20050226.pdfDATE RECEIVED ERMIT EXPIRES
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U6E PERMIT
ZONE IF 2
CITY OF EDMONDS MBEF
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CONSTRUCTION PERMIT APPLICATION JOB e
ADDRESS !-.-7 SUITE/APT#
OWNER NAME/NAME OF BUSINESS I I t - 1 2 q- - 7.
i� U --J� 6,) v�4 6 PLAT NAME/SUBDI VISION NO. OT NO. LID NO.
LCC ILING ADDRESS LID FEE S
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z TESCIR Approvad 13
a 2- ktc-j- 4-U(7 lIU13LIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Flocluned 13
stloot use Permit Roq.d E3
TY ZIP TELEPHONE EXISTING PROPOSED Inspection Requited E3
�� L1 sidewalk Roquired 13
C Ifo ?7�_S3/5 REQUIRED DEDICATION- FT UndnFUTOUnd 13
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RES PRV REQUIRED
NAME P All' METER SIZE LINE SIZE YES NO 1:1
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t= ADDRESS REMARKS
L) OWN E R/CON TRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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NAME CBL#
EN I EERING REVIEWED BY DATE
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CITY ZIP TEL EPHONE
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EORCU SHORELINE OR ADBO INSPECTION BOND
STATE LICENSE NUMBER EXPIRATION DATE ct D BY VARIANC REO'D POSTED
OYES ��O S
C__JC 0 1 tN�U� 4 SEPA REVIEW SIGN AREA HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
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NEW RESIDENTIAL LUMBING MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.)
'Pt ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR i
COMPLIANCE OR 30
ADDITION COMMERCIAL
CHANGE OF USE
REMODEL MULTIFAMILY PARKING I LOT . AREA PLANNING REVIEWED BY DATE,/
1:1 SIGN REQ'D PROVIDED
Ei FENCE 1-7 LO q
REPAIR I
CYDS X FI) REMARKS
OTHER
DEMOLISH TANK 13
GARAGE RETAINING WALL E] FIRE SPRINKLER
CARPORT ROCKERY FIRE ALARM
(TYPE OF USE. BUSIN SS OR ACTIVITY) EXPI 'AIN:
CHECKED BY TYPE OV6STRUCTION CODE OCCUPANT
GROUP
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uj NUMBER NUMBER OF CRITICAL (A)j
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OF DWELLING AR SPECIAL INSPE JAREA OCCUPANT
LOAD
0 STORIES UNITS NU �Z3 REQUIRED [] YES 0 kjQV
DESCRIBE WORK TO BE DONE �k
REMARKS
PROGRESS INSPECTIONS PER UBC 108/171NAL INSPECTION REO'D
MPE vi,7�
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1�1 f-�K r8f P_t, Aldy Description FEE Description FEE
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Plan Check urcharge Z_
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HE . SOURCE' GLAZING % Building Permit City Surcharge
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PLAN CHECK NO' VESTED DATE Plumbing Base Fee
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.21 Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 62 0,
1= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
9 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading
SEPARATE PERMISSION.
Engr. Review
W PERMIT APPLICATION: ISO DAYS
Q. PERMIT LIMIT: I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
OAPPLICANT, 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 Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY 7 7
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY� WAIVE OR REDUCE ANY REQUIREMENTOF ANY CITY ORDINANCE Landscapelnsp. TotalAmt.Due
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NOR LIMIT IN ANY WAY THECITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
i Recording Fee Receipt #
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 APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONs'TRUC_ 'This application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTI IORIZED TI IEREDY, NO PERSON WILL BE EMPLOYED CALL 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 90PNSATION INSURANCE AND RCW 18 27. 0 FICIA1,S SIGNATURE , DATE
5 1 20 �NAIU R . E A)WNEn �n AGENT) PATEXN� (4251
Lmm 771-022V 1IF1 11
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ATTENTrON EXT 1333
IT IS UNLAWFUL TO USE Oil OCCUPY A BUILDING Oil STRUCTUIIE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL Oil A CEIITIFI-
(3ATE OF OCCUPANCY HAS BEEN GIIANTED. UBC SECTION 109
09 03 PRESS HARD -YOU ARE MAKING 4 COPIES
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011;GIIJAI. FILE YELLOW -INSPICTO
PINK OWNEH GOLD - ASSESSOR
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Sound/noise originating frc-n temporary construction sites as a result
of construction activity are exempt from the noise limits of ECC Chapter
5.30 only during the hours of 7:00 am to 6:00 prn on weekdays and
PERMIT#: UO 5
1.0:00 am to 6:00 pm on Saturdays, excluding Sundays and Federal
holidays. At all other times the noise originating from construction EXPIRES:
sites/activities must comply with the noise limits of Chapter 5.30, unless
a variance has been granted pursuant to ECC 5.30.120. ISSUED:
nc. 189'�
City of Edmonds
THIS CARD MUST BE POSTED ON SITE AND AVAILABLE TO THE INSPECTOR
Owner:_ \Ljef��b
Site Address: C�
Proiect: q UO
for P� Zone
Fletbacks
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Front 2,61
Rear: 15
"ide.
