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20010583.pdfIDATE FIC1111D CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION IER NAMENAME 0; BUSINESS qAc) i>"-ro'A --.0 iTiv 'e� CITY ZIP TELEPHONE 0572,11 NAME I PERMIT EXPIRES USE PERMIT ZONE NUMBER JOE ITPAPT- ADDRESS 1 �50 r-�x _T PLAT NAMEISU�BIIIIT.N NO, LOT 10. Ell 10, LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Z=I, d EXISTING — PROPOSED — .1-LI—d REQUIRED DEDICATION— IT — METER SIZE I LINE SIZE 1 10, 11 10(TURES P V REQUIRED YES 0 No 0 RE-AT'S PE11O.—LE FOR EROSION CONTROUDRNNAGE ZIP I crl_=�/4�ks ZgLo_z_- ITE]Z;j -7Z!j: NAME III () I it L6D �ATE tfA" 1-1tf77—(A-�, F�I ENGINEERING ADDRESS i:21 FIRE REVIEWED BY DATE — CITY ZIP TELEPHONE c IS&Ze) - -175-. - IANCE On CU SHORELINE OR ADEN INSPECTION REQ'O E]YES ONO 1plo—O O$TEO STATE LICENSE NUMBER EXPIRATION DA /. il. 'i 'z"o DO SERA REVIEW MPLETI I EXEMPT EX P SIGN A REA ALLOWED 1 PROPOSED HEIGHT ALLOWED I PROPOSED PROPERTYTAX ACCOUNT RCELNO� �'� 9c�b 'I", 0 NEW RESIDENTIAL PLUMBING I MECH LOTCOVERAGE ALLOWED PROPOSED REQUIRED SETBACK$ (FT) FRONT SIDE HEAR PROPOSED SETBACKS JET) FRONT UPSIDE HEAR C MPLIANCE OR 0 AUDIT104 COMMERCIAL CHANGE OF USL PARKING LOT AREA PLANNING REVIEWED Ely DATE 0 REMODEL APARTMENT SIGN RED D PROVIDED PENCE 0 REPAIR C3 GRADING CYDS , — X FT1 I oe 14fimm (ILykid -D4EMOLISH 0 TANK ci OTHER ci GARAGE C3 RETAIN1ND WALL RENEWAL CARPORT ROCKER (TYPE OP USE. BUSINESS OR ACTIVITY) EXPILAN: LS nZ CHECKED By TYP��ONS RUCTION Cull 0 Nr EGUP NUMBER OF 0' RIES . j STO NUMBER OF DW LLING I UNITS All CAL A. S NUMBER SPECIAL INSPECTOR RED B JARIA U�FE YES OCCUPANT LOAD DESCRIBE WORK TO BEGONE REMARAS PRnrRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REC' &--X VALUATION PLAN CHECK FEE HEA GI-AZING' LOT SLOPE I BUILDING CHECK NO: STEDDAT.E PLUMBING MECHANICAL THIS PLRMiT AUT14DR17ES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I:w BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PooUC FA IEFILL I SIDEWALKS, DRIVEWAYS. MARQUEES DOMAIN (CURDS. ETC.,W,LLD..URE SEPARATE PERMISSION. URCHARGE PER1411" APPLICATION: 11B DAYS AR - PROVIDED WORK 'SSTARIEDWITHIN 160DAYS It PERMIT UMIT. I YE R' R' YEA ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION A C PLICANT. ON BE HALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS A P A END INSPECTION FEE Y OF N NTEREST. AGREES TO INDEMNIFY. DEPEND AND HOLD HARMLESS THE CITY OF I I To I ANDSCAPING EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS 110. ANYAND A H'NGT ALLCLAIMS FOR DAMAGESoFWHATEVER NATURE. ARISING DIRECTLY On INDIRECTLY EA INSPECTION FEE RECEIPT PH CAL THE ISSUANCE OF THIS PERMIT. I SSUAICE .1 THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT To o Fy WA'VEI ANYREQUIREMENTO F ANY CITY ORDINANCE DEEMED TO MODIFY, WAIVE OR REDUCE 0 NOR LIMIT IN ANY WAY THE CITY S ABILITY TO ENIORCE ANY ORDINANCE PROVISION' NOR LIM IT IN AN, WAY T-EB TOTAL AMOUNT E In Ell I lip q (a T"'S APPUCAT""'Y ACKNOWLEDGE THAT I "All READ THAT THE INFORMATION APPLICATION APPROVAL I HEREBY AUTHORIZED AGENT OF GIVEN IS CORRECT AND THAT I AM THE W I. OF THE DUE - T h., pp,,Aj.. 0 li,od by kh. A- Yfkj D STATE LAWS REGULATI NO CON5TRUC- R Ra " BIT T'" E N I Q PLY " T CALL . W, BE T'.'D AN. IN .' NO I K -�T ZE 10 FEES N ILL EMP TE D WASHINGTON FELATI�NoGy 0 FOR INSPECTION . VIOLATION OF T C DE T TA e OF $T�.ERTEBY. '. W. RX. EN S ..p S t NtA W 18 27� ATE SIGNED (425) P" vi I I I _IJIL" ATTENTION—V ' I EXT/333 IT IS UNLAWFUL TO USE OR OCCUPY ABUILDING OR STRUCTURE UNTIL 771-0221 HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL FILE YELLOW - INSPECTOR A FINAL INSPECTION CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR �s z m c m m a I I 0 80 c m 10 0 -n m M C) 0 0 Fn C 0) M C) z 4 X z 0 m 60,00, e2 z TIC rn i Ffi� Z. DATE RECEIVED 14 PE4 ��IIIES ZONE CITY OF EDMONDS 'ERM P 'T UMBER 2cou CONSTRUCTION PERMIT APPLICATION los ADD HESS '7j TUAPTN 3u OWNERNAM AMEOFBLISINJESS . FLAT NAMEISUMIVISION NO. LOT NO, 10, LID FEE $ WILING ADDRESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAI TESGP d 8 r>"T�Otll EXISTING_:— PROPOSED� 0 0 CITY ZIP ITELEP"OlE 141-5- -7-7,5. 