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20030928.pdfa DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS MAILING ADDRESS -ZI6111? Rele, /A /--,/ , �, � CITY ZIP TELEPHONE V,n,�&,'x k,) it - I NAME ADDRESS U I CITY ZIP ITELEPHONE e-o-, '4�� ? /9' CITY ZIP TELEPHONE STATE LICENSE NUMBER EXPIRATION 9 rn 0 11 V —C i I i Int IROPERTY TAX ACCOUNTPARdEFLN-0. 1:1 NEW -IWMSIDENTIAL [:] ADDITION COMMERCIAL [j REMODEL MULnFAMILY REPAIR 0 GRADING CYDS DEMOLISH TANK GARAGE CARPORT RETAINING WALL ROCKERY UWE OF USE. BUSINESS N: NUMBER OF STORIES f— NUMBER OF DWELLING 1 11 DESCRIBE WORK TO BE DONE CBL # //05 1 1 PERMIT EXPIRES USE PERMIT ZONE NUMBER &)63 JOB ADDRESS PL SUITE/APT# �0 PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required EXISTING — PROPOSED ICOWNERICONTRACTOR Street Use permit Req'd InspecW" Required Sidewalk Required REQUIRED DEDICATION— FT Underground Wiringroquirod 13 METER SIZE LINE SIZE NO, OF FIXTURES PRV REQUIRED' _T YES 13 NO 13 REMARKS RESPONSIBLE FOR EROSION CONTROWDRAINAGE REVIEWED BY DATE FIRE REVIEWED BY DATE lu I IM, BY VARIANCE OR CU SHORELINE OR ADS# INSPECTION BOND REQ'D POSTED 113YEs 13NO is SEPA REVIEW SIGN AREA HEIGHT COMPLETE , EXEMPT ALLOWED . PROPOSED I ALLOWED . PROPOSED tg.<UMBING/MECH LOT COVERAGE I REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) __% ALLOWED PROPOSED I FRONT SIDE REAR FRONT UR SIDE REAR COMPLIANCE OR CHANGE OF USE LOT AREA PLANNING REVI PARKING EWED BY 9ATE 0 SIGN RE17D I PROVIDED o FENCE X FT) REMARKS o OTHER FIRE SPRINKLER FIRE ALARM I CHECKED BY TYPE ;Vrff CRITICAL \14 �RA AREAS SPECIAL INSPECTION JAREA NUMBER REQUIRED tREMARKS P 0 SS PROGRESS INSPECTIONS PER UBC Description Plan Check I HEAT SOURCE GLAZING % LOT SLOPE % I Building Permit PLAN CHECK NO: VESTED DATE Plumbing THIS PERMIT AUTHORMES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Mechanical k: BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC a DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading M SEPARATE PERMISSION. PERMFTAPPUCATION: Engr. Review ISO DAYS PERMIT LIMM 1 YEAR - PROVIDED WORK IS STARTED WITHIN loo DAYS SEE BACK Engr. Inspection OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection 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 Landscapeinsp. NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - Recording Fee 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 .. �L� THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- TION; AND IN �CA L DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE TATE OF WASHINGTON RELATING To OF THE S FOR INSPECTIO SARAPIE WORKMEN'S COMPIEN SU ANCE AND RCW 18.27. E (OWNER 0 ENT) DATE SIGNED 141125) I-T&- 771-0220 ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE TIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A GER Fl- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 04/02 PRESS HARD -YOU %AR MAWN FEE GROUP OCCUP4 LOAD I NAL INSPECTION REO'D Description FEE State Surcharge City Surcharge 147- Plan Chk. Deposit Receipt # Total Amt. Due Receipt # -_ _ I 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. r— /411 D Ile OR�GINAL - FILE -. YELLOW - INSPECTOR I,/ P INK - OWNER GOLD -ASSESSOR COPIES GREEN - ACCOUNTING Z' 0 m. 41 i . � � ; '. "_ :, 1. 1 RECORD OF INSPECTIONS INSPECTOR DATE APPROVED ..SETBACKS ..................... FOUNDATION: Footing...................... ..................... Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground ....... Rough -In .................. -- - ---- ommer6iii Final ...... HEATING:. Gas'Test ................. Gas Piping ................. Equipment ................. In I Commercial F a ....... EXTERIOR SHEATHING, NAILING .................... ...... FRAMING .. .. ........... ... .. FIRST FLOOR FRAMING... INSULATION ........ .......... Floor Insulation ......... Wall Insulation ............ Ceiling Insulation ....... SHEE*ROCK NAILING ... SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY ................. I RECEIVED , CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMENAME OF BUSINESS 4 MAILING ADDRESS /C5// I? cS �1_ //7- CITY TELEPHONE ZIP I CITY .�(�se_L� e, 7AD RESS _) /-;�l ,, ? / K/- ZIP ITELEPHONE CITY ZIP TELEPHONE STATE LICENSE NUMBER EXPIRATION DATE 11110q PROPERTY TAX ACCOUNT PARCEL NO. [] NEW V"SIDENTIAL 13 ADDITION 0 COMMERCIAL REMODEL 0 MULTIFAMILY 0 REPAIR GRADING CYDS DEMOLISH TANK [3. GARAGE [3 RETAININGWALL CARPORT ROCKERY ME OF USE, BUSINESS OR .NUMBER NUMBER OF OF STORIES DWELLING UNITS DESCRIBE WORK TO BE DONE CBL 0 -7-7 / f) 19 1`1 1 P;:RRAIT PYPIR;:-q I USE PERMIT ZONE NUMBERZO03 JOB SUITE/APT# ADDRESS 14 AL �0 PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 3"W Mci, Jvl)rl� RW P*m* Required Street Use Permit Wd EXISTING — PROPOSED tropection Required Sidewalk Required REQUIRED DEDICATION— FT Urxierilround wirtarequired 13 METER SIZE LINE SIZE NO. OF FIXTURES PFIV REQUIRED V3 I YES[3 NO 13 z I REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE REVIEWED BY DATE FIRE REVIEWED BY DATE VARIANCE OR CU SHORELINEORADBM I INSPECTION I . BOND IBY REQ'D POSTED SEPA REVIEW SIGN AREA OyEs 13NO $ HEIGHT COMPLETE . EXEMPT ALLOWED . PROPOSED I ALLOWED , PROPOSED LOT COVERAGE REQUIRED. SETBACKS (FT.) PROPOSED SETBACKS (Fr.) tzruMBING/MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REAR COMPLIANCE OR CHANGE OF USE I PARKING LOT AREA I PLANNING REVIEWED BY DATE SIGN REQ`F) PROVIDED FENCE x FT) REMARKS OTHER F RE SPRINKLER FIREALARM CHECKED BOY JTYPE2= I Cr 3 0 7 GROUP CRITICAL AREAS __FoccUPANT NUMBER :REQUIRED [] 'T ON JAREA LOAD ]!REMARKS YES PROGRESS INSPTECTIONS PER UBC 1108/FINAL INSPECTION REaD 9 Description Plan Check HEAT SOURCE T GLAZING % LOT SLOPE % Building Permit PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORMES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DOME ON PRIVATE PROPERTY ONLY ANY CONSTRUCTION ON THE PUBLIC Grading 31 3 DoMAlm (CURBS, SIDEWALK% DnriEwAys, MARQUEES. ETC.) WILL REQUIRE t: SEPARATE PERMISSION. Engr. Review PERurrApplijwicim isoDAys 9L PERMIT UUM. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION- 1APPLICAN'r, ON BEHALF OF HIS OR HER SPOUSE, HEIRS,,ASSIGNS ANR SUCCESORS Fire Review IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HO, HMMLES9THECfTYOF in4ectiDn a EDMONDS. WASHINGTON, IT$ OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISINO'DIREOWY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF TMS PERMIT SHALL NOT BE Landscapoinsp. DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 21 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION OWEN 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 TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE E OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTIO) WORMERS COMPEN 0 NSU CE AND RCW 18.27. AWILMR (OWNER 0 ENTI DATE SIGNED 1A0 %425) le-1— 771-0220 FEE DescriptIon FEE State Surcharge I City Surcharge Zj!!� Plan Chk. Deposit .1 Receipt # Total Amt. Due Receipt # APPUCATION APPROVAL This application Is not a permit until signed by the Building OMcIaI or blow Deputy: and Feeli are paid, and receipt Is acknowrledged in space peovided. WFICIAL IGNA7URE u; 771,7w10 _3__ �144 -I,- I IN FARFn RV -DATE ATTENTION bx I I j;j IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE NTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CER Fl- ORIGINAL -FILE YELLOW -INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 — KIN65 COPIES GREEN - ACCOUNTING PRESS HARD -YOU ARE MA