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20020344.pdfDATE RECEIVE USE CITY OF E ONDS ZONE CONSTRUCTION PERMIT APPLICATION JOB OWNER NA;M ADDRESS E 0 BUS[ I SS PERMIT EXPIRES PERMIT NUMB&�y j — %' . Ar I I I �/ C, Uon,.-) TrW nor) PLAT NAME/SUBDIVISION NO. LOT NO MAILING ADDRESS V to CITY A ZIP TELEPHONE C M zz- ADDRESS CITY susissommems NAME ADDRESS CITY ZIP ITELEPHONE 6�"� -C 'm. STATE LICENSE NUMBER ZIP I TELEPHONE NEW RESIDENTIAL [j ADDITION E3 COMMERCIAL [3 REMODEL APARTMENT REPAIR [3 GRADING CYOS DEMOLISH 1:1 TANK GARAGE CARPORT RETAINING WALL 1:1 ROCKERY WOE OF USE. BUSINESS 9R ACTIVITY) EXPLAIN: NUMBER OF NUMBER OF STORIES DWELLING UNITS DESCRIBE WORK TO BE DONE CHECKED BY 000-2- PLUMBING MECH COMPLIANCE OR CHANGE OF USE SIGN FENCE X _ FT) OTHER RENEWAL CRITICAL AREAS NUMBER HEAT SOURCE GLAZING % — LOT SLOPE % I VESTED DATE PLAN CHECK N6 I THIS PERMIT AUTHORC= ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC 3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE SEPARATE PERM;SSION. PERMIT APPUCATION: ISO DAYS L PERMIT ILIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ,-- SEE 13ACK OF PINK PERMIT FOR PADRE 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 I 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 CI1yS ABILITY TO ENFORCE ANY ORDINANCE PROVISION., I HEREBY 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 WO " N`8_9_9jjt'E N SATIO N 'I�SURANCE AND RCW 18.27. AT_T_Eh�1k_10N IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 10/01 LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit RequIred EXISTING PROPOSED Stfsfit Use Permit Rsq'd =n Required REQUIRED DEDICATION— FT 'squired UnderVmM WIringrequired METER SIZE No. OF RES PRV REQUIRED 7' YES NO 13 20 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING REVIEWED/DATE I FIRE REVIEWED BY DATE I I: I VARIANCE OR CU SHORELINE OR ADS# INSPECTION REO'D E3 YES [3 NO BOND POSTED $EPA REVIEW COMPLETE EXEMPT SIGN AREA — ALLOWED PROPOSED _Arro----REIGHT WED OWED PROPOSED EXP LOT COVERAGE ALLOWED PROPOSED FOUI REQUI ETBACKS (FT) PROPOSED ACKS (Fr.) S41DE REAR FRONT USESTIBE REAR z PARKING—,-" REO'D LOT AREA I PLANNING REVIEWED BY DATE 1,PKOVIDED CHECKED B"TYPE OF CONSTRUCTION SPECIAL INSPECTOR REQUIRED [3 OCCUPANT YES LOAD REMARKS PROGRESS INSPECTIONS PER U . BC 1108/FINAL INSPECTION REQ'13 9 VALLIATION $ FEE 1 1) scription I FEE 41an Check Building Plumbing Mechanical r_� A. in ng Engr. Review R 8 C 0 rd Recording Fee I C it S u r CRY Surcharge y Engr. Inspection State Surcharge Traffic Mitigation Plan Ch1k Deposit LRecelpt# 7FIre Review Fire Inspection TotalArr Total Amount Due Landscapelnsp. Receipt # APPLICATION WROVAL CALL ThIs application 13 not a permit until signed by the FOR INSPECTION Building Official Of histhor Deputy: and Fees sfO Paid, and receipt Is acknowledged In space provided, IA95) I —T,&* OFF �CIANATUP D TE 771-0220 _j C) EXT 1333 RE ASEU BY DATE 771-0221 F" ORIGINAL - FILE YELLOW INSP CT R PINK - OWNER GOLD - ASSESSOR z M M C ma� 0 -40 0 C C M M 0 M M 0(j) 0 0 rn C V) X z z 0 M V, a WDATE RECEI - 16c; 1 is,)' LPERMIT EXPIRES 9-17 171--1 L�w -2 CITY OF EDMONDS USE ZONE PERMIT�� NUMBE Z CONSTRUCTION PERMIT APPLICATION JOB RESS ADD SUITWAPT# OWNER NArM F[;USINr PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS () /Q,-� LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP RW Per:= CITY A ZIP ITELEPHONE EXISTING — PROPOSED Street Use Peffrilt RW impseWn Required Sidth-A RsquM C) zz, REQUIRED DEDICATION— FT ndKW-W uWhIng required NAME METER SIZE LINE SIZE NO. OF,�RES PRV REQUIRED YES 13 NO 13 ADDRESS REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE CITY ZIP TELEPHONE NAME 10 ENGINEERING REVIEWED/DATE ADDRESS see z FIRE REVIEWED By DATE TELEPHONE M 0 CITY ZIP VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY REO'D POSTED r3YES E3NO SEPA REVIEW SIGN AREA IGHT 0 COMPLETE , EXEMPT ALLOWED , PROPOSED At toWED PROPOSED., M Ll 0M.2- C TpTrr/ EXP M *i�. LOT COVERAGE REOU pal-ETBAcKs (Fr.) PROPOSED SETBACKS (FT) NEW RESIDENTIAL ECH ALLOWED PROPOSED SIDE I REAR FRONT URSIDE REAR 8 I C I-] ADDITION [j COMMERCIAL c3 COMPLIANCE OR le :0 r. CHANGE OF USE PLANNING REVIEWED BY DATE I In In PAR 06 CtD LOT AREA REMODEL APARTMENT [3 SIGN RE VIDED 10 Fi GRADING CYDS [3 FENCE X I z 13 REPAIR FT) REMARKS DEMOLISH TANK [:3 OTHER (j) pla,-eT k, / re 0 -n 3 GARAGE RETAINING WALL CARPORT ROCKERY [3 RENEWAL MTE OF USE. BUSINESS (?R ACTIVITY) EXPLAIN: CHECKE PE OF CONSTRUCTION CODE 0060ANT ITI M D STY 11*1e76 Pt" I M) (M i G11bUP NUMBER NUMBER OF CRITICAL OF DWELLING AREAS SPECIAL INSPECTOR JAREA OCCUPANT 0 STORIES UNITS NUMBER REQUIRED [:) YES LOAD 0 DESCRIBE WORK TO BE DONE REMARKS ITI 0 PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REGID z VAWATION $ CO) Description FEE Description FEE z Plan Check 0 HEAT SOURCE F_7LAZING % LOT SLOPE Building IT! PLAN CHECK NO: VESTED DATE Plumbing Mechanical Tmis PERMIT ALFTHORMG ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPEM ONLX ANY CONSTRUCTION ON THE PUBLIC Grading Recording Fee 2 3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE. 1: SEPARATE PERMISSION. Engr. Review City Surcharge PERMTFAPPLICATION: 180 DAYS PERMTT LIMM I YEAR - PROVIDED WORK 15 STARTED WrTHIN 160 DAYS Engr. Inspection State Surcharge SEE BACK OF PINK PERMIT FOR MORE INFORMATION I -APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Tra ffic Mitigation Plan Chk Deposit IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF Receipt # EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Review ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Fire Inspection Total Amount Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE I NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANN ORDINANCE PROVISION.' Landscapelnsp. Receipt # Iq I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION � APPROVAL -L-1-24 GIVEN 15 CORRECT, AND THAT I AMTHE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE M COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This soicaflon Is not a permit Until signed by the 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 FOR INSPECTION Building Officlai or his/ber Deputy: and Fees are paid, and recelpt Is acknowledged In spaoe provided. WOW^N`S5gW,,ENSATION,I�SURANCE AND RCW 10.27. O�FF OfTE OWNE R DATE SIGNED IA95) �IANAMTU. I 771-0220 DATE REL"SEO Y ATTENTION M 1333 f IT Is Uhli�WUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE - YELLOW - INSPkCT6R CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FM PINK - OWNER - GOLD -ASSESSOR 10101