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20050333.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION ,ruw"ER NIVEINAME.QF B I - RIO zt C (0 U N S �0 A-, M CtILING ADDRESS 4 4) CITY ZIP ITELEORdNE =A AE ADDRESS ZIP ITELEPHONE NK)S6 C t 6llitZ4 AQDRESS lk L^ CITY EPHONE CBLN RWXAAX��& ! O�M 10!� ,j I I PERMIT EXPIRES U U1 J�D_ OERMIT NUMBER JOB ADDRESS J , t i --;q I kl*- P I SUITEIAPT# __ PLAT NAMEISUBDIVISION NO. LOT NO. LID NO I LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required E3 E3 EXISTING- PROPOSED Street use Permit Req�ired Inspection Required E3 Q Sidewalk Required E3 E3 REQUIRED DEDICATION FT Underground Mold required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I 1 YESM NOO z 0: W REMARKS W OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE z W ENGINEERING FIRE REVIEWED BY BY DATE DATE Uj LL STATE LICENSE NUMBER I - EXPIRATION DATE BY VARIANCE OR CU SHORELINEORADBN INSPECTION REO'D SE PA COMPLETED EXEMPT I Aox)c�r 16Xb pnrrr Cl YES &0 L7- '5161,?zo CA# ZONE SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. WAIVER13 1 ALLOWED PROPOSED I ALLOWED PROPOSED 74%3oo JQQ, S.IaV4. 644)D__ STUDY 13 ::� �� NEW. RESIDENTIAL 1:1 PLUMBING MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE REAR PROPOSED SETBACKS (FT.) FRONT. LJRSIDE REAR ADDITION COMPLIANCE OR 11 z z MIXED USE CHANGE OF USE REMODEL (;� �LTIFA �,Ly 1:3 SIGN PARKIN G REO'D PROVIDED LOTAREA NNING REVIEWED BY DATE El REPAIR GRADING FENCE CYDS 13. X FT.) REMARKS DEMOLISH TANK f _ y O,T iHEP� _OOFL GARAGE RETAINING WALL FIRE SPRINKLER ED FIREALARM CARPORT ROCKERY E OF USE, Bust S OR ACTIVITY) EXPLAIN: TYPE OF CO OCCUPANT NSTRUr70N ROUP G r2 7 �UL W, Yo �v LU NUMBER NUMBER 0 1 ' OF DWELLING SPECIAL INSPECTION CONSULTANT OCCUPANT an UNITS LOAD 0 STORIES REQUIRED DESCRIBE WORK TO BE DONE RE KS d &0C6&e&41rK Ok T GEOTE E�m a BY: I 1A STRUCT �jl B Y: 1�41 71(6 VALUATI014 jy-4-) C, IP:53 A -M?, 0;z( 16) Wb_ 3D"/N_ 5v�rYAV5 V_^ j)e_5:;4 T23" Description FEE Description FEE 40 V1 -Alk, V1 btt� U4 Plan Check State Surcharge HEAT SOURCE LOTSLOPE% V�!JDATE Building Permit City Surcharge PLAN CHECK NO: Plumbing Base Fee THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK To Mechanical BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC Grading DONMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review cc PERMIT APPLICATION: SEE ECDC 19.00.01111 W 911. PERMIT LIMIT: SEE ECDC 19.00,005(A)(6) Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION lint OAPPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire Review Plan Chk. Deposit U) LU IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF _j 2 EDMONDS, ASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # 0: OR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY 4 ALL CLAIMS F x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE 0 CE LandscapeInsp. DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINAN Total Amt. Due NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF This application is not a permit until signed by the THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC_ CALL Building Official or his/her Deputy: and Fees are paid. and TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED receipt is acknowledged in space provided. IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION WORKMEN'S COMPENSATI RANCE AND RCW 18:27. IA S SIGIATU2 k DATE ;ATURE SIPVATURE (OWNER OR�k NT):. r ATE SIGINED (425) ir D/4E 771 m0220 [FRELEASED BY ATTENTION EXT. 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI, ORIGINAL - FILE YELLOW - INSPECTOR FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 I IBC110 / IRC110. PINK -OWNER GOLD ASSESSOR 10104 PRESS HARD - YOU ARE MAKING 4 COPIES z 0 4 0 M (n 0 rn C M 110 0 0 C rn M z K) —4 _z Cn o -n n rn rn oi- 0 rn C Cn C cn rn 0 .z X z Cn z 0, A 0 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 ........................ FIRST FLOOR FRAMING... INSULATION ................... Floor Insulation ......... Wall Insulation ........... Ceiling Insulation ....... SHEETROCK NAILING ... SPECIAL INSPECTION ... Ro- rode C MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY VIA .................. f IV z 0 0 M =i:Tl