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20030860.pdfDATE RECEIVED q FP ERMIT EXPIRES CITY OF EDMONDS USE PER IT ZONE NUMBER,:94Z�2-/,'�?ho CONSTRUCTION PERMIT APPLICATION JOB SUITE/A ADDRESS PT,# IL x 4 OWNER NAME/NAME OF BUSINESS CA k2- L 6 Cf1_C+_ PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ go MAILING ADDRESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING — PROPOSED REQUIRED DEDICATION— FT 1 IFESCP Approved El RW Permit Required 13 Sir at Use Pormit Roq'd 11 Ina;Lflon Required E3 Sidewalk Required E3 Underaround wiring required CITY —ZIP 0 Aj 1) C C1 C6_0 TELEPHONE — '5 14 NAME METER SIZE LINE SIZE NO. OF FIXTURES RV REQUIRED YEPs 13 NO 13 cc W ADDRESS REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE z z EPHONE GAS WE TEST PAUST BE BY CR INSPEGTOR NAME 14 (f-- A 0-r-7-f 5,16t_: CBL# qo� AFFIDAVITS SHAI I 110T ENGINEERING REVIEWED -BY bATE BE ACCEPTED cc 0 ADDRESS q CC 29 Ci Lp 12� FIRE REVIEWED BY DATE Lu M 0 CITY . ZIP eiC j( uF TELEPHONE -7,11 by -11 by73� VARIANCE OR CU SHORELINE OR ADB# INSPECTION REO'D 113YES ONO s PBOND OSTED STATE LICENSE NUMBER EXPIRATION DATE 4C—A gT--� o--7 —7 r2-o / A�jvlp5 I CH9PKED BY SEPA REVIEW COMPLETE EXEMPT 1EXP SIGN AREA ALLOWED , PROPOSED HEIGHT ALLOWED , PROPOSED PROPERT.YTAX ACCOUNT PARCEL NP. NEW RESIDENTIAL LUMBING / MECH >_§P'L0IMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE REMODEL 1:1 MULTIFAMILY SIGN LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT LIRSIDE REAR 13 3 z z PARKING REO'D LOT AREA PLANNING REVIEWED BY DATE GRADING FENCE REPAIR 1:1 CYDS ( X_ FT) REMARKS DEMOLISH 1:1 TANK OTHER z o GARAGE RETAININGWALL F RE SPRINKLER CARPORT 13 ROCKERY F2 ALARM E rE a (rYPE OF USE, BUSINES, I P_QR ACTIVITY) EXPLAIN: NUMBER NUMBER OF CRITICAL OF DWELLING AREAS ST RIES 4-5;2— 1 UNIT NUMBER CHECKED B TA e-ONSTRUCTION iie3crA' COqF_ I OCCUPANT GROUP SPECIAL INSPECTION REQUIRED 0 YES AREA OCCUPAN I LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER LIBC 1108/FINAL INSPECTION REO'D 60 VC -A VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge CK NO: VESTED DATE Plumbing Mechanical 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. Grading Engr. Review PERMIT APPLICATION: ISO DAYS Engr. Inspection 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 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 ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY Fire Inspection Receipt # Landscapelnsp. I Total Amt. Due 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 0 zi NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Recording Fee Receipt # I KNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION VEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL 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 This application is not a permit until signed by the CALL Building Official or his/her Deputy: and Foes are paid. and IN VIOLAT ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged in space provided. WORKMEN S 90KENSATION INSURANCE AND RCW 18,27. OFF ' I S S;ZIGT RE DATE 425 0 771-022 RELEASED BY 'DATV SIGNAT N OR AGENTI C DATE SIGNEIR ATTENTION IF 7— EXT 1333 ------ 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 ORIGINAL - FILE YELLOW - INSPECTOR PINK - OWNER GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 4 0 M X M C M0 0 -10 0 C M Z 0 _n ITIM 0 _0 0 0 C CA C V) M 0 Z z CA z 0 1 0 ITI RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing .., ....................... Wall .......................... Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground ............. Rough -in ................... Commercial Final ...... HEATING: Gas Test .................... ryt) Gas Piping ................. Equipment ........ I ......... Commercial Final ....... EXTERIOR SHEATHING NAILING .......................... FRAMING ........................ FIRST FLOOR FRAMING... INSULATION ................... Floor Insulation ......... Wall Insulation ........... Ceiling Insulation ....... SHEETROCK NAILING ... SPECIAL INSPECTION ... MISCELLANEOUS .......... F INAL APPROVAL FOR 5 OCCUPANCY .................. DATE RECEIVED PERMIT EXPIRES -3 - LLZE CITY OF EDMONDS USE PERMIT ZONE N U M B E R JOB —Z SUITE/APT ADDRESS 57 J�.:5 '1�) CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS P, L) ft� E� —( CA 6C(-Lc-,— PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S 0 MAILING ADDRESS <; Vj PUBLIC RIGHT OF WAY PER OFFICIAL.STREET MAP EXISTING — PROPOSED REQUIRED DEDICATION— FT TESCP Approved RW Permit ' ad Requ:, street use Perm Req'd Inspection Required 13 Sidewalk Required E3 Underground Wiring required 13 ZIP o N W aLl TELEPHONE 2 0 S-'-I 7; NAME METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED YES13 NO 13 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE z z Ru CITY ZIP TELEPHONE PIFF IFST 1111-a- —GAS By- wspmoii OBEFRVFn cay AFFIDAVITS SHALL NOT NAME 14 A VL r7-4 <I 0 Ic Oem G > ICBLq# ENGINEERING REVIEVMD BY BE ACCEKED DATE CC ADDRESS 1 0 2 9 — 1) 1 6i 0 LAJ FIRE REVIEWED By DATE 'al CITY �_(Aa ELEPHONE VARIANCE OR CU SHORELINE OR ADBI I INSPECTION REO'D OYES 13NO BOND POSTED s STATE LICENSE NUMBER EXPIRATION DATE 14c. � -r-,5 -� --7a o /Jq)q/P5j I CHgKED BY 1 a o SEPA REVIEW COMPLETE , EXEMPT EXP SIGN AREA ALLOWED , PROPOSED HEIGHT ALLOWED , PROPOSED PROPERTY TAX ACCOUNT PARCEL NP. NEW RESIDENTIAL LUMBING / MECH >_§PLl ADDITION COMMERCIAL OMPLIANCE OR E] CHANGE OF USE REMODEL MULTIFAMILY SIGN LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT LIRSIDE REAR z PARKING LOT REQ'D PROVIDED AREA PLANNING REVIEWED BY DATE GRADING FENCE REPAIR CYDS ( X FT) REMARKS DEMOLISH TANK OTHER 'a[ r-1 GARAGE RETAINING WALL FIRE SPRINKLER L_J CARPORT ROCKERY FIRE ALARM MW VV (TYPE OF USE, BUSINEER ACTIVITY) EXPLAIN: n -77/1 CHE KED BY ITY ONSTR ON 1 _VCTI H 7T, OCCUPANT GROUP 12 -!42 _A NUMBER OF STORIES ':42� 1 NUMBER OF DWELLING U I CRITICAL AREAS NUMBER SPECIAL INSPECTION ]AREA REQUIRED OCCUPANT LOAD z DESCRIBE WORK TO BE DONE (fo ro v c - 71' (a., -CC To REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D IA)Se4jr Z-Y/ R// 9 7* kg�r elVVW VALUATION Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Sur charge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Grading t 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 LIMIT: I YEAR . PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit a IALL 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCEkRS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY — -- Fire Inspection Receipt # sp. Landscape Insp. Total Amt. Due 9 0 x 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 Recording Fee Receipt # L I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORREC"P, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH C17Y 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 CALL FOR INSPECTION APPLICATION APPROVAL This applicatIon Is not a permit until signed by the Building Otficial or his/her Deputy: and Foos are paid, and _ receipt Is acknowledged In space provided. OFF.67'15 SIG T RE DATE WORKMEN'S C�KENSATION INSURANCE AND RCW 18.27. (425) 771-0220 SIGNAT OR AGEN-1 DATE SIGN D RELEASED BY ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I 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 z 0 m =i 9 ra 5� am C ma 0 80 C � C m IT! jo �i C _z V) 0 In In m a 0 0 M C (j) r. 0) M 0 Z z z 0 m