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20030050.pdf7 5TAP cjk) DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEMAME OF BUSINESS -, 5 D_m"A) s ajov smrim MAILING ADDRESS <e4 7 Q /Qj_1A <7- cl,) CITY ZIP I TELEPHONE NAME ADDRESS CITY ZIP ITELEPHONE *1 1 :13 PERMITEXPIRES USE PERMIT ZONE NUMBER JOB ADDRESS <6—V Lq C, 41 ST 57 PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved AW Parmt Retruired Street Use Permit Reri'd EXISTING - PROPOSED Inspection Required 13 Sidewalk Required 13 REQUIRED DEDICATION- FT Underground WIftg required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YESE3 NO 13 z REMARKS OWNERMONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE NAME cBL# CBL# JQW,adL a&�� mit-, E N GINEERNG R' ENGINEERING REVIEWED BY DATE ADDRESS 111�u 0=z - . CITY ZIP TELEPHONE I 14-IAIWW006 k04 %103& 1 V70 2 72z/ STA`hE LICENSE NUMBER E71 TION DATE KE F FIRE REVIEWED BY IR E REVIEWEE VARIANCE OR VARIANCE OR CU kE DATE / 2 C) ? SHORELINE OR ADB# INSPECTION BOND REQ*D POSTED W cc rL ua";J: IRSOVLtCOUNT PARCE1.1g. BE A REVI SEPA REVIEW OMPLETE C OMPLETE , EXEMPT XP EXP 13YEs ONO $ SIGN AREA HEIGHT ALLOWED I PROPOSED ALLOWED I PROPOSED NEW RESIDENTIAL 0 ADDITION OMMERCIAL zc PLUM13ING MECH COMPL ANCE OR CHANGIE AOFUSE LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR REMODEL 1:3 MULTIFAMILY SIGN PARKING RE470 I PROVIDED LOT AREA PLANNING REVIEWED BY DATE GRADING REPAIR 1:1 CYDS FENCE X FT) REMARKS DEMOLISH 0 TANK OTHER GARAGE RETAINING WALL CARPORT ROCKERY FIRE SPRINKLER FIRE ALARM (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: CHECKED BY OCCUPAN" FIJ24K b&Pr. ITYPEWINST�Vrq, GROUP NUMBER NUMBER OF OF I DWELLING CRITICAL AREAS SPECIAL INSPECTION' OCCUPANT -STORIES _ UNITS DESCRIBE WORK TO BE DONE NUMBBO JAREA REQUIRED [] YE LOAD REMARKS 4 PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REO'D 1 �1 $ Description FEE Description FEE I Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % I Building Permit City Surcharge PLAN CHECK NO: --Al-v VESTED DATE a Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO lz BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC 2 Grading :3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE I= SEPARATE PERMISSION. 2 Engr. Review 5 PERMIT APPLICATION: 180 DAYS IL PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED 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 INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF 2 EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND Fire nspection Receipt # 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 Landscapeinsp. Total Amt. Due NOR LIMIT IN ANY WAY THE C"Y8 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 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 Building Official or his/her Deputy; and Foos are pa d, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In spacoprovidod, WORKMENS COMPEN!9"URANCE AND RCW 18.27. 0 S ATUR11,0. OAT SIGNATU (OWNER 0 AGENT) DATE SIGNED 4NTION 1A25) 7 L 771-0220 4 4 0 REL4ED 13Y I 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 - 1I(SPrCT&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 FINAL PROJECT APPROVAL FORM DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: _FIRE DEPARTMENT DATF34LQ� -ENGINEERING DIVISION DATE- rLamsm PLANNING DIVISION DATE' nzmsm , -Z.Z-- PROJECT. PERMIT #A&,1 ADB# -DATE INSPECTED - 11 Y A& If f aA DESCRIPTION OF WORK TO BE A Held inspection was conducted to determine final compliance with approved plans. Final approval denotes that there are no objections from the above signed Department to the release of PEW_RMAN BONDS and the granting of: GRANT FINAL PROJECT APPROVAL GRAM PROJECT APPROVAL WITH CONDITIONS NOTED a Copy of CONDITIONS given to owner/contractor by.inspector I . FAILED FINAL INSPECTION - OUTSTANDING ISSUES a Copy of CORRE CTION NOTICE given to owner/contractor by inspector. I . 