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BLD20010878(Ct"tp of (eb oubo (Ctrtt"ft"tatit of DEPARTMENT OF BUILDINGS " PER UNIFORM BUILDING CODE SECTION 109 Occupancy established by this certificate: A2.1 Maximum Occupant Load Room capacity signs, Owner of Building: uilding:P�ermit Units:'N/A" V-1 Hour A9LA� n Ath at all times. No. Stories: 1 Basement: Yes U.B.C. 1002) THE Christ Evangelical Lutheran Clj—d& - 'BEEN IN$PECiEDSAND APPROVED' ASS COMPLYING WITH THE REQUIREMENTS OF THE 1997 EDITION OF THE UNIFORM BUILDING=£ODE'AS ADOPTED`'BY THE. CrrY`FORTHE;GR6UP AND DIVISION OF OCCUPANCY AND THE USE FOR WHICH THE PROPOSED OCCUPANCY'tS)CLICSSIFIED. Issued Wis.' =8th.. :;::day oi. /1ori1 2002 CHl � WLDtNG s CIAL BY: This certificate shall be posted in a conspicuous public area end shall nd be removed, nw Ulated or obscured end shall be ,r.Wmd in legible cordtion at all times. Any change of omrpencyor use requires a hAding permit end a new Cer iliieate of Occupancy issued by ft City d Edmonds (ding Official. 6000006 T T T T T T T 121-01(CO) eA-A Temporary Occupancy Expires March 7, 2002& �)�' Iff onmantp tl t r� "jet tqw = -. _--tj&ARTMENTGPBUILDINGS = "---VIVFj PER,UNIFORM BUIL•DING;CODE SECTION 10g AY:.. .2352514th Avenue-W Building"`Permit #: #2004-0878 Occupancy established by this aert'Ificate: DWelling_Units: *''N/W* No. Stories: 1, E F MA: Type, Construction V-1 Hour; Basement: Yes t Allaximum-Occupant Load "45**-Class oo�mLKitchen�Addition (Per U.B.C. 1002) Roorir capacity, signs; w e `u� edrmust�remain posted at allxtimes. s I.. .. E Owner of'Building: Christ Evanslelical LutheranwChurc Address23525 84"'Avenue W Edmonds WA 98026 THE ChrlstEvanaelicaf L'-utheran•'ClurchHAS B�EN�INSPECTED"ANDw" PROVEDAS`�COMPLYING WITH THE REQUIREMENTS OF • s THE 199TEDITION OF.. THE UNIFORM BUILDINWCODE�AS ADOPTED�BY`THE CITY` OR�THE GROUP AND DIVISION OF OCCUPANCY AND THE USE FOR'.WHICH.THE PROPOSED'OCCUPANCY IS,.CLASSIFIED a Issued thlsf i 7th 2001 ' (`411FF Rhill MNr A�FI21A1 ' j k This certificate shall be posted in a conspicuous public area and shall not be removed, mutilated or obscured and.shall be maintained in legible condition at all times. Any change of occupancy or use requires a building permit and a new Certificate of Occupancy issued by the City of Edmonds Building Official. Ww ' a, ATE RECEIVED7. `.PERMIT t ' EXPIRES as CITY OF EDMONDS Z "E 8 PERMIT u BER CONSTRUCTION PERMIT APPLICATION JOB, SUITE/APTk ADDRESS �1f�-' NAME/NAME OF BUSINESS OWNER NAMHRI ply J �dF_ Uj C' �`f ^ PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. w MAILING ADDRESS LID FEE $ Z 3 O 1 I 'PUBLIC RIGHT OE WAY PER OFFICIAL STREET MAP S ed RW Pe Permit RW Permit Required 0 Required CITY. ZIP TELEPHONE EXISTING PROPOSED Street Use Permit Req'd Inepactbn Required O co N REQUIRED DEDICATION FT Sidewalk Required O Underground Wiring required NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES ❑ NO ❑ t, Z ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE Z C7 2 W CITY ZIP TELEPHONE NAME Ezy Pi-ses ,aZtjc, ENGINEERING REVIEWED/DATE ADDRESS 20 FIREI�REVIEWED BY DATE CITY {�`]'/-�/1 ZIP Lwi TELEPHONE `y 'i� ',j ` W Q iff as STATE LICENSE NUMBER EXPIRATIONDATE CH VARIANCE OR CU SHORELINE OR A-DBB# INSPECTION VV f t` YES Q D NO [BOND POSTED k S'Oil- ❑ TAX ACCOUNT PARCEL NO. PROPERTY T SEPA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED j 6 00 EXP I �✓ Z� NEW n'L ElRESIDENTIA PLUMBING MECH 1' / LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR ADDITION COMMERCIAL L `' ❑ COMPLIANCE OR 2 CHANGE OF USE _ ❑ -REMODEL ❑ APARTMENT ❑ SIGN PARKING REO'D PROVIDED LOT AREA PLANNING REVIEWED BY D TE g a. _. r , 4 0/ ❑-REPAIR ❑ GRADING CYDS ❑ FENCE EMA X FT ) S ❑ DEMOLISH ❑ TANK ❑ OTHER O GARAGE RETAINING WALL ❑ CARPORT' _ -Q 0 KERY ❑ RENEWAL """ a (TYPE'OF USE. BUSINESS OR ACTIVITY) EXPLAIN: U „ y;. CHECKED BY, TYPE OF CONSTRUCTION CODE OCCUPANT w NUMBE1 ' NUMBER OF CRITICAL Oi_ Q 2 9 T „GROUP I 10 m !3F ?6. DWELLING AREAS SPEC14L-INSOECTOW AREA OCCUPANT O STORIES UNITS _ NUMBER REQUIRED ❑ YES LOAD DESCRIBE WORK TO BE DONE REMARKS .r w' PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'DTYPE o . m VALUATION FEE PLAN CHECK FEE Pq • HEAT SOURCE GLAZING % LOT SLOPE % BUILDING �•L� PLAN CHECK NO: VESTED DATE PLUMBING ; 'Fs L! MECHANICAL ' THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC J DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE i. GRADING/FILL SEPARATE