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20030116.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS CA-m t, e L-,L, c, A c, u MAILING ADDRESS CITY ZIP ITELEPHONE C—t 7)M r _,,L 16 �S I L) A i�?rt, - -7,TLi - NAME ADDRESS ZONE JOB ADDRESS see PERMIT EXPIRES em:: PERMIT NUMBER �W3-0, I --t SUITE/APT# PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TIESCII Approved RW Perr'4' Required Street Use Poffnit Req'd EXISTING - PROPOSED Inspection ReqLAred Sidewalk Required REQUIRED DEDICATION- FT Underground Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REOUIRSD 1 1 YES E3 NO 13 z REMARKS I 0!?=ONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE 7__� ZIP TELEPHOIE 1 yve is or L vent eannertnIcs 1 required on fuel-L-u.t,�...iiig,,.ippliances In NAME 7—u—aeated spacm UNA-C $15.1.7 14'r 1�1/ Ig L L A tZ o If a A L. s e_ gryjF:vvF,n1n ULj ADDRESS I-ILt FIRE REVIEWED BY DATE Ir CITY ZIP TELEPHONE rztc-_ STATE LICENSE NUMBER EXPIRATION DATE CHE BY VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND REOID POSTED :_� QvFQ QNO S H RGHT #&IF PROPERTY TAX ACCOUNT PARCEL NO. _ NALlix"D PROPOSED Cof�' PLUM S4�e L a P, 16dustrie i , EXP or& NEW RESIDENTIAL PLUMBING I MECH 119ISADY909— . . . . . . . . . . . JAQ&= SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/FISIDE REAR ADDITION COMMERCIAL o COMPLIANCE OR CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED'SY DATE [3 REMODEL APARTMENT SIGN REQ`D I PROVIDE PIP TEST MUST [3 REPAIR I 0 GRADING CYDS [3 FENCE X Fn BE REMARKS U68333 RIFE RED itum Ty INSPECTOR T1 [3 DEMOLISH [3 TANK E3 OTHER AFFIDAVITS SHALL NOT [3GARAGE CARPORT [3 RETAINING WALL ROCKERY RENEWAL BE PTED (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN.L CHECKED BY OCCUPANTP52 ITY:= IC;?? GROUP NUMBER NUMBER OF CRITICAL 1^� OF DWELLING AREAS I SPECIAL INSPECTOR JAREA OCCUPAAT STORIES 74- NITS NUMBER REQUIREDE] YES I LOAD DESCRIBE WORK TO BE DONE REMARKS PR OGRESS INSPECTIONS PER UBC 108/FiNAL INSPECTION REG'D 01 /4'-ii-r VALUATION $ L,) A,'eL.' DescriptIon FEE Description FEE I I'Alf A7. d 4— /)h Plan Check 12#1 HEAT SOURCE GLAZING % V COT SLOPE % Building PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO -To BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading Recording Fee DONIAIMI (CURSB, BIDEEWAILKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. Engr. Review City Surcharge PERMIT APPLICATION: 180 DAYS PERMIT UMrP I YEAR - PROVIDED WORK IS STAMD WITHIN 180 DAYS Engr. Inspection State Surcharge SEE BACK OF PINK PERMIT FOR MORE INFORMATION OIRS 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS Traffic Mitigation Plan Chk Deposit U'* IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS I tit Cl I T VP Receipt # A EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND Fire Review 0 ny ALL CLAIMS FOR DAMAGES OF WHArEVER NATURE. ARISING DIRECTLY OR INDIRECTLY T BE FROM THE ISSUANCE OF THIS PERMM ISSUANCE OF THIS PERMIT SHALL NOT BE Fire Inspection Total Amount Due CE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE I ON CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION., NOR LlMrr IN A14Y WAY THE . Landscapelnsp. Receipt # TION I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL JND OF GWEN IS CORRECT; AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF r THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a permit until signed by the OY 6 TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building official or his/her Deputy: and Fees 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�fINSATIW-INSURANCE AND RCW 18.27. OFFICIALS PIGNAVJRE D TE S10AT&IFit FWNEPJO�AGENT)i DATE SIGNED (425) 0�-Jlr- �1 771-0220 ,fAff f-4 CA I RELEASED BY if DATIc ATTENTION 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 10/01 z 0 0 M M C M 0 C M M 0 111 n M M a 0 0 Rn C2 MO z 0 4 0 M r', 17 -:i -r .,- , , -, , I DATE RECEIVED PERMIT EXPIRES'. CITY OF EDMONDS USE PERMIT ZONE N U M B E R 900-- �C/1/ CONSTRUCTION PERMIT APPLICATION JOB surrEJAPT* ADDRESS OWNER NAMENME OF BUSIN PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS LID FEE $ a"a TESCP APPMW PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP mv Penyot Roquhvd Use Pwmk R*0 CITY ZIP TELEPHONE Go" EXISTING WOW&& �7 12 0 OKQI=wu.,, 13 1 - NAME dfi"ff-b4r4ngF3PPHsniVS EQUIR 0 YES 13 NO 13 M11 UMC 1315.1.7 --heal. ADDRESS R ARKS 0 &fiqP9N@a8 E4"R-EMSItIN CONTRUL/DRIE ZIP TELEPHONE NAME LIPI "r 14 P? tj A.:s 15v e-, ---r EN ED/DA MbWn ElectirfeW Pern&%G' ADDRESS 95A_A__T__ FI REVIEWED BY D CITY ZIP tTELEPHONE L _791/_ /V / 10 '16 _ STATE LICENSE NUMBER EXPIRATION DATE CHECKED By VAMANCE OR CU SHORELINE OR ADS# INSPECTION IPBOND REG'D OSTED [3 YES E3 NO PROPERTY TAX ACCOUNT PARCEL NO. SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED P OPOSED ALLOWED PROPOSED (3 NEW (3 ADDITION [:] REMODEL [3 REPAIR E3 DEMOLISH E3 GARAGE CARPORT CrYPE OF USE. I 6 ==dm NUMBER OF .STORIES DESM13EWORI EXP RAPS PWSED SETBACK I S (FT.) 9 1 JJR SIDE REAR ALLOWED PRO RESIDENTIAL Id PLUMBING / MECH LOT COVE I W—C -0- [:3 COMMERCIAL [3 COMPLIANCE OR CHANGE OF USE PARKING [3 APARTMENT SIGN RECto I PROVIDE1 [3 GFIAD114G CYDS E3 FENCE ( _X_Fr) REMARKS TANK OTHER RETAINING WALL ROCKERY RENEWAL JS;IrSS OR ACTIVITY) =Nj, _dW I M 4' fl -5 CHECKED BY ITYPE N UMOM OF DWELLING CRITICAL AREAS IU4— SPECIAL INSPE UNITS NUMBER REQUIRED 0 YES TO BE DONE REMARKS I 40 I Al e— LUATION $ _I:V=A DATE OCCUPANT GROUP y OCCUPW LOAD I PER UBC 1108/FINAL INSPECTION REGf0 k Alk N Mat% 1b � � � MbL FEE FEE j! Id jgl I _r_ ff & �t b 4- eq YA ) Plan Check /f HEAT SOURCE GLAZING % V LOT SLOPE % Building 4;AS PLAN CHECK NO: VESTED DATE Plumbing A"z Mechanical THIS MWIT AUTHORIZES OMN THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONIX MY CONSTRUCTION ON THE PUBLIC Grading Recording Fee DOMAIN (CUM. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review City Surcharge PERHITAPPLICATION: ISO DAYS PERMIT UMM I YEAR - PROVID11M WORK 13 STARTED WITHIN IWDAYS Engr. Inspection State Surcharge BEE BACK OF PINK PERMIT FOR MORE INFORMATION -APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Traffic Mitigation 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 Review Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHAI1 NOT BE Fire Inspection Total Amount Due DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIUrr IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Receipt # Landscapoinsp. I HERESY ACKNOWLEDGE THAT I HAVE AM 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 THEREBY. No PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building Official or his/her Deputy: and Fees are paid, and receipt Is acknowledged In space provided. WORKMEITSE� URANCE AND RCW 18.27. OffICLAk.S PIGNATURE TE SK DATE SIGNED 1A0 %-125) b I/ /z) 771-0220 DATE RELEASED BY ATTENTION 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 FM PINK - OWNER - GOLD - ASSESSOR 10101 V z 0 M M C PH e-