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20010573.pdf�e Vlew iiKs I DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIJ AP I OW "INAME .1 SUBINESS MAILING ADDRESS /b [PERMIT EXPIRES 4wp--z U S, ' ERI T 04 6�5 gWl-) NU..ER"/- e,!!5- 7 f OF SUITFJAFT' DDAESS &AIIZI 7� '),57 PLAT NAMEISUBDIVISKIN NO. L L�D 110, D FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING — FROPOSED� 0 REOUIREDDEDICATION— FT 0 METER SIZE I N.Sl��' PRV REQUIRED lEl 0 No 0 3 REMARKS OWNEWCONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE CITY ZIP TELEPHONE NAME p iwl 0 p DINE RING REVIEWEDIDATE ADDRESS FIRE R.�IEVIIE..' DATE t. IT E ICEWf4 M VARIANCE OR CU =ELIN ORADIM INSPECTION RE4�k E3 YES No BOND POSTEC SEPA REVIEW CLMPLIlE EXEMPT EXP SIGN AREA A HEIaHT ALLOWED PROPOSED PROP�� CEL NO. C NT PAR 74� C] NEW ESIDENTIAL 0 PLUMBING MECH 0 ADDITION COMMERCIAL o COMPLIA CE OR CHANGEOFUSE REMODEL APARTMENT SIGN C:] REPAIR 0 GRADING CYDS C (PENCE X FT) DEMOLISH [:] TANK ci GARAGE [3 RETAINING WALL C:l RENEWAL CARPORT ... PAY LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (17.) FRONT SIDE REAR PROPOSED SETBACKS (FT.) FRONT URSIDE REAR OT PARKING OT REOM I PR IOED AR AR Pk- NINO .V.-&El E.AFK (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: CHICKEDBY Ty' 01 C.N! !TRUCTION o"jx-- CODE OCCUPANT GROUP NUMBER 0 OF STORIES NUMBEROF GINELL NO UNIT. -1 AREAS NUMBER SPI;0,AlINSlECT.R AREA JOCCU T U R Y!S PAN -RD LOAD REMARKS IN PECTIONS PER UBC 108/FINAL INSPECTION RECI' DESCRIBE WORK TO BE DONE VALUATION FEE 9 2460= "1 PLAN CHECK FEE PLAN CHECK FEE //.-.OUR.E LOTSLOPEl 'BUILDING PLAN CHECK N VESTEDIDATE PLUMBING PLUMBING 'C MECHANICAL F THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILL W ARE DOMAIN (CURBS. SIDEWALKS, DRIVE AYS. MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. URCHAFI.E PERMIT APPLICATION: l...AYS 5 PERMIT LIMIT. I YEAR . PROVIDED WORK 19 STARTED WITHIN 16D DAYS END. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION . ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS END. INSPECTION FEE ;APPLICANT. N NTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF Ih =�=G X EDMONDS, WASHINGTON TSoFFICIALS.E PLOYEES. AND AGENTS FROM ANYAND z ALLCLAIMS FOR DANIAGEjGFWHATEVER NATURE. ARISING D'RECTLYOR INDIRECTLY E RECEIPT 4 THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE K DEPOSIT PLAN CHECK DEPOSIT PLAN cHE ;FROM N AN C E D EMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENTOF ANY CITY ORDINANCE V, ON D SABILITITO ENFORCE ANYORDINANCE PROVISION.' .1 NOER LIMIT IN ANY WAYTHE CITY TOTAL AMOUNT DUE IF CE R MAT o N I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION A PLI� AT'ON APPROVAL P -N T OF GIVE. AND T AT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF IS CDR H "CT .S F.0 NTH CITY AND STATE LAWS REGULATING CONSTALIC' C L CALL 'h ppl-11- 1. -1 � P.'.% b, 7 THE OWNER I AGREE ToCoMPLY �p oy TION� AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED su.'T u 1-II h-11 Dop ty, ald F— all d. Ild -u - o 'OD.Fut'y IN VIOLATION OF THE LA Co IT, . BOR DE OF THE STATE OF WAS INGTON RELATING TO I Sp ,pl �. �.k.—Wdp— p— ol-d- F R INSPECTION _j___ woRKMEN�S.COMFENSATIoWURANCE AND RCW 16.27. OFFICI NA RE ATUA OWNERO AGE I DA�/';D/ (425) 771-0220 1 0 RELE BY ATTENTIOW,,�I-- EXT 1333 IhA I T IS UNLAWFUL TZJSSE OR OCCUPY A BUILDING OR STRUCTURE U L17 TIL 1 0 1 771-0221 I, cE A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CER Fl- ORIGINAL FILE YELLOW -INSPEc(OR FILE Y-LG CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX . K _ . NE P:NK - OWNER ..L. - ..ESSO� P.N 5`98 z 0 m 0 M4 Ofn M M 8 vi o rn a ra z 0 m IN. .) ........... 