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20040777.pdfU UJI Ix 4 DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER VAMEMAME OF BUSINESS Norm m MAILING ADDRESS CITY NAME I CITY I- cstt 1� 14 ZIP TEL - EPHONE 1?0921�,14-Z 5 -7 71 ZIP I TELEPHONE NAME 5 t�, .. �_L �� .. C) L-10 CB )Vio cc 0 ADDRESS C"/�< V3 t .2 0 CITY ZIP TELEPHONE -79 U S ef-2-'S 7 _5 77' STATE LICENSE NUMBER EXPIIJATION DATE 0-CN� - 0 �� V( Rj PROPERTY TAX ACCOUNT PARCEL NO. NEW RESIDENTIAL PLUMBING if MECH ADDITION COMMERCIAL OMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY SIGN REPAIR GRADING FENCE CYDS E] ( x FT) DEMOLISH TANK E3 OTHER oGARAGE CARPORT RETAINING WALL FIRE SPRINKLER ROCKERY FIRE ALARM :-- r L (TYPE OF USE, BUSINESS Pq ACTIVITY) EXPLAIN: NUMBER NUM ER fog _JCRITICAL '0 OF [DWELLING AREAS STORIES U UNITS t 4UMBER DESCRI13E WORK TO BE DONE Re plum tIi k 4ela, L'c±' jA)Ae,,,' f14 . -?,, __s 119 ) n ]DIC11- I I �T - HEAT SOURCE I GLAZING % PLAN CHECK NO: LOT SLOPE % 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: 180DAYS PERMIT LIMIT' I 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 IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF 1HIS PERMIT SHALL NOT HE DEEMED TO MODIFX WAIVE OR REDUCE ANY REOUIHEMENI'OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS 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 WASHINGTON RELATING TO WORKMEN'S CU*ENSATION INSURANRE AND RCW IB 27. SIGNATVRq((6yfNEh)OR *Eq) / �` I DATE $IGNED / PERMIT EXPIRES ,�71,1 USE PERMIT ZONE NUMBE� 7 eOZ JOB SUITEIAPT# ADDRESS -6a PLAT NAME/SUBDIVISION NO, LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP I ESCP Approved RW Permit Required street Use Permit Roq'd (3 EXISTING - PROPOSED Inspection nequired 13 Sidewalk Required 0 REQUIRED DEDICATION- FT Underground Wiring required E3 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES No z REMARKS z z OWNER/CONIRACTOR RESPONSIBLE FOR EROSION CONTROIL/DRAINAGE E5 PIMSUANT TO UPC 008 z UJI 11iEWATERS11UTOFF ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE U1 a: rL VARIANCE OR CU HORELINE OR ADBO I INSPECTION BOND REO'D PC OISTED 10YES ONO s SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED OPOSED PR_ EXP I , I LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR z z PARKING LOT AREA I PLANNING REVIEWED BY DATE 5 REO'D I PROVIDED (L REMARKS CHECKED BY ITYPE 114 G SPECIAL INSPECTION OCCUPANT REQUIRED F] YE JAREA LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/ IBC109/ IRC109 FINAL INSPECTION REQ'D z 5 110SE VALUATION Description Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Fire Inspection Landscapelnsp. Recording Fee CALL FOR INSPECTION (425) 771-0220 A17ENTION EXT 1333 ITIS UNLAWFULTO USE OR OCCUPYA BUILDING OR STRUCTURE UNTI LA FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU- PANCY HAS BEEN GRANTED. UBC109/[BC110/IRC110. FEE HAVE A ly Description FEE State Surcharge City Surcharge h Base Fee Plan Chk. Deposit Receipt # Total Amt. Due Receipt # APPLICATION APPR&_A_L_� This application is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid, and 09/03 PRESS HARD -YOU ARE MAKING 4 COPIES TE ORIGINAL - FILE YELLOW. INSPECTOR PINK - OWNER GOLD - ASSESSOR z 0 1 0 M 11 -n 0 M C M 0 0 0 0 C: M M Z n, -' C _z to -n n M M 0 6) 0 r- 0 M C Cn 911:1) M 0 Z z Cl) 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: Gas Test .................... Gas Piping ................. Equipment................. Commercial Final ....... EXTERIOR SHEATHING NAILING .......................... FRAMING ........................ ,y,,FtR$T. RLOP 31 NG ... v"T.- . I 1 1, INS ................... Floor Insulation ......... Wall Insulation ........... Ceiling Insulation ....... SHEETROCK NAILING ... SPECIAL INSPECTION MISCELLANEOUS .......... FINAL APPROVAL FOR C) OCCUPANCY .................. S- // - CJS ZW q4a,,L0 7 7 7 voo' z 0 4 0 M --I -n M 0 —40 0 M M z C o -n MITI 0 0 M C Cn Cn M 0 Z > z —1 V) z 0 1 0 M !I M