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20030242.pdf0 DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS 15 MAILING ADDRESS CITY ZIP IeAe- � 4 NAME ADDRESS CITY TELEPHONE 411).Ar ZIP ITELEPHONE NAME jCBLN PERMIT EXPIRES .4 USE PERMIT ZONE NUMBER JOB ADDRESS/Z SUITE/APT# Iff zlr= �� - PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TIESCP Approved RW Permit Required street Use Perm" Raq*d EXISTING — PROPOSED Inspection Required 13 Sidewalk Required 13 REQUIRED DEDICATION— FT Underground wiring required 13 METER SIZE LINE SIZ OF FIXTURES PRV REQUIRED YES 13 NO 13 REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDR AINAGE I REVIEWED BY DATE &W 5^1 &1� FIRE REVIEWED BY DATE CITY ZIP TELEPHONE STATE LICENSE NUMBER EXPIRATION DATE CH KED BY VARIANCE OR CU SHORELINEORADB# INSPECTION BOND REO'D POSTED 12�='aj- L I 13YEs 13NO $ M 1�rz SEPA REVIEW SIGN AREA HEIGHT PROPE ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSE D AL LOWED PROPOSED EXP I , I NEW 0 RESIDENTIAL PLUMBING / mECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT.). PROPOSED SETBACKS (FT) FRONT SIDE REAR FRONT URSIDE REAR COMPLIANCE OR ADDITION COMMERCIAL 13 CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED 13Y DATE MULTIFAMILY REMODEL SIGN RECID I PROVIDED GRADING FENCE REPAIR CYDS X_FT) REMARKS 0 DEMOLISH TANK GARAGE RETAININGWALL F RE SPRINKLER CARPORT [3 ROCKERY FIRE ALARM C (TYPE OF USE, BuSINESS ACTNITY) LAft CHECKED BY OF CONSTRUCTION OCCUPANT R .4, 0==M ff'f2lg. jok�rj IV67 GROUP&7j 1:5-3 NUMBER NUMBER OF CRITICAL M OF DWELLING AREAS SPECIAL INSPECTION JAREA OCCUPANT# STORIE UNITS NUMBER REQUIRED [3 YES LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER USC 108/FINAL INSPECTION REO'D a2 2 VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE T_ GLAZING % LOT SLOPE % Building Permft_ City Surcharge PLAN CHECK UO. VESTED [ATE Ag R70 Plumbing Mechanical THIS PERMIT AUTHORLEES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 1= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 3 DOMAIN (CURSS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review pERMITAPPLICATION: 100DAYS 1116 PERMIT umir 1 YEAR - PROVIDED WORK 15 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 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection j 19P Receipt III 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 MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE C NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." 21 Recording Fee Receipt # TLO I HEREBY ACKNOWLEDGE THAT I H E READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT; AND THAT I A&THE OWNER. OR THE DULY AUTHORIZED AGENT OF THE 0 , COMPLY VIM CITY AND STATE LAWS REGULATING CONSTRUC- WNER. al AGREE TO CALL This application Is not a permit until signed by the Building his/her Deputy: and Fees are paid, and NDI TIAE W IJORIZED THEREBY NO PERSON WILL BE EMPLOYED TION; G WORK A IN VIOLATIC/ TH R OF THE STATE OF WASHINGTON RELATING TO C 11410 _QjLCIaI or FOR INSPECTION /Yfftsot is acknowledged In space , E INS; NCE AND RCW 18.27. WORKMEN-? PE OFF S17TURE 0 E WNGORKf SIGNATUR E AG DATE SIGNED 1211035) _.1_1 IP- zo 771-0220 to, -kt DATE D ATTEN N M 1333 7 CI 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 MINE FINAI. PRn.TFC.T APPRnVAT. FnRM a 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Signature I:temp:bldg:fomis:ocaprvl 3/25/04 z 9 0 m :; 9 3: m m 0 —10 0 m m z 10 cl) 0 -n n m m a 0 0 M co co) M 0 Z X z --I 3: vi z 9 0 m 7,-, DATE RECEIVED q4m�'x Ail� 7--- PERMITEXPIRES tl CITY OF EDMONDS 01 USE PERMIT ZONE Zaz COM tq4!:!, NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUTWAPT# ADDRESS OWNER NAMEINAME OF BUSINESS A"� Aahzxlh'114�p PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS I LID FEE $ TESCP Approved RIGHT OF WAY PUBLIC PER OFFICIAL STREET MAP RW Permit Required CITY ZIP TELEPHONE Street Use Permit RoWd EXISTING __ PROPOSED inspection Req&ed sidewalk RaWked REQUIRED DEDICATION- FT UndetWound Ming required 13 NAME METER SIZE LINE SIZE FN0, OF FIXTURES PRV REQUIRED I YES0 NO 13 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE CITY ZIP ITELEPHONE REVIEWED BY DATE ADDRESS 67X 16 Jim F1 E FIRE REVIEWED BY R V' W' DATE CITY ZIP TELEPHONE C__ rL Awd O�5--?2 e-62641 /`7? CV rERE _C_bW_jh5 VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND V PI STATE LICENSE NUMBER EXPIRATION DATE C�FKED 13Y REO'D POSTED 113YEs L-L, 13NO SEPA REVIEW SIGN AREA HEIGHT tPROPE WCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EX P , NEW 13 RESIDENTIAL PLUMBING MECH LOT COVERAGE REQUIRED SET13ACKS (Fr.) PROPOSED SETBACKS (FT.) FRONT REAR. ALLOWED PROPOSED FRONT SIDE REAR LIR SIDE - ADDITION 1:1 COMMERCIAL COMPLIANCE OR 0 CHANGE OF USE 0 REMODEL 13 MULTIFAMILY 0 SIGN PARKING RECID I PROVIDED LOT AREA PLANNING REVIEWED BY DATE' 1:1 REPAIR I [:] GRADING FENCE [3 CYDS X_FT) REMARKS DEMOLISH [3 TANK oGARAGE RETAININGWALL 0- 0 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM OWE OF USE. BUSINESS OR ACTIV" EXPI Alhk CHECKED BY jr<U CONSTRL C a- OCCUPANT ICTION IV67 I... q02 ji GROUFj?I 1:5,dr, SA44 NUMBER NUMBER OF CRITICAL _7 f — OF DWELLING AREAS SPECIAL INSPECTION JAREA OCCUPANTf LOAD UNITS NUMBER REQUIRED [] YES DESCRIBE WORK TO BE DONE REMARKS 1 rl or, �O/ V, E:: �r PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTIO14,,REGI) F V ATION ALUI $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE _F6 LAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECW VESTED DATE Plumbing Mechanical THIS PERMITALITHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading X DOMAIN (C URN. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPUCATIOW.180 DAYS J`P: PERMIT LIMM I YEAR - PROVIDED WORK 18 STARTEID WITHIN 180PAYS Engr. Inspection BEE 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 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 Landscapalnsp. Total Amt. Due DEEMED To MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE C1TYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Recording Fee Receipt # LIMA *E RM THIS APPLICATION; THAT THE INFOR I HERF13Y ACKNOWLEDGE g:T I MATION APPLICATIONAIMPFIOVAL GIVEN IS CORRECT, AND THE OWNER. OR THE DULY AUTHORIZED AGENT OF THE OWNER jI AGREE TO CO M WITH CITY AND STATE LAWS REGULATING CONSTRUC- , CALL, This application Is not a permit until signed t4e " TION;�AJND N E OFILZED THEREBY, NO PERSON WILL BE EMPLOYED T TH OF THE STATE OF WASHINGTON RELATING TO IN V10 I G ;LA R r Alp jRKfZ Sulicung cial or hWMr Deputy ;an d Fees are &d- land ec I Is tiodgealrispacip1byjdad. FOR INSPECTION ac" Twun EN EX 0 IN CE AND RCW 18.27. SIGNATUR E AG NT) DA�SIGNED IA95) QFfSrATUf# r> 771-0220 - ALT DATE TTE A ATTE96N Off 13 33 1 q I d IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL Q3 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