20060337.pdfCITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMIDNAME OF BUSINESS
tA�%JE Q- MNE�b f1A � le-i vvi
MAILING ADDRESS
ot v. -ALDez- -::.-r
CITY ZIP I TE1111OR
,�4yntftAUSK q1B02x> -(-Zs* 4,40 2.�
PERMIT EXPIRES
PERMIT 'X
V& —0-25,37
NUMBER
joB SURCIA—
ATORess at zf, 41 6(ar
71-AT NAMESOBDIVISION NO,
LOT NO.
LID 0
L to FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING PROPOSED
REQUIRED DEDICATION __ FT
PR; TEOUIREG
YE 0 NO 0
REMARKS
OWNERICONTRACTOR RESPONSIBLE Fort EROSION CONTROUDRAINAGE
INAME I ENGINEERING REVIEWED BY FiRE MARSHAL
rm,ce cerm h3r- .
I ADDRESS RECYCLE - RE—W-A"Iff I "T 9.5 PRESENT"E
4 Btx SI-47-S K rIL-1, REMOVAL. OR CAP
CITY C:MZIP _S I TELEPHONE PUBLIC WORKS REVIEWED By DATE
HLCO C-1-P5
41ao (2-" 1-/
1 %,NJ- III
VARIANCE OR ON
SHORELINE on AGE'
H f
PROPERTY TAX ACC6NbA4�4.
' . \ I
W 0()qo,9—
- —_
CM_
—ZONE
SIGN
AREA
HEIGHT
NEW
RESIDENTIAL
0 PLUMBING / MECH
01 WAIVER
ALLOWED PP GF-E.
AL
... . ...
0 ADDITION
_ END,
COMMERCIAL
COMPLIANCE OR
13 STUDY
RREBD
I
PRO
POSED SETBACKS
MIXED USE
USE
CHANGE OF USE
LOTCOVERAG5
ALLOWED PROPOSED
S E Al
REQUIRED SET ACK (F`rI
' T
FRONT SIDE REAR FRONT
FRO
(PT)
URSIDE REAR
M REMODEL
,A Ly]
LD IF A.
ULT
MU
M
F SIGN
C] REPAIR
0 GRADING CYOR E] FENCE X FT)
PARKING
LOT A EA
PLANNING REVIEWED BY
DATE
rl .... Lt..
I�WTANK OTHER
RECIO
�KINO
I PROVIDED
GARAGE
C ARPORT
FIRE SPRINKLER
ROOKERY
[:] RETAINING WALL FISEALARM
REMARKS
OR ACTIVITY) EXPLAIN:
NUMBER
OF
STORIES
NUMBER OF
DWELLING
U NITS
ACNISTR ON
TYPESq
GCCUPA
I
ROUP
REQUIRED 13 YES
REMARKS
7175TECH -REPORT
By.
Description
FEE
Description
FEE
Plan Check
State Surcharge
HEAT SOURCE LOT ILOPI*,* VESTED DATE
PLAN CHECK NO:
JTO
Bulk, Permit
Ing
City Surcharge
Plumbing
Base Fee
THIS PERMITAUTHORLZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Mechanical
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.1 WILL REQUIRE
S EPARATE PERMISSION.
Grading
PERMIT APPLICATION: SEE BODO 19,00.005(A)(5)
Engr. Review
Recording Fee
U PERMIT LIMIT. SEE ECDC 19.00.005(A�(6)
Eng, inspection
Plan Ch1k. Deposit
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
it '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 OROINAI.
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
Fire Review
Receipt If
_1R.p.,I,.n
Total Amt. Due
Landscapainsp.
Receipt It
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION� THAT THE INFORMATION APPLICATION A; ROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF CALL TW,p1K.I,. n.. nrl �,g t,, 11.
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC� Ou"'10"'I"'"'o-P" -F— P" 'd
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED FOR INSPECTION
IN VIOLATION OF THE LAEo DE OF THE STATE 0 WASHINGTON RELATING TO
WORKMEWS RANCE AND RCW 1&27. (425) 0 CIAL GNAI L
COMPENSATJ5��XUO
SIONED
T OW 771-0220
RELEAS BY
EXT. 1333
ATTENTIOW
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 IBC11O / IRC110. PINK � OWNER GOLD . ASSESSOR
6105 PRESS HARD - YOU ARE MAKING 4 COPIES
z
0
i
0
3:
C M
M a
0
80
C
IT, M
z
C
r- -4
0 -n
n
M ro
0 V;
0 r-
0 M
C co
C co
M 0
z
z
CO
z
9
0
ITI
M
FINAL PROJECT APPROVAL FORM
TO:-
DATE: -
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
ENGINEERING DIVISION DATE-
-PLANNING DIVISION DATE -
PROJECT
SITE ADDRESS.
ADB#
..... _DATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED 0 S 7- C 4/0
A field inspection was conducted to determine compliance with -approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
0 Copy of CONDITIONS given to owner/contractor by inspector
I
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0 Copy of CORRECTION NOTICE given to owner/contractor by inpector
1.
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:ten1p:b1dg:fbmis:ocaprv1 3/25/04
z
0
0
C:
MO
-4 0
0 0
C:
4 K
MM
M Z
0 -1
c:
0
I
M
V
0
0
C rn
Cn
Cl)
M 0
Z
71
;o
z
z
9
0
M
Permit Inspection Details
Permit: BLD20060337
RE RM ITT r,,x
'j,
04125/2006 SMITH 20 APPROVED
y
Total Time: 20
Total Inspections:
1 Total Time: 20
z
0
3:1
om
Co
0
C
M
M z
10-4
z
0,n
n
M M
0
0
0
CA
M 0
z
z
M
Vi
5128/2009 1:03:26 PM
Page I of I
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ............
wall ............
Pier/Porch .................
Retaining Wall
Slab Insulation
PLUMBING:
Underground .............
Rough -in ...................
commercial Final
I'D
M 0
HEATING:
-.10
Gas Test ....................
C
-4
M
Gas Piping .................
IT! Z
Equipment ...........
C
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
-4
FRAMING
3:9
M IT!
a C-0
FIRST FLOOR FRAMING_
0
INSULATION ..................
0)
Q 0
Floor Insulation
z
Wall Insulation ...........
Ceiling insulation