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20030769.pdf11 DATE RECEIVED PERMIT EXPIRES CITY OF EDMONDS USE ERFUT ZONECto NUMBIERr-2 .3- 6:j& q CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRESS q56 APP714 WO OWNER NjiME1NAME OF BU ESS SK w1i PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S MAILING ADDRESS .041* PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING - PROPOSED 1 REQUIRED DEDICATION- FT I TESCF PfDvfd RW ParMil Requ:;ed street Use Perm .,. d Inspecwn Req ulred Sidewalk "equir6d Undergrot-d n1mg required 13 1 CITY ZIP ITELEPHONE 0405 -771- qqVV NAME METER SIZE LINE SIZE NO, OF FIXTURES PRV REQUIRED YES13 NO 13 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE CITY TELEPHONE NAME 71. W "A 3) a/ -1-411 ' 1;_4yt,,( , j- 'S-� LL ENGI�RIAG REVIEWED BY DATE Y, 01,G ADDRESS 40C 9j, W FIRE REVIEWED BY DATE W iE CITY ZIP TELE HO VARIANCE OR C U SHORELINE OR,11DB# W- INSPECTION Q'D S WNO BOND POSTED $ STATE UCENSE NUMBER SEPA REVIEW COMPLETE EXEMPT SfGWARE�A ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED PRO COUNT PARCEL NO EXP 00 NEW RESIDENTIAL PLUMBING mECH COMPLIANCE OR ADD COMMERCIAL HANGE OF USE ITION '�< REMODEL 0 MULTIFAMILY IGN LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS'ft) FRONT L/R SIDE REAR z 06 PARKING RE WED LOT AREA PLANNING REVIEWED BY DATE REPAIR 0 GRADING CYDS FENCE X FT) OTHER 13 DEMOLISH TANK FIT _ KS ILL; oGARAGE RETAININGWALL F RE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS OR ACTIVID1 EXPLAIN: C-%-nD2 <-,-, CA t CHECKED BY 1]=14 OCCUPANT GROUP 0 F NUMBER NUMBER 0 OF WELLING STORIES UNITS CRITICAL AREAS NUMBER SPECI ALINSPECTION JAREA REQUIRED [] YES OCCUPANT LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 1108/171NAL INSPECTION REO'D Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % I Building Permit City Surcharge 0, PLAN CHECK N rj .3_ Vol VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK N6TED. THIS PERMIT COVERS WORK TO X BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 160DAYS PERMIT ILIMM I YEAR - PROVIDED WORK 15 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 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 Ir FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE 9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due 0 NOR ILIMIT IN ANY WAY THE CI1YS ABIUTYTO ENFORCE ANY ORDINANCE PROVISION.' zi Recording Fee Receipt # I HEREBY Ag*OWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS 90FRECT; AN OWNER, OR THE DULY AUTHORIZED AGENT OF " IM�� IREE MP' rTH C THE WN . I A 1EE COMP" AND STATE LAWS REGULATING CONSTRUC- G R CALL This application Is not a permit until signed by the IN ) in 0 IZE 4 TJONOANi I DO N( W AU RI THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and IN VIO I OF R CODFCIF H STATE OF WASHINGTON RELATING TO 10 R C TH fEYPN FOR INSPECTION receipt Is acknowledged In space provided. .S C P AIN I SI WORKM 'S COY E N I SU NCE AN RCW 18.27. 4IN OF L URE DATE T SIGNATU E EF DATE SIGNED (425) :L fA/_&1z 771-0220 Ijr6qj_111 *Te- o A'ffEN N Nt 1333 M N IT IS UN UL USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL LA U A FINAL IN PEC ION HAS BEEN MADE AND APPROVAL OR A CEFITIFI- 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 NEW z 0 1 0 11711 :q:% vi� 0 M C M 0 10 0 C 3! r. M M z E: � :� 0 M M 0 C-1) 0 0 Fn C 0) CO) 0 X z z 0 1 0 M M ... .... .. 71 RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ....................... Wall.......................... Pier/Porch ................. Z� Retaining Wall .......... 0 �Slab Insulation ............ PLUMBING: -61 Underground ............. RoUgh�-In ............. M 0 Commercial Final ...... 0 C, HEATING: M GasTest, ............. z Gas Piping .................. Equipment ......... ........ 0 -n, rc n ..... Comme'ial.F! al'..' EXTERIOR SHEATHING NAILING M M .......................... 