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20030289.pdfI DATE RECEIVED XPIRES "VUSE PERMIT A CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION IERINAAfWME OF BUSINEfis , I I - — MAILING ADDRES13 p TELEPHONE CITY '�_ Am rw\ A<, NAME ADDRESS CITY ZIP NAME 1 r1N — jCBL ADDRESSU Z TELEPHONE 'StVrU—CENSE NUMBER EXPIRATIoWDATE i cN05 60 6, PROPERTY TAX ACCOUNT PARCEL NO. n6q NEW RESIDENTIAL 0 ADDITION COMMERCIAL 1:3 REMODEL MULTIFAMILY 0 REPAIR GRADING CYDS 0 DEMOLISH TANK GARAGE 0 RETAINING WALL CARPORT ROCKERY (TYPE OF USE. BUSINESS QR ACTPAM'EXPLAIN:, NUMBER OF NUMBER OF DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE NUMBER C>FW�9 - IT APT# JOB ADDRESS Lj PLAT NAME/SUBDIViSION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Pe'ri'vit Requi.fed arm street Use P in Req'd Inspection Required 13 EXISTING — PROPOSED Sidewalk Required 13 Underground REQUIRED DEDICATION— FT Wiring required 0 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES NO 13 15 REMARKS RESPONSIBLE FOR EROSION CONTROWDRAINAGE OWNER/CONTRACTOR ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE ul cc I M SHO D ' I PBOOSNTED \7A—RIANCE OR CU RELINE OR ADS# INSPECTIO1 REO'D JOYES ONO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT ALLOWED , PROPOSED I ALLOWED I PROPOSED LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr.) 11 PLUMBING I MECH ALLOWED PROPOSED FRONT SIDE REAR = FRONT LIRSIDE REAR COMPLIANCE OR 1:1 OF USE I CHANGE PARKING LOT AREA PLANNING REVIEWED By DATE 13 SIGN REQ`O I PROVIDED I 0 FENCE ( X FT) REMARKS W2&ie4zff FIRE SPRINKLER FIRE ALARM CRITICAL AREAS NUMBER 104SIM '&zg ""' __F__ GLAZING LOT SLOPE % HEAT SOURCE PLAN C iECK NO: VESTED DATE THIS PERMIT AuTHORMES ONLY THE WORK NafED. THIS PERMIT COVERS WORK TO 13E DONE ON PRIVATE PROPERT11 ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 1180DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS 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 AMD HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, APJSING 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 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 WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. SIGNATURE (OWNER 0 AG� DATE SIGNED ra I 1_11 -19 -0:71 )CCUPANT CHECKED BY ITYtE OF CONSTRUCTIOl - U is. GROUP Lvloe tq,-_ SPECTION AREA OCCUPANT SPECIAL IN LOAD REQUIRED [] YES IEMARKS 2ROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REaD $ I - Description FEE Description FEE ?$!5CIrteck State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit *_ Fire Inspection Receipt # Landscapeinsp. Total Amt. Due Recording Fee Receipt # APPLICATION APPROVAL This application is not a permit unul signed by the CALL Building Official or hisiher Deputy: and Fees are paid, and FOR INSPECTION loc"'I" Is aeknoyAodg0d in space provided. LS 61 A URE D 1A10 1425) tl#1 4,ef/A IAIJP Dll� 1 WAS 771-0220 , By DATV REL 13Y CV1r .1 Qla ATTENTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL-FiLE - YELLOW -INSPECTOR PINK -OWNER - GOLD -ASSESSOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 GREEN - ACCOUNTING 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES u 4%1 miaw k i ol co Z� p BAT FTE RECEIVED PERMIT EXPIRES USE PERMIT ,P ZONE CITY OF EDMONDS NUMBER CONSTRUCTION PERMIT APPLICATION JOB /APT# ADDRESS OWNER EXAME OF BUSINESS T! 7, \� -'-) I , v`L, PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING A01DRES!f_ 110 FEE S TESCP Appmved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Requirtedi CA P,�TELEPHONE ZP. Street Use Permit Reerd Inspection Required EXISTING — PROPOSED Sidewalk Required I Undergmund (LI ] (a -'m �) REQUIRED DEDICATION— FT 13 NAME METER SIZE LINd SIZE 0. OF FIXTURES PAV REQUIRED I YES13 NO 13 I P ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE CITY ZIP ]7ELEPHONE NAME CBL# �_(-'rx-'o( x DATE ENGINEERING REVIEWED BY ADDRESS 0 0 n FIRE REVIEWED BY DATE us W I Z TELEPHO I r6 QATE VARIANCE OR CU SHORELI NE OR ADBN INSPECTION BON NUMBER CHECKED 8 REO'D POSTED L C 0- bS V 0'/G� E3YES DID, s SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED N _�o EXP I , I NEW RESIDENTIAL A PLUMBING MECH LOT COVERAGE REQUIRED �E`rBACKS (FT.) PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT REAR FRONT LIRSIDE REAR .,-SIDE ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE [3 REMODEL MULTIFAMILY SIGN PARKING LOT AREA PLANNING REVIEWED BY DATE PROVIDED REPAIR GRADING CYDS [3 FENCE X FT) REMARKS DEMOLISH TANK [:3GARAGE o RETAININGWALL FIRE SPRINKLER CARPORT ROCKERY FIREALARM -4TYPE'OIF,USEhBUSINESS. ORACT)VITY) IEXI"N! CHECKED BY PE ?F CONSTRUCTION co OCCUPANT TY_ A?)rlllq e, C� L_ 0 '�eZ GROUP �P_ NUMBER NUMBER OF OF DWELLING CRITICAL AREAS SPECIAL INSPECTION AREA OCCUPANT STORIES UNITS NUMBER REQUIRED 0 YES LOAD DESCRIBE WORK TO BE DONE . REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D I k 6JW4 6 VALUAnON a Description FEE Description FEE co A/W dAW144E 7V Check I State Surcham z 0 d HEAT SOURCE GLAZING % I LOT SLOPE % Building Permit City Surcharge 0 M - PLAN CHECK NO: VESTED 13ATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY OHLX ANY CONSTRUCTION ON THE PUBLIC Grading It DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL EQUIRE SEPARATE PERMISSIOI& Engr. Review PERMITAPPLICATIOik 1110DAYS, PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 1W DAYS Engr. Inspection I SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIW AND SUCCESORS Fire Review Plan Chk. Deposit IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OR I I 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 Landscapelnsp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY C17Y ORDINANCE NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Recording Fee I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APF ROVAL GIVIEN 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 penrilt unW signod by the 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 FOR INSPECTION SuIldIng oincW or his/iter Deputy: and Fees are paid. and receipt Is ackno%ledg6d in space provIded. WORKMENS COMPENSATION INSURANCE AND RCW 18.27. (425) �F�07; 1810 Z�RE 1-W5 SIGNATURE (OWNER OfAGElq,) DATE SIGNED 771-0220 -iIELEIASEb 'BY DATV ATTENTION Off 1333 ----------- IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - INSPECTOR CATE PF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD -ASSESSOR GREEN - ACCOUNTING 04/02'. PRESS HARD -YOU ARE MAKING 5 COPIES