PERMISSION. Pjj STATE SURCHARGE 47n W PERMIT APPLICATION: ASS DAYS PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES 'SEE BACK OF PINK PERMIT FOR MORE INFORMATION y *APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS ENG. INSPECTION FEE I IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF 2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND LANDSCAPING ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY INSPECTION FEE i _ '• FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE RECEIPT o DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENTOFANY CITY ORDINANCE PLAN CHECK DEPOSIT / s NOR LIMIT INANYWAYTHECITY'SABILITYTOENFORCE ANYORDINANCEPROVISION.• TOTAL AMOUNT DUE RECEIPT C� 52_ 7 I HEREBY ACKNOWLEDGE THAT'I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION �'.. APPROVAL. THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL This application is not a permit until signed by .the IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INN INSPECTION Building Official or his/her Deputy: and Fees are paid, and receipt is acknowledged in space WORKMEN'S COMPENSATIO RANCE AND RCW 18.27. provided. )4; 425� :� g YOASIGNATURE rs , DAT FFI a�LS �' t:t, �_S TORE (O NER ENT) DATE SIGNED 771 —0220 I %sh ArMASE BY DATE ATTENTION EXT 1333 , IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL '-)/& I % k' A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- %T 1—OZZ1 CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX ORIGINAL • F LE YELLOW - SPE TOR / PINK 5/98 - O GOLD . ASSESSOR /V` RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... y Wall.......................... Pier/Porch Retaining Wall ........... Slab Insulation .......... >7 PLUMBING: Underground ............. Rough -in ................... Commercial Final ...... HEATING: Gas Test .................... Gas Piping ....... :......... Equipment ................. Commercial Final ....... EXTERIOR SHEATHING NAILING .......................... FRAMING ........................ FIRST FLOOR FRAMING... INSULATION ................... Floor Insulation ......... Wall Insulation ........... Ceiling Insulation ....... SHEETROCK NAILING ... SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR - g OCCUPANCY .................. - Roo/wo to 49t/a/ 100/ CITY OF EDMONDS PERIktr ZONE R`j� NUMBER ��--� G CONSTRUCTION PERMIT APPLICATION loe sU ADDRESS E/APTp OWNER NAME/NAME OF BUSINESS 15_-.. )� HF LEGAL DESCRIPTION CHECK SUBDIVISION NO. LID NO. w MAILING ADDRESS Z 3 o Q~ l-Crt' PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved RW Permit Required O Q CITY ZIP TELEPHONE NUMBER EXISTING REOyIRED DEDICATION Street Use Permit Req'd O .. PROPOSED Inspection. Required Sidewalk Required O Q NAME cc METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES O NO P Q w ADDRESS REMARKS W t = U a CITY ZIP TELEPHONE NUMBER W W NAME ZIP LICENSE NUMBER ,n , I , EXPIRATION DATE - include all easements Parcel No. .0051(G, j ocx)(la NEW NEW RESIDENTIAL PLUMBIN EC. 10 COMPLIANCE OR ADDITION L4 COMMERCIAL CHANGE OF USE REMODEL APT. BLDG. SIGN GRADING FENCE 11 REPAIR a CYDS. 11 X_FT) DEMOLISH WOODSTOVE INSERT SWIM POOL HOT TUB/SPA RETAININGGARAGE WALL/ CARPORT ROCKERY a RENEWAL ITYPF OF USE. BUSINESS OR ACTIVITY) EXPLAIN: NUMBER NUMBER OF CRITICAL II OF DWELLING AREAS .»r ISTORIES UNITS t NUMBER ' DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) IhlC..AI I III _. {iv•. 1,117£ C�ar17i?L�FCG.1�.i ENGINEERING MEMO DATED N 0 SEPA REVIEW SIGN AREA HEIGHT COMPLETE I EXEMPT ALLOWED I PROPOSED ALLOWED PROPOSED EXP LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT ALLOWED I PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR ;NECKED BY TYF I SPECIAL INSPECTOR REQUIRED /' ❑ YES PROGRESS'INSPECTIONS PER UBC 108 INSPECTION REQUIRED VALUATION FEE - r PLAN CHECK FEE BUILDING HEAT SOURCE: r l GLAZING % PLUMBING Plan Check No. rr�W MECHANICAL This Permit covers work to be done on private property ONLY. Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. GRADING/FILL -STATnURCHARGE Permit Application: 180 Days Permit Limit: 1 Year - Provided Work Is Started Within 180 Days STORM DRAINAGE FEE "Applicant, on behalf of his or her spouse, heirs, as and successors in interest, agrees to indemnify, defend and hold harmless the City of Edmonds, Washington, its officials,. employees', and;agentsfrorTi`ariy'and all claims for damages of whatever nature, arising directly or indirectly from the issuance of this permit. Issuance of this, .permit ,shall noUbe deemed to, modify, waive or reduce any requirement of any city ordinance nor limit in any way the City's ability to enforce any ordinance provision." ENG. INSPECTION FEE PLAN CHECK DEPOSIT TOTAL AMOUNT DUE �1:511 I hereby acknowledge that I have read this application• that the OCCUPANT LOAD 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 THIS PERMIT state laws regulating construction; and in doing the work author.z. 