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950210.pdfCITY OF EDMONDS USE ZONE PERMIT E BIER 95n�t CONSTRUCTION PERMIT APPLICATION S OWNER NAMC. Nr1ME(�OI' BUSINESS ': .l5 I l)A �t^_ •l JOB ADDRESSA/� / 5^ ^ PT a 'V I!L+�_' ^ (� uQ A L 1 F ' ` 'v 0 n\ 71/0/,!/ / LEGAL DESCRIPTION �+ -' -A MAILING AUDHLSS oL.11Al� CH(ECCKK 1UUBOIVIS1ON LID N $o i Q15iTy / (:Iiv ZIP TELEPHONE NUMBER PUBLIC RIGHT�OF WAY PER OFFICIAL STREET AP TESCPA tl ❑ pprove Permit ❑ 1 D'^1 ( [� 1 ."1 0� I('OLL: _� Cj_L I y EXISTING REQUIRED DEDICATION SW Requne0 S"I"Usp P-11 Req'a ❑ t ��" PROPOSEDA-y�� InspeclloA Requnetl NAME ✓� I, C Sidewalk Requiretl ❑ w i w A ADDRESS TE SIZ/q LINE S�dE II NO OF FIXTURES PRV REOUIflED �' R L A rJ D5 �Q•IV. �` t:�li !'Y!(.iJ 3�9 REMAR /� YES No❑ 3 - U Q CITY 7.IP TELEPHONE NUMBER Z �— .��/�/� �ZZ �: Y, 3 i���� ( E %-/I �r 3'71 " 2A E�(� Q /� ''/ s ' • ,/ y ��/ , �I �•Y-/NNl// /�Y✓ W �' ✓ �/i't NAME ��///��� /�}� /�•'1 ��T ADDRESS � 6, f `l>.t) / �l CI Y ZIP TEL HONE NUMBER STATE LICENSE NUMBER EXPIRATION DATE Legal Description of Property - include all easements LOT 13. (3i ,c tK 8 ED:u L'.�u , � vLrv.) � L Ac�S V oL 3 G(- VILA-1 S, •1CiA. L- f J A/L-t-�C.YYI r1JC; ;.TFWC w•T't4 (,A T'l D GC»A'J J- N 1111 No— a- LUT 2.16L:r.KL f76A141 iii ACC r T>I L ;a pt.>t Vol- (fG'PLATS 11 >) Property .� 4 fC =S C1�T S—i '� •(`i `J11,. <(7�`T" O.tR Tax Account Parcel No. jL 5o.._dCr Z.-CJZ+2.—olLig © NEW ® RESIDENTIAL PLUMBING 0AD11I1ION El COMMERCIAL fir© MECHANICAL REMODEL APT. BLDG. {I��1 El SIGN ❑ GRaDIN El ❑ FENCE REPAIR CYOS © DEMIl��6J-I ❑ INSERT E 1_X_FT) SWIM POOL HOT TUBSPA RETAINING WALL/ GARAGEIT ROOKERY RENEWAL (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN'. R Cj I DL-C, A NUMBER Z OF T STORIES I NUMBER OF DWELLING V NK UNITS CRITICAL AREAS //��' �� NUMBER/ DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) ^ SEPA REVIEW ALLOWED PROPOSED COMPLETE EXEMPT 4 J EXP ,RIANCE R CU L IN VIEW BY TBACK — FEET �HEIGHT R IONT S10E I0 REA• 2'- NO I - REQUIRED r uluH e77``''77 / �!l Z UPANT REMARKS ❑ YES /L74 �L Z /�I w5h" PROGRESS INSPECTIONS PER UBC 305` — '"'! `'�- FINAL INSPECTION REQUIRED ,J / Z2 ,&WI f CIS VALUATION FEE PLAN CHECK FEE 7 L HEAT SOURCE GLAZING BUILDING 2E� 037 PLUMBING % Plan Check No. C �� _ MECHANICAL 7/ This Permit covers work to be done on private properly ONLY. Any construction GRADINGIFILL J on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE T 45— Permit Application: 180 Days STORM Permit Limit: 1 Year - Provided Work Is Started Within 180 Days DRAINAGE FEE "Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE V H w successors in interest, agrees to indemnify, defend and hold harmless the City of Edmonds, Washington, its officials, s employees, and agents from any and all claims for damages of iwhatever nature, arising directly or indirectly from the Issuance 0 of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT n� o modify, waive or reduce any requirement of any city ordinance J X nor limit in " any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE provision. � 1 hereby acknowledge that I have read this application; that the information given is correct; and that I am the owner, or the duly ATTENTION APPLICATION APPROVAL authorized agent of the owner. I agree to comply with city and stale laws regulating construction; and In doing the work authoriz• THIS PERMIT AUTHORIZES This application is not a permit until ed thereby, no person will be employed in violation of the Labor ONLY THE signed by the Building Official or his/her Coda of the Slate of Washington relating to Workmen's Compensa• WORK NOTED Deputy; and fees are paid, and receipt is tion Insurance and RCW 18.27. INSPECTION DEPARTMENT acknowledged in space provided. SIGNATURE IOWNER OR AGENT) DATE SIGNED �n c I"jO t(I( +'� CITY. ITY OF EDMON DS OF I IAL'$ r IG NATURE DATE ATTENTION CALL FOR INSPECTION EA DATE IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE - UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR �J nn 7 1 OLLo ORIGINAL — File YELLOW — Inspector A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC / CHAPTER 3. 102 eT PINK — Owner GOLD — Assessor IV � r • _ RECORD, OF INSPECTIONS INSPECTOR DATEAPPROVED SETBACKS............t ---�J �-`- �y,/aT•�� '... FOUNDATION:.�{7'gL,�(/ Footing .................. _ ''�-� 2 i • }'S- :.....,. Wall .......... ... __—�• f - Q'S Pier/Porch.. . ............. Retaining Wall.......r� _....—.r' �? ./� J^5•- :: Slab Insulation............ PLUMBING: Underground ............. C Rough -In ... .......... f._�—•.—_S if ..(j G (o Commercial Final........ HEATING: Gas Test........... .! S Gas Piping...:............ .. . , Equipment. .............." . Commercial Final......... EXTERIOR SHEATHING NAILING... 2 FRAMING ... zCj O(G ID 11vS01ArC, - IwLTv NSULATION: i ,, i G• v/�Zile U Floorinsulation........... I. ..:5 Wall Insulation ........... Ceiling Insulation......... SHEETROCK NAILING ....� .�-•-• G e- 5�-- SPECIAL INSPECTION...... RADON MONITOR AT SITE. h: FINAL APPROVAL I FOR OCCUPANCY........ - __,.� �� • �B • f .. i j 1 aJr�✓ Mj5: W/ �609v,-v sov.4-61 sftr -rzLi5Awail mf�t2tc£as y� ktWS� !°4i14G'B OY S1XV0109 Psi TO JMDinj67 . 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