. I OFFIC SIGNATURE (OW2N2�AAGEN DATE SIGNED (425) 771-0220 A"TT IN Nl�"' EXT 1333 JELEA IT I S t! �WUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL r�NSPECTION A FINA HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE 0 OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES Plan Chk. Deposit Receipt # Total Amt. Due qecq�ipt # .IC ION APPROVAL atio s note permit until signed by the o Isiher Deputy: and as Id, and cknowledued in splylpro=. MY DATE ORIGINAL -FILE YELLOW- INSPECTOR PINK -OWNER GOLD -ASSESSOR GREEN - ACCOUNTING z 0 q 0 IT! --I -n M M 0 C.) 0 C: M M Z X ca o -n n M M 065 0 0 F; C 0) C CO) M C) z z (1) z 0 IT! 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 .......................... TRAMINQ . ........................ FIRST FLOOR FRAMING... INSULATION ...................... Floor Insulation ......... Wall Insulation ........... Ceiling Insulation ....... SHEETROCK NAILING ... SPECIAL INSPECTION MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. 2003. 0& /0 0 M =i 9 RECEIVED-, / 7 I CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEMAME OF BUSINESS -in 4 '0 (.Y) n-1 U m I -,-,I MAILING ADDRESS CITY ZIP TELEPHONE L= j)(n. cl g� I NAME ADDRESS CITY ZIP ITELEPHONE NAME CBLN J5. Ot ADDRESS 0 --I S 4, " CITY ZIP TELEPHONE 0 I= iAyl //�5 726 -,1,(-6-7 - PERMITEXPIRES [ / a__�) V USE PERMIT ZONE -C)G,,I NUMBER JOB SUITE/RT# ADDRESS lo -L z o ( � J 22 '� PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved AW Permit Required Street UBo Permit Roq'd EXISTING - PROPOSED inspection Required 13 Sidewalk Required 13 REQUIRED DEDICATION- FT Underground I Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES RV REQUIRED YES 13 NO 1-1 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING REVIEWED BY DATE ACCE"EV- FIRE REVIEWED BY DATE ul Dr. STATE LICENSE NUMBER EXPIRATION DATE ECKE" garcsies "'I. Be 511 PROPERTY TAX ACCOUNT PARCEL NO. "_' -21 -1-1-Z, 0 %titz"11h At IWJ fiN6 P LVJP JANI $ BOND So expansi, on YEE I POSTED HEIGHT _2RnMSED I ALLOLED PROPOSED SETBACKS (Fr.) NEW RESIDENTIAL BING if MECH REQUIRED PROPOSED SETBACKS (FT.) I?P�LU_m ED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE I I z PARKING LOT AREA I PLANNING REVIEWED BY DATE Lj REMODEL Li MULTIFAMILY L_j SIGN REQD i P REPAIR GRADING 1:1 CYDS FENCE ( _X FT) REMARKS DEMOLISH 1:1 TANK OTHER GARAGE CARPORT -1 RETAINING WALL 13 ROCKERY [3 F RE SPRINKLER FIRE ALARM (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: C_ "Va)C+4_ NUMBER NUMBER OF CRITICA OF DWELLING AREAS STORIES -UNITS NUMBER. DESCRIBE WORK TO BE DONE I b U, 000 (Z)-rU S-1. -4 k ( 1:" HqAT SOURCE GLAZING % LOT SLOPE % a a -s. . I I PLAN CHECK NO: I VESTED DATE 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 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 CIT-Y 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 ABILITY TO ENFORCE ANY ORDINANCE PROVISION., I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT TH FORMATION GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHO ZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- TION; AND IN DOING THE,WORK W �ORIZED THEREBY, NO PERSON WILL BE EMPLOYED U IN VIOLATION OF TH4,413OR AD OF THE STATE OF WASHINGTON RELATING TO 'U� r WORKMEN'S COMPENSYION INSLI NCE AND RCW 18.27. SIGNATURE (OWN pl�' AGE7/ DATE SIGNED Typ J_ vent or- eenneeters reflitif red ekn fixehburn;ng uppliances in unheated spaces. UMC 815.1.7 CHECKED BY ITYPE OP?jSTRUC I(* I OCCUPA0:7 , _' MA GROU to SPECIAL INSPECTION [AREA OCCUPANT REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D I g Alk 115k 9. 1111% 1 Fn or r' n I VALUATION $ Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit F ire Inspection Receipt # ILandscapelnsp. Total Amt. Due Recording Fee Rece�il t # CALL R INSPECTION OFFIR (425) 771-0220 ATTqN �VON IT IS UNCAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAQ,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 hON APPROVAL not a permit until �gned by the her Deputy: andjoes are Id and Wedged In spape pr B�y DATE )�IA ORIGINAL -FILE - YELLOW -INSPECTOR\%-/ PINK -OWNER - GOLD -ASSESSOR GREEN . ACCOUNTING I z 0 M 45i M C M 0 0 0 C M M Z ,C) --I C — > z X 0 x M M a Fo OF - OM C 0) r. ca M 0 Z z z 0 1 0 M