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 Code of the State of Washington relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is tion Insurance aria RCW 1, .27. INSPECTION acknowledged in space provided. SIGNATURE (OWNER OR GENT) DATE SIGNED DEPARTMENT AP _ (/,/A`' �tr...) �1 (1`U� CITY OFOFFICIA EDMONDs T RE DATE �J 11 `✓ ATTENTION CALL FOR /E Ep'SED Bv: DATE r INSPECTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771 0220 ORIGINAL File — YELLOW — Inspector A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK — Owner GOLD — Assessor a Z 9 m 1o2-67 0 RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ................... FOUNDATION: Footing .................... Wall....................... Pier/Porch ................ Retaining Wall............ Slab Insulation ............ PLUMBING: Underground ............. Rough -In ................. Commercial Final ........ HEATING: Gas Test ................. Gas Piping ................ Equipment ................ Commercial Final ......... EXTERIOR SHEATHING NAILING .................... FRAMING .................... INSULATION: Floor Insulation........... Wall Insulation ........... Ceiling Insulation......... SHEETROCK NAILING ...... SPECIAL INSPECTION ...... MISCELLANEOUS FINAL APPROVAL FOR OCCUPANCY .......... 2S cam_ aeon-79� FI14 PROJECT. APPROVAL WRM TO: DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: ���i- �� FIRE DEPARTMENT DATE PLeAse sicN ' PROJECT ENGINEERING DIVISION DATE PLEASE SIGN PLANNING DIVISION DATE PLEASE SIGN SS,/ dN SITE ADDRESS 2 3 szS Y✓�' (,✓ PERMIT # 9--06 %— 067 ADB# DATE INSPECTED 4,.,f DESCRIPTION OF WORK TO BE INSPECTED6 A field inspection was conducted to determine final 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: f-- GRANT FINAL PROJECT APPROVAL *************************************************************************************** GRANT PROJECT APPROVAL WITH CONDITIONS NOTED o Copy of CONDITIONS given to owner/cgntractor by inspector 1. FAILED FINAL INSPECTION - OUTSTANDING ISSUES u Copy of CORRECTION NOTICE• given to owner/contractor by inspector 1. 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Sign ocaprvl.doc.l:temp:bldg:forms 10/O 1 �� ``,,• 5 CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEMAME OF BUSINESS MAILING ADDRESS —'' f CRY ZIP TELEPHONE IFO?'tG/ 147 —_... NAME C ADDRESS QV CRY ZIP TELEPHONE NAME ADDRESS If CRY ZIP TELEPHONE "z PERMIT EXPIRES v " USE PERMIT �ZQNET'�C/_ �11 - NUMBE JOB T��•�)fD IA�_�� SUITEIAPT# ADDRESS 5 5-� � �✓ J PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Require Street Use Penns Regtl EXISTING PROPOSED inspection Required Sidewalk Requin d REQUIRED DEDICATION FT U de de METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I .,,// YES 0 NOW I O = REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLJDRAINAGE ENGINEERING FIRE REVIEWED BY REVIEWED/DATE DATE I a: Q v - r t v STATE UC NU BER SE W0 1 � ..� C t I- EXPIRAON DATE 1j`3 OZ — CHECKEP BY +' VARIANCE OR CU SHORELINE OR ADB# INSPECTION REO'D OYES ENO BOND POSTED O ; SEPA REVIEW COMPLETE EXEMPT EXP SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. NEW RESIDENTIAL ❑ ❑ LUMBIN MECH ❑ ADDITION ❑ COMMERCIAL ❑ COMPLIANCE OR CHANGE OF USE LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE REAR PROPOSED SETBACKS (FT.) FRONT UR SIDE REAR PARKING REO'0 I PROVIDED LOT AREA PLANNING REVIEWED BY DATE ❑ REMODEL ❑ APARTMENT ❑ SIGN g d ❑ REPAIR ❑ GRADING CYDS ❑ `ENCE X FT) REMARKS ❑ DEMOLISH ❑ TANK ❑ OTHER ❑ CARPORT GE ❑ ROCKERY WALL ❑ RENEWAL (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: CHECKED BY 1TY 1` INSTRUCTION JCOD.00CUPANT GROUP �J- s NUMBER OF / STORIES (�� NUMBER OF DWELLING %�� UNITS / ►i CRITICAL AREAS n/ NUMBER NIA A SPECIAL INSPECTOR REQUIRED ❑ YES JAREA OCCUPANT LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REDID i� VALUATION $ FEE FEE Plan Check HEAT SOURCE GLAZIN % LOT SLOPE % Building PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORcros ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t BE DONE ON PRIVATE PROPERTY ONL1L ANY CONSTRUCTION ON THE PUBLIC 2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading Recording Fee SEPARATE PERMISSION. a Engr. Review City Surcharge PERMITAPPLICATION: 180 DAYS o PERMIT LIMIT. