20050492.pdfDATE RECEIVED — -----
MIT EXPIRES
45/�, k FRE R IV
CITY OF EDMONDS NUMBER 24T
CONSTRUCTION PERMIT APPLICATION JOB
OWNER NAME/NAME OF BUSINESS ADDRESS
SUITEIAPT#
`F .4 0 Q_ �4 K
PLA1 NAME/SUBDIVISION NO.
LOT NO.
LI NO.
LID FEES
MAILING ADDRESS
7,05 q 6 4 1) -
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING PROPOSED
REQUIRED DEDICATION FT
TESCPApproved
RW Permit Required
Street Use Permit Required
inspection Required
Sidewalk Required
Underground
wiring required
CITY ZIP
Ebr�ot,�os Topzzl
TELEPHONE
IL/ Lj 55-1
NAME
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
NAME i . I CBL
eri�<A_Got_� 1 (7
ADDRESS
,51(,l NE 0607"' 5-ro
CITY ZIP I TELEPHONE
1�-f4qrloie,L '7002,8j20(o-77F-(D10?
STATE LICENSE NUMBER EXPIRATION DATE BY
P-Ang jo� 6 b X 14 7- 2-q- 0 IST)
PROPERTY TAX ACCOUNT PARCEL NO
NEW ER RESIDENTIAL
ADDITION COMMERCIAL
MIXED USE
REMODEL MULTIFAMILY
1z
REPAIR G CYDS
DEMOLISH TANK
0 =�
CARPORT RETAIN114G WALL
jg��
ROCKERY
P
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
1,\ E t> E_ N -Ft -4:4-
NUMBER NUMBER OF
OF DWELLING
STORIES UNITS
DESCRIBE WORK TO BE DONE
PLUMBING if MECH
COMPLIANCE OR
CHANGE OF USE
SIGN
FENCE
( x FT.)
OTHER
FIRE SPRINKLER
FIRE ALARM
YES 13 NO [3
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
2f Q
Ve(,,Tj ('fr) 4�p OS 10 tj (,�D 41
A/A
I U !:,�
ENGINEERING REVIEWED BY
FIRE REVIEWED BY
� 1
DATE
0
W
z
5
z
uj
LINE
VARIANCE OR CU
SHORELINE OR ADB#
I INSPECTIO
SEPA
A ak M "_�,
Aelm I . 1,11 1
REO D
COMPLETED
EXEMPT
A -pp v'94,11
AppeOV-A I I 113YES
0 NOI
I x
CA# —0 49
ZONE
SIGN AREA
HEIGHT
WAIVER 0
P� 5 S
ALLOWED PROPOSED
I
rz2cg
ALLOWED IMP6_92
1
STUDY 13
—
I —
7-51 1
14 qol
LOT COVERAGE
REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED
. FROUT SIDE REAR
FRONT LIRSIDE REAR
vr^ ) (e�Afia+
-41-90
1 t4 /.s
1-91 LEL
2QI,4,IAI (,),t
PARKING
LOTAREA
PLANNING REVIEWED BY DAT�
R 'D
EQ
PROVIDE[)
10
8 Lo G 0 -61 z3ft) 15.-
I
REMARKS
TYPE �JMIKTRUCTION I ()!�
I OCCUPANT
_PCONSULTANT GROUP
SPECIAL INSPECTION OCCUPANT
REQUIRED C I LOAD
REMARKS
o 1,-e
GEOTECH REPORT
BY:
E t
STRUCTURAL,DES G
BY: I Y_ PE_*2CL6zk
C L 0 S E C,± e— #0 0
VALUATION
$ e�57 & &
pz"", 0
RLL126 ckrm I �J(—, I N- in
es
D cription
FEE
Description
FEE
K U�' ez f �7 q, Um 0- yla)m
Plan Check
State Surcharge
HEAT SOURCE
CS
LOT S PE% VESTED DATE
7�
I — 1
Building Permit
6
Wog
City Surcharge
L
PLAN CHECK NO: � .
