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20030160.pdfrl DATE RECEIVED PERMIT EXPIRES CITY OF EDMONDS ISE ZONE PERMIT NUMBER A_a)5-011i-10_ CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# OWNER ADDRESS —7 01 NAME/NAME OF BUSINESS E= KI PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. Ll Lj MAILING ADDRESS LID FE $ P- TES.1 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW =. P.r: CITY ZIP TELEPHONE EXISTING — Street Use Parrith Req'd PROPOSED Inspection Required Sidewalk Required __!nNtj*jW0cQ Wd q%oq REQUIRED DEDICATION— FT Underlpound wiring required 13 NAME METER SIZE LINE SIZE NO. OF FIXTURES�PRV REQUIRED YES13 NO YES C3 3 z I ADDRESS REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE CITY ZIP TELEPHONE NAME dCBL#94 4- ENGINEERING REVIEWED BY DATE 0 ADDRESS I TELEPHONE CITY giC) '11011414- wA zlp%33sl FIRE REVIEWED BY DATE uj cc 8 3-5 3 -_`011 IS 3 2— 0. STATE LICENSE NUMBER VARIANCE OR CU SHORELINEORADB# INSPECTION BOND EXPIRATIJN D4TE ! jECKE181Y �JJECKE Ict) 0 -14 1--do3l F -ffr� RE22 POSTED — � 13YES A54NO s I I 10 � Y TAX ACCO No. 9 PROPERT SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED MAikg I - I I & P or-O NEW RESIDENTIAL PLUMBING/MECH X LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE REAR COMPLIANCE OR 1:1 ADDITION COMMERCIAL 5 CHANGE OF USE .5' 1 zl�'�'aFa 1:1 REMODEL MULTIFAMILY SIGN PARK G IVROVIDED REO`04P LOT AREA P�ANNI�G REVIEWED BY DATE 0 REPAIR 0 GRADING FENCE CYDS r4o ,,:t: CA ( X FT) REMARKS _ _ DEMOLISH 0 TANK OTHER oGARAGE RETAININGWALL F RE SPRINKLER CARPORT 1:1 ROCKERY FIRE ALARM OWE OF USE, BUSINESS OR Acriviry) M;LAIN: CHECKED BY STRUCTION OCCUPANT ITYPE GROUP NUMBER NUMBER OF CRITICAL W#4f+l -x, OF DWELLING AREAS Fin STORIES I;A44 UNITS N11MBE SPECIAL INSPECTION AREA OCCUPANT LOAD I ,I REQUIRED [:) YES 2:QQ DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER USC 108/FINAL INSPECTION REaO -9 1k E_ f LACE r__ Y I 5"r I W & —D G'C Y, C 2, � a- t— 4 7 — A IF VAI_UATION Description FEE Description FEE Plan Check -76— State Surcharge 1 &15�0 HEAT SOURCE GLAZING % LOT SLOPE % le51,17 — 1 Building Permit 121 City Surcharge 607 PLAN CHECK VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO X BE DONE ON PRIVATE PROPE91Y ONLX ANY CONSTRUCTION ON THE PUBLIC DOMAIN Grading :1 (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 1= SEPARATE PERMISSION. 2 Engr. Review 15 PERMIT APPLICATION: ISODAYS ERMIT LIMM 1 YEAR - PROVIDED WORK 19 STARTED WITHIN ISO 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 VA7:�: 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 PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due ZO NOR LIMIT IN ANY WAY THE C17YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' I Recording Fee LRecelpt # 1 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 APPLICATION APPROVAL 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 Building Official or his/her Deputy: and Foos 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'S5P NSATION INSURANCE AND RCW 18.27. 4EL O�RQIAU IGN DATE SIGNATUR (OWNER' AG NT) DATE SIGNED 1425) Ib I o-3 &=QQ� 771-0220 1__� NIL- RE A D �ATE ATTENTION EXT 1333 lr�y 6 /0,_�.? IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- k J CAi'E OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 ORANAL - FILEt - YELLOW - INSPECTOR PINK - OWNER - GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING EM z 0 M M 0 C: M M C 2 0 .n � I �a q- M 0 Fn C co) CO) M 0 z 0 M to Ai �41 ;'I'. 