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20030249.pdfIDATE RECEIVED (4� ()3 PERMIT EXPIRES iii: MMUMMWAMMCMM USE PERMIT CITY OF EDMONDS ZONE NUMBERV3 JOB # CONSTRUCTION PERMIT APPLICATION ADDRESS z ST— nic , I OWNER NAME/NAME OF BUSINESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. I I 22A L-; CA UJ E-0 LCJ2 Fag MAILIN14—ADDRESS c9 / 7 f cf,!s� L-e uj, CITY ZIP TELEPHONE kfArill d AeJ 3 k)asL9AM I NAME ADDRESS CITY LID FEE $ Ttsur Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required Street Use Permit Rsq'd EXISTING — PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION— FT Underground Wiring required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I I YES13 NO C3 - — REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE GAS Pin TF.RTme-Ir Dc -- NAME CBL N AFFIDAVITS r ENGINEERING REVIEWE DATE HE RUM ADDRESS FIRE REVIEWED'BY DATE lr CITY Z19 EPHONE r VARIANCE OR cu SHORELINIEORADBN INSPECTION BOND S E NUMBER EXPIRATION DATE CHECKED BY REO'D POSTED I I 1$ 13YEs 13NO SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. /7 COMPLETE XEMPT ALLOWED , PROPOSED ALLOWED , PROPOSED I X6, EXP — IDENTIAL PLUMWNtf?M%%E=CH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REAR COMPLIANCE OR ADDITION COMMERCIAL 0 CHANGE OF USE z REMODEL MULTIFAMILY 0 SIGN PARKING—— I LOT AREA PLANNING REVIEWED BY DATE REO`1 REPAIR 0 GRADING FENCE CYDS X FT) 'L�a 13 LF I All 0ANnPPtA- REWRgS7 0 DEMOLISH TANK OTHER II=iyIw-Pd nn filel-hyart)iIngappunum unitested sp UMI C 815.1.7 0 GARAGE RETAINING WALL 0 FIRE SPRINKLER I CARPORT ROCKERY FIRE ALARM a - I (TYPE OF USE, BUSINE" ACTIVTM EXPLAIN- M- CHECKED BY NSTRQCTjON OCCUPA 107z ITYPE G ) NUMBER NUMBER OF CRITICAL OF DWELLING AREAS SPECIAL INSPECTION OCCUPANT LOAD UNITS NUMBER JAREA REQUIRED [] YES DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC I 06/FINAL INSPECTION REG-D 47 umek ou VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % I Building Permit city Surcharge 111f 0 A iZ PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 2 3 DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. - Engr. Review PERMIT APPUCATION: ISO DAYS L PERMIT UUM I WAR - PROVIDED WORK 18 STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION T N BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS ANPIPITEARNEWAGREES Fire Review Plan Chk, Deposit ;L'C 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 Landscapelnsp. Total Amt. Due 9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt N I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF T It tion Is not a permit until signed by the al I THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL icalor 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 n'593011rt Is acknowledged Inspaco provided. WORKMEN'S Rear"TION INSURANCE AND RCW 18.27. SI D E SIGNATUR (OWNER RAGEN-n DATE SIGNED "ATURE 63 (425) WD - -- - - =h,.W- 200 771-0220 8 DATE ATT04TION 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 M C M 10 r M M z Cal 0 M M 0 Fn C2 z 0 4 0 M r I 0 4 'kj�PATE RECEIVED (41 �j (�3 1-�<) PERMIT EXPIRES USE P AMIT F CITY OF EDMONDS ZONE NUMBER W L� U' , JOB # CONSTRUCTION PERMIT APPLICATION ADDRESS' -T OWNER NAMEINAME OF BUSINESS 2,11-1 q Pvc�!Mr 101111 0- - - %- PLAT NAME/SUBDiVISION NO. LOT NO. LID NO. C�q / 7 Oq L'�* Uj - CITY ZIP TELEPHO f 'A-f" a 4 1 As L, 9AJ -,Y. NAME ADDRESS CITY .411 ZIP NAME' ADDRFS8 CITY ZIP E NUMBER i EXPIRAI PROPERTY TAX ACCOUNT PARCEL NO. a= )Haw '01:;�SIDENTIAL -at 0 ADDITION [-] COMMERCIAL 0 REMODEL 0 MULTIFAMILY REPAIR GRADING CYDS DEMOLISH TANK oGARAGE RETAININGWALL C PORT ROCKERY ME OF USE, BUSINE EXPLAIN: NUMBER NUMBER OF OF DWELLING STORIES UNITS , DESCRIBE WORK TO BE DONE P PAIRMAWO Ifl-3071 CBL N CHECKED BY 1 LUMQ�CH� -'COMPLIANCE OR CHANGE OF USE SIGN FENCE FT) OTHER FIRE SPRINKLER FIRE ALARM LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7ESCP Approved RW Pornlit Required sum use P8111111 RW EXISTING - PROPOSED inspection Required Sidewalk Required REQUIRED DEDICATION- FT Underground Wiring required METER SIZE L _LINE SIZE I NO. OF FIXTURES PRV REQUIRED I ; E VES' YES E3 NO E3 _PAIP REMARK -- SAPILY 9 OWNER/ FUT Miffam AGE WKYW CLIMB I aviissaws ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE cc M W I I VARIANCE OR CU SHORELINEORADB# INSPECTION. BOND J, . . RECI'D POSTED 113YES ONO 1$ � .. - SEPA REVIEW SIGN AREA HEIGHT COMPLETE , EXEMPT ALLOWED I PROPOSED ALLOWED , PROPOSED EXP LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR XP tf'L-LG RE D VAAWj1PLMMWWW%#b BY D TE rUffM 6n fuel-bbming appHances In CHECKED BY ITYPE 0 RU_ N CRITICAL I/I Tn7cw AREAS SPECIALINSPECTION JAREA NUMBER rT REQUIRED [] YES REMARKS I PROGRESS INSPECTIONS PER UBC I GROUPK fS., occuPANT LOAD V INSPECTION REOD 9 � 13 IF $ 1 Description FEE Description FEe Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % I 77 Building Permit City Surcharge Rce- A i'e, PLAN CHECK NO: VESTED DATE Plumbing Mechanical TH]IS PERMIT AUTHORIZES ONIN THE WORK NOTED. THIS PERMIT COVERS WORK TO 1: BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading X :1 DOMAIN (CURDS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMrTAPPILICATION: IGO DAYS PERMIT UMM I YEAR - PROVIDED WORK 18 STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMff 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 PERMFE ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapoinsp. Total! Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY C17Y ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # 1 HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN 13 CORRE" 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 n Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED his/her Deput/: and Fee& are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON REWING TO FOR INSPECTION nB; rec pt Is acknowledged In space provided., WORKMENS50MIMTION INSURANCE AND RCW 18.27. 4fj4)VSI9*TURE D SIGNMATURE (OMER R AGE" DATE SIGNED (4-25) rvooMfo �/V 6 0 771-0220 - 3MAM BT I DATE ATTMtION 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 YELLON- 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 11111111 am