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20030313.pdfDATE RECEIVED I [PERMIT EXPIRES f USE PERMIT AA CITY OF EDMONDS ZONE �z NUMBER�w UI/ CONSTRUCTION PERMIT APPLICATION jo _1APT0 AD _,SUITE NAME/NAME OF BUSINESS TONER PLAT NAME/SUBDIVISION NO. LID NO. a nEe,.6aj I::" I MAILING ADDRESS Po PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP I LID FEE S IIESCP Appl= RW '. , ked &2,g 8�sn Street Use Pennh Req'd CITY ZIP LEPHONE 17 EXISTING - PROPOSED- Inspection Required Sidewalk Required 9f3o -7 qyAj REQUIRED DEDICATION- FT Underground Wftg required 13 ,q EZ4 71 NAME METER SIZE LINE SIZE I NO, OF FIXTURES REQUIRED Y,PRV S13 NO 13 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE CITY ZIP TELEPHONE NAME CBL# ENGINEERING REVIEWED BY DATE ADDRESS Z34 I it C__2" I)L4=—. S-1 DATE Y111M, REVIEWED BY,- Lu CITY zip TELEPHONE Z 6'�) 3k? J VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND STATE LICENSE NUMBER EXPIRATION DATE CtH�ql(E REO'D POSTED 113yes 13NO -SIGN PROPERTY TAX ACCOUNT. PARCEL. NO. SEPA REVIEW AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED A= Q0z_04r1> EXP , I , 0 NEW SVIESIDENTIAL E] PLUMBING I MECH LOT COVERAGE REQUIRED SET13ACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR ADDITION COMMERCIAL ci COMPLIANCE OR CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE REMODEL MULnFAMILY 0 SIGN RECID I PROVIDED REPAIR [3 GRADING CYDS 1:1 FENCE x FT) REMARKS DEMOLISH TANK OTHER oGARAGE RETAINING WALL 0 FIRE SPRINKLER CARPORT ROCKERY I -IRE ALARM (TYPE OF USE. BUSINESS OR ACTIVI'M EXPLAIN: Yom CHECKED BY TYPE CONST3UCTION ICODE OCCUPANT GROUP76 g=. e NUMBER NUMBER OF CRITICA OF DWEWNG AREAS SPECtALINSPECTION AREA OCCUPANT LOAD STORIES 1-2 MBER REQUIRED DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECnONS PER UBC 108/171NAL INSPECTION REGeD. VALUATION $ Description TEE Description FEE 16* 116 Plan Check State Surcharge HEAT SOURCE GLAZING % LCIT, SLOPE % Building Permit City Surcharge PLAN C2K NOx VESTED DATE Plumbing a — ?L/fz I Na Mechanical THIS PERMIT AUTHORIZIES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I: BE DONE ON PRIVATE PROPERTY ONLX AM CONSTRUCTION ON THE PUBLIC Grading 9 DOINLAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPILICATION: ISODAYS IL PERMIT LIMIr I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 0 R S 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit 0 F IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF A N D EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # TL C Y ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY r 13E FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscape Insp. Total Amt. Due CE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE ION. - NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' I Recording Fee Receipt # ic? z �TION I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION PZA APPLICATION A L 4T 0 F GIVEN IS CORRECT.AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF rRUC. THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application is not a permit until Signed by the CALL DYED TION. AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED G To 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 acknowledged in space Provided. WORKMENS COMPENSATION,;RRANCE AND RCW 18.27. OFFICIALS SIGNATURE DATE ION DATE SIGNED IA9 %425) )a J 771-0220 DATE ELEA 5 X`irrENTION EXT 1333 0 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 FINAL PROJECT AP FORM z 9 0 m =i 9 m 0 0 0 c rn M Z co) 0 -n n rn m 0 0 0 M C 0) c 0) M 0 Z X z z 0 m 3. SpECTED OUTSTANDING ISSUES GkANT-FINAL PROJECT APPROVAL RE -IN Si or�aprvi.doc.l:temp:bldg:fomisIO/OI I . Ix -7.1 EIVED' F�TIE RECEIVED' T 7) j PERMIT EXPIRES 2 CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION ER NAMEINAME OF BUSINESS MAILING ADDRESS CITY Z yj: � A.. &;:! 0 NAME ADDRESS r -CITY NAME ADDRESS 1��l I I CITY STATE LICENSE NUMBER ZIP I TELEPHONE ZIP ITELEPHONE ,0 &:�ff . 's, JE7. ZIP I TELEPI PROPERTY TAX ACCOUNT PARCEL NO. 022 NEW jirRESIDENTIAL ADDITION COMMERCIAL R EMOPEL [3 MULTIFAMILY REPAIR GRADING CYDS DEMOLISH -YANK oGARAGE o RETAININGWALL CARPORT ROCKERY (ME OF USE. BUSINESS OR ACTIVITY) EXPLAIN: NUMBER' OF STORIES NUMBER OF DWELLING UNITS DESCRIBE WORK TO BE DONE USE PERMIT ZONE NUMBERyff2— JOB ADD::p .je2 'g�j gi�,q PLAT NAME/SUBDIVISION NO. T NO. LID NO. r LID FEE$ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Pamft RoqAf6d Street Use Pernift ReWd EXISTING - PROPOSED Inspectio" Required Sidevralk Required REQUIRED DEDICATION- Fr - U W METER SIZE LINE SIZE NO. OF FIXTURES PAV REQUIRED ] .&AMMJ YES13 NO 13 REMARKS OWNER/CON ;;IM)VRAINAGE REVIEWED BY DATE., IFIRE REVIEWED,BY DATE us 01 0 -2- V� E i VARIANCE OR CU SHORELINE ORADB11 I INSPECTION BOND �DATE CICKED REOD POSTED j� I I 13YES ONO S :3) A SEPA REVIEW SIGN AREA I HEIGHT W k4PT I ALLOWED . PROPOSED ALLOWED , PRO LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) PLUMBING / MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR COMPLIANCE OR 0 CHANGE OF USE I I PARKING LOT AREA PLANNING REVIEWED BY DATE SIGN REOD PROVIDED oFENCE ( X FT) REMARKS OTHER FIRE SPRINKLER FIRE ALARM CHECKED BY ITYPE_QE CONSTNCTION . I CODE OCCUPANT �GROUP76 zym CRITICAL AREAS., SPECIAL INSPECTION OCCUPANT NUMBER REQUIRED [] YES JAREA LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG-D VALUATION Deacription FEE Description FEE ffPAje XtVOA4 S Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CIE VESTED DATE Plumbing Mechanical THIS PEMIT AUTHORECES OfI& THE WORK NOTED. THIS PERMIT COVERS WORK TO t= BE DOME ON PRIVATE PROPERTY ONILX ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURDS, SIDEWALKS, DRIVEVAYS, MARQUEES, ETC.) WILL REQUIRE 'SFIPARATEPEMISSION. Engr. Review PERMITAPPILICATiom 1180DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION I %. 'APPLICAK ON BEHALF OF HIS OR HER Si;608E. HEIRS, ASSIGNS AND SUCCES61`16 Fire' Review Plan Chk. 2� 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 0 ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT $HALL NOT BE Landscapeinsp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 1219:2 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt N I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION APMMAL 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 untli signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her 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. WORKMENS COMPENSATIONMRANCE AND RCW 10.27. OFFICIALS SIGNATURE DATE DATE SIGNED 142 I.-M / /,w tmnL:� �11", A2� )I "1 771-02 20 'RE DATE 19 OTENTION Off 1333 1Y 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 GREEN - ACCOUWING 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES L z 0 4 0 171