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20030217.pdfDATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS Rte.harof 6ur-ri-jaL MAILING ADDRESS -2- �-I- 10 -ViV 4,&e- We4q- ZIP ITELEPHONE NAME ADDRESS CITY ZIP /0111) 1 1 PERMIT EXPIRES 6= USE ZONE PERMIT NUMBERUb3--a4;) JOB ADDRESS -7 La SUITE/APT# Z 3 2- (?- 4/, PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW PerrNt Required Street We Permd RKd EXISTING PROPOSED Inspbetio" RequIred Sidevratic Required .EQUIRED.DEDICAT-ION— _R FT underground Wiring required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I I YES 13 NO 13 REMARKS OWNERMONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE a z NAME CBL AFFIDAVID swo-o. arp ENGINEERING REVIEWEbtA DATE ADDRESS BE ACCEKED 15333 19*Awe A4g_.--VW FIRE REVIEWED BY DATE W CITY ZIP TELEPHONE cc 5;e&**- 793 -q 1$,, M VARIANCE OR CU SHORELINEORADE111 I INSPECTION BOND 'LICENSE NUMBER EXPIFIANION DAT;Ef REQ'D POSTED [3YEs 13NO $ Witt e- 3 7-J V% I I SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCO PAMM.NO. COMPLETE , EXEMPT I ALLOWED , PROPOSED I ALLOWED , PROPOSED pf 001 01 NEW ErRESIDENTIAL arp—LUMBING / MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY SIGN 1:3 REPAIR E] GRADING CYDS FENCE x FT) DEMOLISH 0 TANK OTHER GARAGE CARPORT -1 RETAINING WALL 11 FIRE SPRINKLER ROCKERY FIREALARM ITYPIE OF USE, BUSINESS 0111"AWNMEXPLAIN: NUMBER' CREMOAL OF A AS SMAIES UNITS, NUMBER DESORME WORK TO BE-00NE 35, pop 6v-tA :1&5 " f , 0 Alt 5 4WWW'sr— zxftt� HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 160DAYS PERMIT LIMM 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 ISS UANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* I HEREBY 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 lay IZED THEREBY, NO PERSON WILL HE EMPLOYED IN VIOLATION OF THE MCCODNEE THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSA��URAN� AND RCW 18.27. SIGNATURE (OWNSR O&GENTI DATE SIGNED �f I S/W 1103 LOT COVERAG QUIRED SETBACKS (FT.) I PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR I FRONT URSIDE REAR PARKIN LOT AREA PLAN DATE IPJVIIW 11 E40P � vent nneetnry CHECKED BY SPECIAL INSPECTION JAREA IF REQUIRED [] YES REMARKS PROGRESS INSPECT11IONS PER UBC VALUATION Description Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Fire Inspection Landscape Insp. Recording Fee FEE tv LOAD I INSPECTION REO'D Description FEE State Surcharge City Surcharge Plan Chk. Deposit Receipt # Total Amt. Due Receipt # APPLICATION APPROVAL This appli on Is ot a rmit until signed by the ,3, or Dr 1h?rK-,C-h pu Ing Ofi �11 ty:ppd Fees are paid, and 0, I recel loac owledged1nitoace provided. :IAI q AIMAJAUG4 11 17 1 DATE A HASED &-Or F DATE ' ATTENTION Off 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL T 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 CALL FOR INSPECTION (425) 771-0220 i z 0 4 0 M =i5i 65 � a M C M 0 —40 0 ITI rn IC) � z 0 n rn M a 6i 0 0 Fn z z 0 q 0 ITI m W CITY OF EDMONDS f I CONSTRUCTION PERMIT APPLICATION OWNER NAMEMIAME OF BUSINESS Ri r_6ad rr tA r -r MAILING ADDRESS -7 q —=j-TfiLEPflONE_ -7-1 d, q4 `71— NAME W CITY .,-Zip ITE&PONE LPERMITEXPIRES USE PERMIT ZONE NUMBER JOB ADDRESS 32-19 -7La SUITE/APT# Alf A PLAT NAME/SUBDIVISION N577 LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP AP MY P@frrAtP1=1&d Streel d EXISTING PROPOSED InspecUon Roq#!