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20020269.� DATE DECEIVED�7 PERMITEXPIRES CITY OF EDMONDS usE PERMIT �/ CONSTRUCTION PERMIT APPLICATION JOB /jj SUITE/APT# ADDRESS 06/ OWNER NAMEMAME OF BUSINESS 1 F/YAve ALIF TAE T h0c7 L e ` L ace_ PLAT NAMOSUBDIVISION NO LOT NO LID NO. �i MAILING ADDRESS LID FEE S Q 4, 1 7 F1 rd4 L e • s `/ � vi LA e- PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP sco.nze nw Po� ^ Pnmr.a CITY TELEPHONE EXISTING PROPOSED Pa,mll Pn'd Inepeaien Pn�kea p j gpZIP �©EOUIREDDEDICATION p 0 METER SIZE LINE SIZE No. OF FIXTURES PRV REQUIRED YES❑ NO ❑REMARKS r OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ZIP TELEPHONE NAME t� c r 001C-f I v1lL / I T G ADDRESS ENGINEERING REVIEWEDIDATE C FIRE REVIEWED BY DATE Y CITY 21P U TELEPHONE � STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY YAflIANCE OR CU SHORELINE OR ADB# INSPECTION BOND POSTED 0 •J IryJ{J L o Q PROPERTY TAX ACCOUNT PARCEL NO. F301 O ^QO O/200 SERA REVIEW COMPLETE I E%E PT � SIGN AREA ALLOWED PROgPO�.,s{IED I�1 H HT ALLOWED Pp/OPOSEO I�'I cr700— E%P `Y IJ +I� I(�I NEW ❑ RESIDENTIAL ❑ PLUMBING / NEON LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT.) ALLO ED pR POSED N SIDE REAR WA FRONT IIR SIDE REAR = ❑ADDITION 141 COMMEPCUIL �l ❑ COMPL NICE OR CHANGE OF USE ti PARKING LOT AREA P 1 1 G PEV F Y DATE ❑ HEMODEL ❑. APARTMENT �.,( ISU SIGN REO'D PROVIDED �T �_� O 6 ❑ REPAID El ❑ F ENCE L CY05 X FN REMARKS ❑ DEMOLISH ❑ TANK ❑ OTHER GARAGE RETAINING WALL WPLL ❑ 2 CARPORT [:I ❑ RENEWAL (TYPE OF USE, BUSINESS OR ACTNf1Y) EXPLAIN: � _ ts"Ij 11 J�=ry Ica. CHECKED BY TYPE nc�O UTION "-�% OCCUPANT OPOUP NUMBER %% OF h o JJ NUMBED OF CRITICAL DWELLING O AREAS SPECIAL INSPECTOR AREA OCCUPANT STORIES UNITS NUMBER REQUIRED❑ YES LOAD DESCRIBE WORK TO BE DONE I, REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'Dal � 9 ,T xS..b,l VALUATION $ Description FEE Description FEE Plan Check HEAT SOUP _ SLOPE % Building D f ��T PLAN CHECK Nf 5 /i OATE P jRg 6 THIS PERYRAUTHOPI2ESONLY THE WORK NOTED. THIS PERMRCOVER6 WORK TO �((J7 "-" � `27 j t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ONTHE BLIC PU DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL RPU Grading RGCOftlln Fee g SEPARATE PERMISSION. Engr. Review City Surcharge PERMIT APPLICATION: 1e0 GAYS PERMIT L Mm 1 YEAR -PROVIDED WORK IS STARTED WITHIN tea DAYS Engc Inspection State Surcharge SEE BACK OF PINK PERMR FOR MORE INFORMATION •APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Traffic Mitigation Plan Chk Deposit I / j — IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS. WASHIMGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND Fire Review Receipt ALI. CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY III FROM THE ISSUANCE OF THIS PERMR ISSUANCE OF THIS PERMIT SHALL NOT BE ,] DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT Fire Inspection P Total Amount Due lie OF ANY CITY ORDINANCE Z NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- nsp. Receipt# G VEL HEREBY CORRECT. AND THAT I AME REM THIS THEOWNER. OR APPLICATION; DU Y AUTHORIZED INFORMATION AGENT OF APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.LL ihls application Is not a p-11 u l signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BF. EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TOECTION COMPENSATION INSURANCE AND ROW IB.PT.--� LFORI�N BUIIding OPIcial or his/her Dopuly: ana Foes Alc peld, and receipt is acknowledged inspnco provideWORKMEN'S (OWNER RAGE DATE SIGHED OFFI IALS BIONATURESIGNATURE TE UZ nr�a .. •- 20 RELE D BY ATE ATTENTION 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 OCCUPANY HAS BEEN GRANTED. UBC S CTIO�f 109 � //� i)� FAX ORIGINAL -FILE YELLOW - INSPEC OR PINK -OWNS GOLD - ASSESSOR - ' FINAL PROJECT APPROVAL FORM TO: DATE:_-_ MEMO TO: PERNIIT COORDINATOR, BUILDING DIVISION FROM: __FIRE DEPARTMENT DATE euwseswe ENGINEERING DIVISION DATE PLANNING DIVISION DATE rirwsa swr �1G� P�1�LF Pz�c>=_ PROTECT SITE ADDRESS D(,?1% PERMIT # ADB# ZDOZ 5 DATE INSPECTED_ 7"02 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 GRANT FINAL PROTECT APPROVAL GRANT PROJECT APPROVAL WITH CONDITIONS NOTED ❑ Copy of CONDITIONS given to owner/contractor by inspector I 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 o caprvl.doe.l:temp:bldg: forms 10/01 0 a n m = 6 to 4 cm mo 1 n 0 c MZ O -4 DZ r3: rn O- mm_ Oy r m (A Z X. 2 Z rn O im I ' RECORD OF INSPECTIONS s {. INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: ' ...' ...' ... __ Footing ......... - ': ,. .. Wall .......................... . • �._ - Pledloorch ........ Z'.. Retaining Slab Insulation PLUMBING:. 1'lh; Ul m R Underground .. p - Rough -in .. m p !1 Commercial Finab m HEATING: '.. ... Gas Test .................... Gas Piping .. Equipment -I .. .... Commercial Final 1 m m' -EXTERIOR SHEATHING ,.. ._ t..•. 7 NAILING ... :.....:.. •. rn . '. FRAMING-...... 3e �._ - -. FIRST FLOOR FRAMING... . 1 mrm INSULATION .................... ... Floor Insulation ..:...... -- _ _ _. - ... .. _.. -- , Wall Insulation ........... Ceiling Insulation ....... - N` SHEETROCK NAILING ... �. SPECIAL INSPECTION ... - - M { -MISCELLANEOUS ...........: :. ,. FINAL APPROVAL FOR , MS'.,-., , i _ r ? OCCUPANCY .................. V ;.. :. i 2