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20030226.pdfI DATE RECEIVED �& - 41 7///�q �� [PERMIT EXPIRES U 7; OF EDMONDS Z CONSTRUC ION PERMIT APPLICATION i A OWNER NAMEINAME OF BU NESS D'�- S M el,- IV AD 1L1,67/:,1_7 15 MAILING ADDRESS 71,6- 6UX4 al!9- CITY ZIP E Uln.c� NAME E ADDRESS CITY TELEPHONE CBLO CC 0 ADORE 7,d CITY ZIP TEI -PHONE -7 Z42a2 STATE LICENSE NUMBER EXPIRATION DATE I CHECKED BY PARCEL NO. PRR�OACCOUNT NEW R 12( ESIDENTIAL PLUMBINGIMECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL 0 MULTIFAMILY 'SIGN REPAIR FENCE GRADING CYDS _$ ( t X ill FT) DEMOLISH TANK 1:1 OTHER L1GARAGE RETAINING WALL o F:RE SPRINKLER F RE ALARM _31 CARPORT ROCKERY (TYPE OF SINESS 3R ACTIVITY) EXPLAIN: ec NUMBER NUMBER OF CRITICOW OF STORIES DWELLING UNITS z AREAS NUMBERq7 7 DESCRIBE WORK TO BE DONE _/x 1�- r (7 - al HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: VESTED DATE THIS PERMrT AUTHORM 6 ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 1E DONE ON PRIVAT"PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC DOMAIN (CURBS, 61 )EWALKS, DRIVEWAYS, MARQUEES, E TC.) WILL REQUIRE SEPARATE PERMISSION. 3ERMIT APPLICATION: 180 DAYS IL PERMIT LIMM I YIEJ R - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK )F PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS IN INTEREST, AGREES T ) INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGI S OF WHATEVER NATURE, APJSING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE 0: THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WA VE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 NOR LIMIT IN ANY WAY 7 AE CnYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - I HEREBY ACKNOWLEDGE T IIAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION GIVEN IS CORRECT; AND T iAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO C OMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- TION; AND IN DOING THE M ORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. Sir= DATE SIGNED w 'd a 1;2�= 0—? I x SE PERMIT ONE NUMBER C& OB SUITE/APT# DDRESS PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP IESCP Approved RW ParrrJt R Street U., P:qu:,red nn Raq'd EXISTING PROPOSED Inerpection Required 13 Sidewalk Required 13 REQUIRED DEDICATION- FT Underground wiring required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES E3 NO 13 REMARKS z z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE NGINEERING REVIEWED BY DATE IRE REVIEWED BY DATE UJI M rL VARIANCE OR CU SHORELINE Oil ADB11 INSPECTION BOND REO'D I POSTED I OYES UNO $ SEPA REVIEW SIGN AREA HEIGHT ,OMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED LP_ I I I LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ILLOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE REAR z LOT BY DATE PARKING IECYD I PROVIDED I AREA I PLANNING REVIEWED IL IEMARKS ;HECKED BY TYPE OF CONSTRUCTION CgRg, OCCUPANT GROUP ]rro�1-4�-4 'PECIAL INSPECTION JAREA OCCUPANT 1EQUIRED [] YES LOAD EMARKS IROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D 9 2 I; I Description FEE Description FEE 21an Check State Surcharge 3uilding Permit City Surcharge 3lumbing Vechanical 3rading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # o�11-11 7 Landscapelnsp. Total Amt. Due Recording Fee I Receipt # CALL FOR INSPECTION (425) 771-0220 A ICATION APPROVAL Th pplic Ion Is note permit until signed by the B g Ificial r his/her Deputy: and Fees are paid, and r acknowledged In spa ;ftfilcpilt ,". Ao provided. 0 IALS _VATY? I I A 011JIWIJ`I�� DAT ATTENTION I/ EXT 133 MaW IT IS UNLAWFUL TO U�E OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW -'1`NSP7TO CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING :31VO 03AO8ddV AN 83NAjiO SS3bClCjV X80M .LN3WJL8Vd3CI ONimine SGNOVYCI3 :10 �UIO )7 Adoa ALLID I �� N � <�-� %C .9vits NOUVA3,G CIO Jol .Wbbr:NOLLYA313 NIVH WMA01 .GVf=:NOLLVATM S JONG 9AL".LOIW.LOI la vwi= MY MON 9"Yawy VoWd2V2AO')HM .14,bs ooret V-"v . .LllWOIF=F 09 - art Md"WfiWI)'Ir9,Oft Mai la4uo2 UO"Ma ftw ad "WOM" maw4wm S. ftc *"G -Wdsama t "d Rftw sumw wa Jed WOPFGUUMB f" Poring 'Id3a ONIcnine E5!n'7 h Z 8VW c I. -El, A I B. 3 1- 1 3,mm as�ovdlmww tan 0-1- jrrr ajo,'JA ONIUMNION-31 AS IION SV 03AOUddV 9 - kNAL PROJECT APPROVAL FORM 0 M 2. 