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20030017.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION ER NAMEINAME OF BUSINESS I el zo in fla lok-N. ING ADDRESS CITY ZIP ONE EL NAME - ADDRESS CITY ZIP ITELEPHONE NAME CBLN Ar "k" 110113 ADDRESS P.O. Ila& GOS CITY ZIP TELEPHONE 425 --n AS -7 STATI LICENSE NUMBER EXPIRATION DATE _7 2 _ PROPERTY TAX ACCOUNT PARCEL NO. & -7 !M 61 jdi.�:Jjg -01zVtOd NEW RESIDENTIAL Im PLUMBIN Ec� ADDITION COMMERCIAL COMPLIACAH 0 CHANGE OF USE REMODEL MULTIFAMILY SIGN REPAIR 0 GRADING CYDS FENCE X ( FT) 0 DEMOLISH 1:1 TANK Ei OTHER EiGARAGE I RETAJNING WALL 0 o FIRE SPRINKLER CARPORT ROCKERY FIREALARM UWE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: C-arnb%%ft.0 as ttl A- A NUMBER OF NUMBER OF DWELLING A" CRITICAL AREAS fi�/)+ STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE a 0— PERMIT EXPIRES 11,�ZIZ L� USE PERMIT ZONE NUMBER440� et�fl /7- JOB ffE/APT# ADDRESS E-4wX PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP APprovied RW Permit Required Street Use Permit Req'd EXISTING - PROPOSED inspection Required Sidewalk Required REQUIRED DEDICATION- FT Undo Wound wifing, required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YESM NO C3 z REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE W VARIANCE OR CU SHORELINE OR ADBII INSPECTION I BOND R E Q�D, I POSTED 1$ 13YESUkO SEPA REVIEW SIGN AREA - HEIGHT COMPLETE EXEMPT .ALLOWED PROPOSED ALLOWE PROPOSED , :�� -30 1 EXP LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR REAR Z� IV49 ------------- '01 z PARK REO'D 1 IT AREA I PLANNING REVIEIA ED BY DATIf-' 7 �p /" I - MW Ape,, efg;i2tie'eif eeqv tl Ke,_-_4 if"Ole, — 11 jb d< rre- r,e4 144 C" CHECKED BY rPE OF CONSTRUCTION OCCUPANT 1.11" GROUP SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [:] YES I LOAD REMARKS 9 PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D $ L�_ Description FEE Description FEE Plan Check I State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO* Z-_ VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC Grading X DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 180DAYS IL PERMIT ILIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 160 DAYS Engr. Inspection SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, 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 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection 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 Landscapeinsp. Total Amt. D ue DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 DINANCE PROVISION.- X1 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY OR Receipt # Recording Fee 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION AP*PRVAL 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 This application 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 Official or his/her Deputy: and Foes are paid, and racelpt Is acknowledged In - space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. OFFICIALS NATU DAT (0 NY) OATES NE IA05) ySIGNATURE 771-0220 'PIP 1 6 0 - RE SED BY /DATE F_ ATTMTfOW Off 1333 A IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 2 h1%= A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 3INAL - FILE YELLOW - &SPiVTI�R CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 IT! 0 DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION it WMEINAME OF BUSINESS CITY igilo,owt � N /A ,ADDRESS; CITY NAME ADDRESS oA ZIP I TELEPHONE ZIP 4- CBL N PERMIT EXPIRES USE PERMIT ZONE NUMBERCQS JOB ADDRESS to-30,5 UrrE/APT# i Giml I ses�!AVEL PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP AV AW Pemlt=od Street Use Peffnh Reqd EXISTING - PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION,- FT unds� Wiring required METER SIZE LINi SI�E NO OF FIXTURES REQUIRED YEPs'1V3 NO 13 z I REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING REVIEWED BY DATE z 411 Trw 26 19�& %J!2 FIRE REVIEWED BY DATE 0 CITY ZIP TELEPHONE x 0 -7 M VOM, 1&j2S_-"(p_qSs VARIANCE OR CU SHORELINE ORA B# INSPECTION BOND STATE LICENSE NUMBER EXPIRATION DATE FCHECKED BY �REQ'D POSTED 113vi;s _jWV0 Is =n- % Q lm� SEPA REVIEW SIGN AREA HEIGHT : OPOSED PROPERTY ACCOUNT PARR�Ct_ 3N. COMPLETE EXEMPT ALLOWED PROPOSEDI_' ALL6WE PR 1 4�-- M 00, xit,�qd I 46 &;::� d—o"-36 �22 EXP C M LOT COVERAGE REQUIRED'SkT&I(CKS (Fr.) PROPOSED SETBACKS (Fr.) 9 _[3 PLuMBiN �MECH� ALLOWED PROfOSED FRONT SIDE REAR FRONT LIRS19E REAR C) RESIDENTIAL C 0 C: OMPLI NC OR C ANC OR 4 ADDITION COMMERCIAL CHANGE OF USE PARKING LOT AREA PL4NNJNIG REVIEWED BY DAT&' M �7 '��"Cuu g MULTIFAMILY S RE(Y4ROVIDED 0 REMODEL 13 IGN [:] GRADING FENCE z REPAIR CYDS (_X—FT) OTHER DEMOLISH TANK [3 GARAGE RETAININGWALL F RE SPRINKLER k1b W,5:022 re VOW 0 _Tl ROCKERY FIRE ALARM (.111 CARPORT re JA_1 je-e 0(_ "TI (Tyr ORJ�CTIY�m EXPLAIN' 'OCCI E.OF.qqE., BUSINESS; f �, : - � �A -:. 1. _7 '.I - CrPE OF CONSTRUCTION UPANT" CHECKED BY ic _OE GROUP M M '17 NUMBER IUMBER OF A/ CRITICAL N ON JAREA 'OF DWELLING IV /A AREAS SPECIAL INSPECTI OCCUPANT STORIES UNITS NUMBER REQUIRED LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D VALUATION , 40� 71 lag � 1P. IT11 $ Description FEE Description FEE z 0 Plan Check State Surcharge -4 HEAT SOURCE GLAZING % LOT SLOPE% _oe— 0 Buildina Permit City Surcharge Plumbing PLAN CHECK 01 21 VESTED DATE Z Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I= BE DOME ON PRWATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 11 DOMAIN ACURSS, SIDEWALKS, ORNEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PEj1MISSION._ Engf. Aeview: PERMIT APPUCATION: ISODAYS IL PERMIT ILIMM 1 YEAR - PROVIDED WORK 15 STARTED WffHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 1APPLICAK ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit IN INTEREST. AGREES TO INDEMNIFX DEFEND AND HOLD HARMLESS THE CITY OF --- EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection 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 Landscapeinsp. Total Amt 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.* Recording Fee Receipt # I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRF", 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 This application Is not a permit until signed by the TION. AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building Olficial or his/her Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided. WORKMENS COMPENSATION INSURANCE AND RCW` 18.27. L_ - OFFICI;ALS SL%LATURE NTI DATE SjbNErj IA05) WNATU <� � IdW23 1 YM jig r), tof . 771-0220 Mina R Y /DATE Off 1333 �EA IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- TORIGINAL - FILE YELLOW - INSPP&OR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING