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20030877.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS ry J1_5A. �Iw /_ - /_ h Tz,.; T , C, �, V/)- ! ��_z - S - city ZIP TELEPHONE . NAME ADDRESS CITY ZIP ITELEPHONE NAME CBL# /?. - . r tlAil Z S ADDRESS / Cc 0 0) 0 CITY ZIP -ITELEPHONE STATE LICENSE NUMBER EXPIRATION DATE alECKED BY 3.a r 4 PROPERTY TAX ACCOUNT PARCEL NO. a 9 06 _5z fmv NEW RESIDENTIAL PLUMBING MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY SIGN GRADING FENCE REPAIR CYDS ( - X-FT) DEMOLISH TANK OTHER GARAGE RETAINING WALL F RE SPRINKLER FIRE ALARM CARPORT ROCKERY (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: -5,U-t/ Revrlc 6, NUMBER OF NUMBER OF DWELLING CRITICAL AREAS o STORIES UNITS NUMBE DESCRIBE WORK TO BE DONE HEAT SOURCE I GLAZING % I LOT SLOPE % PLM CHECK MO:,A I — — I VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPILICATION: ISO DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 100 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 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 VIOLAT ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO )NORKMEN!S COMPENSATION INSURANCE AND RCW 18.27. DATE SIGNED /4"-)- -'/'- 0- LPERMITEXPIRES USE Z E ON PERMIT 22 , L NUMBER JOB ADDRESS SULTE/APT# PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required Street Use Pe It Req C, EXISTING PROPOSED Inspection Reqrmuired El SWewalk Required 13 -EQUIRED DEDICATION FT Underground Wiring required 13 'REQUIRED METER SIZE LINE SIZE NO. OF FIXTURES7[;;P�RV YES 13 No E3 z REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE 5 ENGINEERING REVIEWED BY FIRE REVIEWED BY DATE x JARIANCE OR CU SHORELINE OR ADEIII INSPECTION I BOND REQ'D I I POSTED OYES Rq$ --- IIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED _XP , lt,,� I CD 2-5. �-_ I �& I , LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED U, FRONT SIDE REAR q 7.9 15" FRONT 1 53 UR SIDE REAR �T z y PARKING REO'D PROVIDED 7- 1 2 19 AREA 1,+1' PLANNING REVIEWED BY ij� P,_ DA 10 /;" o 5, REMARKS CHECKED BY ITYP!_SL _n7ION 2771 00CUPANjo GROUP /<F SPECIAL INSPECTI01i AREA OCCUPANT REQUIRED [] YES 1 2 LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'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 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES Description FEE Description FEE Plan Check 76 State Surcharge Building Permit City Surcharge _jo,5 Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt. Due Recording Fee ---TReceipt # CALL FOR INSPECTION (425) 771-0220 EXT 1333 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. OFFICIALS SIGNATURE DATE Zi ZI�13 )� rRELEAS BY DATE T 1 1 AL-1-11it Yt:LLLW-1Nt)1`LL;1U N R GOLD -ON D..ASSESSOR �N - ACCOUNTING t z 0 A 0 M M 0 0 0 0 C: --j C 3: rn IT11 z 3: (a 0 _1111 M M 06 0 r, 0 M C CA C CD M 0 z X z z 0 4 0 M b C; v i .c GaMe Dm - 14; - - - A 'T RawAccm ,FX1j1w6 IMP!"lous Surface Coics. x t. Building: 1272 s ft.- Exist. Oriveway 384 sq,fl, Exist. Patio 170 sq.fl, main rmt 65 0' 52.01 OWNERICONTRACTOR IS RESPONSIBLE FOR EROSION CONTROL AND DRAINAGE ADD GUTTEHS/DOWNSPOUTS AND SPLASHBLOCKS GUTTERS/DOWNSPOUTS TO CONNECT TO EXIST. SYST. APPROVED AS NOTED A BY ENGINEERING f Ilk ------ j pimposed Add&" N$ (S - -- D�e , --- —,,Vzz--s PY1 virt immcwe-c Ai)pDf%V 1 071) M Pr Proposed addition 212 sq.ft. Proposed pallo 180 s it PROPOSED ADDITIONS 212 SQ Fr Lot coverage 28.6% Lot area 0.21 AC LQf slope Flat 1000, ZONE 4 Qpmhrk*-Qo So I-EPLAN C1,1 Y C FRON SIDE APPROVED BY PLANNING REAR .. OTHER HEIGHT WISEMILLER ADDITION r-ALD ASSH' I SITE PLAN/ VICINiTY MAP I MAW MTS 9-19m H K SCHROEDERS REPLAT OF FOREST GLENN BLK OU 10518 242nd Place SW, EDMONDS WA 98020 1 omw - LOT 1, 1 ots FINAL PROJECT APPROVAL FORM TO: DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: FIRE DEPARTMENT DATE MXASZ SIGN r ENGINEERING DIVISION DATE FLMSE SIGN PLANNING DIVISION DATE PLEASE SIGN PROJECT IAJi�gAi aefPg SITE ADDRESS LOS_(9 �Z4?,Plo(- P i PERMIT #_Lt96_W60 31 -00 *7 2 ADB# DATE INSPECTED &C�do DESCRIPTION OF WORK TO BE INSPECTED A field inspection was conducted to determine final compliance with approved plans. Final approval denotes that there are no objections from the above signed Department to the release of PERFORMANCE BONDS, and the granting of: /GRANT FINAL PROJECT APPROVAL GRANT PROJECT APPROVAL WITH CONDITIONS NOTED u Copy of CONDITIONS given to owner/contractor by inspector FAILED FINAL INSPECTION - OUTSTANDING ISSUES u Copy of CORRECTION NOTICE given to owner/contractor by inspector I . 