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20030745.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEtNAME OF BUSINESS MAILING ADDRESS - 19 Z_ CITY 71P TELEPHONE -77 NAME ADDRESS CITY ZIP ITELEPHONE NAME CBL ADDRESS Qffy "ZI TELEPHONE 2-82- qoF I zoro- STATE LICENSE NUMBER EXP14TION DATE 14 If j NO. PR9PEIRTY TAX ACCOUNT PARCEL NEW RESIDENTIAL XPLUMBING / MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE 13 REMODEL Cj MULTIFAMILY 0 SIGN REPAIR 0 GRADING CY.S IEICE X Fr) ( _ DEMOLISH 0 TANK 0 O"IHER GARAGE CARPORT RETAININGWALL 11 ROCKERY FIRE SPRINKLER FIRE ALARM (TYPE OF USE, BUSINEIIS OR ACTIVITYI EXPLAIN: 7 air 10 NUMBER OF rNU M"tIE'R F DWELLING CRITICAL AREAS I STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE 2/ /) f� I I PERMIT EXPIRES USE PERMIT ZONE NUMBE��/� JOB SUiTE/APT# ADDnESS/,Z./ �") / / 0, ,3 /0 A� . _ Lassea.. PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ TEscP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit %quiled Street Use P rmit Req'd EXISTING — PROPOSED inspection Requited Sidewalk Required REQUIRED DEDICATION— FT Underground wiring raquired 13 MVER SIZE LINE SIZE OF MIXTURES PRV REQUIRED 43 1 =NO.. YES 0 NO 13 3 1 5 REMARKS z 2FjR PO.N.SIBLE FOR EROSION CONTROUDRAINAGE OWNERICONTR as P — I!e,r Miley all. ENGINEERING REVIEWED BW16 ntJW161 116IJ DATE FIRE REVIEWED BY DATE ul VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND REQ"D POSTED 10YEs 13NOI$ SEPA REVIEW SIGN AREA HEIGHT COMPLETE , EXEMPT ALLOWED _1 PROPOSED ALLOWED I PROPOSED EXP LOT COVERAGE LREQUIRED SETBACKS (FT1 PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR PARK1114- REO'D I rftgfffli'��V+W'Wthe water system REG'D 1-51 w! _,ft-atirt-13 Rmuturr g 40". Ub 9H L/") c&.-P 4:7a C6 VALUATION / fe DescriptIon FEE Description FEE fA A 1,=I,, Plan Check State Surcharge f_/L/ 16146- bLAZING % LOT SLOPE % Building Permit City Surcharge HEAT SOUR915 PLA CHECK NO: VESTED DATE Plumbing Mechanical CHECKED BY ITYP N N GR r I ff" _..� 6��k- SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [3 yF LOAD REMARKS PROGRESS INSPECTIONS PER UBC jl99MLjMP THIS PERMIT AUTHORIMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 13F DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PU13UC Grading I DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS. MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPLICATiON: ISODAVS PERMIT UMM I YEAR - PROVIDED WORK 18 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 Plan Chk. Deposit I Receipt # IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection ALL CLAJMS FOR DAMAGES OF WHATEVER MATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. I Total Amt. Due # DEEMED 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 ___._Zeceipt APPLICATION APPROVAL 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- This application is not a permit until signed by the CALL Building Official or his/her Deputy: and Fees are paid, and TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LA13OR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION1 receipt Is acknowledged In space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. LS SIGN T DATE 1- BIG E low E1,1T) DATE SJONED E low ZFF (42 "ENTION 771-0220 RELEASED BY DATE Off 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL 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 ARE MAKING 5 COPIES GREEN - ACCOUNTING 04/02 PRESS HARD -YOU z 0 0 M 0M M 0 —40 0 M M 0 ITIM 0 0 r M 0 z 0 M a "ll, titlp'? as: 0"1"1 0 4 All .1 I Ill Ile It IS f 19 d d j ast , r It RECORD OF INSPECTIONS IL INSPECTOR DATE APPROVED I d 4 llat NY T is 9 as "'t' SETBACKS Militia Olt' ft, d. d lt ldi a 00 .-,,FOUNDA,, d t& 1 0 6d, A wo, 9 Its 0, 4 d l k 1 11% P. l Wall Z I, N 1 4 l 4 I L I Pier/Porch I d I L .1 Retaining Wall A I L Slab Insulation d I I d 4, PLUMBING6 W lit all Underground. l d .1 d Owl Rougholn a a 0 0 0 9 a a a a 6 6 6 a a 0 4 0 a 4 All 1p,i I L I L I l I I ., Il'L' . — 1 4 '� L ' I I I k f I I f A d k ; � I . 