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20030820.pdfI DATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMIE"E OF BUSINESV-� . P1 W( _r 40 j g MA k-111A -.1-i I y Z—f t- - Iz y CITY)�dM, IIP TELEPHONE I 6 /V 6_7 NAME ADDRESS CITY I I / ZIP I TELEPHONE NAME r,ICO JC ICBLN ADDRESS OTY 'Y_011� _ 3 CITY ZIP TELEPHONE -9 & � W03 du464—,64 STATE LICENSE NUMBER EXPIRATION DATE I C� FILCO C/ aff R(W W/d/0-5- r TAX ACCOUNT PARCEL NO. NEW RESIDENTIAL ADDITION COMMERCIAL 13 REMODEL 0 MULTIFAMILY [:] REPAIR GRADING CYDS 0 DEMOLISH TANK IGARAGE 3 RETAJNING WALL [3 CARPORT ROCKERY (TYPE Ok USE, BUSINESS OR ACTIVITWPLAIN: L Id Nr( VeCo NUMBER NUMBER OF OF t DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE MY lt9jai-ied Wei- fj Ars PLUMBING / MECH COMPLIANCE OR CHANGE OF USE SIGN FENCE FT) OTHER FIRE SPRINKLER FIRE ALARM ?7 CRtTICAL AREAS NUMBER PERMIT EXPIRES :;�49d� USE PERMIT,,&, ZONE NUMBE JOB SUITE1APrT# ADDRESS 3L---,7 �0,,4ellu 2.. PLAT NAME/SUBDIVISION N97-7. L�D NO. L D FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Penna "ifed Street Use Pormil Req'd EXISTING — PROPOSED inspection Flaquired Sidewalk Rwiuired REQUIRED DEDICATION- FT Underground Wiringfectuired cl METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I I I YES[3 NO 13 REMARKS' OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE REVIEWED BY DATE FIRE REVIEWED BY DATE VARIANCE OR CU SHORELINEORAD1111 I INSPECTION BOND REO'D POSTED 13YEs 13NO Is SEPA REVIEW SIGN AREA I HEIGHT COMPLETE . EXEMPT ALLOWED . PROPOSED ALLOWED , PROPOSED LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LiRSIDE REAR z PARKING LOT AREA I PLANNING REVIEWED By DATE REOD I PROVIDED I MUST BE PBESENT EOR TANK FILL, REMOVAL, OR CAP CHECKED BY ]TYPE OF CO OCCUPANT iffiz :W GROUP SPECIAL INSPECTIO� JAREA OCCUPANT REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER U13C 100/FINAL INSPECTION REaD VALUATION $ 1 Description FEE Description FEE Plan Check I I State Surcharge HEAT SOURCE GLAZING % I LOT SLOPE % Building Permit ity Surcharge PLAN CHECK NO: VESTED DATE 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 2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPUCATION: ISO DAYS PERMIT UMIT! I YEAR - PROVIDED WORK IS STAFrMD WITHIN 160 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 EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND 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 Landscapelnsp. Total Amt. Due 91 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENrr OF ANY CITY ORDINANCE 2 NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION APPROV&' 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- CALL This application Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED JN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building official or his/her Deputy: and Foes are paid, and receipt is acknowledged In space provided. -WORKMENS COMPENSATIONL4&WMCE AND RCW 18.27. OFFIgfALFXSIGNATU4 DATE NER _TDATTE SIOWD (425) /Wow, WAGE 771-0220 RELe-ASED BY DA`rE MTENTION M 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 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING I z 0 4 0 m OM c ma 0 -40 0 C= E2 r. m mz 3: (1) 0 -n mm 0 V5 01- 0 rn C 0) c 0) M 0 Z z Cl) z 9 0 m 4 . RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION. Footing..... ................ 0 Wall ......... .................. Pier/Porch ............ M, j Retaining a ......... Slab. insulation .......... PLUMBING: M IV Underground.............. 0 C ic Rough -in ................... M CommerclalFinal Z, HEAT Y:;� Gd�'T,6st ................. 