0 71FRAMING .............. .......... FIRST FLOOR FRAMING... a INSULATION ................... Floor Insulation ......... Wall Insulation, * ........... Ceiling Insulation ....... SHEETROCK NAILING'... z 0 SPECIAL INSPECTION ... M MISCELLANEOUS .......... FINAL APPR OVAL FOR (46. OCCUPANCY .................. L I CEiVED -DATE RE QFPERMIT EXPIRES USE PERMIT CITY OF EDMONDS ZONE(b) NUMBER . -3- 0& qL/ JOB SUITE/APT# CONSTRUCTION PERMIT APPLICATION ADDRESS OWNER NAMEINAME OF BUSINESS Ij 6 —bpi) —k I/A V 15 1 & IL14 1/1/\/ 5 P t PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ z MAILING ADDRESS Loy PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING — PROPOSED REQUIRED DEDICATION— FT I TESCP Approved RIN Permit Requi ad Street Use Perm4f Wd inspection Required Sidewalk Required Underormnd so 13 'ingroqu" CITY ZIP I 222� TELEPHONE 771- t/400 ri NAME METER SIZE LINE SIZE I [ NO. OF FIXTURES 1�11YEPRV REQUIRED S13 NO 13 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLJDRAINAGE )2-e- Llixa-h-d 61,\' CITY ZIP ITELEPHONE Or I G V— NAME INA, 31661 C10 IVA f I CBL# I I -TV I ?I(, �-- a ENGI RAG REVIEWED BY DATE ADDRESS 1Wk/brW 01 Al. FIRE REVIEWED BY DATE W cc rE CITY -.911n q11Z'P &AffLf q EPHO E 7d VARIANCE OR cu SHORELINE OR DB# �4 . INSPECTION "E NO * BOND POSTED I $ STATE LICENSE NUMBER . rem SEPA REVIEW COMPLETE EXEMPT EXP I X SfGN_ARFrA ALLOWED PROPOSED lzr I I -ADO - HEIGHT ALLOWED PROPOSED 00 P =OPCOUNT PARCEL NO J NEW RESIDENTIAL 0 PLUMBING/MECH COMPLIANCE OR ADDITION COMMERCIAL 0 HANGE OF USE REMODEL E] MULTIFAMILY [ON REPAIR GRADING E] FENCE CYDS ( X_ FT) DEMOLISH,,; TANK OTHER o GARAGE RETAINING WALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM ffVE OF USE, BUSINESS OR ACTIV71y) EXPLAIN: fz93rAW*/f I I I LOT COVERAGE ALLOWED PROPOSED REQUIFEDISETBACKS (4FT FRONT SIDE REAR PROPO 3 *r) FRONT LJRSIDE REAR 06 PARKING RECrD PROVID -9 LOT AREA I PLANNING REVIEWED By DATE KS .: _z._+ .2 :Z'k CHECKED BY JTY!��r�'tR N OCCUPANT GROUP NUMBER OF STORIES NUMBER OF DWELLING UNITS CRITIC AREAS NUMBER SPECIAL INSPECTION REQUIRED [3 YES AREAF OCCUPANT LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D I A10% Relftl Iwo a Itto-ellIVA'(15D IwA44 S1W D1501AV 1 -1 111.10 F—bi " I &_ N I HEAT SOUR6E-7,7 GLAZING % LOT SLOPE % PLAN CHECK NO- VESTED DATE D �3_ Vol THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 13E DOI& ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION 014 THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVIEVAYS. MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATIOW. 111110DAYS 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 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 HEREBY A&WILEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS : _ WNER OR THE DULY AUTHORIZED AGENT OF :CT. 0_UW+ftk:RQ_QV ' - AN THE FN I AGREE COMP H Crry*,AND STATE LAWS REGULATING CONSTRUC- CjAUl !T� D OD OW TION. ANI I DOINC! Wo AU ORIZED EREBY, NO PERSON WILL BE tMPLOYED 0 IN VIO IC OF TH R COD OF TH STATE OF WASHINGTON RELATING TO E SU A M 1� SU CE AN A 8 WORK 8 COYPE Y tNpl N RC'W 18.27. alIGNATLIkE k0IIINEF/di A(Ilf NT) DATE SIGNED VALUATION $ W1111111 MM 1 1111111110 Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge P5 Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due 0 Recording Fee Receipt # Z_ CALL FOR INSPECTION 1A9 1425) 771-0220 APPLICATION APPROVAL This application is not a permit unto signed by the Building Official or his/her Deputy: and Fees are paid, and receipt is acknowledged in space provided. OFFIQI$1S SIGNATURE - DATE ft/ hom'alm' L As Y- I *TE ATTE141MONI " I 133J IT IS UNLA UL 10 USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INIPECIION 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 0 ITI M Ma In z ca o -n n M M 0 V5 0 0 Fn MO Z� X z 1711