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20030345.pdfI DATE RECEIVED 'I b L I PERMIT EXPIRES CITY OF EDMONDS as USE PERMIT ZONE NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRESS q�3 7-;� OWNER NAME/NAME OF BUSINE '00" PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS LID FEE S s- TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Partnit RtWired Use Parmit Rect'd CITY ZIP ITELEPHONE Street EXISTING — PROPOSED inspecdo Requited Required Sidewalk" Underground REQUIRED DEDICATION— Fr 13 Witing required NAME METER SIZE LINE OF FIXTURES PRV REQUIRED YES13 NO E3 ADDRESS REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE CITY ZIP ONE NAME 'BL# ENGINEERING REVIEWED BY DATE cc 0 ADDRESS /1 -7 /Art td FIRE REVIEWED BY DATE W CITY ZIP TELEPHONE '04 04 77 rL VARIANCE OR cu SHORELINE OR ADB# INSPECTION 1$ BOND STATE LICENSE NUMBER EXPIRATION DATE C BY REQ'D POSTED I 13YEs 13NO SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOU fr PARCEL NO. _.ETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED , , , I EXP NEW PC�-OLUMBING MECH 1-1 KRESIDENTIAL 0=1116 LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR I COMPLIANCE OR 1:1 ADDITION COMMERCIAL CHANGE OF USE 0 REMODEL MULTIFAMILY SIGN PARKING LOT AREA PLANNING REVIEWED BY DATE REO`D PROVIDED CL GRADING [3 FENCE X REPAIR CYDS FT) REMARKS DEMOLISH OTHER TANK GARAGE -1 RETAININGWALL FIRE SPRINKLER 0 IT FIRE ALARM CARPORT ROCKERY (ME OF USE, BUSINESS OR A3 N: CHECKED�TPE ns OnNSVIN OCCUPANT GRO NUMBER NUMBER OF ARRITICAL OF DWELLING EAS SPECIAL INSPECTION REA OCCUPANT UNITS MBER STORIES &ZE REQUIRED LOAD YES DESCRIBE WORK TO BE DONE le, REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D - S VALUATION Description FEE Description FEE /2,//,Vz7 JA I-, J4,f [&L .4 -&-1 Plan Check State Surcharge I (��r CE G1 AZING I OT sit Opp % Building Permit 'low- City Surcharge PLAN CHECK NO: VESTED DATE Plumbing l'?IAI I Mechanical THIS PERMIT AUTHORMES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t= BE DONE ON PRIVATE PROPERTY ONLI ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) VnLL REQUIRE SEPARATE PERMISSION. Engr. Review 15 PERMIT APPLICATION: 180 DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS 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 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 THE ISSUANCE PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE FROM OF THIS Landscape Insp. 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.' Recording Fee Receipt III I HEREBY ACK14OWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORREC"C* 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 until signed by the TION; AND IN DOING THE UTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE 1.4000 ADE OF THE STATE OF WASHINGTON RELATING TO Building Official or his/her Deputy: and Fees are paid, and FOR INSPECTION receipt I,j acknowiedgod In space provided. it��PEN97 CE AND RCW 18.27. OFFICIALS) iGN yuRE D ITE E Offj6ENT)j DATE SIGN (425) j;,7f1jP :III V , 771-0220 —RECEASEb By j )bATE/ ATTENTION Off 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUII DING 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 4 0 M q:q OM C M 0 C Irn 0 _Tl M M 0 0 M 0 z z 0 q 0 M 71" . It DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS 1n4,1Z_3f,1 MAILING ADDRESS CITY ZI ITELEPHONE NAME CITY ZIP I TELEPHONE NAME CBL # ADDRESS CITY Oe ZIP TELEPHONE A YwAllwe4 9we��, 5;"d, -1-- 7,-, STATE LICENSE NUMBER EXPIRATION DATE C 8, PROPERTY TAX ACCOUNT PARCEL UO. ,;2 7A q,26;/)Oh-9il5�e�0 NEW 0111 ESIDENTIAL W-*LUMBING / MECH ADDITION COMMERCIAL 101% COMPLIANCE OR CHANGE OF USE REMODEL MULnFAMILY SIGN III REPAIR GRADING CIMS FENCE X Fn DEMOLISH TMK OTHER 0 GARAGE CARPORT RETAJNINGWALL ROCKERY FIRE SPRINKLER FIRE (TYP E OF USE. BUSINESS ORACTVnYjA!X"N: ALARM 21 NUMBER NUMBER OF LCRITICAL OF DWELLING AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE bll/,/10� ,�YVCE GLAZING FL f LOT SLOPE % PLAN CHECK NO: VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPEM ONLI ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURSS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMITAPPLICATION: ISO DAYS PERMIT UMIT: I YEAR - PROVIDED WORK 19 STARTED WTTHIN 180 DAYS SEC BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, 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 NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAAfE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CnYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION 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- TION; AND IN DOING THE WOR THORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABODFPC'��ODE OF THE STATE OF WASHINGTON RELATING TO wonKmE%vc00FMRXnq*VMtwCE AND RCW 18.27. DAT12 SIGN6 A ,q FPERMIT EXPIRES USE PERMIT ZONE NUMBER&OO JOB SUITEIAPT# ADDRESS /,5/,5 _ (F& 7--A PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7ESCP AP=sd RW pannit stre4t Use Penn" RW EXISTING - PROPOSED Inspection Requked Sidewalk Requited! REQUIRED DEDICATION- FT Underground Wkingrequited 13 METER SIZE LINE Sli�7. OF FIXTURES PRV REQUIRED YES 13 NO 13 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE VARIANCE OR CU SHORELINE OR ADB# I INSPECTION I BOND REO'D POSTED 13YEs 13NO S SEPA REVIEW SIGN AREA HE113HT COMPLETE . EXEMPT ALLOWED . PROPOSED I ALLOWED . PROPOSED LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR I I I z PARKING LOT AREA PLANNING REVIEWED BY DATE REO'D I PROVIDED I I REMARKS CHECKED BY OCCUPANT GROUP j SPECIAL INSPECTION JAREA OCCUPANT REQUIRED LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REG'Dt VALUATION $ I %IV-1.11L 6616W Description . FEE Description FEE Plan Check State Surcharge Building Permit "7 City Surcharge Plumbing AlAl Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt Due Recording Fee Receipt N 22L Z! CALL FOR INSPECTION 1A 1-425) 771-0220 � APPUCATION APPROVAL This &Wlcswn is not a permit Until signed by the Building OineW or hisfiter Deputy: and Fees are paid, and receipt I's acknovuledged in space provided. OFFICIALS PIGNA7URE TE _T1141 _�ELEASEB 6V'- v - ) ' JbATE/ ATTENTION 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