20060318.pdf= I
PERMIT EXPIR
'PERMIT 1) .
CITY OF EDMONDS
NUMBER. 2M P (53d
IT.
CONSTRUCTION PERMIT APPLICATION
Ic
ADDRESS
0 HER I 1U1IN
PLAT NAMLISUBDIVISION NO,
LOT No
LI NO
L
-LID FEE s
MAILING ADDRESS
PUBLIC RIGHT OF WAY IEH OFFICIAL STREET MAP
6:_�2 a 11-n-)2 e- I L-r,-,,C I-e—
EXISTING. PROPOSED
13
IIP
TELEPHONE
il, eas
REQUIRED DEDICATION ___ FT
a
'13 3
NAME
METER SIZE
LINE SIZE
NO, OF FIXTURES
PR� TEOUIRED
I
YES C NOO
I
--ADDRESS
REMARKS
OWNERICONTRACTOR RESF�0ANPk6EfObtRObb ffLR1ftqI3iRVft
J_
TELEPHONE
U, t\/ I VEA (07 1 J'L 119) ME
1,q
PROPERTY TAX ACCOUNT RCELNQ
VARIANCE OR Do SH.1
/71 Lij"7310 /n t77 /7 Q
c"
ZONE
SIGN
BIG
ARIA
ALL.-C""HROPOKIED
NEW
16 RESIDENTIAL
ILGMGIN.IMOCH
0 IVER
D PROIDS.
A D
COMMERCIAL
13
COMPLIANCE OR
A(ST By
U
FPARKING
7AREAPLAN�NING
0 ADDITION
MIXE o
LJ CHANGE OF USE
LOT COVERAGE
SETEACKI, SUR TBACKSIFT
REQUIRE SET ACKSA`T) PRoPo" DS
'R s, GE REARI
Fj REMODEL
[3 USE
n MULTIFAMILY
rl SIGN
ALLOWED PROPOS ED
FRONT SIDE RE FRONT
S, m
REPAIR
FENCE
f-1 GRADING GYGS [3 1 X F,)
G
LOT I
P� A, REVIEWED By DATE
_ _
OTHER
DICHO PROVIDED
011,v� 4 1,10,
DEMOLISH TANX F1
I
n RETAINING WALL FIRE SPRINKLER
0 GAZRIF.G'�T FIOCKERY FIREAI.ARM
- r JL
WA&4, ?5. Ib. A Q�&.L AC,
(TYPE OF USE. SUSWESS,��WPI.Aft
av-,ol > E, I b e-
toy,%
noer- t'Va-_
NUMBER
OF
STORIES
DUN, SIR F
UW ULING
NNITS o
Typ�� TIoN
CODE
OCCUPANT
GROUP
DESCRIBE TO BE DONE
SPECIAL INSPECTION
__q�
CONSULTA T
OCCU ANT
REQUIRED E3 YES
LOAD
REMARKS
REPORT
SGY�OTECH
STRUCTURAL DESIGN
By.
VALUATION
FEE
Description
FEE
LOT SLOPS% 11ST11 DATE
Plan Check
Stale Surcharge
rDescription
..ilding ENFH
City Surcharge
Pu.Dmg
Base Fee
TIIIIIERMITAUT".�2ESO"LYT�lE�.RKNIITID, THIS PERMIT COVERS WORK TO
Wo HT�
. I
Mechanical
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: SEE ECDC 19A0,05(A)S)
IA
PERMIT L MIT: SEE ECDC I9.0D.00SJAH6)
Engr. ReView,
Recording Fee
SEE BACK OF PINK PERMIT FOR MORE INF08MATION
Engr. Inspection
-Plan Chk. Deposi
'APPLICANT, ON BEHALF I HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESSORS
OF
Fire Revi—
Receipt H
ININTEREST EMNIFY, DEFEND AND HOLD HARMLESS THE CITY
To IND OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
ToN'ITS
EDMONDS AAGREGES
AL CLAIMSW SHIN
FOR DAMAGES OF WHATEVER NATUR AR 'SING DIRECTLY OR INDIRECTLY
E `
:R:,.I�P:..nhw
:77
Total Amt. Due
a45—
FROM THE ISSUANCE OF THIS PERMIT. SSUANcE OF THIS PERMIT SHALL NOT BE
` DEEMED TO MODIFY, IN IVE R REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
. .... .....
Receipt It
rX�lc
0 N OR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,
Landscapeinsp.
I
APPLICATION
APPROVAL
IHERE Y ACKNOWLEDGE THAT I HAW READ THIS APPLICATION; THAT THE INFORMATION
CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
CALL
Th� I , A .HHI nlil AKIn.ol LIy Ih.
IF11 "I'"
IS
GIVEN8
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONS THU.
FOR INSPECTIO
N .1h—I .1 r-11 Dept, ald F 11, Pald,
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMP LOYED
IN VIOLA CODE OF THE STATE OF WASHINGTON
01 URE E
WoRKME
(425)
SIG TUR RA
LRELATING JTO
I
771-0220
11AL'"I'
FILEAS DBY A a
EXT. 1333
ATTOt CTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL NSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI-
it
ORIGINAL . FILE YELLOW - INSPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. USC109 / IBC110 I IRC110.
PINK OWNER GOLD -ASSESSOR
PRESS HARD - YOU ARE MAKING 4 COPIES
61os
z
0
i
0
M
M
C:
mo
0
0
C:
M
M z
JO --I
C: 2
Cn
0
n
x
Mr.
0
0
To
z
CA
z
9
0
M
Permit Inspection Details
Permit: BLD20060318
PERMIT-TRAX
04/2412006 SMITHM 0 INSPECTION COMPLETED
y
Total Time: 0
Total Inspections: 1
Total Time: 0
z
0
S
0
74
b
M
M
0
0
M
M
10
Z
>
0
M M
0
0 Im
ITI 0
Z
z
z
0
M
61212009 9:21:52 AM
Page I of I
211
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing......................
wait ...........
Pler/Potch'.. ...............
Retaining Wall ...........
Stab Insulation ..........
PLUMBING:
0
Underground .............
Rough -In ...................
0
Final
pri
C
commercial
171113
0
HEATING:
0
C
Gas Test ....................
3: M
IT z
Gas Piping ..........
C
Equipment
>
..........
Commercial Final
0-11
EXTERIOR SHEATHING
;-D
-K
NAILING ..........................
i"
M I'D
FRAMING ........................
a V;
0
0 Fn
FIRST FLOOR FRAMING
C 00
K 0)
INSULATION ...................
M 0
Floor Insulation
;D
Wall Insulation ...........
-4
Ceiling insulation
z
SHEETROCK NAILING
-4
SPECIAL INSPECTION
z
0
IT
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY .................
00000"