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20000253.pdf-1 DATE RECEIVED PERMIT EXPIRES %/00 USE PERMIT ;40025A CITY OF EDMONDS ZONE NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUITEJAFT# ADDRESS OWN:�,AMEINAME OF BUSINESS fy- IS PLAT NAMEISUBDIVISION NO. LOT NO. L .0. L�. FEE S MAILING ADDRESS af PUBLIC RIGHT OF WAY PER OFFICIAL STRE ET MAP P. A— CITY ZIP E ISTING - PROPOSED rL1111NE r\ x E, XID, C'\ REQUIRED DEDICATION- FT - NAME METER SIZE I LINE SIZE I NO. OF FIXTURES P V REOUIRED YES 0 NO 0 ADDRESS To. .11-SOLE FOR ..NTFI...AINAGE TELEPHONE NAME FIRE REVIEWED BY DATE :17Y ZIP TELEPHONE VARIANCE OR CU SHORELINE OR ADB. INSPECTION RE 0 a C3 YES 0 NO I BOND IPOSTED I ,TATE LICENSE NUMBER EXPIRATI KED BY AATE SEPA REVIEW COMPLETE I EXEMPT R _SXSN AREA ALLOWED I PROPOSED HEIGHT ALL PROPOSED I RoPr/gjQpUNT PARCE� NO. - '9060 _ Oil -0t NEW RESIDENTIAL PLUMBING I MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT.) FRO SIDE REAR PROPOSED SETBACKS (FT.) FRONT UPSIDE FEAR C] ADDITION COMMERCIAL C MPLIANCE On ,�E CHANGE OF USE PLANNING REVIEWED BY DATE 0 REMODEL 0 APARTMENT 0 SIGN 0 REPAIR 0 GRADING DYES 0 FINDS "A' 0 GHA'ING R IT) X F Cy DS 0 T' REMARKS HE"A'KS 0 OTHER 0 DEMOLISH 0 TANK o OTHER D EMOL'SH 0 TANK o GARAGE 0 RETAININYGWALL 0 RENEWAL UEN CARPORT FOQKF EA ,,PE 01 USE 11S 01 ACTIVITYI EXPLAIN: .U`SH S ff-I - CHECKEDBY PA CODE 0 Nbl_� 1 -7 GGRC'UP NUMBER OF R STORIES NUM EA OF ( DWEOLUNG UNITS RiTtCAL I - A EAS NUMBER F..IALIN RECTOR JAREA REQUIRED 0 YES OCCU AIT LOAD DESCRIBE WORK TO BE DONE REMARKS ROGRE...N.IECTIONS PER U.0 113.1FINAL INSPECTION RED' P P.O.. CTO.. IN VALUATION I FEE PLAN CHECK FEE C 'ECK FEE HEATSOURCE LOT SLOPE I L' I ""' " BUILDING 6-A7 PLAN CHECK NO: PLUMBING MECHANICAL '.I. PERMIT COVERS Wo RK To THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO MPLAN CONSTRUCTION ON THE PUBLIC BE DONE ON PRIVATE PROPERTY ONLY. AN' CONSTRUCTION ON THE PUBLIC .,A FA -IN �L' "AB.-BES ETEW�LL RE-U'RE DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE z SEPARATE PERMISSIGM '.I.. L PCHARG5 q46RC P �� 2 PERMIT APPLICATI NE 180-AYS -B DAYS STARTED WITHIN '.B -AS PERMIT LIMIT. I YEAR , PROVIDED WORK IS STARTED WITHIN 18D DAYS END REVIEW FEES No FEES on. INFORMATION SEE SACK OF PINK PERMIT FOR MORE INFORMATION HEFS AIS'-N S AND EUCCES.FS 'A' ON BEHALF OF HIS OR HER SPOUSE� HEIRS. ASSIGNS AND succEsoRs ENG. INSPECTION FEE END INSPECTION FEE �FUCANT, AN. OLD HARMLESS THE Cffy OF IN NTERES1. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING LAN.S."H. 'YEES AN. AGENTS FRo. ANY AN. 2 EDMONDS, AC..NGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND IF IS ARISING DIRECTLY OR INDIRECTLY ALL CLAIMS FOR DAMAGES 05 WHATEVER NATURE' ARISING DIRECTLY OR INDIRECTLY INSPECTION FEE INSPECTION FEE RECEIPT FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE AN A DINANC Y EQUIREMENTOF ANY CITY OR N PLAN CHECK DEPOSIT 0 NOR LIMIT IN ANYWAY T14E C1TY*S ABILI (Y To ENFORCE ANY ORDINANCE PROVISION" RECEIPT/57/ TOTAL AMOUNT DUE I HERESY 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 PIP P­,I THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC, PERSON WILL BE EMPLOYED CALL sI11IZ9`G'ffi­I 01 1,111hal Deput, a�d F­ - PItd. ,d TION AND IN DOING THE WORK AUTHORIZED THEREBY, NO I N VIOLATION OF THE LABOR CODE OF THE STATE ol WASIUIGTON RELATING TO FOR INSPECTION ph-k-Odge ­p­p­­d, WORKMEN S COMPENSATION INSURANCE AND RCW 18 2 OFFICIA S TURE D E SIGNATURE (OWNER A T) ) L-E SIGNED (425) Z�;Z� 'S­Lk.