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20030246.pdfPERMITEXPIRES DATE RECEIVED 0 '�) �] SE PERMIT ZX3. ZONE _ CITY OF EDMONDS NUMBER JOB SUITE/AK# CONSTRUCTION PERMIT APPLICATION ADDRE OWNER NAMEINAME OF BUSINESS ss 21 k Iq -- jq�� 4Fqo HOLrLA PLAT NAMEISUBDIVISION NO. LOT NO. L�D NO. MAILING L D FEE S ADDRESS TESCP AVINOVed PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Pernift 'loquired 19c)-y'154 ST Street Use Permn Roq'd CITY EXISTING — PROPOSED Inspocilo Required ZIP TELEPHONE Sidswalk'n1squifed Underormw I 7f REQUIRED DEDICATION— FT Wiring requoUt 13 rid ��j �X NAME METER Sr__ OF 0 IRED �G+�N;;Iz - 'u' Q 0 f Oger fffe Mau rYqW M o IC33 Ol' AOSS R Ul %A ADDRESS WNER/C jqEFffMLlhEflR*%MpNtATft$ffAINAGE ty Code. ECDC 19.30.020(c) CITY ZIP ITELEPHONE CiVel cc NAME L�-Sco ADDRESS tb� r) rALA�1, CITY-% 46flc�' 9 Z'PI I STATE LICENSE NUMBER ncgla,2 PROPERTY TAX ACCOUNT PARCEL NO. CBL#Vej I I I'VELEPHONE I&IJ EXPIRATION DATE on �2 �� I ENGINEERING REVIEWE"S PIPE TEST MUST FIRE REVIEWED IN AFFIDAVITS SHALL 0 VARIANCE OR cu SHORES14a I AWTION BOND REO'D POSTED I r[33,YoEs 13NOIS HEIGHT SEPA REVIEW SIGN AREA COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED I W cc IC EXP , , I LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) NEW RESIDENTIAL PLUMBING/MECH ALLOW lifie I sial! _""" OR ! DE REAR 00 ADDITION 11 COMMERCIAL COMPLIANCE OR CHANGE OF USE Ob �Iectrical Peri�it bm PA K;1"7L Dfi rE E REMODEL MULTIFAMILY SIGN RECYO 0 REPAIR FENCE GRADING X CYDS FT) REMARKS 1:1 DEMOLISH TANK OTHER [3 GARAGE CARPORT FIETAININGWALL FIRE SPRINKLER 0 ROCKERY F1RE ALARM (ME OF USE, BUSINESg OR ACTIVTM EXPLAIN: CHECKED BY OCCUPPAW(3 R aa,_ GROU ITYP=)118 IC?V NUMBER OF NUMBER OF DWELLING RITICAL AREAS Kfr SPECIAL INSPECTION AREA OCCUPANT STORIES U NITS NUMBER QUIRED [] YES LOAD DESCRIBE WORK TO BE DONE REM KS PROj!M!!MEGTION6_RE_R UBC IGO/FIIJA INSPECTI REG-D. z 9 10 1 776e H or It, (ZT1Ujj1;%A'L1- - - - I i P__ 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: IGO 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 CI1YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECP 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 COMPENSAT!q,?01Vj09,ANCE AND RCW 18.27. S�lr.N�MTURE, IZ��) �ENI) -63 DATE SIGNED ol-9 .7 Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge 5. Plumbing 3e Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscape Insp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION (425) 771-0220 APPLICATION APPNOVAL This application is not a permit until signed by the Building Olficial or histher Deputy: and Fees are paid, and receipt Is acknowledged In space provided. OFFICIALS SIGNATLARr 410Y R E L E A S E'_D' /DATV ATTENTION LA 1 1 jjj 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 DATE RECEIVED PERMITEXPIRES USE PERMIT �00,3_ CITY OF EDMONDS ZONE NUMBER JOB SUITE/APT# CONSTRUCTION PERMIT APPLICATION ADDRESS 2-q t OWNER NAME/NAME OF BUSINESS � �j HOL t pLAT NAME/SUBDIVISION NO, I LOT NO. LID NO. MAILING ADDRESS !F1 LID FEE $ CITY .;el (_ id — NAME ADDRESS CITY NAME ADDRESS ZIP TELE HONE i 9( A;)d -17��- 176 ZIP ITELEPHONE CIT)r ) Z�Nv&'d I c)i0j 9 STATE LICENSE NUMBER :11I PROPERTY TAX ACCOUNT PARCEL NO. NEW RESIDENTIAL ADDITION COMMERCIAL REMODEL MULTIFAMILY REPAIR GRADING CYDS 0 DEMOLISH [3 TANK EGARAGE 3 [3 RETAINING WALL CARPORT ROCKERY (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: NUMSE_ R NUMBER OF OF DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE P 1pr 4--r i I. "UNI Tkziur Appro"d PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required Street Use Permit Raqd EXISTING — PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION— FT Undergrourid �4hthet the water NO 13 z REMAR I OWNEjGJ§NfMR%SAH� Aplaiglol"MON&GI I I rmnotwaff nn an nni Water tanka Lnu I I ENGINEERING REVIEVNJ PIPE TEST MUST E FIRE R_ AMDAWM SM NOT VARIANCE OR CU sHaR[§Ip MW 'JIVION BOND aD POSTED 1$ SIGN AREA SEPA REVIEW pn� HEIGHT COMPLETE . EXEMPT ALLOWED PRO qF:n ALLOWED , PROPOSED1 PIPLUMBING / MECH ALLO COMPLIANCE OR 13 CHANGE OF USE R1 SIGN REO`O FENCE X FT) REMARKS OTHER FIRE SPRINKLER FIRE ALARM CRITICAL AREAS NUMBER HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONIX ANY CONSTRUCTION ON THE PUBLJC DOMAIN (CURDS, SIDEWALKS, DRMVAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMITAPPLICATION: ISO DAYS PERMIT U84M I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION -APPLIqANT. 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 ANYWAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION GIVEN 18 CORRECT6 AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF n cc — --tv - MY Akin STATE I AWS REGULATING CONSTRUC- CHECKED BY SPECIAL INSPE REQUIRED REMARKS PROGRESS Description Plan Check Building Permit Plumbin g Mechanical Grading Engr. Review Engr. Inspection AREA FEE REVIEWED BY (S (FF.) REAR z 06 OCCUPAW3 GROUP OCCUPANT LOAD INSPECTION RE1170 Descriptiolit, FEE State Surcharge City Surcharge �15, - Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp- Total Amt. Due Recording Fee Receipt # APPLICATION APP11OVAL This application Is not a permit until signed by the 1"Gwnn.". I A n ILPALL Building Official or his/her Deputy: and Fees are paid. and 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 FOR INSPECTION receipt Is acknowledged In space provided. WORKMEN'S COMPENSATI DATF . 9,0p"NCE AND RCW 18.27. S=IGNATURE N qENT) I DATE SIGNED OFFICIALS S17T (425) - 4 A ` 7, ZZ - / I L_-_-, — 11DATK �771-0220 RELEASED BY MENTION 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- 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 9 0 ITI OM M 0 0C M Irn 0 _n M M M 006 C 0) M 0 z V) z 9 0 M