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20030115.pdf0-0hV100 �. DATE RECEIVE�� CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEMAME OF BUSINESS 14 0-A-�dU;44— MAILING ADDRESS I I ZZ,�Z, 3 ^IAI CITY ZIP LEPHONE iffl-7-17200 633- NAME ADDRESS CITY ZIP LERMITEXPIRES P [USE PERMIT ' E 'ON NUMBEFtAO3- 1� C JOB SUITE/ J AOC DRESS f PLAT NAMEISUBDIVISION NO. I LOT NO. ',—j I POO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved AW Pennit Required Street Use PannK Req'd EXISTING — PROPOSED inspection Required Sidewalk Required REQUIRED DEDICATION— FT UndsWound Wiring required METER SIZE LINE SIZE NO. OF FIXTURES PAV REQUIRED 0 I YES C3 NO 13 3 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE NA CBL # /(j ENGINEERING REVIEWED BY DATE CC 01 ADDRESS DATE Lu FIRE REVIEWED BY W CITY ZIP TELEPHONE Ir i;� BOND l' STAJ LACENSE NUMBER C E ED BY VARIANCE OR CU SHORELINE OR ADS# INSPECTION I — — REQ'D POSTED & — 1, X�H I/T 0YES SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX AC CE 0. COMPLETE EXEMPT ALLOW9P PROP SE ALLOWED PROPOSED 00 ff Ap- 7 , , It 2 NEW RESIDENTIAL PLUMBING/MECH LOT COVERAGE REQUIRED SETBACKS/(FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE PARKING LOT AREA NNING REVIEWED BY REMODEL [3 muLnFAmiLy IGN REaO I PROVIDED tao FENCE REPAIR GRADING X CYDS F7) REMARKS DEMOLISH TANK OTHER oGARAGE [3 RETAININGWALL FIRE SPRINKLER FIRE ALARM CARPORT ROOKERY M?E OF USE, BUSINESS OR ACTWM EXPLAIN: CHECKED BY TYegPj_CPNSTqUCTION CO E OCCUPAN &7-q 'el 15? 2& GROUP .19 NUMBER NUMBER OF CRITICAL Ur - —1. - 11� AREAS SPECIAL INSPEC='TISON AREA OCCUPA7/ STORIES UNITS NUMBER REQUIRED 0 Yr LOAD .9 YES DESCRIBE W RK TO BE DONE 31 IA A 2 U REMARKS ON REG'D PROGRESS INSPECTIONS PER UBC 1OWFINAL INSPECTI on n_e� Mf t-)CA- VALUATION r 12 Description FEE Description FEE State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit ;7 City Surcharge PLAN CHECK NO: VESTED DATE Plumbing bfi 2 do - 57:Z tx Mechanical THIS PIERMITAUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 190DAYS CL PERMIT LIMIr I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK 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 # ;/// q ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscape Insp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE — 21 NOR LIMIT IN ANY WAY THE cays ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPUCATION 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- This application Is not a permit until signed by the CALL 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 Building official or his/her Deputy: and Fees are paid, and FOR INSPECTION receipt Is acknowledged In space provided. WORKMEN. ION INSURANCE AND RCW 18.27. OFFIC S SIGNA�URE DATE SIG (OWNkR �R A DATE SIGNED 1425) 771-0220 BY E ATTENPGN:'-- XR91WD Off 1333 /�T IT IS LqlaWFUL 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 F M —JUL tl ATE RECEIVED is d,� . , " PERMI 7.0 )).5?,l T EXPIRES USE PERMIT "EDMONDS ZONE NUMBEk4�OS- tl�IIZT I CITY F CdNSTRUC TfION PERMIT APPLICATION JOB RESS SUITEIAPT# I ADD OWNER NAME/NAME OF BUSINESS _1�4 (� k1i uda- J.,-- X4— I' I I Q t�zl i le PLAT NAME/SUBDIVISION NO. LOT NO. 