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection State Surcharge SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUC.CESORS Traffic Mitigation Plan Chk Deposit IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Review Receipt # ALL CLAMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE 9 Fire Inspection Total Amount Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE p = NOR LIMIT W ANY WAY THE CITY S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Landscape Insp. Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN 18 CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CRY AND STATE LAWS REGULATING CONSTRUC- CALL This application is not a permit until signed by the TION. AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Qlficial or his/her Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTONRELATING TO FOR INSPECTION receipt is acknowledged in space provided WORKMEN'S COMP NSATION INSURANCE AND RCW 18.27. OFFIj=TURTE SIG RE (OWNE DATE 81 NED C♦425,A771-0220RE IRVED BY DATE ATTENTI N EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 0221 771- A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL FILE YELLOW -INSPECTOR 10/01 CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK -OWNER • GOLD - ASSESSOR RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... Wall .......................... Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground ............. Rough -In ................... Commercial Final ...... HEATING: Gas Test .................... Gas Piping ................. Equipment ................. Commercial Final ....... EXTERIOR SHEATHING NAILING .......................... FRAMING ........................ FIRST FLOOR FRAMING... INSULATION ................... Floor Insulation ......... Wall Insulation ........... Ceiling Insulation ....... SHEETROCK NAILING ... SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR 60 OCCUPANCY .................. 21 , a60 � osrN **� GATE RECEIVED +h.. C.12•--' PERMIT VEXPIRES CITY OF EDMONDS uSE �� `n '� .• `-� ' PERMIT r� ;Z°"E J NUMBER��"�Z �. CONSTRUCTION PERMIT APPLICATION JOB SUIT APT# ADORES$�7 � 4- OWNER NAME/NAME OF BUSINESS/ram_ PLAT NAME/SUBDIVISION NO. LOT NO: LID NO. w MAILING ADDRESS LID FEE $ escPApproved p 0 ,q Q!/" iL _ _ 7._a z 0 7 i'�r PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Parmlt Requi ed QQQ EXISTING PROPOSED Street Use Perm. ReeeqqqQQQ Inspection Requlredbg SidewelkT CITY '.}: ZIP - TELEPHONE �ii•:N_i/� �6r �/�"'W �C i� J �•'' .V ,I REQUIRED' DEDICATION FT qu.ed undergroM Wldng.required NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED _ YES ❑ NO ❑ rc UJI ADDRESS REMARKS QWNER/CONT94,f RFRESPONSIBLE FOR EROSION CONTROUDRAINAGE Z a 2% ' 2 � / / 0,0 Z W L L ft�l rN l f�iJ />,.../ I� GGJ+f T� CITY ' ZIP TELEPHONE NAME v a, ! . ENGINEERING EVI WE /DA % • ' % I f r, fo_ rN, ADDRESS "/' a Z F R D B IF DATE it CITY ZIP TELEPHONE I I O LL V RIANCE OR C SHORELINE OR ADB# INSRECTI N BOND POSTED STATE LICENSE NUMBER EXPIRATION DATE CH C ED BY �7�C� G C J i f—f (j �c� - . '`.. I i . 67° 92, �,.,.-- . � a. I q ETVES , ONO SEPA REVIEW SIGN AREA HEIGHT W PROPERTY TAX ACCOUNT PARCEL NO. /� p c/ '/j 10.. p4© Ci COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED -1 �7ZS I! I �,/ EXP ! Q RESIDENTIAL' �LUMBING ECH LOT COVERAGE LOWED PROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE REAR PROPOSED SETBACKS (FT.) FRONT UR SIDE REAR VAUDI�'Tlo COMPLIANCE ORN :;11eCOMMERCIAL ❑ 2� �� 1� , J' t V r Z - i CHANGE OF USE ❑REMODEL ❑ APARTMENT* ❑ SIGN g a PARKING REO'D PROVIDED LOT AREA ^•p PLANNING REVIEWED. BY DATE / !'SS.•. - 4114 FENCE ❑ REPAIR RA I G C�YDS/ ❑ ( X FT) �►�� OTHER ❑ DEMOLISH ❑ TANK ❑ 2 ❑ GARAGE RETAINING G WALL ❑ ❑ RENEWAL ' ,f'I C •ii . (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: / v Li a v CHECKED i TYPE (�E OJ�S UCH ON ' OCCUPANT GROUP;:.^) 'CTOA (ro/ar�-1/'�t I NUMBER NUMBER OF CRITICAL w SPECIAL INS REQUIRED ❑ YES ; AREA } ,.., { ,: 'i OCCUPANT t ,LRA4,� m O O , STORIES DWELLING O NITS AREAS NUMBER 1 DESCRIBE WORK TO BE DONE REMARKS a...., PROGRESS INSPECTIONS PER UB0 108/FINAL INSPECTION`REO' J AO/9 5iv ,cA042 Ory o x � aq • V VALUATION FEE 1 / 'BANC ECK FEE HEAT SOURCE GLAZING ° LOT SLOPE % " Q BUILDING" �" PLAR CHEC t O VESTED DATE, PLUMBING r.- THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADING/FILL 2 DOMAIN' (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE :^., SEPARATE PER ISSIO . KSll SURCHARGE PERMIT APPLICAT1� @ S' -:,, At V Nk PERMIT LIMIT: 1 YEAR - PROVIDED WORK f� WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE:INMRMATION EryG REVIEW FEES ENG. INSPECTION FEE ? 2 () 'APPLICANT, HIS OR HER SPOUSE, HEIRS, ASSIGNS AND N ON BEHALF OF SUCCESORS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY. OFIQDStSRPIN6 i EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND E ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISINGDIRECTLYORINDIRECTLY RECEIPT = FROM THE ISSUANCE OF THIS PER4T:.ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT °.� DEEAQEDTOMODIFY,WAIVEORREOIJ ANY REQUIREMENT OF ANY CITY ORDINANCE / _7r✓� tJ / / NOR'LIMITINANY WAY THE CITY'SABIL'ITY.TOENFORCE ANY ORDINANCE PROVISION.' = RECEIPT TOTAL AMOUNT DUE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED ,• �, Building Official or his/her Deputy: and, Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO';, FOR INSPECTION receipt,isacknotAdged'inspace provid'd.. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. ; ` '" { . OF.FICIA t AT � OATS . SI N TUBE (OWNER Pi 4I7:) DATE SIG ED 'DAT E771-0220 A D BY ATTEN ION > EXT 333 IT IS UNLAWFUL TO, USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 AFINAL INSPECTION HAS BEEN MADE' AND APPROVAL OR A CERTI.FI, CATE OF OCCUPANCY'HAS BEEN GRANTED. UBC SECTION 109 A� rv,. ORIGINAL- FILE YELLO • INSPE OR `�M�X ' PINK- .' OWNER GOLD •ASSESSOR ,�' /.' 5/88. SETBACKS ..................... FOUNDATION: Footing ...................... Wall.......................... Pier/Porch ................. Retaining Wall .:......... Slab Insulation .......... PLUMBING: Underground ............. Rough -In ................... Commercial Final ...... HEATING: Gas Test .................... Gas Piping ................. Equipment ................. Commercial Final ....... EXTERIOR SHEATHING NAILING .......................... FRAMING ........................ FIRST FLOOR FRAMING... INSULATION .............::.... Floor Insulation ......... Wall Insulation ........... Ceiling Insulation ....... SHEETROCK NAILING ... SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. RECORD OF INSPECTIONS INSPECTOR DATE APPROVED 4f?,-7 ID/ cal y VAS 0200/-DER✓ C FIAL PROJECT APFROVAL90RM TO: DATE: D MEMO TO: PERMIT COORDINATOR, $UIGDING DIVISION FROM: FUZJ� DEPARTMENT DATE MXW SIGN ENGINEERING DIVISION DATE PLEASE SIGN PLANNING DIVISION DATE !!I/L�/ v z P PROJECT SITE ADDRESS ��� o�� f%i M eZv.&., PERMHT #491--WzV� ADB# 00 - I i DATE INSPECTED (, 6 DESCRIPTION OF WORK TO BE INSPECTED A field inspection was conducted to determine final 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: iV GRANT FINAL PROJECT APPROVAL GRANT PROJECT APPROVAL WITH CONDITIONS NOTED o Copy of CONDITIONS given to owner/contractor by inspector 1. FAILED FINAL INSPECTION - OUTSTANDING ISSUES o Copy of CORRECTION NOTICE given to owner/contractor by inspector 1. 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Sign ocaprv1.doc.1:temp:b1dg:forms 10/01 FINA PROJECT APPROVAL ORM TO: DATE: MEMO TO: PERMIT COORDINATOR,13UILDING DIVISION FROM: ��''L �`- FM DEPARTMENT DATE PLEASESIGN ENGINEERING DIVISION DATE PLEASE SIGN PLANNING DIVISION DATE PLEASE SIGN PROJECT �- C _ K SITE ADDRESS VC 1/V PERMIT # 2c)1- �%� 2 �-Z ADB# ATE INSPECTED��y / DESCRIPTION OF WORK TO BE INSPECTED KI L A field inspection was conducted to determine final 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 ❑ Copy of CONDITIONS given to owner/contractor by inspector 1. FAILED FINAL INSPECTION - OUTSTANDING ISSUES ❑ Copy of CORRECTION NOTICE given to owner/contractor by inspector 1. 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Sign ocaprv1.doc.1:temp:b1dg:f6rms 10/01 FIN* PROJECT APPROVAL ORM TO: DATE: MEMO TO: PERMIT COORDINATOR, $UILDING DIVISION FROM: FIRE DEPARTMENT DATE PLEASESIGN . 51) o ►, t4- 1 L� M- 1 ENQINEERJNG DIVISION DATE 12 ^ D PLEASE SIGN PLANNING DIVISION DATE PLEASE SIGN PROJECT C' f= L. G SITE ADDRESS 3 SZ � PERMIT # # DATE INSPECTED DESCRIPTION OF WORK TO BE INSPECTED�Llf 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 of the described work GRANT FINAL PROJECT APPROVAL *************************************************************************************** 1. 