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20030837.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS C MAILING ADDRESS W c ZIP TELEPHONE Y, NAME ADDRESS CITY ZIP ITELEPHONE NAME r - P_� t, / k-:- 1-101';tle 0/�� 1 67 ADDRESS CITY ZIP7�7TELEPHONE 1_7 STATE LICENSE NUMBER EXPIRATIOI� DATE P-cr j 1�_/ 1., 0 '_( P PROPERTY TAX ACCOUNT PARCEL NO. V()-V:;\7= C)I)r-) (�,VJVD�- NEW 0 RESIDENTIAL Q PLUMBING �D ADDITION 0 COMMERCIAL o COMPLIANCE OR CHANGE OF USE ja REMODEL 0 APARTMENT [I SIGN REPAIR GRADING CYDS FENCE X I _ __ FT) r] DEMOLISH TANK OTHER o GARAGE CARPORT [3 RETAINING WALL ROCKERY RENEWAL [TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: i2,i�- 5 r,—Iv cir. NUMBER NUMBER OF CRITIC L OF DWELLING AREAS UNITS NUMBER -STORIES DESCRI EWORKTOSEDONE r ott T-V OX tgrap4 Cf (-,P44/ "'0 0 Vj- HEAT fiOURCE GLAZING % LOT SLOPE % 0 (L-- I I PLAN CHECK NO: I VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DGIIIWN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 100 DAYS CL PERMIT LIMIM I YEAR - PROVIDED WORK 15 STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION APPLICAUL ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS I." ull, U" 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 21 NOR LIMIT IN ANY WAY THE CITY'S 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 CONSTRLIC- TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLAT ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN!S COMPENSATION INSURANCE AND RCW 18.27. Q �TR:JWNER OR DATE SIGNED 0 PERMIT EXPIRES USE PERMIT ZONE NUMBER (&K,5 . 0:93413 JOB . I SUITEIAPT# ADDRESS / 0 7 / 9'->M'9 P�_ 5 11 / PLAT NAME/S U BDIVI SION NO. LOT NO. LID NO, LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required Street Use Permit Roq'd EXISTING — PROPOSED Inspection Required 13 Sidewalk Required 13 REQUIRED DEDICATION— FT Underground w1ring required 13 METER SIZE LINE SIZE I NO. OF FIXTURES i RV REQUIRED I YEPs 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE reg ired -3,1 fuel-l-,n-ningappliac unh,—aied space-s. UMC 815.1.7 FIRE REVIEWED BY DATE 1'-.0 VARIANCE OR CU SHORELINE OR ADB# INSPECTION REO'D [3 YES (3 NO BOND POSTED SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED POSED PRO EXP , , I LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LJRSiDE REAR PARKING LOT A9EA I PLANNING REVIEWED REO'D I PROVIDED I BY DATE REMARKS CHECKEDBY TYPE NSTRUCTION Cog,, OCCUPANT I YWFC GROUP SPECIAL INSPECTOR OCCUPANT REQUIRED [:] YES JAREA LOAD REMARKS 2 PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 10/01 VAILUATION $ FEE Description FEE Plan Check Building Plumbing Mechanical Grading Engr. Review Engr. Inspection Traffic Mitigation Fire Review Fire Inspection Landscapelnsp. CALL FOR INSPECTION IA95 02 ) 771-0220 EXT 1333 771-0221 FAX _ff 1-mx Recording Fee City Surcharge State Surcharge Plan Chk Deposit Receipt # Total Amount Due Receipt # APPLICATION APPROVAL This application Is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid. and 11 receipt Is acknowledged In space provided. 7. FALSSI �NTURE DATE By I DA ORIGINAL -FILE - YELLOW- INSPECTOR PINK -OWNER - GOLD-ASSESSON� z 0 1 0 M '4 =5 5i � 0 M C M 0 —40 0 C � M M M z 10-1 C _z 0 _n n M M 0 61) 0 o Fn C ca M V) M 0 Z r- X z z 0 1 0 M RECORD OF INSPECTIONS INSPECTOR DATE APPROVED "SETBACKS ....................... FOUNDATION: Footing ....... .............. Wall.......................... Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: 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 -44 OCCUPANCY .................. ATE RECEIVED PERMIT EXPIRES USE PERMIT CITY OF EDMONDS ZONE N U M B E R (A't -/, CONSTRUCTION PERMIT APPLICATION JOB -) LI-)Alr ADDRESS 10 _) D SUITE/APT# OWNER NAME/NAME OF BUSINESS 005 PLAT NAME/SUBDIVISION NO. LOT NO. 7 LID NO. 15 MPLING ADDRESS A& P"' 57 P JUBLIC RIGHT OF WAY PER OFFICIAL STREET LID FEE S TESCP Approved MAP RW Porn* RacpAred C1 ZIP FYOW105 TELEPHONE f J^)�- q EXISTING - PROPOSED street use I'sanit R&Wd Inspection I'loquired SidewalitRaq Ired u :)o 0'�" REQUIRED DEDICATION- FT UndeVoLod Wiringrequired NAME METER SIZE LINE SIZE 1 NO. OF FIXTURES 1 RV REQUIRED .1 1 YEPs 13 NO 13 ADDRESS CITY ZIP [TELEPHONE NAME pP55oe "7 cc ADDRESS 111�j CITY ZIP TELEPHONE -7 STATE LICENSE NUMBER EXPIRATION DKT_E7 ED BY PROPERTY TAX ACCOUNT PARCEL NO 0 NEW RESIDENTIAL PLUMBING ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE UREMODEL, APARTMENT SIGN E] REPAIR GRADING CYDS 0 FENCE I _ X FT) DEMOLISH E] TANK 0 OTHER GARAGE RETAINING WALL CARPORT ROCKERY RENEWAL (TYPE OF USE. BUSINESS OR -.�CTPM EXPLAIN: e-111 Cr NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES UNITS NUMBER DE57I3tW(2M TO B 6DONE fnt,&*4 f.7 11.— Ice 13 p P, I ni:::* 0 11- I)TV) Vir.- LCrAT"" I ff a,4( t:;Ij _r_Arhj- HEA6§PURCE GLAZING % LOT SLOPE % PLANCHECKNO: VESTED DATE THIS PIERMrr AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COV Rs FE BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE P= To DOMAIN (CURDS, SIDEWALKS, DRr&VAY0, MARQUEES, ETC.) WILL REQUIRE t: SEPARATETERMISSION. PFRM1rTAPPLlCi;ON: ISODAYS 916 PERMIT LIMIr 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 RE13UCE ANY REQUIREMENT OF MY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENIIORCE 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 WORKMENS COMPENSATION INSURANCE AND RCW 18.27. ,�TURE �(ER �QRA6' DATE SIGNED REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE 11.114111,0A wig IM91:1 tinbutW spacm on ENGINEE FIRE REVIEWED BY UMC 815.1.7 DATE VARIANCE OR CU SHORELINE OR ADB# INSPECTION I PBOND REQ'D OSTED J3 YESL. 13 No SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT ALLOWED . PROPOSED ALLOWED . PROPOSED LOT COVERAGE I REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED I FRONT SIDE REAR FRONT L/R SIDE REAR PARKING LOT AREA PLANNING REVIEWED BY DATE REOD I PROVIDED I I CHECKED BY ITYPE SPECIAL INSPECTOR JAREA REQUIRED [] YES OCCUPANT GROUP )� OCCUPANT LOAD IREMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REOV A I I cri I IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 10/01 VALUATION $ Plan Check Building Plumbing Mechanical Grading Engr. Review Engr. Inspection Tralfic Mitigation Fire Review Fire Inspection Landscapeinsp. CALL R INSPECTION 1425) V"I", 771-0220 EICT 1333 771-0221 FAX FEE Description FEE Recording Fee City Surcharge State Surcharge Plan Chk Doposit Receipt # Total Amount Due A Receipt # jolz/� APPLICATION APPROVAL This application Is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid, and receipt Is acknowledged In space provided. FF1 LS SIGN URE DATE RELEASED BY DA-Eg LU IC Ir ORIGINAL -FILE - YELLOW -INSPECTOR PINK -OWNER - GOLD -ASSESSOR t z 0 4 0 r9 =i9 in � 0 M C M 0 —10 0 C M M 10 Z 0 _TI M M a _0 0 0 C (j) 9: CO) M 0 Z z 0) z 0 A 0 ITI