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20030108.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS ROBEKT avR&35 MAILING ADDRESS zqOs 1'5q*th 2PICE S�E_ CITY ZIP TELEPHONE '000 -001-14ELL ozo NAME ADDRESS CITY ZIP I TELEPHONE NAME AAfiTjqAjw Settvice Cot) 1kX ADDRESS ?2? kiwomp AafjqF� CITY ZIP TELEPHONE 141worib 96033 025) (903-3o.3,>� STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY 7FA5C06 nA I Qw PROPERTY TAX ACCOUNT PARCEL NO. 5ZIBI 60o - oo -5 - 0065 C] NEW RESIDENTIAL PLUMBING / MECH 0 ADDITION E] COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL APARTMENT 0 SIGN C3 REPAIR GRADING CYDS FENCE I X FT: DEMOLISH TANK OTHER E3 GARAGE r.ARPnRT �ETAINING WALL 0 RENEWAL (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: NUMBER NUMBER OF OF DWELLING STORIES I I UNITS DESCRIBE WORK TO BE DONE CRITICAL AREAS NUMBER /V PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB SUITE/APTN ADDRESS -741-4 1?6"h QR!5Er SVJ CW400011S MO; MENMEM� PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required Strent use Permit Roq'd EXISTING - PROPOSED Inspection Requited Sidewalk Required REQUIRED DEDICATION� FT Underground Wiring required METER SIZE LINE SIZE I I NO. OF FIXTURES PRV REQUIRED YES 0 NO 0 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ENGINEERING REVIEWED/DATE ;0 FIRE REVIEWED BY DATE M VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND REO'D POSTED I (:)YES (:) NO SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED 'ALLOWED PROPOSED 4. IRE M RSHALI I EXP r= 0 Mff f S MKS; �(Fr) 10VAL, PROPOSED SETBACKS (FT.) ALAMPTEP %STE I S1 Dr R FRONT � UR SIDE REAR "ANK FIT ri OR CAP z IZ z PARKING LOT AREA I PLANNING REVIEWED BY DATE REO'D I PROVIDED CHECKEDBY ITYPEOF NSTEION Com... OCCUPANTR y 17/1 GROUP -3 SPECIAL 7NSPECTOR AREA OCCUPANT REQUIRED 0 YES LOAD REMARKS z PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RE01D a i VALUATION FEE PLAN CHECK FEE HEAT SOURCE GLAZING % LOT SLOPE % BUILDI14� Wl� PLAN CHECK NO: VESTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADING/FILL DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. IV" ESURCHARGE PERMIT APPLICATION: 100 DAYS PERMIT LIMIT' I YEAR - PROVIDED WORK IS STARTED WITHIN ISO DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS ENG. INSPECTION FEE IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING 2 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND INSPECTION FEE 04 ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY RECEIPT x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT 0 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE _j 0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* RECEIPT xi worma� TOTAL AMOUNT DUE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION --APPLIbA—TION 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 CONSTRLIC- 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 histher Deputy: and Fees are paid. and IN VIOLATION OF THE LABOR-60DE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided WORKMEN'S COMPE14S SO �ANCE AND R CW 18.27. 1 OFFICIALS SIGNATRE DAIE St:2NER 0 DATE SIGNED (425) 27//D = 771-0220 .......... 