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20030132.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS PK(PO-, —ioryi -4 Gut MAILING ADDASS LOZ9 (Wk Ave, LAJ- CITY ZIP TELEPHONE E,Aman di (o - T 13 NAME ADDRESS CITY ADDRESS STATE LICENSE NUMBER ZIP [TELEPHONE 9/ ZIP NO. CBL # F_� ERMIT EXPIRES USE PERMIT ZONE NUMBEFr_� , JOB SUITE/APT# ADDRESS PLAT NAME/SUBDIVISION No. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TES Approved AW CP: PfZV irld Permit Required It R street use Permit Req'd EXISTING — PROPOSED— inspection Required sidewatic Required REQUIRED DEDICATION— FT Underomund Wiring required 13 METER SI ZE LINE SIZ OF FIXTURES PRV REQUIRED YES 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE BY DATE FIRE REVIEWED BY DATE I I VARIANCE OR CU SHORELINE OR ADBN I INSPECTION BOND REO'D POSTED 13YEs 13NO Is BEIRA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED I PROPOSED ALLOWED , PROPOSED. EXP NEW [g/RESIDENTIAL CH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) L/RSIDE REAR ALLOWED PROPOSED FRONT SIDE REAR FRONT ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE z ; REMODEL MULTIFAMILY SIGN PARKING REQ`D PROVIDED LOT AREA PLANNING REVIEWED BY DATE CL GRADING 63"REPAIR 1:1 CYDS FENCE E3 ( X Fr) I REMARKS r RMAIN's 4V b 19.30.020 DEMOLISH TANK 0 OTHER 3WRrh52UM11EGEffiAff*VAtW(MV) BE INSTALLEp NEAg GARAGE RETAININGWALL CARPORT ROCKERY FIRE SPRINKLER FIRE ALARM THE WATm SHUMFF (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN - NeW lif)4P_ (Y41Kr- +0 dU-�-C CHECKED BY C�� OCCUPANT J, WQ-� — jTYPEjF)CPNSTRCTION GROUP NUMBER OF 2- NUMBER OF DWELLING CRITICAL AREAS SPECIAL INSPECTION [AREA OCCUPANT LOAD STOR ES UNITS NUMBER REQUIRED DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D 9 I RePLI ir / I n.5 +rA in-k IR VALUATION $ SH&L BE INSTMLW ON THE LM AN Y 14rf as" -I m-DUMALZINO Deacirlption FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit VESTED DATE Plumbing Mechanical City Surcharge PLAN CHECK NO: THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC Grading LL 3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WI REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPILICATION: 180 DAYS 116 PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection 605- SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICA1`9 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 x EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection 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 Landscapeinsp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CIIYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' — Recording Fee 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 C17Y 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 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 recolpti3acknow[odgodinspacaprovidod. W0RKMEN'S5pMFSNSAT1ON INSURANCE AND RCW 18.27. 0 1 LS SI N TURE DATE SIGNATUR AGENT) DATE SIGNED IA9E U(OWNiAR/jR 771-0220 Zf#-7 I CIL& 2 r REI F:AStn BY AT T E N 170'N M 1333 IT IS UNLAWFUL 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 FINAL PROJECT APPROVAL FORM TO: DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION z 0 m =i ii us 4 cl m c ma 0 -10 0 c: � m m MZ m M 065 0 0 Fn C (j) c cl) M 0 Z z z 9 0 m .3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date sign ocaprvl.doc.l:temp:bldg:formsIO/OI m I DATE RECEI]�� 0. [PERMIT EXPIRES f CITY OF EDMONDS USF PERMIT ZONE NUMBERC4Q20 CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRESS 4w OWNE NAMEINAME OF BUSINESS M , "? P 1 o (" -I Go y I e- PLAT NAME/SUBDIVISION NO. LOT NO, LID NO. MAILING ADDdEdS LID FEE S z1q2(1 TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required CITY ZIP TELEPHONE Stfast Use Permh AKd EXISTING - PROPOSED Irapectio" n*quw Sidewsht Required Aljr LAj 2o 4 13 FT UndwWMW REQUIRED DEDICATION Wiring required NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YESO NO 13 I z ADDRESS REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLJDRAINAGE CITY ZIP TELEPHONE NAME jCBL .;�e jb ENGINEERING REVIEWED BY DATE ADDRESS DATE FIRE REVIEWED BY CITY ZIP TELEPHONE If VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND STATE LICENSE NUMBER EX;P�I�RAT� CHgqKED BY REO'D POSTED 113YEs JP:ATE 13NOI$ F& zz & y , ? �'y 12, z Wjv PROPEMY ACCOUNT PARCEL NO. SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED I I , EXP NEW 0001RESIDENTIAL M�A�ECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE REMODEL MULTIFAMILY SIGN REO'D PROVIDED I Ga/REPAIR 0 GRADING FENCE I CYDS FT) X REMARKS 0 DEMOLISH TANK OTHER oGARAGE RETAININGWALL 0 FIRE SPRINKLER FIRE ALARM CARPORT ROCKERY (TYPE OF USE, BUSINESS OR ACTIV" EXPLAIN* wevi Ujo ter ho e - n44f, �1_0 CHECKED By ITypE T CTION CQK OCCUPANT b., GROUP f/ I 4 127nz C/ A NUMBER NUMBER OF CRITICAL OF DWELLING AREAS SPECIAL INSPECTION OCCUPANT STORIES 2- -UNITS NUMBER [AREA LOAD REQUIRED [:] YES OF -SCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD 1 r 'CA r C ((I k) ik) r 2 Ak Aek A-111MI ETC III H UAnON La Description FEE Description FEE Plan Check State Surcharge HrAT SOURCE GLAZING % LOT SLOPE % T_ Building Permit .0— City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I= BE DONE ON PRIVATE PROPERTY ONLX AM CONSTRIUCIrION ON THE PUBLIC Grading DOMAIN (cuRas, sioEwALrs. DRIMMAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPUCATION: 1800AYS 13. PERMIT LIMIr I YEAR - PROVIDEDWORK 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 INDEMNIF% DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, FT$ OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection 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 9S DEEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE N , OR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Recording Fee 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- 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 OMctal or his/her Deputy: and Fees are paid, and FOR INSPECTION receipt to acknowledged In space provided. WORKMENS PWTSATION INSURANCE AND RCW 10.27. 0 S SI N, LIRE E PT SIGNATUn (OWNER AGEIM DATE SIGNED IA13 Dd d'1-03 771-0220 RELEASEt1D3r1BY DATV ATTENTION W 1333 IT IS UNLAWFUL 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