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20030918.pdfI i DATE RECEIVED/ CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS IIF,<- V, \.,v r — --I V_- 0 MAILING ADDRESS !9,0a (. -a VQ CIfy- ZIP TELEPHONE Laz!�1"'zz.W, I q..1 5, 9, Z__ NAME ADDRESS CITY ZIP ITELEPHONE NAME CBL N ADDRESS rl 1 PERMIT EXPIRES �/, USE PERMIT ZONE Pjk4. N U M B E -2V'�5' JOB SUITE/ ADDRESS�y �Z-; , PLAT NAMEISUBDIVISION NO. I LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required U Streal Use Poffnil Req'd EXISTING — PROPOSED inspection Required Sidewalk Required [3 13 REQUIRED DEDICATION— FT Underground Wiring required E3 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 0 j YES 13 NO 13 Z REMARKS z z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE I i ENGINEERING REVIEWED BY C--Pdl If- :z 4 Z' 1 4= - r E CITY ZIP TELEPHONE oio,j g?=2:?!. Arp— q e STATE LICENSE NUMBER N DATE �AUVE=3 TAX ACCOUNT PARCEL NO. NEW RESIDENTIAL PLUMBING / MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE 0 REMODEL 13 MULTIFAMILY SIGN REPAIR GRADING 1:1 CYDS FENCE X—FT) DEMOLISH 1:1 TANK GARAGE —1 RETAINING WALL 1-1 F RE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS OR A5TUrM EXPLA#j: 4 NUMBER NUMBER OF CRITICAL OF DWELLING AREAS 0$10/60 STORIES UNITS IER DESCRIBE WORK TO BE DONE HEAT SOURCE I GLAZING % LOT SLOPE % PLAN CHECK NO: Lr VESTED DATE 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. PERMIT APPILICATION: IBODAYS PERMIT LIMIT 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 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, on 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 COMPENSATIONIMURANCE AND RCW 18.27. AGENT) DATE SIGNED DATE FIRE REVIEWED BY DATE VARIANCE OR CU SHORELINE OR ADB# I INSPECTION BOND REU, POSTED I 113YES�,MO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOW�D PRO POSED , , EXP LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS ALLOWED PROPOSED FRONT SIDJ REAR / FRONT URSIDE REAR , i!�d ;-7 �0 - 1 ;7,0 -5 1-5 _" I 1? 17, I ��l PARKING LOT AREA LANNING REVIEWED BY DATE REO'D PROVIDED q -�7 1, G i-n ff:�l kfs e— CHECKED BY [TYPE V)VCTION OCCUPANT GROUP SPECIAL INSPECTION REQUIRED YES AREA MX_-- -7,90e-1 OCCUPANT LOAD W REMARKS ] 2 PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D !3 VALUATION 1. .1.14 910 1 Descilption FEE Description FEE Plan Check Woo State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review PlanChk.Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Recording Fee Receipt # APPLICATION APPROVAL CALL This application is not a permit until signed by the Building otficial or his/her Deputy: and Foes are paid, and FOR INSPECTION receipt is acknowledged In space provided. OFFICIALS SIGNATURE DATE M (425) �h 771-0220 SED BY ATT9NTION E)Cr 1333 A > -�oo IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL b.9 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - F 1, Ow INSFI�CTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER - GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING 0 co k z 0 A 0 ITI :iii X M C M 0 40 0 C 4 C X M ITI z g) --I C _z o -n n M M 0 0 0 C 0 C 0) ITI 0 -zi Fn ro� z 0 A 0 M RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... Wall .......................... !D3 Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground ............. Rough -in ................... Commercial Final ...... HEATING: Gas Test .................... Gas Piping ................. Equipment .1 ................ Commercial Final ....... EXTERIOR SHEATHING NAILING .......................... FRAMING ........................ FIRST FLOOR FRAMING ... INSULATION ................... Floor Insulation ......... Wall Insulation ........... Ceiling Insulation ....... SHEETROCK NAILING ... SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. _�rT DATE RECEIVED IECEh [PERMIT EXPIRES CITY OF EDMONDS USE PERMIT OF ZONE jq_ 1.5-NUMBER--��/�/,��, CONSTRUCTION PERMIT APPLICATION JOB OWNER ADDRESS SUITE/OPT# NAME/NAME OF BUSINESS _V -/4F/'Z C(3 IJ C_ PLAT NAME/SUBDIVISION NO. LOT NO, LID NO. MAILING ADDPESS LID FEE $ V '_Q PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Appr v 'Ied RW Permit Re U"_ ZIP TELEPHONE EXISTING — PROPOSED Sri at Use Perm eq Ins;:t1on Required IY-2 Sidewalk Required 13 V&Yd 0AIJ i- REQUIRED DEDICATION— Fir undaramund NAME I Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YESD NO 13 z ADDRESS REMARKS z OWNERMONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE z CITY ZIP TE EPHONE NAME CBL# __S:� �e—' K cc ADDRESS ENGINEERING REVIEWED BY DATE 0 INNO CITY ZIP f: ONE FIRE REVIEWED BY DATE Lu 0 -7 J4 -2 '19.5 4- <5 9`8 rL STATE LICENSE NUMBER EXPIRATION DATE VARIANCE OR CU SHORELINE ORADE111 BOND RE POSTED I.INSPECTION 1$ L14 Al 2 6- 9-5, = YES3kO PROPERTY TAX A CO NT PARCEL NO. 4C=!!=Ii SEPA REVIEW SIGN AREA COMPLETE EXEMPT ALLOWED PROPOSED HEIG ALLOWED OPOSED qlllyy) 6 j 'RESIDENTIAL 19/ EXP , [3 NEW PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS fd) ' ALLOWED PROPOSED FRONT Slo� REAR FRONT L/RSIDE REAR ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE z REMODEL MULTIFAMILY SIGN PARKING LOT AREA [PLANNING REVIEWED BY REO'D I P OVI% REPAIR GRADING FENCE 0 ae q CYDS X FT) RE MARK REMARKS 1—/ DEMOLISH TANK RETAINING ;?-..A4 - ks e- EGARAGE WALL D CARPORT ROCKERY FIRE SPRINKLER OF USE, FIRE ALARM 7 (TYPE BUSINESS OR A TIV EXP f F rx - L EC KED BY 441 CHECKED BY I TYPE Of-LUNSTRUCTION OCCUPANT,,� NUMBER NUMBER OF — CRITICAL (4/-) '1_4 /V GROUP OF DWELLING UNITS AREAS MBE NU R OA b1l P Cl L S E A IN P SPECIAL INSPECTION JAREA OCCUPANT '0 QUI REQUIRED YES LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D 69�d4c_e f C- 112 I' / - t VALUATION $ ti , Description FEE Description FEE Plan Check State Surcharge / 05 HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge 15— PLAN CHECK NO,,- VESTED DATE Plumbing THIS PERUIT AUTHORIZES ONLY T�E_ W1116C NOTED. THIS PERMIT COVERS WORK TO Mechanical BE DONE ON PRIVATE PROPEMY ONLY. ANY CONSTRUCTION ON THE PUBUC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading SEPARATE PERMISSION. Engf: Review PERMITAPPUCATION: ISO DAYS PERMIT ILIMIr I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT POR MORE INFORMATION Engr. Inspection 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit A53 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 Fire Inspection Receipt # 311) 0 OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY h FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF Landscapelnsp. ANY CITY ORDINANCE NOR LIMIT Total Amt. Due IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Recording Fee Receipt # k? I HERE13Y 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 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 CALL This application Is not a permit until signed by the IN VIOLAT ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING To FOR INS PECTION Building Official or his/her Deputy: and Fees are paid. and receipt Is acknowledged In space provided. WORKMEN!s COMPENSAPQNINWNCE AND IRCW 18.27. BIG Oh AGEN"T) I I DATE SIGNED (4265) OFFICIALS SIGNATURE DATE i7E(rNj la, 771-0220 P) —1 RUVEASED BY DAt ATTK14TION 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 - INSPtCTOR 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 A z 0 4 0 M -1 -n M C M 0 0 —10 0 C -1 C X M M 0 Z -4 x 0 -n n M M C3 0 10 M C (j) C Cn M 0 Z X z W z 0 1711