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20000600.pdf-1 ATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION I,IAIIING AD RIESS a -�,a 1 05 L0 CITY ZIP I TELEPHONE I'D,-] b '1� '13 CITY zip ELEPHONE STATE LICENSE NUMBER EXPIRATIONDATE I_VHECKEDBY kN3__1 lu 1) C3 New RESIDENTIAL PLUM.IN. I ME.H E] ADDITION COMMERCIAL 0 C MPLIANCEOR CHANCE OF USE REMODEL APARTMENT CD SIGN REPAIR GRACING CYDS E] FENCE I X FT) DEMOLISH TANK o OTHER c3GARAGE CARPORT Ill.TA,11,1.1NG WALL C] P . 0. RENIWAL CTIVITY) EXP IN: NUMBER NUIIERIF OF .WELL NO I AREAS I UNIT. NUMBER -STORIES DESCRIBE WORK TO BE DONE LOT SLOPE % PLAN CHECK NO: ... IED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION PERMIT APPLICATION: 180 DAYS PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION ;APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, FIEIRS. ASSIGNS AND SUCCESORS N NTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF 2 EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AN. ALLCLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERM T SHALL NOT BE a W.E.ME..MO.iFlWAIVE0RFE..GEA. REOUlREM5NT OF ANYCITY ORDINANCE T 0 0 NOR LIMIT IN ANYWAY THE CtTY'S ABILITY TO ENFORCE ANY RGINANCE PROVISION.' I I m PERMIT EXPIRES USE PERMIT ZONE N _o,C)4C)C UMBER 2 JOB SUITEJAPTN ADDRESS Lo PI -AT NAMEISUBDIVISION No. 0. LIO NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAI Pw 11 11 EXISTING — PROPOSED — REQUIRED DEDICATION— FT — PRV REQUIRED fRES YES 0 No 0 REMARKS nWNPRICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ENGINEERING F--l-1. FI E REVIEWED By DATE VARIANCE OR CU SHORELINE OR ADEIN INSPEOCTION R 0 I PBOND oETE OYES ONO SEPA REVIEW SIGN AREA EIGHT COMPLETE EXEMPT I ALLOWED I PROPOSED ALLOWED I PROPOSED EXP LOT COVERAGE REQUIRED SETBACKS (FTJ PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE HEAR PARKING LOTARIA JPILA NlM6REVIEWIDBY OAT' REDD I PROVIDED I [�_HECKEDEW I TYPE OF CONSTRUCTION oocu — _ ,_ I c4p�l 1 1 1 'CUPANT )AD REMARKS PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D a V_ VALUATION FEE BUILDING PLUMBING 130, MECHANICAL — RCHARGE rGRADING/FILL ENO. REVIEW FEES ENG. INSPECTION FEE LANDSCAPING INSPECTION FEE PLAN CHECK DEPOSIT ECEIPT R E.@PT TOTAL AMOUNT DUE RECEIPT I HEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATIOW THAT THE INFORMATION APPLICATION APPROVAL GIVEN 15 CORRECT, AND THAT AM THE OWNER, OR THE DULY AUTHORIZED AGENT 01 ; Thl,t �PPIIIII 11 'It I P11- 'It" I'V " Ih, THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC CALL B.�Idml Oth-I -1 blII-1 D-Puly: .,t,l F d. ,d TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED WASHINGTON RELATING TO FOR INSPECTION tp p 1-d- IN VIOLATION OF THE LABOR CODE OF THE STATE OF WORKMEN S COMPENSATION INSURANCE AND RCW 10.21. Ta7 (425) OFZ A�� DATE SIGNATURE DATE SIGNED -7 A hmn 771-0220 rn 46:=w RELEASED BI ATTENTION - EXT 333 IT IS UNLAWFULTO USE OR OCCUPY ABUILDING OR STRUCTURE UNTIL 771-0221 OID A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAtLIFILE CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX "It. - GILD 5`98 z m rn 0 -40 00 m M 10 0 _n n -4 = c . 1. MITI 0 o m 0 z z z 9 0 r', (_"�.ATE RECEIVED V1 Fp ERMIT EXPIRES 'ISE PERMIT 20"b400 v CITY OF EDMONDS Z..E ku; - NUMBER PERMIT APPLICATION JOB 9UIT9/APT# CONSTRUCTION ADDRESS tq 0� U) oa� 7,ZE;F 0 j)A V4 PI.AT NAMEISUBDIVISION NO. LOT NO. L�D NO. �BU71 MAILINGADDRESS L D FEE S TESCP APPM.1 E3 n 05 u) PUBLIC RIG14T OF WAY PER OFFICIAL STREET MAP W. 0- CITY ZIP ITELEPHONE EXISTING PROPOSED� ..