20060305.pdfD"BIECEIIED
I PERMIT
EXPIRES
CITY OF EDMONDS
UkE
ZOH
PERMIT
NUMBER 01"_ __006
10.
SUTTEIAPT-
CONSTRUCTION PERMIT APPLICATION
ADDRESS
OWNER EBB
FLAT A.SI�LSGIIIII.N NO
LOT K..
110 NO. I
Z�
FEE I
MAILING ADDRESS
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING
_U.
WIl'ARI—Le u
Z Fl 0
s"ss' ", R_
P�
0
Xs'00 0
C
GHY ZIP
ITILIPH011
REOUIRED DEDICATION
IT
METER SIZE
LINE Sll�
NO. OF FIXTURES
PRV REQUIRED
I
YES NO
11
ADDRESS
REMARKS
OWNERICONTRACTOR RESPONSIBLE
FOR EROSION COAT OUDRAINAGE
NAN,-
ADDRESS
) �F4
EA.IN;J'G RE VIEWEDIDATE
FIRE REVIEWED BY DATE
CITY ZIP
�%" V__�
TELEPHONE
VARIANCE OR CU
HORELINEORADB.
INSPECTION
I 'IOND
O'TED
STATE LICENSE NUMBER EXPI.All.NDATE
-
IBY
ES
OYREG;(�.
$EPA REVIEW
SIGN AREA
(�nA
EIGHT
PROPERTYTAX ACCOU P EL NO. _o/ 0&
06 9
COMPLETE EXEMPT
EXP 1 )�
ALL C
S C,
Vft I PF�po�
0 NEW
0
LO COVERAGE
ALLOWED PRO POSED
REQUIRED S8TBAC (
EFRO
'PROPOS D SETBACKS (FT.)
F80NT UPSIDE REAR
c4iA -0 ( 6— -Y
0 ADDITION
COMMERCIAL
OMPLIANG F
0 CHANGE OF USE
14
4,
REMODEL
A-FTMENT..
0 SIGN
HE PARKING I
LITAREA
I PLANNING REVIEWE?BY, _,DATE
REPAIR GRADING ,,,
n FENCE
X IT�
[3 DEMOLISH C] TANK
C3 OTHER
c3GARAGE RETAINING WALL
CARPORT QGKIERY
[3 RENEWAL
�7LAI
(TYPE 0�;)�F�7 p�T/V
17
Ir
OHICK108Y
IT GO up
ROU PT_
I co&31 0 c Z_
NUMBER
I NUMBER 0 F
DWELLIN
ITICAL
A EAS
1
SPECIAL INSPECT
OCCUPANT
OF
STORIES
UNITS
NUMBER
SECURE 1) c] YES
LOAD
DE:�IBE WORK TOa:;;E%6jiok
64mll
-A-5;
GRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'l
K'2�46 z&-wAk*To 19
VALUATION I FEE
z
0
4
35
V; -4
a m
C: m
M 0
0
0
c
m
m z
jo
0
n
m m
0
0
0 M
C ri)
C rw
M 0
Z
74
;u
z
4� J 71LAKAW
X4911
PLAN CHECK FEE
-3-0-
,
HEAT SOURCE
LOT SLOPE %
BUILDING
z
E
F.EG.ANIGAL�E
9
PLAN CHECK N
DATE
PLUMBING
IQ 10
IVIESTE.
"V)
0
I m
THISPEAMITAUTHO IZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
U
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE P BUD
GRADINGIFILL
B
OMAIN (CURDS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL RED IRE
SEPARATE PERMISSION.
loo
Z RMITAPPLICATI N: TOO DAYS
E
P. PERMIT LIMIT, I YEAR PROVIDED W RK IS STARTED WITHIN 180 DAY$
SEE BACK Oi PINK PERMITOOR MORE INFORMATION
A ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
;APPLICANT.
N MITE EST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF
AND AGENTS FROM ANYAND
2 EDMONDS, WASHINGTON, ITSOFFICIALS, MPLOYEES,
ALLC SFOR A AGESOFWHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
0
LAW tSCUA IT ALL
FROM THE NOE OF THIS PERMIT, ISSUANCE OF THIS PERM SH NOT BE
INSeEOXtOAL�E
PLAN CHECK DEPOSIT
RECEIFY
I
DEEMEDTOMODIFY' WAIVEORREOU EANYPEOUIREME�TOFANYCTYORDINANC5
0 NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
RECEIPT,;�n
ml
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT THE INPORMARON
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
ThIl ppl,es,e P po,llt 11fil 1,11d by t hO
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
PERSON WILL BE EMPLOYED
CALL
D'il de,g 011,111111 hillhll 01putY: end Fees I T eld
TtON; AND IN DOING THE WORK AUTHORIZED THEREBY. NO
IN VIOL; 0 HE L T STATE OF WASHINGT IN RELATING TO
e,��.P.
FOR INSPECTION eeeet is 1�kllllodgld .. spec. P_
WORKMEW ENSA D RCW 18.27
�W
OFFICIALS SIGNATURE DATE
SIG</
DATE SI.vG
(425)
In '-�' c, �c'
_�&., U
, , &
z zi f.
771-0220
'<
ELEASED By DATE I
A-ItENTION
EXT 333
2110 4
7
IT IS UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTIL
771-0221
L— '�
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE - YELLOW I.;PECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER � GOLD - ASSESSOR
0
Permit Inspection Details
Permit: BLD20060305
PERMITTRAX
05/24/2006 MS 30 APPROVED
y
Total Time: 30
Total Inspections: I
Total Time: 30
im
M
M
0
80
C
M M
10 4
0,
-n
rn M
0 17,
0
M 0
M
z
z
o
0
M
5128/2009 2:31:39 PM
Page I of I
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall
Pier/Porch ..........
Retaining Wail ...........
Slab Insulation
171
PLUMBING:
6nderground ............. .
x
Rough -In ...................
ITI
C
IT
Commercial Final
0
0
HEATING:
C
IT
Gas Test ....................
lTI z
Gas Piping
z
-4
Equipment .................
on
Commercial Final
n
EXTERIOR SHEATHING
-4
=
M IT1
NAILING ..........................
a V)
0
FRAMING ........................
0
C
FIRST FLOOR FRAMING
C
Q 0
INSULATION ..................
Z
7`1
;13
Floor Insulation
__4
Wall Insulation ...........
x
z
Ceiling Insulation
__11
x
SHEETROCK NAILING
z
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY
vo