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20030201.pdfI DATE RECEIVE PERMITEXPIRES MIL4103 USE PERMIT CITY OF EDMONDS ZONE NUMBER ��OZOJ JOB 9UITE/APT# CONSTRUCTION PERMIT APPLICATION ADDRESS 7,Z&� - I - &(-A-) OWNER NAME/NAME OF BUSINESS PLAT NAMEISUBDIVISION NO. _� LOT NO. LID NO. 1—h LID FEE S MAILING ADDRESS TESCP ApPrVv*d PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required Q1-113 Street Use Permit Req'd C174Y ' EXISTING — PROPOSED Ins4cWnRsquksd ZIP TELEPHONE Sidewalk Required REQUIRED DEDICATION— FT Underground 4ggoI W=g F0q— [3 .gg 9 2w z1)_<;-7 NO. OF FIXTURES PRV REQUIRED YESC3 NO 13 NAME METER SIZE LINE SIZE J ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE CITY ZIP ITELEPHONE NAME ^C 'IT'Y.... ZIP TELEPHONE I - yra, — r _ - LiWR—ATION DATi STArCENSE NUMBER 1jQE13V0'771?0 I . COUNT PARCEL NO. On .0 A in, EW ff--RESIDEWAL ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE 0 REMODEL MULTIFAMILY Sir N REPAIR GRADING CYDS FENUE X FT) DEMOLISH 0 TANK OTHER GARAGE [i RETAININGWALL FIRE SPRINKLER FIRE ALARM CARPORT ROCKERY OWE OF USE, BUSINESS OR ACTIVITY) EXffl;AIN: NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIEEfj�� UNITS NUMBER DESCRIBE WO&K Tg BE DONE A —� - 1,—4 HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: VESTED DATE THIS PERMrr AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOLMN (CUR13S. SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPILICATION: 180 DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS 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 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 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - I HERESY 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- 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 WORKMEN'S COMPEN==CE AND RCW 18.27. SIGN AowNFR nnlAnF:mTy:'JJ DATE SIGNED J-6iffiawd .. spaces. UMC 815.1.7 FIRE REVIEWED BY DATE us VARIANCE OR CU SHORELINEORADBO I IN PEQ 'ON I BOND SRE7D POSTED JOYEs 13 $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT ALLOWED . PROPOSED I ALLOWED , PROPOSED LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR PARKING LOT AREA I PLANNING REVIEWED BY DATE RECID I PROVIDED CHECKED BY ITYPE U%;UU GROU LOAD SPECIAL INSPECTION JAREA OCCUPANT REQUIRED 0 YES I 1.0 V INSPECTION RECI VALUATION BEA CEPTE11 'FEE Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Recording Fee Receipt # 11.4 CALL FOR INSPECTION (425) 771-0220 , ATION APPROVAL 9 appi US is not a permit until signed by the ull g 01111 or his/her Deputy: and Fees are Paid. and Y11 1, recq�t is acknowledged in space pcovidad. SI ATURKE DAT7o AVY0 IL M) I J / P15rEMD BY bA* ATTENTION /r 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 L z 0 M M M 0 ic M 171 2 0 _n .M M M Fn 0 z 0 M z FO Ol Ca I ol Fn m I (��DATE �RECEIVED� t, �4(�3 PERMIT EXPIRES —r— C TY OF EDMONDS IT USE PERMIT ZONE NUMBER NSTRUCTION PERMIT APPLICATION JOB ADDRESS YUIT�APT# OWNER NAMEMAME OF BUSINESS /V PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS LID FEE $ TESCP a RW Per= :E-,d, Street Use Permit &Wd PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP CITV ZIP TELEPHONE EXISTING — PROPOSED--- Inspection Required Sidewak Required 9JD 20 7// CWL J/7 IF REQUIRED DEDICATION— FT UndOWMM WIPU taqukW 13 - METER SIZE LINE Slii7 NO. OF FIXTURES PRV REQUIRED NAME YES13 NO E3 _I REMARKS ADDRESS OWNIlIMC011IRPL, OR Rr*rVrM010Lr r M310111 CON I "UTMEM I Tvoe B or L vent connectors I CITY ZIP TELEPHONE - uIrm on fuel-Ijurong UPPMUM M! NAME c4a] ENGINEERING REVIEWED BY DATE ADDRESS FIRE REVIEWED BY DATE CITY ZIP A TELEPHONE VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND PTAT7UENSE NUMBER, EXPIRATION DATE A— CHECKED REQ'D POSTED I JkWI�7T-f 077RO [:]YES 13NO HEIGHT PROPERTY TAX AC-C-OU CEL NO. .1 PARCEL M.N SEPA REVIEW SIGN AREA COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED OSED 7, QL)!�g q5 EXP , , —P t-0% LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) &JEW 0--RESIDENTIAL ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR 0or — I COMPLIANCE OR ADDITION 0 COMMERCIAL 0 CHANGE OF USE PARKING LOT AREA LANINING REVIEWED BY DATE MULTIFAMILY 0 REMODEL SIGN REOD PROVIDED REPAIR GRADING o FENCE CYDS X _FT) REMARKS OTHER ]'DEMOLISH [3 TANK (F(iwlim 169 [3GARAGE RETAINING WALL FIRE SPRINKLER 0 CARPORT ROCKERY FIRE ALARM UYPE OF USE, BUSINESS OR ACTIVITY1 DWN: CHECKED BY OCCU ITYPE ?7fR ]n GROU NUMBER No UMBER OF R[TICAL OF WELL NO CREAS SPECIAL INSPECTION JAREA OCCUPANT STORIES!ff�� UNITS NUMBER REQUIRED [:] YES I LOAD DESCRIBE DONEI REMARKS AAR. PROGRESS INSPEOMMS"14WAWSISTION REG'D f j OBSERVED BY WY INSPEMR 02, !:A MOM --- SWL NOT VALUIAnON HE-ACCEFtED 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 AUTHORMES ONIJV THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS. DRMVAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPUCAT!'ON: ISO DAYS PERMrr IUMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORKATION "APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIR r S. ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit . IN INTEREST. AGREES TO INDEMINIF% DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt N ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT' ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapeinsp. Total Amt Due DEEMED TO MODIF% 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 HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPAJ CATION APPRdVAC GIVEN 13 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. 1'�458PPII CALL LjonisnotapermItuntilsignodbythe t TK)N; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED I ff; full g 0111 or his/her Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION rec tizacknomModgedinspecoplovided. ti, WORKMENS COMPENSAlp"SUM AND RCW 18.27. SI ATURE DATE _ff SIGNAIWAF/tOWNER DATE SIGNED GENT) (425) W.D Iq 6 h& 1 7 3 771-0220 hip BY 0 Y 4 ATTENTION I MA 1 -11 4 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