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20030283.pdf171 < DATE RECEIVED elllm & I IJIAAO�0�1 [PERMIT EXPIRES fA—d(44 USE PERMIT CITY OF EDMONDS 11NE._a NUMBER JOB SUITE/APT# CONSTRUCTION PERMIT APPLICATION ADDRESS -7 OWNER NAMEINAME OF BUSINESS 5TF-VJ5AJS MEDICAL- #0SP/M_ PLAT NAME/SUBDIVISION NO. LOT NO. L D NO. MAILING ADDRESS L�D FEE S TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Perrrdt Required 2-1 irk sr sw Street Use Peffnit RKd CITY EXISTING — PROPOSED Inspection Raquired ZIP TELEPHONE Sid**alk Required 0 REQUIRED DEDICATION— FT Underwound am WMg required NAME METER SIZE LINE S��7 OF FIXTURES PRV REQUIRED I YES 13 NO 13 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE (3 CITY ZIP ONE NAME CBL# _W44t, FY" 54FA97%Y IAY,. ENGINEERING REVIEWED BY DATE ADDRESS 4!�E Pu FIRE REVIEWED BY DATE CITY ZIP TELEPHONE Y_ F-03 1,�JV.4JWJ�06 01 ikio-i q25-jp-76 2,?1z VARIANCE OR CU SHORELINE OR ADS# INSPECTION BOND STATE LICENSE NUMBER EXPIRATION DATE ECKED B REO'D POSTED IS 13YEs 13NO SEPA REVIEW SIGN AREA HEIGHT PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED ALLOWED PROPOSED U2EXP , LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr.) NEW [j RESIDENTIAL 0 PLUMBING I MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR COMPLIANCE OR Lj ADDITION OMMERCIAL OF USE 0 z CHANGE PARKING LOT ARE A PLANNING REVIEWED 13Y DATE REMODEL MULTIFAMILY SIGN RECID I PROVIDED GRADING FENCE X REPAIR CYDS ( _ FT) REMARKS DEMOLISH TANK OTHER oGARAGE RETAINING WALL CARPOPIT ____-ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: I CHECKED By F CONSTRUCTION CODE OCCUPANT In 1TVE_ f&*1_ &APA 7 GROUPg , NUMBER ..-? I NUMBER OF CRITICAL SPECIAL INSPECTION AREA OCCUPAN`f OF �DWELLING�� AREAS LOAD STORIES UNITS NUMBER REQUIRED OYES DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REGID 4 VALUATION Description FEE Description FEE Plan Check ;1,,, State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECW;.f VESTED DATE Plumbing Inee L6gvl Mechanical THIS PERMIT AUTHORIZES ONLY i&r WORK NOTED. THIS PERMIT COVERS WORK TO t BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 0 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. t Engr. Review PERMITAPPILICATION: 180DAYS 06 PERMIT ILIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION I 'APPLICANT, ON BEHAI ' F OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit IIN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY ANU Fire Inspection Receipt # IALL 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 !3 DEEMED TO MOOIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* x 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 IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building Official or histher Deputy: and Fees are paid. and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. [_efT1Ct!rNATP/P/' SIGNATURE (OWNER 0 GE DATE SIGNED 10.25) 4, /?I M44L 0.3 771-0220 RELEASED BY I DATf INTI ON 01UNLAWFUL Off 1333 W TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YEL OW - INSPE06OR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING less z 0 :1 FIN* PROJECT APPROVAL ARM TO: — DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: FIRE DEPARTMENT DATE-6 =L2, namism -ENGINEERING DIVISION DATE- nzMaw -PLANNING DIVISION DATE namsm PROJECT SITE ADDREs -2 3 2. o 2.1 CA __� 1^o< PERMIT 100 --- �ADB# DATE INSPECTED--& DESCRIPTION OF WORK TO BE INSPECTED- LLaX, Atan=6L A Held inspection was conducted to determine final compliance with approved plans. Final approval denotes that there are no objections from the above signed Department to the release of PERFORMANCE BONDS and the granting of: )(",-GRANT FINAL PROJECT APPROVAL GRAM PROJECT APPROVAL WrIH CONDITIONS NOTED u Copy of CONDITIONS given to owner/contractor by inspector I . FAILED FINAL INSPECTION - OUTSTANDING ISSUES u Copy of CORRECTION NOTICE given to owner/contractor by inspector I . 