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Si ocaprvl.doc.l:temp:bldg:fomisIO/OI z 0 M =i'-fi Ui --I 3: C M MO 0 -40 0 C: 4 r. 3: M M Z ID -i C Cl) 0 _n n M M a 0 0 M C CD r. CO) Q 0 Z X z CD z 9 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 .......................... I.0 FRAMING........................ FIRST FLOOR FRAMING ... Nv� INSULATION ................... Floor Insulation ......... an insuiation ........... Ceiling Insulation ....... rvyl SHEETROCK NAILING ... SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. 2003 0 1? 077 lt� DATE RECEIVERD CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAUF ni: ni inimpqr j 12ta 4L MAILING ADDRESS / -7 0;_�O - AJEE C114f - , IN 11 TELEPHONE NAME A—DDRESS C3 CITY ZIP ,:*. xi z;;Ir -, NAME CBL ,q r- ��-r_s ____ � I E ADDRESS 01 CITY ZIP TELEPHONE VIS11 a*4Z - -71�1 STATE LICENSE NUMBER . I EXPIRATION DATE I alECKED QY �7/4f_ or4iO3 la'�r 11At fe-4 PROPERTY TAX ACCOUNT PARCEL NO. /L21 PERMIT EXPIRES USE 'OERMIT ZONE NUMBER JOB SUITE/AP'T# ADDRESS ,�,5S7 -7 Ab PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP AP IR Iled nW Permit 'ZV EXISTING PROPOSED- Street Use Parrnit Req'd Inspection Required Sld&waik Required [3 REQUIRED DEDICATIJQN FT unoergrouna Wiring required METER SIZE LINE SlZi NO. OF FIXTURE S RV REQUIRED YES [3 NO 13 REMARKS z z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE -7 mc. At, OWrO7211, REVIEWED BY /�� FIRE REVIEWED BY DATE JARIANCE OR CU SHORELINEORAD1111 i INSPECTION I BOND REQ'D - POSTED OYES dKO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED Pf 06 Y� z0v -1 /kW 49000 z5. A= Ili - EXP NEW RESIDENTIAL PLUMBING / MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT L/RSIDE REAR ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE' 13567. (�* . 5 Jk. 9- 79 1 14 T1 53 A-c REMODEL MULTIFAMILY SIGN A R K' G G PARKING P N DIED P R OVIDE REO'D PROVIDED E D v 7 L( LIP- AREA 0 A R EA — PLANNING REVIEWED BY PLA 2- z C 10 13 REPAIR GRADING CYDS FENCE X 0 E A R K S REMARKS DEMOLISH 13 TANK o OTHER M coal GARAGE RETAINING WALL 13 F RE SPRINKLER ALARM kREQUIRED In I bile CARPORT ROCKERY FIRE OWE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: - _!5Lt A/ IF 6VY10c, el� 1%1>1&0V C HECKED BY : 0 ITYPE "91=71ON T U I Ce '?�7 OCCUPAP GRO 3 C NUMBER OF NUMBER OF DWELLING CRITICAL AREAS Cl L Sp SPECIAL INSPECTION AREA OCCUPANT LOAD STORIES UNITS NUMBER��_ ] Y [] YES z 15 Z nFarRiaF WORK TO 13E DONE REMARKS 2 PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D � HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK VESTED DATE THIS PERMIT AUTHOR12ES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK T7 t BE DONE ON PRIVATE PROPERTV ONLY. ANY CONSTRUCTION ON THE PUBLIC DOLUUM (CURBS, SIDEWALKS, DRIVEINAVS, MARQUEES, E-rc.) WILL REQUIRE SEPARATE PERMISSION. PERMITAPPLICATION: 160DAYS PERMIT 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 a EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND IALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, AFUSING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMrr. ISSUANCE OF THIS PERMIT SHALL NOT BE 9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION! MI 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 VIOLAT ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN!S COMPENSATION INSURANCE AND RCW 18.27. Y7 !,V; -ATTM. TION' IT IS UAAWFUL 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 VALUATION $ )z �L Description FEE Description FEE Plan Check State Surch 76w Building Permit )6_ City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection IM Fire Fire Lan Rec I Review Plan Chk. Deposit Inspection Receipt # dscapelnsp. Total Amt. Due ording Fee Receipt # APPLICATION APPROVAL CALL This application Is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid, and R INSPECTION receipt is acknowledged In space provided. OFFICIALS S GNATURE DATE 142 7 771-0220 RELEABb,/BY DATE EXT 1333 ORIGINAL-FittE YELLOW. INSPECTOR PINK -OWNER GOLD -ASSESSOR k It e-% f%e%picc - GREEN -ACCOUNTING U-f1U4 t-11111r-bb rIA " TUU M r- IVIMF%l ij z 0 1 0 m :;,-h am C m 0 -40 0 C: __4 r, X M m Z 0 x m M a 0 0 M C co) C 0) M 0 Z z z 0 4 0 m