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20030282.pdfDATE RECEIVED :�6 CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAkWUNME C f % J�USINESS MAILING ADDREJS 9 Noe --- CITY ZIP ELEPHONE e(A VA 045 ft)2(pT.542_jloob(21�� NAME ADDRESS CITY NAME 'XDDRESS —0 CITY STATE LICENSE NUMBER ZIP ITELEPHONE ZIP TELEPHONE PROPERTY TAX ACCO CEL NO. 0 [3 NEW RESIDENTIAL ADDITION COMMERCIAL 0 REMODEL MULTIFAMILY 1:1 REPAIR 0 GRADING CYDS 0 DEMOLISH 0 TANK [i GARAGE CARPORT o RETAININGWALL ROCKERY (TYPE OF USE. BUSINESS OR ACTIVITY1 EXP cm+ !arww% i tic; NUMBER NUMBER 00 OF DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE 0 '�-j 1) G 'Iea Xov- CBL N CHECKED BY PLUMBING / MECH COMPLIANCE OR El GE OF USE �SIGN oFENCE ( — _FTI OTHER FIRE SPRINKLER FIRE ALARM PERMIT EXPIRES 0 USE PERMIT ZONE N NUMBER JOB SUITE/APT# ADDRESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S TESCP AF rF. PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Penr`111R street Use Parm, W, EXISTING — PROPOSED Inspection RaquirOd Sidewalk Required REQUIRED DEDICATION— FT undistwomw W11fl, required METER SIZE LINE SIZE T_'�C, OF FIXTURES PRV REQUIRED 1 YES NO C3 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE BY DATE FIRE REVIEWED BY j DATE III VARIANCE OR CU SHORELINEORADB# 1, INSPECTION BOND REQ'D POSTED Is Ai-,,-A,-"jE3YEs GW5 , SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWE13 PROPOSED I Z,4 0 , 2__0 40 1 W ,A- 14' I EXP V" LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR NA IVA z PARKING I LOT AREA I PLANNIN 13 REVIEWED BY DATE REO'D . — CHECKED BY ITYPE OF CONSTRUCTION CODE OCCUPANT GROUP CRITICAL AREAS SPECIAL INSPECTION AREA OCCUPANT NUMBER P I LOAD tRIEQUIRED [] YES REMARKS I PROGRESS INSPECTIONS PER UBC I 081FINAL INSPECTION REG'D f see— A ed, Description FEE Description FEE Plan Check State Surcharge —HEAT SOURCE GLAZING % LOT SLOPE % Building Permit city rcharge 06� PLAN CHECK 110: VESTED DATE Plumbing bill Mechanical THIS PERMIT ZiH&RtzEs ONLY THE IiORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading U 2 DO&WN (CUFM, SIDEWALKS. DRIMMAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 100DAYS ILIMM I YEAR - PROVIDED WORK 16 STAFITED WITIRIN 180 DAYS Engr. Inspection SEE BACK OF P114K 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, IT$ OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE FROM THE ISSUANCE OF THIS Landscape Insp. Total Amt. Due 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 # 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 THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a permit until signed by the TION; AND L4 DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO Building Official or his/her Deputy: and Fees are paid, and FOR INSPECTION receipt Is acknovAodged In space provided. WORKMEN'S COMPENSATION INSURANCE AND RCVV 18.27. 0 ALS Sl ATURE DATE SIG E (OWNER OR DATE SIGNED IA05) %-VK- P919L4, 0 7/Z 1-03 771-0220 SED B E I N M 1333 1 AzAm. j IT IS UN FUL TO USI OR OCCUP) A BUILDING OR STRUCTURE UNTIL V_1_Qy_t&rA4I'1 441 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- bRIGINAL - FILE yELLaAf i'Ns;/r.TOR 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 USE DATE RECEI CITY OF EDMONDS C CONSTRUCTION PERMIT APPLICATION 0 �11- OVVNI�ER NAMEfNAME OF BUSINESS J5 MAILING ADDRE4S T-'-iV4CAe- Noe,' CITY ZIP ITELEP ONE e t�' 4 2� 1�r 1-1TI ADDRESS Crty ZIP ITELEPHONE NAME 1CBL# CITY ZIP I TELEPHONE STATE LICENSE NUMBER EXPIRATION DATE I CHECKED BY PROPERTY TAX ACCOL �TAARCEIL NO. :�i!t 60001 00 0 NEW RESIRENTIAL 0 PLUMBING I MECH [3 ADDITION COMPLIANCE OR COMMERCIAL 1:1 GE OF USE 0 REMODEL MULTIFAMILY ZIGN REPAIR GRADING CYDS 0 FENCE X FT) [3 DEMOLISH 'TANK 0 OTHER [3 GARAGE [3 RETAININGWALL 0 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM_ ME OF III BE, BUSINESS OR ACT,IVffY) EXPLAIN: i tj NUMBER OF NUMBER 09 DWELLING CRITICAL AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE Mao -Vor-e-n4mW uJa.A4 —HEAT SOURCE GLA23NO % LOT SLOPE % PLAN CHEC�N '17 , ,. VESTED DATE CQ THIS, PEwrr AUTHORIZES ONW THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PMVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSIOIL PEaurrApPuCATtow loodAys PERMIT ILIMM I YEAR- PROVIDED WORK 15 STARTED WITHIN 180DAYS 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 INDIREMY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MOD" WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT. 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 WORKMENS COMPENSATION INSURANCE AND RCW 1027. (OWNER DATE SIGNED 1 q.-I-03 ATTENTION I PERMIT EXPIRES Is - USE PERMIT ZONE Y2 N NUMBER JOB SUMAPTO ADDRESS L)3 —a PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approbsd AW Pom* 11SWIred 6 st Use Pwmit Reld EXISTING -- PROPOSED kapoctlon FlsquM SklawalkRoquined REQUIRED DEDICATION— FT Undargmurid %VWgrsqWW METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES 13 NO 13 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE REVIEWED BY FIRE REVIEWED BY DATE DATE I I IEL VARIANCE OR CU SHORELINEORADB# I INSPECTION I BOND I Adw OYE REO'D 1 $ POSTED SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED , PROPOSED ALLOWED PROPOSED -0 7,00 - .XP vo ZA 14 LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR IVA I AIA I . /VA r' PARKING LOT AREA PLANNING REVIEWED BY DATE REO'D I PROVIDED A/,4 REMARKS CHECKED BY ITYPE OF OCCUPANT GROUP SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [3 YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 11081FINAL INSPECTION RE VALUATION Description Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Fire Lan Rec FEE Description FEE State Surcharge 71,0) City Sprcharge 79 Review Plan Chk. Deposit Inspection Receipt # dscapeinsp. Total Amt. Due zi rdlng Fee Receipt # WjA!z APPLICATION APPROVAL CALL This application Is not a permit until signed by the Building OMcW or hWher Deputy: and Fees are paid, and ,R INSPECTION receipt Is acknowledged In space provided. O7F NATURE ATE I VJALS 610 TU '11, 1 /Z (425) % 9// 7 � 771-0220 DATI M 1333 J$17 IT IS UNLAWFUL TO USk OR OCCUF4 A BUILDING OR STRUCTURE UNTIL NAL LE YELL N A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI, SRIGI -FI YELLOW/I SP CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN -ACCOUNTING ------ ---- it 1000