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20030107.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWN9%NAME/NAME 0 BUSINESS e MAILING ADDRESS C16 f 11 L)C_ / CAJ 10 35� 1 (P P CITY ZIP ITELEPHONE f�_M, 6 Z NAME ADDRESS 93 CITY ZIP ONE NAME _rCBL # USE ZONE JOB ADDRESS . PERMIT EXPIRES PERMIT 'Z -7 NUMBER 0 0) SUITE/APT# of e7 /,12 PLAT NAME/SUBDIVISION NO. LOT NO. L D NO. L:D FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7ESCP Apixoved MY Porrnit Required Street Use Poffntt Roq'd EXISTING - PROPOSED lnspocftn Required Sidewslic Required REQUIRED DEDICATION- FT UWeWound 0'* u wim quired 13 mg "*q ME-rER SIZE LINE SIZE NO. OF FIXTURE S PRV REQUIRED �T V S E TYES13 NO 13 REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE I ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE us cc CITY ZIP _FELEPHONE M VARIANCE OR CU SHORELINE. OR AD13# I INSPECTION BOND STATE LICENSE NUMBER EXPIRATION DATE I CHECKED BY REQ'D POSTED SY 13YEs 13NO S $EPA REVIEW SIGN AREA I HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE . EXEMPT ALLOWED . PROPOSED ALLOWED , PROPOSED -0 NEW RESIDENTIAL ZKeMBINMECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR I COMMERCIAL �e�ANCE OR ADDITION CHANGE OF USE E] REMODEL MULTIFAMILY SIGN PARKING LOT AREA PLANNING REVIEWED BY DATE REaD I PROVID U TO UPC 605.2 i'122= REPAIR GRADING FENCE X CYDS ( _ _ FT) A =--- REMARKS SHAU BE INSTALLED ON TEIE DEMOLISH TANK OTHER LWAS IT EMIRS THE BUILDING oGARAGE RETAININGWALL FIRE SPRINKLER FIRE ALARM CARPORT ROCKERY NONNI OWE OF USE, BUSINES$ Q0 ACTIVITY) EXPLAIN: CHECKED BY CONSTRUCTION E OCCUPANT ITYPE/F GROUP 43 7UMEIER NUMBER OF CRITICAL OF DWELLING AREAS SPECIAL INSPECTION OCCUPANT STORIES UNITS NUMBER JAREA REQUIRED YE LOAD 0 DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D ram& a&zz�� tv VALUATION Description FEE Description FEE State Surcharge Plan Check HEAT SOURCE GLAZING % LOT SLOPE % T Building Permit ZIA City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I= "' 'NE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 180DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON ESHALF 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 # IALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapoinsp. Total Amt. Due 9 DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 2 NOR LIMIT IN ANY WAY THE C11YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee Receipt # �zit-I&5A 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 T it.. * is not a permit until signed by the to 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 p his/her Deputy: and Foes are pald, and CALL BuIligyp iSI IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO .1p I� 1) FOR INSPECTION r elpti cknowledged)pspacoprowlded. WORKMEN3X.GMNNSATION INSURANCE AND RCW 18.27. OFFICI A R E SIGNA PA DATE SIGNED WSII d?A9 A. %-Wr-5) 1 111(05 =GE:W I U 7. ___ z 771-022 0 RgE SiMY DATE 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 NEW 5 ECT APPROVAL FOR14 FINAL Pjm%jJ TO: DATE: DING DIVISION MEMO TO: PERMIT COORDINATOR, BUR FIRE DEPARTMENT DATE FROM: b-1 1 9L03 &tuem ENGINEERING DIVISION DATE nEmsm % % PT.AWN[TWrir DTVTSION DATE 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Si o caprvl.doc.l:temp:bldg:fonmIO/OI z 9 0 m 'A =n- CA 5� om c ma 0 --lo 0 C � m m M Z 0--1 � -Z c 4 4 vi 0 -n n -4 m m a 