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20000795.pdfp� CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMENAME OF SUSINEPS 1 .1 cf10 �a I aa/" V,>l f Y-,) ZIP EPHO�E rc—ITY) I CITY 7AM E TELEPHONE A 0 PERMIT PIRES — USE PERMIT ZONE 0 llul) —NUMBER JOB SUITEIAPTU ADDRESS L5 Q PI -AT NAMEISUBDIVISION NO. LOT L NO. L�D 0 FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP w;—, A—- S".., U.. —.1 EXIS ING — PROPOSED - REOUIRED DEDICATION— FT V RlaUIRll YEI _S 13 NO 0 REMARKS OWNPRICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE CQ 4't KS FIRE REVIEWED BY DATE ITY ZIP TELEPHONE VAFIANCE OR CU EH.FEIINE OR A.S- MPECTI N REO'D 0Y,S ONO ..NO POSTED LICENSE NUMBER EXPIRATION —S CHE K bl ii SEPA REVIEW EXEMPT SIGN AREA ALLOWED FOlOSED HEIGHT OSED ALLOWED P801 A T PARCEL NO. OME�707 _ 0, -af ov, —,t-/ EXP I , LOT COVE AGE A EOUIRED SETBACKS (Fr.) PROPOSED SETBACKS (M. NEW RESIDENTIAL ED] LUMBING I MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT, UR SIDE REAP D ADDITION COMMERCIAL o 0 MPLIANCE OR CHANGE OF USE PARKING LOTARIA PLANNING REVIEWED 11 OAT 0 REMODEL D APARTMENT (:] SIGN [REO'D I PROVIDED 0 REPAIR D GRADING GYCS D FENCE X ITI FE.AFKS A D DEMOLISH Wr TANK OTHER Clze An, oGARAGE M RETAINING WALL RENEWAL CARPORT ROCKEBY TIVITY) EXPI-AIN: 0 By C.E,0KEO,8,yPE�y Ty STRUCTION ODE NUMBER NUMBEROF "I' IC L __7 'AREA IN ' S ECIA -TOR �YES OF STO IES DWELLING UNITS I R NUEAS R _ A MBE 'U, REQUIRE, M[3 DESCRIBE WORK TO BE DONE GLAZING I 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 REOUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 18DVAYS PERMIT LIMIT: 1 YEAR -PROVIDED WORK IS STARTED WITHIN 180DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS I N I E ES AGREES To :NDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF T. S JNGTON TS FROM ANY AND o NT A S. i TS OFFICIALS, EMPLOYEES. AND ADEN E ONG WA A ALL CLAIMS FOR DAMAGE OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT $1HALL NOT BE OR FIE DUCE ANY P EQUI REMENT 01 ANY CITY ORDINANCE D EMEDTOMODiFY WAIVE 0 WE 'SABILITY TO ENFORCE ANY ROMANCE PROVISION,' m NOR LIMIT IN ANYWAY THE CITY REMA PROGRESS INSPECTIONS P R UBC 108/FINAL INSPECTION REQ'Dj� E P z VALUATION FEE PLAN CHECK FEE PLUMBING MECHANICAL GRADINGIFILL OF 5 ENG. REVIEW FEES END INSPECTION FEE USCAPING INSPECTION PEE PLAN CHECK DEPOSIT RECEIPT TOTAL AMOUNT DUE RECEIPT /�Z70 IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION� THAT THE INFORMATION LICATION APPROVAL GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF - Th,, ppl—t— 11 1 -1 . p,,.,l ­.1 ,911d by tho THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTnUC 0 THEREBY. NO PERSON WILL BE EMPLOYE CALL E.,I d,,K, 011,­1 11 hl��hl, TION; AND IN DOING THE WORK AUTHORIZ L D N OF THE 4AB DOE - F THE STATE OF WASHINGTON RE ATING To FOR INSPECTIO14 , _w p—id- ... 'Dt 11 1--ldg IN VIOLATI WORKMEW 0 COMPENSATIZESII.AN.S AND FGW 1. 0 FIG, SIINAISL. TE, (425) IATE 7 tSIG 0.5&� 6 03L-J 771-0220 R ... A�Eft'y' EXT1333 ATTENTION IT IS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL FILE - YELLOW - INSPECTOR A FINAL BEEN GRANTED. UBC SECTION 109 FAX PINK -OWNER - GOLD -ASSESSOR CATE OF OCCUPANCY HAS 5198 z m om IT, 0 0 c m z jo-4 om :c 9 m M 0 C-1) 0 o Fn c: cl) c ca O� ;u z -4 X cl) z i m FINAL PROJECT APPROVAL FORM TO: .DATE: MEMO TO: PERM[IT COORDINATOR, BUILDING DIVISION FROM: IRE DEPARTMENT DATE,��2�--�-J6 'PN G DIVISION DATE— z PLANNING DIVISION D 0 PROJEC e)--)- JDI- SITE ADDRESS— 0 C= M M 0 0 pEMT #_2�g�,S �ADB# INSPECTED C -49 X M DESCRIPTION OF WORK TO BE INSPECT M Z C 2 > -4 A field inspection was conducted to determine compliance with approved plans. Final approval. denotes that c') there are no objections from the above signed Department to the granting of: 0 -n n --4 approval of the described work M M 0 Ui Performance Bonds associated with the project may be released 0, S C: M, 90) M 0 Z GRANT FINAL PROJECT APPROVAL > z FINAL PROJECT APPROVAL WITH CONDITIONS NOTED _______L_GRANT 1 z 0 i ______FAILED FINAL INSPECTION - OUTSTANDING ISSUES 0 M I 2. 