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20000847.pdf- ! 1 2�Z6�' CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION EROMEINA.I.I.111NE S alc&lv�'A ING ADDRESS Rw 1-11 '4, � PERMIT EXPIRES USE PERMIT ZONE &S NUMBER 1013 ADDRESS 2)471TEI'T' PILAT NAME/SUBDIVISION NO. _i?o_TNo,__ LONG. LIG FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP APP-d P.- =.d EXISTING - PROPOSED - REQUIRED DEDICATION- FT METER SIZE LINE W� NO, FIXTURES PRY EQUIRED I A�GF YES 0 No 0 REMARKS OWN5R/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE 'ITY ZIP JTELIIIIONI NAME I OA, J 4 /J; d ENGINEERING REVIEWEDIDATE '76"S 9'.x /07-/ FIRE REVIEWED By DATE CITY v.T--w2p-.F' ZIP W-A TELEPHONE �-77 - 469 VARIANCE OR CU SHORELINE 08 ADBN INSPE07ION REGO OYES 'N. 'OG 1 POSTED 9,4V&jjPj1QVV4f1A TION DATE 61 62- CHECKEDBY SERA REVIEW COMPLETE I EXEMPT Exp SIGN AREA ALLOWED I PROPOSED . HEIGHT ALLOWED PROPOSED I PROPERTY TAX ACCOUNT PARCEL NO. �2_36-16w O/S_00 JR NEW C3 ADDITION 0 REMODEL 0 REPAIR 0 DEMOLISH oGARAGE C ARPORT RESIDENTIAL ;4 PLUMBINGIMECH C] COMMERCIAL COMPLIANCE 08 CHANGE OF USE 0 APARTMENT 0 SIGN FENCE r-I ( _ I _ ITI C3 TANK 0 OTHER 0 R I.NG WALL R-EWAL E Y R=N T COVERAGE OW ALL LOED PROPOSED REOUIRED SETBACKS (FT.� FRONT SIDE REAR PROPOSEO SETBACKS IM. FRONT URSIDE RSA14 PARKING R JEWED-BY DATE RIMARKT AA WrLk,_ CTIVITY) EXPLAIN: CHICK1101Y ITYPE DIST OTION OCUPANT GROUP NUMBER OF STORIES UM LL 'Ol N BEN WE G NIT. "'T'C AL 'AREA. NU. B P E 2dPRDnRrqS SP DIAL INSPECTOR [AREA REQUIREI C] YES -LOAD DIICRIIEZ_I,KT :hD= "j!E OAkz pZjm A #4441 REMARKS INSPECTIONS PER UBC 1081FINAL INSPECTION REO' VALUATION FEE PLAN CHECK FEE PLAN CHECK FEE HEAT SOURCE GLAZING I LOT SLOPE I BUILDING I BUILD N PLAN CHE�� VESTED DATE - PLUMBING PLUM IN ' I L MECHANICAL M C. A CA THIS PERMIT AUTHORIZES ONLY THE WORK "DIED. THIS PER"IT COVERS WORK TO BE DONE ON PRIVATE PROPERTY 0 ANY CONSTRUCTION ON THE PUBLIC NLY� GRADINGIFILL a SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQU E DOMAIN CURBS. 3 SEPARATE PERMISSION, MURCHARGE PERMIT APPLICATION; IBODAYS o PERMIT LIMIT'. I YEAR � PROVIDED W RK IS STARTED WITHIN IBDDAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION M.EOEIIT ON BEHALF . OF HIS OR HER SPOUSE, HSIRS, ASSIGNS AND SUCCESORS ENG. INSPECTION PEE ;APPLICANT. N INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS HE CITY OF LANOSCAP NG 2 EDMONDS, WASHINGTONSITS OFFICIALS, EMPLOYEES� AND AGENTS FROM ANYAND INSPECTION FEE ALLCLAlMS FOR DAMAGE OFWHATEVER NATURE, ARISING DIRECTLYOR INDIRECTLY FA M THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT, SHALL NOT BE DEoEMED MODIFY, WAIVE .1 FBDUCE ANY REQUIREMENTOF ANYC TYORDINANCe PLAN CHECK DEPOSIT 1111EIIT �o NOR UMtT IN ANYWAY THE CITY�S A51LITY TO ENFORCE ANY RDINANCE "ovislo"', TOTAL AMOUNT DUE ]HERE Y ACKNOWLEDGE THAT I HAVE READ THIS APPL CATION: THAT THE INFORMATION APPLICATION A PPROVAL GIVENIS CoPPEC AND THAT I AM THE OWNER, OR TrS DULY AUTHORIZED AGENT Or I T. T THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGUILATING CONSTRUC BE EMPLOYED CALL jj��w D ... 1,; Ad F .1. 1.10, TtON; AND IN COIN THE WORK AUTHOAIZED THEREBY, NO PERSON WILL GTHE CODE OF THE STATE OF WASHINGTON RELATING 10 FOR INSPECTION '-'PI m ..k ... a.