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990372.pdfUS PERMIT O -1 0 m C= my 1O O C Y, s m L ;' mz (J i C Z r N -1 �1 mym QN C �' m m0 Z z m ^ I ATTENTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL FILE YELLOW INSPECTOR HAS BEEN GRANTED. UBC SECTION 109 PINK OWNER • GOLD ASSESSOR CATE OF OCCUPANCY s•Pe EXPIRES �Z PERMIT Z�'3 �90�7'�' CITY OF EDMONDS 2ONE , 3 NUMBER CONSTRUCTION PERMIT APPLICATION TDB suITE/APT, /''1G ADDRESG Z'J! I / L,'� OWNETR NAME/NAME OF BUSINESS / 1 _ LEGAL DESCRIPTION CHECK SU8011I1ION rvO. LID NO. w MAILING ADDRESS � O�S/"' PUBLIC RIGHT OFWAY PER OfFICIAIBTREETMAP O `.[�I�-'�� CITYL-f-�•`� zipEXISTING REQUIRED DEDICATION— s�eoleune Po9mn° Aa ❑ P�� pI / /,\T(EL�EPHONE 9 O�)2�V y�s` PROPOSED 5'eewan xeau ieaee ❑ NAME METER SIZE LINE SIZE NO. Of FI%TURFS PRY REQUIRED O YES ❑ NO ❑ � � ADDRESS REMARKS a CITY ZIP TELEPHONE NAME ENGINEERING MEMO DATED REVIEWED By ADDRESS FIRE MEMO DATED REVIEWED BY - a i CITY 21P TELEPHONE � ��.� � ( �C/1 A �lQ/ _ �.L-'/ a.� VARIANCE OR CU AOBa SHORELINE a STATE LICEN/SI�E�N(U`MBER EXLPIRATVIJONQ`O,AJT'Ef GHECKE Y yy�'')JJ��4CJ- __ E G PROPOSED flI VEXEMPI" APOOPOSED DN ALLOWESIGN—AREA r' LCG�G 1 ILLi I � ode t COMPLETE ALLOWED LEGAL DESCRIPTION OF PROPERTY INCLUDE ALL EASEMENTS O E%P _ LOT COVERAGE REQUIRED SETBACKS (FTI PROPOSED SETBACKS (FT,) SIDE REAR FRONT VR SIDE REAR ALLOWED PROPOSED FRONT D PARCEL NO. DATE g pRp TY TAX ACCOUNT LOT AREA PLANNiN'G REVIEW By �' ❑ NEW RESIDENTIAL ❑ PLUMBING IMECH REMARKS ❑ ADDITION ❑ COMMERCIAL ❑ CHANGE OF USE ❑ REMODEL ❑ APARTMENT ❑ SIGN GRADING FENCE ❑ REPAIR ❑ CYOS ❑ ( _� X FT) CHECKED BY TYPF OF CONSiPUCTION CODE OCCUPANT GROUP ❑ DEMOLISH ❑ TANK ❑ OTHER ' OCCUPANT SPECIAL INSPECTOR AREA - i ❑CARPORT ❑ RETAINING WALL ❑ RENEWAL REQUIRED ❑YES LOAD GARAGE ROD EFY F ITYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: REMARKS � %S6l� Gd �� T►4+.� PROGRESS INSPECTIONS PER UBC 108 w NUMBER NUMBER OF CRITICAL ' o OF DWELLING AREAS a STORIES UNITS NUMBER � DESCRIBE WORK TO BE DONE ' eb`�F� E3fL4L.C� E>(Zr%Q= �� � FINAL INSPECTION REQUIRED VALUATION FEE PLAN CHECK FEE HEAT SOURCE GU121NG % LOT SLOPE% BUILDING PLAN CHECK NO: VESTED GATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO f BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADING/FILL — DOMAIN (CURBS,SIOEWALKS, DRIVEWAYS, MAROUEES,ETC.) WILL REQUIRE J SEPARATE PERMISSION. STATE SURCHARGE PERMIT APPLICATION: 180 DAYS PERMIT LIMIT: 1 YEAR -PROVIDED WORK IS STARTED WITHIN 190 DAYS STORM DRAINAGE FEES 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND GUCCESORB ENG. INSPECTION FEE IN INTEREST, AGREES TO TO: DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM:. FIRE DEPARTMENT DATE �J— —QZ PIfJ3e510N .. ENGINEERING DIVISION DATE PLlASC9GN PLANNING DIVISION DATE rtaseswro PROJECT U/(�P SITE ADDRESS PERMIT # q 3� � —ADB# DATE INSPECTED DESCRIPTION OF WORK TO BE INSPECTED C%� U ws s 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 granting Of: Final approval ofthe described work Performance Bonds associated with the project may be released GRANT FINAL PROJECT APPROVAL GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NA*CC,�,, o ✓UN d'`c` i ��ryMfNTs 9199.9 FAILED FINAL INSPECTION - OUTSTANDING ISSUES it,,: o%t, or9 1 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL ocaprvl.doc.l:temp:bldg:forms6/98 z 0 0 rn Cn = cm m0 00 oC mz 1 DZ r= rn n mm_ ON r �N 7r mn 2 z x to z 0 0 m L RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: r. Footing ...................... . i.. Wall .......................... . . Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... ' PLUMBING: Underground ............. - Commercial Final ...... HEATING: Gas Test - -; Gas Piping _ ..;. :Equipment .....: Commercial Final ...... - EXTERIOR SHEATHING ;. - NAILING FRAMING........................ INSULATION ................... ... _Floor Insulation ......... ..:. Wail Insulation ........... Ceiling Insulation ....... - - SHEETROCK NAILING ... SPECIAL INSPECTION -... MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. "NOS42 / PERMIT EXPIRES CITY OF EDMONDS PERMIT io�E NUMBER 9�9037 Z �: m —i ll fn c m m0 on C mZ Ate_ DZ r2 co) mm_ O� C N Z'I T_ A Z 1 !Jl - Z 0 _a n ', m I. I. _ 1 ATTENTION TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL IT IS UNLAWFUL AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW RJSPECTOH A FINAL INSPECTION HAS BEEN MADE HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER • GOLD- ASSESSOR CATE OF OCCUPANCY n,aP z PERMIT APPLICATION AOB SUITErAPL CANSTRUCTION nooREss OWNER NAME NAME OF BUSINESS 'A.I. o �- LEGAL DESCRIPTION CHECK SUBOIJISION NO. Llp NO. w MAILING ADD. EBS !••L 30 f� � � PUBLIC FIGHT OF WAY PER OFFICIAL STREET MAP O l CITY ZIP TELEPHONE E%ISTING REQUIRED DEDICATION_ ° � PROPOSED wa O NAME METER SIZE LINE SIZE NO.OF FIXTURES PRV REQUIRED O YES ❑ NO ❑ - r ADDRESS REMARKS � a CITY ZIP TELEPHONE NAME REVIEWED BY ENGINEERING MEMO DATED I � ¢ ADDRESS FIRE MEMO DATED REVIEWED By � CITY 21P TELEPHONE O Q VARIANCE OR CU ADBx SHORELINE n STATE LICENSE NUMBER E%PIRATION DATE CHECKED BY SEPA REVIEW SIGN AREA HEIGHT L� I COMPLETE I EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED LEGAL DESCRIPTION OF PROPERTY -INCLUDE ALL EASEMENTS EXP 0 F _ LOT COVERAGE REOUIREp SETBACKS (FT.) PROPOSED SETBACKS (FT.) FRONT VR SIDE REAP ALLOWED PROPOSED FRONT SIDE REAR O PROPERTY TA% ACCOUNT -PARCEL NO. LOT AREA N W DATE o J ❑ NEW l/ RESIDENTIAL ❑ PLUMBING /MECH REMARKS ,w' ❑ CHANGE FUSE ❑ ADDITION � COMMERCIAL ❑ REMODEL ❑ APARTMENT ❑ SIGN GRADING FENCE ❑ REPAIR ❑ CYDS ❑ ( X FT) CIiECKEO BV TYPE OF CONSTRUCTION CODE -GROUP I ❑ DEMOLISH ❑ TANK ❑ OTHER I SPECIAL INSPECTOR AREA OCCUPANT LOAD } ❑GARAGE RETAINING WALL RENEWAL - REQUIRED ❑YES CARPORT ❑ R Rv ❑ F (TVPE OF USE. BUSINESS OR nC,TIVITY)EXPLAIN: REMARKS INSPECTIONS PER UBC 108 0` _ PROGRESS w NUMBER NUMBER OF CRITICAL a pp DWELLING AREAS p STORIES UNITS NUMBER � DESCRIBE WORK TO BE GONE (,, = FINAL INSPECTION REQUIRED VALUATION FEE PLAN CHECK FEE HEAT SOURCE GLAZING%. LOT SLOPE": BUILDING PLAN CHECK NO: VESTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO BE GONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRAOINGIFIIL - DOMAIN (CURBS,SIOEWALKS, DRIVEWAY S, MAROUEES,ETC,) WILL REQUIRE J SEPARATE PERMISSION. STATE SURCHARGE E PERMIT APPLICATION: 180 DAYS FEES PERMIT LIMIT: 1YEAR -PROVIDED WORK IS STARTED WITHIN 180 GAYS STORM DRAINAGE 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS ENG. INSPECTION FEE � IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONOS. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND OR INDIRECTLY ALL CLAIMS FOR DAMAGE SOF W HATEVER NATURE, ARISING DIRECTLY FRDM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT REDUCE ANYREQUIREMENT OF ANY C TY � NOR LEMIT NnNDYIWAYyTHE CITY TO ANY ORDINANCE PROVNSIONE TOTAL AMOUNT DUE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL GIVEN IS CORRECT; AND THAT I AM THE OWNER. OR TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCCALL This application is nolapoemll unlll signatl by lho THE OWNER.IAGREE IN DOING THE WORK AUTMOR12E0 THEREBY. NO PERSON WILL BE EMPLOYED - B°Pilin9,011iciel or hlslpor Dopuly: antl Faes aio paid, Pntl TION; AND IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION ro�mpli�a,waowlmBnal°sPacoprar�d°tl, WORKMEN 'SCOMPENBATJ NSURANCE AND RCW 10.21. �yyI� OFFICIALS SIGN LIRE DATE DATE BIG ED (YG5) ` SIGNAT IOWNERO GEN) � 7 771 'U22U RELEASED OY DATE �.