1. 2. 3. GRANT PROJECT APPROVAL WITH CONDITIONS NOTED FAILED FINAL INSPECTION - OUTSTANDING ISSUES RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL ocaprvl.doc.l:temp:bldg:forms6/98 RECEIVED QEHAg1XPIRES4 , t CITY OF EDMONDS SE PERMIT ZQN NUMBER r CONSTRUCTION PERMIT APPLICATION JOB SUITE/APTN i40DRESS � � � Nrt OWNER NAME/NAME OF BUSINESS ARISC, w I A N , 1 9Y ► 1 / y� �Q� �,v n V+/J 1h WWW `�.I PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. . LID FEE $ x W MAILING ADDRESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Pa Approved S eP u e Permit Aeq'd O �s a� \? Li EXISTING PROPOSED Inspection Required Sidewalk Required CITY ZIP TELEPHONE O�` REQUIRED DEDICATION FT Underground Wider required NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES ❑ NO O t7 Z a W ADDRESS REMARKS Z = OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE z IY CITY ZIP TELEPHONE NAME � 1004122 , I JIV S. ENGINEERING REVIEWED/DATE ADD SS 1 ' V crz,� a = F E BV ATE p W CITY ZIP jLLEPHONE T,,E�rL VARIANCE O U U SHORELINE OR ADB# INSPECTION � YES � NO REQ'D BOND POSTED STATE LICENSE NUMBER EXPIRATIO Warr& 1 06CD� 3 QATE Syr V^ , (�4e$, j� �/ CH BY SEPA REVIEW COMPLETE I EXEMPT EXP SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED a +PROPERTY TAX ACCOUNT PARCEL NO. D © NEW ❑ RESIDENTIAL ❑ PLUMBING / MECH AUDITION COMMERCIAL COMPLIANCE OR ❑ CHANGE OF USE ❑ REMODEL ❑ APARTMENT ❑ SIGN LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE REAR I PROPOSED SETBACKS (FT.) FRONT UR SIDE REAR. 2 Z g REO'PARKING D PROVIDED LOT AREA PLANNINGREVIEWED'SY DATE • s!r REPAIR GRADING FENCE ❑ d Q CYDS ❑ ( X FT) REMARKS 4r ❑ DEMOLISH ElTANK ❑ OTHER Z a(TYPE IF m O ❑GARAGE RETAINING WALL CARPORT: ❑ ❑ RENEWAL ' OF USE. BUSIN S QR ACTIVITY) EXPLAIN: CHECKED BY T P ION r l OCC 7 GR I NUMBER OF STORIES NUMBER OF IALIrJ� /� AREAS NUMBER %"% ` SPECIAL INSPECTOR REQUIRED ❑YES JAREA OCCUPANT LOAD 'DESCRIBE WORK TO BE DONE : � REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D o m ► u SYA LL Qp� AW Si ? 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 DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC ,2 GRADING/FILL DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE -3 SEPARATE PERMISSION. ' " I'E SURCHARGE 2 W PERMIT APPLICATION: 180 DAYS a PERMIT LIMIT. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION y '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 LANDSCAPING f EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND INSPECTION FEE CC ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY x = FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT RECEIPT C DEEMEDTOMODIFY,WAIVEORREDUCEANVREQUIREMENT OFANY CITY ORDINANCE NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' RECEIPT TOTAL AMOUNT DUE 1 HEREBY ACKNOWLEDGE T T 1 HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION GIVEN IS CORRECT; AND T T I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPROVAL THE OWNER. I AGREE TO CO PLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application is not a permit until signed by the TION; AND IN DOING THE WO AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Qlficial or his/her Deputy: and Fees are paid. and IN VIOLATION OF THE LA CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION,, receipt is acknowledged in Space proyideq, , N'S COMPENSATI I SURANCE AND RCW 18.27. r` 1 kOt ICIALS SIGN/,T RUR DATE IGN (425) SIGNATliDATE Al/ 1V 0 771 -022�1, i ^ REL ED BY ATy ATTENTro EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING, OR STRUCTURE UNTIL 771-0221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBG SECTION 109 FAX ORIGINAL -FILE YELLOW -INSPECT PINK - OWNER • GOLD ASSESSOR - 5/98 v RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... Wall .......................... Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground ............. Rough -In ................... Commercial Final ...... HEATING: Gas Test .................... Gas Piping ................. Equipment ................. Commercial Final ....... EXTERIOR SHEATHING NAILING .......................... FRAMING ........................ FIRST FLOOR FRAMING... INSULATION ................... Floor Insulation ......... Wall Insulation ........... Ceiling Insulation ....... SHEETROCK NAILING ... SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. Z aoo� obs7/ FIN L PROJECT APPROVAL %RM TO: DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: FIB DEPARTMENT DATE j --2 - C'l PLEASE SIGN n ENGINEERING DIVISION DATE PLEASE SIGN PLANNING DIVISION DATE PLEASE SIGN PROJECT GL- C G SITE ADDRESS '2- 3 J� 2-,S" &� q fi A VC, I& PERMIT 4-6Q l — DCu 0 7 ADB# DATE INSPECTED 2 `�— e DESCRIPTION OF WORK TO BE INSPECTED A field inspection was conducted to determine final 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: L GRANT FINAL PROJECT APPROVAL GRANT PROJECT APPROVAL WITH CONDITIONS NOTED o Copy of CONDITIONS given to owner/contractor by inspector 1. FAILED FINAL INSPECTION - OUTSTANDING ISSUES q Copy of CORRECTION NOTICE given to owner/contractor by inspector 1. 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL, Date Sign ocaprv1.doc.1:temp:b1dg: forms 10/01 8LoC,. Pater " ,BATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS Q,IST e'VP,P_4fGF4Lv7'h/GAP-r./ C F/vltG yt MAILING ADDRESS 23 S' 2 5' S #''"� � �•� s�' CITY ZIP TELEPHONE �fn qv NAME ADDRESS CITY ZIP (TELEPHONE NAME ADDRESS CITY ZIP TELEPHONE St ra- w d 949 1 3-5 120& 365_ STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY PROPERTY TAX ACCOUNT PARCEL NO. / O ❑ NEW ❑ RESIDENTIAL PLUMBING / MECH ❑ AUDITION COMMERCIAL ❑ COMPLIANCE OR CHANGE OF USE ❑ REMODEL ❑ APARTMENT ❑ SIGN ❑ REPAIR ❑ GRADING CYDS ❑ FENCE X ( FT) DEMOLISH TANK ❑ OTHER GARAGE ❑ RETAINING WALL C] RENEWAL CARPORT cnrucwv (TYPE OF USE,'BUSAESS 9R ACTIVITY) EXPLAIN NUMBER 11 STORK,'q'V5j NUMBER OF UNITSLING CRITICAL AREAS NUMBER DESCRIBE WORK TO BE DONE �r Gas wl E-rr-rc .,. 4) 0613 7. 4, � ,.� f--s � ,N l-w-1 � � GO c A'G T71b N . ADD G 4-S L (O-11"a #q-.,./ 0 G © rrl r1? . Ifo o & ry , 0'. • HEAT SOURCE I GLAZING % I LOT SLOPE % PLAN CHECK NO: IVESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. j PERMIT APPLICATION: 180 DAYS PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS 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 ORDINANCE I NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATIO14 OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WOIKMEN'PICOMPENSATION INSURANCE AND RCW 18.27. ISIG TUR ( WN R GjENT) I DATE�G � AVENTION ' IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE. UNTIL A FINAL INSPECTION HAS BEEN MADFFFFFdAN0,/APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRAN ED.' UBC SECTION 109 5(9B PERMIT -EXPIRES j USE ZONE/�L/ PERMIT NUMBER JOB ADDRESS /J (� r� SUITE/APT11 +)4Ar V L PLAT NAME/SUBDIVISION NO. LOT Np. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved Q RW Permit Required O Street Use Permit Req'd C) EXISTING PROPOSED Inspection Required Sidewalk Required Q REQUIRED DEDICATION FT Underground Wiring required METER SIZE LINE SIZE N0.OF FIXTURES PRV REQUIRED YES ❑ NO Q REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUORAINAGE REVIEWED/DATE FIRE REVIEWED BY DATE z Z 2 w W VARIANCE OR CU SHORELINE OR ADB# INSPECTION I BOND REQ'D POSTED YES ONO SEPA REVIEW SIGN AREA HEIGHT COMPLETE I EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR,SIDE REAR Z 2 PARKING LOT AREA I PLANNING REVIEWED BY DATE g REO'D I PROVIDED,. is CHECKED BY SPECIAL INSPECTOR AREA REQUIRED ❑ YES COQB OCCUPANT 7GROUP r OCCUPANT LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'Q o m VALUATION I FEE PLAN CHECK FEE BUILDING PLUMBING MECHANICAL GRADING/FILL SURCHARGE ENG. REVIEW FEES ENG. INSPECTION FEE LANDSCAPING PLAN CHECK DEPOSIT TOTAL AMOUNT DUE ``-Jy APPLICATION APPROVAL GALL This application is not a permit until signed by the -Building Official or his/her Deputy: and Fees are paid, and OR INSPECTION recei;It is acknowledged in space provided.. OFC S SI. TVRE ti [ ATE �45) tE k � —V2'2O,r`,%" �I'i71 REL'EASEDBY ;AT It EXT 1333 771-0221 r. FAX ORIGINAL - FILE • YELLOW - INSPECTOR PINK -OWNER GOLD -ASSESSOR RECORD OF INSPECTIONS INSPECTOR PATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... Wall.......................... Pier/Porch ................. Retaining Wail ........... Slab Insulation .......... PLUMBING: Underground ............. Rough -In ................... Commercial Final ...... HEATING: Gas Test .................... 1 IMSy Gas Piping ................. CDs �s 1-7 ^ G Equipment ................. Commercial Final ....... EXTERIOR SHEATHING NAILING .......................... FRAMING ........................ FIRST FLOOR FRAMING... INSULATION ................... Floor Insulation Wall Insulation ........... Ceiling Insulation ....... SHEETROCK NAILING ... SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR 8 OCCUPANCY .................. �' ID E RECEIVED •a '�"� ". i"c/ IG.' a; r e <a / P ,RMII°'LXPIAft JdZIM < u�;', CITY OF EDMONDS USE PERMIT //�y•, ZO"E / NUMBER�/�—��83 CONSTRUCTION PERMIT APPLICATION BUITE/APTp ADDRESS ADDRESS 3 5 'i � (,/ W 0 ER/N1AME��yyMA�M�E.•O�F BUSINESS 4 • ' PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ IE UJI MAILING ADDRESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING PROPOSED TESCP Approved p RW Permit Requ6ad Q Street Use Permit Req'd U Inspection Required 0 Sidewalk Required 0 z O `7 tltl c • z S W �- 5 T �•S CITY ZIP TELEPHONE � REQUIRED DEDICATION FT underground Wlring required NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED / YES O NO O ADDRESS REMARKS Z x QWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE a W CITY ZIP TELEPHONE NAM&. /1�LT t �y 4" TW jP - N`" t� C_ ENGINEERING REVIEWED/DATE • o I 1 ¢ ADDRESS rY �V FIRE REVIEWED BY DATE yi CITY ZIP TELEPHONE = VARIANCE OR CU SHORELINE OR ADBN INSPECTION OO BOND POSTED STATE LICENSE NUMBER EXPIRATION DATE CHFfiKEO BY o%'/oi/0 Wa1"� ESO NO SEPA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED a PROPERTY TAX ACCOUNT PARCEL NO. 7 0 © EXP I ✓ NA ❑ NEW❑,I RESIDENTIAL PLUMBING MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE REAR PROPOSED SETBACKS (FT) FRONT UR SIDE REAR ADDITION COMMERCIAL COMPLIANCE OR IVI C]�1 ❑ f�14 MA IVA CHANGE OF USE z ❑ REMODEL ❑ APARTMENT ❑ SIGN REQ'D PROVIDED LOT AREA PLANNING REVIEWED BY DATE g FENCE ❑► REPAIR ❑ GRADING CYDS ❑ ( X FT) MA I /I Gil REMARKS ❑ DEMOLISH ❑ TANK ^ ❑ OTHER ` z ( I GARAGE REIAIDI WALL ❑ CARPORT ❑ ❑ RENEWAL a(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:. CHECKED BY TYPE OF PONSTRUCTION CODE OCCUPANT ¢ ! C�7 uK G' _ GROUP NUMBER OF CRITICAL cNUMBER SPECIAL INSPECTOR AREA OCCUPANT OF DWELLING AREAS OSTORIES . UNITS NUMBER- REQUIRED YES LOAD f7 DESCRIBE WORK TO BE DONE sees REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D o 4+ 1.2 C. A--,S o=v lrw i+ c— C m I!> a c. q-&vo, t- ie- r4 e G O J l.�'- Ka . Z AJ aKfl�C73 ' G A..S P 1PiN4, ennq /T 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 DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE, GRADING/FILL DOMAIN (CURBS, D i SEPARATE PER ISSION. ¢ PERMIT APPLICATC 1�$ n 3AiF SURCHARGE a PERMIT LIMIT: 1 YEAR - PROVIDED WO IS RTED WITHIN 9 0 AYs ' ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION ,, y APPLICANT, ON BEHALF O11 11 AO'N NGyINSPECTION FEE INTEREST, AGREES TO -"'INDEMNIFY, DEFEND AND HO A? HARMLESS THE CITY OF Q EDMONDS, WASHINGTON. ITS,OCpF'ICIALS, EMPLOYEES; 4RDA F� T9F QIu,' ANtjgqN LANDSCAPING _INSPECTION FEE a ALL CLAIMS FOR DAMAGESOE'WHATBVER NATURE,ARISINGb1 ECTLYORINDIRECTL� x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT.SHALL NOT BE RECEIPTPLAN CHECK DEPOSIT DEEMEDTOMODIFY, WAIVE•ORREDUCE ANY REQUIREMENT OFANY CITY ORDINANCE = NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANYORDINANCE PROVISION.' TOTAL AMOUNT DUEwoo- RECEIPT y� ► 1 ` � V I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING, CONSTRUC- CALL This application is n6t'a'permil until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON �ELATING Building Official or his/her Deputy: and Fees are paid, and TO FOR INSPECTION receipt is acknowledged in space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. SIG TORE NER ENT) DATE OFFICIAL ATUR 7 DATE (425) It t H ; y tP r nv. , r 771 O22Or"'''` RELEASED BY ATE A ENT.ION EXT -1233 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 2 kol A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- gaiGINAL CATE OF OCCUPANCY HAS BEEN GRANTED.- UBC SECTION 109 - FILE YELLOW -INSPECTOR FAX PINK -OWNER GOLD -ASSESSOR 5/98 RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... Wall .......................... Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground ............. Rough -In ................... Commercial Final ...... HEATING: Gas Test .................... Gas Piping ................. Equipment ................. Commercial Final ....... EXTERIOR SHEATHING NAILING .......................... FRAMING ........................ FIRST FLOOR FRAMING... INSULATION ................... Floor Insulation ......... Wall Insulation ........... Ceiling Insulation ....... SHEETROCK NAILING ... SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR 44ft1m__ OCCUPANCY .................. �' (btm VT- 2cn:) I — oZ z- R54, ) aodl,v 01/4fga/