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20030250.pdfI DATE RECEIVED 41 CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAIUIE/NAME OF RURESS MAILING ADDRESS S4,dl ZIP 2t) I TELEPHONE q 0 2h 16 NAME ADDRESS CITY ZIP TELEPHONE ENA E BLN uwg�tfvez:_ seeyze�- C ADDRESS Pa so)�. :21A 9-7-1 IP I TELEPHONE 2-q 1 06 1&7. STATE LICENSE NUMBER EXPIRATION DATE 00ni :3tV*5ki+ 13'�;PZT IROPERTY TAX ACCOUNT PARCEL No. -720 NEW KRESIDENTIAL M!OXDDITION COMMERCIAL REMODEL MULTIFAMILY REPAIR GRADING CYDS DEMOLISH TANK oGARAGE CARPORT RETAININGWALL ROCKERY CrYPE OF UV INESS OR ACTIVTM EXPLAIN: NUMBER OF NUMBER 0 DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE :rjj.67Aj/ -70,4219 X-V 70z LERMITEXPIRES P USE PERMIT ZONE NUMBER JOB ADDRESS a SUITEIAPT# PLAT NAME/SUBDIVISION NO. LOT NO. LrD NO't)' 7 LID FEE S TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Ponrit Req ("d u:, Street Use Perm Raq'd EXISTING - PROPOSED inspection Required 11 Sidewalk Required 13 REQUIRED DEDICATION— FT Und&rW"4 JA"eepulred [3 M ER SIZE OF FIXTWfE REQUIRED Obtali ff'e"C`f1r+,N1])ernu tMey YES NO 13 z z IRE A Mad StrIM z 0 E CONTRACTOR RESPONSIBLE FOR EROSION CONTRO AGE ENGINEERING REVIEWED BY 1�pe B or L vcx,� I— ''K11 C DATE NqUftV*011111 ECTION IS] ONO 4CM jjfjp'1EQ'D P801STED unbea"Sp s 13NO S HEIGHT XEMPT ALLOWED . PROPOSEDTALLOWED . PROPOSED us Ir Ix EXP I I I I LOT COVERAGE _QU'R1D SETBACKS (FT) REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) P' 2rPLUMBING I MECH ALLOWED PROPOSED T FRONT �jRON SIDE SIDE REAR R FRONT L[RSIDE REAR F COMPLIANCE OR z CHANGE OF USE 0 SIGN PARKING RECeD PROVIDE�6&tflvt I T I DECTbA FENCE Arlell #Me HV_9HnLL nW I ( FT) REMARKS OTHER " A f"LLER � ED F RE SPRINKLER FIRE ALARM CRITICAL AREAS NUMBER k CHECKED BY ITYPEnly ION IC !?E7 OCCUPANT GROUP A- 62 SPECIAL INSPECTION REQUIRED 0 YES 111PROGRESS JAREA OCCUPANT LOAD REMARKS INSPECTIONS PER UBC 108/1FINAL INSPECTION REG'D <--- Al nz, All'). M 1) 1).41 M I L_ k,,7 A? k , 1,',2 /V /,,n )-F 2ic EL&A' 6ft5 VALUAnON $ Ale liry M AM)661-AJO�5;3 41 "U, Description FEE Description FEE (Z— dale� kk�j__� Plan Check State Surcharge HEA'�AQJJRCE GLAZING %or LOT SLOPE % Building Permit City Surcharge SE PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHIORGMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: ISO DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS 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 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 Landscapeinsp. Total Amt. Due 71; DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee Receipt 0 )In-7'4 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN 13 CORRECT. AND THAT I AM THE OWNER. ORTHE 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 LABOUQIDE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATIQ)MW5URkNCE AND RCW 18.27. SIGN TURE f4g%IfER Oft W.'e NED DATE yve zj TO APPLICATION APPROVAL This application Is not a permit until signed by the CALL Building Official or hi5ther Deputy: and Fees are paid, and R INSPECTION receipt Is acknowledged In space provided. OFFICIALS SIGNAT E 4 DATE (425) 71.� 3 771-0220 kR—L--ASED 13Y DAIFE -4714 , I "ICRI IT IS UNLAWFUL TO USE OR OCCUPY A BUILDIN& OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CEFITIFI- 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 I DATE RECEIVED PERMIT EXPIRES UNF: ZONE PERMIT CITY OF EDMONDS NUMBER CONSTRUCTION PERMIT APPLICATION JOB SURVAPT# ADDRESS Vallem OWNER NAMENAME OF BUSINESS _T' PLAT NAME/SUBDIVISION LOT NO. LID NOV el K) 71 MAILING ADDRESS LID FEE [_2`AM0NJS. I - 1ZESCP _14WOVed PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Porn* Required 2, 3-2 S I I I ) Ir,4 �fJ P, )A/ Street Use Pennh RsqV TELEP EXISTING — PROPOSED truipatl- R@qWtsd CITY ZIP __ HONE SidewsA Required CIV REQUIRED DEDICATION '."g m"'Ad 13 0 2 � I . 