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20020379.pdfI DATE RECEIVED /1 0, z__ I PERMIT EXPIRES CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION USE PERMIT ZONE NUMBEPOW (5311 JOB SUIT ADDRESS <:6-0 1 3/7 wau-mi-I L 7NER NAMENAME OF BUSINESS r ;4 �P f- 41 Ae I/ PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S MAILING ADDRESS e) 0 41 .7 k /-,,- dg 0/. PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING — PROPOSED REQUIRED DEDICATION— FT TESGP ApPr=,d Aw Perfrill R Street Use Parmh R&q'd Inspec-tion Required Sidewalk Required Underground Wiring required 13 CITY ZIP IfELEPHONE NAME METER SIZE LINE ;��. I OF FIXTURES PRV REQUIRED YES 0 NO 13 ADDRESSr REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE CITY ZIP //41 A 11 TELEPHONE NAME Wd /k.,,/;S0-) 4!�� f ENGINEERING REVIEWED/DATE ADDRESS 4"' FIRE REVIEWED BY DATE ld It CITY ZIP d C /0 TELEPHONE 4� VARIANCE OR CU SHORELINE OR ADS# INSPECTION REQ'D E3 YES [3 NO PBOND OSTED STATE LICENSE NUMBER EXPIRATION DATE Ac J HLI C �4 EC SEPA REVIEW COMPLETE I EXEMPT �EXP SIGN AREA ALLOWED , PROPOSED HEIGHT ALLOWED , PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. 0 Ncj'c c:lo \111� RESIDENTIAL /MECH NEW Qt_SLUM;2 ADDITION 13 COMMERCIAL [3 COMPLIANCE OR CHANGE OF USE % REMODEL L APARTMENT SIGN REPAIR [:3 GRADING FENCE X CYDS I FT) DEMOLISH [3 TANK OTHER o GARAGE RETAINING WALL CARPORT 1:1 ROCKERY [3 RENEWAL LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT UR SIDE REAR PARKING REOD I PROVIDED LOT AREA PLANNING REVIEWED BY DATE REMARKS (TYPE OF USE. BU EBB OR ACTIVrM EXPLAIN: xlef 5 ; Jr � X, 'k / CHECKED BY ITYPM RUCTION 'r TT OCCUPANP,2 GRO Jo� I NUM 0 F dwoi' STME-Sa NUMBER OF DWELLING UNITS R 'ICAL C r C ARE N R U�As SPECIAL INSPECTOR REQUIRED [] YES AREA OCCUPANT LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REaD e. X, VAWATION $ Description FEE Description FEE Plan Check HEAT SOURCE GLAZING % LOT SLOPE % Building PLAN CHECK NO: VESTED DATE Plumbing I Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPEFITY ONLY ANY CONSTRUCTION ON THE PUBLIC Grading Recording Fee DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. Engr. Review City Surcharge PERMIT APPLICATION: 180 DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARITED WITHIN 180 DAYS Engr. Inspection State Surcharge SEE BACK OF PINK PERMIT FOR MORE INFORMATION ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS Traffic Mitigation Plan Chk Deposit ;APPLICANT, N NTEREg T, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND Fire Review Receipt # 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 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Landscapelnsp. Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL 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- CALL Thi Lion Is not a permit until signed by the I TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Bulletin or histher Deputy: Fees are paid, and M.C.I., IN VIOLATION OF THE Uk�S�DE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION I. acknowledged In0ce pr 2��- WORKMEITS COMPENSA3) I 'U CE AND RCW 18.27. U OFFI 61NATURE ATE E W;N�E DATE SIGNED (425) MR �'3 771 -0220 j';��kSED BY D&E E10ION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 01�'IGINAL - FILE YELLOW - INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR 10/01 TE RECI RE ERMIT EXPI S Fp r 'E RECEIVED Ta..' USE PERMIT ZON9 CITY OF EDMONDS NUMBER;09 653 CONSTRUCTION PERMIT APPLICATION JOB 7NADDRESS 0 ER NAME/NAME OF BUSINESS tj a-t t, i PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. ,r;4 .' VA- /3, MAILING ADDRESS LID FEE S YESCP ApPnr.Vd kP #, dyc I?,,, PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW PenrAt Rotpiked Street Use Pwmk Rocfd CITY ZIP IfELEPHONE EXISTING — PROPOSED kapodi-ReqtAred Side0rok R"UW J REQUIRED DEDICATION— FT Uroderground 13 )49 Wking required NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED At YES13 NO 13 ADORES$ REMARKS OWNEFUCONTRACTOR RESP ONSIBLE FOR EROSION CONTROUDRAINAGE TELEPHONE CITY 70, Zip /lea /k-, Cj NAME Wo/ #Of,/, so-) cc�--- ENGINEERING REVIEWEDIDATE ADDRESS P / 4.2 4-0 FIRE REVIEWED BY DATE CITY TELEPHONE IZE Is 4 0 VARIANCE OR CU SHORELINE OR AOB# INSPECTION BOND STAM LICENSE NUMBER EXPIRATION DATE ECK POST REOID ED [3Y ES (3 N c -* 0/ 3!� 4 0 v SEPA REVIEW SIGN AREA HEIGHT PROPERTr.rAJc 'ACCOUNT PARCEI No COMPLETE EXEMPT ALLOWED PROFPSED ALLOWED . , PROPOSED EXP 77, 'LOf 66VERAGE REQUIRED SETBACKS (FT.) P9dPOSED SETBACKS (Fr.) 0 N ';I' EW �E iNTIAL/ PLUM CH -PF FRONT LIR SIDE REAR LOW9t1 �IIDFOSED �AONT OMP CE OR ADDITION [3 COMMERCIAL iCHANGE,O.F.USE 'OT REMODEL H APA�T�64i-' �r AREX PLXN91 06 PARKING NG fii�PZD W 3 8 IGN REOD PROVIDED' 'GRADI FEN CE 13 REPAIR Cr X -,FIEMARKS 0 DEMOLISH [3 TANK [j OTHER 13 GARAGE RETAINING WALL CARPORT 13 ROCKERY RENEWAL (ME OF USE, SUPESS OR ACIIVFM EXPLAIN: C?" OCCUPAN CHECKED BY RUCTION GR K NU NUMBEROF L 0 DWELLING SPECIAL INSPECTOR AREA: OCCUPANT FM STOZErS69 UNITS NUMBER C>1 /0-3 REQUIRED [3 YES LOAD DESCRIBE WORK TO BE DONE 4 REMARKS _2 eo, PROGRESS INSPECTIONS PER UBC'108/FINAL INSPECTION RECVD, -�< PA to L I VAWATION $ I I Description I FEE I Discription I FEE Plan Check vo z HEAT SOURCE I--7L;O— NG % LOT SLOPE % Building —0, 0 IT! PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES OMY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PIUVATE PROPEM ONLI AM CONSTRUCTION ON THE PUBLIC DOUAIN (CURES, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading Recording Fee Engr. Review City Surcharge SEPARATE PERMISSION. PER11111'rAPPLICKnON: 1180 DAYS PERMIT LIMM I YEAR - PROVIDED WORK is sTAnTEr t-T.THIN iso DAYS SEE BACK OF PINK PERMIT FOR MORE IHFG.�4ATION Engr. Inspection State Surcharge Traffic Mitigation Plan Chk Depo 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, AMIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Review Receipt # 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�. 9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE I I I NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Landscapelnsp. Receipt # I HERE13Y ACKNOWLEDGE THAIr'l HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CGRRECr 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- CALL TN9 n is not a penn until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NOIPERSON WILL BE EMPLOYED Build or hWftw Deputy: Fees am paid, and IN VIOLATION OF THE LA OF THE STATE PF WASHINGTON RELATING TO FOR INSPECTION we leaO.nowieftedin ce Wt WORKMERS COMPENSAX NCE AND RCW 18.27. ;�E OFFI rGNATUR AATE RE 4 DATE SIGNED 1A05) 5 10-a 7A 771-0220 By DATE ATTEWION Off 1333 '7RF&FA'1E1 IT IS UNfAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 1 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE - YELLOW - INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FM PINK - OWNER - GOLD - ASSESSOR 10/01