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20031000.pdf,A�"uNDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION iR NAMF/NAME OF 7SINESS .4� . I NG ADDRESS 7 2�"t--3o NAME ADDRESS CITY NAME fA CITY ML ZIP ZIP ZIP STATE LICENSE NUMBER 01,wq Ptq moo a C' PROPERTY TAX ACCOUNT PARCEL NO. :11 � 44.c.� TELEPHONE TELEPHONE 077,07A TELEPHONE 'qzSxM'4�89q1 EXPIRATION DATE a/11,111104 I __ [PERMIT EXPIRES mommmommmods USE PERMIT /0( ZONE NUMBER JOB -fi SUITEI # ADDRESS (op release PLA NAME/CUBDIVISION NO. LOT NO. LID NO. LID FEE S TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required Street Use permit Req'd EXISTING — PROPOSED inspection Required Sidewalk Required REQUIRED DEDICATION— FT Underground Wiring required LINE SIZE NO. OF FIXTURES PRV REQUIRED METER SIZE I — . YES 13 NO 1:1 REMARKS OWNER/Cl ENGINEERING FIRE REVIEWED BY CB ot 1§1112IMM 970AM ivaird dn fuel-burili'llig REVIEWED/DATE DATE ALLOWED BOND POSTED a z rr w z z 8 z W W M rL EXP bwwarstff� -1 LOT COVERAGE REQUIRED SETBACKS (FT.7 rROPOSED SETBACKS (Fr.) C-] NEW 00"RESIDENTIAL 53000PLUMBING / MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT lJR SIDE REAR COMPLIANCE OR ADDITION C3 COMMERCIAL CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE rcreR E M 0 D E L [:] APARTMENT SIGN PROVIDED REPAIR 0 GRADING FENCE REMA KS CYDS 0 x FT) OTHER DEMOLISH (3 TANK GARAGE 0 ROETAINING WALL 0 RENEWAL z 0 CARPORT R CKERY_ (TYPEOF SE. BUSINESS OR A5ZVITY) CL CHECKEDBY JTNMUS)��N COD _g OCCUPANT �rj GROUP W NUMBER I"IUMBER bF CRITICAL 0 OF DWELLING AREAS SPECIAL INSPECTOR JAREA OCCUPANT M UNITS NUMBER REQUIRED 0 YES LOAD 0 STORIES DE_WIBE WORK TO BE DOME 1 (0 a, REMARKS L;A�cr.. r_Gf2CrA PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REQ'D a //0'00o ATtz's 7P&lrrAaee,.,_. Pur 'Z::� 46 61111200ef bownpvi-t _—�I)RIWLLA VALUATION FEE PL� __'j_____7LAZING % LOT SLOPE % HEAT SOURCE BUILDING VESTED DATE PLUMBING PLAN CHECK NO: MECHANICAL 06 THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILL DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE do A 1 :3 SEPARATE PERMISSION. t SU CHARGE 19:�jlt 0 0 a PERMIT APPLICATION: 180 DAYS PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION -APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS ENG. INSPECTION FEE IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING 2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND INSPECTION FEE ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY RECEIPT X FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENTOF ANYCITY ORDINANCE 00 0 NOR LIMIT IN ANY WAYTHE CITY'S ABILITY TO ENFORCE ANYORDINANCE PROVISION.* TOTAL AMOUNT DUE R C (0 LID 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 CONSTRUC- This application is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL Building Official or his/her Deputy: and Foos are paid. and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO OR INSPEC N receipt is acknowledged in space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. SIGNATJR ATE a - wa�-- �JC SIGN OW R AGENT DATE SIGNED (425) 'v 77 4W I �Zlz`k-3_ 771-0220 R-'9SED BY ATT9NTION EXT 333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UN IL 771-022 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI I- ORIGINAL - FILE YELLOW - INSPECTOR CATE OF OCCUPANCY-H,,AS BEEN GRANTED. UBC SECTION 109 F PINK - OWNER GOLD - ASSESSOR I" L I t RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing...................... Wall.......................... Pier/Porch ................. Retainirig Wall ........... Slab Insulation .......... PLUMBING: U.ndergroun d ............. gough -in .................... Commercial Final .... HEAMN6.�' Gas Test .................... Gas Piping ................. Equipment.................. Fi *I'"' 6o'm'mercial ina EXTERIOR SHEATHING a. 71:1 NAILING .......................... FRAMING ........................ FIRST FLOOR FRAMING... INSULATION ................... Floor Insulation ......... Wail Insulation ........... .... ...... Ceiling Insulation ....... . SHEETROCK NA ILING SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .......... ....... 0010 M Rv M; M 0 M Sn M, 0. I I I .144 '%ATE RECEIVED F�ER71MIT EXPIRES USE PERMIT CITY-OPEDMONDS ZONE NUMBER OW JOB UITE/A I 1 (0 "CONSTRUCTION PERMIT APPLICATION ADDRESS 01-WR NAMPINAME OF E S PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. I LID FEE $ MAILING ADDRESS IESCP Approved 01 I%.— ? PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW permit Required 0 Street Use Parmit Req'd 0 0 :1 -7 Inspection Raq ired EXISTING — PROPOSED 0 CITY ZIP ELEPHONE Sidewalk Required E3 REQUIRED DEDICATION— FT Underground ired T NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES E3 NO 13 z uj z ADDRESS REMARKS UDRAINAGE z WNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTRO 0 I z CITY ZIP 17E�ONE flu I& 2ft 14 A NAME N Min ENP!NEERING RhEMPAWATE-. CE jkDDR9SS 0 z '7 ib ce Ave.- LA.) *�W-7 FIRE REVIEWED BY DATE W 0 cc CITY ZIP TELEPHONE IE .1 0 MtA I mouft"Alke- —Igave- &145 4zf3-rMq- I — M VARIANCE OR CU SHORELINE OR ADF# INSPECTION FBOND STATE LICENSE NUMBER EXPIRATION DATE CHECK By REQ'D OSTED 0 YES 0 NO fe(p OT W z C> lxdld =i:fi . 11 . 04- SEPA REVIEW SIGN AREA HEIGHT RTY TAX ACCOUNT PARCEL NO. �COMPLETE I EXEMPT ALLOWED I PROPOSED ALLOWED PROPOSED PROPE M 00 EXP M LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) REAR C)'NEW' grRESIDENTIAL WPLUMBING I MECH ALLOWED PROPOSED' FRONT SIDE REAR FRONT URSIDE 0 C: COMPLIANCE OR z CHANGE OF USE ADDITION 0 COMMERCIAL z PARKING LOT AREA PLANNING REVIEWED BY DATE 01 R 0 APARTMENT 0 SIGN REQ'D I PROVIDED EMO,DEL 10 0 GRADING FENCE X kER�IR CYDS FT) EMARKS r 0 OTHE R '76 . &LISH TANK 0 0 o GARAGE 0 RETAIN RENEWAL 0 — CARPORT ROCKar WALL 0 r_ (TYPE OF-VSE, BUSINESS OR ACTIVITY EXPLAIN: 0. CHECKEDBY TYPE OF CONSTRUCTION ODE OCCUPANT LI'd Malvf.. GROUP M M NUMBER UMBERbF CRITICAL OF WELLING AREAS SPECIAL INSPECTOR JAREA OCCUPANT LOAD STORIES UNITS NUMBER REQUIRED 0 YES L DEARIBE WORK TO BE --c_:;Arritn,70 AEMARKS M 0 SiTrA I I&A2 PROGRESS INSPOCTIONS PER UBC 108/FINAL INSPECTION REO'D 5 HOJ000 ATUfS 6a6 Parnaer e,.. D z VALUATION FEE z GLAZING % % BU, ILDING HEAT SOURCE LOT SLOPE % M VESTED DATE PLUMBING PLAN CHECK NO: MECHANICAL 04) THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIRPERMiT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTROCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE GRADIYGIFILL :3 SEPARATE PERMISSION. 4 1 MASIUCHARGE PERMIT APPLICATION: 180 DAYS PERMIT LIMIT'. I YEAR - PROVIDED,WORK 13 STARTED WITHIN 180 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'ENp. INSPECTION FEE -API�LICANf, 6N B&ALF OF Hi�'OR HEIiSPOUSE, HEIRS. ASSIGNS AND SUCCES I N INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPI G 3 EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND INSPECT11 E ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT RECEIPT 01 00 DEEMEDTO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANYWAYTHE CITY'SABILITYTO ENFORCE ANY ORDINANCEiPROVISION.' R CEP 7 — TOTAL AMOUNT DUE 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 This application Is not a permit until signed by the THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL Building Official or his/her Deputy: and Foos are paid and 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 OR INSPEC N receipt is acknowledged In space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. 1 FICIALSSIGNATURA TATE IGNATURE(O RAGENT DATE SIGNED (425) at-4- - V 771-0220 R E SED BV L k-3. ( E.XT 333) ATTtNTION . _1 If qTIL IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE U ft If-022 R A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI I- ORIGINAL - FILE YELLOW - INSPECTO K GOLD - ASSESSOR CATE OF OCCUPANCY -HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER 1. 5/9�_