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20030724.pdfDATE RECEIVED ERMIT EXPIRES FP USE PERMIT ZONE CITY OF EDMONDS NUMBER JOB SUITE/APT# CONSTRUCTION PERMIT APPLICATION ADDRESS OWNER NAME/NAME OF BUSINESS cl' cl 3 gS'�'A Pz L-,,/ i t '. I r I - I PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. L-C) V�' -a - - e MAILING ADDRESS / 1 -3 V& CITY 9 16- 2 oz 'PI ITELEPHONE CVev,e tf �� 4 "1 Z � -- 3 14 -- ozod i NAME C 0 .9 kl�4 Lj CITY ZIP TELEPHONE Ell,e,r -e, qZi�- 3 14' D 7-6, LN NAME ADDRESS 113 1 CITY ZIP TELEPHONE F-V e V e. H q�10011 I STATE LICENSE NUMBER EXPIRATION DATE C01299M "I/// I L-1660c- Nx-, PROPERTY TAX ACC .pl!n PARCEL NO.,,,, � i � NEW 'WRESIDENTIAL 1:1 PLIUMBING/MECH ADDITION COMMERCIAL COMPLIANCE OR 1:1 CHANGE OF USE REMODEL MULTIFAMILY 0 SIGN REPAIR GRADING E] CYDS "IFENCE X" 4— X 4�0 FT) DEMOLISH [:] TANK OTHER oGARAGE CARPORT o RETAINING WALL ROCKERY FIRE SPRINKLER FIRE ALARM (TYPE OF USE, BUSINESS OR_6CTIVTTYLEXPLAIN: NUMBER NUMBER OF CRITICAL OF Z_ DWELLING I AREAS . .STORIES UNITS NUMBE� DESCRIBE WORK TO BE DONE to-001 / I k/ " d- S LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required Street We Permit 1100 EXISTING - PROPOSED Inspection Requ" ded Re Sidewalk quire REQUIRED DEDICATION FT Underground Wiring required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 0 YES 13 NO C3 REMARKS z OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLiDRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE VARIANCE OR CU SHORELINE OR ADB# I INSPECTION 1$ 1�3OND REOP p OYES XO SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED , PROPOSED EXP LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR PARKING PLANNING REVIEWED BY DATISN VIDED 110 I ( ka.-rl- -5,1,1,e Yo' nod- ro I 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. PERMIT APPLICATION: ISO DAYS PERMIT LIMIM 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 INDEMNIFX 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 REA') 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 D0114G THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATI?,VNSP�ANCE AND RCW 18.27. �TURE (OWNER DATE SIGNED 1 4 _-.4. - -C/-Z -- C)'s CHECKED ft? TYPE = I 900JE UPAN) I Lj'- GROUP SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [] YES I LOAD W REMARKS la. - PROGRESS INSPECTIONS PER UBC 108/FINALINSPECTION REO'D 9 VALUATION $ Description FEE Description FEE Plan Check State Surcharge Building Permit 5zlic City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION (425) 771-022 0 LICATION APPROVAL th applicati s not a permit until signed by the Bufln Official r s/h.r Deputy: and Foos are paid, and i'ecelpt a nowlodgedinspaloprovldod.--- OfF11 LS SIG URE Dff \,q�TASED BY ATTENTION/ EXT 1333 wnl� IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- IISPEC OR GINA - FILE YELLOW TOR P . CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 Z. VN GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING t z 0 4 0 ITI -i -n 3: M C M 0 -10 0 C � C IT11 1711 z g) —1 C _z Cn 0 -n n M ITI a 65 0 0 Fn C cl) C V) Q 0 Z X z 0) z 0 q 0 ITI RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ....... .............. Wall........................... Pier/Porch ................. Retaining Wall ...... Slab Insulation .......... PLUMBING: p Underground ............. Rough -in ................... Commercial Final ...... HEATING: GasTest .................... 