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20030264.pdfDATE RECEIVED 'Iz93 —1 1 PERMIT EXPIRES CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION USE PERMIT ZONE/ 'PP2 '5 N U M B E R JOB SUITEIAPT# ADDRESS 4�2 OWN R NAMENAME OF BUSINESS 4 . -Maxir-) k) I C H__:__Z�Lac ._(_(0 01�1 I PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S MAILING ADDRESS h.. 4C);a, PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTIN — PROPOSED REQUIR ?fttIj1% or onnu tc I fZ1'qfT"LW TESCP Approved RW Permit Required street Use Permit Req�d Sidewalk Required W',�."d q,.d 13 CITY ZIP :7 ?j ]TELEPHONE :4� , ) /A'::4 9AME METER I Mli unhPated gpa&rz. 17— 14636fWgiapp U WiC 815.1.'7SI3 lanawfail MIWI ED N 13 ADDRESS REMARKS--- OWNER/CONTRACTOR RES CITY ZIP T ELEPHONE US NPETESI' MUST RF NAME �Z�6�4 BLN 7,�; q OBSERVED BY CITY INSPECTOR ENGINEERING DATE REIMIYAVITS SMLL NOT A=419 ADDRESS <D^ V-L/ y FIRE REVIEWED BY DATE lE CITY ZI-P TELEPHONE I VARIANCE OR CU I SHORELINE OR ADB# L ?_02 44 Vi jMs INSPECTION 1 REQ'D E3NO1$ D P800SNED STATE LICENSE NUMBER EXPIRATION DATE 0 "� e, ep 3 _3 CRECKED BY' SEPA REVIEW COMPLETE , E EXP SIGN AREA - ALLOWED PROPOSED HEIGHT ., ALLOWED PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. 92024 NEW 0 RESIDENTIAL PLUMBING/MECH ci COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE REMODEL MULTIFAMILY SIGN 13 REPAIR [3 GRADING FENCE X CYDS ( — — FT) OT OTHER HER DEMOLISH [3 TANK 7 RE PRINKLE oGARAGE -1 RETAININGWALL FIRE SPRINKLER FI RE M CARPORT 0 ROCKERY 0 FIRE ALARM LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE REAR PROPOSED SETBACK$ (Fr.) FRONT UR SIDE REAR PARKING REQ`q;��EA PLANNING REVIEWED BY DATE k7&09:_00_10y_ RE nl&-p eyceed"'.52po" Mda t5a 2 k^A4,$+ be- Kle_11-.vere-m (TYPE OF USE. BUSINESS OR N: A CHECKED BY TYP ONSTR*nON CM 7 OCCUPANT GROUP 4"4 NUMBER OF STORIES NUMBER OF DWELLING I I CRImCA�L��j J EA ARIM 2 ICY I Nu E lk-.F SPECIAL INSPECTION REQUIRED [:) YES AREA OCCUPANT LOAD DESCRIBE %9MTO BE DONE i N �- T::� F-� M REMARKS PROGRESS INSPECTIONS PER UBC 1108/171NAL INSPECTION REO'D. 67 cAv)-r 71�kLSI, Af' r-I J 19, A-vzl, A $ Description FEE Description FEE Plan Check State Surcharge H SOURCE GLAZING % LOT SLOPE % 1 Building Permit City Surcharge PLjWCHECKNO- VESTED DATE /C7_ Plumbing 1-150D — Mechanical 4k� THIS PERMIT AUTHORLMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC 2 Grading 3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPLICATION: 100 DAYS PERMIT ILIMM 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, AFUSING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT UP ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Recording Fee Receipt N 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT, AND THAT I AM THE QWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE To COMPLY WITH AND STATE LAWS REGULATING CONSTRUC. CALL This application Is not a permit until signed by the r,"� TION; AND IN DOING THE WORK AUTHO D THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE THE STATE OF WASHINGTON RELATING TO T FOR INSPECTION receipt is acknowledged In space provided. WORKMENS_��P SATION INSURA AND RCW 18.21 DATE SIGNATU —DATE SIGNED (425) o �INATTU '1 1 % F-4 771-0220 A FrE ED BT ATE ATTENT16N M 1333 wamg&:� IT IS UN�A L TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL IMPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE - YELLOW - IdS4TOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER - GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING DATE RECEIVED PERMIT EXPIRES PERMIT ZON . y ke Ee NUMBER -USE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICAT. ION JOB SUITIVAPT# ADDRESS NAME/NAME OF BUSINESS 0 t—je— 0S PLAT NAMEISUBDIVISION NO. LOT NO. LID NO LIDAES MAILING ADDRESS. PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP w Por 8 Met as a 0 ulfed EXISTING — PROPOSED CITY ZIP TELEPHONE Tr*A M O'b" REQUIRED DEDICATION— FT METER SIZE LINE SIZE OF FIXTURES PAV REQUIRED tiAME YES 13 NO 13 REMARKS CONTROL/DRAINAGE ADDRESS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CITY ZIP TELEPHONE 11 P1 FTF NAME CBLN IN[ 'qW a W ME NM NMI III NGINEERING REVRNEDIM 11111DATE ADDRESS Arvjoo. V—,(-/ r q DATE Z� FIRE REVIEWED BY p Lu Ic 0 C17Y z�i� TELEPHONE Ir VARIANCE OR CU SHORELINEORADB# INSPECTION BOND. STATE LICENSE NUMBER EXPIRATION DATE CHECKED 0 L * REQ'D POSTED. A (3 s i? SEPA REVIEW SIGN'AREA HEIGHT. COMPLETE EXE ALLOWED PROPOSED ALLOWED PRqtPsAD- PROPERTY TAX ACCOUNT PARCEL NO. Ann =4 EXP In NEW RESIDENTIAL PLUMBING I MECH LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT 0 COMPLIANCE OR ADDITION COMMERCIAL 13 CHANGE OF USE 1C MULTIFAMILY REMODEL SIGN PARKING EA PLANNING REVIEWED BY RECIP CL IT! 10 FlEkIR GRADING FENCE CYDS x FT) r RE!" C: z Loy OTHER DEM668H TANK zg loe Pve)l-re IVA :� (A GARAGE RETAINING WALL FIRE SPRINKLER ff.CARP0RT 'Te . oi- ROCKERY FIREAL.ARM N'� t CHECKED BY TYP ONSTR ION OCCUPA ACXW WRE OF USE, BUSINESS OR.,,ff_%6E)TJAN: V1, 11- 22� Ic -GROUP A/ '/ ., 4 M SPECIAL INSPECTION JAREA -666UPANT LOAD NUMdER, NUMBER OF CRITICAL .0 - . --e WELLING F 0 AREAS KZ STORIES UNITS NUMBE 1% REQUIRED [] YES rn DESCRI!!��TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC I 88/FINAL INSPECTION RECtD, e, fd'�G� U'q Tr' en5Z JO) A F) VALUATION Description FEE Description FEE j'. z Plan Check State Surcharge I Building Permit City Surcharge 0 M T SOUR GLAZING % LOT SLOPE % Plumbing PLP#CCHECK NQ* VESTED DATE Mechanical "Is PFRMrF AUTHORRIS ONLY THE WORK NOTED. THIS PIERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTI ONW. ANV CONSTRUCTIION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRftVAYS, MARQUEES, ETC.) WILL REQUIRE ,�TE�ERMISSION. SFAR PERMFTAPPUCATHM 1901DAY8 PERMrr LIMM I YEAR - PROVIDED WORK IS STARTED WrrH1IN 180 DAYS Engr.: 1�spect!prt, SEP ,WK OF FINK PERMfr FOR 1111101`11qk��ORIIAATIIDN heo Ri4lew Plan Chk. Deposit I PPUC ANT, ON BEHALF OF, HIS OR HER SPOUSE, .. HEIR , S . , ASS . IG I Ns A�D SUCCESOIiIS ;A N INTEREST, AGREES'TO1 INDEMNIFY, DEFEND AND HOLD HARMLESS 1HE 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 Landscape insp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE C"YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Receipt # Recording Fee I HEREBY AC4(NOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICAT ION APPROVAL GIVEN IS CORRECT. AND E NER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO T " I AND STATE LAWS REGULATING CONSTRUc- COMP :3K Hr This applicaillon is not a permit until signed by the CALL ED THEREBY. NO PERSON WILL BE EMPLOYED TION; AND IN DOING THE 0 ED TH IN VIOLATION OF THE LABOR C DE THE STATE OF WASHINGTON RELATING TO Building Official or hIsiber Deputy: and Fee$ are paid, and FOR INSPECTION receipt is acknowledged In space provided. WORKMENS NSURAN AND R _E�PE SATION I CW 116.2!�� 0 S ATUR, DATE IA95) SIGNATUR (o D E SIGNED -4-03 '4A 771-0220 ATE RE ED BY ATTENT N 'A EXT 1333 IT IS UN L TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL IN ECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- - ORIGINAL - FILE - YEI I Ow Idsps6TOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 -YOU ARE PRESS HARD IES GREEN - ACCOUNTING MAKING 5 COPI-5