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20030092.pdfI DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS MAILING ADDRESS -W- �4 . CITY �29d� NAME ADDRESS CITY ZIP I TELEPHONE NAME CITY ZIP I TELEPHONE STATE LICENSE NUMBER TAX ACCOUNT 0 NEW RESIDENTIAL 1:1 ADDITION COMMERCIAL 0 REMODEL MULTIFAMILY 1:1 REPAIR GRADING CYDS 0 DEMOLISH TANK GARAGE RETAJNINGWALL El CARPORT ROCKERY (ME OF USE. BUSINE IR ACTIVTM EXPLAIN: NUMBER OF NUMBER OF DWELLING STORIES UNITS ITS :',.DESCRME.WORK TO BE DONE , I -W CBL 0 PERMIT EXPIRES bSE PERMIT /72/5_NUMBER"4�� Z�e,�� JOB SUITE/APT# ADDRESS D PLAT NAMEISUBDIVISION NO. P T NA M E S U B LOT NO. LID NO. LID FEE $ 'G PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP PU 0 L'C R T 0 F TESCP Approved RW Permit Requited street use Permit Rq.d EXISTING PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION— FT REQUIRE I C underground Wiring required SIZ METER SIZE M T j LINE SIZE OF FIXTURES PRV REQUIRED YES13 NO 13 z REMARKS z M S WNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE 0 OW ICO T C akJ FIRE REVIEWED BY CHECKED BY - VARIANCEORCLI SEPA REVIEW COMP-LETEEXEI DATE DATE ORELINEORADB# I INSPECTION BOND )WPH— PI REO'D 113YES &9 POSTED � SIGN AREA I HEIGHT ALLOWED . PROPOSED I ALLOWED . PROPOSED 0 /111*9 EXP I ",-_ __+_ _.:� - LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) 1:1 PLUMBING / MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR I COMPLIANCE OR e --- 2 0 CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DA E 11 SIGN REOD I PROVIDED FENCE r- lo FT) REMARKS �,ODAf7_ -F-ELOCA LEE- AWL FIRE SPRINKLER FIRE ALARM V?-,( 4T7 Int-l- j- _rv) rr j:;,FW lfz�_ CHECKED BY TYPE CRITICA AREAS SPECIAL INSPECTION NUMBER REQUIRED [3YES h - dl— RPUARKR HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECKAOx VESTED DATE 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. PERMffAPPUCATION: ISO DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SFE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIF"X DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLO`1EES. 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 CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION., I HEREBY 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 WORKMEN'S SOMKNSATION INSURANCE AND RCW 18.27. SIGNATURE (OWN61 AGENT) DATE SIGNED OCCUPANT GROUP OCCUPANT LOAD PER UBC 1108/FINAL INSPECTION REG'D VALUATION $ 1 Description FEE Description FEE Plan Check State Surcharge Building Permit Plumbing City Surcharge Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp. Total ALmt.Duejj,, Recording Fee Receipt # CALL FOR INSPECTION IA03 %425) 771-0220 APPLICATION APPROVAL This application Is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid, and receipt Is acknowledged In space provided. OFFIC S N DATE RE D BT DATE ATTENTIOW Off 1 33 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 N OC � r. M M z C� "n 01 M Fn rn 0 z 0 0 M I -7 LTERECE EXPIRES LPERMIT E RECEIVED/, ZONE PERMIT USE I CITY OF EDMONDS NUMBERC�e CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRESS OWNER NAMEINAME OF BUSINESS at, PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS V LID FEE S TESCP Approved �3��4 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Requited Street Use Permit 1101d um CITY ZIP/ ]TELEPHONE EXISTING PROPOSED Invoodonw SIdewak Required REQUIRED DEDICATION- FT urldercrourld Lva Wiring required 13 NAME METER SIZE LINE SIZE I NO. OF FIXTURiq PRV REQUIRED I YES13 NO 13 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROPORAINAGE CITY ZIP ONE PAII t6 WCAfef) P_5 1 NAME jCBLN I i. N,-n� b.-crrm 41"Z1VAf-*,- I ENGINEERING REVIEWED BY DATE KODRESS gk�i FIRE REVIEWED BY DATE CITY ZIP TELEPHONE 9C IZ6 VA RIANCE OR CU SHORELINEORAD111 INSPECTION BOND STATE LICENSE NUMBER EXPIRATION DATE I CHECKED BY f+ / p, REO'D POSTED YES AID - I 1$ SEPA REVIEW SIGN AREA HEIGHT �ROPWTY TAX ACCOUNT PARCEL N_Q. COMPLETE EXEMP ALLOWED PROPOSE,D ALLOWED PROPOSED 00 E. = :;,a texz'q EXP I NEW RESIDENTIAL PLUMBING / MECH LOT COVERAGE REQUIRED or 1BACKS %114 % I ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR ADRITION COMMERCIAL COMPLIANCE OR CHANGE OF USE ............ It, ' 1:3 REI�QOEL MULTIFAMILY SIGN PARKING COT AREA REO'D PLANNING, REVIEWED BY DAIE /'t_ RE.PAIR [3 GRADING CyDS 0 FENCE X FT) EMARKS F D MOL19H TANK S�t fatowl. 74 ocATT AN Ir' oGARAGE CARPORT RETAININGWALL E] ROCKERY [:3 FIRE SPRINKLER FIRE ALARM OWE OF USE. BUSINES�� ACTIVITY) EXPLAIN: OF CONSTRUCTION OCCUPANT CHECKED BY CODE _;5/46gA�7�- 7,*,:::� ]TYPE GROUP I NUMBER OF NUMBER OF DWELLING CRITICAL AREAS SPECIAL INSPECTION JAREA OCCUPANT LOAD STORIES UNITS NUMBER REQUIRED DESE E WORj( TO BE DONE Vie 1?11 REMARKS I. , �,V=' PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D Z_ X 4-,E WY1 14 12 r- / 'A e2 L 1-1 'a %1A I I 1.�^kl TW = I1111IF-11-0111111 kw IN AKI co (eaz $ Description FEE FEE Description FEE IV Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit city Su%hx PLAN CHECK VESTED DATE Plumbing Mechanical THIS PERMff AUTNORMS ONLY THE WORK NOTED. THIS, PERMIT COVERS WORK TO t: BE DONE ON PRIIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading 2 WI :1 DOMAIN (CUPJIS. SIDEWALKS, DRIVEWAYS, MAROUEEG, ETC.) ILLREQUIRE SEPARATE PERMISSION. 9 - Engir. Review PERMIT APPILICATION. IGODAYS I PERMjT umm. i YEm - PROVIDED WORK IS STARTIED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION *AP ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire RiIivlew Plan Chk. Deposit IN 1 T, 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 DIRECTILY4R INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT�SHALL NOT BE Landscapeinsp. 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 ORDWA14CE PROVISION. - Recording Fee j Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICAiiON; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECr AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF %HE 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 Officlial or his/her Deputy: and Fees are paid. and FOR INSPECTION receipt Its acknowledged In space provided. WORKME??8 COMPA&TION INSURANCE AND RCW 18.27. OFF S DATE SIGNATURE OWNER AGENT) DATE SIGNED (425) 771-022W RELRAIIED BY DATE ATTENTIO M 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 REENE