00 \ :5 c \ (4 J)FZ I LQ "N, L()T I lhic 1 mr\r-O MUST BE IN PLACE AT TIME OF FOUNDATION INSPE(J%TION Z —ZONE L5:>—'F5 - -1 SETBACKS: FRONT. SIDE REAR-- I Q OTHER --- HEIGHT iiE2' -- I E75 Its d . ..... .. .. " Ini, 41 . co:, is 1-4 JD' MEE C EI V E D F E ID" ;0i 2 0 0 3 -PN11*7 CoutsffER RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS 15 MAILING ADDRESS P. o. CITY NAME ADDRESS CITY NAME 4--sof%s ADDRESS to ) 0 CITY 4 STATE LICENSE NI. co Iii) PROP NEW ADDITION REMODEL REPAIR E] DEMOLISH oGARAGE CARPORT (R?E OF USE, I I ZIP TELEPHONE C&OLid A)bLe'- ZIP .. ITELEPHONE CBL If 941 0� PERMIT EXPIRES j USE PERMIT ZONE NUMBER JOB ADDRESS SUITE/APT# c��70�'t /�� PLAT NAME/SUBDIVISION NO. -1 LOT No. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Pernitt Required Street Use Permit Req'd EXISTING — PROPOSED Inspection Required Sidws& Required REQUIRED DEDICATION FT Underilround Wiring required METER SIZE LINE Sli��O. OF FIXTURES PRV REQUIRED YES C3 - , NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE -7 z it � Aft A) 0, or 'A zIP"iF535 TELEPHONE -OgS 3 — -% 2— 'ON DATE I AhWFKEQ BY IM, 4 RESIDENTIAL COMMERCIAL MULTIFAMILY GRADING CYDS TANK A13RETAININGWALL ROCKERY 18 OR ACTIVITY) EXPLAIN: .21012 11 PLUMBING / MECH COMPLIANCE OR 1:1 CHANGE OF USE 0 SIGN FENCE X FT) 0 OTHER FIRE SPRINKLER FIRE ALARM NUMBER NUMBER OF CRITICAL OF W 4W D ELLING AREAS STORIES UNITS NUMBEllf DESCRIBE WORK TO BE DONE ENGINEERING REVIEWED FIRE REVIEWED BY DATE DATE 0 z W VARIANCE OR CU SHORELINEORADB# I INSPECTION BOND RE92 POSTED is 10YES AANO SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PO ED e EXP LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWE& PROPOSEQ_j FRONT SIDE REAR FRONT LIR SIDE REAR tA ZAY6 d- 9) 1 5 1 P.) I Z (A re - PARKING LOT AREA P$ANNING REVIEWED BY DATE . ; REQ`D PROVIDED I 1-40 C' fA,X-3.�i REMARKS CHECKE;'BY ITYPEtWSTRUCTION COQE OCCUPANT GROUP 12, SPECIAL INSPECTION JAREA OCCUPANT YES I ;? LOAD REQUIRED REMARKS PROGRESS INSPECTIONS PER UBC 1108MINAL INSPECTION REaD WWII I be 1 11111111111116 Description FEE Descriptiorn FEE Plan Check -76 I State Surcharge HEAT SOURCE _1_____6LAZING % LOT SLOPE % Building Permit 6q City Surcharge PLAN CHECK N VESTED DATE 22 Plumbing Z5"a Mechanical THIS PERMIT AUTHORCMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I= BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading 2 DOMMN (CURBS. SIDEWAM, DRIVEWAYS. UARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. t: Engr. Review x PERMIT APPLICATIOft 180 DAYS PERMIT Limm i YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION I SUCCESORS 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESO 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 III Jdj ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY ISSUANCE OF THIS PERMIT SHALL NOT HE FROM THE ISSUANCE OF THIS PERMIT. Landscapeinsp. Total Amt. Due DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Recording Fe3 I HEREBY ACKNOWLEDGE THAT I kAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT; AND THAT I AM THE OWNER. OR THE OULY AUTHORIZED AGENT OF 11HE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application In 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 STATEOF WASHINGTON RELATING TO Building Official or his/liar Deputy: and Fees are paid, and FOR INSPECTION receipt Is acknowledged In space provided. WORKMEPrS,=ATION INSURANCE AND I RCW18.27. DATE rb nATF qjnNpn I d 0`7 ",.;. C 1,11/ri/113 771-0220 A D C� Vr ATE ATTENTION EXT 1333 6 /0�3 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORI&INAL-Fil - YELLON- INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER - GOLD -ASSESSOR I \�N/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING i - - ____.'__ . . .. � - _j .......... ... z 0 0 IT11 M ni 0 C IT! z 0 "n M M 0 0 0 z z 0 IT11