1 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date si ocaprvl.doc.l:temp:bldg:formslO/01 z 0 m =i 9 55 � am c ma 0 80 a -4 r. MM MZ 10--i cm 0 -n ,n m M a 0 0 M C 0 c 0) M 0 Z X z z 0 m M CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS MAILING ADDRESS 11T�Y�� ZIP ITELEPHONE NAME ADDRESS CITY 147 ADDRESS CITY STATE LICENSE NUMBER ZIP ITELEPHONE ZIP I TELEPHONE ACCOUNT PARCEL NO. NEW -"ZX RESIDENTIAL �0� ADDITION C REMODEL MULTIFAMILY REPAIR GRADING CYDS DEMOLISH TANK GARAGE RETAINNGWALL 0 CARPORT ROCKERY UWE OF USEAUSINESS OR ACTIVITY) EXPE A NUMBER NUMBER OF". OF DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE CBL N �,v ;:? I �7Nr_101`1 PERMIT EXPIRES .441L- �/C-- USE ZONE PERMIT NUMBER JOB SUITE/APT# V ADDRESS PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP MCI Appm-d RW .r. 1'.'ked Street Uga Permit RWd EXISTING PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION— FT Underground Wiringrequired 13 METER SIZE, LINE SIZE NO, OF FIXTURES PRV REQUIRED I I YES13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE 0- RLL- %�o -g— :V1, tj Py k., I tj C,�7r ( 00 0x)04_:3^%j1:;rr% Ac-. k1frTl[:_.1n /-)Kl 191 4ti ENGINEERING REVIEWED BY -1- K A (- /, A I . A—, 1 45, FIRE REVIEWED BY DATE 1 1011 VARIANCE OR CU SHORELIINEORADB# I INSF12E [ON BOND JE(7 CHECKED BY 30 POSTED I SEPA REVIEW IGN AREA DYES; ONO is HEIGHT COMPLETE . EXEMPT ALLOWED , PROPOSED I ALLOWED , PROPOSED PLUMBING/MECH LOT COVERAGE REQUIRED SETBACKS (FT.) REAR PROPOSED SETBACKS (Fr.) FRONT L/RSIDE REAR ALLOWED PROPOSED FRONT SIDE 1 COMPLIANCE OR 0 CHANGE OF USE 4 PARKING LOT Al 1EA PLANNING REVIEWED BY DATE SIGN REO'D PROVIDED $ FENCE .(-x 117FT) I REMARKS jFr) o OTHER FIRE SPRINKLER FIREALARM CHECKED BY ]TYPE OF CONI RUCTION 172 OCCUPANT GROUP �9 V. A�---Lov P702 191�5_ CRITICAW_Iff,V f - AREAS SPECIAL INSPECTION JAREA OCCUPANT — NUMBERq7 J(,,f 2 REQUIRED 0 YES I LOAD 1 11) r 4c 11r- v'Z-< 11C_ I REMARKS PROGRESS INSPECTIO�j PER UBC I 08/11FINAL INSPECTION REQ'D Alk Ask= minexismes lia $ Description A =_E Description FEE Plan Check S Surcharge HEAT SOURCE T—GLAZING % LOT SLOPE % Building Permit City Surcharge Plumbing PLAN CHECK NO: VESTED DATE Mechanical �2 T Y THE WORK NOTED. THIS PERMIT COVERS WORK TO PERMIT AUTHORIZES OHL _,"IS BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC Grading DOMAIN (CURSS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Engr. Review SEPARATE PERMISSION. PERMIT APPUCATION. 180 DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION Fire Review Plan Chk. Deposit 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Inspection Receipt # 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 BE FROM THE ISSUANCE OF THIS PERMrr. ISSUANCE OF THIS PERMIT SHALL NOT Landscapelnsp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR Llkliiff IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,' 1 Recording Fee Receipt III 1 HEREBY A�KNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION A ATION APPROVAL Fp4c 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- ThIlApplIc" n Is not a permit unfit signed by the '1 CALL 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 Bu 0 clal r his/her Deputy: and Fees are paid, and FOR INSPECTION 7.7 r 1ptl acknowledged Inspe5a provided. WORKMEN'S S "MP NSATION INSURANCE AND RCW 18.27. Of IALS G -DATE (425) 11 SIGNATUR((OWNEJOR AGE DATE SIGNED 771-0220 'RE DATV ATTENTION / y t:A 1. 1;j 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 - INqP MR 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 4 0 M =i:%