20040521.pdfI
EXPIRATION DATE
5. Z/ - CD6—
PROPERTY TAX ACCOUNT PARCEL NO.
NEW
RESIDENTIAL
_��COMMERCIAL
ADDITION
��REMODEL
M
MULTIFAMILY
REPAIR
0
GRADING CYDS
DEMOLISH
TANK
GARAGE
CARPORT
RETAININGWALL
ROCKERY
(TYPE OF USE.. BUSINESS OR ACTIVITY) EXPLAIN
- /47C/on
%/PL.UM ZING ME7CH
COMPLIANCE OR
CHANGE OF USE
SIGN
FENCE
( X FT)
OTHER
EFIRE SPRINKLER
I FIRE ALARM
__'__F`NUMBER 0 CRITICAL
NUMBER Iv F A
OF DWELLING N
STORIES UNITS u M tw_rh�
DESCRIBE WORK TO BE DONE
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ADDRESS
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PLAT NAMEISUBDIVISION NO.
PERMIT EXPIRES 4g�
PERMIT
NILIMBER-�,�,_�)
SUITEIAPT#
LID NO.
LID FEE $
TESCP Approved
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP it E3
"W Permit Rriqu:�CR"q'
Sir,,, us, Perm d [3
EXISTING - PROPOSED In "Oqul'ed E3
E3
d1.3 14,qw1d
Underground
REQUIRED DEDICAIION_ FT Wiring required 13
S PRV REQUIRED
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YES 13 1 FE
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REMARKS
OWNERICON1RACIOR RESPONSIBLE FOR EROSION CONTROL/DRAINILAGE
LU
ENGINEERING
HEAT SOURCE GLAZING LOT SLOPE %
VESTED DATE
PLAN CHECK NO:
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' 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
;APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
N INTERE�T- %GREES 10 INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON. ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
ALI. 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
NOR LIMIT IN ANY WAY THE C11YS ABILITY 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 EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASIIINGTON RELATING TO
WORKMEN'S COMPENSATION I lySU,RANCE AND RCW 18.27.
Sl��.URE (OWNER 0 /A' N DATE SIGNED
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DATE RECEIVE
L 7
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS
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MAILING ADDRESS
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CITY ZIP TELEPHONE
DRESS
CITY
911
TELEPHONE
NAME CBL # Y ,
ADDRESS
.4 F PO—
��EPHONE
CITY z;I �P TELEPHONE
STATE LICENSE NUMBER
Fri
DATE
FIRE REVIEWED BY
DATE
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VARIANCE OR CU
SHORELINE OR ADB#
ON
T"
'NSREO
BOND
POSTED
6D 0
OYES N
S
E
SLIE�Pf � RE V�I � W
__T�
Co P ETE EXEMPT
SIGN AREA HEIGHT
ALLOWE D PROPOSED ALLOWED PROPOSED
EXP
LOT COVERAGE
REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT)
ALLOWED PROPOSED
FRONT SIDE REAR FRONT UR SIDE REAR
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PARKING
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LOT AREA
PLANNING REVIEWED BY DATE
9L
REO'D
I PROVIDED
REMARKS
OCCUPANT
TYPE QF 3TFIUCTION co i�
�HECKED BY GROUP
SPECIAL INSPECTION JAREA OCCUPANT
REQUIRED C] YES I I ) LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D
VALUATION
Description
Plan Check
B ilding Permit
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
FEEd Description FEE
State Surcharge
rg
1?4? Ircha #e
City Surcharge
Base Fee
Fire Review Plan Chk. Deposit
Fire Inspection Receipt #
Landscapeinsp. Total Amt. Due
Recording Fee Receipt 0
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�PPLICATION APPROVAL
This application is not a permit until signed by the
CALL Building official or his/her Deputy: and Fees are paid, and
receipt is acknowledged in space provided.