0�;-6rq REOUIRED DEDICATION— FT METERSIZE LINEIIZI NO, OF FIXTURES PFV R'OU""O NAME _f I YES 0 NO 0 F34i rum pt=.iz? P, 'ADDRESS EMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROEDR MADE 15.411 REVIEWED By DATE r CITY ZIP TELEPHONE VARIANCE OR CU SHORELI NE OR ADEN INSPEEC '71ON C OY. OiNo I PBOND. ETE STATE LICENSE NUMBER EXPIRATIONUATE fPIRE I/CHECKEOlky . A414 &4 a'— 1) SE. FEWE. COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED NEUFT ALLOWED PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. EXP 0 LOT C VERAGE REQUIRED SETBACKS ITT I PROPOSED SETBACKS (M. P 0 LUMNG IMECH 0 N RESIDENTIAL col LUMBING I MECH 0 N ALLOWED PROPOSED FRONT SIDE REAR FRONT JRSME REAR IANOE OR 0 0 Co MPLJ A IT I 0 N C3 COMPLIANCE OR 0 AUDITION COMMERCIAL cl CHANGE OF USE G C E 0, USE PARKING LOT AREA PLANNING REVIEWED By DATE IANO APARTMENT SIGN R - ON EM 0 E L D REMODEL 0 0 REOO PROVIDED N E 0 E C REPAIR 0 GRADING C,.S 0 FlI,iCE FT) 11A US Ej OTHE t4EMOLISH 0 TANK ci OTHER G IN A GE RIIAINr. WALL.. C) RENEWAL cl G RA E 11 F C3 ENEW L CARPORT RPONT BOOK �A. <71 Ott EXPLAIN �N_) EXPLAIN ITYPE OF USE. BUSINESS CRACTIVFTY) U44&1 nZ CI!IECKEOBY ITYPUONITFUCTION GROUP CCUPAN�� r NUMBER i SPECIAL INSPECTOR' 111"IAN I c OF I STOR' BE PEOUIRED [3 YEE JAMEA LOAD 0 DESCRIBE Wo K TO BE DONE REMARKS —1-13— I.F.—TInNq PER UBC 1081FINAL INSPECTION REO'D. q I r_,a-rl6 -i e, 04 4--X li5177 1'r t7 Ir PL�N CHECK FEE HE GI-AZING % LIT SLOPE BUILDING -4;4- --L Ix PLAN CHECK NO: DATE PLUMBING _fSTED — MECHANICAL THIS PERMIT AUTHORIZES ONLY T'HE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADWGIFIL� SIDEWALKS, DRIVE S, MARQUEES. ETC.) MILL REQUiR E DOMAIN (CURDS. WAY SEPARATE PERMISSION. unc-RGE PE MI PACARtO.t. C�DA E�WITHIN . B Too DAYS PERMITUMIMIYEAR P INDEDWORK START BEE BACK OF PINK PERMIT FOR MIQRE`INFORMATION ENr. REVIEW FEES 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESOR ENG. INSPECTION FEE IN INTEREST. AGREES To INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF ANYAND a EDMONDS, WASHINGTON, ITS OFI!CIALS, EMPLOYEES. AND AGENTS FROM ALLCLAIMS FOR DAMAGESOF WliXTEVER NATURE. ARISING DIRECTLYOR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT,SHALL NOT BEE PLAIN CHECK DEPOSIT IFECE'll DEEMED TO MODIFY. WAIVE OR REDUCEANY REOUIREMENTOF ANYC TYOFDINANC 0 NOR LIMIT IIANYWAYIHE CII'IABILITYTO ENFORCE ANYORDINANCE P 'oV"'oN' TOTAL AMO I HEREBY ACKNOWLEDGE THAT I HAVE REA, A'PL'CATIO', THAT THE INFORMATION G IRS . LY AUTHORIZED AGENT OF 2 o . . GIVEN IS CORRECT. AND THAT I AM THE W R THE 7 TELAWSREGUILATINGCONSTRUc PLY WITH CIT IANDS A CALL THE OWNER ,,I�AAGREETO 710N, AND ,NG E PKA ZED T�EREBY. No PERSON WILL BE EMPL TED T'o NO 61 TZ STATE OF WASHINGTON RELATI oy 0 FOR INSPECTIOI IN VIOLATI E OR C DIE NCEA PCW1827. —or WORKMEN WEN SIGNATUPE (OWN (425) 4 2a`__ �_'SIGNID 1 .0 ( 771-0220 vv EXT1333 ATTENTIO IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 L- A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX 8 gVALUATION FEE c) r T T VALUATIONF.I,.E. C) r,/ ) -) j AL ,�pp�ICA 10�N APPRO�VAL T Pp� )'�`7 Off F-d' ... . ..... 'r d 1� LS SIGN RE OAT mz . TE UAII �E�SEDBY ORIGINAL FILE - YELLOW INSPECTOR PINK -OWNER - GOLD ASSESS- z 0 0 rn I= M 0 E= rn ID Fn 0 -n IT m M -0 Fn Q 0 z z ED z 9 0 m