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20000281.pdf� m [PERMIT EXPIRES ZL� CITY OF EDMONDS USE PERMIT Z.IIE > ()OZS, NUMBER CONSTRUCTION PERMIT APPLICATION JOB s TEMPTY ADDRE=iL(! < OW ,r - 4 M) P- NAMIISUIOIIIIIIIN NO, lOTNO_ L�DN '�E�AMEOFPNESS k/ , r pt I D FEE $ MAILING AFES 23 0) 1 eo r�4 - F f. PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP PROPOSED- REQUIRED DEDICATION- FT w';z-, 00 R ' u. Rl_llll%�0 0 00 9 IKP FTELEPHONE "NAME PAV EOUIRED YE. 0 NO 0 t: ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE CITY ZIP ITELEPHONE I I-uc, ENGINEERING REVIEWEDIDATE ADDREJS F_ FIRE REVIEWED BY DATE TELEPHONE �C VARIANCE OR CU SHORELINE OR ADIS. INSPECTI RED ON 'D 0 Y 0 ES . OSTEC I I'D 0 STATE LICENSE NUMBER EXPIRAT E t< o CHECKED SY SERA REVIEW CO EXEMPT MPLETE EXP SIGN AREA ALI PROPOSED WED HEIGHT ALLOWED , A PRO Y TAX AC 0 TPARC L NO. -ml -011 0 NEW RESDENTI L PL...IN. I E- LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS III FRONT SIDE REAR PRC1O1.SET.ACI(SIlI FRONT URSIDE REAR o COMPLIANCE OR 0 P<AD.ITION AL CHANGE OF USE CPARTMEN'JT LOA PARKING LOTAREA P NNING PEW EWEDBY DATE DEL A R ENA 0 SIGN C3 P.Mo P T. [3 REa VIDEO D PRO F NOE n REPAIR 0 GRADING CYDS Fl (E_ X FT) -MEN OTHER C] DEMOLISH 0 TANK A 0 RETAININGWALL RENEWAL RA E El GCAFlPGRT ROCK�RY I PEOFUSE.SLISINES ORACTIVITY)EXPILAIN::'�,, c CHECKpy TY, F CONSTRUCTION It4l, 10 GROU JC7 CCUPANk NUMBER OF C NUM ER OF VWLL'NG NITS I CRITICAL AREAS NUMBER ............ SPECIAL IN. T..T REQUIRED [3 YES YES 'E.U';�G C7 A EA I OCCUPANT LOAD DESCRIBE ftRK TO BE DONE c), REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO' ATION VALUATION IALU FEE FEE PLAN CHECK FEE A N C H E C' FEE GLAZING I LOT SLOPE % U I N BUILDING L I G C�_E NO' VESTE D DATE PLAN --EC No. I N PLUMBING LU --- 17� ME MECHANICAL 1: ANEAL AD .'ZE. LY THE -T THIS P IT o W THIS PERMIT AUTHORIZES ONLY THE WORK NOTED� THIS PERMIT COVERS WORK TO H BIT T. ON R N E E RK To P - ns n"C B UC U U 8 DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PU IS ON A NE PG" TE PROPERTY ONLY ANY CONSTRUCTION ON THE p I FILL GRADINGIFILL RA N DIE 11 R.S S'..WALKS. "'VEW.Y. '.A ... ES. ET WILL ED OMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC�) WILL REQUIRE A C G , SEPARATE PERMISSION. "B"A" E PERMISSION -a-Zi5IT. a RCHA--� CHAFI.� '51 cz IT PPL' "o. "" DAYS PERMITAPPLICATI N 180DAY- P. RM T _ P R I. ' YEAR -o"D.- W-R IS STARTED WITHIN "'. A,. PERMIT LIMIT. I YEAR - PROVIDED WOoRK IS STARTED WITHIN IBB DAYS E 'TL IT ENO R ENG. REVIEW FEES VIEW SEE BACK OF PINK PERMIT FOR MORE INFOR ATION E� BACK OF PINK PERMIT Fo. -o-E IN'... T.. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS P LK: T L, F HIS R E. ADZ HEIRS A ... N. AN. SUC ESo.. A P AN ON HA - o - S SPE 'TU.N FEE C ENG. INSPECTION FEE END N -7ND$CAPING ;APPLICANT� C o .LESS THE CITY OF Y, DEFEND AND HOLD HARMLESS THE CITY OF G H I T ST RE�S T 'NDEMN F EIEND AN D HA N NTIREST. AGREES TO IIDIMMIF I N �RE A - ' Y L N B C APING __ .'.'N'T. NO A AN E TS, UM NY G IS EDMONDS, WASHINGTON� ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND IS N IT. OFFICIALS EMPLOYEES A A. N INSPECTION FEE IN S PEC "ON IF DIRECTLYOR INDIRECTLY ALLCLAIMS FOR DAMAGESOFWHATEVER NATURE,ARISING RECEIPT FRO THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT,SHALL NOT CBE DEEMED 10 MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY C Ty ORDINAN E PLAN CHECK DEPOSIT I NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,' EIPT /-S_.9JlQ TOTAL AMOUNT DUE I HEREBY ACKNOWLEDGE THAT: HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT. AND THAT A. THE OWNER. OR THE DULY AUTHORIZED AGENT OF T.SOWNER I E Ly WITH CITY AND STATE LAWS REGULATING CONSTRUC� Al I HOk AND N HE WORK ON WILL BE EMPLOYED CALL ,' ". IF 'a GTTOCO AUTHORIZED THEREBY. NO PER IN 11OLATI 11 1 LANX 'N"F THE STATE OF WASHSINGTON RELATING TO I -Pt I, ack-ledgOd i� ... p-d- FOR INSPECTION WORKMEN F sFT,.