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20020097 (2).pdfI DATE RECEIVED FPERMIT EXF a U CITY OF EDMONDS Z CONSTRUCTION PERMIT APPLICATION i A OWNER NAME/NAME OF BUSpf?S _64*�c ft MAILING ADDRESS q A WR'a-C 1;Tc- 2.01 I Clij ZIP q7OTj L ELEPHONE V03 IV- 7 -/e/JZ NAME ADDRESS C3 CITY ZIP TELEPHONE NA 7 Ll ADDRESS 106 6 AIX azo# A& CIP ZIP 17 TELEPHONE Wr !��3 --$ef /--ift 4 STATE LICENSE NUMBER EXPIRAJION DATE 196(49-102.7-9-4 PROPERTY TM ACCOUNT PARCEL NO. -MOM NEW RESIDENTIAL PLUMBING ECH 0 ADDITION OMMERCIAL COMPLIANCE OR AC 0 CHANGE OF USE REMODEL [] MUL11FAMILY SIGN REPAIR 0 GRADING CYDS FENCE X FT) DEMOLISH 11 TANK OTHER GARAGE -1 RETAINING WALL 0 FIRE SPRINKLER CARPORT 11 ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: NUMBER NUMBER OF CRITICAL OF RIES DWELLING AREAS UNITS NUMBER DESCRIBE WORK TO BE DONE /dIMW ny 44114, IV Ao�� 2,69 42 HEAT SOURCE GLAZING % LOT SLOPE % PILAN CHECK NO: VESTED DATE THIS PERMIT AUTHORLEES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN JCURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PFRMITAPPLICATION: 180DAYS EL PERMIT LIMIT: I YEAR - PROVIDED WORK IS STARTED WITHIN ISO DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT; ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIFY: DEFEND AND HOLD HARMLESS THE CITY OF x EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND IALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY 91 FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 MODIFY, NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION., I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- 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 WORKMEN ',44%PENSyfN INSURANCE AND RCW 18.27. SIG RE DATES NE SE PERMIT -7 ONE &j) NUMBER,/�O,/L 00 DDRESS '5 1 SUITE/APT# 1 PLAT NAME/SUBDIVISION NO. NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP AP RW Parrnhp=bd Sir &I Use Permit Raced EXISTING — PROPOSED I= Required Sidewalk Required REQUIRED DEDICATION— FT UnderWound Wiring required [3 METER SIZE LIN�� NO. OF FIXTURES PRV REQUIRED I YES 13 NO 13 z I REMARKS z z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE I I NGINEERING REVIEWED BY DATE IRE REVIEWED BY DATE Lu W r6 VARIANCE OR CU SHORELINEORADB# I INSPECTION REOD 13YES 13NO I BOND POSTED $ SEPA REVIEW SIGN AREA HEIGHT 'OMPLETE EXEMPT ALLOWED PROPOSED AL LOWED PROPOSED KP , , I LOT COVERAGE REQUIRED SETBACKS (FT.). PROPOSED SETBACKS (FT.) LLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR z ;R57rP _aN DATE PARKING iECYD I PROVIDED I LOT NING REVIEWED BY :HECKEDBY ITYPfbO CONSTRUCT39N OCCUPANT 14 �COnf GROUP 3 PECIAL INSPECTION [AREA OCCUPANT 1EQUIRED 13YE LOAD EMARKS IROGRESS INSPECTIONS PER U13C 108/FINAL INSPECTION REO'D Z-4A A A— eZ- -2 � � — I I $ 1 Description FEE Description FEE Plan Check State Surcharge 3uilding Permit City Surcharge Plumbing 60 Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt. Due 41;16 & Recording Fee Receipt # CALL FOR INSPECTION (425) 771-0220 APPLICATION APPROVAL This application is not a permit until signed by the Building Otficlall or his/her Deputy: and Fees are paid, and receipt Is acknowledged in space provided. OF Cl �"AgTq )TE 4 7 WA .5911z J&_xzle 4 RELEAM fDATV ATTENTION EXT 1 3 % IT