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20030067.pdfAV=L DATE RECEIVED I 1 1 1 PERMIT EXPIRES USE PERMIT CITY OF EDMONDS ZONE NUMBER "&27,0 - 091e-7 JOB 1UITE1APT# CONSTRUCTION PERMIT APPLICATION ADDRESS 7 F ,4-3-2 OWNER NAMEINAME OF BUSINESS 9 PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. L 4? tell, 67 42-, MAILING ADDRESS LID FEE $ T1E5E;F A PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Psrrr,'1"-1a.:q.lsd1, 7 w 3 2- y iSw. use parmli Raq d 1,7 SUat inspection Required CITY ZIP TELEPHONE EXISTING - PROPOSED Sidewalk Required REQUIRED DEDICATION- FT Underwound wiringrequired NAME METER SIZE LINE SIZT7. OF FIXTURES PRV REQUIRED YES 13 NO I 1 6 15 ri ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE CITY ZIP TELEPHONE NAME CB*t Cor6hhe 1.141 ENGINEERING REVIEWED By DATE CC E ADDRESS 90 FIRE REVIEWED BY DATE W 01 CITY Zip ELEP)ONE VC, 0j 16 x VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND EXPIRATION DATE BY POSTED STATE LICENSE MBER REQ'D 113YEs E3NOIS HEIGHT Corst G 10 L2 051a i t SEPA REVIEW SIGN AREA PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED j5�0 ;711gl EXP , I , LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) NEW RESIDENTIAL t(CLUNIBING MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR COMPLIANCE OR Lj ADDITION COMMERCIAL 0 CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE REMODEL MULTIFAMILY [3 SIGN RECrD PROVIDED GRADING CYDS o FENCE X FT) REMARKS REPAIR 1:1 OTHER DEMOLISH TANK EGARAGE o RETAINING WALL FIRE SPRINKLER r FIRE ALARM CARPORT ROCKERY a R E OF USE. BUSINESS OR ACTPM EXPLAP: CHECKE E OF.pAftiSfRUCTION OCCUPANT Ak. ii;g- Nh,'/v Hame GROUP N154BER NUMBER OF AL cR-Fric, 47 AREA OCCUPANT OF DWELLING AREAS SPECIAL INSPECTION LOAD STORIE UNITS NUM13PR REQUIRED [] YES DESCRIBE WORK TO BE DONE ke 0 IVn -`4XA REMARKS .0 t_0 PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D F w4l/j a I mil 11 n 'VALUATION jkiDOA OA o 60A 9 e A44 aalue,,e jbatcet 14A� 9r,9D Descrihon FEE Description FEE Plan Check arg. State Surc9harge H&SOURCE GLAZING% LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIE PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t-- BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 2 ET :1 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES. C.) WILL REQUIRE It: SEPARATE PERMiSSION. Engr. Review 2 5 PERMIT APPUCATION: 180 DAYS IL PERMIT ILIMM 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 a EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY THIS PERMIT SHALL NOT BE FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF Landscapelnsp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION AFPROVAL 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 IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO Building Official or his1her Deputy: and Fees are paid. and FOR INSPECTION receipt Is acknowledged In space provided. WORKMEN'S COMPENSATION URANCE AND RCW 18.27. OFF DA E . SIGNAT�W (OWN GENT) DATE qGNED " PA (425) ZIAGN C ;?, �)3 RA-4 17( le.7 � 0 A-3 Yd Cl 771-0220 RELEASED BY- DATE ATTENTION EXT 1333 _ �_� ka t�_ �J_xle � 3 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL ILE - YELLOW. 14ECTOR 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 M M M 40 0 M M 0 _n ITIM 0 Fn ca 0 ;tl z z 0 ITI 9 13 DATE RECEIVED ys' 9 9145 1 " � I PERMIT EXPIRES - CITjY OF EMONDS USE ZONE --- PERMIT NUMBER qoi�?; CONSTRUCTION PERMIT APPLICATION JOB ADDRESS SUITE/APT# 7 OWNER NAME/NAME OF BUSINESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS LID FEE S 7 t4 3 1- 1-7 X (I, L, Sw PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP I PUGF Approved RW Permit Required street Use Permit Reqd ZIP TELEPHONE EXISTING PROPOSED Inspection Required SIdwalk Required L'n " 0 ut% C- IRO -1- 6 "x-c- 7%4-ji-ILIt REQUIRED DEDICATION— FT und"grourid Wiringroquired 13 NAME METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED YES 13 NO ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE CITY ZIP ONE NAME CB C'or.5 Yoh ENGINEERING REVIEWED BY DATE ADDRESS I uAo)(a)io wqt6;46.,dA,c, A z FIRE REVIEWED BY DATE Lu 0 CITY ZIP ONE TELEP SA CI4 '.54 VC, drf/ 0 M 0 A, ' # —W VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND STATE LICENSE i7l MBER EXPIRATION DATE By REO'D POSTED 10YES ONO s Cor St G� f IT/ 061-0(t :H SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED W, EXP , zlt . C M NEW RESIDENTIAL MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED S ETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR 0 0 r �4' COMPLIANCE OR N 0 COM ERCtAL E] CHANGE OF USE PLANNING BY DATE rn PARKING LOT AREA REVIEWED 0: REMODEL 13 MULTIFAMILY SIGN REOD PROVIDED rn GRADING o FENCE X I REPAIR CYDS _FT) REMARKS., ARL z o OTHER DEM014PH TANK ps LjU L 4 v; i':�' GARAdE RETAINING WALL F RE SPRINKLER CARPORT 0 ROCKERY 0 FIREALAAM 0 M?E OF USE, BUSINESS OR CT n MM EXPL41": CHECKED BY ITYPE 0WRUCTION OCCUPANT GROUP M M NUMBER NUMBER OF CFVITICAL a DWELLING AREAS SPECIAL INSPECTION AREA OCCUPANT F' : LOAD 0 0 ATORiEs UNITS NUMBER REQUIRED [3YES r-SCA ONE REMARKS 0) e PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D M 0 Flie It. t Ile ry tooA OA lj( 0 114 Al �,A e VALUAnON z $ �0100 A&D Descrihon FEE on Description FEE Z. Plan Check wge rch a State Suo']Y. .5 i I I 0 IT! HI;AT 9OURCE GLAZING% LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical —a,%uv-ru=wwnnkeunvcn -ruin PERMIT COVERS WORK TO t: BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOUN (CUPM, SIDEWALIKS, 13RnFEWAYS, MARQUEES, ETC.) WILL REQUIRE N SEPARATE PERMISSION. Engr. Review PERMITAPPLICATION; ISO DAYS PERMIT Lium I YEAR - PROVIDED WORK IS STARTED WITHIN ISO DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION ------- 6�=M 'APPUCAK. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIG68 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 THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE 5 FROM Landscape Insp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 21 NOR LIMIT IN ANY WAY THE CITYG ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT TH 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 EMP LOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building OfflclW or his/her Deputy: and Fees are paid. and receipt is ackricrMedged In space provided. WoRKMENS COMPENSATla��URANCE AND RCW 18.27. OF�CIA GNP D7AE SIGNAT 5 (OWN I �GENTI/ DATE GNED 1A92" ) ello 771-0220 F(ELEASED BY DATE ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI - 1. Al F - roR CATE OF OCCUPANC Y HAS BEEN GRANTED. UBC SECTION 109 541 10 :5 PINK - OWNER GOLD -ASSESSOR PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING 04/02