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20030339.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEKWE OF BUSINESS r? r) n 0 on d MAILING ADDRESS CITY ZIP ITELEPHONE &� M (1,9,g( v I A-- ar" - NAME ADDRESS oxi�d, PERMIT EXPIRES AUSE PERMIT I ZONE V!X7 NUMBER V Ir JOB SUITE/AM# ADDRESS a I F I �jss PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Pernift Requ:red street Use Peffn t Req'd EXISTING — PROPOSED inspection Required Sidewalk Required REQUIRED DEDICATION— FT Underground Wiring roquived 13 METER SIZE LINE SIZE F FIXTURES PRV REQUIRED YES 13 NO 13 z REMARKS z a OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE !I CITY ZIP TELEPHONE NAME C 9 L NgpZ..., lype is or L vent conlilectOrs In ADDRESS 4_. ri-01- ur-Alug appi lances unhealed sp"es* UMC 81i.1.7 DATE 4 (I 1A ��(Y) �C 2 F1 U By DATE W ZIP �,FELEPHONE -,-29;1 n2da STATE LICENSE NUMBER EXPIRATION DATE �_ VARIANCE 01 Reg4diess of Q- W599CTIQU BOND . REQ'D Meth 4Cft SySteM W E�l tSC1qL)[,4 c2 M —Ilk %01 OSED PROPERTY TAX ACCOUNT PARCEL NO. . A%O on R ot water t inks per (Nnt Y, A NEW RESIDENTIAL LUIMBING/MECH N& LOT COV FX6V7' oftww ALLOWED tAk(iW JFW*OSED SETBACI S (FT) 1 -An .. -_ RgNT LJR SIDE EAR COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE I 0% As Ifift V% r. rrt%lr 11111111110 z 6MREMODEL [3 MULTIFAMILY 0 SIGN PARKIN IEA4*kN REO'D Ma.—L. ERED BY -a&-By DATE PTY INSPECTOR [:] FENCE REPAIR GRADING CYDS X FT) REMARKS ffFjMWIT3 I OT SHALL N 0 DEMOLISH 0 TANK 13 OTHER BE AUCEPTED [3GARAGE [3 RETAININGWALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE. BUSINESS OR ACTIVTM EXPLAIN: CHECKED BY CONrfjN ITYPIVU /11 e ICLI GROUP f 7 _OCCUPANV__21 NUMBER NUMBER OF CRITICAL OF DWELLING AREAS SPECIAL INSPECTION JAREA OCCUPANT STORIES UNITS NUMBER REQUIRED [] YES LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 11081FINAL INSPECTION REO'D L&L-tt AN QteJ VALUATION $ L Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORLZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 160 DAYS PERMIT LIMM I YEAR - PROVIDED WORK 15 STARTED WITHIN 180 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 INTEREii 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 MATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapeinsp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION., M -_ Recording Fee Receipt # I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION .APP CAT ION APPROVAL 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 appli tion Is not a permit until signed by the TION; AND THE WORK AU EREBY, NO PERSON WILL BE EMPLOYED DOINP Y�IORIZED TH ,IN OF ffHE OF THE S IN VIOLATION TATE OF WASHINGTON RELATING TO u FOR INSPECTION Ing c I or his/her Deputy: and Fees are paid, and r a ack nowlodgel ad. WORKMEN'S CO EN I E AND a 18.27. 0 L S N URE ATk DATE SIGNED (42Q) 5.1 I 771-0220 DATE ;1�3 RE ATTE ION 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 OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING i I I I � t � a I W. I All RECORD OF INSPECTIONS 13 I Iq DATE . RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS MAILING ADDRESS Sb_) CITY ZIP _�� a ,,,,,,TELEPHONE A NAME ADDRESS CITY ZIP ONE rc B L —7 NAME ADDRESS -2 PERMIT EXPIRES USE. PERMIT �QNE � O(Y)- 01��3n NUMBER JOB ADDRESS :E I S— SUITE/APT# PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP MCI Ap=, "" 'r., Street Use Parmh Raqd EXISTING — PROPOSED Inspectson Plaquited Sidmabc 11"Wred REQUIRED DEDICATION— FT Undergmund WWAg required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I I YES E3 NO 13 z REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGI Rnmullow of whather is —en ax dwed, the watell By expaml ake ma ifn an aH hot water tanks pff 11"11,=D ItDC DATE 19.30.020 (c) I It A I I I %-I I __I f I A I J I IV-V- FIRE REVIEWED BY DATE ZIP qTiLEPHONE M VARIAN SHOR j�INE OR APB# I BOIS I It STATE LICENSE NUMBER EXPIRATION DATE L;-<HqCK �E� �0_ or vent POSI :D P;CEJ 1E.1 -b — SE. REVI TROPERTY TAX ACCOUNT PARCEL NO. Sprin OUMD8 _%110 TED PRO'OSED EXP 0 NEW RESIDENTIAL LUMBING MECH LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr.) I ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REAR COMPLIANCE OR ADDITION COMMERCIAL 0 CHANGE OF USE IMREMODEL PARKING.---- -1 LOT AREA I PLANNING REVIEWED BY DATE. 0 MUL11FAMILY 0 SIGN RECfD I PROVIDED GREPAIR 0 GRADING CyDr [3 FENCE ( _ X_FT) d%-Ito REMARKS %WW nil ""HIT BE 6 Is `ss's' DEMOLISH TANK [3 OTHER wn ov Cnv, jum-MR11 o GARAGE RETAININGWALL 0 FIRE SPRINKLER SHA_ CARPORT ROCKERY FIRE ALARM 11C ArlITPUn _ (TYPE OF USE, BUSINESS OR ACTIVITYI EXPLAIN: 3�L CHECKED BY ITYP — — --- - —] C"71- OCC CONVU N UPA�6 P (-/ T GROUP M NUMBER NUMBER OF CRITICAL OF DWELLING AREAS SPECIAL INSPECTION OCCUPANT STORIES UNITS NUMBER REQUIRED JAREA LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC I GO/FINAL INSPECTION REaD VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit fi_j City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMff AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPEMY ONLY. ANY CONSTRUCTION ON THE PUBUC Grading DOMAIN (CURDS, SIDEWALKS, DRMVAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPUCATIOW. 180 DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FDA. 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 C17Y 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 Landscapeinsp. Total Amt. Duo DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR UMIT IN ANY WAY THE CnYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION., I Recording Fee Receipt Receipt I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APICATION APPROVAL P I GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF �by THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL appi tion Is not a onn it untO signeYd the TION; AND IN DOINP THE WORK AL"ORIZED THEREBY, NO PERSON WILL BE EMPLOYED Mc orffilOer Deputy: and Fees are pald, and g fic IN VIOLATION OFjrH/E8 THE STATE OF WASHINGTON RELATING TO OF f FOR INSPECTION r e acknovdodgeg In space ad. M114W WORKMEN ;1EN I �E AND �T 18.27. DATE SIGNED (425) t WSN URE I AT 01P/, A ) Y/'Im In-uzzu RE AVMD BY DATE ATTENTION 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- 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 ..... .. ... z 0 M am C ma 0 80 C m m C _z 0 _n "n m M C K V) . 1, M 0 z z m