ide:
S 0 -7.5'
Height: 1
Variance #:
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Inspmfions
Approv
Notes
#1 ENGINEERING
MOBILIZATION AND EROSION CONTROL INSTALLATION MUST BE APPROVED PRIOR
TO COMMENCEMENT OF ADDITIONAL WORK.
(425) 771-0220 A326 Mobilization / Erosion Control
Tightline/Footing Connection
Detention/Storm Connection
Forms (sidewalk, driveway)
Water Service
:IRA
---------------------
- - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - -
- - - - - - - -
--- - - - - - - - - - - -- w - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - -
-------------------------
Permit # Side Sewer
Permit # Exist SS Lateral
Permit 9 Right -of -Way (s(w, c/g, paving)
—
Permit 9 Grease Interceptor
#2 SITEMEMOLITION Pre -Demolition
Asbestos PSCAA Permit
AVB Water
Sewer Cap
Cleaned Site/Final
- - - - - - - - - - - - --- - - - - - - - - - - -
- - - --- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - -
#3 FOUNDATION Setbacks
Footings
Foundation Wall
Piers
Re-
Slab Insulation
M- .0 a o UA-77X- 0J9P-.Su& ---
Acidemc -------
- - - - - - - - - - -- - - - - - - - - - - - -
#4 PLUMING Ground Wok
Permit# yt&.M�� Rouph In
Other
-
-- - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - -- - - - - - - - - - - - - - - - - - --
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#5 PUBLIC WORKS Cross Connection Control
(425) 771-0235 Trash Enclosure
#6 MIECH/HVAC Gas Test/Pipe
Permit 91 Ncucf�o Equipment
fo —
- - - - - - -- - - - - - - - - - - - - -
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#7 FRANIHNG Exterior Sheathing
Shear Nailing
First Floor Framing
Framing
Height Check
ms
Lo- 0S
- - - - - - - - - - - - - - -
- - - - - -- - - - - - - - - - - - - - - - - - - -
-- - - - - - - - - - - -- - - - - - - - - - - - - -
#8 INSULATE CAULK Wall
Floor
Ceiling
- - - - - - - - - - - -- - - - - - --
(g,/& -05
#9 SHEETROCK NAIL
#10 FIRE INSPEC'TIONS Hydrant
(425) 771-0215 Fire Protection
Fire Detection
Add[Css & AjjQ
-- - - - - - - - - - - - - - - -
- - - - - - -
FINAL PROJECT APPROVALS *f
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in g 425-771-0220 x 1326
Planning 425-771-0220 x 1335
Fire 425-771-0215
FINAL OCCUPANCY APPROVAL***
k�PIBUILDING (425) 771-0220 x 1333
THIS BUILDING OR -ANY PQRTION THEREOF IS NOT TO BE OCCUPIED PER IRC 109 AND IBC 109 AND 11 OL
UNTIL ALL APPLICABLE CITY DEPARTMENTS KAVE RANTED A FINAL APPROVAL
Call (425) 771-0.220 x1333 for BUILDING INSPECTIONS
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FINAL PROJECT APPROYAL FORM
TO:
DATE:
ME7MOTO: PERMITCOORDINATOR, BUILDING DIVISION
FROINC. FIRE DEPARTMENT DATE
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ENGINEERING DIVISION DATE
PLEASE SIGN
PLANNING DIVISION DATE
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PIXASUSIGN
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PROJECT
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SITE ADDRESS— 4 2
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PERMIT 9 ADB# DATE INSPECTED e
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DESCRIPTION OF WORK TO BE INSPECTED
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A field inspection was conducted to determine compliance �vith -approved plans. Final approval
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denotes that there are no objections from the above signed Department ..to the release of
PERFORMANCE BONDS and'the granting of:
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GRANT FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL WITH CONDITIONS. NOTED -
0 Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0
0 Copy or CORRECTION NOTICE given to owner/contractor by.i npector
2.
3.
RE -INSPECTED OUTSTANDING.fSSUES - GRANT FINAL PROJECT APPROVAL.
Date Signature
1:.tetnp:b1dg:fonns:ocaprv1 3/25/04