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20030186.pdfG, . DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION 77NAME?jE ]aNESS 7-- _f 1 t4q� L L I N G A��SS zi 0 _/ J*373c) CITY ONE - ye 4��;o /Z 4 - V V 15-4/ clut ZIP ITELEPHONE ICBL# ZIP TELEPHONE LICENSE NUMBER ROPERTY TAX ACCOUNT PARCEL NO. to le) !:L 7.6 RESIDENTIAL [3 ADDITION U-05MERCIAL [3 REMODEL [3 MULTIFAMILY REPAIR GRADING CYDS DEMOLISH TANK oGARAGE CARPORT RETAINING WALL ROCKERY (TYP BE U 9INESE OR ACTIVITY) NUMBER' NUMBER OF// OF DWELLING VIA STORIES UNITS DESCRIBE WORK TO BE DONE I - PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB SUITE/APT# AD AJ PLAT NAME/SUBDIVISION NO. LOTAO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Appr RW Permit RZV1r6d Street Use Permit ReWd EXISTING — PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION— FT Underground Ming required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES 13 NO 13 z I REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE is PUftb1JAWF'f0 ECDC 19.30.020 FIRE REVIEWED BY WATER SHUTOFF DATE DATE 1,10 VARIANCE OR CU SHORELINE ORADBI 1 INSPECTION I BOND REO'D POSTED 13YEs 13NO 1$ SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT ALLOWED . PROPOSED I ALLOWED . PROPOSED LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr) M--fLUMBING / MECH ALLOWED PROPOSED FRONT SIDE REAR I LIR SIDE REAR FRONT 2 0 COMPLIANCE OR CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE 0 SIGN REOD I PROVIDED I FENCE I ( X_ FT) REMARKS fin-5-2 OTHER PA-MS11ANI 11pr- A WATBR. SERVICE SHUrOFF 0 FIRE SPRINKLER S= BE INWfALLtW il.)N FIRE ALARM — __ ___ CHECKED BY E 0 ON;W/C CODE OCCUPANT '44_0_ue_� TN GROUP ghITICAL f:7 AREAS SPECIAL INS�ECTION JAREA OCCUPANT NUMBER_ REQUIRED LOAD A L IREMARKS A 1PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG-D 19 �e -,b --, _,�L_, . I ("'4—If AC_ VALUATION IJ $ 4� Description FEE Description FEE Plan Check state Surcharge HEAT SOURCE LAZING % LOT SLOPE % T 6 Building Permit City Surcharge PLAN CHECK NO* VESTED DATE Plumbing -76- 11:6.-z A -7 s; Mechanical THIS PERMIT AUTHORMES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading a— 3 DOMAIN (CURBS. SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 180 DAYS L PERMIT LIMM I YEAR - PROVIDED WORK IS 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 2 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 TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due LDEEMED NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee Receipt # M92 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 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 LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building 01ficiall or histher Deputy: and Fees are paid, and receipt Is acknovAodged in space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. OFFICIALS SIGNATURE DATE 8IGNATU E WNER OR GENT) I DATE SIGfiED T __1 771-022U R SED BY DATE ATTENI(IbW M 1333 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 - INSPr---- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING IMEM z 9 13 DATE REqEIVED ��4 I I j CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION NAME7E O&6UqINESS L LIP V *3 3o ZIP TELEPHONE /.A .06- V P BQ 10�tL L 14AME-. — I Zip TELEPHONE CBL 0 . 1 *6 Cny Zip TELEPHONE g / 6 -.4 4/8-470 '14'd;66& '? 6, 1,20 - LCENSE NUMBER EXPIRATION D)kTE C CKED IU) z LILle PROPERTY TAX ACCOUNT PARCEL NO. 5-9o�7tog§`00 AZO/tOD — M0*9E_W RESIDENTIAL U&-%LUWW / MECH ADDITION 2-1COMMERCIAL COMPLIANCE OR 0 CHANGE OF USE REMODEL MULTIFAMILY [:] SIGN 1:1 REPAIR GRADING___"r_'_ .7- 13 CYDS [3 FENCE ( _ X_FT) . [3 DEMOLISH [j TANK OTHER oGARAGE CARPORT RETAININGWALL ROCKERY FIRE SPRINKLER FIRE ALAqM D(PIRES L USE PERMIT ZONE NUMBER A!o'5 t:z56 JOB sunTJAPTO AD ,qW,Q , PLAT NAME/SUBDIVISION NO. LOT70. �LID NO. LID FEE S PUBLIC RIGHT OF WAY 1511 App"'v0d PER OFFICIAL STAFEi MAP RW Ponflit RaWlf Strom Use PKMN EXISTING — PROPOSED InspwtionFloquired SidowmARoquIrW REQUIRED DEDICATION— FT — lMgf@qL&W 13 METER SIZE LINE SIZE —I N 0. OF FIXTURES PRV REQUIRED I YE s C3 NO 13 z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE PURSUANT TO SH t. M:;LM NEAR ENGINEERING REVIEWED 1311M WATM S DATE FIRE REVIEWED BY DATE I I!, VARIANCE OR CU SHORELINE ORADB# I INSPECTION I BOND REO'D POSTED 13YEs 13NO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE I EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED _xP I ZrRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) LOT COVERAGE REd ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR PARKING LOT AREA PLANNING REVIEWED BY DATE RE110 I PROVIDED I TO 12C 1505-2 REMARKS A;WATMi i0MC13 SHUT01W 11TYP USINESS.OR ACTIVTM # I i CHECKED BY ... JaPE-OF.CONSTRUCTION CODE OCCUPANT =1 4 GROUP I N NUMBER UMBER OF// RITICAL 6 OF DWELLING AREAS !;PECIAL INSPECTION AREA —202= OCCUPANT —STORIE UNITS NUMBER REQUIRED [:] YES LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC'108/FINAL IN SPECTION REaD Alk Ah a AIL oft FMk -_ I I HILHAN - U 61 VALUAIION U $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE T GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO- 01 VESTED DATE Plumbing -70- Mechanical t THIS LY THE WORK NOTED. THIS PERMIT COVERS WORK TO h BE DONE ON PRIVATE PROPEffff ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading JVJIGH X3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE L SEPARATE PEfI!tION. 2 Engr. Review PERmrrAPPucxnoN: &DAYS PERMIT UMIR I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION S ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS 'R Fire Review Plan Chk. Deposit ;=CANT 0 F EREiT. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF N D EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # L Y ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY BE FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Laqdscapeinsp. Total Arnt. Due ICE DEEMED TO MODIFY, WAM OR REDUCE ANY REQUIREMENT OF MY CITY ORDINANCE IN . - NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROMON. ffi Recording Fee Receipt # rION I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION P APPLICATION AP ROVAL r OF GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF UC THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- I1] CALL This application Is not a pemit until signed by the YE TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building OfWal or his/her Deputy: and Fees are paid, and To IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknaMedged In space provided. Won��EfNr'S 'COMPENSATION INSURANCE AND RCW 16.27. OFFICIALS SIGNATURE DATE SIGNAT E WNER 0 DATE SIqhED 11425), 771-0220 BY DATE ATTEN'AbN EXT I �33 ikOJAhi 1L2 J19 - JT 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 - I�SPE4R CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING