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20000189.pdfCITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION CITY ZIP I TELEPHONE 1 c_hmf1lvbs qfrl.2 TELEPHONE ISEE PERMIT 2 C)j p3 9 ZON NUMBER _�oj JOB SUITEJAPT# ADDRESS 5- —7,v PLAT NAMElSUDDWIS1ON NO� LOT No, LID NO, L F ID !ES S —Z.Ll. RIGHT OF WAY PER OFFICIAL STREET MAP a P TE -P Alp— I RES PW P.anl S P.— a., d EXIII ING — PROPOSED— aa.. . 1.10- R.""d REOUIREDD15DICATION� FT .ETEIT SIZE LINE SIZE 10 OF FIXTURES ED RE U RE D OIL PFV ED PRI Y S NO . YES NO 0 —1—EIRLE FOR EROSION CONTSOUVnAINAGE C4 C�- 7;�-< ENGINEERING R5VIEWEDIDATE R�( 3 12 2 & FIRE REVIEWED By DATE ZIP ILIPIOME 6 - 5V 7-9'11/ 7 F GE OF OU VARIANCE OR CU SHORELINEOAADB� [3YES ONO NUMBER E_Xl.HXTCN DATE CHECKED By Lt L C 6 C / eJ J �o R U k/1'a/0 0 — — — �EPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED R. P L NO. I I , ;S�UNT SW,_ _To _ LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS FT) �RSIDE FEAR NEW RESIDENTIAL ED] PLUMBING I M CH ALLOWED PROPOSED FRONT SIDE REAR FRONT ADDITION 0 COMMERCIAL ci COMPLIANCE OR USE 0 CHANGE OF PA KING OT AREA PLANNING REVIEWED By DATE A aP..T .. T PARTMENT m SIGN RED 'D PROVIDED REMODEL L-i I REPAIR ci GRADING CYDs PENCE FENCE 0 ( _X _PT) X ARK S F — ARKS ME; DEMOLISH E] TANK 0 IF GARAGE CARPORT C3 RETAINING WALL ROCKE RENEWAL l"TY CHECKEDBY T" IT" NUMBER NUMBEROF I AL "�'E`A'CARL C, L EP rz�IAL INSPECTOi OF ,a,ELL NG AR _ B REQUIRE. S�y.. L TORIES UNITS ER N,MEE .. FIRE WORK TO BE DONE 'Z PLAN CHECK FEE LOT SLOPE I 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 QN THE PUBLIC GRA.INGIFILL oOMAIN (CURDS, SIDEWALKS, DRIVEWAYS . MARQUEES. ETC.) WILL REQUI RE SEPARATE PERIMISSION� PERMIT APPLICAll N: — DAYS PERMIT LIMIT. I YEAR, PROVIDE. WORK IS STARTED WITHIN 180 DAYS ENG, REVIEW FE ts SEEBACK OF PINK PERMIT FOR MORE INFORMATION HIS OR HER SPOUSE. HEIRS. ASSIG S D SUC ES ., END INSPECTION FEE ;AP,PLIEI.A�IST��IAI.IEEHALTF.OF N NT R E. INDEMNIFY, DEFEND AND HOLD HA L S THE ITY 0 LANDSCAPING N TON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANYAND E010111- WAS"' ' INSPECTION FEE ALLCLA'., I...A.AGE OF WHATEVER NATURE. ARISING MECT Ll 0 INDIRECTLY NOT BE OF THIS FE1111 ISSUANCE 01 THIS PERMIT SHALL ORDINANCE_ PLAN CHECK DEPOSIT ,�,E,,SlU,A,NCl ��.T W_E OR REDUCE ANY REQUIREMENT OF ANY CITY PROVISION 'DINANCE TOTAL AMOUNT DUE THAT I HAVTE READ THIS APPLICATION. THAT THE NIO mATI-N I HEREBY ACKNOWLEDGE GIVE IS LQRE%ANo IHE OWNER OR THE DULY AUTHORIZED AGENT OF ` CToATPLY. NR A.R TO GM WITH CITY AND STATE LAWS REGULATING COf4STRUO THE 'W P D LOIE CA ILL T AND ll� DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL RE TV OF WASHINGTON RELATING 10 FOR INSPECTIl IN "DILATION OF THE LABOR CODE OF THE STATE "'KMENS Co.PENSATION INSURANCE AND RCW 18.21 ATE IGNED (425) sl T) '4�1 771-0220 EXT 333 ATTENTION IT IS UNLAWFULTO 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. UBC SECTION 109 FAX i OCCUPANT GROUP 108/FINAL VALUATION I FEE �FiPT L V;�i APPLICATION, PPROVAL —la - ThIl ppll.anaa I t 7 dF`pon-d d and dano 1, h,aihll DlPad, and a P.d.d. �PFICZIALS, NATURE DATE u, ORIGINAL FILE YELLOW - INSPECTOR PINK - OWNER GOLD - ASSESSOR \J11 z 0 m 0 80 m -Z o -n -n -4 = m m 0 0 0 c z z z 9 0 m DIVISION Performance Bonds associated with the project maybe released z 0 1 0 m =1 �n m C M 0 -40 on C A m z 0-1 C: — > z --i Co 0 -n > m M 0 0 0 M C CD 9 Co M C) Z � .Am ;u z Cn z 0 m CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER 14AMEINAME OF BUSINE�S , CITY ZIP TELEPHONE 1 `vnll -1 wvm e-7&jl., TELEPHONE PERMIT EXPI USE ZONE ERMIT 2oo-leg -PLIMSER JOB ADDRESS,&�> SVITEIAP 0 _7,V — PLAT NAMEISUBDIVISION NO. I T No. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP T � P_I S,_ U'. EXISTING — PROPOSED - REOUIREDDEDICATION— FT NO.OFIIXTURES IRV REQUIRED YES E3 NO REMARKS —FRI—NTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ENGINEERING JE 16V-tgf; A ISI DDR P6 e�< -2 2 J, CITY ZIP FIRE REV15WED By DATE <;e ft6 1*10 I STATE LICENSE NUMBER EXPIRATION DATE CHECKS' ly VARIANCE OR CU SHORELINE OR ADBI INSPEallON BON 921ION 1, OSTED F�LC6(10 0 YES 0 NO AGO 4?6 T PAR EL NO. SEPA REVIEW COMPLETE EXEMPT SIGN AREA HEIGHT ALLOWED PROPOSED ALLOWED PROPOSED 4 PR��X I I I EX P LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT) NEW RESIDENTIAL C3 PLUMBING I MECH ALLOWED PROPOSED FRONT SIDE HEAR FRONT UR SIDE REAR C3 ADDIT10N COMMERCIAL COMPLIANCE OR El CHANGE OF USE —rNI10 PARKING LOT AREA REVIEWED BY DATE 0 REMODEL 0 APARTMENT [:) SIGN REUD I PROVIDED E] REPAIR GRADING C,DS 0 FENCE ( X FT) REMARKS DEMOLISH C3 TANK GARAGE M RETAINING WALI CARPORT SOCKE 0 (TYPE OF LJSE� --- IN r /0�7,07 17,- I'IJ 6; CHECKEO.1 1!�FE �ONSTRUCTIO-, Cq' .. PA.Te 1 POOP NU"'EFOF CRITICAL SPECIAL INSPECTOR OCCUPANT Ir OF STORIES - LING UWNIESL AREAS NUMBER JARIA EQUIRED R YES LOAD DESCRIBE WORK TO BE DONE REMARKS Prtnr.RIF�q INqPFf!TIONS PER UBC 108/FINAL INSPECTION REG' /I III( //PC, �, "y 1,9 0?0177 O)l 'eAll �4� r�q,- yk, / PLAN CHECK FEE I HEAT SOURCE GI.AlING% LOT SLOPE I L o T SLOPE % BUILDING T' D TE D A PLAN CHECK NO: 11ESTID GAT I E PLUMBING P I MECHANICAL THISPERMITAUTHO IZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO T' BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTA UCTioN ON THE PUBLIC GRADINGIFILL I FEoU"`E DOMAIN (CURB$. SIDEWALKS, DRIVEWAYS , MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. SO CHARGE 5' PERMfTAPPLICATiON: 180DAYS PERMIT LIMIT. I YEAR -PROVIDED WORK IS STARTED WITHIN 18D DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION S p PLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS ENG.INSPECTION FEE ;A S H Y N NTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF I" ANDSCAP NO L I L G E S Ro Y AND EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANYAND DIREC ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING I RECTLY OR INDIRECTLY I " NSFECTION FEE FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PFRMIT,SHALL NOT BE PLAN CHECK DEPOSIT DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY c TY ORDINANCE NOR LIMIT IN ANY WAYTHE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISIONq' 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 THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGO ATINGCONSTRUC CALL I ION, AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE LEMPLOYED I WASHINGTON RE ATING TO FOR rINSPECTI, IN VIOLATION OF THE LABOR CODE OF THE STATE OF WORKMEN S COMPENSATION INSURANCE AND CW 18 27, DATE S GNEO (425) 2TI 1 0 0 771 022P ATTENTION EXT 333 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. UBC SECTION 109 FAX a VALUATION I FEE S, vz) IPT Ll APPLICATION APPROVAL TNI I- - . 9.1 11 lIg-d by Ihl 5111d,19 011,1 ol hl�lhor DnPuty: ,d a.d d "C"LS �AT ZA� EL ORIGINAL 'ILE 1ELI-OW INSPECTOR PINK OWNER GOLD -ASSESSOR z 9 -5 0 c: rn ma 0 80 c -4 X Im jo -4 0) 0 -n n _q m rn 0 0 o C v) rn Z,, --I z 0 1 0 m