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20030113.pdf0 DATE RECEIVED F PERMIT EXPIRES CITY OF EDMONDS SE ZONE PERMIT NUMBER CM� CONSTRUCTION PERMIT APPLICATION JOB SUITE/APTO ADDRESS ('�; OWNER NAMEINAME OF BUSINESS "'� �fiv/_" AIWAJD�AA S PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS LID FEE S .3 Z-0 S' S. TESCF Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP AW PerrrA Required —.—AVC. CITY ZIP TELEPHONE EXISTING — PROPOSED street use Peffnit Reqd Wpecdon Required 14FS) 7-7�r- ZJZ Z REQUIRED DEDICATION— ___T Sidewak Required FT Undeigrourid WMg-faquited 13 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED �A YEs13 NO C3 ADORES REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE CITY ZIP HONE if At Zkfkl 165� EU991-1 PiT A LUEE F, NAME ba 2)2� 'rj V 'afiCkM"V OV- I- jj�i t4c. CN M !�M V_, I,). VJ ENGINEERING REVIEWED/DATE ADDRESS A191ajLP;-LL- -'2114 1 M FIRE REVIEWED BY DATE CITY ZIP TELEPHONE cc IE EXPIRATION 57T STATE LICENSE NUMBER '7 ED BY ECK VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND &k� REO'D POSTED AF__[3 YES �j(NO SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXE ALLOWED PROPOSED ALLO POSED PRO .3 -)-7 /jWED I EXP 0 NEW 0 RESIDENTIAL PLUMBING MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR z 0 ADDITION COMMERCIAL rl COMPLIANCE OR ------ HANGE OF USE PARKING REMODEL [3 APARTMENT SIGN LOT AREA R PROVIDED I PLANNING REVIEWED BY DATA [j REPAIR 0 GRADING FENCE CYOS X FT) REMARKS [j DEMOLISH TANK OTHER GARAGE [3 RETAINING WALL RENEWAL CARPORT ROCKERY OWE OF USE, BUSIPIESS OR ACTIVITY]i EXPLAIN: a BY CODE OCCUPANT CHECKED TYP:,� �ORUCTIQ GROUP NUMBER NUMBER OF CRITICAL OF DWELLING AREAS 11 SPECIAL INSPECTOR OCCUPANT 8 DRIES UNITS NUMBER JAMEA REQUIRED 0 YES LOAD DESCRIBE WORK TO BE DONE REMARKS '4 PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG-0 Pert-4 tr -e/ S 04 n4 VALLIATION $ Descrip!Ion FEE Description FEE Plan Check :2 HEAT SOURCE GLAZING % LOT SLOPE % Building PLAN CHECK VESTED DATE Plumbing C/2 Mechanical THIS PERMIT AUT"ORMFS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading Recording Fee DOMAIN (CURBS, SIDEWALKS, ORIVIEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review City Surcharge 46 PERMIT APPILICATION: ISODAYS PERMIT LIMR! I YEAR - PROVIDED WORK IS STAMD WfTHIN 180 DAYS Engr. Inspection State Surcharge SEE BACK OF PINK PERMIT FOR MORE INFORMATION ;APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS Traffic Mitigation Plan Chk Deposit N INTEREST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF DM NOS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Review Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE 01: THIS PERMIT SHALL NOT BE Fire Inspection Total Amount Due 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.' Landscapoinsp. Receipt # 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 THE 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 THERE94 NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Foes are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided. WORKMEN$ COMPENSATION INSURANCE AND RCW 10.27. OFF AL I URE - DATE NAW�4WNOJOR AGENT) DATE SIGNED 1425) _TAr FA IVIX 771-0220 mmi R SED BY rjATE ATTENTION IT IS STRUCTURE UNTIL M 1333 I UNLAWFUL TO USE OR OCCUPY A BUILDING OR 771-0221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI_ ORIGINAL -FILE - YELLOW-1 PELITOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK -OWNER - GOLD -ASSESSOR 10101 0 I DATE RECEIVED [PERMIT EXPIRES PERMIT CITY OF EDMONDS ZONE NUMBER c4AZ_�)- J013 SUrWAPT# CONSTRUCTION PERMIT APPLICATION ADDRESS OWNER NAME/NAME OF BUSINESS PLAT NAME/SUBDIVISION NO. LOT NO. UD NO. MAILING ADDRESS L UD FEE S I