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20040064.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS 14 n vi LM MAILING ADDRESS u z CITY ZIP TEL EPHONE ��7Jmotdf NAME W t= ADDRESS x 0 CITY ZIP I TELEPHONE NAME CBLN "If Wil "/ Ae�ll I / li Ir AD�LRESS I O< zip TELEPHONE 0 _2^ 9"��o 9 to 0 f -1 STATE LICENSE NUMBER EXPIRATION DATE j CHECKED tU- AA rxJ PROPERTY TAX ACCOUJNT PARCEL NO. uj I0_j Vol /,2,00 El NEW RESIDENTIAL PLUMBING / MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY SIGN REPAIR GRADING Gyms FE14CE X FO F-1 DEMOLISH M TANK F� OTHER GARAGE CARPORT RETAINING WALL ROCKERY M FIRE SPRINKLER FIRE ALARM (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: .1 W NUMBER NUMBER OF CRITICAIii OF DWELLING AREAS UNITS 0 STORIES NUMBER DESCRIBE WORK TO BE DONE topl-lldet( -rq HEAT,SOUR E GLAZING % LOT SLOPE % C) PLAN tHECK NO: 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 APPLICATION: 180 DAYS PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WiTHII4 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS IN INTERE�T, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGEN IS FRONT ANY AND ALL CLAIMS FOR DAMAGES OFINHATEVER NATURE, ARISING DIRECHY OR INDIRECIly FROM 1 HE ISSUANCE OF I HIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT 13F DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILIIY 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 1;1;�LOYED IN v;6LATION OF THE LANB—C.ODE OF THE STATE OF WASHINGTON RELATING 10 WORKMEN'S COMPENSAY40N INSURANCE AND RCW 18 27. DATE S' G� 1 1-2- PERMIT EXPIRES 1[7-77W :L LISE PERMIT IS F ZONE NUMBER2 -0 1 r JOB -3 SUITE/APT# Jo ADDRESS PLAT NAMEISUBDIVISION NO __rNO LID NO. LID FEE $ TESCP App(aved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Rw Pormit Horitsifod ,"mr,rVe Permit Fileri'd EX., I" lnspiich�n Hequired r POSED jr j=allOioquirod RFPU MIAIM' IEjLL%ffj a jnd Wirin ".a MtEQ PRV REQUIRED t�k I ------- --TET Cl NO REMARKS OWNER/CONTRACIOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING REVI BE ACCIEPTED FIRE REVIEWED BY DATE F17TAIN Lu z z 6 z W UJI It M VARIANCE OR CU SHORELINE OR ADB# INSPECTION I BOND REO'D I I POSTED [1YES ONO IS SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , I , LOT COVERAGE REQUIRED SETBACKS (IT) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REAR E3 z 2 z PARKING LOT AREA PLANNING REVIEWED 13Y DATE n REO'D I PROVIDED I i IL REMARKS CHECKED BY ITYPE GROUP C SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [] YES LOAD REMARKS z PROGRESS INSPECTIONS PER UBC 1 08/FINAL INSPECTION REO'D i] VALUATION Description Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Fire Inspection Landscapelnsp. Recording Fee I CALL FOR INSPECTION (425) 771-0220 ATT8NTION ,!�l EXT 1333 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 FEE Description State Surcharge City Surcharge Base Fee FEE Plan Chk. Deposit Receipt # Total Amt. Due Receipt # APPLICATION APPROVAI Thih application is not a pernill until signed by the Building Official or his/her Deputy. and Fees are paid, and receipt is acknowiLdged in space provided. C S SIGNAIU� I AIE I � �j ? 71, �ItASFD BY ---L-DATE I 09,03 PRESS HARD -YOU ARE MAKING 4 COPIES OHIGINAIL. FILE YELLOW INSPECTOR PINK OWNEII GOLD ASSESSOR n M z 0 i 0 M --i -n 0 M C M 0 0 C) 0C I K :E M M Z g:) --I CE rj) 0 -n MIT! 0 0 0 M Cf) Cn M 0 Z z Cn z 0 1 0 M I I bOF INSPECTIONS RE9011 INSPECTOR DATE APPROVED ..................... FOUNDATION: Footing...................... Wall .......................... Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground ............. Rough -In ................... Commercial Final ...... HEATING: Gas Test .................... Ll s Gas Piping ................. Equipment ................. 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 .................. 2— "f evn 14, - z 0 1 0 M --I -n 0 M C M 0 0 0 0 C M M Z r') --i C Cn 0 -n _n --I M M M 0 0 M C (1) 9 0) Q 0 Z z —4 M W z 0 0 M DATE RECEIVED .