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20000289.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION ER NAMEINAME OF BUSINESS -- , . r, — A A AILING AfBIEEB AV o- TELZ ADDRESS ZITY CA m lu Js all. NAME (4o yr, 4wLt.mryJ PERMIT EXPIRES USE PERMIT ZONE 2aO, 2bj NUMBER joB SUITEIAPT4 ADDRESS 10-'\ Avi. PLAT NAMEiSUBDIVISION NO. LOT NO. L I L�DN D FEE PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP T-PAe EXIS ING — PROPOSED - DEDICATION— FT _REQUIRED .ETER SIZE LINE SIZE NO. 01 1I.TUR. REQUIRED I I I YEBRV 0 NO Eml 7E­MARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ADDRESS &w- 3 R I I FIR REVIEWED By DATE v a CITY L-RwL9tTl)& 9 )46ZNEh31-';I�q T, VANANCE OR CU SH REUNEORADBN INSMECT 'ON RE.-D 60 N POE - TED STATE LICENSE NUMBER DAT HEC- fq 4,EXP O'ES (:)No SERA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED m A o5i PROPERTY TAX ACCOUNT PARCEL NO. I I I LOT COVERAGE REQUIRED SETBACKS (M. PROPOSEDSETBACKS (PT 0 NEW TIAL PLUMBING I MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT UP SIDE FEAR ADDITION L C MPLIANCEOR CHAN EOFUSE PARKING REO'D PROVIDED I LOTAPEA 1PI-ANNINGRIVIEWEDEW DATE 5MO DEL SIGN NCE REPAIR C] IRIIINI CYQE El PE_ X _ FTI.) --s DEMOLISH TANK J� OTDg::r4 E G A RETAIN;,NYG WALL RENEWAL j AR GE ROCKS CARPORT (TYPE OF Ut BUSINESS OR ACTIVITY1 E�F%Aft '9q-,2-71 NSTRUCTION NJ C 1 001 1 0 CUP GnOUP�� N 0 U"BER F 0 TOR, ES Ns.ER EL" .G T. .'T �AL REAB U. E. T�N SPECIAL INSPECTOR CCUPANT REQU PEO [] YES JARE� 0— DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER LIBC 108/FINAL INSPECTION REO'D A f�;ftq VALUATION FEE PLAN CHECK FEE vc, L 0 TEL 0 PE IlEAl SGOEO, G2G= LAE % - BUILDING B U 'ESTE. A T PLAN CHECIAN IVE EDDATE UD' I N. PLUMBING P L I— MECHANICAL TEHANA PERMIT COVERS WORK TO THIS PERMIT AUTHORIZES ONLY TNE WORK NOTED, THIS PERMIT COVERS WORK TO CTI ON ON TH E PU. I " BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. --AMN.FILL GRADING/FILL STATE SURCHARGE STATE EU F-HARGE PE RMITAPPLICATI. ; 10D.- P 0 - WITHIN ". DAYS PERMIT LIMIT, I YEAR - ROVIDED W RK IS STARTED WIT91N 180 DAYS SEE BA K OF INK PERMIT FOR MORE INFORMATION C P ENG. REVIEW FEES PPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND S.CCSSORS A T L S T I Y IN INTEREST. AGREES 0 INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF 2 EDMONDS, WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND AULCILAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TWO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITY S ABILITY TO ENFORCE ANY ORDINANCE PROVISION6m ENO. INSPECTION FEE LANDSCAPING INSPECTION FEE PLAN CHECK DEPOSIT TOTAL AMOUNT DUE RECEIPT / M F"; .3 El 1,5 D- jo 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. THAT THE INFORMATION GIVEN CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF IS T RUC' THEOWNER, IAGREE 0 COMPLY WITH CITY AND STATE LAWS REGULATING CONST TION, AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYTED IN VIOLATI ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING 0 WORKMEN'SCOMPENSATION INSURANCE AND RCW 18,27 Ll A I N APPR61AL CALL p.ty, 1�d Fees- pl.d. D FOR INSPECTION OFFICIALS SIGNATURE DATE SIGNATURE 10WIE50R AGENT) - I DA:;tNED (425) A 771-0220 / / / 7 A? G I LEA 0 DATE ATTENTION EXT 333 ITIS UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTIL 771-0221 INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- FILE LOW I'NS EJOR ORIGINAL YE P A FINAL CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR ­8 z 0 m :q 96 m c 0 i " m 0 80 A