IS UNLAWFUL TO UZ OR OCCUPY A BUILDING OR STRUCTURE UNTIL - hwlA!v , I , A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW. INSPECT& CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING :'I 113ATE RECEIVED CITY OF EDMONf)S CONSTRUCTION PERMIT APPLICATION' OWNER NAMEINAME OF Buslurtas ZILING ADDRESS IPT TELEPHONE c'7,. q z , 70 NAME ADDRESS CITY ZIP ITELEPHONE ......... . Alf USE PERMIT ZONE 60 — &V? It! NUMBER , JOB ADDRESS 1� 151 R) I/ PlIf SUITE/APT# *?.Ora PLAT E/SUBDIVISION N 7T LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Pemat Required Street Use Permit Rsqd EXISTING — PROPOSEI) inspection Required Sidewa* Required REQUIRED DEDICATION— FT — Underground ng 9 req METER SIZE LINE S�A�NO. OF FIXTURES -',PRV REQUIRED I I YES[3 NO E3 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE 15 W 0 NA7— _n(MRrs RA.1 t145& . 6Wif i�d CBL # 1 ENGINEERING F(EVIEWED BY DATE A DRESS 1660 Me //ZF A6 FIRE REVIEWED BY DATE Lu IZIP -7"J 71 ;LE 77PHO N I F E TE VARIANCE OR CU SHORELINEORADB# INSPECTION REO'D 13YES 13NO BOND POSTED $ z 06 I STATE LICENSE NUMBER EXPIRAJIOP DIE C E _SEPA REVIEW COMPLETE EXEMPT EXP SIGN AREA ALLOWED , PROPOSED HEIGHT ALLOWED , PROPOSED PROPERTY TINX ACCOUNT PARCEL NO. r -A. NEW RESIDENTIAL PLUMBING ECH A COMPLIANCE OR ADDITION *,.COMMERCIAL CHANGE OF USE REMODEL MULTIFAMILY 0 SIGN [j GRADING [:] FENCE X 0 REPAIR CYDS Fr) 11-DEMOUSH TANK 0 OTHER ,GARAGE RETAININGWALL 0 F RE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, eu�piNESS OR ACTIVfM EXPLAIN: 4!�)� 1&15-1 1a22U!h__10 LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT LIRSIDE REAR PARKING REQ`D I PROVIDED LOT AREA PLANNING REVIEWED BY DATE REMARKS CHECKED BY TYP 01 CONSTRUCTJPN L-AA jr� tfo& LAM CC) OCCUPANT GROUFF 6 NUMBER NUMBER OF CR`TICAL OF DWELLING AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE /JLjrj2W AA/ - AREA SPECIAL INSPECTION REQUIRED [:] YES CU PANT REMARKS PROGRESS INSPECTIONS PER LIBC 108/FINAL INSPECTION RECtD hii klrl&4- almai iv &Anse-, 2994-Z 21=5609 E-7-- A��iizdr2 ff - I - if . 'k - - - A A A j---- --0' 4A - — E % HEAT SOURCE GLAZING % LOT SLOP PLAN CHECK NO: VESTED DATE THIS PERMIT AUTHORIMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PFRIAITAPPLICATION: 1910 DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT. ON BEHALF OF His OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON. ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN 18 CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC" TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION_9F THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN`SXMPENSA?I1ON INSURANCE AND RCW 18.27. DATE SIGNEIY 1�1 17 / 07 ATTENTION IT IS UNLAWFUL TO UiE OR OCCUPY A BUILDING OR STRUCTURE UNTIL am A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YE1I0A1-INRP�,TA CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 KING 5 COPIES GREEN ACCOUNTING PRESS HARD -YOU ARE MA Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION 1A0 1.425) 771-0220 EXT 1333 APPLICATION APPROVALf This application Is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid. and receipt Is acknowledged in space provided. OF 4 MT 0 TE �j I " REL BY fDATV 71 z 0 1 0 M M -18 0 M M —Z 0 M M. o Fn C 0) M 0 z z 0 4 0 M