--7 A,9 (e /o CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS MAILING ADDRESS 1043 Bell St CITY Edmonds ZIP E&NNNNO 900 NAME ADDRESS CITY ZIP NAME TELEPHONE TELEPHONE CEIL ils USE ZONE JOB ADDRESS 1 1! , - -, 7 PERMIT EXPIRES PERMIT NUMBER t SUITE/APT# 1043 Bell St PLAT NAME/SUBDIVISION NO LOT NO. LID NO. LID FEE S TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Rriquirad Street Use Permit Roq'd EXISTING - PROPOSED inspection Required Sidewalk Required RE Fr underground QuIRE 1-1 ... ,red MEJuiadd MtUEthl requiredRES Y PtREQUIRED U ras NO 13 kRE - fibilLICbeROLIDRAI 4AGE OW nstalled on all hot water tanks. 1UPC 603 I ENGINEERING REVIEWED BY DATE cc Lu z z Fj z LU ADDRESS I 12601 132 Ave NE VVIIIIII 1711111TTeMors MqtbiAmd FIRE REVIFWER E� Oil luell urning lPlAiallces uj CITY TELEPHONE ZIP pRssing Kirkland 98034 4 25-814- 3124 throjilif, 11.14 VAF16.t��OFIt�U. WSHftLAPMb4A013I?@j INS��NOJIU.).Z IOND -mSTED STATE LICENSE NUMBER EXPIRATION DATE CHr r12 FASTWHC052DF 2-16-051 SEPA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. 00434204102600 EXP I , , r_1 NEW RESIDENTIAL PLUMBING/ MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT LIRSIDE REAR z COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE z z PARKING LOT AREA PLANNING REVIEWED BY DATE 15 113. REMODEL MULTIFAMILY SIGN REQ'D I PROVIDED GRADING FENCE REPAIR CYDS ( x FT) REMARKS DEMOLISH TANK OTHER GARAGE RETAINING WALL FIRE SPRINKLER FIRE ALARM CARPORT ROCKERY (TYPE OF USE. BUSINES&-U�CTIVITY) E4PLAIN: BY OCCUPANT (17) ICHECKED <ffA i LlLlh e ITYPE GROUP NUMBER OF NUMBER OF DWELLING CRITICAL AREAS SPECIAL INSPECTION OCCUPANT STORIES UNITS NUMBER REQUIRED [3 YES LOAD DESCRIBE WORK TO BE DONE _JAREA REMARKS z PROGRESS INSPECTIONS PER UBC 108/IBC109/IRC109 FINAL INSPECTION REQ'D REmove/replace gas watt=�r heater in garage 40,000 btuts VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit city Surcharge 45 PLAN CHECK NO: VESTED DATE Plumbing Base Fee 30 Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 9 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE J SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: IBODAYS IL PERMIT LIMIT: I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION U) '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 2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND Fire Inspection Recei pt # cc ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Total Amt. Due To a A DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Recording Fee Receipt # c I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT TIIE INFORMATION APPLICATION APPROVAL 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- TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL Building 011icial or histher Deputy and Fees 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 INSURANCE AND RCW 18,27. OFFICIALS SIGNATURE DAT E SIGNATURE (OWNER DATE SIGNED -z- (425) Or e, 771-0220 - DATE BY ATTENTION EXT 1333 ITIS UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTILAFINAL INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU- ORIGINAL FILE YELLOW INSPECTOR PANCY HAS BEEN GRANTED. UBC109/iBC110/IRC110. PINK - OWNER GOLD - ASSESSOR 09/03 PRESS HARD -YOU ARE MAKING 4 COPIES z 0 1 0 M -i -n Fn -4 0 M C M 0 0 --i (-) 0 J= M M Z 10--1 C 0 _T1 n -4 :C M M 0 V5 0 r- 0 M C cl) F, (n M C.) Z r- M z --I X 0) z 0 M i 0 q RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ...................... . FOUNDATION: Footing .............. ........ Wall .* ................ ....... Pier/Porch ........ ........ Retaining Wall .. ........ Slab Insulation .......... PLUMBING: Underground .... ........ Rough -In .......... ........ Commercial Fina ...... HEATING: Gas Test .......... ......... Gas Piping ....... ......... Equipment ....... .......... Commercial Fina ....... EXTERIOR SHEATHING NAILING .......................... FRAMING ........................ FIRST FLOOR FRA14ING ... INSULATION ......... ......... Floor Insulation ......... Wall Insulation ........... Ceiling Insulation ....... SHEETROCK NAILING ... SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL =OR 4_5 — 0 OCCUPANCY ....... .......... Z9 The Initials MT are WWI' ThotilpsOii, a temporary contract illspector for the CitY. z 0 i 0 M --i -n 0 M C IT! 0 0 C M M Z 0 _n n M M 0 0 0 M C cl) 9 (n ITI 0 Z > z C/) z 0 1 0 M