0. MAILING ADDRESS I ILIDFEE $ TESGF Approvea PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW parrm Roquir 7.2- ^/A/ J1 at Us* Psrrrtft�d .CITY ZIP EXISTING PROPOSED inspection Required ITTLEPHONE Sidewalk Required REQUIRED DEDICATION— FT UnderWound 6?V-77 633-63 _�_o _0F wiringroquirad PRV RE061RED NAME METER SIZE LINE SIZE FIXTURES YES 13 NO 13 z ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE CITY ZIP ITELEPHONE NAME L# ENGINEERING REVIEWED BY DATE 'AbbRESS FIRE REVIEWED BY DATE crTY ilp TELEPHONE ON Tin 5-775- BOND VARIANCE OR CU SHORELINE OR ADB# INSPECTION -aeppw t3 E)C _ 8VT9UCEMjNT6E NUMBER I 6�, E3Y REO OSTED 4"ItIlIv, . - I. �, = L F: 1L $ is, 'Rigg= SIGN AREA HEIGHT AM /Ai, SEPA REVIEW ALLOWED , PROPOSED PROPERTY TAX AC PARCEL NO. COMPLETE EXEMPT AtILOWT PROP6S�E A 7& Z EXP LOT COVERAGE REQUIRED SETBACKSI'(FT.) PROPOSED SETBACKS (FT.) NEW RESIDENTIAL PLUMBING/MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR MMERCLAL COMPLIANCE OR ADDITION R050 0 CHANGE OF USE j PARKING LOT AREA I PLANNING REVIEWED BY �DATJ, IGN PROVIDED REMODEL MULTIFAMILY :' 0 REPAIR GRADING MS X REMARKS FENCE Fn OTHER DEMOLISH TANK oGARAGE RETAININGWALL [D.,F11RE SPRINKLER CARPORT ROCKERY F Rl� ALARM 6INE68 OR CrYPE OF USE, BU ACTIV", EXPLAIN: k. 3� ' C�E OCCUPANI,.., CHECKED BY TYEE&LWNST CTION 7 GROUP NUMBER NUMBER OF CRITICAL OF DWELLING AREAS SPECIAL INSPECTTION AREA OCCUPAW I LOA GTOR19f NUMBER REQUIRED [I YES DESCRIBE IVRK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION RECVD C, 4�1 J VALUATION Description III& A01k 111111 M mno cn 106 1 FAI FEE Description FEE 22= State Surcharge t�EAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PIAN CHECK NO: VESTED DATE Plumbing Mechanical TM& PERMIT AUTHORIZES ONW THE WORK NOTED. THIS PERMIT COVIER$ WORK TO t: BE DONE ON PRIVATE PROPERTV ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOUAIN r (CURN. SIDEWALKS. DRIVEWAU, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. ngr. Review PERMFTAPPLICA k, & PERMT LIMM. I YEM ` PROVI 0 Vik D=IN 1800 r. Inspection RMIT _ I BEE13ACKOFPIWiCPERUFT R ON � I 1APPLICANC, 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 OFFICIIALS. EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspoction Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Total Amt. Due 2E 13 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITY$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- ecording Fee Receipt # . I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIONG THkrtk"AOkAi(0k_C- APPLICATF )ROVAL 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 THEREBY. NO PERSON WILL BE EMOLDYED Building 0111clal or Na/her Deputy: and Foos are paid, And IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELAANG TO FOR INSPECTION receipt Is acknovlodged in space provided. WORKME INSURANCE AND RCW 10.27. OFFIC S SIGNAJURE DATE FON DATE SIGNED A6 W14 71 7 -0220 k)'BY OTE `ATTE11MN_(_' EXT 1333 R L I A, � 3r IS UNI:XWFUL TQ USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGIN FILE YELLOW - INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK ER GOLD -ASSESSOR �NR EEN ACCOUNTING 04102 PRESS HARD -YOU ARE MAKING 5 COPIES 11