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20030347.pdfRECEIVED —0 S PERMITEXPIRES USE PERMIT CITY OF EDMONDS ZONE NUMBERC�A�� CONSTRUCTION PERMIT APPLICATION JOB SUITE/APTi ADDRESS 0 9 aj- OWNER NAMEINAME OF BUSINESS 9 1 C_ t4 4 r>—D S 7—v 4- -2- -r PLAT NAMEISUBDIVISION No77 LOT NO. LID NO. MAILING ADDRESS LID FEE S 0 0 .1 —b (� TIESCP Ap PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW FlennitpIr"eqVired CITY ZIP TELEPHONE I Street use Pentill Radfd EXISTING — PROPOSED Inspection Requited Sidewalk Required E-Z rv� C1 t,40 2-01 -7-71-5C, -7 6 REQUIRED DEDICATION— FT Underground winngf wm CI NAME METER SIZE LINE SIZE OF FIXTURES PFIV REQUIRED 13 YES13 NO 13 N ADDRESS REMARKS z z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE CITY ZIP TELEPHONE NAME C13L # GAS PIPE TEST MUST BE 0 q5a OBSERVED BY CITY E OR ti�- ik A -a- le- ENGINEERING REVIEJ DATE VIDAVITS SHALL NOT ADDRESS k `� 20 Aj nr A f%'%EF%EB FIRE REVIEWED BY DATE W CITY ZIP TELEPHONE t. Se -A,- Tg-:F ct& 1 -114 z 0 STATE LICENSE NUMBER EXPIRATION D, BY VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND REO'D POSTED is OYES 13NO 0 rn SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE , EXEM13T ALLOWED PROPOSED ALLOWED PROPOSED P NEW RESIDENTIAL MBING MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR M C: COMPLIANCE OR rl ADDITION COMMERCIAL 0 CHANGE OF USE In 0 REMODEL muLnFAmwy SIGN PARKING LOT AREA PLANNING REVIEWED 13Y DATE RECYO PROVIDED 0 C FENCE REPAIR GRADING CYDS X Fn REMARP M M 13 DEMOLISH TANK 0 OTHER Type B or t vellit CGUTIMIM 7 GARAGE RETAANING WALL FIRE SPRINKLER 13 appiwilew In CARPORT ROCKERY FIRE ALARM WVE OF USE. Bu l OR ACTIVnW) E%PLAIN: CHECKE BY TYPE OF g CEA OCCUPANT OUSTRUCTION 0 "n 1 .1 - =e 4 9 i7 NUMBER NUMBER OF CRITICAL OF DWELLING AREAS SPECIAL IN CTIO OCCUPANT M M STORIES U NITS NUMBER REQUIRED LOAD nYES DESCRIBE WORK TO BE DONE K� -S Tk" L-c— c V_ ep G:,) REMARKS Fn PROGRESS INSPECTIONS PER UBC 106/FINAL INSPECTION REG-D ',Jf #j A. C_ r- "..j CA M 0 \,r— ccv-4 b 'n VALUATION X $ z 4.1 Description FEE Description FEE Plan Check State Surcharge z HEAT SOURCE LAZING % LOT SLOPE % Building Permit city surcharge 0 PLAN CHECK NO: VESTED DATE Plumbing M Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t= E DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUSUC a Grading 23 DOMAIN (CUR3S. SIDEWALJKS, DRIVEWAYS, MARQUEES, Lrrc.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PEPMITAPPILICATION: 180DAYS CL. PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICAK 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 MATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMrr. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Total Amt. Due 91 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 NOR LIMIT IN ANY WAY THE C17YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt 0 I HEREBY ACKNOWLEDG V' REA THIS APPLICATION; THAT THE INFORMATION E %TT11 HAZ OWNER, APPLICATION APPROVAL GIVEN is CORRECT; AND THE DULY AUTHORIZED AGENT OF IE OR THE OWNER. I AGREE TO H CITY AND STATE LAWS REGULATING CONSTRUC- COMPLY ENZED This application is not a permit until signed by the CALL AND N DO G TlEfRK THEREBY, NO PERSON WILL BE EMPLOYED TION; 11 Building Official or his/her Deputy: and Fees are paid, and IN VIQLATION 0 OR fE'OF THE STATE OF WASHINGTON RELATING TO fTHE L OR receipt Is a FOR INSPECTION cknowlodged In space provided. P I AN WORKVEN'S CO PENSATI IN 14 CE AND RCW 18.27. LS S;lGtATjiJFIE DATE SIGIR:ECNAER (W, Efy DATE SIGNED fEj 11110 771-0220 RELEA ED VATE ATENTION M 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 YELLON- 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 0 0 se d! ?nvL;Fpr!!q �� I i lfvsv�Tfo` 'dowd dd V' p t RECORD OF INSPECTIONS INSPECTOR DATE APPROVED k, 4 4W 4-4 wood 0 d 6 1 1 6 d t 'BACKS am %dip 61- 61 d, dit I . I dd� 1 0 a POUNDATION% %of 0. did t 6 it, tit f.."d j 0 Wall oteseffoos be &**Osseo$, d 4 d, 0 Pier/Porch d.. .1� 1 .1 dp 6 Retaining Wall RIP, k. UJ I I I I I I ip 41 1 Riah Inq I 1 1. 