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20010902.pdfV)ar LA51c __l CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNE"AMENAMEOPBUSASSS +�' 6x- 0 K-71. FT NAME t, 10 FPERMITEXPIRES 2;L� US' PERMIT ZONE NUMBER C�V loa SUITEJAPTV PI -AT NAMEISUDDIVISION NO LOT No, LID NO, I LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 1—p EXIS ING — PROPOSED— AEOUIRED DEDICATION— IT METER SIZE LINE SIZE, NO,OFRXTUF. PAV REOUIRED I REMARKS I YES 0 No Ej WDRESS 1100 v_vlpAAll_ 's t -r— OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ZIP ZIP TELEPHONE TW &ME L /— c_ ,,,,rlfv&L QVA&r ENGINEERING REVIEWED/DATE ADDRESS 114zq At"e iD V'rr)g ro� FIRE REVIEWED BY DATE ZL_i� �1_6 (7f4o �Fvcha I TELEPHONE 33LI 2/97 L125- VARIANCE OR CU SHORELINEORADDO INSPECTION Y REO'D 0 Es ONO IPBOND OSTEC STATE LICENSE NUMBER geA) -rj 'F CHE SEPA REVIEW COMPLETE I EIEVIT E.P SIGN AREA ALLOWED I I .10SED RED ALLOWED , PIOPOSID T PA�KL NO. 0 C) 0 p W;Ti7o z_ n 99 NEW b RESIDENTIAL PLU BING I MECH 0 ADDITION COMMERCIAL o COMPLIANCE OR K CHANGEOFUSE 0 REMODEL APARTMENT 0 SIGN ci FENCE C] REPAIR 0 GRAOING CYDS x FT)) C) DEMOLISH TANK oGARAGE RETAINING WALL '0 RENEWAL CARPORT MKERY LOT COVERAGE ALLOWED PROPOSED REOUIRED SETBACKS (FT.) FRONT SIDE REAR PROPOSED SETBAC S FRONT UR SIDE REA("R I PARKING REaD I PROVIDED PLANNING REVIEW E D6Y DATE FEMARKS CONSTRUCTION ..0 NUMBER c I�TICAL OF R occ-PA I DWELLING AR AS SPECIAL I JAREA! LOAD UNITS NUMBER REGUIRED C] YES To BE DONE REMARKS =�pRnrRrsq INSPECTIONS PER UBC 10S/FINAL INSPECTION VALUATION VALUATION FEE PLAN CHECK FEE HEAT SOURCE 111INI I LOT SLOP' I BUILDING PLAN CHECK NO: ED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. AN' CONSTRUCTION ON THE PUBLIC GRADINGIRLL WFEE. DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS ETC.) WILL REQUIRE PRECEIP SEPARATE P...'MARQUEES, SSION. E,. PERMIT AIPLICATI W 10 DAYS PERMIT LIMIT, I YEAR , PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION ENG. INSPECTION FEE OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESOR5 ;APPLICANTONBEHAL N NTEREST. AGREES TO :NDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF ANY AND D-oNDS-WA N. ' ICIALS, EMPLOYEES, AND AGENTS FROM I ALLCIIMSFOR AM G i Fs ATEVER NATURE. ARIS NGD.1-1. SHALL NOT BE E FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE 01 THIS PERMIT DEEIVED'O MODIFY. WAIVE OR REDUCEANY REQUiREMENTOF ANY CITY ORDINANCE PLAN CHECK DEPOSIT NOR L­TINANY WAYTHECITY'SASILITYTO ENFORCE ANYORDINANCE PROVISION. TOTAL AMOU14T DUE IHEREBYACKNOW EWE THAT] HAVE READ THIS APPLICATION THAT THE E.Fo MA11ON I �� P APPROVAL GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY ALI Ho a A ENT OF ­1 ..0 119— by T E OWNER, I AGREE TO COMPLY WITH STATE LAWS REGUI-ATI NIS CONSTRUC- CALL Ey a LOYED TION AND IN DOING THE WORKAUTHORIZ' DANHDREBY. No PERSON WILL E Emp RELATI NO TO FOR INSPECTION d ly� III— pl—ded. IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON WORKMEN'S �MENSATION INSURANCE AND RCW 18.27 OF IC LS SIGNATU SIGNATU:S1211NI 31. E SIGNED (425) OEL 2 /VL, 771�0220 ABED BY ATTENTION EXT/333 ITIS UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTIL 771-0221 A FINAt_ INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL FILE . YELLOW -INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. LISC SECTION 109 FAX PINK-OWNEA - GOLD ASSESSOR sms z m rn m 8 .1 RIM 0 A m M 0 rn (a ca C, ;a z 0) z m RECORD OF INSPECTIONS M mT 1 m RECEIVE17 F_ I I IZ(,'l I ? PERMIT iiPIRE9 CITY OF EDMONDS USE PERMIT ZONE NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUITUAPTO ADDRESS OWNER67�MEOF BU sr," a PLAT NAME�SUSDIVISION L�o No L 0 FEE S MAILINGADDRESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAI EXISTING — PROPOSED- AEOUIREDDEOICATION_ FT — MP,.,.R R­k da's . 