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20010397.pdf.DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION IER NAME/NAME OF BUSINESS CITY J ZIP TELEPHONE kyp0woo_CJ wo . �{aS- NAM ADDRESS CITY ZIP TELEPHONE NAME ytif CITY 0111611 ❑ NEW ❑ ADDITION ❑ REMODEL ❑ REPAIR ❑ DEMOLISH GARAGE ❑ CARPORT ITYPE� NUMBER OF . '1 / 221 PERMIT EXPIRES USE �� 5 n PERMIT pJ 0 i z°NE cx � NUMBER �,I✓V 1 V JOB SUITEIAPT. ADDRESy&,1/o,/ `J ,7Gy4t � U� • . l PLAT NAMEISUUBDIVISION NO/. LOT NO. LIO NO, 0 FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP B �.I U.. P-11 R.Q a FXIST ING PROPOSED vne REQUIRED DEDICATION FT �j°�'!'O "! METER SIZE I LINE SIZE I NO.OF FIXTURES PRV REDUIREO ES O NO Cl ',Cl \' REVIEWED/DATE ENGINEERING 44"1 x/ IRE.REVIEWED BY DATE ZIP TELEP ONE .y ' /VARIANCE 0 -7V oUlO� OR CU SHORELINE OR ADBM INSPECTION BOND R EXPI ATION DATE CHECKED BY NA NA ❑ REOQ/ POSTED YES �^IO J� e0g16' // "1 Q IV SERA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSE NT PARCEL NO. -000 -0/6 EXP •QI�I LOT COVERAGE REQUIRED SETBACKS (FT) ROPd5E0 SETBACKS I"..) ESIDENTIAL ❑ PLUMBINO/MECH A�LLIOWED`1 PROPOSED SIrE REA ROI�IT VR REAR COMMERCIAL COMPLIANCE OR ❑ `� NQIJ�.i �^FRONT c.�l I7.r �� 1�V L�DE �I ❑ CHANGEOFUBE PARKING LOT AREA PLANNING REVI V Y DATE APARTMENT ❑ IGN REO'D I PROVIDED - L _ c/ I m ❑ S FENCE ❑ ❑GRADING CYDS 1 _ X/_ FT) ❑ TANK $4 A.p- YNlUc- ❑RETAINING WALL ROCKERY ❑ RENEWAL OR ACTIVITY) EXPLAIN: NUMBER OF nwFll lN[, I CRITICAL AREAS THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC UOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REOUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 1 BO DAYS PERMIT LIMIT: 1 YEAR • PROVIDED WORK IS STARTED WITHIN ISO DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS 'J IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF S EDMONDS,WAEHINGTON. ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANYAND ,4LLCLAIMS 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 NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' [CHECKEDBY ITYPEOF AUNSTFUCTf�N I�� I GROUPANT N PECTOR AREA ❑ YES OCCUPANT LOAD REMARKS S INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D c r VALUATION FEE PLAN CHECK FEE BUILDING PLUMBING . MECHANICAL GRADING/FILL -9F SURCHARGE ENG. REVIEW FEES •' ENG. INSPECTION FEE LANDSCAPING INSPECTION FEE PLAN CHECK DEPOSIT RECEIPT'- TOTAL AMOUNT DUE RECEIPT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF PO WITH CITY AND STATE LAWS REGULAT ING CONSTRUC CALL TH.ia epplica, ie Rol a pormll v.I,l signed by the Fees an0 THE OWNER. I AG FEE TO COM TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED RELATING TO FOR INSPECTION Builtlin 011icielor hWher Deputy: end aee paid, go ipl is ack wlBdged y:.pecp prp— d. IN VIUUTION OF THE LABOR CODE OF THE STAVE OF WASHINGTON WORKMEN 'SC SATION INSURANCE AND ROW I8.21. AT SIGNA UR :OWNER AGENT) DATE SIGNED (425) _ 771 -O2GO DAT EXT 1333 REL ED BY , ATTENTION 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- ORIGINAL FILE YELLOW INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX - PINK - OWNER GOLD- ASSESSOR S198 • m —I •R cM m0 �0 OG m m DZ ' O� Im m 0 (q C C4) C0 fn Zr �1 a a z a 0 z O -1 n IT! 1 I: RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Fcoting ...................... Wall.......................... Plot/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 .................. 7o4ffx®rWA01, r t� d O 1 m' w { m { m 01 O C; .I � Y G m1 lo-. i....' CZ y m m e'1 Fn I T' O, n: M. ! z tf �r r �� .