--a�- 9� 1 771-0220 REL ED DATE ATTE4"o 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- ORIGINAL � FILE - YELLOW INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK OWNER - GOLD ASSESSOR 5198 .......... 7. PERM PIR qj PE CITY OF EDMONDS NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUITEIAPT. ADDRESS,7(�J& / 'S �WNYMEINAME OF BUSINESS PLAT NAMSISUBDIVISION NO. LID NO� LO LID FEE S MAILING ADDRESS c ;;­-e 0 PUBLIC RIGHT OF WAY PER 05MCIAL STREET MAP w; '.11 IN -e 0 Lk � , ee.. V. 0 EXISTING — PROPOSED R 01 d 0 --wee,wes 0 CITY ZIP .."is- rLEPH HE FT — REQUIRED DEDICATION �A TER SIZE LINE SIZE NO, OF FIXTURES PRV REQUIRED NAME YES 0 NO 0 I R MARKS ADDRESS OWNERICONTRACTORW S OSIll ON ROUDRAINAGE 5 CITY ZIP Ivil 661 In NAME `z- NNEERING REVIEWEDIDATE ADDRESS FIRE REVIEWED By DATE CITY ZIP TELEPHONE z PBOND. VARIAN E OR CU SHORELINE OR ADS# INSPEC STE RED 9 lf 0 STATE LICENSE NUMBER DATE CHECKEDBY Q YES 0 NO SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPG, D ppopqg��gUNT 0. o/ I EXP X m c m LOT COVERAGE REQUIRED SETBACKS TIFT) P804P SED SETBACKS (FT.) IL ... IN. I ALLOWE. PROPOSED FRONT SIDE BEAR FRONT 'SSIDE REAR U N-R SIDENTIAL 0 COMPLIANCE OR ADDITION COMMERCIAL o CHANGE OF USE AREA PLANNING REVIEWED By All 2 PA LOT 0 REMOPEL APARTMENT SIGN REO'D PROVIDED q L- X m m z FENCE 0 REPAIR 0 GRADING CYCS C] I _ X PT) REMARK. 10 DEMOLISH TANK Cl OTHER GARAGE C] llETA,1.1,1,NyG WALL RENEWAL L-1 CARPORT 0 On (TYPE OF UE�S�BSS OR ACTIVITY) EXPLAIN: CHECKEDBY T*PGjfCCWqON —JCODE�.7- OCCUPAN Clt GROUP m M 0 .0 BES N MBES F ELUNO G CRITICAL AREAS SPECIAIIN --.B AREA 0 COURANT LOAD OFM R STO ISS U R DS NUMSE REQUIRE 0 YES 0 0 o rr; DESCRIBE WORK TO BE DONE EMARKS ROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D 3. c co mo Z�"I 777P z VALUATION FEE ra I PLAN CHECK FEE z HEAT SOURCE LOT SLOPE % BUILDING 9 0 C) rn LAN CHECK NO: PLUMBi G MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRAOtNG/FlL!- 2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUI 7 SEPARATE PERMISSION. I RCHARGE ER.ITAPPLICATION: 180DAYS e. PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION I PLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS S E RS EN.AN PECTION FEE ;A �Y AND HOLD EBB T E ITY F LANDSCAPIN N INTEREST. AGREES TO INDEMNIF �LDE"NG PL.YEES AHD=L E, E. TS H EDMONDS, WASHINGTON, ITS OFFtC Y WSPECTIONFEE N=D RECEIPT ALLCLAIMSFORDA AGESOFWHATE----,,- - I PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT FROM THE ISSUANCE OF THIS REDU E ANY REQUIREMENT OF ANY CITY ORDINANCE DEEMED TO MODIFY� WAIVE OR C RECEIPT 15 0 NOR LIMIT IN ANY WAYTHE CITY'S ABILITYTO ENFORCE ANYORDINANCE PROVISION.' TOTAL AMOUNT DUE f I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATIONs, ,rROVAL GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF This ppl-l", is "t , IF eil ,gii-d by the ULA 'G CONSTRUC s e Fees., ­d, led CALL Buildleg Olkill ., hil/hal 0 T EOWNER. I AGREE TO COMPLY WITH CITY ANDSTATE L.AWS `%GN WITLL BE EMPLOY is g. I TION; AND IN D ING THE WORK AUTHORIZED THE 'E.Y. N PER ED d e p- p-id.d. TO INSPECTION IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING FOR WORKMEN'S COMPENSATION INSURANCE AND RCW 1B 27 OFFICIA S ATURE L D E DATE SIGNED (425) r SIGNATURE)(OWNER G 7 771-0220 IELIA E Y- DATE Ext.M.� ATTEhT I OW 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 - GOLD - ASSESSOR CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109 FAX PINK - OWNER