FOR INSPECTION
(425) GN T(I E DATE
t
_Al� �("/p V
771-0220 REL BED BY /bATE
I=Vlr -1 *12,201
(AT-1 t: I I U
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
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
- 1 1 1 �� . , V - //
ORIGINAL - FILE YELI-OkINSP&O
PINK -OWNER GOLD -ASSESSOR
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MAY-11-2004 14:06
P.03/03
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For BuOding DOPAMM"
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Appkarg Ad*v" /,);�J
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I pmiect Description
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syo*m Ana"&
on
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teration Exceptions
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L3 L,,,= U= W% of ew tiftma am rww, md lrzWW 10tng Mftgs 18 r0t bfkV Vxmawd
Ma)dmum Allowed
Lighting Watta e (Interior)
Allomd
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aempancy 00=rWW
watts per fe
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Tabis 16-1 (OVO - ;;&I WWAPMU twm from *X*XA"
T0WAJW*WWatt$
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Proposed attalze (Interior) (KW not mmd TOW Nm*d Wa"m 'or lnmdm)
Lighting W
Waft
Cn
NuW6ff Of
watw
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Fbaure DowdPOW
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TqW propowd WgtW ff*y ;R—exomd TOW AJkrwod Walb for InUKW
TCtmJ Pmpowd Waft
X
maldmum Allowed Lighting Wattage (Exterior)
AkrAmd Waft
Am& In f?
AJkmed Waft
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per fe of pw U
(or if for
X fe (or X
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025 We
0
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facRdO w" or uw pqdffwgar meu,40 btft not
'roW AJbwed Wottal
tW bulurtg wwor. moQm
pro osed Li ting Wattaae (Exterior) PAay rKd mmoad ToW Alawad Waft for EAwkx)
W*ft
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TotW Propoead We= nW roW waft Rw morw
4. 1 P
ToW PmP0@Qd
RECEIVED
TOTAL-
P. 03
MAY 13 20N
11. YL
PERMIT
COUNTER
MAY-11-2004 15:01 P.02/02
Fteeaij!gve SI!aM 0=VWW W*Shouns. elorso w9ma, or Ak9aft Sbrap hWV@M cow
Qualification' Check -list Lv"Paam V" W* 0 at Woot W% of *&m In Vu Wow m*M 9 fox aftim.
RAW 0 =**WW b" 18 TOW Ord 66"
ww~ is co en mffrbw of bum In 1. Fbam am *wramort, rswAsr*94 wM Q* orw or tm kff4w, w4
tospawfAMMIN WCOCIC CWWV 2. UuMis am T-11, TA T-8 W PL., MW ' t Lwr4* arm 5-aO Wafta, wW
Wasts own Spam W PWM If M
"Ofied, W LPA Ch*gw& 4. Sakoft am Woabu* bWkft
Table 15-1 Unit Lighting -Powek Allowance (LPA) for Interior Lighting
UW
U00
LW
(Wft*i
pe %,cps
2.3
M Im. wd fir* sfa�
1.2
Barber shcM tM�& Shaps
Hew
-.2-
2
LgbomWW
plarft
AWCrA rap* mKOPER
-2
1.5
P40ta
Cdewkwjae fow eatfly
1.6,
F!CILO� WofthMS, Nrw*V
1z.
Ralf a 12 , Fbftl te,!�M
calm, elatiom aub -t..6-9 - .
1.5
kwwhAbffl
1.5
UMW
1z
Aktn3ft 510=6 NK9M-
0.4
NeN hoi
1.5
M Will stogas (pWjo mck
1.5
Maq
1.4
PISM g2§VeM1!g Onh?
s&,c)ob lx&�35 whod g2tatan5 day cam cwftt-
1M
Cawnon &raa,,cordd0!!k bbbim (wypO Md 2M2LU�W
1.3
0S
Offte bukkiM W0WM*r*ftT0Aft MW In fKMW of
agm um " (kthMV but rd WTMd %7 KhOCIS
hoopkm* hft*xm�;mumo=vk bwft
Factnota few Tsble'11S.1
1. incgminwWchauselonotmendonWqxxiffcd S
�y, the Unft PawrAUawaxce shall be dctxmInW by the buildin offidal.This
doucu4nat1on sholl ba basad upon do =uost couipoxiMa coo 4odaw in the ubla, Sm SaAca 1512 ibr ezompt MML
7. Ut wms per squaw fDot mri beincressed, by two pm=t per foot ofodUPS WSW "m twenty feet, unlom qmdfic&Uy domw
odmviw by mbwp t footmotes.
