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20030172.pdfPERMIT EXPIRES USE PERMIT CITY OF EDMONDS ZONE NUMBER C5�eL,516 AI JOB SUITFjorpe CONSTRUCTION PERMIT APPLICATION ADDRESS OWN7EMEINAME OF OUPESS LO PLAT NAME/SUBDIVISION NO. LOT WO. LID NOo r LID FEE S MA17 ADDR MAP TESCP AP �'=_ .1 --,# 3 1 PUBLIC RIGHT OF WAY PER OFFICIAL STREET Rw PerrrAt11 ed �Voo / � �/ /, , Z�— , 61d Street Use Peanit RKd t- 6 2u-1 - CITY ZIP TELEPHONE EXISTING — PROPOSED inspection Required Sidewalk Required REQUIRED DEDICATION— underground FT WjMg required 13 iNAME METEH SIZE LINE SIZ�*j NO. OF FIXTURES PRV REQUIRED YES C3 NO CI ADDRESS G REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE C11y. ZIP TELEPHONE 6tno.-; � V 1,�)/) 6 -J /9- 8 74 7 'NAME CBL 1V (e ENGINEERING REVIEWED BY DATE DATE FIRE REVIEWED BY W cc ZIP TELEPHONE C_ If,;. '/ 4 VARIANCE OR CLI SHORELINE OR ADBI INSPECTION BOND MATE LICENSE NUMBER EXPIRATION DATE ECKED By REO'D POSTED I �kl .4 1) 0j__ 3-7 0 el- /, A I 12L— DYES 13NO $ 2 SEPA SIGN AREA HEIGHT ROPERTY TAX ACCOUNT PARCEL NO. . REVIEW COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED :z o e) EXP , , , 21NEW RESIDENTIAL ErPLU MBING / MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) SIDE REAR FRONT URSIDE REAR ADDITION M_c6mm ERCIAL COMPLIANCE OR rl CHANGE OF USE ALLOWED PROPOSED FRONT z PARKING LOT AREA PLANNIN13 REVIEWED BY DATE rl REMODEL MULTIFAMILY SIGN REO'D PROVIDED I I REPAIR GRADING FENCE X CYDS ( FT) REMARKS DEMOLISH TANK E] OTHER ciGARAGE o RETAININGWALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM USE� BUSINESS Trp"q.EXPLAIN:j CHECKED BY TYPE OF CONSTRUGnON CODE occu 17- E& S & k W -7 NUMAER OF N OF DMING CRITICAL AREAS SPECIAL INSPECTION OCCUPANT LOAD STOR ES UNITS NUMBER rAREA REQUIRED D=j DONE 1 ."L- REMARKS PROGRESS INSPECTIONS PER UBC 100/FINAL INSPECTION REO'D $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading a DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 180 DAYS M. PERMIT LIMM I YEAR - PROVIDED WORK 16 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 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 Landscapelnsp. Total Amt. Due NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- ! Recording Fee Receipt # I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION AMICATION AP ROVAL 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 This application Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOaSODE OF THE STATE OF WASHINGTON RELATING TO Building Otficlal or his/her Deputy: and Fees M paid, and FOR INSPECTION receipt Is acknowledged In space provided. WORKMENS COMPEN NCE AND RCW 18.27. 1 - OFFICIALS SIGNATURE DATE SIG —NAPE (OW JER'O�A& DATE S�NED (425) _L M_ - Vl_�?Izp 00 771-0220 .6L&ASED BY DATE ATT Off 13,33 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 �DAT:ql]VJD�j A" PERMIT EXPIRES CITY OF EDMONDS USE PERMIT ZON NUMBER C!�&g CONSTRUCTION PERMIT APPLICATION JOB _le surmf1mr)v ADDRESS of �� -7. OWNME7 OF BUOESS 12_j&�A lnw - - t—oLoe , L LC PLAT NAME/SUBDIVISION NO. LOT"No. LID NO. 15 AVr —131mVG LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Ap proved 0 RW Perrnit Required Street Use Rsq`d 'Po CITY ZIP,,,/ Peffnit Inspection FaquIred EXISTING — PROPOSED I Sidewalk Required ije-zt6x'� ITELEPHONE 991 Aej6 REQUIRED DEDICATION_ FT Underground Wiririg required 13 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 0 NO 13 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE cl�yj ZIP TELEPHONE �9- 8 NAME CBL# ENGINEERING REVIEWED BY DATE CC ADD EBB U 74600 S. / CI ZIP PHONE ITELE FIRE REVIEWED BY DATE -A �g_ 174_7 VARIANCE OR CU SHORELINEORADB# INSPECTION BOND O'S NUMBER EXPIRATION ECKED Y REO'D POSTED I ZTE I OC I 19 OyEs [3 NO S i/0 L 4 b Pr 3-7 2 ffo � j SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED -r?,6 7DO 0 do t 040 EXP , , 0 RESIDENTIAL 200PLUMBING/MECH LOT COVERAGE kftUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) REAR FRONT LIRSIDE REAR ALLOWED PROPOSED FRONT SIDE ADDITION ERCLAL COMPLIANCE OR M CHANGE OF USE REMODEL MUL11FAMILY SIGN PARKING LOT AREA I PLANNING REVIEWED BY DATE REO'D I PROVIDED GRADING FENCE REPAIR CY69 ( _ X_FT) REMARKS OTHER 13 DEMOLISH TANK _'^,61 tx1lum GARAGE RETAINING WALL F RE SPRINKLER FIRE ALARM CARPORT ROCKERY F USF. BUSINESS =OEXPLAIN zu_4.�� CHECKED ;BTYTYPE OF CONSTfMCTION OCCUPW ICODE a SMN 97 GROUF/2.. NU ER N OF CRITICAL /r OF DrEMING AREAS V - SPECIAL INSPECTION JAREA OCCUPANT STO IES UNITS NUMBER LOAD REQUIRED [] YES D tvt� Avjm-z It REMARKS PROGRESS INSPECTION S PER UBC 108/FINAL INSPECTION REG-0 it I A Description FEE Description FEE Plan Check State Surcharge HEAT SO: GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE 0. Plumbing 2 . :�� Mechanical Yz2 THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 11 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. . Engr. Review I PERMIT APPUCATI-O—W-- t;DAYS I CL PERMIT IUMM 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BXCK 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 Landscapeinsp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 21 NOR LIMIT IN ANY WAY THE CITY$ ABILHY TO ENFORCE ANY ORDINANCE PROVISION." Recording Fee Receipt # I HERE13Y 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- 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 Olficiall or his/her Deputy: and Fees are paid. and IN VIOLATION OF THE E OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged In space provided. WORKMENS COMPEN CE AND RCW 18.27. 1 1 �. I OFFICIALS SIGNATURE DATE E( DATE *NED IG E GE 1A0 1425). -V 0 771-0220 DATE ABED BY ATTENT64 EXT 1333 A -7 J17 0 IT IS UNLAWFUL TO USE OR OCCUPY A 13UILDING OR STRUCTURE UNTIL L-' / W4ZU&k 4" 4L-- _/ 4 /L/ ' _J A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A GERTIFI- OnIGINAL-FILE YELLOW: INS(ECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK-OWNEFI GOLD -ASSESSOR GREEN - ACCOUNTING 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES z 0 0 m m m 0 C m 10 0 -n m m 0 6 Fn Cm C CD 0 z 0 I 0 m