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20030103.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS ft A MAILING ADDRESS Sj AMEP ZIP Zlmd,L� NAME ADDRESS CITY NAME ADDRESS t A �Q� -- swj�&� ( STATE LICENSE NUMBER ZIP ITELEPHONE PROPERTY TAX ACCOUNT PARCEL NO. 121S EXPIRATIOI NEW 1:1 RESIDENTIAL ADDITION PIOMMERCIAL REMODEL [] muLnFAmiLY REPAIR 0 GRADING CYDS DEMOLISH TANK [3 GARAGE CARPORT RETAINING WALL ROCKERY (ME OF USE, BUSINESS OR ACTIVITY) EXPLAIN' PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB SUITE/APT# ADDRESS 42!J PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Perma Required Permit Rsq'd +-1'A1-6R@quIf&d EXISTING — PRaPMSfia----w=N=!==— M ETrEOZ11- t.',',�E SIZE,- jejftr" I PtREOUIRED a state NO C3 z REE= OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAG 06- ENG EWdEjfWyL vent conneClOr-Zi DATE Uanciesin 1 L FIRE RMt%W spaces, DATE Lu cc IEL VARIANCE OR CU SHORELINE OR ADi# I INSPE&TI-0-14- BOND BY REO'D POSTED SEPA REVIEW SIGN AREA DYES ONO $1 HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP Iuk� - - I -- I - LOT C FRO CKS (Fr.) PLUMBING/MECH ALLOWED E)ITT"bl." REAR COMPLIANCE OR CHANGE OF USE PARI SIGN RECID oFENCE ( FM REMARKS OTHER FIRE SPRINKLER FIRE ALARM NUMBER NUMBER OF CRITICAL V OF DWELLING AREAS STORIES ffm UNITS IVA— I NUMBER DESCRI13E WORK TO BE DONE CHECKED BY ITYPEP 10 SPECIAL IN8PECTI0= REQUIRED [] YES REMARKS expansior, tanks. are to hiffiper DATI 19-30.020 (c) GROUP OCCUPANT LOAD I PER UBC 108/FINAL INSPECTION RECVD D f\j )]12 nk Description FEE Description FEE - Plan Check State Surdiarge HEAT SOURCE T GLAZING % LOT SLOPE % Building Permit City Surcharge_ PLAN CHECK NO: VESTED DATE Plumbing '-0yj Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBUC Grading 2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PFRMfTAPPUCATION: 160 DAYS IL PERMIT UMir I YEAR - PROVIDED WORK IS STARTED WITHIN 160 DAYS Engr. Inspection SEE 13ACK 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 III ALL CLAJMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapeinsp. Total Amt. Due DEEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - Recording Fee Receipt III 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 CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application 15 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 FOR INSPECTION Building Olficial or his/her Deputy: and Fees are paid, and receipt is acknowledged In space provided. WORKME" COMPENSATP)JRX"CE AND RCW 18.27. OFFICIALS SIGNA14JRE DIE ( E DATE SI NED (425) =NERR 771-0220 41 y lVz- RELEASED BY DOE ATTENTION 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 - 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 M =V% M M OC � z M jo z 0 n M M 9 V) 6 Fn CIO C 0. M 0 z z 0 0 M a N7 nATE RECEI 0 CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION [ER N&MEMME OF BUSINESS K I 'St A CrA ffl, NAME ADDRESS CITY NAME ADDRESS A STATE LICENSE NUMBER u ) I rj)s ZIP ITELEPHONE �A_7)11\1 14-1)<- ZIP ITELEPHONE TELEPHONE"--' PROPERTY TAX ACCOUNT PARCEL NO. NEW RESIDENTIAL ADDITION P OMMERCIAL REMODEL MULTIFAMILY REPAIR GRADING CYDS DEMOLISH TANK GARAGE CARPORT o RETAININGWALL ROCKERY (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAJN: NUMBER OF NUMBER OFITV/11'�'. DWELLING STORIES UNITS I DESCRIBE WORK TO BE DONE CBL 6SE PERMIT ZONE NUMBER JOB SUIMAPTO ADDRESS E L 1E S I( PLAT NAMEISUBDIVISION NO. P L NAI S U So I LOT NO. LID NO, T LID FEE S UA 0 F A Y PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP C G H T W P B RI 7E RVSCP*PmAVPt=ed Street Use Fiffnit Rsq�d EXISTING - PROPOSED Impection Required REQUIRED DEDICATION- FT Sidewalk Required Und2ro.r.ound Unft� 13 M ETT Ll S& LIN S Erect FIXTUREO. r= cM loe E PRV QUIRED PR V z_ t4 NO 13 REMA fad=rl I OWNE CONTRACTOR RESPONSIBLE FOR EROSION CONTROLUIDFRLAINA Co CT9 C$%- ENGINE IIWMMEV7ED ITY DATE required on fuel-buridng applianceS In .- - -.2 FIRE R IAVED By DATE If VARIANCE OR CU SHORELINEORADB# I INSPECTION BOND C x ED BY REQ'D POSTED COMPLETE t8XjPP"1%WRLLVWEV'FHCFrU3C17 E M Is open 'LL at fjxpan�jn I -ALLUvvcv rn ocu rn tenh EXP PLUMBING I MECH LOT C ALLOWED COG1K SET S( 3ETBA S I SIDE R @JONT,* LIR SIDE REAR COMPLIANCE OR CHANGE OF USE PARKING LOT LOT AREA EA PLANNING REVIEWED BY DATE SIGN RE12D ED I PROVIDED o FEN CE X FT) REMARKS 0 OTHER SPRINKLER oFIRE FIRE ALARM CHECKED BY I TYP�� E OCCUPA rwn CIL GROUP DAL IVI+ SPECIAL INSPECTION JAREA 8 OCCUPANT IER REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REa VALUATION $ Description _6160 a FEE Description FEE Plan Check State Surcharg HEAT SOURCE GLAZING 14 LOT SLOPE % F Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mectfinical THIS PERMIT AUT14OREM ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBUC I Grading 3 DOMAIN (CURBS. SIDEWALKIh DRIVIEWNYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PFAMITAPPUCATION: 180DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION *APPLICANT. ON BEHALF OF HIS OR HER SPdUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk- Deposit IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE C17Y 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 PERMIT. ISSUANCE OF THIS PERM" 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 CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Receipt # Recording Fee I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPUCATION APPROVA L GIVEN IS CORREM 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 unfil signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOfj CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building Olficlal or his/her Deputy: and Fees are paid, and receipt 13 acknovAedged In space provided. 'WORKME" COMPEN AND R __%18.27. OFFICIALS SIGNAIURE DATE _tSM11)?19"CE _ _ E 1. ER E -DATE SIGNED Ty R 1A 03 P111,25) =T 1) 771-0220 L RELEASED BY I DAtE A'17TENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRLICTURE 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 04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z m =i :_n am a M 418 0 C: � -C m Z > 0 m m a 75 G m 0 ;0: z CD z 0 1 0 m