1 jLt�i` iflMinn -1 I I 1. DATE RECEIVED PERMIT EXPIRES lIZ16114 USE PERMIT CITY OF EDMONDS ZONE NUMBER4,4�� CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# OWNER NAMEINAME OF BUSINESS ADDRESS C) 'ie �- t 2 1 (- 0 A V5 fN T_ V Ad PT -7- PLAT NAME/SUBDIVISION NO. LID NO. MAILING ADDRESS c (f C) CITY ZIP TELEPHONE E _D ^"\ - 9 (!�O 2.01 -7 -71 -5 (, -7 E� ADDRESS CITY f ZIP ITELEPHONE NAME jCBL# 0 0 iA V_ ADDRESS k C'k 2- 0 1'j C_ t--w, CITY ZIP TELEPHONE Sl�� TTI,;C- I P-C (,- -3 & 4 14 STATE LICENSE NUMBER EXPIRATION DATE KED t� tz'f -�- � 'P 1 -3 0 // ' MV PROPERTY TAX ACCOUNT PARCEL NO. NEW RESIDENTIAL PLUMBING/MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY SIGN 0 REPAIR GRADI NG CYDS FENCE X FT) 11 ( DEMOLISH TANK 0 OTHER E3GARAGE RETAININGWALL [3 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (ME OF USE. SUSINffl" OR ACTIVTM EVLAIN: 4 NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE ( 6 01 S t' tA V�j 1�� tA e Vj A HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: VESTED DATE THIS PERMIT AUTHORIMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLZ ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS. SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION. IGO DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 1130 DAYS SEE 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, A14D AGENTS FROM ANY AND ALL CLAMS 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 ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANYWAY THE crrys AeiLrTy TO ENFORCE ANY ORDINANCE PROVISION.- weem I HEREBY ACKNOWLEDGE TV 11 tVj READ THIS APPLICATION: THAT THE INFORMATION GIVEN WCORRECT, AND T IE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE T IPLY WH CITY AND STATE LAWS REGULATING CONSTRUC- 0 COMPLY TION, AND TH NORK ORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN Do G - E' I IN VIQLATION 0 THE LA IA,E1OF THE STATE OF WASHINGTON RELATING TO '0 , f P WORKMENS CO PENSAT11 CE AND RCW 18.27. DATE SIGNED S -fl — L_ LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Appr RW Permit A=1red Street Uso Permit Reti'd EXISTING — PROPOSED Inspection Required Sidewalk Required 13 REQUIRED DEDICATION— FT UndergMund Widnilrequirod 13 METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED I YES 13 NO E3 Z REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIBRAINAGE z GAS PIPE TEST MUST BE OBSERVED BY CITY INSKCMR ENGINEERING REVIEWED BY SIN M171--jelilijbil DATE FIRE REVIEWED BY DATE 9u ir M VARIANCE OR CLI SHORELINEORADBM INSPECTION BOND REO'D I POSTED I MYES ONO 3 SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , , , LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR PARKING LOT PLANNING REVIEWED BY DATE REO'D I PROVIDED I AREA I IL UMC 81S.1.7 ROUP FAREA OCCUPANT SPECIAL 114SPECTION REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D R1 %I 'I VALUATION whill INKS a INEV $ 6 On S�T Description FEE Description FEE Plan Check State Surcharge Building Permit City Surch arge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt. Due Recording Fee Receipt 0 CALL FOR INSPECTION 771-0220 EXT 1333 APPLICATION APPROVAL This application is not a permit until signed by the Building Omcw or his/her Deputy: and Fees are paid, and receipt Is acknowledged in space provided. 0 RE DATE LS S I ="A 'A RELEASED BY aTE Ji IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES ORIGINAL -FILE YELLOW -IN! PINK -OWNER GOLD -AS,' GREEN - ACCOUNTING z 0 4 0 M M M OC �c 11711 M z 0 In ,3T!, I M M Fn C V) K CO) X z 0 4 0 ITI