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20030921.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF 13USINESS /U /V 7 e- pit Lie .44 L MAILI G ADDRESS 1, 6, or� , 5-f— CITY TELEPHONE 'elmw NAME ADDRESS CITY LICENSE NUMBER TAX NEW ADDITION 0 REMODEL F] REPAIR [:] DEMOLISH [:3 GARAGE CARPORT (TYPE OF USE, BUSINEE NUMBER OF STORIES DESCRIBE WORK TO BE HEAT SOURCE PLAN CHECK NO: M I PERMIT EXPIRES \—LI 11 jU �_;L USE PERMIT ZONE NUMBER&_'� JOB ADDRESS SUITE/APT# PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required Sir 01 Use Permit Roq'd EXISTING - PROPOSED In=ction Required E3 Sidewalk Required E3 REQUIRED DEDICATION- FT Unde grourut Widn'D FOquirod E3 METER SIZE LINE NO. OF FIXTURES PRV REQUIRED YESE3 NO M z REMARKS z z OWNER/CONTRACTOR R A E (5 i___. - 6 ZIP TELEPHONE or L vent connectuta 1 -0 111111 'm required,,ii, fuel -burning upPlla= CBL # ed spaces. me tinb.'!at ENGV� �1.UVIAW&DOY' DATE FIRE REVIEWED ATE W BYGAS PIPE TEST MUST BE Ix ZIP TELEPHONE murgin RV C! EXPIRATION DATSL 3h CHECKED BY VARIANCE OR �EWTMR BOND POSTED IRIDAVITS-D RO M a 0%0%V-1 NO S 192 Z SEPA REVIEW tjj$I(j&Ub0 I L-Lj HEIGHT PARCEL NO. 3--�n I 100 COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED , PROPOSED oinlo EXP 2-P'Lu O-RESIDENTIAL M13ING / MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED E REAR COMPLIANCE OR COMMERCIAL 1:1 CHANGE OF USE z Regard sf of whether the w#,ter syste]m� 13 MULTIFAMILY 13 SIGN PAR u"Mmomemiks ar6A D X aro"T REO' ORRER QoFn 1118*!�'t requinj water tanks per I GRADING FENCE 3 CYDS El X_Fn REMARKE - WICOde. ECDC 19.30.020(c) 1:1 TANK OTHER 1 RETAINING WALL F RE SPRINKLER 3 ROCKERY FIRE ALARM �p AF[Vrrj) EXIIL�JN: CHECKED BY TYPE OF CODE OCCUPANT US'I0_WLQ- 7ffUCTION 9 ] GROUP F1-3 I 74 NUMBER OF CRITICAL DWELLING AREAS _ — SPECIAL INSPECTION OCCUPANT UNITS NUMBER JAREA REQUIRED [] YES LOAD ONEA REMARKS ores IC AA7 PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D .'-Vj 2__ e. 8�5n& _A111 ODD f3tU_ T__ VALUATION Description FEE Description FEE Plan Check State Surcharge GLAZING % LOT SLOPE % VESTED DATE Building Permit Plumbing Mechanical City Surcharge 7�2 P-% THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WnRK TO 1= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading :3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE t: SEPARATE PERMISSION. 2 Engr. Review 6 PERMIT APPLICATION: 180 DAYS PERMIT LIMIr 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 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 91 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due 0-5 1/0 5-- 0 NOR LIMIT IN ANY WAY THE C17YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Recording Fee Receipt # Ea� 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- CALL This application Is not a permit until signed by the TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees 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 COMPENSATION INSU"E AND RCW 18.27. FFI LS SIIG*TURE DA SIGNA" (OWN DATE SIGN (425) ( 0 ilk. All �RA 1,27 A a�' 771-0220 —ATET REUASED BY 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 t z 9 0 ITI --I -n M C M 0 0 0 C -4 C X M ITI Z 0 _n n M M 05 0 r- 0 M C V) ic (1) ITI 0 Z X z W z 0 IT1 Act 0'> I Readwin, Jennifer From: j.kimlicka@comcast.net Sent: Monday, May 17, 2004 10:35 AM To: readwin@ci.edmonds.wa.us Subject: permit 2003-0921 Dear Robin: As per our discussion this morning, I did not have any other gas appliances installed other than the 04; stove, due to financial constraints. Thank you, .7 . t 0 Jeannie Kimlicka 8606 238th ST SW Me Edmonds WA 98026 "'CRON, 425-640-7460 I El RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ...................... FOUNDATION: Footing ....................... Wall ........................... . Pier/Porch ................. RithInIng Wall ........... Slab Insulation .......... PLUMBING: �Underground ............. R,ough-In ................. Commercial Final HEATING: Gas Test .................... Gas Piping ................. Equipment ................. Commercial Final ....... EXTERIOR SHEATHING NAILING.......................... FRAMING ........................ FIRST FLOOR FRAMING... INSULATION ................... Floor Insulation ......... Wall Insulation ........... Ceiling Insulation ....... SHEETROCK NAILING ... SIECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. IN z 0 0 IT! :q =4 M C M 0 —1 1 i 0 0C M �z I DATE RECEIVE" PERMIT EXPIRES USE PERMIT ZONE CITY OF EDMONDS NUMBE CONSTRUCTION PERMIT APPLICATION JOB I ADDRESS OWNER NAMEINAME OF BUSINESS SUITE/APT# PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. p-) A) Z-1 e_44 MA�G ADDRESS LID FEE S TESCP Applav PUBLIC RIGHT OF WAY PER OFFI��L STREET MAP RW Permit Flaqvirod 0 -60,01 _,�z 3 9 1 Street Use Permit Floerd CiTly EXISTING - PROPO Inspection Required 13 TELEPHONE S arwalk Required 13 IN 'ddarground Un 1(w ad E3 REQUIRED DEDICATION- FT 1 Wiring requir ZIP NAME METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED YES 13 NO C3 z ADDRESS REMARKS z OWNERICONTRACTOR RE!L2gggMFQ&x&M CITY ZIP ONE FZ_p B or L vent connectors & ain fuel -burning UPPIlaucas NAMEu,,,,., CBL N required Pace& tijjjl:vlle unbcated S cc ADDRESS E N G 1tLff49,Q.0 VJ i Wfil �' ON" BE DATE TEST MUST 'D 156 FIRE REVIEWCMSERVEDBY CITY JNSPECIUK LU cify ZIP TELEPHONE 0 lraniLlorre a ICE LMU a a SJL-Lna ECTION BOND Al; SEQ 6D 01 POSTED OWr 0611PYE N VARIANCE OR STA)t LICENSE NUM13ER EXPIRATION DAT6 -'h CHECKED BY CU /L-An R 11 1 � VN� y-IL21 >k LIT SEPA REVIEW SIGN AREA HEIGHT Q PROPERJY TAX qOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED I PROPOSED ALLOWED I P_ POSED uoll La --,� ";It) 0 1 0 o i oo EXP 6._AV_ _r the mter M 013 1 KS (Fr.) !l RE IRED ETBACKS (FT.1 P& I 1:1 NEW D-R-ESIDENTIAL 0- <LUMBING/MECH ALLOWED WC P&MO to REAR , @pie, )r plax COMPLIANCE OR ADDITION COMMERCIAL 1:1 CHANGE OF USE required pn all hot water tat ke per CW AfflqeI.A*.W1 ")BY DATE PARk i % REMODEL MULTIFAMILY 1:1 SIGN REO'D I E GRADING FENCE X FT) REMARKS REPAIR CYDS 1:1 ( OTHER DEMOLISH TANK GARAGE RETAINING WALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINES I ,A_04� ACT!VITY) EX IN: P CHECKED BY TYPE OF UUUCTION CODE OCCUPANT CRITICAL 19-7- GROUP NUMBER NUMBER OF OCCUPANT OF DWELLING AREAS SPECIAL INSPECTION JAREA I UNITS NUMBER REQUIRED [] YES LOAD STORIES ;�, DESCRIBE WqRK TO BE DONE REMARKS f PROGRESS IN CTIONS PER UBC 108/FINAL INSPECTION REO'D z�)4 f-'7-3 VL5 ?��3nv� *61 VALUATION f Li I)TDL- Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit 70-0 City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 180 DAYS PERMIT LIMM I YEAR - PROVIDED WORK 15 STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION Fire Review Plan Chk. Deposit '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 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 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE - 10- 0,1 NOR LIMIT IN ANY WAY THE CI1YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee Receipt # 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 APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTFILIC- CALL This application is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his1her Deputy: and Foos are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided. WORKMEN'S COMPENSATION INSUR14JE AND RCW 18.27. DA FFIWLS SIG TURE 1� 1 � r SIGNATURE (OWNER,�! APENT), DATE SIGNED (425) 0 V 771-0220 RELEASED BY DATt 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 CERTiW- ORIGINAL -FILE YELLON- INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR GREEN - ACCOUNTING 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES k z 9 0 M M M 0 80 C M M z 0 M M 0 7W 0 r_ 0 M C ca M 0) ITI 0 Z z 3: 0) z 0 M