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20030213.pdfI DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSIN%SS CITY Z IP T�LEPH ONE NAME 67LI&W A� J ADDRESS 0!��z -0- 0,7 k-W k!g CITY I ZIP I TELEPHONE NAME . I CBL ADP��. ZIP I TELEPHONE LICENSE NUMBER --117 "2— 0 PERMIT EXPIRES 6SE ZONE PERMIT 5 -_ NUMBER "Vio JOB Th ITE/APT# ADDRESS___ —,q A v e— .1su PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Ap MY Pennit"1101".dw Street Use Permit Req'd EXISTING - PROPOSED- Inspection Required 11 SkIrroralkRtretuired 13 REQUIRED DEDICATION- Fr Underground wiring required 13 METER SIZE LINE SIZE OF FIXTURES PRV REQUIRED �NO.. NO 13 r..j ECDC fffff3 REMARKS OWNERICONT E qvnqm IfeAu QT-TA1 -1 � RH INNAFLILA,112111,11 111�11E% 11 ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE W VARIANCE BOND ORcu A10YJRW8hMW&MPF POSTED PROPERTY TAX PARCEL NO. SEPA REVI COMPLETE E%0EkM09"WJWRMRWHPROPOSED T !&COUNT NEW RESIDENTIAL PLUMBING / MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) FRONT SIDE REAR FRONT URSIDE REAR .,,XQ I COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE z REMODEL MULTIFAMILY SIGN PARKING REO'D PROVIDED VCM-MATE IRMEQ TO HAVE A REPAIR GRADING FENCE P4 w '&FP"" .yr,S x FT) REMARKS "IT -SIPHON DEVIM M=jrjcjgI) DEMOLISH [3 TANK 0 OTHER GARAGE -1 RETAINING WALL FIRE SPRINKLER 1:1 FIRE ALARM CARPORT ROCKERY (174YPOF USE, BUSINESS OR ACTIVrM EXPLAIN: CHECKED By 17yp=ION OCCUPANT CM GROUP NUMBER 4UMBER OF CRITICAL OF DWELLING AREAS SPECIAL INSPECTION JAREA OCCUPANT STORIES UNITS NUMBER REQUIRED [] YES LOAD DESCRIBF,t(PflKTO Vj0QNE L U0 REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D we"J VALUATION Description FEE Description FEE Plan Check State Surcharge Aw!TFICE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORRES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 1= BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC 23 Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: ISO DAYS n PERMIT LIMM 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICAK 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 91 DEEMED OF ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT 0 NOR LIMIT IN ANY WAY THE CITY% ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - Recording Fee Receipt # I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORREC"P, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CRY 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 histher Deputy: and Foos are paid, and IN VIOLATIONPF-JUJE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged in space provided. I�ORKMEN*S POYPENOtTION INSURANCE AND RCW 16.27. OFFICI!,La SI NANU DATE SI G^ DATE [GNED 00% 0 771-0220 RELEASED BY DjTE EXT 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 -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 z 0 0 am a M a 0 r m m Z 5) 03 m m o Rn 0 z m FINAL PROJECT APPROVAL F01M z 0 m =i :_n v i ---ri am c Ma 0 80 c -4 r. MM M4 z o"n n m m 06 0 r. 0 M M 0 Z r- z --I 3: ra z 9 0 m RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Signature I:temp:bldg:forms:ocaprvl 3/25/04 I V RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINqS AW f, d-7 .1 [�- f-f I �� - I V2 CITY ZIP ITELEPHONE ---AN . -Af�- vau w NAME — ADDRESS I 6> �?� iffl CITY ZIP ITELEPHONE NAME 0 ZIP I TELEPHONE STATE LICENSE NUMBER I ;r- tcrx-, �imur IRQPERTY'rAx Ar.COUNT PARCEL NO. NEW RESIDENTIAL ADDITION COMMERCIAL 0'REMODIEL. 0 MULMFAMILY REFWR GRADING CYDS 0 DEMOLISH 0 TANK [3GARAdE CARPORT o RETAINING WALL ROCKERY (TYPE OF USE, BUSINESS OR ACTIV" EXPLAIN: NUMBER NUMBER OF OF DWELLING LTORIES UNITS DESCRIBE WORK TO BE DONE aptz- ?&AAA PERMIT EXPIRES ZONE PERMIT ) 5 _ NUMBER _100 JOB ADDRESS e NSUITE/APT# -qi-h jqV _ PLAT NAME/SUBDIVISION NO. T NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Tt3ur Appro-d RW Perrntt Requited EXISTING PROPOSED — street Use Permit ROQV inspection RetiLked j TO EC .30.020 REOU RVO smo""Re'"d Uncis� "g requirw 13 METER S LflF9SyRST-keftffVM SWA7 RV REQUIRED IsfunCIFF YES13 NO 13 REMARKS OWNER/CON' 1ROSION CONTROL/DRAINAGE Alk An liou "�r;pkluTEU ENC31NEERING .PAW M tft. M3.1 DATE AWATO SWIM SHMPP FIRE RM 1315 "W"MM t'WM DATE rL VARIANCE OR CU SHORELINEORADBO I INSPECTION 1$ BOND Y REO'D POSTED [3YEs ONO SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED , PROPOSED_ EXP I I PLUMBING / MECH LOT COVERAGE REQUIRED SETBA QQSED SETBACKS (Fr.) UR SIDE REAR ALLOWEDgj=%M4S COMPLIANCE OR An Rgou=ID To HAVE �r- A CHANGE OF USE — SIGN PARKING PM 1010��D BY DATE REO'D I 110N DEKWE 1N9VJ1y-D- FENCE X FT) REMARKS OTHER F RE SPRINKLER FIRE ALARM CHECKED BY ITYPE MECOWRIOCTION E OCCUPANTe GROUP 11M CRITICAL - AREAS SPECIAL INSPECTION OCCUPANT NUMBER JAREA REQUIRED 11 YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1 08/FINAL INSPECTION REa $ I Description FEE Description FEE )IE&T SOURCE GLAZING % LOT SLOPE % Plan Check State Surcharge Building Permit 40 City Surcharge 5- PLAN CHECK NO: VESTED 13ATE Plumbing Mechanical THIS PERMIT AUTHORIZIES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 1= BE DONE ON PRIVATE PROPIEFITY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading 2 3 DOMAIN (CUPM, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISMON. Engr. Review PERMIT APPLICATION: 180DAY8 IL PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION I '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 a EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND Fire Inspection Receipt # IALL CLAIMS FOR DAMAGES OF WHATEVER MATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE 9 DEEMED TO OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due MODIFY, WAIVE 2 NOR LIMIT IN ANY WAY THE CnYS ABILITY TO ENFORCE ANY ORDINA14CE PROVISION.- 1 ' Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFOAMATION APPLICATION AP PROVAL 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 penrit unUi signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and IN VIOLATION QP-TH LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION recolpt Is acknowledged In space provided. E�N ' EN TION INSUR ANCE AND RCW 18.27. WORKM S� 1A9 OFFICIaS SIJ3NATUPE DATE . SIG T DATE JIGNED 11425 IMACIPq (24 16) '��=j 771-0220 -RELEASED BY Off 1333 �ff IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLON- INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS H.,�RD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING