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20000016.pdfDATE RECEIVED PERMITEXPIRES CITY OF EDMONDS USE ZONE PERMIT NUMBER -A00016 CONSTRUCTION PERMIT APPLICATION JOB ADDRESS SUITVART. -s' p L V_� OWNER NAM NAME OF BU NESS WIN IR 1111 NO, ��AAVE�11,1 PLAT NAMEISUB DIVISION NO. LID FEE S MAILING ADDRESS . rL PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISIING_ PROPOSED— lElCP A"—., 0. CITY ZIP TELEPHONE REQUIRED DEDICATION FT — --- Wj,I­.q­d PRV REQUIRED C NAM�E AnDRESS YES E3 NO 0 REM RKS — ... 1—T.—T— FOR EROSION CONTROUORAINAGE TIT—Y zip I TELEPHONE NAME c SE�EWEDIDATE _Q ENGINEERING a ADDRESS CA A(lbl 2 FIRE REVIEWED BY DATE CITY ZIP TEIEPHONE u VARIANCE OR CU SO SH07ELINE OR ADBN INSPECTION POSTED .0 STATE LICENSE NUMBER �KED BY RE 0YES01771N. SERA REVIEW COMPLETE EXEMPT SIGN AREA HEIGHT ALLOWED PROPOSED ALLOWED PROPOSED �PRORERTY TAX ACCOUNT PARCEL NO. I I V, UP - LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS tFTI REAR FRONT UPSIDE REAR NEW [�RE.IIDENTIAL PLUMBING MECH ALLOWED PROPOSED FRONT SIDE C3 ADDITION _.P., COMPLIANCE OR Al CHANGE OF USE RA KING LOT AREA PLANNING REVIEWED BY DATE C3 REMODEL I Ej APARTMENT SIGN RECID PRO �DED I REPAIR C] GRADING CYDS 0 (FENCE X FT) REMARKS DEMOLISH 0 TANK o OTHER — (')I, I,� o GARAGE CARPORT C] RETAKININYG WALL RENEWAL ROD F C] 0 _TTYPE OF —USE. BUSINESS OR T- 7 EXPI-AIN: ECKEDBY T RE OF CON N CODE T OCCUR OUPA NUMBER N MISER F CR ITICAL SPECIAL INSPECTOR AREA OCCUPANT OF D ELLIN AREAS gq 9 REQUIRED 0 YES LOAD o STORIES U IT. NUMBER DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC IOWFINAL INSPECTION RED P HEAT SOURCE GLAZING % LOT E % PLAN CHECK NO: '1­1 JVESTIEG�� THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO U kTE BE DONE ON PRIVA PROPERTY ONLY. ANY CONSTRUCTION ON THE P BUC 2 DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE m SEPARATE PEQISSION. RE MIT APPLICATION: ISO DAYS YE S PERMIT LIMIT: I AR! PROVIDED WORK I STARTEOWITHIN lEODAYS SEEBACK F PINK PERMIT FOR MORE INFORMATION HER S ;A PLICANT. ON BEHALF OF HIS OR PEONJOSE S 0 F �NHDElHRoSLD`ISA`N AN SUCCESORS NPNTERFST, AGREES TO 1401FIVINIFY RMLE THE CITY OF I S FROM ANY AND EDMONDS, WASHINGTON, ITS OFFICIALSE EMPLOYEES. AND AGENT ALLCLAIMS FOR DAMAGESOF WHATEVER NATURE. ARISING DIRECTLY GR­­ FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SMALL NOT BE -I DEEMED TO MODIFY. WAIVE OR REDUCEANY REQUIREMENT OF ANY CITY ORDINANCE NORLIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCEANY ORDINA 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 THEOWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- TION; AND IN DOIN THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE LEMPLOYF G TOO IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RE ATING WORKMEN*S COMPENSATION INSURANCE AND ACW 16,27. Z a m c M 0 80 c m m Z S 0 _n m M 0 o o Fn C ca Z I.AN CHECK cl) Z BUILDING PLUMBING m MECHANICAL GRADINGIFILL STATE SURCHARGE ENG. REVIEW FEES ENG. INSPECTION FEE LANDSCAPING INSPECTION FEE RECEIPT PLAN CHECK DEPOSIT RECEIPT TOTAL AMOUNT DUE APPLICATION APPROVAL TN. IIPPft-I­ '- 1-1 A P-1 CALL 'U"dl�g olli,ml ot h,�­ . — FOR INSPECTION recalpt is ackn—lodg.d .