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20030134.pdf13 LIATE . CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NA&'=E OF B SINESS nn 7 MAILING ADDRESS Z_ 3e'�2 2- CITY ZIP TELEPHONE L: 95-070- r - NAME ADD is CITY 16 z'pk KL5 A/` NAME _r7W CBL 70DRESS---g- 13a A, i. CITY TELEPHONE l" ;Z;r &2S. STATE LICENSE NUMBER EXPIRATION ATE PROPERTY TAXP/i 012,02 ACCOUNT PARCEL No. 9 6 0 0 NEW RESIDENTIAL PLUMBING/MECH 13 ADDITION ��COMMERCIAL COMPLIANCE OR 13 CHANGE OF USE *M SIGN REMODEL MULTIFAMILY GRADING FENCE REPAIR CYDS ( _ X_FT) TANK 0 DEMOLISH 0 OTHER GARAGE [3 RETAINING WALL CARPORT 0 FIRE SPRINKLER ROCKERY FIREALARM (TYPkOF USE. BUSINESS OR 11 CAMP41141: IS C 9. <Vz� "S LPERMIT EXPIRES Z, USE ZONE PERMIT NUMBER JOB ADDRESS SUIMAPT# PLAT NAME/SUBDIVISION NO, LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Perrmit Rewired Street Use Permit Req'd EXISTING _ PROPOSED Inspection Required f Sidawalk Required REQUIRED DEDICATION— FT U Wiring raquirsid 13 SIZE METER LINE SIZE N IXTURES PRV REQUIRED YES13 NO E3 z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAI NAGE IF DATE z 0 FIRE REVIEWED BY DATE 0 us Ir M VARIANCE OR cu SHORELINEO ADB# I SPECTIOU BOND Re* I POSTED $ r ) M C: M SEPA REVIEW COMPLETE EXEMPT AREA e,. * 0 ALL PROPOSEDA — HEIGHT .:�ALLOWEO PROPOSED EXP 5,y t.+-- 1 .4 1,V —4 0 LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS FT.) FRONT SIDE REAR PUOPOSEO SETBACKS (Fr.) FRONT LIRSIDE REAR M rn C: 2 PARKING LOT A REA PLANNING REVIEWED BY D REO`0 PROVIDED ATE IL A file, AIZV**Iro "1.4, In 01 M M ovaAWa CID NUMBER NUMBER OF, CHECKED By ITYefi:", TRIUCTION OCCUPANT a OF STORIES DWELLING ROUP C) G SPECIAL INSPECTION UNITS. DESCRIBE WORK TO BE DONE REQUIRED YES JAREA OCCUPANT LOAD U/ 0 REMqRKS A. PROGRESS INSPECTIONS PER USC 10WFINAL INSPECTION REG'D door- :r C4 VALUATION $ z Description "FEE DescriptIon FEE HEAT SOURCE GLAZING % LOT SLOPE % Plan Check State Surcharge M PLAN CHECK NO: Building Perm it City Surchp.,rge VESTED ZT"E Plumbing THIS PERMIT AAffHORaES ONLY THE WORK NOTED. THIS PERMIT COVERS W t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCT, ORK T73 2 ON Mechanical DOMAI ON THE PUBLIC I If (CURBS. SIDEWALKS, DRIVEWAYS. LURQUEES. ETC.) WILL REQUIRE Grading 1: SEPARATE PERMISSION. 92 PFFIMITAPPUCATION: IGO DAYS 0. PERMIT LIMM I YUR - PROVIDED WORK IS STARTED WITHIN Engr. Review 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCEsORS IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF Fire Review Plan Chk. Deposit EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY Fire Inspection Receipt # ROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE On REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. NOR LIMIT IN ANY WAY THE CITYS A131LITY TO ENFORCE ANY ORDINANCE PROVISION. - Total Amt. Due I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY Recording Fee Receipt # AUTHORIZED AGENT OF THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC APPLICATIO N APPROVAL — TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON EMPLOYED RELATING TO CALL Title application Is not a permit until signed by the Bull 0111cial or his/her Deputy: and Fees are WORKMEN'S COMPENSATION INSURANCE AND RCW 18,27. FOR INSPECTION Paid, and ecolpt Is acklowtodgod In speco Provided. SIG"RE (OWNER OR Ap 'DATE ?Y,." ONED 1 (425) OFF SIGNATU TE 771-0220 ATTENTION Off 1333 ATE L_�2 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL /03 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI. CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 ORIGINAL -FILE YELLOW- INSPECTOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES PINK -OWNER GOLD -ASSESSOR GREEN - ACCOUNTING ey, 14 f it it? IT s�,-- I 4.Ii Ik AI J:v. 14 It I t I 1 4 AdIF .11 P It xt I I It I III ..., I I I I - I 9 CITY OF EDMONDS GARY HAAKENSON MAYOR Re.* #o2aiiia469/ Stan permit (2nd notification) This letter is to inform you ffiat ffie fees must be paid and the silgn permit issued by 2=24mO3 to avoid code enforcement action. Please note, ff this deadline is not met, an Order to Correct will be posted and may result *in fines up to $ioo a day until resolvecL The amount on the permit is $6o, owing C 0 ity of Edmonds Development ServiiCe.S Division 425"771m0220 Incorporated August I 1 1890 Sister Citv m Hekinan. Jat)an P I 4% 1 I I r Ji I P wit I ., It I 05 A r I' I Ir I T I . FiNAL PROJECT APPROVAL FORM z 9 0 m am c Ma 0 80 m mz 10-1 0 -n n � 52 K m M a 0 0 M V) M 0 Z M z W z 9 0 m RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Sign, ocaprvl.doc.l:temp:bldg:form-;10/01 ko) I jo� ATE RECIO' , :�A PERMIT EXPIRES oz, USE PERMIT CITY OF EDMONDS ZONE NUMBER a(f _)3 CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRESS 44 t, y 9 9 OWNER NAAEINAME OF DOSINESS r) fj i e_ LLCjCrU C PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS LID FEES Z_ 3t<_,? 2- i—rc 9 TESEX AP�r� PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit 116WIrod Me Parmh Rac(d ZIP TELEPHONE Sum EXISTING - PROPOSED Im"cdon PAqtdred Sidewalk Roqt*ed L? OC 9 uwarground REQUIRED DEDICATION FT Wiring required NAME METER SIZF LINE SIZE NO. OF FIXTURES PRV REQUIRED I T YEs13 NO 13 z ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE _F CITY ZIP TELE 70NE (-U NAME iL gd INIA "NG REVIEWED BY DATE ADDRESS F 7_1�o6j1eV1fr_ 11,11e:! �j FIRE REVIEWED BY DATE Lu CITY ZIP TELEPHONE V14t.ox-� (� 4,0 j STATE LICENSE NUMBER EXPIRATION PATE EcRto-ey VARIANCE OR Cu SHORELINE 04 ADQ# V INSIPECTIOW BOND POSTED I ,�M-1 S 'V - PROPERTY TAX ACCOUNT PARCE 0 SEPA REVIEW SIGNIAREA F, HEIGHT COyT M P� PROPOSED Al 0 0 EXIP 7 NEW YSIDEN9AF/ gl�QNk4GjMECH RAGE E!.qETBA�PKS (Fr.) PROPOSED SETBACKS (Fr.) f %-M oSIDE-f) REAR FRONT L/R SIDE REAR 0 ADDITION MMERCiAl. ci COMPLIANCE OR CHANGE OF USE . REMODEL AJP,I- L .. �; 9 5' 6. PARKING IF taFAREK' REV&W5 t, DATE REO'D [PROVIDED] I . FENCE E3.,REPAJR GRADING CYDS 0 X IFY) 2n!Mi TL 77 0 DEMOLISH r] TANK _44. , dt P 1-10 , P9 JA E [3GAF& RETA�41NG WALL $WINIfL - ER,�t CARFOF[T ROCKERY FIqE ALARM'! - e V eL PW g I(TYP (NESS OWA 511, NSTRUCTION OCC C ECKE'D PE OF CO UPANT P �F&t I 'GROUP NUMBER NUMBER OF CRrTICAL OF DWELLING AREAS SPECIAL INSPECTION 'OCCUPANT 'f STORIES UNITS NUMBER JAREA -LOAD REQUIRED [3 DESCRIBE WORK TO BE DON REMARKS INSPECT18Ndi diR U610,4061FI"PoEirriON REaD 7 (4/4 PROGRESS 6" 7' X C4 S In 11 y "q71114 71 7 (f7p Z -r7777 FEE Description FEE 5 Plan Check 17ts�—tcharge GLAZING % LOT SLOPE % T I Building Permit City Surcharge 5— - &D FSOURCE HECK NO: VESTED DATE C, 2 — Y. 4 Plumbing —PL:c Mechanical THIS PERMIT AUTHORIZES ONLV THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONL%t ANV CONSTRUCTION ON THE PLIBUC Grading DOMAIN (CUIRBS. SloEWAUM. DRIVEWAYS, UARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review ,,.PEMITAPPUCATION: 190DAYS PERMIT IUMM I YEAR - PROVIDED WORK IS STARTED WITHIN 100 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. Deposft, 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 NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMTE ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF MY CITY ORDINANCE Landscapelnsp. Total Amt. Due NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." al Recording Fee Receipt # Lime? I I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL olvEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH MY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a permit until signed by the 7ION; 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 I Buildlilla Official or his/her Deputy: and Fees are paid, and FOR INSPECTION I/ Fecelptis ackt.owlodged In el�ace provided. WORKMENS COMPENSATION INSURANCE AND RCW 18.27. 0 ATE SIGN�. REJOWNER OR A E DATE SIGNED 0/ O;k 71---V K)j IAO 025 771 _1111199n InArc AlibitION U M 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL C_`1/_R.; � a7\1 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 GREEN - ACCOUNTING PRESS,HARD -YOU ARE MAKING 5 COPIES.:_. z 0 0 ITI 0 C M M 10 co 0 Irn in 0 Fn 0 X z ca z 0 4 0 M