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20030125.pdfS,+~-s moo DATE RECEIVED [PERMIT EXPIRES USE PERMIT CITY OF EDMONDS ZONE 6ALL NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUITEIAPT# ADDRESS 0±2ppItMEI��IIE OF BUSINESS :Z-3:Z n r_ j�L::�60 xs LL L PLAT NAME/SUBDIVISION NO. LOT NO. L�D NO. 15 MAILING ADDRESS L D FEE $ TESCP AP PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Rw Perm"=ad street L CITY ZIP TELEPHONE EXISTING — PROPOSED Inspection Required Sidewalk Required 13 REQUIRED DEDICATION— FT underground Wiringrequired CI NAME METER SIZE LINE SIZE FNO. OF FIXTURES PRV REQUIRED YESM NO 13 z AiY6'RESS (j REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE z S:P-- a ZIP TELEPHONE 7 AAME ICBLN IP I TELEPHONE <71//6 9 L�06 9'71L 7 NUMBER 'Hu"ally. 0 9 C6 672 M'b Z_ Ct C) / ` 0 1:1 NEW [j RESIDENTIAL WEEDECH ADDITION COMMERCIAL E] COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY El SIGN 13 REPAIR GRADING 0 CYDS FENCE 1:1 ( — X — FT) [:] DEMOLISH [] TANK OTHER oGARAGE CARPORT ci RETAININGWALL ROCKERY F RE SPRINKLER F!RF ALARM ITYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: W NUMBER NUMBER OF CRITICAL a OF DWELLING AREAS STORIES UNIT NUMBER 0- DESCRIBE WORK TO BE DONE A_ - — I HEAT SOURCE GLAZING % I LOT SLOPE % PILAN CHECK NO: I VESTED DATE THIS PERMIT AUTHORRES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC DOMIUN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 180DAYS PERMIT UMrP I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICAK ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMrr IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION 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 wonK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPEN=SURANCE AND RCW 18.27. 8i&NAT_Uft (OWNER 04AGENTj�, DATE SIGNAD DATE FIRE REVIEWED BY DATE W VARIANCE OR CU SHORELINE OR ADBN INSPECTION BOND REO'D I POSTED I [3YEs ONO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , I LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR I I z PARKING I LOT A REVIEWED BY DATE REO'D I PROVIDED REMARKS CHECKED BY LW OF-CO.NgRyCTION CO OCCUPAN16 I_J.-r1C6,M6ff,_ GROUP SPECIAL INSPECTION JAIREA OCCUPANT REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REO'D VALUATION $ Description FEE Descrillotion Plan Check State Surcharge Building Permit City Surcharge Plumbing e_1 loe_l :2 G-1 Mechanical Grading Engr. Review Engr. InspecOon FEE Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION 1405) 771-0220 APPLICATION APPROVAL This application Is not a permit until signed by the Bullaing Official or his/her Deputy: and Fees are paid, and receipt Is acknowledged In space provided. I GNA D 2111T 'RE ED DATIf ATTENTION M 1333 1 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL ( 01 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- _'_�6RIGINAL- 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 m �f DATE RI 6erw rse_ DATE RECEIVED I PERMIT EXPIRES CITY OF EDMONDS USE PERMIT ZONE NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUITEIAPT# ADDRESS OWN NA AMEOFOUSINESS I 37,Em c�� S L L L PLAT NAME/SUBDIVISION NO. LID NO. LOT NO. MAILING ADDRESS LID FEE S 1E.0 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW ired P:== CITY ZIP TELEPHONE Street Use Permit Reld EXISTING PROPOSED inspection Required Sidewalk Required LLaLe, �iPgz.?z REQUIRED DEDICATION— FT r4truround Wirlog,equired .13 'NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED —DRESS 4100, YES13 NO 13 AD (j /-)u REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE CIT)�4 `P TELEPHONE 0 6 7J.7 NAME CBL# ,2_.-,r V ENGINEERING REVIEWED BY DATE 0 t Am. On C I W/') pi, TELEPHONE FIRE REVIEWED BY DATE I 97� 7 TATE UNSE NUMBER EXPIRATION D E I VARIANCE OR CU SHORELINE OR ADBN INSPECTION BOND REO'D POSTED L 3 t=j 13YES 13NO $ SEPA REVIEW SIGN AREA HEIGHT PRQ"e1I`Y"0t7Cr) Nb C, f COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED Z _ C), EXP , , , NEW RESIDENTIAL ECH WaD� LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) L/RSIDE REAR ALLOWED PROPOSED - , JONT SIDE REAR FRONT ADDITION COMMERCIAL COMPLIANCE OR %J CHANGE OF USE REMODEL mummmit:y 0 SIGN PARKING REO'D I PROVIDED LOT AREA I PLANNING REVIEWED BY DATE REPAIR 0 GRADING FENCE CYD�' S ( - X_Fn REMARKS 0 DEMOLISH 0 TANK OTHER oGARAGE CARPORT RETAININGWALL ROCKERY FIRE SPRINKLER FIREALARM (ME OF USE, BUSINESS OR ACTIVITY) EXPLAIN: CHECKED BY ITYEE O&CONSWUCTION OCCUPANT GROUP III NUMBER NUMBER OF T-CRITICAL OF DWELLING AREAS SPECIAL INSPECTION JAREA OCCUPANT STORIES UNITS NUMBER REQUIRED [3 ' YES LOAD DESCRIBE WORK TO BE DONE REMARKS .A81!i2t,13 time llj�� PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RE0-D 'Ai--,. mijI 60A& Al-_, , t4i- /. � _z_ -.*- bf) I,. VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % IPT "PE % Iiu) - ilding Permit City Surcharge PLAN CHECK NO: VESTED DATE li P16"ind 2 i _,1! 10"'r Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) wiLL REQUIRE qrading SEPARATE PERMISSION. I ?. I > . � . - I a Engr. Review PERMITAPPLICATION: IGODAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN ISO DAYS Engr. Inspection GEE 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 # ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Total Amt. Due DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - Recording Fee Receipt # 1-1 A I I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION H R BY G 01VENN IS CORRECT, AND THAT AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF IVE IS THE OWNER. I AGREE TO COMPLY WITH C17Y AND STATE LAWS REGULATING CONSTRUC OW 0 [T:nlON; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED" I VIOL IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO T woR M I WORKMEN'S COMPEN=SURANCE AND RCW 18.27. DATE SIGN,20 81GNATUJJ� (OWNER OF(AGE")—, APPLICATION APPROVAL This application is not a peffnit until signed by the CALL Building Official or his/her Deputy: and Fees are paid, and R INSPECTION receipt Is acknowledged In space provided. I I IG D�TE (425) 771-0220 RRESED DATE( — ATTENTION Off 1 3 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL �7_ 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 t z 0 d 0 M rn C ITI C ITI M 0 "n M M ITI a 0 0 Fn C C 93) ITI 0 z z ITI