� 13 13, Wringfoquired 0 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES C] NO 13 REMARKS z OWNERICONTRACTOR RESPqN j1B,LE,,F.CR.Me QO.UTROLJDRAINAGE 1 M U4 5. DC "11:4 NAME --ICBL.# L411?p nr onvr Anow :5 I BOB ENGINEERING REVIEWEV& 11"11110Wbol DATE ADDRESS 5313 CITY ZIP TELEPHONE FIRE REVIEWED BY DATE Uj cc g?L vo 763 115 1 STATE LICENSE NUMBER EXPIRATION DAT CHECKED By VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND H J413 2-) VVI oil REO'D nA- YES ONO 'POSTED $ SEPA REVIEW COMPLETE EXEMPT HT PROPOSED PPMEAW'TAX.-'�ACCOUNT'PARCEtTO.� t 003 001 I EXP NEW . �RESIDENTIAL [BOILUMBING MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR ADDrriON COMMERCIAL o COMPLIANCE OR CHANGE OF USE PARKIV L LOT I REMODEL MULTIFAMILY SIGN , D P VGV IL AREA vent PLANNING REVIEWED BY DATE nnectors REPAIR GRADING CYDS FENCE 1:1 -A A- —1 r__ P IIR "Fly ( X FT) E �s DEMOLISH 1:3 TANK OTHER U Wea filffi= i wC 81 S I!, GARAGE rl RETAININGWALL FIRE SPRINKLER L4..ROCJ(ERY_:1 (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: 4 CHECKED BY ITYP F-C r"Tob co�� occu GROU cnffubi R:5 UMBER 'OF NUMBER OF CRrrwAL STORIES DWELLING UNITS' AREA! I NUMB SPECIAL INSPECT16N AREA OCCUPANT REQUIRED [] YES LOAD DESCRIBE W0RKTq,BqPqNE- - REMARKS PROGRESS INSPECTIONS PER UBC 64A 1108/FINAL INSPECTION REG'D ed 5 R V (4 ,a /Zow, A24a 4�ggii VALUATION en eA, -7-7, Dikirlptibin c&A Plan Check HEAT SOURCE GL40NG % LOT SLOPE % I Building Permit PLAN CHECK NO: VESTED DATE Plumbing THIS PERMIT AUTHORIMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Mechanical BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC Grading 11!� Tq-) WILL REQUIRE PERMIT APPILICATION: 1150 DAYS Engr,'Review PERMIT ILIMM I YEAR - PROVIDED WORK 18 STARTED MTHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORO INFORMATION -APPILICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF NDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE. ARISING DIRECTLY OR INDIRECTLY Fire Inspection FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIYSHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. NOR UMrF IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Recording Fee I HEREBY 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 CRY AND STATE LAWS REGULATING CONSTRUC- 'AMT*IZED CALL 7ION; AND IN DOING THE WO THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE R CODE THE STATE OF WASHINGTON RELATING TO FOR INSPECTION WORKMENS COMPENSA�I[NVRANC AND RCW 10.27. SIGNATURE (OWN OR GENT) DATE SIGNED 1A 03 16 We-5) ?4--kf 103 771-0220 Deibilptlon'�' FEE State Surcharge City Surcharge Plan Chk. Deposit Receipt # Total Amt. Due ev 1 W-_ 1 Receipt # �R APPLICATION APP*RVAL TWs applicatI6411i'not a permit until signed by the 9 Offlor hisoer Dopuly: d Fees are paid. and I 'ecelpt ac"Iedged Inrpca provided. ;"P(E�l I;' _-:1 i DATE ,IALS SIG :AUED BY--' I DATE ' ATTENTION Off 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 ORIGINAL - FILE YELLOW - INSPECTOR PINK - OWNER GOLD - ASSESSOR 04102 PR;:q-q wARn . vni I ARF mwamrz -r% r-iripwQ GREEN ACCOUNTING t z 0 m =i:% 7W � am C MC) 0 0 0 C 3� C m m z co 0 -n ffl m a 7W 0 0 Fn C 0) K V) ITI 0 z if C11) z 0 1 0 m