3. ___RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL ocaprvl.doc.l:temp:bldg:forms6/98 r 7 CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION ER NAMENAME OF BUSINEPS 5LE CIT ZIP TELEPHONE 10 -- ) 0 4 ---j -11 - -W) -.') 1- NAME 7oPERM!T EXPIRES US' PEFjAIT ZONE NUMBER Aft"716, JOB SUITEIAPT# ADDRESS g .�� I PI.AT NAME/SUBDIVISION NO. I IOTNll,,. LID NO, LID FEE S TEICP 4­1 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP SI—I U.. P.— EXISTING — PROPOSED— ....... REQUIRED DEDICATION— IT IEP [VIR'QUI'070 REMARKS 11HPAI—NTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE 'ITY ZIP ITEIEPHON1 NAME L CA-C lu FIRE REVIEWED By FIRE REVIEWED By DATE :ITY ZIP TELEPHONE Z" OR 0,11 SHORELINE OR ADBN - INSI F 13 YE Olt SEPA REVIEW SIGN AREA HEIGHT ROPE TY TAX ACCO TPA CEL NO. rVAIIINCE COMPLETE EXEMPT ALLOWED PROPOSED [ EXEMPT ALLOWED P OPOSED SO-7-2 1 0 EXP LOT CO ERACE MED SETBACKS (I'l) -VERA-E NEW RESIDENTIAL 0 PLUMBING I MECH 0 ALLOWED PROPOSED FRONT SIDE AEAA FRONT UR SIDE REAR COMM C, ADDITION COMMERCIAL . "ANCE 0. C MPLIANCEOR CHANGE OF USE PARKING PLANNING REVIEWED By DATE 0 REMODEL 0 APARTMENT C] SIGN REDD PROVI--- C] REPAIR [3 GRADING CYDS PENCE 0 ( x FT) .,.A." 0 DEMOLISH 0 TANK Qq OTHER QkcNn, , . ci GARAGE M RETAINING WALL CARPORT ROCK"Y - 0 FENEWAI 'TYPI OF USE=IVITY) EXPLAIN CHECKED BY TY STRUCT­ OCZ �ODE I GROUT_S_ -NUMBER NUM ERF, ICAL AR EAS IPICIALINSIEGTOR ARIA OCCUPANT W.BLL No OF G STORIES UN,�E NUMBER REQUIRED M LOAD DESCRIBE WORK TO BE DONEg�.. REMA KS MAR S ...lK.rAlRI.SlE.TI.NS PER UBC 108/FINAL INSPECTION IRE.' VALUATION I FEE PLAN CHECK FEE HEAT S0111CI GLAZING I LOT SLOPE I BUILDING PLAN CHECK NO: rISTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTEO THIS PERMIT COVERS WORK TO BE ... ON P.,VATE PROPERTY NLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILL ..A", SIDEWALKS, DRIVEWAYSI,MARQUEES. ETC.) WILL REQUIRE SEPARATE PER SSU)N. gftj&SU�CHARGE c PERMITAPPLICATI N: 100-AYS PROVIDED ORK IS STARTE. WITHIN 180 DAYS PERMIT LIMIT. I YEAR P' W ENG REVIEW SEE BACK OF PINK PERMIT FOR MORE INFORMATION p -A PLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS p p FFOR ENO INSPECTION FEE IN INTEREST. AGREES TO INDEMNIFY. DE CITY OF NDSCAPING 2 EDMONDS, WASHINGTON. ITS DFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS DAMAGES OF WHATEVER NATURE. ARISING D RECTLY OR INDIRECTLY INSPECTION FEE RECEIPT z FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK 'Elll T m DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE I S - El NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. W Y T. " TOTAL AMOUNT DUE IR c6pT 7 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN I CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF S T - . P.—I �,g­d by thl THEOWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONST RUC_ C ALL Buil ow-l h-11 Doly: 1,,d F111 .10 P d ,d TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PER50N WILL BE EMPLOYE LATI WASHINGTON RE NO To FOR INSPECTION bd N LATION OF THE LABOR CODE OF THE STATE OF I Vio WORKMEN'S CO SURANCE AND FtCW 18.27. MPENS;;g�,A _FS Fll�/� I.N SIGNATURE (::p -) __ — DAT (425) /-A-V I I . 'RELEASED By DATE .�ENT), EXT1333 ATTENTION IT IS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 HAS BEEN MADE AND APPROVAL OR A CERTlFl- ORIGINAL -FILE - YELLOW -INSPECTOR A FINAL INSPECTION CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK � OWNER . GOLD - ASSESSOR SISS z 0 m c 0 m 0 --10 0 rn mz Oil -n -4 X m M o a o C cli MCI) M C) z z 0 m