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20030251 (2).pdfLVER DATE RECEIVED 'USE CITY OF EDMONDS ZONE CONSTRUCTION PERMIT APPLICATION JOB ADDRES! OWNER NAMEINAME OF BUSINESS At cy� �4A I — GEKg%9K PLAT N MAILING ADDRESS - VL V)s;m Pc_AcF_ PUBLIC CITY ZIP TELEPHONE EXISTII� IF,> U 0 Ij t,& IL __ )2 L) 2 1, _q q —7-777 q REQUIF NAME METER ADDRESS REMARI OWNER CITY ZIP TELEPHONE NAME ICBLN ADDRESS FIRE CITY ZIP TELEPHONE PERMIT EXPIRES PERMIT NUMBEIf�- " yjz ?,q &//S-/kz,./v� E/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ 3HT OF WAY PER OFFICIAL STREET MAP IFESCP Approved RW Permh Required Street Use Pannit Ftoq'd PROPOSED Inspection Required Sidewalk Required i DEDICATION— FT UnderWound Whing requirad 13 ZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YESD NO 13 )NTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE -41 REVIEWED BY DATE BY DATE I lowl VAARF031AN EORCU SHORELINEORADBN I INSPECTION STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY REO'D PBOND OSTED I 113YES $ SE2A REVIEW EXEMPT SIGN AREA ALL.OWEDPROPOSED HEIGHT ALLOWED PROPOSED COMPLETE Z2 -T EXP COVERAGE PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (FT) FRONT LIRSIDE REAR PLUUBLUGI MECH LOT NEW ESIDENTIAL ALLOWE3 ADDITION COMMERCIAL COMPLIAN R OFUSE WING LOT AREA PLAANIN"REVIEWED,BY D I REMODEL REPAIR MULTIFAMILY SIGN GRADING CYDS [3 FENCE X Fr) I_ - PA REQ`D_jf=D REMARP S 1=5 DEMOLISH 0 TANK OTHER GARAGE CARPORT RETAININGWALL ROCKERY FIRE SPRINKLER FIRE ALARM BY P CO R C occu GROU CTI _!ARf4. OCCUPANT LOAD [3 YES S INSPECTIONS PER UBC I 08/FINAL INSPECII tun RE.0-0 (TYPE OF USE, BUSINESS OR A CHECKE) ,��T I 4�_ . NUMBER OF STORIES 7)NITS I UMBER OF )WELLING CRITICAL AREAS SPECIALINSPECT16N NUMBERW:::�o REQUIRIO - .,DESCRIBE WORK TO BE DONE REMAR 1W, -fAAA9-, - PROG;ES I , � - - _L , 7 ___ L i 1 11 - - I U C—Im 111key"174jil' tfif, q4v$l Plan I H GLAZNG % LOT SLOPE % Buildi PLAN CHECK NO: VESTED DATE Pluml Mech THIS PCRMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC 31 DOMAIN (CuRSS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. PERMITAPPLICATION: ISO DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 1130 DAYS Engr. SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire IN INITEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire I ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Land DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR UMIT IN ANY WAY THE CrIYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION..' Recc I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFonMATION GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- THE OWNER. I AGREE 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 FOF WORKMENS COMPENSATION INSURANCE AND RCW 18.27. ER OR AGENT) DATE S1qN ED A'17TENTIOW IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 04102 PRESS HARD -YOU ARE h Permit i Insp. Fee CALL INSPECTION 4A#Nr—% ItIt'"I FI-0220 Cr 1333 FEE Description FEE State Surcharge City Surcharge KING 5 COPIES Plan Chk. Deposit Receipt # Total Amt. Due Receipt # PA I N APPFIOVAL n . I . permit unfil Signed by the hilith., Do . and Fees arp paid, and rinepacepipvVed. In I rvi r0)0_,j,TFR/7,, W` I 00'afflAl ORIGINAL - FILE YELLOW - INSPECTOR PINK - OWNER GOLD - ASSESSOR GREEN - ACCOUNTING z 0 4 0 m :q :fi 55 ;1 am a mo 0 80 c ic MM m z 0 -n n � 3� ic m m 10 55 0 o Fn C (j), K co) M 0 Z M z 5� cl) z 9 0 m RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Si ocWvLdocJ.*mp-bldg:fou8sl0/0l FINAL PROJECTAPPROVAL FORM TO: DATE:— �MEMi) TO: PERMIT COORDINATOR, BUILDING DIVISION FRONI: FIRE DEPARTMENT ENGINEERING DIVISION DATE�-/* ...,0000000r "AAA PLANNING DIVISIONDATE� 4: ��PROJECTI. W. SrrEkDDRES$- W, PERNaT �ADB# DATE INSPECTED�- DESCRIPTION OF WORK TO BE INSPECTED -A'fieldilispettion In I al was conducted to determine final compliance with approved &ns.