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20030047.pdfDATE RECEIV7 C CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION ER FAMEWME OF BPMESS ING ADDRESS ZIP TELEPHONE NAME rt, ADDRESS I I CITY ZIP ITELEPHONE NAME e-0 JCBLH 1214!15 /Zfi OCIV 774 ADDRESS gql D M(m,91, 51j, C ZIP TELEPHONE L9 (ktowp_ S' I? —,7&s,3 STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY b 00 3 ZU ;I PROPERTY TAX Ar FITY TAX A _,CO PARCEI -NO. 727V 3�&�,2LI,97el 4 !�ECH) 13 NEW 0 RESIDENTIAL PLUMBII C R COMMERCIAL COMPLIANC R ADDITION CHANGE OF USE REMODEL 13 MULTIFAMILY SIGN FENCE GRADING 0 REPAIR CYDS X_ FT) OTHER 0 DEMOLISH TANK oGARAGE RETAINING WALL FIRE SPRINKLER CARPORT 0 ROCKERY FIRE ALARM (TYPE O"Sk, BUSINESS OR ACTIVITY) EXPLAIN: NUMBER UMBER OF DWELL NG CRITICAL In OF I AREAS 9 STO IES UNITS NUMBER DESCRIBE WORK TO BE DONE 24-2 HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHFC9f NO Vi-STED DATE 5zz 1 reeeeeem THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPUCATION: IGO DAYS PERMIT UMIr I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY 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 BE DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE C17YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION., I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT, AND T14AT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OEfHE STATE OF WASHINGTON RELATING TO WORKMEMS COMPENSATIO"SURANOWAND RCW 18.27. DATE SIGNED 11-36--dz FPERMIT EXPIRES USE PERMIT ZONE -eO NUMBER",� JOB ADDRESS SUITE/APT# L PLAT NAME/SU B DIVISION NO. LOT NO. LID NO. LID FEE S nbur APP(Ov9d PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required Street Use Parrnit Req'd EXISTING — PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION— FT Und0foround Wiring required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I I YES 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE REVIEWED BY DATE FIRE REVIEWED BY DATE VARIANCE OR CU SHORELINE OR ADB# I INSPECTION BOND REn.r) . POSTED gjaz�oyrii;go I s $EPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED I ALLOWE PROPOSED I I I 5r I LOT COVERAGE I REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED I FRONT SIDE REAR FRONT UR SIDE REAR PARKING I LOT AREA I PLANNING REVIEWED BY REMARKS CHECKED BY TYPE O"TPS�RYTY CW_7 I OCCUPANT I GROUP z SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [] YES I LOAD i REMARKS 2 PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'O VALUATION Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION (425) 771-0220 EXT 13133 APPLICATION APPROVAL' This application is not a permit until signed by the Building Official or histher Deputy: and Fees are paid, and receipt Is acknowiedged In space provided. 0 A 1 10 E !r�01=4 I j b I /) -q � /t�� 14 t1_ I IV %.If �er k&� -_ E ED BY DATE 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 YELLON- INSPECTA CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING KI z 0 0 M C m 0 C M m.� z 10: 01 M M Ca 0 Fn Cm Civil mo z 0 m Im a 0 I t 4 RECE17 C CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION IER PAME/?(AME OF %MESS ?-A/va L-f t I ING ADDRESS ;7 -Z ,So ZI TELEPHONE AAMVIK NAME 14 n- miro CITY ZIP ITELEPHONE NAME BLN H a to ADDRESS 91//D jqer1r,91,5tAJ- Cl ZIP TEI�EPHONE lroevotaos, STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY NEW 1-1 RESIDENTIAL 9144, PLUMBINC!!CH) ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE QREMODEL 0 MULTIFAMILY SIGN ri REPAIR GRADING CYDS FENCE ( X FT) DEMOLISH [3 TANK OTHER 0 GA�AGE RETAINING WALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE BE BUSINESS OR ACTIV" EXPLMN: NUMBER OF, ',, - 0. UM ER OF 1 NOWEBLING A/A CRITICAL AREAS Al� STORIES C , UNITS - NUMBER DES I CRIBE WORK TO BE 13ONE jjf�lij 1 laz;., ts;r/ 41- 7-1 /��- P MIT EXPIRES ERI USE PERMIT ZONE NUMBER 60" :OB SUITE/APT# ADDRESS else PLAT NAME/SUBDIVISION NO. LID NO. LID FEE S FESCP Appr&4§d PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW permit Required Street Use Pernt" Wd EXISTING - PROPOSED Inspection Required rAdbvslk Required REQUIRED DEDICATION- FT I underground so 11faquIZ METER SIZE LINE SIZE I NO* OF FIXTURES YEPRV REQUIRED S C3 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE FIRE REVIEWED BY DATE DATE VARIANCE OR CU SHORELINE OR ADS# I INSPECTION BOND RF4 POSTED 1)kor :013YES 01$ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT I ALLOWED PROPOSED ALLOWE� PROVO I I I — — I - LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR RE PARKING LOT AREA I PLANNING REVIEWED BY DIT E / /J,.k W Ir 0 CHECKED BY I TYPE= CODE T71 GROUP OCCUPANT,,� SPECIAL INSPECTION REQUIRED [] IREMARKS YES JAREA OCCUPA1,11 LOAD -1 PROGRESS INSPECTIONS PER UBC 100/FINAL INSPECTION RE01D MAI I I a X11ri /-C�- lflo;e) I HEAT SOURCE GLAZING % LOT SLOPE % PLM CHECF NO: VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. i PERMIT APPILICATION: 100 DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WrrHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION -APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY 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 CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECr AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH C17Y AND STATE LAWS REGULATING CONSTRUC- TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OWME STATE OF WASHINGTON RELATING TO WORKMEWS COMPENSATIQN.WSURANOVAND RCW 18.27. DATE SIGNED 3o -,Oz 06AFy,liption FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk, Deposit Fire Inspection Receipt # ' Landscapelnsp. Total Amt. Due 75 Recording Fee Receipt # '.122a CALL FOR INSPECTION (A9 1,425 771-0220 EXT 1333 APPLICATION APPROVAL' This application is not a permit until signed by the Building OfflcW or his/her Deputy: and Fees are paid, and receipt Is acknowledged In space provided. 0 1 [ON PATE OW1,403 ;f, BED BY DATE IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL z Z/ I, �/ A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW. 4SPECTIR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD L -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING SEEM z 0 0 M