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20030178.pdfDATE RECEIVED A, -A t, PERIMIT EXPIRE F DINNEEN USE PERMIT /10675- 0 19-3 ZONE CITY OF EDMONDS NUMBER, CONSTRUCTION PERMIT APPLICATION — JOB ILW *ITEAPT#��2/j ADVYAO 7 `-4- NAME7.E OF QUMES.% LLL 00.9 r No. LID NO. PLAT NAME/SUBDIVISION NO. LO' ('r LID FEE S ,,AICING AD4fSS 5340 -USCP AP1=11ed PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Perm" A street use Permit ".0. EXISTING — PROPOSED Inspection Required Sidewatk Required CITY,.) ZIP TELEPHONE j REQUIRED DEDICATION— FT red cl !,il� METER SIZE LINE SIZE-1 NO. OF FIXTURES PRV REQUIRED Y ES 13 NO 13 1 z 5 . . d ADDIIES REMARKS OWNEFUCONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAUE ZIP TELEPHONE ICBL#_ ENGINEERING REVIEWED BY DATE cc A as 0 0 DATE ul FIR REVIEWED BY It CI ZIP TELEPHONE Q -74 Ir 06-.2 SHORELINE OR ADI INSPECTION BOND VARIANCE OR CU POSTED RECI'D LICENSE NUMBER EXPIRATION A L CHECKED BY I 13YEs 13NO is 7Z;4,4,o $EPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROP SED , ALLOWED PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. I -17907 OOOQ EXP I NEW 0 RESIDENTIAL 6;;P�Lum BING MECH LOT C - OVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FR ONT SIDE REAR FRONT URSIDE REAR COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE REMODEL MULTIFAMILY SIGN REOD I PROVIDED FENCE GRADING REPAIR CYDS x FT) REMARKS OTHER 0 DEMOLISH TANK 0 GARAGE RETAINING WALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM OF USE, BVSINESAS OR A i ffn CHECKED BY ITYfE OF CQNSTRU PT!ON CODE OCCUPANT — ' - - Ll .17 GROUP R 2,j4&e_Ax_ NUMBER CRITICAL DWELLINV AREAS - SPEcTION AR A!!!! OCCUPANT SPECIAL IN tF' LOAD OF UNITS NUMBER STORIES I I IJVA REQUIRED S YE 13 YES :rf DE01-0jac uunav 7n 0C Wnurl REMARKS PROGRESS INS PECTIONS PER UBC 108/171NAL INSPECTION REOID L/ 2 Al VIA V ad let A V&U 'nON J VAI/ pt'On Description FEE Description FEE �,A 01, Plan Check State Surcharge HEAT GLAZING % LOT SLOPE % Zuilding Permit City Surcharge PLAN CHE01 VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO It BE DONE ON PRIVATE PROPERTY ONLI ANY CONSTRUCTION ON THE PUBLIC Grading 2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: ISO DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WIITHIN 180 DAYS Engr. inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION El Fire Review Plan Chk. Deposit ,APPUCANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESO FIS IN INTEREST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # EDMONDS, WASHINGTON, ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. APJSING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due 9 DEEMED TO MODIFY, NOR LIMIT IN ANY WAY THE CIJYS 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 This application Is not a permit until signed by the THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL Building official or his/her Deputy: and Fees are paid, and TION; AND IN DOING 'THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED RELATING TO receipt Is acknowledged in space provided. FOR INSPECTION IN VIOLATION OF THE LA13OR CODE OF THE STATE OF WASHINGTON - DATE WORKMENS COMPENSATIO N INSURANCE AND RCW 118.27. OFFICIALS SIGNATURE ,atd (OWNER 0 DATE SIG ED (425) 771-0220 R By BAT ATTEWIM Off 1333 W-0 M.O.111NAL IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- - FILE