—ff) 0
Plumbing
Base Fee
_
O�
j
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Grading
Engr. Review
PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
PERMIT LIMIT: SEE ECDC 19.00.005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
M/I
,'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS
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 THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY's ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Fire Review
Plan Chk. Deposit
Fire Inspection
Receipt #
Landscapoinsp.,
Total Amt. Due
Recording Fee
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVEREAD 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 or THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENS INSURANCE AND RCW 18:27.
ln��
CALL
FOR INSPECTION
1_1�
APPLICATION APPROVAL
This application is riot a peifii,t until signol by the
Building Official or hisiflner Deputy and Fees are pald,ind
receipt isacknowlodged in space provided
--nFFIPi,tS SIGNATME DATE %
SIGNATURE (OWNER 0 AGENT DATE SIGNED (425)
771-0220 REL SI
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-
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / IBC110 I IRC110.
10104 PRESS HARD - YOU ARE MAKING 4 COPIES
u
I I Wul
ORIGINAL -FILE - YELLOW -INSPECTOR
PINK -OWNER - GOLD - ASSESSOR
W
0
z
V
z
0
q
0
M
-4 -n
C/)
M
M 0
10
0 C:
M
M Z
X
o -n
T1
_11
3:9
MM
0
0 M
C C/)
9 co
Q 0
Z r-
3:
z
0)
z
0
1
0
M
L)ES CRjp7-IOIV
PNE ACRES L07-pq.
7-14F WE 57-,qAL= NE �,- o,=
"E ',Sp_
7 �4 k+ -SEC- 25 -7WP. Z7
N-R-3 aw. t4. iNt5HOt4ISH
COUN7-Y
0 Nap,
JOSEPH CHRI.S71AN
2226s 9r0""'AV8.'W
PARCE4 544200/023ooa<
IMPERVIOU-5 5-UR.P.ACE
....,.C)'k'VtqER/CONTi3AC,'T(.'jR IS RESPONSIBLE -PROPOSED GARAGE SID4 13
r r
Ay +60 13
OR
PROPOSED o/z/vEw
EV W
P/WP405, .41.1<WAy /_99 jo
..........
L07. COVERAGE
()D
10 13' (15%).
QD
ADD GUTTERS/DOWNSPOUTS LOT AREA z
—AND SRASHBLOCKS
co a
0sa
0
m
L0.r 5'LOPE
-Ir CAI.XS
RESUB
YEIGI
um
. .... ......
-7 200 A= 9re. 75'
4 M
JUN
0
8-7 9 a .75' 0 C
ILDING DEPARTMENT
11Y-OF �DMONDF?— C
X M
M Z,
. ............... Av(� - c=2
q 7. z_ > --I
1c
co
0
N
3:
M M
05
AS NOTED 0-
APPR WEI, r
ZV_ 31, EERING 0 M
7 p c 0
Q 0
0 te Z r-
Datp
In
X
97
>
-)7-
%3
CD
z
0
YQE M
RELOCAT)a
j qzw 0 -F=MfA SXkS-T. IUMSOP
ocx)CX�o
(7,
MAY G BE
10 c
sVZW,0RjVgW
-S
0
1z 6M 0i I tj OAJ ND INSPECTION REQUIRED
0 PIZIVRTF, &,.M._ANH0Lr5
'6Cr . . ; ) I
F"'O' 1APPR.0ACY.:
0 rhLO Flag
APP LANNING n. Come
ROV D BY p
j2A 9r,��Ave.w, Setbacks Required Actual
W Front
Oro I:b /0 IF (r"ub) t415 Sides
Rear +
Other
Height
Z 3"
LLO
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
PLEASESIGN
�d_ENGMEERING DIVISION DATE
z
PLFASC SiGN
0
PLANNING DIVISION DATE
M
PLEASESIGN
PROJECT
=n
OM
C
SITE ADDRESS- 22.Z4
M 0
PERMIT 92(eVI ADB# DATEINSPECTED
0
0 C::
M
M Z
ID
DESCRIPTION OF WORK. TO BE INSPECTED
C z
A: field inspection was conducted to determine compliance with approved plans. Final appioval
U;
denotes that there Are no objections from the above signed Department to the release of
0 -n
-n
PERFORMANCE BONDS and the granting of:
MM
0 Fn
GRANT FINAL PROJECT APPROVAL
0
OM
C
Q.()
Z r
GRANT. PROJECT APPROVAL WITH CONDITIONS NOTED
z
�0 Copy of CONDITIONS given to owner/contractor by inspector
Cn
z
0
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
M
0 Copy of CORRECTION NOTICE given to owner/contractor by inpector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signatitre
1:1einptb1dg:fomv;:ocaprv1 3/25/04