2 b In -35'25 - '1-,, -1 NAME ADDRESS CI NAME ADDRESS p 0 E30 CITY STATE LICENSE NUMBER ZIP 21A 9-7-7 ZIP I TELEPHONE ROPERTY TAX ACCOUNT PARCEL NO. 0 72 '1 QQQ DQ JQ 2 NEW IN, ESIDENTIAL CWADDMON COMMERCIAL REMODEL muLnFAtAiLy REPAIR GRADING , CYDS DEMOLISH TANK oGARAGE o RETAININGWALL CARPORT ROCKERY OWE OF USfflrftjINESB OR ACTIVITY) EXPLAI iA 5�w7lA NUMBER OF NUMBER OF DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE T'111.6-rA -70, 000 F, YES [3 21 NO 13 is or L vent connectors FIRE R iWqShvd on fuel-bViMng aPPO or L Vpn' C)nnectorS unheated space& UMC 815.1.7 V6 VARIA E OR CU U B REO'D POSTED PO [3YEs 13NO s SIGN ARE SEPA rREVI F A; HEIGHT EW .TE E PROI PLV I PROPOs ALLOWED OPOSE1 COM I PT ALLOWED EDF PCOMPLE E EXEMPT ALLOWED PROPOSED ALLOWED PR .0 1 1 1 1 1 2rPLUMBING/MECH LOT COVERAGE SETBACKS (FT.) I PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED �EQUIRED FRONT SIDE REAR FRONT LIRSIDE REAR L: I COMPILIANCE OR GA I)ID Tra I IDID Ir am 011MIS CHANGE OF USE I 6 go I 1691 AH&W A or- 0 SIGN PARKING REQ`D PRO 1 WM"dlr if FT) I REMARKS Ilia Antm F RE SPRINKLtR' '7' - FIRE ALARM —cRrrICAL CHECKED BY ITYPE107fliON OCCUPANT GROUP T REAS LNUMBER KA— SPECIAL INSPECTION JAREA REQUIRED [] YE jk OCCUPANT LOAD /is REMARKS ROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RECYD P 04 In h 1) .1/ f1/7 i L_ 67 If A, % V bA5 PV '!571)b ;,?)Ie AV -rue?, 'VA'V; VALUATION $ Description --- " " FEE FEE Descirlption FEE Plan Check State Surcharge RCE GLAZING %-e LOT SLOPE % 15 1 Building Permit V City Surcharge LAN CHECK NO: VESTED DATE Plumbing THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Mechanical V BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTIRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MAMUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PErtmrrAppudmow. isomys F_ PERMIT UMrP I YEAR - PROVIDED WORK 18 STAITMD WITHIN 180 DAYS Engr. Inspection OEM BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICAlfr. 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 CLAIM3 FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISBUANrE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due NOR LIMIT IN ANY WAY THE CRY$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Ell I" Recording Fee Receipt N 2S11 �_f I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN 18 CORRECT: AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WTTH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This applicatIon Is not a permit until qned by the TiON; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building OMcW or his/her Deputy: and Foot are paid, and IN VIOLATION OF THE LASO ZDE OF THE STATE OF WASHINGTON RELATING TO gFtkN FOR INSPECTION receipt Is acknovAefted In space provided. PEN�Tjll WORKMERS COM I " AND RCW 18.27. OFFICIALS 91ONAT4,51E DA7E SIGIf L�X)ER On 0 IED _0TURE 19 '� 'V f, -:�'w (425) -3 "77-4 n#2*n RELEASED By r DAtE ff1SENT f -;N:� 10 N EXT 1333 U UNLAWFUL TO USE OR OCCUPY A BUILDINIOR/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 GREEN - ACCOUNTING PRESS HARD -YOU ARE MAKING 5 COPIES z 0 0 M M M C7 M 10 z 0 In MITI 0) Fn 0 z 9 0 M