Loading...
20030310.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS "en ZT LA ?4 MAILING ADDRESS r ,�Q q z / CITY ZIP ITELEPHONE f1*_W11 tufVU NAME ADDRESS CITY ZIP TELEPHONE NAME ci� le, - In 14 tf4-r WC A 'MR e& A hUJA(-1_ ZIP TELEPHONE STATE LICENSE NUMBER EXPIRATION DATE P-,q e�olo3l us ZONE JOB ADDRESS I PERMIT EXPIRES PERMIT NUMBER PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Parrnit Required Street Use Pernaft Rsqd EXISTING — PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION— FT Underground Whingfequired 13 METER SIZE LINE �� OF FIXTURES PRV REQUIRED 13 YES 13 NO 13 z REMARKS I OWNERICONTRACTOR RESPONSIBLE FOR EROSION C2ERWDRAIN* a A NEW x RESIDENTIAL PLUMBING / MECH ADDITION 0 COMMERCIAL COMPLIANCE OR 13 CHANGE OF USE REMODEL YW MULTIFAMILY 0 SIGN 0 REPAIR GRADING CYDS FENCE X FT) DEMOLISH [3 TANK OTHER oGARAGE CARPORT -1 RETAINING WALL 0 ROCKERY FIRE SPRINKLER FIRE ALARM OWE OF USE, BUSINESS OR ACTI;M NUMBER NUMBER OF CRITICAL OF DWELLING I AREAS I STORIE:Mkl-T UNITS NUMBER et-T L vent connectors fda-burning appflances REVIEWED BY 5, VARIANCE OR CU SHORELINEORADBO 1. INSPECTION I BOND REO'D POSTED 13YEs 13NO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE , EXEMPT ALLOWED , PROPOSED ALLOWED , PROPOSED _xP LOT COVERAGE REQUIREn SETBACKS (Fr.) PROPOSED SETBACKS (Fr. ALLOWED PROPOSED FRONT SIDE REAR FROt Tr UR SIDE REAR I rAMININU DATE RE IL flVM.%%j'0f`whet+ the water syst..] CHECKED PE OF STffiUCTIgfN SPECIAL 11 SPE ON NREA REQUIRED 0 YES REMARKS PROGRESS INSPECTIONS PER USC 11 I I EFICR r \.CA- 1, V 4 VALUATION $ Description FEE Plan Check HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC a 3 DOMAIN (CURBS. SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE t: SEPARATE PERMISSION. 2 5 PERMITAPPUCATION: ISO DAYS 0. PERMIT LIMIT! I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION Building.Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection OCCUPANT LOAD Description State Surcharge City Surcharge FEE (,-ro '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 2 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 Or THIS PERMIT. ISSUANCE OF THIS PERMIT HALL NOT BE Landscapelnsp. 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 HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN 13 CORRE" 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 ThisR lication 15 not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Build M at or his/her Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO F R INSPECTI N ?W-51t Is acknowltidgohn space prgvlded. WORKMEN'S C NSATION INSURANCE AND RCW 18.27. OF Ell URE DATP ;FDAS I rl /�TUR�E g SIG UR (OWNER R AGE" DATE SIGNIED (425) D BY 7TI- E D BY DATE ATTENTION FEXr 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 OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING �e � 0 IT! M C M C M M z Coll 301 M o Rn C2 0 z 0 0 M I QVATE RECEIVED PERMIT EXPIRES 10-3 10L. - use PERMIT ZONE C)j:20 C17Y OF EDMONDS NUMBER_;��__�� CONSTRUCTION PERMIT APPLICATION JOB ADDRESS SUITE/APT# am OWNER NAME/NAME OF BUSINESS k_ D PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. 1z - zLq MAILING ADDRESS I LID FEE $ (7� 0( Z 4tLd PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP APPMO RW Permit Required Use Peffnit Raq'd CITY ZIP TELEPHONE EXISTING - PROPOSED Street Inspection Required Sidewalk Required EDICATION_ FT REQUIRED or UndwWMM WWg required NAME METER SIZE LINE SIZ� NO. OF FIXTURES PRV REQUIRED 0z YES [3 NO 13 I ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROVDRAINAG� z z CITY ZIP [TELEPHONE NAME Type B or L vent connectors /11? - /A /4 6 /rT //Va IcBO/5 ENGIN Efeqqgft"�ftfue1-burrJrig applianiNAn AbDRESS r- HIS-1-7 1�14) A wJA IU�heatllkl 22§M,_ 1 -1 F 1—go BY DATE cjj�y- ZIP V TELEPHONE Ir a6 P_ 1� alaa VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND LICENSE NUMBER DATE E REQ'D POSTED I 10YEs is 13NO il?m 'A. -a "I ( k PrLzL 0 SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED P7 8 D , ZZIM7 EXP , I , , 'NEW RESIDENTIAL PLUMBING MECH . LOT COVERAdE, REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR ADDITION COMPLIANCE OR COMMERCIAL CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE 06 REMODEL MULTIFAMILY 13 SIGN REOfD PROVIDED I I REPAIR GRADING FENCE . CYDS 0 X Fn REMARKS DEMOLISH TANK OTHER oGARASE 0; RETAINING WALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM MPIE OF 0S6,.E1=;;W8 cm. CHECKED BY OF OCCUPANT ItYPE 'GROUP NUMBER k OF BER OF LLING CRITICAL AREAS SPECIAL INSPECTION OCCUPANT STORIES&11`�' NUMBER REQUIRED [:] YES JAREA LOAD TO BE DONE REMARKS W­"�IJW­11693 jN REG'D UANOMINM I .1 . A . j: AV $ DescrIption FEE ggscription Plan Cjeclf j_ 77­4 iState Surcharge FEE HEAT SOURCE GLAZING % LOT SLOPE % BuI4 k'rmft V City Surcharge 1 Plumbing t.." PLM CHECK NO: VESTED DATE Mechanical - ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO THIS PEMIT AUTHORIZES 13E OWE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 112b In DOMAIN (CURN, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 180 DAYS PERMIT LIMM 1 YEAR - PROVIDED WORK IS STARTED WITHIN 100 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, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE A14Y REquIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due NOR LIMIT IN ANY WAY THE C"" ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Oecording Fee Rpeelpt ff I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMAI 10N APPLICATION APPROVAL GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE, DULY AUTHORIZED AGENT OF THE OWNER. I AGR To COMPLY WITH CITY. AND STATE LAWS REGULATING CONSTRUC- CALL This Wcallon Is not a permit &fll signed by the.. TION; AND IN THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED DOINCV IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION OuildiVOIllicial or his/her Deputy: and Fees are paid, and /r")At is arknowledg"n space pirgoided. WORKMEIk? 11�ISATION INSURANCE AND RCW 18.27. OF SI TUREO A`fr(,�� BIG R AGE DATE SIGN D =OWNER ED BY DATE ATTENTION . ..... -UNTIL( EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER - GOLD -ASSESSOR 64/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN .,ACCOUNTING ".4 z 9 0 M