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20030029.pdfDATE: RECEIVED I CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEifNAME OF BUSINESS 42 / Ldj.1r_!S (jHPje MAILING ADDRESS 21Q0i5L I o— CITY ZIP TELEPHONE ��04 W"? VA)06 NAME ADDRESS CITY ZIP ITELEPHONE PERMIT EXPIRES USE PERMIT ZONE NUMBER 0 0 Z JOB # ADDRESS 9-og I — I Uj PLAT NAME/SUBDIVISION NO. LID NO. [i6T LID FEE S TESCP Appmod PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP AW Permit Required Street Use Permit RKd EXISTING PROPOSED lnspftWn Required Sidewalk Required REQUIRED DEDICATION— FT Und&WMM Wiring required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES13 NO E3 Z REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE NAME L # w ff-Kf�,INSPECVON REQUIRED ENGINEERIM Ris�� TO BE CLEANED OF Dfffftg ADDRESS SID§ jRMk4p=V FIRE REVIEWEEWPEM UNEI 6�7TE CITY 71P ONE T�� WATM IE 0 no VARIANCEORNU 2W8Rffi%AA%ffffMW BOND STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY POSTED AT SEPA REV SIGN AREA PROPER711 TAX A 0 V_f 7TITY otj COMPLETE rjWTD sNvMjqRjftftC nbjfWED PROPOSED CHECIMIST -3 EXP ON ACK OF NEW PLUMBING / MECH -169' IENTSED SETBACKS (FT.) LOT COVERA ;K)RESIDENTIAL ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE z REMODEL MULTIFAMILY SIGN PARKING LOT AREA I PLANNING REVIEWED BY DATE REQD I PROVIDED 0 REPAIR GRADING FENCE CYDS X FT) REMARKS NFO MOLISH 0 TANK A.9a oGARAGE [3 RETAINING WALL 0 FIRE SPRIAKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS OR ACTIVrM EXPLAIN: CHECKED BY OCCUPANJ�� JTYPE'� -GRO TP9 NUMBER NUMBER OF CRITICAL OF DWELLING film I ARE& SPECIAL INSPECTI OCCUPANT ON LOAD STOR ES UNITS NUMBER� JAREA REQUIRED [] YES DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER U13C 108ifFINAL INSPECTION REO'D 71-eA) Oo� 4-pt ex�, / $ F Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: 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 PUBLIC 2 Grading 3 DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUI RE SEPARATE PERMISSION. Engr. Review PERMIT APPILICATION: isoDAys PERMIT ILIMM I YEAR - PROVIDED WORK 18 STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION -APPLICAK 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 DEEMED TO MODIFY: WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APP4 CATION APPROVAL EN IS CORRECT%, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF AIV IE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL i pplica on Is not a permit unfil signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED 71di fficial r hIsther Deputy: ang, Fees are pald, and IN VIOLATION_S)E_THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION I a elptis cknowfodgedinripfi4eprfAqW. WORKMEN:�<OMPEI�SATION INSURANCE AND RCW 18.27. 0 A SIG E TE 8IGNATU (OWNER R AGENT) DAT SIGNED 1A 11925) 771-0220 RElAftab'ey DATE ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW- INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING 44 Z 0: fm 0 Ct ilk, M 10 cz� 0 In C The Initials MT are Milton Thompson, a temporary contract inspector for the City. I DATE RECEMiD CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS L l6 /C.5 4HP �e MAILING ADDRESS �4�1100L 1 16 /�Vr_ WWe 21 CITY ZIP TELEPHONE aH _.r WI? ?L?40 .... gV01 2T14 NAME ADDRESS ZIP ITELEPHONE NAME CBL# Nadle5_ 190111 12111V ADDRESS ARORI �,6,fye CITY ZIP TELEPHONE !!