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Si ocaprvl.doc.l:tenip:bldg:formsIO/OI kO I C 11t, 10 F I -i a JP01 mcnnan ng: INAPFCtIONS ' �PATE RECEIVE Vx N, PERMIT FiRES USE PERMIT ZONE CITY OF EDMONDS NUMBER JOB SUrrE/APT# CONSTRUCTION PERMIT APPLICATION AD DRESS OWNER NAMEINAME OF BUSIWNE _16IR _//'01 SIS —I :5Fr&VAAJS M5D1(_dL_ 90SIO/ML PLAT NAME/SUBDIVISION NO._ LOT NO. LID NO. MAILING ADDRESS LID FEE $ TESGF Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW PerrrA R&WIred -731 o zi b7q, sr stij Street Use Peffnit Reti'd CITY ZIP TELEPHONE EXISTING PROPOSED Inspection IFIsquired SideweA Required REQUIRED DEDICATION— FT un"Wwrid bill opm. 9koz o #Z!; 'Vo (0 o wifto requirec! 13 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 13 NO 13 z ADDRESS REMARKS 'BLE FOR EROSION CONTROLIDRAINAGE OWNER/CONTRACTOR RESPOqQj CITY ZIP NAME CBLN I rr--cia"L.- F/" &OACrLf Et9GINMjRG TREVIEWED BY DATE ADDRESS Llz -31 3& -014 I/E KJ 6-2" k1RE REVIEWED BY DATE us CITY ZIP TELEPHONE Y— 0.2 4::5�yojwcob 1 seeg t' 412r &76 2,? -2 VARIANCE OR CLI SHORELINEORADBO INSPECTION BOND 8 TATE LICENSE NUMBER E XPIRATION DATE E;W�" REQ'D POSTED . - . [3yEs 13NO $ SEPA REVIEW 8 I GN AREA HEIGHT PROPERTY TAX ACCOUNT, PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED R D q EXP , , '�'A'\PLUMBING/MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETB OKS (Fr.) NEW [j RESIDENTIAL ALLOWED PROPOSED FRONT SIDE REAR, FRONT LIRSIDE REAR CO PLIANCE OR DITION MMERCLAL vdo�D &O'Co GE OF USE PARKING LOT AREA PLANNING REVIEWED By DATE SIGN REOD 11 REMODEL MULnFAM I PROVIDED 06 o FENCE [3 REPAIR GR)kklk� X FT) REMARKS .0 DEMOLISH OTHER &2NG WALL [3 GARAGE CARPORT UWE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: __7 CHECKED BY TXPE OF CONSTRUCTION Ic LE OCCUPANT GROUP CR7 .NUMBER I I AL UMBER OF ARE OF WELLING AS D N14 SPECIAL INSPECTION OCCUPANf UN STORIES 34:aNITS NUMBER JAREA REQUIRED [3yES LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REW VALUATION 11VIO !1 $ Description FEE Descriptlan FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge VESTED DATE PLAN CH!:r Plumbing Mechanical THIS PERMIT AUTHORINS ONLY Art WORK NOTED. THIS PERMIT COVERS WORK TO FRIAN P t: 13E DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading Ivi I 0HU I DOMWN (CURRS. SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. t Engr. Review PEnmiTAPPUCATION: 1e8 DAYS IL PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN ISO DAYS Ehgr. Inspection IF sr.g BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS Fire Review la I. /9 Plan Chk. Deposit IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THEL CITY OF nDj EDMONDS, WASHINGTON, ITS OFFICIALSI. EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Recelpt 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 DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE tM LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' M Recording Fee Receipt # I HEREBY ACKN61i�LEDGE 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 P 'FN IS C" THE OWNER. I AGREE TO COMPLY WITH C17Y AND STATE LAWS REGULATING CONSTRUC- E WNER 0 CALL This application Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED N AND I Building Official or hisitier Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO VO"TION ; � FOR INSPECTION receipt Is arknovAodgod In space provided. LIN WORKMENS COMPENSATION INSURANCE AND RCW 18.27. OR EN'S C Ic ATE IGNATU (OWNER Off'AGEN DATE SIGNED S N (425) M4(t 03 77i-0220 RqEASEO BY DATI �IJENTION Off 1333 k j, rMS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL IZ, A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- IN ORIGINAL - FILE - YELLON - ' SPE11TOR 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 M M M 0 C: M 10 z 0 9M 0 Fn cf) z 0 M