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20030716.pdfklk�L DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS L-K T_�,) L L C. MAILING ADDRESS 7 2-1 - CITY LJ,4 ZIP ITELEPHONE �IC-tA_)CAGI_Le NAME . ADDRESS &jAY _lSvim 110C CITY ZIP ITELEPHONE NAME jCBL# ADDRESS 9 CITY ZIP TELEPHONE 98/obi STATE LICENSE NUMBER EXPIRATION DATE A�K\ _T L/ PROPERTY TAX ACCOUNT PARCEL NO. 00 .5 50100 00 0 Z_ 0 1 NEW RESIDENTIAL PLUMBING / MECH COMPLIANCE OR ADDITION COMMERCIAL El CHANGE OF USE 0 REMODEL MULnFAMILy SIGN REPAIR 0 GRADING CYDS FENCE X FT) DEMOLISH TANK OTHER r GARAGE RETAINING WALL 0 F RE SPRINKLER I P.APPnQT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS OR ACTIVTM EXPLAIN: NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES L I UNITS ____�NUMBER DESCRIBE WORK TO BE DONE r*'Is -) - 2 " C' M ?_ 9 6 A M e- r_ HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: VESTED DATE 0 THIS PERMIT AUTHOR ZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLIt ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPILICATION: 160 DAYS PERMIT ILIMM I YEAR - PROVIDED WORK IS STARTED WITHIN ISO 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 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 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 WORKMEN'S COMPENSATjp*94rb�IANCE AND RCW 18.27. SIGNATURE JOWNER OtAQE;7 I K�� TE SIGNED PERMIT EXPIRES USE PERMIT ZONE NUMBER 3 - 07y IV JOB SUITE/APT# ADDRESS :TC// b? Z PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Parrivit Required Street Use Parmh ROCIAT EXISTING — PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION— FT Underground widno required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES 13 NO REMARKS z z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAIN,AGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE tu cc 1 6: VARIANCE OR CU SHORELINE OR ADB#_j INSPECTION 1$ BOND REQ*D POSTED 13YEs 13NO SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT ALLOWED . PROPOSED I ALLOWED , PROPOSED LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIFISIDE REAR I I — z PARKING LOT AREA I PLANNING REVIEWED BY OWE REO`D I PROVIDED REMARKS CHECKED 13Y ITYPE OF CONSTMCTION jCQPE I — .0(XUFAN I V9V GROUP S -IAL INSPECTION OCCUPANT PEI, JAREA REQUIRED Ild LOAD y&YES REMARKS PROGRESS INSPECTIONS PER UBC 1108/171NAL INSPECTION REaD lk�_ [_ - - --- Description FEE Description FEE Plan Check state surcharge. :!!!!Z Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit I I cl 0 Fire Inspection Receipt # Landscapeinsp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION (425) 771-0220 APPLICATION APPROVAL This application Is not a permit until signed by the Building Official or hi0or Deputy: and Face are paid, and faccipt Is acknowledged in space provided. OFF14C SI &ARE DATE qjj /�2 BY DATE ATTENTION " 1 1 JJ IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL () F I i A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLON- 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 z 0 0 M M M 0 C 4 r, I , I M M 0 _n In M 1711 0 Fn C 0 0) z 0 M Re In P A( Cl In D 21 1j" T R CONSTRUCTION INSPECTION REPORT port Number 001 qxwfion(s) Performed: Structural Steel Fabrication ,oject: Compass Health Permit Number. dress: 7416 21e Ave SW, Edmonds Job Number 03-454 ient: Charter Construction Client Address: 980 S Hamey St, Seattle spector d Date Remarks Newman Visually inspected and approved fillet welds according to AWS DIA standards In the fabrication of (3) saddle D-03 brackets fbr the bldg retrofit. E7018 elecliodes were used. WABO ceMW welder = J Sole, #SOL 707777, Exp 7-1-03. oples