­1 F—IdId. OFFI ALSStGNATURE DATE (425) k-kc)- - I 771-0220 BE LEASED By DATE ATTENTION EXT 333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI� 109 ORIGINAL -PILE - YELLOW- INSPECTOR PINK - OWNER - GOLD - ASSESSOR FAX CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 5198 ATE �RECEIVEO PERMIT EXPIRES' USE ZONE PERMIT CITY OF EDMONDS NUMBER CONSTRUCTION PERMIT APPLICATION JOB A ODRESS SUITE/APT# -5. VJ I D I L - WNER NAMEJNAME OF BUSINESS PLAT NAMEISUBDIVISION NO. LOT NO. 110 NO, UD FEE S MAILING ADDRESS All-- 13 -71e9 RIGHT OF WAY PER OFFICIAL STRE ET MAP 4�;., P.,.K R.q d __f CITY ZIP TELEPHONE EXISTING — PROPOSED . sld­l� Re REQUIRED DEDICATION— FT — U.­'... W, e METER SIZE LINE SIZE NO.. OF FIXTURES PAV REQUIRED NAME YE S 0 No 0 -ADDRESS ROSION CONTROl_IDn AINAGE CITY ZIP NAME ADDRESS CIT, STATE LICENSE NUMBER EXPIRATION PROPERTYTAX ACCOUNT RCELNO, C] NEW C] RESIDENTIAL LUMBING / MECH 0 MPLIANCE ZR ADDITION COMMERCIAL C C] REMODEL C3 APARTMENT SIGN FENCE REPAIR I X FT) E..U.li TANK m OTHER 0 G A A E RETAININ.WAIL n RENEWAL C F.CK"', j ARPGRT (TYPE OF USE. BUSINESS OR ACTIVITY) EXPl_AlN: NUMBER OF STORIES NIMBIROF DWELLING UNITS TICAL AREAS NO MBER DESCRIBE WORK TO BE DONE I \ -sc C�,( �-� ­�- "o, FIRE REVIEWED BY DATE -T—.-4NTE. VARIANCE OR CU SHORELINE OR AD54 I N777-- D OYES ONO I COM SERA REVIEW ILETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT POSED ALLOW. IR- _XP I I LOT COVIRAG� I ED ROPO SETBACKS (Ft) ALLOWED r FRONT URSIDS REAR PARKII tl"EA III BY ATE REDD I PR Do ,EC,<ED TYPE 01 OONSTFI,�5N ­1 -n-n-�­ �-j BY L BY _rp-EC'AL'NSPECTOR AREA OCCUPANT REQUIRE S LOAD D 7[7]YES REMARKS PROGRESS INSPECTIONS PER UBC 10811FINALtNSPECTIC 4 VALUATION FEE PLAN CHECK FEE HEAT SOURCE GLAZING LOT E I BUILDING PLAN CHECK NO: FESTED,� PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVER WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILIL IS DOMAIN (CURBS. SIDEWALKS, DRIVE WAYS, MARGUEES, ETC.) WILL REOUIRE , It SEPARATE PERMISSION. STATE SURCHARGE PERMITAPPLICATI M 1800AYS PERMIT LIMIT. 1 YEAR , PROVIDED WORK IS STARTED WITHIN 180 DAYS ENS. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION P LICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS ENG. INSPECTION FEE ;AP N INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF FROM ANY AND LANDSCAPING 2 EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS A OANIAG FWHATEVER NATURE. ARISING DIRECTLYOR INDIRECTLY LLCL"MS=ANCE INSPECTION FEE RECEIPT FROM THE G ESToll. PERMIT. ISSUANCE OF THIS SHALL NOT e PLAN CHECK DEPOSIT 0 , FPERMIT WAIV CE DEEMEDTOMODIFY. EOR REDUCE ANY REGUiREMENTO ANYCITYORDINAN E TO ENFORCE ANY ORDINANCE PROVISION.- R 0 NOR LIMIT IN ANY WAYTHE �R`Y'S A51LITY TOTAL AMOUNT DUE I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION,�PPROVAL GIVEN IS CORRECT. AND THAT I AM T14E OWNER. OR THE DULY AUTHORIZED AGENT OF T �o Ppli- 11- 1- P-11 ule" �Q­ "Y THE OW LAWS REGULATING CONSTRUC. NER. I AGREE TO COMPLY WITH CITY AND STATE CALL oiI dl�ho ofr,,i,j ., he�el DIP.tY: ..d Foes alo ­'d. .�d TION: AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED OF WASHINGTON RELATING TO FOR INSPECTION , ... Pj,, �k­llldgld 11 op.co p—dod. IN VIaLATI ON OF THE LABOR CODE OF THE STATE WORKMEN'S COMPENSATION INSURANCE AND RCW 18,27. FF151ALS SIGNATURE DATE (OWNER OR AGE S16111 (425) SIGNATURE ��DATE 9vzl�_A�le V/-,- 771-0220, -RELEASED 11 DATE EXT 33� 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- OR-NAL-11LE Y�Ll_.W-INSPEGTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK. - OWNER GOLD - ASSESSOR z m Vi -4 3: M M 0 0 c M 0 c > O"n In m M a 0 0 c TO c - - , m z -1 z m