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20040497.pdfDATE RECEIVED 1L ZI [PERMITEXPIRES CITY OF EDMONDS USE PERMIT ZONE NUMBER,�_�QZ,�"Y 4- CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRESS OWNER NAME/NAME OF tSINESS L 7.0 � &J, 'L V �.k > PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE $ LCC u MAILING ADDRESS z 0 q PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP IFSCP Approved fjW Permit Required (3 --a EXISTING — PROPOSED " rl Street use Permit Hort'd E3 inspection I-loquired [3 Sidewalk Required E3 CITY ZIP TELEPHONE 1 .25-- 7 ?Aj— REQUIRED DEDICATION— FT underground Wiring required [3 NAME le%A� METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 13 13 z It e, 4 4 YES NO cc uj I= ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE z z z Obtain ul CITY ZIP TELEPHONE tic, 44.!r- q,5-1 P d4!qtr1cqj Pery-nit f== NAME CBLA �zqje A-i I , i?k Indushies cc ENGINEERIN"VQQ9D.5X..._ DATE ADDRESS 0 FIRE REVIEWED BY DATE Lu cc rz CITY 0 ZIP TELEPHONE rZ VARIANCE OR Cu SHORELINE OR ADBP I I INSPECTION REO'D BOND POSTED IS STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY DYES ONO SEPA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. 6 b & 0 00Z) Z�,7 6*7 , , EXP NEW RESIDENTIAL PLUMBING 69 LOT COVERAGE REQUIRED SETBACKS FT) PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR COMPLIANCE OR [T'ADDITION COMMERCIAL CHANGE OF USE z PARKING REO'D ROVIDED LOT AREA PLANNING REVIEWED BY DATE E�REMODEL 1:1 MULTIFAMILY SIGN 5 I REPAIR GR�= FENCE CYDS ( — X FT) REMARKS AypL' mlinecturs E] DEMOLISH E] TANK El OTHER r-eqtdr-ed fuel sit bumingappHallacmfu GARAGE RETAINING WALL FIRE SPRINKLER 11 CARPORT ED tinhainted sillarps- TIMC 815 j__:7 z ROCKERY FIRE ALARM L r _j (TYPE OF USE. INESS OR APTIVITY) JXPLAIN' cc 0 71-L CHECKED BY TYPE.OF CONSTRUCTION C70P OCCUPANT GROUP NUMBER NUMBER OF CRITICAL U) Lu a 3 SPECIAL INSPECTi6N* REA OCCUPANT In OF DWELLING AREAS 0 STORIES UNITS NUMBER REQUIRED [:] YES r LOAD DESCRIBE WORK TO BE DONE REMARKS z PROGRESS INSPECTIONS PER UBC 108/IBC109/IRC109 FINALINSPECTION REQ'D F3 WO�I_AAI� L.L_AA�r CILA-1— I. —I GAS NPE lur musir-ut OBSERVED Ot f,1TY 1NSPE1"Tftrr--- L; Uh '&7,Z � C' 0-1 2b� VALUATION AFFIDAVIT3 SHAtt NOT P /11 ��r — $ BE WEPTED Description FEE Description FEE Plan Check State Surcharge JEAT SOUR q4AZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: 9 VESTED DATE Plumbing Base Fee . Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review IM Lu PERMIT APPLICATION: 180 DAYS ..... PERMIT LIMIT: 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 Lu _j 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 W 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 Landscape Insp. DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Total Amt. Due X0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # I /f- I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION GIVEN IS CORRECT., AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- I his application is not a permit until signed by the CALL 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 CODEDF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION r ipt is acknowledged in space provided. WORKMEN'S COY; INSUR�ACE AND RCW 18.27. ,Te�TION U__ 0 FI A� SIGN URE D E, E WNEFI�>A A I DATE (425) 1?�) I T sIZD54;� S? R t I I I V, P 771-0220 RE LFASED BY - ATE - ATTENTION E)ff 1333� IT IS UNLAWFULTO USE OR OCCUPYA BUILDING OR STRUCTURE UNTILAFINAL INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU- ORIGINAL - FILE YELLOW. INSPECTOR FANCY HAS BEEN GRANTED. UBC109/IBC110/[RC110. PINK - OWNER GOLD - ASSESSOR 09/03 PRESS HARD -YOU ARE MAKING 4 COPIES z 0 1 0 M --i -n Cn M M 0 0 0 C: M M Z C) 4 _z 0 -n n M M 0 Fn 0 r- 0 M M Z z z 0 1 0 M RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION'. .,Footing ........ Wall ....... ..... Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground ............. Rough -In ................... Commercial Final ...... HEATING: ',;at% as s .................... Gas Piping ................. Equipment................. Commercial Final ....... EXTERIOR SHEATHING NAILING .......................... FRAMING ........................ RRST�FPPOR FRAMING ... I.NSULATI ............... Floqr:.I�slgl hition ......... W01nsulation ........... Ceiling Insulation ....... SHEETROCK NAILING ... SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. oil The Initials MT are Milton Thompson, a Winporary contract inspector for the City. z 0 A 0 M —i -n C M M 0 0 -40 0 C M M Z C _z 0 _n n M M 0 0 0 M 0) C/) M 0 Z z C/) z 0 ITI