0 0 M C CD c CD M 0 Z z --I x 55 z 9 0 m 0 ..A P.DATE RECEIVED wpm CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OV 4J99.1AAME/NAME OF BUSINEU L MAILING ADDRESS a 35?) cov CAI CITY TELEPHONE �im_ 6z,PZ- CV 20C,-12,q7-- 3Y NAME ADDRESS CITY ZIP NAME ICBL# CITY ZIP I TELEPHONE STATE LICENSE NUMBER NEW RESIDENTIAL ADDITION COMMERCIAL REMODEL MULTIFAMILY 0 REPAIR GRADING CYDS DEMOLISH 0 TANK GARAGE o RETAININGWALL CARPORT ROCKERY (TYPE OF USE, BUSINES ACTIVIM EXPLJ�tN: NUMBER NUMBER OF OF STORIES DWELLING UNITS DESCRIBE WORK TO BE DONE DATE I CHECKEDBY ka-,Pt9MBINV MECH '-e�IANCE OR 13 CHANGE OF USE SIGN FENCE ( X FT) OTHER FIRE SPRINKLER FIRE ALARM PERMIT EXPIRES USE PERMIT eZ ZONE f 11 ) 3. () I (j -� NUMBER VU J013 SUITE/APT# ADDRESS j/ "I (�' 4 a PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Ffbt;V;;PMV*d AW Parmit Required Street Use Permit Racfd EXISTING - PROPOSED Inipwilon Required Sid&wo* Required REQUIRED DEDICATION- FT Urtdarground Wiring required 13 METER 817E LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES 13 No 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE BY DATE FIRE REVIEWED BY DATE VARIANCE OR CU SHORELINE OR ADB11 INSPECTION , BOND REO'D I POSTED I [3YEs CINO S SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEM PT ALLOWED PROPOSED ALLOWED PROPOSED EXP , , , LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE HEAR FRONT LIRSIDE REAR PARKING LOT AREA I PLANNING REVIEWED BY DATE REO'D I PROVIDED I MRSIJAW TO..UPC 605.2 I LINE AS ff ENTERS THE WELDING CHECKED BY I TYPE OF CONSTRUCTION DE uu&;UrANI GROUP 2d CRITICAL AREAS SPECIAL INSPEC TIONJAREA "OCCUPANT NUMBER RE LOAD REMARKS j PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REG-0 VALUATION $ HEAT SOURCE GLAZING % LOT SLOPE% Building Permit - PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHOREMS ONLY THE WORK NOTED. THIS PERMIT COVi-61WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPUCATION: 180DAYS PERMIT UMM I YEAR -PROVIDED WORK IS STARTIED WITHIN 180DAYS Engr.r Inspection-, SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT. ON BEHALF- OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS Fire Review IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE C17Y OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND Fire InsplAn ALL CLAIMS FOR DAMAGES OFWHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE- OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE LAnYscape Insp. DEEMED TO MODIFY, W" OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROW Recording Fee I HEREBY ACKNOWLEDGE THAT I HAVE R S P NN; THAY 7UE INFORMATION A0Z GIVEN IS CORRECT; AND THAT I AM THETOWTNHEIR. r U R ZED AGENT OF U11 = ffH CITY AN GULATING CONSTRUC- THE OWNER. I AGREE TO CC) LVV-' D STJVgA CALL ORIZEE 'T , N& TION; AND IN DOING THE WORK HERE V N RSON WILL BE EMPLOYED IN VIOLATION 0 AT OF WASHINGTON RELATING TO ,LTHE LABOR C D OF THS-,STAT .4 Vbw FOR INSPECTION WORKMEN INS_ 18.27. 'T ,,4JMh1I%NSATION GI SIG E Of�AGEN[1) 7 DATE SIGNED 1425) 71 0220 FEE Description State Surcharge' I -City Surcharge FEE Plan Chk. Deposit Receipt # Total Amt. Due Receipt # IPLICATION APPROVAL )P(G-u rittif Until signed by the fticla�= serputy: and Fees are paid. and U elptil -1;tnowI0d9ej4nspac? Zovided. !�VRE DA7 FY DATE ATMNTION LAI 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