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20030077.pdfit DATE RECEIVED o LP.ERm IT EXPIRES - 291,2q CITY OF EDMONDS USE PERMIT ZONE NUMBERW03-007-7 CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRESS ac 12 r.. OWNER NAME/NAME OF BUSINESS 7Ack -��4c- vA c- P, PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS LID FEE S A V E *N TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Parmit Required Paffnh Rsqd - CITY ZIP TELEPHONE Street Use EXISTING — PROPOSED Inspection Required [3 Sidewalk Required 13 FjM0NjS. W4. 7FOX)l Lai 77C--'7-5-F;C, REQUIRED DEDICATION— FT Underground Witing required 0 MME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES13 NO 13 1 1 z 5 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE CITY ZIP TELEPHONE I /1-i Lai , /6tjvi? &ji,-XA�s P-01 i - NAME CBLN - WHEAT C0NTR1kQTltA4P TNI12. I DATE ADDRESS FIRE REVIEWED BY DATE W CITY ZIP TELEPHONE Mi3kjl�ECI I I/;z_5 OS-336(o _ VARIANCE OR CU SHORELINE OR ADB# INSPECTION BON STATE LICENSE NUMBER EXPIRATION DATE cijaggrRay REO'D POSTED 10YEs 1 E A.7 C,,j 4/2-:51 L" ONO $ SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED IQ EXP I , I .400 1:1 NEW RESIDENTIAL 0 PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWED SIDE REAR FRONT URSIDE REAR PROPOSED FRONT COMPLIANCE OR 1:1 ADDITION COMMERCIAL 0 CHANGE OF USE z REMODEL MULTIFAMILY [:1 SIGN PARKING LOT AREA I PLANNING REVIEWED BY DATE REOD I PROVIDED I GRADING o FENCE 1:1 REPAIR 0 CYDS X FT) REMARKS 0 DEMOLISH 11 TANK OTHER ills, 4�11A&At? IGARAGE -1 RETAINING WALL 0 FIRE SPRINKLER 3 0 CARPORT ROCKERY FIRE ALARM (_rYPE OF USE. BUSINESS OR EXP CHECKED BY 'PE OF� C SZTR CTION OCCUPANTX JCOf GRID 7, NUMAR NUMBER OF CRITICAL OF DWELLING AREAS i�2 - - 15.— SPECIALINSPE ION AREA OCCUPANT LOAD STORIES UNITS NUMBER REQUIRED DESCRIBE WORK TO BE DONE ( 'oar REMARKS sk' 114 XM PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D 4 4101 fqLvr I 'rj *v ck Z� ,i - t 7!" AO .44 1 L #,- 1-- ---- w&mj� . $ 7;w I - Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing III.51-C40 Mechanical THIS PERMIT AUTHORGMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC 3 Grading 3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. E FC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPLICATION: lea DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 100 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit ;APPLICANT N INTERE9T, 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 PERMrr. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due x NOR LIMIT IN ANY WAY THE C17YS 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 THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknovidedged In space provided. WORKMEN'S COMPENSATI!19�0�NCE AND RCW 18.27. TE SIGNATURE ( 90"INY, O�A4ENT) DATE SIGVED (425) 7PCM WSIAT 771-0220 _9ELEZED BY DATr/ ATTER"T ION 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- ORIGINA6(1I E 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 M M IT! 0 C IT11 C2� 0) 0 _n M III 0 0 Fri C (4) M 0 z M Ilk 4 0151 I RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS 7ACkl'r, S4ohjEk "LING ADDRESS RC) 12*k AV If CITY ZIP TELEPHONE FA rVIC,04 JS 11 W4. 780xi q.15-77(--75f(6 NAME ADDRESS CITY ZIP NAME ADDRESS SW PARV, OE CITY ZIP MIAAEo 36A"75 STATE LICENSE NUMBER W9 E A.-r (_1T `184:� CBL N 10 TELEPHONE 495 OJ3- 336�, EXPIRATION DATE I CtV qh5lb4 I m By PROPE t%CCOUNT PARCEL NO. �'51) -1^ M�) 1�1 9 I — 2 QQ i. *ErNEW RESIDENTIAL PLUM13ING I MECH IADDITION 3 COMMERCIAL COMPLIANCE OR 0 CHANGE OF USE REMODEL muLnFAmILY SIGN REPAIR 0 GRADING CYDS FENCE X FT) DEMOLISH TANK OTHER oGARAGE ci RETAINING WALL cl FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (jYPE OF USE, BUSINESS OR WlVffY) EXPWN: - I 13 NUMdER NUMBER OF OF DWELLING CRITICAL AREAS STORIES UNITS NUMBER DES TO BE DONE C 0 Af ACW, 10 14 F100117 0I'fJ1f)C4 Im low WI AA -4 j-,f I .1-e HEAT SOURCE GLAZING % " LOT SLOPE % PLAN CHECK NO: VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPEM ONLY. ANIV CONSTRUCTION ON THE PUBLIC DOMJUN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, EYC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION-. 180 DAYS PERMIT UMM I YEAR - PROVIDED WORK 18 STARTED WITHIN 180 DAYS BEE 13ACK OF PINK PERMIT FOR MORE INFORMATION 'APPUCAffr, 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 PERMrr. ISSUANCE OF THIS PERMIT $HALL NOT BE DEEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' I f, I I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION 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- 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 WORKMENS COMPEN CE AND RCW 18.27. SIGNA =( O�V I DATE SIGPED 7j PERMIT EXPIRES USE ZONE PERMIT ?_5 - 00 7 NUMBERWO JOB SUITE/APT# ADDRESS I jj� jVt tj,. PLAT NAME/SUBDIVISION N5. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICLAL STREET MAP TESCP Appl=. W,., Sh" Use PanNt ROO EXISTING — PROPOSED inspection Required Sidsw&lk Required REQUIRED DEDICATION— FT Urufargmund Wiringfequired METER SIZE LIN E SIZE .0 F FIXTURES PRV REQUIRED . YES NO 13 z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE I I- . I A - . A - - - - - 1liAf1V'W__ EN1GrIN1`EE�R91N1ZGfE9E6 BY DATE VAR IANC11fOFI C0W MAIEL-INE on ADBN INSPECTION BOND REQ`D 113YEs 1. POSTED 13NO SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROP08ED EXP , , , LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR PARKING LOT AREA PLANNING REVIEWED BY DATE R EO`D I PROVIDED L REMARKS CHECKED BY I TYPE OF STRUCTION CODE OCCUPANT;e' A/ SPECIAL INSPE -TION AREA OCCUPANT REQUIREI S LOAD !S (E. 7 REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REaD A— 2�/IIAA — -r!!2F—AA s Iwo. e__"! DescriptIon FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. inspection Fire Review PlanChk.Deposft Fire Inspection Recelp! # Landscapelnsp. Total Amt. Duo 0 Recording Fee -.q/.2&2t 14�f j , CALL FOR INSPECTION (425) 77,1/-bi2O APPLICATION APPROVAL This application is not a permit until signed W the Building Official or hisftr Deputy: and Fen are paid. and receipt is acknowledged In space proMad- F S T ATE O:M I Ih-7,19 —RELEASE'D BYJ / DATFJ ATTE111TION Off 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL ILL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CER-rlFI- ORIGINA'L�11E - YF1 LOW- INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER - GOLD -ASSESSOR 04/02 GREEN - ACCOUNTING PRESS HARD -YOU ARE MAKING 5 COPIES