m z z 0, 'n -4 � ! , 3: m m 0 o a c mo z z 9 0 m mi a M. a i m 00 -.40 0 C, m z 0 -n -74: 0 0 c TO i z 0 JL- CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION ER NAMEMAME OF BUSINESS CITY bods Ii,01 NAME c A—E.. CITY IF T J� bN NAME Nof I PERMIT EXPIRE'S BE PERMIT G E N NUMBE ow SUITEIAPT# DURESS I 93U, - V), A VI! FLAT NAMEISUBDIVISION NO. LOT NO. LID NO. 11. FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP App—d P"' U.: P—=14,I d EXISTING — PROPOSED— S�,-'.", RP'l',u,'," REQUIRED DEDICATION— FT — U.,—d METER SIZE LINE SIZE OF FIXTURES P V REQUIRED I PO. Y ES 13 NO 13 REMARKS MMERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE A-w 3 (S I I p. D - FIRE REVIEWED BY FIR R ' WEDS DATE 0 E CITY ZIP T L11" HE q jHOFELINE INSPECTION VARANCI OR CU OR ADB# I PBOND REO-D OSTED STATE LICENSE NUMEER DATE CHECKED By E3,ES E3 NO �J:�k *r-IRB'. SEPA REVIEW SIGN AREA HEIGHT PROPOSED PROPERTY TAX ACCOUNT PARCEL NU. COMPLETE EXEMPT ALLOWED I PROPOSED ALLOWED , 9 1A iN I vb I --S a 3 EXP I LOT COVERAGE REQUIRED SETBACKS (FT.1 PROPOSED SETBACKS (Fr.) NEW RESIDENTIAL C] PLUMBING I MECH ALLOWED PROPOSED FRONT SIDE FEAR FRONT LIA SIDE REAR ADDITION OMM ERCIAL COMM o C MPLIANCE OR COMPLIANCE R CHANGE OF USE PARKING LOT AREA PLANNING -7-E. .1 DATE,,,, APART EN 'D I P--V IDEO _ 0 REMODEL SIG. V REPAIR GRADING CYOS F NOE ( _ X FT] DEMOLISH TANK OTH t�� 0 GARAG ET � CARPIOR F RMNEG WALL _] a L. RENEWAL (TYPEOF UEnSINESSORA IVITY) EXPLAIN: _,IW — F TQFI_ NUMBER OF DWELLING UNITS CRITICAL AR AS NUMBE2_ LNUMBER G_CRIBE WORK TO BE DONE CHECKEDBY ITYP51CONSTAUCTION -5"P�ANT E A INSPECTOR JAREA II.A. �.'EQUIREO F1 YES UBC 108/FINAL VALUATION FEE L/ PLAN CHECK FEE HEAT S )uR GLAZIN I% LOT SLOPE % 8U LDIIG PLAN CHECK N� �ESTED DATE MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILL DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE :I SEPARATE PERMISSION. L STATE SURCHARGE PERMIT APPLICATION: 181) DAYS PERMIT LIMIT. AR - PROVIDED WORK IS STARTED WITHIN 180 DAYS I YE ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORM ION PPLICANT, ON BEHALF 0 F HIS OR HER SPOUSE, HEIRS. AllIGNSAND 5UCCESORS CITY OF ENG. INSPECTION FEE ;A :NDEMNIFY, DEFEND AND HOLD HARMLESS THE N INTER ST. AGREES TO E FROM ANY AND LANDSCAPING PEE 2 ED `oNoS'WA HINGTOM TS OFFICIALS. EMPLOYEES, AND AGENTS AU.CLAI MS FOR DAMAGESOFWHATEVER NATURE. ARISING DIRECTLY DR INDIRECTLY BE INSPECTION RECEIPT x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT I DEEMED TO MODIFY. WAIVE QR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE PLAN CHECK DEPOSIT 0 NOR LIMIT IN ANY WAY THE CIT Y'S ABILITY TO ENFORCE ANY ORDINANCE PRQVISION,� IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION A 111IN I$ CORRECT, AND THAT I A. "E OWNER. OR THE DULY AUTHOR ED AGENT OF Thl, IPP I THE OWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC BW&lo Of"'c".1' ." D.P71%-1 I— TION. AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYE D WASHINGTON RELATING TO TION .­pj .lk­Iodqod,n �P... F—A.dp IN VIOLATION OF THE LABOR CODE OF THE STATE OF WORKMEN S COMPENSATION INSURANCE AND RCW 18.27 OFFICIALS SIGNATURE DATE Sl�NED (425) -10 C' 771-0220 D E . EA D ATTENTION EXT 333 IT IS UNLAWFUL TO, USE OR OCCUPY A BU ILDIN G OR STRUCTURE UNTIL 771-0221 A FINAL INSPECT ON HAS BEEN MADE AND APPROVAL ORJA CERTIFI- DRIGINAL - FILE YELLOW - INSPECTOR ASSESSOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 09 -B FAX PINK OWNER GOLD z 9 -�l 0 0 m c m 0 80 m m z jo o -n m rn 0 C o Fn ca c. ;a z z 9 0 m