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20030049.pdfI DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEMAME OF BU�N SS /',�)_a o-1 1).�- n MAILING ADDRESS 3 �CITY,W,/ ZIP NAME ADDRESS CITY ZIP N�71;AIVAIZ/j_ --- 1��a J,4 J yam MMIIIIII ZIP PCENSE NUMBER 16 TTY TAX ACCOUNT PARCEL NO. TELEPH NE V� 1673-116 CBL N PERMIT EXPIRES USE PERMIT ZONE A.— NUMBER C015 JOB ADDRESS aL _�3 7 , /1) SUITE/APT# PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW PernM Requited Street use Partnit Reqd EXISTING - PROPOSED Inspection Required Ell Sidewatic Requited REQUIRED DEDICATION- FT underground Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES13 NO C3 z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING REVIEWED BY BE ACCEPTED DATE FIRE REVIEWED BY DATE TELEPHONE OR CU SHORELINE OR ADB# INSPECTION BOND EXPIRATION DATE CH REO'D POSTED I L-00 13YEs 13NO 2j SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPTTALLOWED . PROPOSED ALLOWED , PROPOSED I ul 01 Iz 0 NEW MeRESIDENTIAL PXLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRO NT UR SIDE REAR I COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE I PARKI [GrUp DT@#E4 leemmaMrs DATE Pm. 0 REMODEL 0 MULTIFAMILY SIGN I I Ro 0 REQ`D E -i I req4red on rgel-burning applianas In [] GRADING FENCE REPAIR CYOS t - X FT) REMARKS unheatetl spacm UIMC 815.1.7 DEMOLISH 13 TANK OTHER 0 GARAGE -1 RETAINING WALL FIRE SPRINKLER CARPORT 0 ROCKERY FIRE ALARM MPE OF USE. BUSINES OR ACTIVITY) EXPLAIN: CHECKED By. CONSTRUCTION OCCUPANT ITYPLPF GROUP NU E NUMBER OF CRITICAL 0 DWELLING AREAS SPECIAL INSPECTION AREA OCCUPANT LOAD UNITS NUMBER REQUIRED [:] YES DESCRIBE WORK TO BE DONE REMARKS PROG 04- -1 is open or dosed, expansion tanks are �7L9.,o 0o A -Xr, -e- required on all hot water ta er _P "91 A r 0 " - L /1, t, �ZL_ VALUATIO kouv 19-30.020 j&,1,0L_ h6i'110L d D0 $ V Description FEE Description FEE je, 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 BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC Grading DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMrrAPPUCATIOH: IGO DAYS L PERMIT UMIM I YEAR - PROVIDED WORK IS STAffIrED WITHIN 180 DAYS Engr. Inspection SEE BACK 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 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 Landscapelnsp. 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 # 1 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 CCNSTnUC- 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 Building FOR INSPECTION Oificlal or histher Deputy: and Fees are paid, and receipt Is acknowledged In space provided. WORKMEN'S COMPENSATION INSURANCE ANP, RCW 18.27. 0 1 P(I L I NfUlqE E SIGN=ATUREER G DATE WKI b4l y (425) 7�� 0 at4 Z2202 771-022 DATZ RELEASED BY ATTFrN*nN 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 z 0 d 0 M M ME 10 0 C: j! r. M M 10� z 0 _n M M a Co 0 0 r-n z z 0 -1 0 M A I . ,pt It it RECORD OF INSPE TIONS pI to INSPECTOR DATE APPROVED p It, t%4 t,;J4 &A.. too sets ar f It. I%*. I KS j t� I 1 1, 4%, f v a oil t 04 It It fit41 it v Ing ti Wallassess Dal *ease safes assents Pier/Porch Retaining Wall' it %. 1. j. I i I'. I. I I it 41 1. Slab Insulation I I I PLUMBINGO lit, Underground I I P. I Ito 'I 14 It It "I Roughw*ln a 0 0 0 a Its a a 6-0 a'* 6 at 0 4 it f, Commerc. I tit o1al Final' tojeese It t L IA I I it it HEATING % 4 1 I-1, - I t I I, I, I I I tit I p G 'a' Test ��!o Ga's *PIp'Ing 1 4 1 1 1 1 1 t r F 1) 1. 