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Sip, ocaprvl.doc.l:tay.bldg:formsIO/OI m A6 k,. RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMMME OF 13USINESS MAILING ADDRESS (;r,q7,9 /90' 5-7. .—SW CITY ZIP TELEPHONE LW.1MjQS, gJA '919020 NAME ADDRESS CITY NAME ADDRESS &2:31 CITY )-441VA.)W00b STATE LICENSE NUMBER ZIP ITELEPHONE CBL # ZIP TELEPHONE #?,r &It) 77 EXPIf4TION DATE V� I rAn,t:L NEW RESIDENTIAL PLUMBING / MECH [j ADDITION WMERCIAL COMPLIANCE OR 011`C 1:3 CHANGE OF USE REMODEL MULTIFAMILY SIGN REPAIR GRADING CYDS FENCE X FT) 0 DEMOLISH TANK OTHER [3 GARAGE RETAININGWALL 13 o F RE SPRINKLER CARPORT ROCKERY FIRE ALARM '(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: n NUMBER NUMBER OF CRITICAL OF STORIES . DWELLING UNITS AREAS NUMBER DESCRIBE WORK TO BE DONE FA —CASo ..HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: 10%_^ I VESTED DATE r. IPERMIT EXPIRES USE PERMIT ZONE NUMBER JOB ADDRESS <6V Lj� 0 PLAT NAMEISUBDIVISION NO. LOT NO. LID NO LIDWr= s PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCF Approved .f(W Pennit R"uIred Street Use Pennit Req'd EXISTING - PROPOSED Inspection Requirsil a REQUIRED DEDICATION- FT U=kw MMU requhred 13 METER SIZE LINE SIZE NO. OF FIXTURES PAV REQUIRED YES 13 NO 13 z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING REVIEWED BY I 9ft 11111151 DATE FIRE REVIEWED BY DATE us oc VARIANCE OR CUI SHORELINE OR ADB# INSPECTION BOND REO'D POSTED SEPA REVIEW SIGN AREA 113YES 13NO 1$ HEIGHT 11510MPLETE . EXEMPT ALLOWED . PROPOSED I A" OWED . PROPOSED LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE �..REAR PARKING LOT AREA PLANNING REVIEWED BY DATE REO'D I PROVIDED 1 1 06 REMARKS CHECKED BY jTYP!�ACVr+, OCCUPAN" GROUP jo SPECIAL INSPECTION' JAREA OCCUPANT REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD VALUATION $ 1 Description FEE Description Plan Check State Surcharge Building Permit City Surcharge Plumbina I 11111111 I 402.2. I Mechanical THIS PERMIT ALIT"ORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONGTRUICIrION ON THE PUBLIC Grading DOMAIN (CURB$, SIDEWALKS, DRIVEWAYS, WJIGUEES, ETC.) WILL REQUIRE SEPARATE POWISSION. Engir. Review PERMITAPPLICATION: 180 DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED 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 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 4- FROM THE ISSUANCE OF THIS PERMrT. 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 CHYS ABILITY 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. OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CrrY 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 Offlclal or his/her Deputy: and Fees we pald, and' IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In spaceprovided. WORKMEN COM iNpWriRb�RANCE AND RCW 18.27. LEN BIG (OWNER 04 AGENT)) t. DATE SIGNED 1A10 %-FK- 5) Q�F �STU tZqT .1 771-0220 'RELFAEO BY DAT A OFENTION EXT 1333 A A , i j IT IS I ONLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLON - 19SFECTdR CATE OF OCCUPANCY:K43 BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD -ASSESSOR 04/02 PRESP-HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING