20040133.pdfa
DATE RECEIVED PERMIT EXPIRES
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US E PERMIT
CITY OF EDMONDS ZONE NUMBER
JOB SUITE/APT#
CONSTRUCTION PERMIT APPLICATION ADDRESS Tk �—j ll�()
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OWNER NAMEINAME OF BUSINESS 4,
AL"_ek 3, LLA — Thie PLAT NAMEISUBDIVISION NO. LOT NO. LID NO
U LID FEE S
MAILING ADDRESS I
TESCP Approved 0
'0 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required 13
6 Street Use Permit Req'd 0
CITY I P I E LE PH ON E EXISTING — PROPOSED inspection Required 0
Z Sidev,alk Requited C3
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0 REQUIRED DEDICATION Underground
wiring required E3
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NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
YES 0 NO 13
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OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE
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FIRE REVIEWED BY DATE w
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VARIANCE OR Cu SHORELINE OR ADBN INSPECTION BOND
STATE LlIbENSE NUMBER EXPIRATION DATE CHECKED BY 461-0-13 POSTED
10YES'" ONO $
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PROPERTY TAX )Pff
COMPLETE , EXEMPT ALLOWED , PROPOSED ALLOWED , PROPOSE
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LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (IT)
NEW RESIDENTIAL PLUMBING ir MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR 0
COMMERCIAL COMPLIANCE OR 0 4 z
ADDITION z
CHANGE OF USE z
PARKING LOT AREA PLANNING REVIEWED BY DATE 1
El REMODEL MULTIFAMILY SIGN REQ'D I PROVIDED t5.1 (30 (L
GRADING FENCE I i I ;?2t 7/0+
REPAIR F-1 CYDS 0( .--- X—Fr) REMARKS k k*Q-,
DEMOLISH TANK 1:1 OTHER V
GARAGE RETAINING WALL FIRE SPRINKLER
CARPORT E] ROCKERY 1:1 FIRE ALARM
(TYPE OF USE, BUSINESS OB ACTIVITY) EXPLAIN: CH CKED I BY TY FC T UCTION OCCUPANT
if 51? GROUP
ul NUMBER NUMBER OF CRITICAL �Ikl'IPIR
a OF DWELLING AREAS SPECIAL INSPECTION JAREA OCCUPANT
M UNITS NUMBE LOAD
0 STORIES R REQUIRED
DESCRIBE WORK TO BE DONE
REMARKS
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PROGRESS INSPECTIONS PER UBC 108/FINA
VALUATION
Description FEE Description FEE
Plan Check State Surcharge
URCE GLAZING % LOT SLOPE % Building Permit City Surcharge
CK NO: VESTED DATE Plumbing Base Fee
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
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: 180DAYS
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PERMIT LIMIT: I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
U) Fire Review Plan Chk. Deposit
Cn 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
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 Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTIN OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF I HIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due
x 0 Non LIMIT IN ANY WAY THE CITYS ABlH1Y 10 ENFORCE ANY ORDINANCE PROVISION." Recording Fee Receipt N
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAI` I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPRO L
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application is not a permit until signe! he
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 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 2T
OFFI S SIGNA URE DATE
SIGNATURE WNEn,6R AGENT) DATE SIG ED
(425) &AXW
-71 "\,z, � , � & HE[- ED BY I DATV
771-0220
ATTENTION EF 1333
L 47411 �?/A
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTI w') k,11-2
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - INSPECTOR/_7
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR
09/03 PRESS HARD -YOU A AK619 4 COPIES
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
PLEASE SIGN
ENGINEERING DIVISION DATE
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PLANNING DIVISION DATE__!/z /':1 _+
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DESCRIPTION OF WORK TO BE INSPECTED
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A field inspection was conducted to determine final compliance with approved plans. Final approval
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denotes that there are no objections from the above signed Department to. the release of
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PERFORMANCE BONDS and the granting of:
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V11 GIANT FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0 Copy of CORRECTION NOTICE given to owner/contractor by inspector
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RE -INSPEC TED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Si
ocaprvl.doc.l:temp:bldg:fonnsIO/OI
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -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 ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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