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 07Z.Ifv/ N . . DATE RECEIVED ':1 1 f� CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS L J'K C_ r-) i \A, MAILING ADDRESS / 1 -3 1 1-1 V6- CITY oz Pt TELEPHONE f�vev -C fj L"i 4 1 NAME 6 till ",a wt�e_ 5 ADDRESS M E3 AV,4 Lj CITY ZIP JTELEPHONE Evev'e"�4 NAME 4 (^(� o I X ADDRESS 0 8 / / 3 / I / I / -,r"h /I t., cl— C1 CITY ZIP TELEPHONE r v - r e t-t STATE LICENSE NUMBER /_ Y, r� ,, 0 er PROPERTY TAX ACC(1UN` EXPIRATION DATE 0- 0 3 NEW jWrRESIDENTIAL ADDITION COMMERCIAL REMODEL. MULTIFAMILY REPAIR GRADING CYDS DEMOLISH TANK GARAGE RETAINING WALL CARPORT ROCKERY [TYPE OF USE, BVSINESI� OR ACTII��MJEVLAIN: M NUMBER BER OF OF DWELLING STORIES "U UN MIT S DESCRIBE WORK TO BE DONE HEAT SOURCE I GLAZING % PLANCHECKNO: one-*2 7 � 6, ICBLN * I-- PLUMBING/MECH COMPLIANCE OR CHANGE OF USE SIGN %--IFENCE I �� X /5C' FT) OTHER F RE SPRINKLER FIRE ALARM CRITICAL AREAS , .4 -41 C kA LOT SLOPE % VESTED DATE PERMIT EXPIRES USE PERMIT 1V ZONE 7.: NUM B E R SUITE/APT# Z;RESS 3 6 PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. 0 cl LID FEE $ PUBLIC RIGHT OF WAY PiR OFFICIAL STREET MAP TIES P Approved RW CParmilt Required EXISTING - PROPOSED SIteot Use Parmit Req'd Inspection Required Flaq Sidewalk uLred REQUIRED DEDICATION 'ff FT Underground Wiring required METERS E LINE SIZE NO. OF FIXTURES PAV REQUIRED YES 13 NO [3 REMARKS OWNEFIXONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE "IV-.O REVIEWED BY DATE '�'o KI kv -I 0egim FIRE REVIEWED BY DATE VARIANCE OR CU SHORELINE OR ADBff INSPECTION BOND I EQ I [3Y ES UO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED , 1 1 EXP I/ (n, 6 LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR PARKING LOT AREA PLANNING REVIEWED BY DATE(?/ VIDED r y) 0 z 0 W cc rL CHECKED BY I TYPE 07 f� I _VLOUUr^N I GR Up oe, ) q, J SPECIAL INSPECTION AREA OCCUPANT REQUIRED [] YES LOAD Aik 0 REMARKS 1% 35 PROGRESS INSPE S=108;T REO'D 13 UU1111111 lsim-i inmr R 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 t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 23 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. ) �' k Review' .. I . . . ..' PERMIT APPLICATION: 118016AYS I tqf_ngr. 06 PERMIT LIMM 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 SUCCEs6Rs Fire Review Plan Chk. Deposit IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF 2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # IALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY BE 9 FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due 0 ,I NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee =celpt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION PPL C TION APPROVAL GIVEN IS CORRECM 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- CALL In applica0grys not a permit until signed by the Fees * j 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 FOR INSPECTION Bu In Officlal,dr Pis/her Deputy: and are paid, and I , ecalpt qknowlodged In spofe provided. WORKMEN'S COMPENSAT191X#S�rNCE AND RCW 18.27. OfFItjWLS SIG E 0 Sjp?��URE OWNER 0 A'Eq DATE SIGNED 7- - 0 -.S (425) fA r VUR "I v� 4 .zi-<-,f C'1 1 771-022 0 RE ASEQ B Y,11 DATE ATTENTIONP' EXT 1333 i;lb IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAI( - FILE) - YELLOW - AsPEC"rOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING t z 0 M :n- M C M 0 0 C -4 K X M M Z 1c) --i C 2 0 _n n M M a —0) 0 0 Fn C cl) C 0) M 0 Z r- z z 0 1 0 M