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20030317.pdfCITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAJU*OF BUSINESS "I- / 'f . I I MAILING ADDRESS j 7-33&7 A,-e,, NAME ADDRESS CITY ZIP I TELEPHONE NAME I - I CBL ar ADDRESS or CITY IP STATE 0CENSE NUMBER -Z— PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB PT ADDRESS 161, li`�t IJ NEW SIDENTIAL ".�MBING / MECH ADDITION COMMERCIAL COMPLIANCE OR C14ANGE OF USE 13 REMODEL MULTIFAMILY SIGN REPAIR GRADING CYDS rl FENCE X Fri DEMOLISH [3 TANK OTHER GARAGE -1 RETAINING WALL 11 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS ?1Vrr_N NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE I E % HEAT SOURCE GLAZING % LOT SLOP PLAN CHECK NO: VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY 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 "APPLICANFT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE, ARISING 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 C17Y 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 19 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 WORK3AIS COMPENSAT12 INSURANCE AND RCW 18.27. ER IIATE SIGNED I -)tq ^ -,-> PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required Street Use Permit Reced EXISTING — PROPOSED Inspection Requited sidewalk Fisquired nEQUIRED DEDICATION— FT UndorW&jnd Wiring required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED �13 �NO13 OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE W VARIANCE OR CU SHORELINE OR ADBN INSPECTION BOND REO'D POSTED I 13YES ONO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , I , LOT COVERAGE REQUIRED SETBACKS (FT:) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REAR DATE PARKING REO'D I PROVIDED LOT AREA PLANNING REVIEWED BY REMARKS CHECKEDBY IT)YWFCO T��C OCCUPANT GROUP 7- 04 SPECIAL INSPECTION jAnEA OCCUPANT REQUIRED LOAD REMARKS PROGRESS INSPECTIONS PER UBC 110811FINAL INSPECTION REaD I $ F_ Description FEE Description FEE Plan Check State Surcharge I Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review E;0��' !Za Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION 771-0220 EXT 1333 APPLICATION APPROVAL This application is not a permit until signed by the Building Offlgipl or histher Deputy: and Fees are paid, and P In space prov�ed. ;fiK-t) acknowledged OFFI N URE /11ATE Tway IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL - " I Z---, I L-K-_1 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINA1 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 SEEK] It CITY OF EDMONDS - CONSTRUCTION P�RIMIT APPLICATION OWNER NAMEftt!W.OF BUSINESS r AILING ADDRESS (i ) ��12AIO - . 2 I= ADDRESS CITY NAME A S el 0 ZIP ITELEPHONE A XPIRES Z, USE-' PERMIT ZONE P 72/4 NUMBER L-'(Y) i JOB ADDRESS Sul PLAT NAME/SUBDIVISION NO. Lar NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Pom*At Required EXISTING - PROPOSED street Use Peffnh Roo Inspection Required Sidewatit Required EQU*I�ED DEDICATION- FT Underground Wiring requirod V&ER SIZE LINE SIZE NO. OF FIXTU PRV REQUIRED 1 WNERICONTRACTOR RESPONSIBL� FOR E�O I N CONTROL/DRAINAGE 0 V. ENGINEERING REVIEWED BY DATE . . Ili q r(,- r I FIRE REVIEWED BY DATE "CITY ZIP TELEFMONE t zlz�la7 ': --- VARIANCE OR CUI SHORELINEORADB# INiPECTION BOND STATE ENSE NUMBER NE eC4CK.ZED 13 I REO'D POSTED DYES 13NO $ SEPA REVIEW SIGN AREA HEIGHT, MY.,TAX'AC CEL 0., co PROPOSED ALLOWE EXP .,NEW, W*OaSIDEN.Tl�z A VMBi�3 MEC jv LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT LJRSIDE REAR, Cj ADDITION, EI b_0M_M5R6M,: [OCHAGEOFUSE PARKING LOT AR PLANNING REVIEWED BY DATE REMODE L -j�o :�MuLmp&y ri SlGt� PROVIDED REPAIR [3-GRADING I� CYDS FENCE x FT) REMARKS DEMOLISH TANK OTHER oGARAGE RETAINING WALL 13 FIRE SPRINKLER El ALARM CARPORT ROCKERY FIRE P (TYPE OF USE.-BUSINE6� OR�, ��N: CHECKED BY TY T C098.1 41 JUGROU OCCUPANT-' NUMBER OF NUMBER OF DWELLING CRITICAL AREAS wh) SPECIAL INSPECTION OCCUPANT STORIES UNITS NUMBER �REA REQUIRED 0 YES LOAD DESCRIBE WORK TO BE DONE ;REMARKS PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REG-0 -7 - I 146t�E 42/2,'�E . fW111", Alh VALUAnON $ Description V Willi FEE Description FEE Plan Check State Surcharge NEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORUES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I= BE DONE ON PRIVATE PROPERTY ONLY. AM CONSTRUCT]ION ON THE PUBUC Grading 2 DOMAIN (CURBS, SIDEWALKS, DRIVIEWAYS. MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION., t: 15-rigir. Review PiRMrfAPi6cA-noN: loo, A" IL PERMIT UUM I YEAR - PROVIDED WORK 15 STARTED WITHIN 180 DAYS Vr S SEE BAE� 00 PINK PERMIT FOR MORE INFORMATION -APPUCANT; ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF Fire Review Plan Chk. Deposit IN INTEREST. a EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND IALL CLAIMS FOR DAMAGES OF WHATEVER MATURE, ARISING DIRECTLY OR INDIRECTLY Firs Inspection Receipt # FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscape Insp. Total Amt. Due 9 DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 2 NOR LIMIT IN ANY WAY THE CWTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee L 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 CRY AND STATE LAWS REGULATING CONSTRUC- CALL This appli n is not a permit until signed 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 Building Official or hialhat Dep�ty: And Fees are paid, and it acknovilodgodip space provided. WORKMENS COM PENSATION INSURANCE AND RCWJ8.27. OFFI%NAT ENT at TU! ER 0 ENT) DATE SIGNED IA9 tz 70 771-0220 I DATt Y EWT16N M I a133 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINALIFILE -1YELLOW- INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER - GOLD -ASSESSOR GREEN - ACCOUNTING 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES I z Lu 0 al M M C M __110 0 0 C: M M IL 10 0 In rn M 0 0 Fn a riji 0 z z 0 4 0 M SEEM