3, Watts pce apm Ext of rocon rany ba Warvaecd by two poroent per floot of cciHnS hdSht.sibomro tvadva 6=L
4, FW all other spacem, such as, scating and commm mroms an ft Unk MShf P~AUmww* for antonbly.
5. Wam per squam amit of room may bo bxrcawd by two pm=t pie foot, ofoAft hdght above n1w bet.
6. Includca puW maw and c2nopy.
7. in cum in which a lighting plan Is mcbmittail for only 4L portion at a aocr, a tbit u&bdng Power Alkwance.of 1.3$ way be used for
amble offioe floor am mind 0.80 watts per squam foot &� be gad ft dw com ows, which mmy Lwluda clovator space, lo� om
and"rom Canwoo arous, an beiiin dcflaal do not Incla& xn�ll ouacoarsoC
a. For the.fire ou,04or.-it thip. UnIt Ughtin Power Allowmcc is 1.0 w persquaroftt.
9. For Woar oport WW== t cottit a with Rejament spectaw S. the Lhit Ughting Powa Alkwance for the court xm Is 2.6 Wain per
wpm 10CL
10. For both Rc%P A and RMH 11, Hot for fivo-standing c Employ, baUding showcase illumination and disoxy window iftnination I fteft'led
within two foct at tho wind(Yw am MwWL
Rmil A allmn a Unit Ugbting Power Allowan cc of 1.0 watts per nuare fi]CL Gelling, mountad 4"Nable tauptan balosce and RD
abachoodise disphy Illumirmuice arc c=mpt
pAuU B sUows a Uhit UghtinS Power Mowmcc of 1.5 wulb per jqu= fixjt,-jnclqdjng an coiling moantod worchandin df splay
huninarks.
ll.. Pmvided tbat a floor plan, Indicating rook locodon and height, Is subtuittod, the square foota furawarehmm"bodefinad-fir
oomVudnS do inWiyr_Vk4-Ughdn,PoW Allowance, so tho twos" (&com- side oWY)
%Any wthi� floor-orft'n WY
TOTAL P.02
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LCOATION MAP m
NORTH
RECEIVED
MAY 1 3 2004
'j".rj( (mopy PERMIT COUNTER
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
,,,-< FIRE DEPARTMENT DATF//
FROM: ---------- 1� - � � �
PLEASE SIGN
ENGINEERING DIVISION DATE,
PLEASE SIGN
PLANNING DIVISION DATE
PLEASE SIGN
PROJECT
V P
SITE ADDRESS I �
PERMIT ADB# -DATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED
A field inspection was conducted to determine compliance with - app . roved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
_2LGRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
0 Copy of CONDITIONS given to owner/contractor by inspector
I .
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0 Copy of CORRECTION NOTICE given to owner/contractor by inpector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:temp:b1dg:fonns:ocaprv1 3/25/04
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
ry)
Rough -In ...................
Commercial Final ......
HEATING:
Gas Test ....................
Gas Piping .................
E,,Ipm,nt
Commercial Final .......
EXTERIOR SHEATHING
NAILING..........................
4ji
FRAMING........................
SOL
FIRST FLOOR FRAMING ...
Ak INSULATION ...................
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
C)
SHEETROCK NAILING ... 7
SPECIAL INSPECTION
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MISCELLANEOUS ..........
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1 0 FINAL APPROVAL FOR
4-- Cn �3
4- OCCUPANCY ................
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