LULW Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW PerfrA ReqAred .3 zo 4vc - S, Street Uso Pem-A Ra<d LEPHONE EXISTING — PROPOSED kopscoonflAquIred 81dirw"Plaquired oCITY ZIP _F7 REQUIRED DEDICATION— FT underground mj)j� I 47S) -7 Z z WIMO roqww NAME METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED WA --I — YES 13 NO [3 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLfDRAINAGE CITY ZIP :gqS(Mk% Owmp- WILL -Bg, 1REQUIP-ED -TO Pc 5IZk;�5 Vk;� E&MI-1 All A Meg- [ 0 0 NE DDRE S8 PLAT NAME PU13UC RIG EXISTING R QUI r E R =D METER SIZ REMARKS OWNERICOI NAME 17Lfl�kMe�K OV- SWiNc, CNM Qn 11,6-114 - ENGINEERING REVIEWED/DATE ADDRESS FIRE REVIEWED BY DATE CITY ZIP -FiLE-PHONE x INNS BY VARIANCE OR CU SHORELINE OR ADBO INSPECTION BOND STATE LICENSE NUMBER EXPIRATION CHECKED 13YREO-0 POSTED ES :&NO SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ILLOWED PROPOSED ALLOWED POSED PROPERTY TAX ACCOUNT PARCEL NO. 1 W EXP e�2 ga")7 PRO LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) NEW [3 RESIDENTIAL 0 PLUMBING MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR ADDITION OMMERCIAL rl COMPLIANCE OR Xc GE OF USE PARKING LOT AREA PLPNNING REVIEWED BY DATF (3 REMODEL APARTMENT JWS I :GN REO`D PR :13 IT [3 GRADING o FENCE X 13 REPAIR CYO ( — FT) REMARKS 13 DEMOUSH [3 -TANK [3 OTHER GARAGE [3 RETAINING WALL CARPORT ROCKERY [:3 RENEWAL (TYPE OF USE. BUSIVS8 OR Acnvny) EXPLAIN: CHECKED BY JTYPE.0�f206R ;UCT VIO �C 0 DO- OCCUPANT GROUP NUMBER 14UMBER OF CRITICAL SPECIAL INSPECTOR JAREA' OCCUPANT OF DWELLING AREAS R LOAD STORIES UNITS NUMBE REQUIRED 0 YES ,05SCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER USC 108/FINAL INSPECTION RE= Per %x, 1 12,1' RI 0 oviat -5 1 jLo, ME a VAWATIQN $ Description FEE Description FEE Plan Check HEAT SOURCE GLAZING % LOT SLOPE *% Building I Z./i PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PMWAUT14ORMES ONLYTHE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DOME ON PRIVATE PROPEM ONLX ANY COWMUCTIOM ON THE PUBILIC Grading Recording Fee 2 3 DOMALN (CUNg, SIDEWAM, ORMVAM MARQUEES, ETC.) WILL REQUIRE t: SEPMATEPIER1111110111014. Engr. Review City Surcharge PERMIT APPUCAT16M 16'0 DAYS PERMIT UMM I YEM -PROVIDED WORK IS STARTED WITHIN 180DAYS Engr. Inspection State Surcharge SEE BACK OF PINK PERMIT FOR MORE INFORMATION IAPPUCANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESOF..tO Traffic Mitigation Plan Chk Deposit EI NTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS IHE CITY OF D=DS, ANY AND Fire Rav'lew Receipt # WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ALL CLAIMS FOR DAWAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE 188UANCE OF TH19 PERMrr. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MOMF% WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Fire Inspection Total Amount Duo NOR UUrr III ANY WAY THE CrrrS ABILITY To ENFORCE ANY ORDINANCE PROVISION.' Receipt # --------- Landscapelnsp. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION APPROVAL GIVM IS CORRECT. AND THAT I AN THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH C17Y AND STATE LAWS REGULATING CONSTRUC* CALL This application Is not a permit until signed by the Building 0111cial or hWMr Deputy; and Foos are paid, and 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 receipt is acknowledged In spaca provided. WORKMEtcS COMPENSATION INSURANCE AND RCW 18.27. OFF191ALS SIG , URE DATE R AGENT) DATE SIGNED 111113 VMS) f ��ER 771-0220 R ED BY TE 0121 Arl"ENTION 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 - INS CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - 0 * G, 1101011 0 m am a mg 10 0 m m 1100 z 0 `T1 n M M DO-) 0 6 Fn C2 ic m Z X z 0 1 0 m