1 1 1 . SAC I I Pou ent Equipm I IN I ,X Commercial Final. d I I p I : I I I E IN I N P.1, XTERIOR SHEATHING I" r 'I p r . . I d t p I d d I I -NAILING-m .... I L I.' I I I I I I �il t III, 11�401.,l 'As! a':; I I It FR NG- AMI 74' 1.- ' I r I I, to a 1 9 0, m assess ant seen slaves m 10 C z 0 an m m C Sit I 31 Z, 0 ... ....... ,0DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF B SS f")a "i'l 0 MAILING ADDRESS C! 1-Y ZIP �TELE HINE opo 1 �7� 3, 67- - // N NAME ADDRESS CITY ZW NAME- _,5111k_V111111, r-_ ADDRESS P o - 1 7— - I , PFENSE NUMBER FTAX ACCOUNT PARCEL /j ,: 2 7 � 0,� 5, 09. 11 ZIP TELEPHONE -) V 0)---1 C�- 1 12 Ob- 2d7-YI EXPIRATION DATE I C!Hlf�CKED BY 2_7j,61p,,; Aj� NEW [ZrRESIDEN'tG, ADDITION 0 COMMERCIAL REMODEL mummmy REPAIR GRADING CYDS DEMOLISH TANK oGARAGE RETAINING WALL CARPORT ROCKERY ME OF USE. 0 OR ACTIVITY) EXPLAIN: NUMBERi DF gUE&; DWELLING UNITS DESCRIBE WORK TO BE DONE [LjeVLUMBING/MECH aCOMPLIANCE OR CHANGE OF USE 0 SIGN o FENCE X FT) [3 OTHER 1 F RE SPRINKLER 3 FIRE ALARM 1�, . I PERMIT EXPIRES 4Z,-" USE PERMIT ZONE e:5� NUMBER :OB SUITE/APT# ADDRESS PLAT NAMEISUBDIVISION NO. LOT NO. L D NO. L�D FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP App"ried AW Permit Required Street use Permit Wd EXISTING — PROPOSED— Inspection Required Sidewatic Required REQUIRED DEDICATION— Fr UndergprourW Witing required 13 METER SIZE LINE Sl!!T. OF FIXTURES PRV REQUIRED I YES 13 NO E3 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE 0%&Aft MeEft— ___ __ FIRE REVIEWED BY BY Nji RP.r.F9TI;1j DATE DATE .ARIANCE OR CU SHORELINE OR ADB11 I INSPECTION I BOND REO'D POSTED 13YEs 13NO S SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED SED ALLOWED , PROPOSED EXP PROPO LOT KS (Fr.) PROPOSED SETBACKS (Fr.) ,ALLOWE OSED FRONT SID HEAR— A051 REAR L vent conne(p= PA REGID K5 W 916 [U'M" SPM* UMC 81S.1.7 I CHECKED BY ITYP CONSTRUCTION GOLW ILAAMPANI ivvk /�ili` �7 GROUP CRITICAL W49—L." z AREAS SPECIAL INSPECTION JAREA OCCUPANT C In LOAD NUMBER REQUIRED 0 YES R )U M tRE ARK 9'0.,906;161 All -fl? /I e, ,e & /&-_ /A site Waller "MGM Is on Or cbmd. expansbn grequiVried.on al hot water tan I ]ON VALUAnON ECDC 19.30.020 (c) $ A — Description FEE Description FEE "nil 1101, rfl� Plan Check State Surcharge HEATSOUIRJAIV MtWI: LOT SLOPE % 7PVESTnED Building Permit City Surcharge PLAN CHECK NO: DATE Plumbing Mechanical THIS PERMIT AUTHOREMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRrvATF_ PROPERTY ONL% ANY CONSTRUCTION ON THE PUBLIC Grading 3 DOMAIN (CURBS. SIDEWAILICS, DRIVEWAYS, MARQUEES, E TC.) WILL REQUIRE SEPARATEPERMISSION. x,�leview �n F5 PERMITAPPLICATf ,MY%rrHIN 8 1 UMM I YEAR - PROVIDED W 90 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION ngyr. inspection ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit ;AFJ�LICANT� N rEREST, 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 '75 FROM THE ISSUANCE OF THIS PERMM ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' 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 THEREIT4 NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO iFOR INSPECTION Building Official or his/her Deputy: and Fees are paid, and receipt Is acknoWedged In space provided. WORKMENS COMPENSATION INSURANCE AN9, RCW 18.27. U D TE SIGNATUIRMEER GE DATE PIGNED 'A'05)- o �IL�)[N E 7(s 771-0220" B'Y RELEASED I bATr/ ATT9NWON 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 04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING . .... ..... - -_ ----- - - z 0 om M rn M 10 0 _n .n MIMI 0 0 Fn 710 M z 0 4 5 M