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20030630.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION I OWNER NAMEINAME OF BUSINESS MAILING ADDRESS ZZq\4, 1 S bA_) CITY ZIP TELEPHONE _rFhW'_0NLC2 I NAME ADDRESS CITY ZIP ITELEPHONE CBL N W ADDRESS 0 0 o C1 rao 4'�oJ Q)�-4jl 9ITY TELEPHONE U ' I Sf) 0 - 78 2- lito �1 e. ,z'g STATE LICENSE NUMBER EXPIRfTIO DATE 41 PROPERTY TAX ACCOUNT PARC -,\ N ,_ , _ _ _�k NOj.,N z N 13 NEW RESIDENTIAL / MECH 1:1 ADDITION COMMERCIAL _�T_LUMBING COMPLIANCE OR ri CHANGE OF USE 1:1 REMODEL kMU LTIFAX41LY SIGN 1:1 REPAIR E] GRADING CYDS FENCE ( X FT) DEMOLISH TANK OTHER GARAGE RETAINING WALL F RE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINES;.qR ACTIVI'M EXPLAIN: NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE . KIT - I AP74- ) K) V1 1AVA 1 �6 rO HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: 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. PERMITAPPLICATION: ISO DAYS PERMrr LIMM I YEAR - PROVIDED WORK 15 STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMrT FOR MORE INFORMATION APPLICANT. 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, 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 CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION., I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMAT16N 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 WORKDOS COMPENSATWNINSLWNCE AND RCW 18.27. DATE SIGNED ATXENXION IT 1�_�AWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FlITAL 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 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING FERMIT P EXPIRES USE PERMIT ZONE NUMBER Leo JOB ADDRESS SUITE/APT# T PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP APPfov RW Permit ReqViffid Street Use Permit Req'd EXISTING - PROPOSED Inspection Required 13 Sidewalk Requ Ired 13 REQUIRED DEDICATION- FT Underground Wiring required El METER SIZE LINE SIZ�7 NO. OF FIXTURES PRV REQUIRED I YES E3 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE VARIANCE 08 CU SHORELINEORADBN I INSPECTION PBOND REQ'D OSTED SEPA REVIEW SIGN AREA OYES 13NO $ HEIGHT COMPLETE . EXEMPT ALLOWED . PROPOSED I ALLOWED . PROPOSED LOT COVERAGE REQUIRED SETBACKS (FT.) PCIOPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REAR PARKING LOT AREA PLANNING REVIEWED BY DATE REO'D I PROVIDED I I REMARKS CHECKED BY I TYPE r�FWT CON cmpt-'\ OCCUPANT UU GRO SPECIAL INSPECTION JAR EA OCCUPANT REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1108/11FINAL INSPECTION nru-u VALUATION Description Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection FEE Description FEE State Surcharge City Surcharge Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Recording Fee Receipt # APPLICATION APPROVAL CALL This application is not a permit until signed by the Building official or his/her Deputy: and Fees are paid, and FOR INSPECTION receipt Is acknowledged in space provided. OEICIAL6IG D TE (425) 771-0220 - wL ttwa, DATV EXT 1333 a z 5 W Ix M z 0 1 0 M =i 1-H M C M 0 -40 OC --I K 3: M M T4 10 �; z 0 M M a 5 0 6 Fn C (j) M Cf) M 0 Z r- 7-1 z --I X Vi z 0 q ?5 M RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ....................... Wall.......................... Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground ............. ZZIZ e23 Rough -in ................ Commercial Final ...... HEATING: Gas Test .................... Gas Piping ................. Equipment ................. Commercial Final ....... EXTERIOR SHEATHING NAILING .......................... FRAMING * ....................... FIRST FLOOR FRAMING... INSULATION ................... Floor Insulation ......... Wall Insulation ........... Ceiling Insulation ....... SHEETROCK NAILING ... SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. 5w V& 30v The initials RSR are Rick S. Roberts, a temporary contract inspector or the City. DATE RECEIVED CITY OF EDMONDS' CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS e Ph a- HZE, f\j E C N�j A N4 Lef,0 'i I MAILING ADDRESS +J M -1 ��l t3 - zz7o4l, CITY �(-- h NAME ADDRESS CITY ZIP ZIP ITELEPHONE cl fD\Y�,__U I 1111W ADDRESS 10011 ZIP e7to Rit STATE LICENSE NUMBER PROPERTY NEW ADDITION REMODEL REPAIR DEMOLISH GARAGE CARPORT OWE OF USE. I I �) _I CBL qY01 TELEPHONE V)0-7(62-- EXPIRATION DATE I ( [3 RESIDENTIAL [] COMMERCIAL _WN;u`l.TIFAMIl.Y GRADING CYDS TANK RETAININGWALL ROCKERY S,QR ACTIVM EXPLAIN: NUMBER NUMBER OF OF DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE A6-9 IQ P LUMBINGIMECH 1)<_1 COMPLIANCE OR 13 CHANGE OF USE SIGN FENCE ( _ X_FT) OTHER F RE SPRINKLER FIRE ALARM CRITICAL AREAS UMBER AA N PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB ADDRESS C5 - _Z_��l T,* SUITE/APT#9 5T <;w #/)_A PLAT NAME/SUBDIVISION NO. I LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Ag)Pr*v&d AW Permit Requited Street Use Permit Req'd EXISTING - PROPOSED Inspection Required 13 Sidewalk Required 13 REQUIRED DEDICATION- Fr Underground wiring required El METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES13 NO 13 z REMARKS z OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE DATE FIRE REVIEWED BY DATE Lu VARIANCE OR CU SHORELINE ORADB11 INSPECTION BOND REQ'D I POSTED 1$ DYES 13NO SEPA REVIEW SIGN AREA HEIG COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , I , LOT COVERAGE REQUIPED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR PARKING LOT AREA 7REVIEWED BY REO'D I PROVIDED DATE REMARKS CHECKED BY ITYPE 1=21 JC06�) OCCUPANT GRO SPECIAL INSPECTION JAREA OCCUPANT REQUIRED LOAD REMARKS - PROGRESS INSPECTIONS PER UBC 11081FINAL INSPECTION RE01_D $ 1 Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge k� . .... PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPUCATION: 160 DAYS PERMIT LIMIr I YEAR - PROVIDED WORK IS STARTED WITHIN ISO DAYS Engr. Inspection 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 EDMONDS, WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND Fire Review Plan Chk. Deposit 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 CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Landscapelnsp. Total Amt. Due Recording Fee Receipt # APPLICATION APPROVAL 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 VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORIWISN'S COMPEN CE AND RCW 113.27. CALL FOR INSPECTION This application is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid, and receipt Is acknowledged In space provided. 0 TE VU_WW%LQ1Q1UFV 5 N7 OR'AQEtM./ DATE SIGNED 1A9 02 771-0220 I RELEASW'B�V_ DATEI ATITENXION hA 1 1 Jj ------- IT I$ 4WWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FlITAL INSPECTION HAS BEEN MADE AND APPROVAL ORWI CERTJFI- ORIGINAL -FILE YELLON- INSPECTO CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD-ASSESSO GREEN - ACCOUNTING 04102 PRESS HARD -YOU ARE MAKING 5 COPIES 4 z 9 0 M --I -n fn C M 0 -40 0 C E2 ic M M z 10--I C o -n n M M 0 us 0 0 rr; C Ch 91:11) M 0 Z X z z 0 1 0 ITI