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20030024.pdfI DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION ER NAMEINAME OF BUSINESS MAILING ADDRESS r?n eK� ISU151 0 1 ZIP TELEPHONE NAME ADDRESS CITY ZIP ITELEPHONE NAME lCBL ADDRESS n 64P &P, tzF-" ZIP TELEPHONE 2e,Tyawx1r_�1 fty;:r qq—s � ci�s 610 o ST5V %W%1%%R05A ME WT DATE I CHECKED BY 2n� It r�ll = - Lifig PROPERTY TAX ACCOUNT PARCEL NO. 1.—+C) 'S o o Li NEW RESIDENTIAL PLUMBING/MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY �XSIGN REPAIR GRADING CYDS FENCE X FT) DEMOLISH TANK OTHER oGARAGE ci HETAINING WALL o FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM UWA OF USE. BUSINESS OR ACTIV" EXPLAIN: M NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE HEAT SOURCE GLAZING % LOT SLOPE % PLANCHECKNO:_ VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. t: PERMIT APPUCATION: IBODAYS IL PERMIT UMrP I YEAR - PROVIDED WORK IS STAffTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION PERMIT EXPIRES USE PERMIT ZONE 6C, NUMBER B ADDRESS SUITE/APT PLAT NAME/SUBDIVISION NO. No. LID NO. LID FEE S I ESCP APPrOv9d PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW PerrrAt Requit Street Use Permit Raqd EXISTING — PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION— FT Undargiround Ming required 0 METER SIZE LINE SIZ� NO, OF FWURES PRV REQUIRED YES 13 NO 13 3 REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE I -ENGINEERING REVIEWED BY ;I Kc(_cn.ALLA= 146102- FIRE REVIEWED BY DATE UJI 01 If VARIANCE OR CU SHORELINE Oil ADI1# IN111CTION BOND J POSTED I Fx&v & eEO'D =S Yr 13NO S SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSEC�; ALLOWED PFIOP08ED 'XP , *77.57 -74P,99 14, , LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR we, 6 0 0 fvle— z 1 PARKING LOT AREA PLANNING REVIEWED BY DATE REO'D PROVIDED I I I W6 1-7 /,& CHECKED BY ITYP 0 SjaUCTI9N CME OCCUPANT V7PO I ef 7 GROUP SPECIAL INSPECTION JAREA OCCUPANT REQUIREDJ:]YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC-108/FINAL INSPECTION REG'D Descriptign FEE Description FEE pWjJ!h'jcNk State Surcharge Building Permit City Surcharge 5— Plumbing Mechanical Grading Engr. Review Engr. Inspection '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 Landscape Insp. I U 8 Total Amt. Due I Uj DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE L-22r__ 0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' zi Recording Fee 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 This application Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED INYA)h%UPN OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building Official or his/her Deputy: and Fees are paid. and receipt Is acknowledged In space p(ovided. ,e1RKMEN11%fOMPENSATIO3M,SURANCE AND RCW 18.27. 0 ALS SI URE DATE SIGNATU -0 R NE YAGENT) DATE SIGNED 1A t-125) IVI-CQ 771-0220 41DA0TE/ -RE ED BY ATTENT40'9— IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 13 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE - Y LL CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER - COLD - ASSESSOR 04/02 PRESS HARD -YOU A KING 5 IES GREEN - ACCOUNTING in FINAL PROJECT APPROVAL FORM . FA WA MEMO TO: PERNHT COORDINATOI� BUILDING DIVISION 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Si ocaprvi.doc.l:temp:bldg:formsIO/OI z 9 0 m -q:9 m a 0 0 c MM m z ca 0 -n n m m a 0 0 M cl) co) M 0 Z I co) z 9 0 m a 0 ATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION RR NAMEINAME OF BUSINESS IMAILING ADDRESS 1?hei?il,� 1�1_60 I NAME ADDRESS CITY ZIP TELEPHONE qui R60 __1% ZIP ITELEPHONE NAME CBL# ADDRESS AWN— ZIP TELEPHONE S�%QPVIWOCAIAE b. I DATE W" CHECKED By' 4e�, APt hid = to (7 1, L22 PROPERTY TAX ACCOUNT PARCEL NO. 11 0 (:�> 11 NEW 13 RESIDENTIAL PLUMBING if MECH 0 ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY -SIGN GRADING FENCE REPAIR CYnq I X FT) DEMOLISH 0 TANK 0 OTHER GARAGE o RETAININGWALL El FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (Ti OF USE, BUSINESS OR ACTIVITY) EXPLAIN: NUMBER OF UMBE' NUMBER OF DWELLYING 0 CRITICAL AREAS STORIES U ITS N LVZ,4 NUMBER DESCRIBE WORK TO BE DONE HEAT SOURCE GLAZING % I LOT SLOPE % PLAN CHECK NO:, I VESTED 13ATE PERMIT EXPIRES 7 USE PERMIT ZONE Li NUMBER 0 JOB ADDRESS SUITEIAPT# PLAT NAMEISUBDIVISION NO. 7 NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STRI MAP TESCP APPrOv*d RW Pam* Required Street use Permit RaiTd EXISTING — PROPOSED inspection RociWired Sidewalk Reqir6d REQUIRED DEDICATION— FT Undargmund Wiring required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I I YEs13 NO 13 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ENGINEERING REVIEWED BY DATE 02— FIRE REVIEWED BY DATE VARIANCE OR CU SHORELINEOFIADBff INSPECTION I BOND _REOD I RPES 13NO I POSTED IS SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSECII; IA ALLOWED PROPOSED , 77-571 '74P.89 14' 1 + , _XP LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR'SIDE REAR we. 0 PARKING LOT AREA PLANNING REVIEWED BY DATE REQO PROVIDED 1 I I m/4, 1; UCTI ir JVN CCWW_�OCCUPANT 77 Iq _/ I GROUP INSPECTION JAREA OCCUPANT !D LOAD �ESS INSPECTIONS PER UBC IGO/FINAL INSPECTION REaD $ Descriptign FEE Description FEE ;�h k = State Surdharge Building Permit 4 190 City Surcharge Plumbing Mechanical THIS PERMIT AUTHORLIMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading M M DOMAIN (CURBS, SIDEWALKS, DRwEwAys, MARQUEES, FTC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 161 PERMIT LIMM I YEAR - PROVIDED WORK 15 STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 1APPLICANT, 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 # AM CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Total A I. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABlIJTY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee Receipt # I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT, AND THAT I AM THE OWNER. ORTHE 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,Y*ft%WN OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building Official or his/her Deputy: and Fees are paid, and receipt Is acknowledged in space provided. /W6RKMEN OMPENSAT CE AND RCW 18.27. 0 DP IALS-81 UQE DATE SIGNATUR WNER 0 AGENT) DATE SIGNED IA03 025) LIIIG�N 771-0220 RrE ED BY 'DATE VATTENTION T 13X IfIS 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 ORIGINAL -FILE - YE'lai PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU Ave I�IKING 5 COPIES GREEN - ACCOUNTING 1 z :4:fi aj � M rn -48 C CDP Cal M T 9 0 0 Fn C 0: X z 0 1 0 171