20020825.pdf"'DATE RECEIVED
[PERMIT
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USE PERMIT
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CITY OF EDMONDS NUMBER ,�4�4
CONSTRUCTION PERMIT APPLICATION 'AODRESS 1_0 7 SUITEIAPT#
OWNER NAM &I
OF BUSINESS
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LID FEE S
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ADDRESS REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY ZIP ONE i,1 1A
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NAME _JCBLa
L-CYA L A4 E C L0 �J I Cfi E14.1NEEMNS REVIEWED BY DATE
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STATE LICENSE NUMBER EXPIRATION DATE )VARIANCE
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SERA REVIEW SIGN AREA HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO, COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
5&4 - /D 30Y XP , I ,
NEW LOT COVERAGE E.UI.E. .—ACKS (-I PF1.FdRE. SET-.- 1-1
ALLOWED PROPOSED FRONT SIDE REAR FRONT LIFISME HEAR
COMPLIANCE 08
ADDITION CHANGE OF USE
REMO PARKING I LOT AREA REVIEWED BY DATE
DEL 0 SIGN REO'D I 1.0W.E.
REPAIR [j GRADING El 11
CYOS I X Fn REMARKS
DEMOLISH TANK [:] OTHER
El GARAGE 0 RETAININGWALL FIT SPRINKLER
PORT FIOCKEAY E ALARM
CAR Fj.E
(TYPE OF USE, BUSINESS OR ACTIVFM PLAIN:
0 CUPANT'
CHECKED BY ITYPE JVON 7T
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45C Zel"14F 7A LA7. REPAIR- rA,5AIcA7foJ j� 4q GROUP
NUMBER NUM11,F.1.01 CR�ITAICAL
SPECIALIN PECTION JAREA
OF L/,900 5,,r4. L.C.UPANT
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STORIES NITS NUMSER REQUIRED
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DESCRIBE WORK TO BE DONE A f Z,�is 10 mm lir "2.00 Z - 0 ?, 2 1 . REMARKS
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'1GRESS INSPECTIONS PER USC 1081FINAL INSPECTION RECIO
xj OrAl C I- S PAC er . is
I I Deacriotion I FEE I Desorlption I FEE I
Plann Check
State Surcharge
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HEA�ZRCE —ING % LOTJSLOP�%
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Building Permit
City Surcharge
PLAN CHECK NO.-,W_ (/�ro I VESTED DATE
Plumbing
Plumbing
Mechanical
c 'Cal
THIS PERMIT AUTHORIZE S ONLYTHE WORK NOTED. THIS PERMIT COVERS WORK TO
C BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
2
Grading
r I g
a E
:1 OIMALIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETCJ WILL REQUIRE
SEPARATE PERMISSION,
Engr. Review
PERMIT APPLICATION INDAYS
PERMIT LINUT. I YEAR. PROVIDED WORK IS STA TEDWITHIN 1.00AYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-APPLIC NT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON ' ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt
ce ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY 08 1 DIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALNI NOT BE
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscape map.
Total Amt. Due
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
____ - ___
Recording Fee
Receipt #
1 HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT; A D THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
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TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
CALL
B.,'Thacapplic.
dies officf.1 ., JaWhca Barely: and Face are Paid, and
IN VIOLATION OF THE OF WASHINGTON RELATING TO
THE STAT
FOR INSPECTION
ccelpt is ack—teegod In space rea,ided.
EA��NOF
WORKMEN's COMPEN OF AND How 18.27.
OFFICIALS SIGNATURE DATE
SIG DATE SIGNED
(425)
771 -0220
D BY DATE
ATTENTION—
Off 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
4��
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORiGINAL-FILE - YELLOW
CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109
PINK -OWNER - rOLO-ASSESSOR
04102 PRESS HARD -YOU ARE MAKING 5 COPIES
GREEN - ACCOUNTING
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