1� DATV RELL SEDB1F A7fENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR 5/98 FINAL PROJECT APPROVAL FORM TO: z 9 0 m =i 9 V5 � am c ma 0 80 c E� K m m 10 CO) 0 -n n m m 0 a; of- 0 M C (j) c 0) M 0 Z M z -q 3: V5 z 0 1 F) m ocaMj.doc,j:mW-.bldS:forms6l98 I- � - � � � - . - I I I th Is r7) I pw'v I ....... P.Mn . A I's il Is, w I O:kkk sVP i;o '14 1 10 Is Its tt rn,, I d J, vo I I I f I DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS ROBEgT up, kj IS MAILING ADDRESS 2114oS I-5q1h ?Lna- Sir — CITY ZIP TELEPHONE —66--HELL �9017- NAME ADDRESS CITY ZIP I TELEPHONE NAME 166P TAII,)k- Co., 1kX- IlAt' ItV rTul -'XitVil(IF 0 ADDRESS ?2 /<I rK6wr) VftjLf CITY ZIP TELEPHONE V1fewLqv0b `76033 1(f2r.)803-3.) STATE LICENSE NUMBER A0,nq,5u)66DvJ EXPIRATIONDATE 3/t8 low I CHECKEDB PROPERTY TAX ACCOUNT PARCEL NO. 000 - 00,5 - 0065 0 NEW RESIDENTIAL 0 PLUMBING / MECH C3 ADDITION 0 COMMERCIAL IA 0 COMPL ANCE OR CHANGE OF USE 0 REMODEL 0 APARTMENT 0 SIGN 0 REPAIR 0 GRADING [3 FENCE X CYDS ( FT) 0 'DEMOLISH 0 TANK C:] OTHER o GARAGE C3 RETAINING WALL Chf1PORT ROCKERY 0 RENEWAL (TYPE OX USE, BUSINESS OR ACTIVITY) EXPLAIN: *PvmlrP' R,Qtr- mo Fim- ATE910 NUMBER OF NUMBER OF DWELLING CRITICAL AREAS STORIES UNITS NUMBER DESCRIBE WORWTO BE DONE Sic —AL W 7"' U L PERMIT EXPIRES seseresssessessej USE ZONE IZM 2JA PERMIT seems NUMBER JOB SUITE/APT# ADDRESS 74,3 1`76 oh 9e02 S7,1?fc-F SW I'Doo h 9e02 PLAT NAM E/SUBDIVI SION NO. LOT NO. I LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCPApproved d RW Penn: R P:"Uk* Street Us -1 1.1-d EXISTING — PROPOSED inspection Required 0 Sidewalk Required REQUIRED DEDICATION— FT Underground Wiring required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 0 NO 0 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE 6 ENGINEERING REVIEWED/DATE FIRE REVIEWED BY DATE w VARIANCE OR CU SHORELINE OR ADBN INSPECTION BOND REQ'D POSTED 0 YES C3 NO_ SEPA REVIEW SIGN AREA I HEIGHT COMPLETE I EXEMPT ALLOWED I PROPOSED ALLOWED I PROPOSED LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACK$ (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR z 1 2 z PARKING LOT AREA PLANNING REVIEWED BY DATE REO'D I PROVIDED WEWK . .'. , I U., CHECKED BY TYP TION T!( I CCUPANTp3 AA Jemw-ve SHAL ICT70 G SPECI t FIRA vf% OCCUPANT REOU L MOR T r-UR 01461 Am - LOAD REMARKS TnLt On CA z PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'Dj� 0 Cal PLAN CHECK FEE HE ATSOURCE GLAZING % LOT SLOPE % BUILDING PLAN CHECK NO: VESTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO., BE DONE ON PRIVAT� PROPERtY ONLY. ANY CONSTRUCTION ON THE PUSUC GRADING/Fll�l 60MAIN (CURBS, SII.DEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. .61ft SURCHARGE PERMIT APPUC�TJON;, 180 DAYS PERMIT LIMIT' 1 YEAR - PROVIDED WORK IS STARTED WITHIN 160 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION , *APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS ENG. INSPECTION FEE IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANYAND, INSPECTION FEE ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT DEEMEDTO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAYTHE CITY'SABILITY TO ENFORCE ANY ORDINANCE PROVISION. - TOTAL AMOUNT DUE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORM— 1— 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 LAELQrNDE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATJOWNSUFtANCE AND RCW 18.27. DATE SIGNED AWENTION 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 VALUATION 4 EIPT APPLICATION APPROVAL CALL This application is not a permit until signed by the Building Official or his/her Deputy: and Foes are paid. and FOR INSPECTION recolpt Is acknowledged in space provided. (425),4, OFFICIALS SIGNATORE 771-0226 ki-EKSED 0 DATI!f EXT 1333 771-0221 FAX ORIGINAL - FILE - YELLOW - INSPECTOR PINK OWNER - GOLD - ASSESSOR -