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20030295.pdfI RECEIVED f N FPERMITEXPIRES us� PERMIT r'�� 'ZOO CITY OF EDMONDS ZONE NUMBER 0 JOB SUITE/APT# CONSTRUCTION PERMIT APPLICATION ADDRESS OWNINAMEfNAME OF BUSINESS 4 "I A A�._ PLAT NAME/SUBDIVISION N LOT NO. LID NO. MAILING ADDRESS LID FEE S TESCP Approved Pro L/ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP AW Permit Required x 9 Streel Use Permit Rect'd EXISTING - PROPOSED Inspection Requited CITY ZIP ITELEPHONE% SidewalkFzuIred Underground F&Aoft�Q REQUIRED DEDICATION. FT Wiring required 13 NAME METER SIZE .1 LINE SIZE NO. OF FIXTURES PRV REQUIRED YES E3 NO C3 z ADDRESS REMARKS OWNEWCONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE CITY ZIP PHONE NAME CBL# ENGINEERING REVIEWED BY DtTE ADDRESS 14 WO-3 FIRE REVIEWED BY DATE A, CITY TELEPHONV M VARIANCE OR CUI SHORELINE OR ADB# INSPECTION BOND STATE LICENSE NUMBER EXPIRATION 6ATE-1 CHEC ED 13Y REO'D POSTED OyEs ONO $ SEPA REVIEW SIGN AREA HEIGHT P 0 CEL NO. COMPLETE , EXEMPT ALLOWED , PROPOSED ALLOWELOLPROPOSED, 01 L Os EXP LOT COVERAGE REQUIRED SETBACKS (Fr.) -PROPOSED SETBACKS (Fr.) 16ARSIDENTIAL PLUMBING if MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR COMPLIANCE OR YADDITION /6 COMMERCIAL CHANGE OF USE PARKING LOT AREA D.BY DATE 0 MULTIFAMILY IGN PROVIDED REMODEL REaD ] PLANJING REVIEWE qF GRADING FENCE REPAIR 1:1 CYDS X _FT) REMARKS C OTHER DEMOLISH 1-1 TANK oGARAGE RETAINING WALL FIRE SPRINKLER CARPORT 11 ROCKERY FIRE ALARM ME OF USE, BUSINESS OR A;rffl!4�2 CHECKED BY ITYPE 0 U OCCUPANT GROUP N BER LIM NUMBER OF CRITICAL OF DWELLING AREAS SPECIAL INSPECTION JAREA STORMS PC I UNITS NUMBER REQUIRED [] YES DESCRIBE WORK TO BE DONE REMARKS ONREaO PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTI 2 f 047 a A-) U/01, VALUATION $ Dewription FEE Description FEE V Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % I Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHOREMS ONLY THE WORKIT6M' THIS PERMIT COVERS WORK TO 1: 11 INE I" PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC TC.) WILL REQUIRE Grading DOMAIN (CURBS. SIDEWALKS. DRIVIEWAYS. MARQUEES, E SEPARATE PERMISSION. Engr. Review PERMIT APPILICATION: 160 DAYS PERMIT LIMM I YEAR - PROVIDED WORK 15 STARTED WITHIN 180 DAYS Engr, Inspection SFE RACK 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 MATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscape Insp. Total Amt. Due 91 DEEMED M MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 2 HOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee .,LRecelpt # 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPUCATION APPROVAL GIVEN IS CORFIECT� 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- �Thlsonlshnot a permit Until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL Bull to or Depirly: and Fees are paid, and IN VIOLATjeN-or DE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION i C isa nowledgad InsRoce provided., ,t,LABOR CO WORKMEIT3��TION INSURAYCE AND RCW 18.27. OF IALS III U BIG ER DATE SIGNED (425) 771-0220 DATE ENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 06GINAL - 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 r,.7 m 0 PERMIT EXPIRES 7JO US9 ERMIT ZONE K5 -12. PNUMBER CITY OF EDMONDS Of-() CONSTRUCTION PERMIT APPLICATION SUFMAPTO AARESS iw�� (i OWNE NAME/NAME OF BUSINESS I PLAT NAME/SUBDMSION