0 a; as PipIng . ................. ,..,EquipmentI .................. . rn EXTERIOR SHEATHING'_ m NAILING. ................... ...... FRAMING ............. ........... -,-,,�:��.FiAsT FLOOR FRAMING.;. :1 Al Floor Insulation ....... I DATE RECEIV .0'rPERMITEXP IRES L69:�� I , e CITY OF EDMONDS USE PERMI ZONE x7,;� :ON NUMBE�� CONSTRUCTION PERMIT APPLICATION I JOB SUITE/APT# ADDRESS /0 S OWNER NAMEWE OF BUSINESS^ 1_�( - &/ hij-r/4 VAPIC, PLAT NAME/SUBDIVISION No. LOT NO. LID NO. I ___ 15 MAILINqADdRtSS LID FEE S 03 70- X �fl- yz TESCP AppmVed PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Parrr9t RaWked CITY ZIP TELEPHONE Streel I I- Permil Req'd EXISTING — PROPOSED Inspection Requited Sidewalk Required Undergmund 7 ?f 6 REQUIRED DEDICATION_ FT vVinngreciLibmd NAME METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED A / A I YES C3 NO 13 z ADDRESS REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE 1 ZIP LEPHONE NAME 010 TC;B"L# /to zN-Ir 4 q�_ ENGINEERING REVIEWED BY DATE ac ADDRESS 310 Cno FIRE REVIEWED BY DATE ul CITY ZIP TE.LEPHONE gew -, 64 1 rl- W If to�?>2 q VARIANCE OR cu SHORELINEORADIM INSPECTION BOND S TE CENSENUMBER EXPIR TION DATE HECKED BY' REO'D I POSTED I Co C/ 41COU / Lo 5- [ DYES ONO s 14 PROPERTY TAX ACCO PARCEL NO. SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , , NEW RESIDENTIAL PLUMBING/MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR COMPLIANCE OR 13 ADDITION COMMERCIAL I CHANGE OF USE I REMODEL MUI.TIFAMILY SIGN PARKING LOT AREA PLANNING REVIEWED BY DATE "PLANNING RECID I PROVIDED 06 REPAIR GRADING Ei FENCE . CYDS X Fn REMARKS DEMOLISH 1ANK E] OTHER MUST BE PRESENT FeR oGARAGE RETAININGWALL FIRE SPRINKLER CARPORT "'ANK FILL, REMOVAL, OR GA12 I ROCKERY --FIRE ALARM (TYPE Of USE, 13USIN SS ORPIVITY��LAIN: 12 OIL C & /" I r. smov I N CHECKED BY ITYPE OF CONSTRUCTICIN OCCUPANT GROUP -Vsp fiAzK: NUMBER NUMBER OF CRITICAL 13 OF WELLING AREAS SPECIAL INSPECTION r STORIES UNITS NUMBER ]AREA LOAD REQUIRED [] YES DESCR18E WORK TO BE DONE REMARKS �57 A p PROGRESS INSPECTIONS PER UBC IOU/FINAL INSPECTION REQ'D 10 .,00,,,7( ai-iO' d Ul& Ale& �Vh Hill -ailt 71/WS Cat 11F�_ 7' OlUd VALUAnON P0 011-1661 ELT r;l1pi- 60rs awd rM 276w... $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO. VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 1: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PU13UC 2 Grading DOMAIN (CUFIBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE .1 SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION:180 DAYS PERMIT UMM 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 SPOU9E, HEIRS, ASSIGNS AND SUCCESORS I Fire Review Plan Chk. Deposit IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF i — EDMONDS, WASHINGrON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND 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 Landscapeinsp. Total Amt. Due 650- DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CRY ORDINANCE 0 NOR LIMIT IN ANY WAY THE CITY$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION 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 applicidlcin� Is ri�i a pirmit until signed by the CALL TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED . Building Oftial or his/her Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR IN SPECMON' Is a&novAedged In space provided. WORKMEN$ CO NSA1,1�ffE AND RCW 10.27. _-Iftolpt OFFI IA!SIGNATUI*/ DATE A DATE SIGFD 142r :E �9 71"ZI I /.2 �G& 1 0/ Q 1 771-0220 % RELEASED BY D&E 7 ATTENTION 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 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING