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20030142.pdfI DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BLI 7s C64Ut1_y%__1 (D 615r2Z MAILING ADDRESS - 2= CITY ZIP TELEPHONE NAME ADDRESS CITY ZIP TELEPHONE NAME CBL# _T14J4 I-S tota/vI '&/Ak AA Ilua ADDRESS CITY ZIP TELEPHONE 1_1&0:e1JA.Y,tAM TRIV I 4AV- 44f 014-K ITAIT'LICENSE NUMBER' ROPERTY TAX -ACCOUNT PARCEL NO. KfNEW 0 RESIDENTIAL 0 ADDITION [:] COMMERCIAL [:] REMODEL 0 MULTIFAMILY REPAIR 0 GRADING CYDS DEMOLISH TANK 0 GCAARPAOE RETAININGWALL FIT ROCKERY (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIIN: P_QS1>WT/ am I NUMBER OF 4 NUMBER OF DWELLING OW tUNITS STORIES TS DESCRIBE WORK TO BE DONE HEAT SOURCE GLAZNG % PLAN CHECK NO: [PERMIT EXPIRES -MENNEN 6 S-E PERMIT ZONE NUMBER W__7 14�Z_ JOB SUIT # ADDRESS <6L�� PLAT NAME/SUBDIVISION NO. LID NO. LID FEE S TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Psfmll Required Street Use Permit RKd EXISTING — PROPOSED InspecUon Required Sidewalk Required REQUIRED DEDICATION- FT Undeforound 13 METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED YES 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE REVIEWED BY DATE FIRE REVIEWED BY DATE W. r VARIANCE OR Ed-l—SHORELINE OR ADB# 1. INSPECTION BOND I REO'D POSTED IMES 13NO IS SEPA REVIEW SIGN AREA I HEIGHT COMPLETE . EXEMPT I ALLOWED , PROPOSED ALLOWED I PROPOSED LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT) PLUMBING / MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR COMPLIANCE OR CHANGE OF USE PARKING LOT ARF,11 PLANNING REVIEWED BY DATE SIGN REOD I PROVIDED FENCE ( _ FT) REMARKS OTHER FIRE SPRINKLER 0 FIRE ALARM CHECKED 13Y OF OCCUP r ITYPE CON Ic R GROUPP3 CRITICAL AREAS SPECIAL INSPECTION JAREA OCCUPANT NUMBER REQUIRED [:) YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REG'D VALUATION $ Description FEE Description FEE Plan Check State Surcharge LOT SLOPE % Building Permit City Surcharge VESTED DATE Plumbing (40 Mechanical Plan Chk. Deposit Receipt # Total Amt. Due 011; Receipt 0 atlon Is not a permit until signed by the il or his/her Deputy: and Foos are paid. and Is acknowl)dgug In space provided. JATM15: 0^ -r I/ DATE BCD BY - DA-Ft: ATTENTION MA 1 1;3;3;3 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 GREEN - ACCOUNTING 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES THIS PERMIT AUTHOR&M6 ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUSUC Grading DOMAIN (CURsS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERIMITAPPLICATION: 1180DAYS PERMIT LIMIr I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection 17-7 SEE BACK OF PINK PERMIT FOR MORE INFORMATION 1�2 'APPLICANT ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review 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 Fire Inspection FROM THE ISSUANCE OF THIS PERMrr. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. NOR LIMIT IN ANY WAY THE CITY$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION." i — Recording Fee 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- CALL TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE E OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION WORKMEN',YCO INS CE AND RCW 18.27. SIG TUAPWN AG . . ....... M� DATE SIG�qED —40 LJ 1A %4251 Z, J,- 771-0220 z 0 4 0 m q :-n m m -10 0 0 M M z ic) o -n n -4 3: m m 0 0 0 M cl) M 0 Z .q� M z co) z 9 0 m RE-INSpECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL Date Si ocaprvl.doc.l:temp.bldg:formsIO/OI I PATE RECEIVED PERMIT EXPIRES CITY OF EDMONDS USE PERMIT ZONE (A'2— NUMBERW-7- CONSTRUCTION PERMIT APPLICATION JOB # ADDRESS I (—I oc OWNER NAMEfNAME OF GUSINWS Z, ACrAu zi� PLAT NAME/SUBDIVISION N OT NO. LID NO. 0-7 MAILING ADDRESS / 4 jesr LID FEE 6 TESCP APPMW PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Peffnit Required di street Use Peffrilt fmqv CITY ift ZIP TELEPHONE EXISTING — PROPOSED Inspoctlon PAquired "ad REQUIRED DEDICATION— FT uws� METER SIZE LINE��. OF FIXTURES PRV REQUIRED I YEs13 NO 13 z ADDRESS REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAIMAGE CITY ZIP ONE A NAME CBL _Ti4k)e. '01"'m ry ENGINEERING REVIEWED BY DATE ADDRESS 10 . A 4 - - FIRE REVIEWED BY DATE CITY ZIP TELEPHONE VARIANCE OR CU SHORELINEORADBO INSPECTION BOND STATErUCENSE NUMBER' EXPIRATIONDATE REO'D POSTED YA.!�O*lz / AOI6 [3YEs 13NO S SEPA REVIEW SIGN AREA HEIGHT P UNT PARCEL NO. COMPLETE , EXEMPT ALLOWED , PROPOSED ALLOWED , PROPOSE13 EXP NEW RESIDENTIAL PLUMBING I MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR ADDITION COMMERCIAL COMPLIANCE OR 0 CHANGE OF USE REMODEL 0 MULTIFAMILY SIGN PARKING LOT AREA I PLANNING REVIEWED BY DATE REQ`D PROVIDED I REPAIR 0 GRADING FENCE CYDS X FT) I REMARKS DEMOLISH TANK OTHER An GARAGE RETAINING WALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM UWE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: WT/ CHECKED BY ITYPE OF N ION c OCCUP a a I Vp M GROUPP3 F NUMBER NUMBER OF CRITICAL OF DWELLING AREAS SPECIAL INSPECTION OCCUPANT —STORIES UNITS NUMBER JAREA REQUIRED LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 1108/171NAL INSPECTION REG'D Pint: w6ko� �2 A-Otf VALUAIION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE T_=�_NG % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing (40- Mechanical THIS PERMIT AUTHORMES ONLY THE WORK NOTED. THIS PEMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY OHLX ANY CONSTRUCTION ON THE PUBLIC Grading DO&IIAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PEFMFTAPPUCATIOW. 1606AYS PERMIT UMM I YEAR - PROVIDED WORK 18 STAMID WFTHIN 100 DAYS Engr. Inspection 7- 707 BEE BACK OF PINK PERMIT FOR MORE INFORMATION FN-.- '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, IT$ OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # I CLAIMS FOR DAMAGES OF WHATEVER NATURE* APISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapalnsp- Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE Crr1rS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." -0 I Recording Fee Receipt N ID �2zz 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION LICATION APPROVAL GIVE IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF -A THE UER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- /TjI8 Ication is not a permit unill signed by the �1 CALL TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED or his/her Deputy: and Fees are paid, and IN VIOLATIOIJ OF THE LA96A-CQDE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION r elpt Is acknow"00 Irispace "ed. fll7r WORMENIrO= INSU:!�CE AND RCW 18 27. 0 j ZjDATE SIG ED qC=R �.dDATE IA05) 7- 771-0220 ��D BY ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I A 11NAL INbrk:L; I IUN HAti t%t:t:N MAUk: ANU AVrHUVAL Utl A Utti I Irl- 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 - ACCOU.SITING