- CE AND HCWI827 OFFICIALS DATE (425) 21Z DA 771 -0220 RELEXSEDBY VATE ATTENTION EXT 333 IT IS UNLAWFUL TO USE 08 OCCUPY A BUILDING 08 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 a RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ................. FOUNDATION: Footing ...................... Wall ............... .......... Pier/Porch ................. Retainini; Wall ........... Slab Insulation .......... Pit PLUMBING: :3 ATE RECEIVED( -7 PERMIT EXPIRES USE P RMIT CITY OF EDMONDS ZONE UMBER 4),002sll CONSTRUCTION PERMIT APPLICATION JADE RE SUITVAPT# Do 16A) S 4 Y)Y 0 AMEMAMEOF YINESS P NAMEISUBDIVISION NO. LOT NO, 1111 NO, I LID FEE S M [LIN ADD ES TESCPAPP— 0 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP P.— 1, 0 EXISTING — PROPOSED- 0 REOVIREDDEDICATION— FT PHI REQUIRED c NAME YES 0 NO 0 REMARKS ADDRESS .-PONSPI E FOR EROSION CONTROUDRAINAGE CITY ZIP TELEPHONE AME ir REAL ry ENGINEERINGVVMf� J,&!bL 3 s*W-G'DATE DOR S 7 z FIRE REVIEWED BY DATE SHOREUNE OR ADS# INSPECTIO D s VARIANCE OR CU REG POSTED STATE LICENSE NUMBER CHECKED By YE G S 011- 06 SERA REVIEW N Alpt�IA. HEIGHT G PROPOSED FOE�., PA0PEhTY TAX A PA RCEL NO COMPLETE EXEMPT ALLAZ ALLOWED S m EX -� 9 P M 10 0 0 REDSETBACKSH'T.) PROPOSEDSETRACKS(FT.) LOT COVERAGE REQUI E FEAR FRONT JRSiDE REAR ENTIAL LOWED PROPOSED FRONT SID 0 NEW PWM81NG I MEC4 AL COMPLIA CE OR XADDITION 0 COMMERCIAL .0 CHANGE OF USE ING REVIEWED BY DATE M fn 0 REMODEL El APARTIVIENT SIGN REOD I PROVIDED 10 FENCE C] REPAIR 0 GRAD] IS CYDs 0 , X FT) REIVARXP h.DEMOLISH 0 TANK OTHER o GARAGE 0 RETAINING WAZI FIE�E AL� 0 CARPORT T PE OF USE, BUSIN ESSOR CTIVITY) EXPLAIN: ITY 1: 1 N C NT C.ECKEDSY P OGCCOUPA ;e3_ jw �h m M I te tNj NUMBER NUMBER CRITICAL OCCUPANT AREASP SPECIAL INSPECTOR LOAD 0 o Fn JAREA DWELLING P, OF G, REOUIRED n YES o STORIES U NUMBS c 0) (a z M 0 5, z DESCRIBE WORK TO BE DONE REMARKS INSPECTION$ PER LIBC 108/FINAL INSPECTION REO'D OGRESS X z 0) VALUATION FEE z PLAN CHECK FEE 9 0 LOT SLOPE I m BUILDING PLAN CHECK NO: PLUMBING IVESTE1111 MECHANICAL TM..PERMIT AUTHORIZES ONLY THE WORK NOT 0. THIS PERMIT COVERS WORK TO L E ONE ON PR.VA E PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILL SIDEWALKS, DRIVEWAY S MARQUEES, ETC.) WILL REQUIRE DOMAIN (CURBS, . SEPARATE PERMISSION, RCHARG� PER IT APPLICATION! ISO DAYS f PERMIT UMIT. I YEAR . PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFOR ATION ENG. INSPECTION FEE -A PLICANT. ON SEPAL SIGNS AND SUCCESORS P FOFHIS OR HER SPOUSE, HEIRS. S THE CITY OF To EMNIFY, DEFEND AND HOLD HARMLESS LANDSCAPING IN INTEREST, AGREES IND A FROM ANY AND INSPECTION FEE 2 EOMONDS�WASHINGT ITS FFICI L EMPLOYEES, ANDAGENTS S' OF 0 VER NATURE� ARISING DIRECTLYOR INDIRECTLY RECEIPT ALLCLAIMS F013 DAMAO E WHATE NOT BE FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL PLAN CHECK DEPOSIT GEEMEDTOMOIN Y�WAIVEO REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE I 'S ASIUTYTO ENFORCE ANY ORDINANCE PROVISION.* REC NORLIMIINANY "THECITY ........... I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION �,l R AL GIVEN IS CORRECT, AND TH AT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF P, REGULATING CONSTRUC- 1,.Z CO. A� ..II I EOWNE I BEE TO APLY WITH CITY AND STATE LAW p P 0 .1p"I"', . 'S TION AND IN ING THE WO K AU HORIZED THEREBY, NO EPSON WILL BE EMPLOYED E 01 THE STATE OF WASHINGTON ELATING TO TION Ipt,, cknmtodged sPacO P1045166 HE LASO IN VIOLATIO DATE WORKMEN" P�NSATIO ANCE AND RCW 18.27. OFFICIALS NAT RE - I , 0 (425) 1 " t 2 �3.� m a 1 1 1 _vla" RELEASED By D E EXT 333 ATTENTION IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 YELLOW - INSPECT FILE - O"� A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL � HAS BEEN GRANTED. UBC SECTION 109 FAX PINK -OWNER - GOLD - ASSESS I q 16 CATE OF OCCUPANCY SIBS -