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20030348.pdfI DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS MAILING ADDRESS 24122 76 Ave W CITY ZIP TELEPHONE Edmonds 98026 1425-673-9350 NAME ADDRESS CITY ZIP I TELEPHONE NAME ICBL# cc 01 ADDRESS 12 01 132 Ave NE CITY ZIP TELEPHONE Kirkland 98034 1425-814-3124 STATE LICENSE NUMBER EXPIRATION DIATE FASTWHC052DF 2-16-05 PROPERTY TAX ACCOUNT PARCEL NO. 00491'QQQQQ901 NEW RESIDENTIAL PLUMBING/ MECH ADDITION COMMERCIAL COMPLIANCE OR 0 CHANGE OF USE REMODEL MULTIFAMILY SIGN REPAIR GRADING o FENCE CYDS X FT) DEMOLISH TANK OTHER oGARAGE RETAININGWALL F RE SPRINKLER 0 FIRE ALARM CARPORT ROCKERY (TYPE OF USE. BUSINESS OR ACTIV EXPJ,.W. ny, rc NUMBER OF NUMBER OF DWELLING CRITICAL AREAS f**J STORIES UNITS NUMBER DESCRIBE WORKsro BE DONE 000 btu's HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMITAPPILICATION: ISO DAYS PERMIT ILIMM 1 YEAR -PROVIDED WORK IS STAnIED WITHIN 180DAYS 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. 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. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABIL17Y TO ENFORCE ANY ORDINANCE PROVISION., 1 HEREBY 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 M 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 WORKMEN'S COMPENSATI"NRANCE AND RCW 18.27. SIGNATURE (OWNER OR(A NT) DATE SIGNED / I I �-/ . - Ze r [PERMITEXPIRES us PERMIT ZONE NUMBER, JOB SUITE/APT# ADDRESS 24122 76 Ave W PLAT NAMEISUBDIVISION NO. I LOT NO. I LID NO. PUBLIC 19MONMOMPM UPF19YAL49RUT MAV Ww"SwI �NJ6%fnf%4ed EXISTIN ill OPOn Pro4gpL cLxp Rocrd �s 1 nj a d METER 111211y tvfflb SUPW F'RV REJUIRED 0 z REMARKS TE9115 NO 13 OWNE CQ��OR EROSION CONTR_0LtD@ALttA_GE ]�Me B or L vent connectors reqWredonfuel-buy.*WngappHancesin FIRE REVIEWED,$-------- W RESSUREMULMRVALVEMM SHALL BE INSTALLED NEAR VARIANCE OR CU MLWAWMN I BOND REQ'D POSTED 113YEs- ONO $ $EPA REVIEW SIGN AREA HEIGHT COMPLETE I EXEMPT ALLOWED I PROPOS., ED I ALLOWED I PROPOSED1 LOT COVERAGE E§ (�rjl) SETBACKS (Fr.) ALLOWED PROPO;dL r Wft ) UR SIDE REAR BE INSTALLED ON THE PARKING JL"u RE11D I PROVIDED REMARKS CHECKE13 BY CODE-e-1 OCCUPANTrZ ITYPII'M I GROUP SPECIAL INSPECTION OCCUPANT REQUIRED 0 YES JAREA LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RECI'R_] 9 $ 449.00 Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge 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 IA05)OFFICIAL�SIGNA %-Tlr- 771-0220 APPLICATION APAPOVAL This application is not a permit unfit signed by the Building Official or his/her Deputy: and Fees are paid, and receipt Is acknowledged In space provided. HE D TE -7- //ZV/4 47-W)'1' 1`114LE- A§ED BY ATTENTION I - EXT 133 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 IUV PERMIT EXPIRES �Z2L2 CITY OF EDMONDS USE PERMIT ZONE NUMBER(��O&_1�3�� CONSTRUCTION PERMIT APPLICATION JOB SURVAPT# A111E s124122 7. Ave w OWNER NAME/NAME OF BUSINESS Brian Nichols 0, PLAT NAMEISUBDIVISION NO. LOT NO, MAILING ADDRESS * iE 11 24122 76 Ave W P PUB E L S k0n tan as P Roq�d 11 a Wnn or IWA I n od R1 CITY ZIP TELEPHONE EXIS Wall to, u Edmond� 98026 425-673-9350 REOU % W aft fill (d 2 NAME METEjW 'LINE-sizE --&AV4QUIRED YESC3 NO 13 z I ADDRESS REMARKS z OWNER/CONTRACTOR RESP ONSIBLE vent connectOrs CITY ZIP EPHONE ro%—^ R 0xL d=d_qp.N* warr.. CW0 Llk E!ast �Iater Heater ENGI ERING REV DATE ADDRESS PURSUA NT TO ECDC 19.30-020 12601 132 Ave NE JL%X;0Ub%AffQR . - - 1 911"1 — . FIRE REVI W0V_xW_11R_F jjqSTALLED NEARIATE SHALL uj CITY zip TELEPHONE 1 WATER SHUTOFF Kirkland 98034 425-814-3124 ____THE — VARIANCE OR CU IATEJ STATE LICENSE NUMBER EXPIRATION DATE REO'D POSTED ro OYES 13NO S FASTWHCO52DF 2-16-05 SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT 4MQ2ED ALLOWED.' PROPOSED 00491'00000901 EXP VICE NEW . RESIDENTIAL . Ej PLUMBING/ MECH BEW;W�WS ET L fFROPOSED S SACKS (Fr.), ALLO Ro T UR SIDE REAR COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE tin AS IrTr z REMODEL MULTIFAMILY SIGN PARKING LOT AREA PLANNING REVIEWED BY DATE RE11D PROVIDED CL I 0 FENCE REPAIR GRADING CYDS X Fr) REMARKS OTHER DEMOLISH 0 TANK GARAGE RETAINING WALL o FIRE SPRINKLER FIREALARM CARPORT ROCKERY OP.AQT Wtm..' UVETY) OCCWANT GR OUPL CHECKED By TYPEM TITM NUMBE R NUMBER OF CRITICAL OF, DWELLING AREAS �_ SPECIAL INSPECTION AREA OCCrANT R f1j STORIES UNITS NUMBE L LOAD REQUIRED [3YES DESCRIBE WOAK#f0 BE DONE ReMoVe/replace gas water heater REMARKS INSPECTIONS AER UBC 168/FINAL INSPECTION RE01D PROGRESS in utility closet 40,0 0 btu's $ 449.00 Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE T GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO l= BE DONE ON PRIVATE PROPERTY ONLY. ANV CONSTRUCTION ON THE PUBLIC Grading",, Dcm�_(TSS, �!DEWAILKS. DRMVA I= , WE.*, U,.IF i Aj. 4kilz t: 'Engr. Review PERMIT APPILICATION: 1180DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 160 DAIS 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 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 NOR LIMIT IN ANY WAY THE CrTVS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt N I HEREBY ACKNOWLEDGE TKAT 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 CITY AND STATE LAWS REGULATING CONSTRUC- CALL This aolcailori Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building OtBcW or hIsAw 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 p(ovIded. WORKMENS COMPEN11ATI RANCE AND RC.W 18.27. OFFICIALS SIGNAJAJRE TE SIGNATURE (OWNER OR +M DATE SIGNED (425"' U) 4/ 771-0220 I RELEA6EO BY OATIf 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 I z 0 ITI M rn 0 C ITI 2 0 _n M M 0 0 0 C9 MO X z z 0 11 0 rfI