20060504.pdfDATE RECEIVED
CITY OF EDMONDS
PERMIT
NUMBER
CONSTRUCTION PERMIT APPLICATION
AD.
OWNER NAMEINAME OF BUSINESS
AIM, 4 . :TkkEf_
PLAT NAMI, 5UOU11111LIN No
L11 10 LID NO
MAILINGADDRES'
"orrTs
—?—A K- ') `LAk.1 AV W
2
PUBLIC NIGHT OF WAY PrB OFFICIAL FTIH`rT MAP
�,�Lli'11,1111411111�,Z��, 10
CITY ZIP
FX.STIN. P110,CSI-O
cut
4,LE11ONE
13
NAME
MEIE.SIZE UNL 11, PFAV REQUIRED
R12C_f�,.
I
YES D No E3
ADDRESS
R-.ARBS
OWNER=NTRACTOR RESPONSIBLE FOR EROSION CONTROLADFIAINAGE
CITY ZIP
CIL'
ENGINEERING REVIEWED BY
DATE
AS Al%ve
RECYCLE REVIEWED BY
DATE
CITY ZIP TELEIR.1,1E
PUBLIC WORKS REVIEWED BY
—UA—TE
z
STATE LICENSE NUMBER EXPmATIONDATE CHECKEDBY
FIRE REVIEWED By
DATE
0
I
0
VARIANCEORCU SHONELINEORADBr INSPECTION SEPA
PROPERTY TAX ACCOUNT PARCEL NO,
cr�l lq42z-
RECTID No J.."PLEIED -APT
Ye
13 SO
I
:,
CAP ZONE SIGN AREA 1E111T
NEW ESBIE TIAL ILUMBINGIMECH
A
13 WAIVER
AL- I P..P-ED I A —WED
ADDITION [:] COMMERCIAL C MPLIANGE OR
0 STUDY
PROPOSED SETBACKS (FTI
M 0
C] MIXED USE CHANGE OF USE
LLLOTCOVERAGE ED
A OWED PROPOS,
REQUIREDIET ACKS FT)
FRONT SID BEAR FRONT LMSIDE NEAR
0
MEMO BE, SIGN
0
8
0 MULTIFAMILY
E:] REPAIR CIBACIING Cy.. FENCE
X FT)
PARKING IDTAREA BLA NINGREVIEW50BY DATE
C:
3: 1711
DEMOUSH E] TANK E3 OTHER
REQ� 'DEC)
D I PIOV
M z
to
oGARAGE RETAINING WALL o FF2 SPRINKLER
CARPORT REAL
REMARKS
ROCKERY -ARM
BUSINESS OR ACTIVITY) a
R I nr,up TA,�"
0 -n
0
d
ROUPANT
G P
DESCRIBE WORK TO BE DONE
SPECIAL INSPECTIO0
CONSULTANT OCCUPANT
LOAD
REQUIRED 13 YES
U INZION�
REMARK-
z
ITI 0
GEOT CH REPORT
z
By�
7-1
STRUCTURAL DESIGN
BY:
BY
$
Description
FEE Description FEE
LOT SLOPE% VESTED DATE
LOT SLOPE- .
Plan Check
State Surcharge
&H:�;�URCE I
Building Permit
City Surcharge 1",5-
0
4
PLAN CHECK NO:
j$VAIUATI.N
Base Fee
0
1TI
a B ve W. �
N E E Be RI To
0 LYT.-W.-K. ..T C
THIS PERMITAUTHORVES ONLYTHEWORK NOTED, THIS PERMIT COVERS WORK TO
Mechanical
T. Us
'.P.R 0 Ly ANY CONSTRUCT 0.0 - R L"'
TV N
BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION,
SEE ECDC 19.00.005A)S)
Grading
Recording Fee
PERMIT APPLICATION:
P I.n L, IT 'SEE ECDC 19.00,005(A)(6i
EFIMM LIMIT.,
Engr. Review
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
Plan Chk, Deposit
OF ,a OR . BS,.US .'BE , Be . S G SUCCE.EOFIS
LICANT. ON BEHALF OF HIS 08 HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS
Receipt It
;AP
N INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Inspection
Total Amt. Due
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
D=T=FY� WAIVE OR RE LICE ANY REQUIREMENT OF ANY CITY ORDINANCE
- —
4,54
N P Vista
WAY THE CITY'S A51LITY TO ENFORCE ANY ORDINANCE RO N,'
Landscapelnsp.
I
Receipt #
APPLICATION APPROVAL
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORM -ION
DULY AUTHORIZED AGENT OF
CALL
TI1,F p—I PI.I X,,,XKI , IF.
GIVEN IS CORRECT; AND THAT I AV THE OWNER, OR THE
THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
FOR INSPECTION
B.M 0011 .1 h.A.1 D.1LI1 I rd F pad rd
TION: AND IN ODIN THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
G
STATE OF WASHINGTON RELATING TO
.Pns .�knX!,1.dpdY, �p .d.d
IN VIOLATION OF THE LABOR CODE OF THE
WORKMEN S COMPENSATION INiikVNCE AND RCW 18:27�
(425)
_bF Sl N T A DA�E
C'
E SIGNED
771-0220
By
RELEASED"
EXT. 1333
ATTENTION
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. UBC1 09 1 IBC11 0 / IRCII 10.
PINK -OWNER GOLD - ASSESSOR
Was PRESS HARD - YOU ARE MAKING 4 COPIES
Permit Inspection Details
Permit: BLD20060504
PERMITTPAX.
. . . ... . . ... w
1210812006 Snook 0 APPROVED
y
Total Time: 0
Total Inspections: I Total Time: 0
4 -n
0 C
M
0 -n
M M
0
rj)
0
M
7/2/2009 10:56�25 AM
Page I of i
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing......................
wall........... ... ............
Pier/Porch .................
z
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
M
C
Rough -In ..............
rn 0
0
-40
Commercial Final
C:
—4 M
HEATING:
X rn
IT z
Gas Test ...............
C:
GasPiping .................
85
Equipment .................
0
Final
"n
Commercial
EXTERIOR SHE A T HIN G
M M
0
NAILING ... . . .
0
FRAMING ...................
0
C (a
r V)
FIRST FLOOR FRAMING...
Q C)
INSULATION ...................
Floor Insulation
Wall Insulation ...........
z
Ceiling Insulation
V)
z
SHEETROCK NAILING
SPECIAL INSPECTION
0
ITI
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................