01, MV X5 co,�pomw i RECORD OF INSPECTIONS I 10 0 A v00000, 0-ATERECEIVED CITY OF EDMONDS CONSTRUCTION PERMIJ A�PLIPI�O.N OW MAILINGADDRESS E NAME j ADDRESS CITY ZT-7PHONE N;W 1-44 I ADDRESS Zip) yXZ;NyVHONIIF, El CiTt J ROIM�ZCCOUNT PARCEL 110, &z�� 1 -424 0 NEW 0 PLUMBING I MECH C] ADDITION o C MPLIANCE OR CHANGE OF USE 0 REMODEL 0 SIGN 0 REPAIR 0 GRADING CNDS FENCE 0 X 0 DEMOLISH 0 TANK oGARAGE 0 R Nr WALL CARPORT ROF 0 ENEWAL NUMBER NUMBEROF DWELLING A. OF UNIT S NUMBER _STORIES DESCRIBE WORK TO BE DONE 111110IIIIIIIIII IZES NLY THE WORK NOTED. THIS PERMIT COVERS WORK TO THIS PERMIT AUTHO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC 2 WAYS, MARQUEES. ETC.) WILL REQUIRE DOMAIN (CURSS. SIDEWALKS, DRIVE SEPARATE PERMISSION, PERMIT APPLICATION: 180 DAYS PERMIT LIMIT. I YEAR . PROVIDED WORK IS STARTED WITHIN 190 DAYS SEE BACK OF PIN K PERMIT FOR MORE INFORMATION 'APPLICANT ON BEHALF. HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESOR IN NTER.Sl A.FEE. TO INDEMNI DEFEND AND HOLD HARMLESS THE CITY 0 t� Fy. NYAN EDMONDS, WASHINGTON, ITS OFFICIALS . EM PLOYEES, AND AGENTS FRO. A ALLCLUMS FOR GAMAGESOF WHATEVER NATURE. ARISING DIRECTLYOR NDJRECT�Y FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT 8 0 DEEMED TO MODIFY. WAIVE OR REDUCE AN' REQUIREMENTOF ANY CITY ORDINANC 10-Fp-i:Rm!T EXPIRES USE ZONE 4&- _,,)& 7ff JOB M.4 1,01 SUIT.PT. ADDRESS PLAT NAMEISUBDIVISION NO, LOTNO. LID No. LID FEE S PUBLIC MONT OF WAY PER OFFICIAL STREET MAP wp.z7z., EXISTING — PROPOSED — "� 0 REQUIRED DEDICATION— FT PRV REQUIRED YES 0 NO 0 REMARKS WNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUORLtNAGE GINEERING III L FIRE REVIEWED BY DATE VARIANCE OR CU E OR ADB. EL'NE INS PICTTION RE SO B ONG POSTED 0 YES NO OYE _I S No L SERA REVIEW T MPLIT, EXEMPT ON A', PROP0511 ALLO:,WED, PROPOSED E, NT HEI HT ALLOWED PROPOSE —11 1% EC XP I LOT COVERAGE REQUIRED SETBACKS jFr.j PROPOSED SETBACKS (FT.)4 ALLOWED PROPOSED FRDNT SIDE REAR FRONT PARKING OT AREA PLANNING REVIEW By DATE C-�' :5 RE 'D I PROVIDED @ALLOWED CHECKEDDY NT SPECIAL INSPECTOR 0.— 1 0 JAREA EOUIRE C3 YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D VALUATION FEE PLAN CHECK FEE BUILDING PLUMBING MECHANICAL GRADING/FILL URCHARGE END REVIEW FEES S ENG. INSPECTION FEE F 0 RECEIPT E PLAN CHECK DEPOSIT E C NOR LIMIT INANYWAYTHE CITY-SABILITYTO ENFORCE ANYORDINANCe TOTAL AMOUNT DUE RECEIP I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THAT THE INFORMATION PPLICATION APPROVAL GIVEN I CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT 01 Ths pplkat— i, , p,,,,l .t,l lig— by NCR AGREE TO COMPLY WITH CITY AND STATE LAW REGULATINGCONSTRUC, THE OWS I LL CA L C AL 8061,; Offill-I , hi$Mll 001�11: .�d F... — pa,d. a.d EPSON WILL BE EMPLOYED O'S TION: AND IN DOING THE WORK AUTHORIZED THEREBY. N Re ATING TO OF WASHINGTON L F/.R IMPECTION N opt.l -k—lodged 11 lPabb pmv,d9d IN VIOLATION OF THE LABOR CODE OF THE STATE 18.27, A BE WORKMEN S qOMPSNSATION UPNNCEANDRCW CA ED (425) OFFI ATUR OWNERO AGEN. I 771-0220 DATE ATTENTI EXT 1333 IT IS UNLAW2LTWE R -CCU'y A BUILDING 0 STRUCTURE U TIL 771-0221 ,.T,.. . - A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A DER FI L-PILE OW - IN;PECfOR ORIGINA YELL OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION i0el FAX PINK -OVINE GOLD -ASSESSOR R CATE z 0 om c rn 0 80 c A m 0 F; 0 n m m 8 o Fn z m