NO. LOT NO. LID NO. MAILING ADDRES L/ p.0. Box 58 LID FEE $ 7ESCP Ap PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW F,0mVt=6d CITY ZIP TELEPHONN 7 5 Street Use Permit Wd EXISTING - PROPOSED inspection Required Sidwalk Required UnderWound CLI REQUIRED DEDICATION FT Wmg requkod NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES13 NO 13 ADDRESS REMAR OWNM:QW&�CTOR RESPONSIBLE FOR EROSION CONTROLJORAINAGE I_Ct-P�IkQIJ P&1P90V'%:,;0 0-5 CITY 71P ELEPHONE NAME CBL# ENGINEERING REVIEWED BY DATE ADDRESS 41.4 1 7DO3 RIP FIRE REVIEWED BY DATE U, I cc CITY TELEPHON Emess ism Ir STATE LICENSE NUMBER V_V. EW R IDENIIAL 0)S 8�ADDITION 4"4,COMMERCtAL REMODEL [] MULTIFAMILY REPAIR [3 GRADING CYDS [3 DEMOLISH 0 TANK .o GARAGE CARPORT [:] RETAINING WALL ROCKERY (TYPE OF USE, BUSINESS OR ArjjeNZ_ NUMBER OF STORIES NUMBER F 0 DWELL NG UNITS DESCRIBE WORK TO BEDONE 11 z 1_4 V HEAT SOURCE GLAZING % CHECKED BY PLUMBING/MECH COMPLIANCE OR 0 CRANGEOFUSE %[:] IGN FENCE t X FT) 0 C THER F RE SPRINKLER FIRE ALARM VARIANCE BOND POSTED SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED , PROPOSED ALLOWED , PROPOSED =XP �LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWED-' PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR PARKING .1 LOTAREA 1PLANJINGREVIEW . ED BY DATE REQD PROVIDE .REMARKS CHECKED BY TYPE 0 S OCCUPANT.,,n GROUP CRrriCAL AREAS 710N AREA OCCUPANT NUMBER REQUIRED [:] YES I LOAD I ROW111 Description FEI� Description FEE Plan Check State Surcharge LOT SLO 7E% C Building Permit City Surcharge PLAN CHECK NO: f A--,'l vE7 D IIATY P1UIhy9 Mi6anlcal THIS PERMIT AMUnTMHOR&MMS ON WM WC�R_KVV rED. THIS PERMIT COVERS WORK I t: BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading 11 3 DOUAIN (CURBS. SIDEWALKS, DRIVEWAVS, MARQUEES, ETC.) WILL REQUIRE t: SEPARATEPF"ISSION. Engr. Review PERMIT APP ucATIolt'icoome PERMT LIMM I YEAR - PROVIDED WORK 15 STARITED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION R S ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review ;APKJCAW, 0 F N INTERE" AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF D EDAM ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND Fire Inspection Y ALL A 1AGES OF WHATEVER MATURE. ARISING DIRECTLY OR INDIRECTLY ,,,,[TON. 'a ICE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE BE Landscapeinsp. CE IFY; WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE ON . W V AY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - Recording Fee TION I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION TOF GiVEN 18 CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF F UC. THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC. CALL T )YED TION; AND W DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED 3 To IN VIOLATIOWVP-PS LABOR CODE OF THE STATE OF WASHINGTON RELATING TO TI FOR INSPEC ON BUJI WORKMERS;JW StrION INSURAVE AND RCW 18.27. OFF IA ER DATE SIGNED /A25) J_ 771-0220 g1A AltENTION Off 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CEFITIFI- ATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION log PRESS HARD -YOU ARE MAKING 5 COPIES Plan Chk. Deposit Receipt # Total Amt. Due Receipt # APPLICATION APPROVAL as Wqn Is not a permit unW signed by the &I orlds/hor Deputy: and Fees M paid, and 7//A� DATE IGINAL-FILE YELLOW- INSPECTOR PINK -OWNER GOLD -ASSESSOR GREEN - ACCOUNTING