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20030983.pdfa DATE RECEIVED )` CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS . A�AWEP MAILJtLG ADDRESS UVIK 7-A (&7- Rd CITY TELEPHONE fzep NAME ADDRESS CITY r ZIP ITELEPHONE NAME CBL " Is q. NIC 0 42, C ADDREF )< "O� CITY ZIP TELEPHONE _Se�&f fi'2 E If _V? /7 X ,?Cg 0 _# F 1-7 STAPMBER EXPIRAJION�TE� 0AECK ,_ICENSE NU 10V '(eC / dF NEW RESIDENTIAL ADDITION COMMERCIAL REMODEL MULTIFAMILY 1:1 REPAIR 1:3 GRADING CYDS 0 DEMOLISH TANK IGARAGE 3 CARPORT o RETAININGWALL ROCKERY (TYPE OF LISS, BUSINESS F—M I Ad N. / I- = ( NUMBER OF NUMBER OF 13WELLING 1TORIES UNITS DESCRIBE WORK TO BE DONE �4' 110P 367 q*j-( - alvd pqkma� I P-P112tirt ^7- HEAT SOURCE GLAZING % PLAN CHECK NO: PLUMBING / MECH COMPLIANCE OR CHANGE OF USE 0 SIGN o FENCE FT) OTHER FIRE SPRINKLER FIREALARM CRITICAL AREAS NUMBER 3 LOT SLOPE % VESTED DATE PERMIT EXPIRES U97- PERMIT ZONE C_�NUMBER _ JOB SUITE/APT# ADDRESS,,�y� 11,07- Rd PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESGF AP r=,d Rw ParrrAtPR Street Use Pannit RWd EXISTING - PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION- FT Underground Wiringrequirod 13 METER SIZE LINE SIZE OF FIXTURES PRV REQUIRED YES13 NO 13 REMARKS z z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE I REVIEWED BY DATE FIRE REVIEWED BY DATE Lu cc tIANCE OR CU SHORELINE ORADB# I INSPECTION BOND REO'D POSTED SEPA REVIEW SIGN AgEA 113YEs I 13NO I $ HEIGHT COMPLETE . EXEMPT ALLOWED . PROPOSED . ALLOWED , PROPOSED LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR z PARKING LOT AREA PLANNING REVIEWED BY DATE REO'D I PROVIDED I CHECKED BY ITYPE OF CON [ON OCCUPANY . GROUP6// SPECIAL INSPECTIOf4 AREA OCCUPANT REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL. INSPECTION REO'D $ ___ I Deacription FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPUCATION: 180 DAYS PERMIT LIMM. I YEAR - PROVIDED WORK 15 STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp- DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CiTY8 ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT; AND THAT I AM THE OWNER. OR THE DULY AUYHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION WORKMENS C5�99NGAZ��RANCE AND RCW 18.27. I NER Ofl�dE DArE 1 3IGNED (425) "(GI �/ J3 771-0220 %TTENTION W 1333 Plan Chk. Deposit Receipt # Total Amt. Due Receipt # APPLICATION APPROVAL This application Is not a permit until signed by the ding Official or his/her Deputy: and Fees are paid, and I receipt Is acknowledged In space provided. 4.0 a QNhjdL-ri mr. DATE 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 CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING 1 EINAL PROJE ROYAL EORM TO: -DATE: ��MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION '—Q 3 FROM: YERE DEPARTMENT DATE-Laal-d— WA EN GINEERING DIVISION DATE________�__ z —P LANNING DIVISION DATE 0 m S1%M)WDRES S 6 am m 0 0 --J)ATEINSPECTED. X m M z :,,-,--','.:DESCR . IPTIONOTWORKTOBEINSPECTED U67—Z /L"p AnLA—,w I!V z �Afield M;S' ection was conducted to determine compliance with approved plans. Final approval denoteiftt P. there 'a're'no 66tiOnS from' the above signed Department to the granting of . 0 _n 3:9 miva approval of the described work mm 0 Fn Performance Bonds associated with the project may be released C 0) MO z 'GP AM FINAL PROJECT APPROVAL z GRANT,FINAL PROJECT APPROVAL WITH CONDITIONS NOTED z 0 ��AILED FINAL INSPECTION - OUTSTANDING ISSUES 0 m 2. —RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL oca.prvl.doc.l:tenip:bldg:forms6/98 F n RECORD OF INSPECTIONS INSPECTOR DATE APPROVED �SET6ACKS ...................... FOUNDATION:' - Footing ............. Wall..... ................... . Pier/Porch ................. Relaining,Wall,', Slab insulation .......... PLUMBING: - I . I k Underground Rough -in ................... -Commercial Flhal,....,.' M hEATING*- z Gas�Test .......... ........ .. Gas Plpjng ........... Equipment� 1. ................ Commercial Final ....... EXTERIOR SHEATHING NAILING . . . . . . . . . . . . . . . . . . . . . . . . . FRAMING .................... FIRST FLOOR FRAMING... INSULATION ................... M DATE R�ECEIVED I PERMITEXPIRES CITY OF EDMONDS USE PERMIT ZONE NUMBERc4�__5_6�9,�19_3 CONSTRUCTION PERMIT APPLICATION JOB surrE/APT# ADDRESS 1&7- /,qC/ OWNER NAMENAME OF BUSINESS NA( KER PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILW ADDRESS TA C &T Rd LID FEE S TESCP Appoved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW P.", "Ukad Street Use Permit AWd CITY ZIP TELEPHONE LL" EXISTING — PROPOSED hupectionRaquW Sidewalk Requkad REQUIRED DEDICATION— FT Undergmund Whing req" 13 ��ds NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED A 1A YES 13 NO C3 I z / ADDRESS IVII+ REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE CITY ZIP ELEPHONE NAME t—Itco 61, ENGINEERING REVIEWEDUU ADDRES" .0. 1 6ax /A;. r NJ L FIRE REVIEWED BY DATE lu C113e ZIP TELEPHONE 1 117 Ir W VARIANCE OR CU SHORELINE OR ADS# INSPECTION BOND STAB LICENSE NUMBER EXPIRAgnON DFrE .1 CHECKED BY RECID POSTED 113YES, is Ft C C 0 c / 6 (F(j 0? 4/ ONO SEPA REVIEW SIGN AREA. HEIGHT PROPERTY TAX A :�;07 PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROP BED 10 EXP I , NEW C<RESIDENTtAL PLUM13ING I /MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Ft) ALLOWED, PROPOSED FRONT � 'SIDE REAR FRONT UR SIDE. REAR COMPLIANCE OR [j ADDITION Ej COMMERCIAL 0 CHANGE OF USE z 0 REMODEL mucrimmiLy SIGN PARKING LOT'AR PLANNING. REVIEWED BY DATE REaD PROVIDED 1. F1_q MARSHAL FENCE REPAIR GRADING CYDS X FIT) 1� EMARKS IVIUD I t1t -PRBTN-T FOR o OTHER S rO'TANK [3 DEMOLI.H I=IA 51-111f% I -ILL, -REWML: OR CAP aGARAGE RETAINING WALL 0 FIRE SPRINKLER CARPORT 0 ROCKERY FIRE ALARM (ME OF, USE� BUSINESS A V,0C,4,r1n VIONIN6� TYPE OF CO CODE. CHECKED_ NSTRUCTION OCCUPANT BY GROUP NUMBER NUMBER OF CRITICAL OF DWELLING AREAS SPECIAL INSPECTION JAREA OCCUPANT —STORIE UNITS NUMBER REQUIRED LOAD , YES DESCRI13E WORK TO BE DONE )'411PPOW Sqki'ei REMARKS PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REaD r,4"1Wj&,qA6 3 T/04401 'Ov'd tlwu��,� 6V Mn# AWE VALUATION $ Description FEE Description FEE Plan Check Stat Surcharge HEAT SOURCE GLAZING % LOT SLOPE % T Building Permit /A_ City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO .:�SE DOME ON PnIVATISPROPERTV ONLY. M�CONSTRUQTION ON THEPUBLIC G d`nj ra 60MAIN (CURBS, SiD&EVALKS, DRIVIEWAWMARQUEES, ETC-) WILL REQU:R'E SEPARATE POWISSION. Engr. Review PERMIT APPLICATION. 160DAYS PERMIT LIMM I YEAR -PROVIDED WORK IS STARTED WITHIN 180DAYS Engr. Inspection SEP- BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review 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 Inspection Receipt # I Ill FOR DAMAGES IF WHATEVER IRE, ARISING DIRECTLY OR IN11"ECI FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PR17ASION.' !2 Iz Recording Fee Receipt N I HEREBY ACKNOWLEDGE *THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPR I 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. CALL,,. This application Is not a porMit Until signed by the TION; AND IN GOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED ding Oftial or his/hot Deputy: and Fees are paid. and IN VIOLATION OF THE LABOR CODE OF THE 13TATE OF WASHINGTON RELATING TO FOR INSPEC71ON recolptleacknovAodgedinopece provided. WORKMEIT$ qg*11164GAT1�14 INSURANCE AND RCW 18.27. "�O �Fl S N T URE DATE Sig NT) 'A'35) 3 771-0220 -ON RELEA �DY— ATTENf I EXT 1333 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 CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING -----------