� �� p... p-d.d. IN VIOLATION OF LABOR '�PORKM(if,?'S COMPENSATIO INSURANCE AND HOW 18,27. OFlICIA �A_TE (425) o o �NEO KLEASEDBY DATE �ENTI EXT1333 IT IS UNLAWFFYTI USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 L-- INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORKIINAL-FILE YELLOW -INSPECTOR A FINAL CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK-O.NER GOLD -ASSESSOR 198 z 0 4 5 . I m 0 m c m 0 0 c m m z 0 -n n X M M 0 0 o Fn 0 7-1 Z z 0 0 M .7, E. FPE EXPIRES MIT CITY OF EDMONDS PERMIT NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRESS S PLAT NAME/SUBDIVISION Nil. ZIfbT NO. �O NO� LID FEE $ INGADDRESS PUBLIC IGHT OF WAY PER OFFICIAL STREET MAP P.- '".- j A4li E.Is. — PROPOSED— d P n 0 I -- I R- ZIP TELEPHONE REQUIRED DEDICATION— FT Wl� 1.1-d 0 No OF FIXTURES PAY REQUIRED 7t=: I YES 0_ NO 0 FEES REMARKS REMARKS DRAINAGE —FRICONTRACTOR RESPONSIBLE FOR EROSION CONTROU W '0 CITY ZIP ITELEPHONE NAME .4- Ad"', ENGINEERING Vff 1W a 4 gp NM V CWWr_-DATE E a 2 -04 J 5 AO?ESSgd)( /oz/ FIRE REVIEWED By DATE ZIP CITY w t-vm UAL_.. WOV6 I TEELE11111 771�-4,elre '6 y I VARIANCE OR CU SHORELINE OR AOB� INSPECTIO OYREO.- E. ED STATE LICENSE NUMBER EXPIRATION DAi ED Do') ..... .. jY -,4 0 rn c rn c: m m E_ COMPLETE EXEMPT SEPA A �.I F01 AREA ALLOWED PROPOSED ALLOWED PROPOSED 'PROPERTY TAX ACCOUNT PARCEL NQ� yz5a,�-01& - .CH NEW PLUMSING MECH 0 AQOIT L COMPLIA CE OR K`N CHANGE OF USE 0 REMODEL SIGN LOTCOVESAGE LOWED BE. ALLOWED PROPOSED REQUI13EDS BACKS ET (7 SID FRONT E REAR PROPOS DSETBACKS(FT,) FRONT URGDE REAR P�ARKING AEO'D ;REARKS PROVIDED =LOTAREA PLANNING REVIEWED By DATE 0 FINDS REPAIR GRADING YDS X FT) X 0 DEMOLISH TANK o OTHER S o GA AGE RETAINING WALL CARPORT cl ADD [3 RENEWAL A ca rn m a 5 O_ Of a 0) r CD T,VI I') CHECKEDBY ITYPEf OCCUPANT GA OUR NUMBER OF STORIES. NUMBER OF WELL.. UNITS ... . . ...... --FI=AL SAS NUMBER S ECIAL INSPECTOR RPOUIRED 0 YES AREA OCCUPANT DESCRIBEW AKTOBED NE REMARKS PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D M 0 ;D z vA ATION PLAN CHECK FEE z 9 HEAT SOURCE LOT SLOPE % BUILDING ?5 m PLAN CHECK NO: IVESTID DATE PLU BING MECHANICAL THIS PERMIT AUTHORIZES ONLIT"Elln. NOT D* lIASPEnMTCOlEllWOAKTO _ PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBU BE DONE ON P VATE GRADINGIFILL 0 ...A,. .UA.II, SIDEWALKS, DRIVEWAYS A UEES. ETC.) WILL REQUIR PEQMA SEPARATE SSION. URCHARGE P MIT APPLICATION; 100 DAYS W A PERMIT LIMIT,. I YEAR . PROVIDED OAK IS STA TED WITHIN 180 DAYS ENG, REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION ENG, INSPECTION FEE 'APPLICANT, ON BEHALF OF HIS On HER SPOUSE, HEIRS- ASSIGNS AND EUCCEE.FE IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENT S FROM ANY AND INSPECTION FEE z ALLCLAIMSFOADANIAGESOFWHATEVER NATURE. ARISING DIRECT LYORINDIRECTLY ECEIRT I FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEM40 TO 101111 WAWEII REDUCE ANY 'EQUIREMENTOF ANY CITY OROINANC PLAN CHECK DEPOSIT �ORLIMIT'NANY WAYTHE CITY'S ABILITY TO ENFORCE ANYORDINMCE PROVASIOW RECEIPT I HEREBY 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 Th-ppill,110 lIlPlIffltuJssgn-dbyIhl THEOWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTAUC- ftildilgOlflcial. hl.�., U.P.ty: d F... e. P.4 Fd TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO -0p, I. ..kn-l�dq.d il p- pwld.d, TION —OF WORKMEN'S COMPENSATION INSURANCE AND ROW 18.27. FICIAL K,Nhej DATE SIGN (OWNERO ADEN IS SIGNED (425) /0 771-0220 LEASE. BY 0 A—TTENTIO EXT/333 ------ IT IS UNLAWFU�Tl USE 08 OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 0 RIGINAL - FILE YELLOW - INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR 5,98