1­ a,, lae,,­ R.... a vnnN,'.'­d TELEPHONE IELIPHONI q1 el qqtj- q1le NAME V_ !7_1 N...IFI.TURE. J�Y�PFVFE.UIFE. Is NO 0 73 DRESS 11w 0, MARKS GE WNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTSOLMRAINA I CITI- I ITILIPHONI_,, 'I '('V KEDBY IV L/LfN-1 f 11W. .— 9 IIUIZ� 1AZf PRYM FIRE REVIEWED BY DATE I I CITY TELEPHONE '2- VA ANCE OR CU SHORELINE OR ADS. INSPECTION I BOND REO'D POSTED [3YES [3NO ST SE REVIEW COMPLETE I EXEMPT SIGN AREA ALLOWED PROPOSED 1 HEIGHT ALLOWED PROPOSED 1 pggW0jNTFARtLNO. Z� n 0o 0( 0 It NEW 0 RESIDENTIAL PLUMBING MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS JFTJ FRONT SIDE SEAR PROPOSED SETBACKS (FT.) FRONT LNISIDE REAR 0 ADDITION COMMERCIAL C] ClIPLIA lEll CHANGE OF USE I . I I PARKING LOTAREA DATE REMODEL APARTMENT 0 SIGN REG D I PROVIDED I 19LANNIOGRIVIEWIDBY REPAIR 0 SPACING 0 5 YD C3 FENCE X ASKS C] DEMOLISH TANK C] CGARAGE ARPORT 0 RETAININGWALL ­X'RY RENEWAL 1 ------ TY CONSTRUCTION lCong I OCCUPANT VITY) EXPLAIN: CHEC 1191 NUMBER- .R -F .U. AS BAB SPECIALEIDNSFECTOR w :9§ OF STORIES OWE No LL, UNITS NUMBER REQUil YES JAREA DESCRIBE WORK TO BE DONE —REMARKS iecn a iIj PROGRESS INSPECTInNQ PER UBC 4 ILF AA I A IMP CK F E' P LAN CHECK FES LA N C H E GLAZING % P E LOT SLOPE % L T SL. o o 'L D N G BUILDING U PLAN CHECK NO: T D D A E �TEDDATE E 6 E N G PLU EIING L U I H A N I C AL MECHANICAL M E C M IT V S oRK T o E E W THIS PERMIT AUTHO UES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO - CT-oN ON T I' E P -L' C BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC RE ETC.) WILL REQUIRE I L E W L C IN "IL L G GRADINGIFILL B DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS. MARQUEES, SEPARATE PERMISSION. U H .�"SUR HARGE �RA PERIARIAPPLICAR N; ISGDAYS 1 YEAR. W W Ill. A S PERMIT LIMIT. PROVIDED ORK IS STARTED WITHIN 180 DAYS IF ENG. REVIEW FEES SM SEE BACK OF PINK PERMIT FOR MDRE INFORMATION END INSPECTION PEE ENG. INSPECTION FEE 'A PLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS p L SS T Ty IN INT R ST. AGREPS TO:NDEMNIPY. DEFEND AND HOLD HARMLESS THE CITY OF E E LANDSCAPING oM DA ENTSFRo. ANYAND EDMONDS. WASHINGTON. TSOFFICIALS, EMPLOYEES, AND AGE C 5 M-EC'LY.R INDIRECTLY LAIMSFoFIDAWGESOFWHATEVER NATURE. ARISING DIRECTLYO C ON FEE INSPECTION FEE , S ALL SH FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT Y C� E OR REDUCE ANY REQUIREMENT OF ANY CITY E DEEMED TO MODIFY. WAIV ORDINANc 0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' m I TOT L MoU , U TOTAL AMOU NT DUE I HEREBY ACKNOWLEDGE THAT I HAVE READ THI S APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF A G I THE OWNER, I AGREE To COMPLY WITH CITY AND STATE LA -SR ED ULAT No CONSTRUC. CALL D EBY W'L TION IN ONG THE WORK AUTHORIZED THE No PE s m I. BE EMPLOYED ANDI I L WASHINGTON RE ATING TO FOR INSPECTV IN DLAT ON OF THE LABOR CODE OF THE STATE OF VI; WORKMEN'SC2hIFENSATIO INSURANCEANDRCWI8.27. SIG DATE SIGNED 1 (425) /Z/q _J0 1 771-0220 ATTENTION C/7— EXT/333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORJA CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 09 FAX VALUATION I FEE ­­.. ne, a pe—I nal.,on.dl b, Iha 11 h—al D­ty: and Foes are, ­1. and n, Olt,, TL_S �11._NATUHf 5ED ORIGINAL -FILE - YELLOW - INSPECTOR MNK-OnVNER - COLD -ASSESSOR Z 0 0 rn c 0 ' : m rn 0 -n MT aca 0 0 0 z m