YELLOW. IN5FhUIOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR ARE MAKING 5 COPIES GREEN - ACCOUNTING 04/02 PRESS HARD -YOU ,�D �Zf 'tATE RECEIQ Al YN Z 'PERMIT EXPIRESq E PERMIT 17 - ZONE CITY OF EDMONDS JV U NUMBER JOB CONSTRUCTION PERMIT APPLICATION qlTFJiAPT# orNAME"IE OF �LWES5 AD A PLAT NAME/SUBDIVISION NO. LCrt NO. LID NO. Y r eCINGAD S Oft LID FEE S 4L&J z& 3 3 0 TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Rw Parrrj, Required Req-d -4j( ZIP , TELEPHONE EXISTING — PROPOSED Street Use Permit Inspection Required Sidewalk Required WJA REQUIRED DEDICATION— FT Underaround Mine required 13 NAME METER SIZE LINE Slii7. OF FIXTURES PRV REQUIRED YES13 NO 13 z AD E SK .41FMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLJDRAINAGE xdg� ZIP 9 goa 6 TELEPHONE cplo & -,q 77 'NAME CBL N NGINEERING REVIEWED BY DATE D S 990 13 - FIRE REVIEWED BY DATE LU C1 ZIP TELEPHONE 1mr VARIANCE OR Cu SHORELINE OR ADS# INSPECTION BOND T S A LICENSE NUMBER EXPIRATION CKECKED BY REO'D POSTED 113 4?7ATE YES 13NO $ SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED '11f V7 /,0 0 EXP_� A , , PLU [3 NEW RESIDENTfi_6 PLUMBING MECH LOT COVERAGE REQUIRED OETBACKS (Fr.) PF�DPOSED SETBACKS (Fr.) LOWED PROPOSED FRONT SIDE REAR M95 �DE REAR 0 ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY E T11 U REMODEL MULTIFAMILY SIGN REO'D PROVI DED 1� I GRADING FENCE 0 REPAIR CYDS X FT) REMARKS DEMOLISH TANK OTHER 0 GARAGE, RETAININGWALL F RE SPRINKLER F11REALARM CARPORT ROCKERY 4 B] fy) w(Poof CHECKED BY TWYPE OCCUPANT—. F,9914STRU — GROUP NUMOER OF NUMBER ftj DWELLIN CRITICAL AREAS SPECIAL INSPECTION AR A occu PA�ff LOAD STORIES UNITS NUMBEFf REQUIRED [3.yES DEPCJMr-.WnA1C-Tn AC rv%u9 REMARKS PROGRESS INSPECTIONS PER UBC 1 08/FINAL INSPECTION REO'D — 9 A' V 11A V lilitintu 6i-i6n API /a VALUAnON �f V IVII'661 6W $ /'Iq ALWde�" Description FEE Description FEE %_ , loe _�Lj ) . 11 !:H_Aj 11 %. / ilj_� 0 Plan Check State Surcharge HEAT SOUR-CE GLAZING % LOT SLOPE % Building Permit City Surcharge VESTED DATE Plumbing' PLAN Mechanical THIS PERMIT AuTHoR&ms ONLV THE WORK NOTED. THIS PERMIT COVERS WORK To ONLY. ANY CONSTRUCTION ON THE PUBLIC BE DONE ON PRIVATE PROPEMV Grading DOMAIN jCURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL E?UIRE �A W tj SMTE PETISSION. Engr. Re�ew PEWITAPPLICATION: IGO DAYS ! I IL PERMIT UMM I YEAR - PROVIDED WORK IS STA HIN lea DAYS Engr. Inspection MOREV SEE BACK OF PINK PERMIT FOR FO=ON '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 Landscapelnsp. Total Amt. Due 7K5 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # � I I HEREBY ACKNOWLEDGETHAT I HAVE READ THIS APPLICATION"'THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT6 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 TW9 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 LABOR CODE OF THE STATE OF WASHINGTON' RELATING TO FOR INSPECTION 0WIding OMCW or his/her Deputy: and Fees are paid, and receipt Is acknowledged In space proyided. WORtVAERS COMPENSATION IN9URANCE AND RCW 18.27. OFFICIALS SIGNATURE DATE ,Vast%, Slatift - OWNER 0 1 DATE SIG ED (425) �_�IJC)lf)2) 771-0220 DATII g C1 ATTENT1614 EXT 1 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL _(.17Y 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 G4/02 PRESS HARD -YOU ARE MAKING 5 COPIES z 0 0 M M C M 0 0 C M M C 0 _n M M 0 0 Fn C MO z 0 M