�&j STATE LICENSE NUMBER EXPIRATION Dff I CHECKED gY PROPTIrMM00b 3 0 0 NEW IRDIESIDENTIAL 0 ;LUMBING/MECH ADDITION #0— COMPUANCE OR COMMERCIAL 0 CHANGE OF USE REMODEL muLnFAmiLY SIGN REPAIR GRADING FENCE CYDS x FT) �MVMOLISH TANK GARAGE CARPORT o RETAJNING WALL F RE SPRINKLER ROCKERY FIREALARM M?E OF USE. BUSINESS OR ACTIVTM EXPLAIN: NUMBER 'OF NUMBER OF DWELLING fj Im CRITICAL =23:lbt) STORIES UNITS DESCRIBE WORK TO BE DONE ./ " ol . - tv) a% .1 HEAT SOURCE GLAZING % I LOT SLOPE % PLAN CHECK NO: I VESTED DATE THIS PERMIT AUT"ORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOIMN (CURBS. SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPILICATIONI* 180 DAYS PERUIIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN lea DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICAPM ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE C17Y OF 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 HE DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITY$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION." I HERESY ACKNOWLEDGE THAT I HAVE READ TI�S APPLICATION; THAI THE INFORMATI OWEN IS CORRECTAND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENTt THE OWNER. I AGREE TO COMPLY WITH C17Y AND STATE LAWS REGULATING CONSTRUC- TIM AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION� HE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO ..P WORKMEN" M.ERfATION INSURANCE AND RCW 18.27. SIGNATUlf (OWNER ,fiR AGENT) DATE SIGNED bf�� t*7— jmy I / M - /.T_ 1!:2z _:NP.qe` I PERMIT EXPIRES 1:3 USE PERMIT Z. ""4L-0— 4 Z,1 NUMBER 0 0 JOB ADDRESS wee PLAT NAME/SUBDIVISION NO. LID NO. 77 LID FEE S TiEsCP App=rovadsd Paz PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP AW Pe Requic Street Use Permit "'d EXISTING — PROPOSED inspection Requited Sidewalk Required REQUIRED DEDICATION— FT Undamrouad WhIng required 13 METER SIZE LINE SIZE OF FIXTURES PRV REQUIRED 1 YESO NO E3 z REMARKS I OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE FR-E--INSPECTION RF_QU1KEU 2STREETTO Bit CLk1A1q_ 0 SIDE SEW ENGINEERIN I BY DATE 0 WA -MR ?AErMR TO B13 REMOYED OR —0— alliazz, "ELAUM FIRE REVIEWED BY D h tu im Dump srm 6 T lz 0 DUMP AT APPROV IE VARIANCE (3 1AAM MM BOND OMM" F8 ST ON BACT POSTED MECrit C I, . ��NmBzi . 1 $ — .&;,, nt7frff4w9mnnm_R-�M SEPA RtM — SIGN AREA HEIGHT COMPLETE - EXEM-P-T-1 ALLOWED . PROPOSED ALLOWED . PROPOSED LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR. PARKING LOT AREAJ PLANNING REVIEWED BY DATE REQ`D I PROVIDED L 2 CHECKED BY ITYPE OF CONSTRUCTION OUGUFAN R SPECIAL INSPECTION AREA OCCUPANT REQUIRED [:] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REaD. $ 1 Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge �'5 Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt. Due Recording Fee Receipt # APP CATION APPROVAL' C gica lei p; n Is not a permit until signed by the CALL 11 , nj r hisiher Deputy: i Fees are paid, and '. , W FOR INSPECTION r7N;;tis cknowledged In ant �Qe PrVod. SIG TE 121-35) /�o 771-0220 AwYBY D E cv"r .1 &292 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 04102 PRESS HARD -YOU ARE MAKING 5 COPIES ORIGINAL - FILE YELLOW - INSPECTOR PINK - OWNER GOLD - ASSESSOR GREEN -ACCOUNTING \4 z 0 M M C M 0 C M M z C 0 _n M M Fn C M 0. 7J z 0 0 M