-I a.approv d6notW,.that,,there'.. e s 6 are no objections . from the above signed Department to th relea e f -PEP BONDS,*and the granting of LL�LMANT FINAL PROJECT APPROVAL' GRAIMPROJECT APPROVAL -WITH CONDITIONS NOTED Q ITIONS given to owner/contractor b 'TIONS "ven to ID. FINAL INSPEC STANDING ISSUES ID 7FTAX IN PEC N- bT S f CORRECTION CE given to owner/contractor by inspector E 'TION ja CORR C 2. 3. RE-INSP Date OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Si z 9 0 M Qm a ma 0 80 C —1 C 3: rn fn z 0 -n n rn M 0 ED 0 0 Fn C Ca M C4 rn 0 z z Cn z 9 0 M m DATE RECEIVED J 0, PER IT EXPIRES — I I CITY OF EDMONDS "BE PERMIT - NE or NUM&M—�,)Z CONSTRUCTION PERMIT APPLICATION 1013 ADDRESS # W OWNER NAME/NAME OF BUSINESS 4 RPLAT ,; cy, NAMEISUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS LID FEE S IE;4 V) mi puq c E PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7ESCP AppmVed RW Pofn* Requk*d RWd CITY ZIP TELEPHONE EXISTING — PROPOSED Suest Uso Permh Im4wWRequired SidmalkRequirad 1(142 _5) 2 _q L-77 Lq REQUIRED DEDICATION— FT _[Z. Un&wwotmd WkingrequWW 13 -Lb NAME METER SIZE LINE SIZE OF FIXTURES PRV REQUIRED '3 YES E3 NO 13 ADDRESS REMARKS OWNER/CONTRACTOR RESPONS ISLE FOR EROSION CONTROLIDRAINAGE CITY ZIP ADDRESS TELEPHONE CBL 0 .., i ENGINEERING j CITY ZIP TELEPHONE STATE LICENSE NUMBER EXPIRAnON DATE I CHECKED BY LZ1271 I z:;1 If 2L1 NEW RESIDENTIAL' )(ICOMMERCIAL EOH 0 ADDITION R OF US REMODEL MULTIFAMILY SIGN .[3 REPAIR GRADING CYDS o FENCE X Fn [3 DEMOLISH 0 TANK OTHER oGARAGE RETAININGWALL 1:3 FIRE SPRINKLER FIREALARM CARPORT ROOKERY I[TYPEOF USE, 13USINESS OR A NUMBER OF 0 DWELLING AREAS CAITICALY0 UNITS NUMBER _ITORIES DES CRIK- WORK TO BE D I ON I E FIRE REVIEWED BY DATE DATE IEL. VARIANCE OR CU SHORELINE ORADE111 INSPECTION I BOND REOM I 13YES *13NO POSTED 1 $ � — 13EPA REVIEW SIGN AREA HEIGHT COM.PLETEEXEMPT ALLOWED PROPOSED, ALLOWED P BED __XP LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr,) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/nSInE REAR z PARKING REQ`D I PROVIDED 1 LOT AREA EWED BY DATq I ;INW7 ],,fodd J111017 1 CHECKED BY P CgOR ey"11 CFDSD -,I. uu-u V., . G.R U . SPECIAL INSPECTION RE4 AR OCCUPANT REQUIRED rl YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RE(WD "7'A AP A VALUAn0N $ Nb Deicriptlon ...,FEE DescrIpflon FEE Plan Check State Surcharge H on GLAZING % LOT SLOPE % Building Permit [A City Surcharge PLAN CHECK 1106 VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORM OHW THE WORK NWED. THIS PERMIT COVERS WORK TO t: BE DOME OH PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBILIC RxgTing /fill M3 DOLILAIN (CURBS, SIDIEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PEmrrAPPucATi6N: imAys PERMIT ILIMM I YEAR - PROVIDED WORK 19 STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION "APPL " ICANT. ON BEHALF OF HIS 6R,HER SPOUSE, HMS. ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit IN INTEREST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEEI;, 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 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapainsp. Total Amt. Due NOR LIMIT IN ANY WAY THE CnVS ABILITY TO ENFORCE ANY ORDINANCE PROIVISION." Recording Fee Receipt # 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION PPLI ATI ON APPFIOVAL GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF THEOWNER. I AGREE M COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL I al rmIt unW signed by the 6p�glc nisnotaps 4nO /co,. ,TION; AND IN"ING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED I I I 3up c or Ohle/hor Do yfy: and Fees aq paid, and P IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION el Is acknowladg9b in space projed. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. 0 [A 10 TURE G RE "ER AGEN"T) DATE SIGNED 0% (4201 #/��D/AT 0 �OR 110!&.3 771-0220 dATE r,,r"BY ATTENTIOW m 1333 .......... ........ IT IS UNLAWF6L TO USE OR OCCUPY A BUILDINr. 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