to: X client contractor Architect x Bulklino Dept. Technical Responsibility: x Engineer David Lyal-Project ManaW Is report applies only to the Rom tested or reported and Is the exclusive property of Otto Rosenau & Associates, Inc. Reproduction of this report, Kcept In full, without written peirnission from our firm Is strictly prohibited. Page I Of 1 6747 M.L. long Way S.. Seattle, Washiroon 98118 - Phone (206) 725-4600 or 14M"TT04-US — Fax (206) 723-2221 xm No.: T-104 evised: 05/03 I 7 V. P�AN- DATE RECEIVED PERMIT EXPIRES USE PERMIT ZONE J�� CITY OF EDMONDS NUMBER 3 f%_nM T93111111% InN F32111.11111 AJDDII lf%ATlf%kl JOB SUITE/APT# OWNER NAME/NAME OF BUSINESS __ I. K MAILING ADDRESS -7 Z�Z 1 5:6 CITY Lj'4 ZIP ITEL114id 0G&_)CA2:rLS I NE NAME ADDRESS CITY Zip mad TEL E -86 -S —I I co NAME ICBLN 12—ti ADDRESS CITY,�� ZIP 172- ,).1 98 TELEPHPNE XY16 > STATE LICENSE NUMBER EXPIRATION DATE P Ch "e;A) L/ PROPERTY TAX ACCOUNT PARCEL NO. 0 00 0 0 NEW RESIDENTIAL PLUMBING MECH ADDITION COMMERCIAL % t COMPLIANCE OR CHANGE OF USE REMODEL 0 MULTIFAMILY SIGN REPAJk GRADING �CYDS FENCE x FT) 0 DEMOLISH TANK OTHER GARAGE FORT RETAJNINGWALIL AOCKERY FIRE SPRINKLER FIRE ALARM (TYPE OF USE, BUSINESS OR',ACTIVffY) EXPLAIN: 4_'__a NUMBER NUMBER OF CRITICAL OF DWELLING fAREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE 0) — 2 "' M?- 4jcw r HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: o-7 7--1-001 VESTED DATE THIS PERLuT AuTHonTzes 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. PERMITAPPILICATION: 118PDAY8 PERMrr ILIMM I YEAR - PROVIDED WORK 15 STAFOED WITHIN ISO DAYS BEE BACK OF PINK PORMrr 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 MATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMrr. 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. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECII 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 LABqjCODE OF THE STATE OF WASHINGTON RELATING TO WORKMEWS COMPEN::;=CE AND RCW 18.27. SIGNATURE (OWNER Od AGENTi I I DATE SIGNED ADDRESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TEScr APPf&i*d RW ParrM Rewired St" Use Pwmii R90 EXISTING — PROPOSED IrApeclort Required sidewalk Rewired REQUIRED DEDICATION— FT UrAWWOurld =91 — METER SIZE LINE SIZE I NO. OF FIXTURES I PRV REOWRE REMARKS I I 'A YES13 N 0 D13 OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE REVIEWED BY DATE FIRE REVIEWED BY DATE I VARIANCE OR CU SHORELINE OR AD" I INSPECTION 1. BOND REQ'D POSTED 13YEs 13NO SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT ALLOWED . PROPOSED I ALLOWE . LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REAR PARKING LOT AREA I PLANNING REVIEWED BY DATE REO'D I PROVIDED I REMARKS 0FIN son sh CHECKED BY ITYPE OF SPECIAL INSPECTION JAREA REQUIRED Nf VAWAnON $)A,/.A UIAMPANI GROUP OCCUPANT LOAD INSPECTIONS PER UBC 1108/FINAL INSPECTION REO'D Plan Check Building Permit Plumbing Mechanical Grading Engir. Review Engir. Inspection FEE Description �A State Surcharge City Surcharge MOO mw .. is Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscape Insp. Total Amt. Due Recording Fee Receipt 0 APPLICATION APPROVAL CALL This application Is not a pemilt until signed by the Building Offlekd or his/her Deputy: and Fees are paid, and FOR INSPECTION recelpt Is acknoModged In space provided. OFFIC 81 E DATE 142=1 IL --�J71 / 119 771-0220 Y /12 / DATE ATTENTION Off 1 33 1 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 16r (-/LQ-5 A FINAL INSPECTIO� 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 z 0 =1 0 ITI M C ra 0 —40 OC � x 7 ITI M C _z 0 ITIM ai t" Fn C 0 ca z 0 0 M