=.,a A-lull.d 0 REC FT ===;z- is .-and loo,int—il 13 NAME METER SIZE :YNP SI; ADDRESS REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE CITY ZIP JTELE'111�1 NAME Jlr_r_gw wn-Y&P 14&ftT&25 601-V mj,�- ENGINEERI ADDRESS WEDIDATE os 12_14 §i FIRE REVIEWEDBY DATE CITY ZIP TELEPHONE MIMI z 'IM3,1 V'p5) 'Szo- wits STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY VARIANCE OR CU SHORELINE OR AOIM INSPECTION RED . -0.- POSTED I OYES [3NO m SERA REVIEW FALLOWEDPRO�OSED SIGN AREA k HEIGHT PROPERTY TAX AD 11 EL 10, NIP E EXEMPT COMPLETE ALLOWED I PROPOSED ALLOWED PROPOSED Xp I NEW RaIDENTIAL Ix ILUNHIM. I NIECH LOT COVERAIII REOUII�ll SETBACKS I FRONT SIDE RE A(FFTI PROPOSED SETBACKS 11, FRONT, UR SIDE REAR . ; Do m ADDITION COMMERCIAL c3 COMPLIANCE OR CHANGE OF USE ___jATE M 0 -18 0 REMODEL APARTMENT -4 X REPAIR IFIA1111 CYDS X FT) REMANKS M M Z 1c) -4 E) DEMOLISH C] TANK c3 OTHER p z Ir r-1 RETAINI WALL�' C] RENEWAL ci GARAGE NO CARPORT I_J ROCKER, , 6; (TYPE OF USE. BUSINE OR CTIVITY) EXPLAIN: OHICKIDBY "'U'73— 1-7 O'n JTYPIO��W Is NUMBER NUMBEROF I OF WELLIN CRITICAL AREAS OCCUPANT M m do k STORIES NITS NUMBER LOAD a DESCRIBE WORK TO BE DONE REMARKS 0 0 PROGRESS INSPECTIONS PER UBC 108fFINALINSPECTION REO'D 3 CE RE126ACC 67n'.5 ld))q 9 (j) M C) z VALUATION FEE PLAN CHECK FEE z HEAT SOURCE GLAZING % LOT SLOPE % BUILDING 9 0 tLAN CHECK Ng STIED DATE PLUMBING m MOCHW164L THIS PERMIT AUTHORIZES . ONLY THE WORK NOTED. THIS PERMIT COVERSWORKTO L BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILL DOMAIN ICURBS. SIDEWALKS. DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE PER SEPARATE MISSION. S C.-' PERMIT APPLICATION: 180 DAYS PERMIT LIMIT'. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS EN. R VIEW FEES ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION E.-S ON BEHALF OF HIS ORHER SPOUSE, 01EIRE. ASWGNS AND Su`ip!ESC�RS END INSPECT.14, ff. ;APPLICANT 'TV OF INT Redr. AGREES DEFEND AND HOLD HARMLESS CIT F DEMNC,y TO:TSOFF �THilqANVVAOD LANDSCAPING ED S,WASHINGTON, �LS. EMPLOYEES. AND AGENTS F �Y AN. NO NIOE R DAMAGESOFWHATEVER NATURE. ARISING DIRECTLYOR INDIRECTLY INSPECTION FEE INSPECTION FEE ALLCLAIMSFO FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT RECEIPT D EMEDTO MODIF�, WAIVE OR FIEDUCEANY REQUIREMENTOFANY CITYORDINANCE 0 E , 0 NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANYOADINAN!12��I_ CEIPT r vo AMOUNT DUE IR IS6qq S. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION APPROVAL GIVEN RRECT. A 0 THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF S T THE OWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONS TFIUC- This applicallm is - I P"nal Until S10-8d bY In' Foos CALL'- � M TiON; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMP ILOYED RELAT NO TO ponl—d B,,Idi,g 01111ill -1 hiah" Gopuly�:' and _ t a awipt 1, ,kI,,I,dged I. spacts pmuidld. R INSPECTIOI IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON WORKMENS COMPENSATION INSURANCE AND RCW 18.27. [FO - OFFtCIALS DATE SIGNATURE (OVINER Rk�!N DATE SIGNED �SATI�`�: (425) 771-0220 RELEASED BY DOE 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 Or OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 ORIGINAL - FILE YELLOW - INSPECTOR 00 PINK - OWNER GOLD - ASSESSOR FAX s`SS