4 1 . ".P I i Cohslrr�erclal Final 6 d M a 1 4 d I I . L l I d 1 0 t N 1 .1 , , ID d k d C d j: P HEATING: I I gas I �Iill: st., 1, 9 il- I I f I d d '�r L r d d L k Gas'Test 17, 'd bases I It I k d 0 IN . o 0 lk I G 6 go$, 1*1@00# 606044 k 1ping On I, l+ I P I k .'I Y I I d 17 d I I r I Equipment I P d so*$ 46686600 l 9 . as d I IN I k M Y, k 4 1 Pr 4 1 "No I ' r, Commercial Final 1 1. , z I d I r I d d E)ffERIOR SHEATHING J. NAILING d I I I d I k 4 4, 1 f l,� Ill I I . d. R, All, FRAMING r r tv ilt, I I v I . g; a 'I Isla, f d - ' I ; I lI . I X ( ' - I I r FJRSTFLOOA FRAMING... 1, k k Pei . . f' 4 l� � I . I L 6t" 14 go d 11' k ULAT1110 Pr r I., r to r d a It k I 1 4 d r Floor Insulation I k dismiss iWall Insulation. r. 9 a a 9 14 a 6 9 6 k 4 1 4. 1 'r I I . I d d 'L Ceiling Insulation d d .S HEETROCK NAILING d SPECIAL INSPECTION 4 I to k it MISCELLANEOUS ....... gas k d FINAL APPROVAL FOR OCCUPANCY 0 d jr� I; It glop It k IIIIII-ittill A ATE RECEIVED TE RE PERMIT EXPIRES "'W"T LFSE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME IE OF XUSINESS MAILING ADDRESS _(9 Z_ / / CITY ZIP ITELEYHONE tdl;*,wd .F q,-0201 Vag- 77 V V� ADDRESS CITY ZIP ITELEPHONE NAME WIV, ol CBLj 9C ADDRESS CJ TELEPHONE 2 2- STATE LICENSE NUMBER EXPIRATION DATE PRQPERTY TAX ACCOUNT PARCEL NO. 6V?-71.(CX300e) NEW RESIDENTIAL MBING I MECH x Lu EADDITION COMMERCIAL COMPLIANCE OR l CHANGE OF USE REMODEL MULTIFAMILY SIGN GRADING FENCh 0 REPAIR CYDS ( ! X Fn DEMOLISH TANK OTHER GARAGE RETAININGWALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM @ij OWE OF USE, BUSINFeSij OR ACTIVITY) EXPLAIN: NUMBER NUMBER OF CRITICAL OF STORIES DWELLING UNITS AREAS NUMBER DESCRIBE WORK TO BE DONE ZONE 1-r-MINIIII 1 - NUMBEeaL -e�7 V JOB SUITEIAPT# ADDRESSLLZI ,a 10 jol/v.) PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ CP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP AW Permit Required Street Use Paffnit Reqd EXISTING — PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION— FT nderground idng required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 13 NO 13 z REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE GAS PIPE TEST MUST BE I ". i'4 I zjW E GLAZING % I LOT SLOPE % NO: I VESTED DATE THIS PERMIT AUTHORMFS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRr4AT1E PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN JCURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPUCATION: ISO DAYS PERUIT UMM 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 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 HERE13Y 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 WOR.I(MEITS COMPENSATIOHJNSURANCE AND RCW 18.27. DAvg AT SIGNED f'/z'z/o-S ENGINEERING REVIEWED BY Big list I DATE FIRE REVIEWED BY DATE 1 1! rL VARIANCE OR CU SHORELINE Oil ADIIII I INSPECTION I BOND REQ'D POSTED 13YES ONO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE , EXEMPT ALLOWED . PROPOSED ALLOWED PROPOSED EXP I .. LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR __ I z gigtugara am TE REO'D of wh�w the water Wdemil CHECKED BY I P OCCUPAIW GROUP SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D PuRsuANT To UPC 605.2 VALUATION AS IT RMMS THE BUILDING Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical AM 12 a Grading milli Engr. Review --.-bl Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION 1A %-W'35) 771-0220 EXT 1333 APPLICATION APPROVAL This applicaflon Is not a permit unfit signed lti� the Building Official or hIs/hor Deputy: and Fees are paid, and - - receipt Is acknowledged In space provided. I OF?F�jSSIG I N T�E DATE 47 169 zz A RELEASED BY DATEO IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL 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 I