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20030095.pdf11 DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS 9(qN Hc,(-)vrioo�� 15 MAILING ADDRESS �F 13 `7 CITY ZIP TELEPHONE C-Wy) 20'�o 1 ("'7 !� - NAME ADDRESS CITY ZIP [TELEPHONE NAME CBLN Coop g(_-Rv16C-j C0Pj--=> 10yq ADDRESS I '� I '-"' I '? , , CITY ZIP, TELEPHONE STATE LICENSE NUMBER EXPIRATION DATE C C 0 0_0 !�' C �k _( M L_1 fbdvl� I ,-21 / -A &.-aGu 1 / " ( j NEW RESIDENTIAL PLUMBING I MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULnFAMILY SIGN REPAIR 0 GRADING CYDS FENCE X FT) 0 DEMOLISH TANK OTHER [3 GARAGE RETAININGWALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS OR ACTIVrMUP 14: NUMBER, NUMBER OF —] CRITICAL OF STORIES 4.� DWELLING � UNITS AREAS NUMBER DESCRIBE WORK TO BE DONE All 7 103 USE ZONE 12�-Isl JOB ADDRESS PERMIT EXPIRES PERMIT NUMBER SUITEIAPTO 4_A AVF PLAT NAME/SUBDIVISION NO. LOT NO. LID NO, LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Pefrnit Required Streat Use Poffnit 7R9qW'd EXISTING — PROPOSED ed Inspection Required ilk Required REQUIRED DEDICATION— FT 1:011WNER/CONTRACTOR Underground g required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 1 1 1 YES13 NO 13 REMARKS RESPONSIBLE FOR EROSION CONTROUDRAINAGE �11(5�Aj W. K__1120XIM�M�z -FWL�_TY F&-L-1- Or- H-0f/ce)C/(2 PIP10( 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 PROPERTY ONLY. ANY rONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) W`1LL REQUIRE SEPARATE PERMISSION. PERMIT APPILICATION: 180DAYS PERMIT ILIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS N 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 FR 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 ACKWOWLEDGE 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 OWNE"G_R'E�E TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- TION; AWIN DOINGVTHE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOUTION OFTHE LAQQELCODE OF THE STATE OF WASHINGTON RELATING TO WOAKMEN'S COMPENSAPOWIftliLRANCE AND RCW 18.27. OV0110- ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY I --D E W 11C A WATERSMICE if&ibg Im BOND VARIANCE OR CLj�t%gPftfftQM? INO POSTED I3 3YES S "CON 0 SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT I ALLOWED , PROPOSED I ALLOWED , PROPOSED L LOT COVERAGE REQUIRED SETBACKS (FT.) t PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR PARKIN DATE PE%i"t REO'D I WIRM'"If" SH L BE STALUD NEAR REMARKS THP WATF-R SHITMFF --i CHECKED BY TY DO N N OCCUPANT GRO CIP SPECIAL INSPECTION JAREA OCCUPANI REQUIRED 0 YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC I 081FINAL INSPECTION REaD /n-- H9 VALUATION $ !YCI v Description FEE Description escil"Pt'Or DR FEE Plan Check State Surcharg e State Surchar, Building Permit City Surcharge �5_ Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION 1A10 s-25) 771-0220 ____ APPLICATION APPRd_VAL This applicaflon Is not a permit until signed by the Building Official or his/her Deputy: and Fad3 are paid, end receipt Is achnowledgod in opaco provided. OFFICIAL S DATE RELEASED BY DATE U ATTENTION It A I I U 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 =1 0 M :;:ii uj � M N W I- Im z 30� IT11 z 0 4 0 ITI I IZATE RECEIVED 7 0 `3 PERMITEXPIRES 'USE DF:92UIT CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS 900 F1 og IV 0 0/9 MAILING ADDRESS !R 1 3 `7 Iq Lv 1-f 0617W CITY ZIP I TELEPHONE G! P11 61V0.5 �07_0 1 Lf).5% NAME ADDRESS CITY ZIP NAME q00P CLe-rvlcu- ,f ccap 10�q ___ICBL# ADDRESS I el I 'T I ? "� H\,e CITY ZIP TELEPHONE `?c 9?' 1 'LOL 7 77 - 306, 0 STATE LICENSE NUMBER E:X:PI: TION DATE CMECRW BY 17c) CJD.5�r, �r � 3ROPEITTY TAX ACCOUNT PARCEL NO. ,V-7-49_-V4U00_) 052:Z QCJ NEW WhESI DENTIAL 0 ADDITION COMMERCIAL 1:1 REMODEL MULTIFAMILY 1:1 REPAIR GRADING CYOS 0 DEMOLISH TANK GARAGE RETAINING WALL CARPORT ROCKERY (TYPE OF USE, BUSINESS OR ACTIVITY) N: NUMBER NUMBER OF OF STORIES) +Fx�j DWELLING UNITS HiESCR BE WORK TO BE DONE &11`10W CONW16--c-riorlif �Acef-Klc_ bvrriz-a Py--y-4 11E JZ,'S LP NUMBER JOB ADDRESS 70 AVe: _00q" SUITE/APT# PLAT NAME/SUBDIVISION NO. LOT NO. D NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP ApPrOv6d Aw Pennit Required Street Use Pturnh Req'd EXISTING - PROPOSED inspection Required Sidewalk Required REQUIRED DEDICATION- FT Underground Wring required METER SIZE LINE SIZE I I NO. OF FIXTURES PRV REQUIRED YESC3 NO '13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE z ENGINEERING REVIEWED BY DATE PUMU W upc 6os.2 CPA FIRE REVIEwEDgyAU Bla JMAJAJM� ON T'%E U11 cc jMsAS1TNM%WT=R=VW rL VARIANCE OR CU SHORELINEORADBO I INSPECTION BOND REO'D POSTED I 13YEs 13NO 1$ SEPA AEVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT I ALLOWED . PROPOSED I ALLOWED . PROPOSED PLUMBING / MECH LOICOVERAGE R EQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) LIR SIDE REAR ALLC1*D PR Af%lb—Anw, 19 15R.8fil �W, EinE COMPLIANCE OR CHANGE OF USE A 1DD01VMMeQ1 IVR DIPPV.T n SIGN PARKING-- w REOD PROVI - DATE WtARMMytft - I THE WAL SHUTOFF FENCE x FT) REMARKS o OTHER ]REMARKS FIRE SPRINKLER FIREALARM JEW CHECKED BY I TYP&I .10ME. OCCUPANT pe GR CRITICAL AREAS IVA- SPECIAL INSPECTION ,h JAREA' OCCUPANT LOAD NUMBER REQUIRED [3YES 1 7 PECTIONS PER UBC 108/FINAL INSPECTION RECVO a rZ AM-") I -A �_f,4(L qetAj CCfPC,�'( N 4 To H or- P/ P1 AJ< HEAT SOURCE T God( "G LOT SLOPE % PLAN CHECK NO: VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBUC DDIMN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMITAPPILICAMON: 180DAY8 PERMIT UMTr I YEAR - PROVIDED WDRK IS STAKIeu WTrHIN 180 DAYS SEE BACK OF PINK PERMIT FOR UORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS I 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 MATURE, 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 CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVE=F259; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE P TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- TION; A)IMLN DOINCVTHE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN V.KKATION OF E LAUDBLCODE OF THE STATE OF WASHINGTON RELATING TO WORNMEN'S COVE"NSAJOW117ftWCE AND RCW 18.27. DATE SIGYD & ?, / 0 1 JAZI 4zT4XJr_U L_ VALUATION $ _196 Llj!�" Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing ks 000 30.--. Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt 0 Landscapeinsp. Total Amt. Due Recording Fee Receipt # CALL FOR ONSPECTION IA25) 140`111" 771-0220 EXT 1333 APPUCATION APPROVAL This application Is not a pormit until sigined by the Building Official or his/her Deputy: and Not we paid, and receipt Is acknovAodged In space provided. OFFICIALS I DATE T 9U W__ L �� 7-1)j RELEASED BY D&E __11 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES ORIGINAL -FILE YELLOW -INSPECTOR PINK -OWNER GOLD -ASSESSOR GREEN - ACCOUNTING t I k - z 0 =1 0 m =i am a m H 0 C: A r. ID � C Z gas 0 rn C9 z CA z 9 0 m