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20030351.pdfI i F—DATE CITY OF EDMONDS I / CONSTRUCTION PERMIT APPLICATION OWNER NAMEr,,ME OXSINESS L eje, MAILING ADDRESS 9 70 (k -2-3 6 tk �f 5' LJ CITY zip TELEPHONE cc, 4vli, %_7y—M -7 .� L no,101 2X116 NAME ADDRESS CITY ZIP I TELEPHONE NAME 10 1 1 CBL #` CITY ZIP I TELEPHONE STATE LICENSE NUMBER EXPIRATION DATE _F CHECKED 13Y TAX PERMITEXPIRES USE PERMIT ZONE NUMBER JOB SLIITEIAITAI ADDRESS PLAT NAME/SUBDIVISION NO. LOT NO, L�D NO. L D FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Aripwoved RW Permit Requ:;*d Street Use Perm Raq.d EXISTING — PROPOSED InspecWn Required 13 Sidewalk Required 13 REQUIRED DEDICATION— FT Underground Wiring required C3 METER SIZE LINE SIZE NO. OF FIXTURES PAV REQUIRED YES13 No 13 REMARKS z OWNER/CONTRACTOA it z SHALL BE INSTALLED NEAR 1 ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE gg;RRj;A= :CQ IlDr Mlq 2 ul VARIANCE OR CU BOND I kV WVJ&Mft�FF POS 3TED 1:1 NEW ;9 PLUMBING / MECH EADDITION 3 'NeMIDENTIAL COMMERCIAL COMPLIANCE OR 1:1 CHANGE OF USE 1:1 REMODEL MULTIFAMILY SIGN ir- 11 REPAIR GRADING CYDS FENCE X_Fn DEMOLISH TMK OTHER ZI GARAGE CARPORT RETAINING WALL ROCKERY FIRE SPRINKLER FIRE ALARM (TYPE OF USE. BUSINESS ORACTPi=,EXPI:A1Nil,,1 W NU BER NUMBER OF CRITICAL 0 1 DWELLING AREAS M OF ci STORIES UNITS UMBER DESCRIBE WORK TO BE DONE HEAT SOURCE GLAZING 9iii— 1 LOT SLOPE % PLAN CHECK NO: I 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 DOLUUN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPUCATION: ISODAYS PERMIT UMIT I YEAR - PROVIDED WORK 15 STARTED WITHIN 180 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, 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 ABILITY TO ENFORCE ANY ORDINANCE PROVISION,' I 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 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 WORKMEN'S,PCIM%SATION INSURANCE AND RCW 18.27. DATE SIGNED S'-W - 0 3 SEPA REVIEW COMPLETE EXEj1aW ' 4 N 1, �%R@,Iflrr ED PROPOSED EXP I , LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR z PARKING LOT AREA I PLANNING REVIEWED BY DATE I REO'D I PROVIDED REMARKS CHECKED BY SPECIAL INSPECTIC REQUIRED [] YES REMARKS (3 INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D I z 9 OCCUPA GROUP OCCUPANT LOAD $ 1 Description FEE Description Plan Check State Surcharge Building Permit City Surcharge Plumbing A11), Mechanical Grading Engr. Review Engr. Inspection t FEE Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION 1A0 1,425) 771-0220 APPLICATION APPROVAL This application Is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid, and receipt Is acknowledged in space provided. OFFICIALS SIGNATVRE TE jj bl 1��A ASE'D BY' J DATt ATTENTION f 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 =i M C M 0 0 0 C :1 c M M z _z co 0 _n M M q 65 0 0 Fn C: (j) C V) M 0 z z 0 4 0 M RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: - Footing........................ Wall .......................... Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Vnderground ......... Rough -in ................... Commercial Final ...... HEATING: Gas Test .................... Gas Piping ................. Equipment .................. Commercial Final ....... EXTERIOR SHEATHING NAILING .......................... FRAMING ........................ FIRST FLOOR FRAMING... INSULATION ................... Floor Insulation ......... Wall Insulation ........... Ceiling Insulation ....... SHE ETROCK NAILING SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR 1?-63 OCCUPANCY .................. DATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/ ME O�gUSINESS Lm r V es MAILING ADDRESS of 9 70 6 23 6 t4 �f LJ CITY ZI TELEPHON ? ?o2o 2x 6 E:j""Is P NAME ADDRESS CITY NAMEa ADD08—S CITY STATE LICENSE NUMBER ZIP ITELEPHONE ZIP I TELEPHONE NEW All�rlffDENTIAL ADDITION COMMERCIAL REMODEL MULTIFAMILY REPAIR GRADING CYDS DEMOLISH TANK GARAGE o RETAINING WALL CARPORT ROCKERY (TYPE OF USE, BUSINESS OR ACTnE7LA17 NUMBER NUMBER OF OF DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE [�7ERMIT EXPIRES ZI Z USE PERMIT ZONE NUMBER A10 3 JOB SUITE/APT# ADDRESS / , � z_j PLAT NAM EISU BDIVI SION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TIES 'Oved =11"R.,.� RWI�a street use I'affrill RaCfd EXISTING - PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION- FT Undargmund Wiring required CI __�'ETER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YESO NO 13 REMARKS z z OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE I E PURSUANT To Ecr%ry .- -_ -_ - CBL 0 A PF=URE WZULATOR- _r7._jU-WU, VALVE (L3= ALI= BE it R ENGINEERING REVIEWED BY T XaIALLED RM HF, WATER SFRJTOFF FIRE REVIEWED BY DATE W cc VARIANCE OR CU SHORELINE 08 ADB# I INSPECTION I BOND CHECKED BY REQ'D POSTED OYES 13NO S SEPA REVIEW HEIGHT COMPLETE , EXEMPT ALLOWN0 96W Lt*P PROPO A *Afij !a 6P5.2 EXP oty AV j PLUMBING I MECH LOT COVERAGE ALLOWED PROPOSED COMPLIANCE OR S CHANGE OF USE PARKING LOT AREA PLANNING REVI D BY 3 ' NC ME E 0 C H OF USE EWE [3 SIGN REO'D PROVIDED 1 FENCE I :1 ( X FT) REMARKS OTHER FIRE SPRINKLER FIRE ALARM CRITICAL CHECKED BY ITYP77/) AREAS SPECIAL INSPECT16N ATIOA NUMBER REQUIRED [] YES REMARKS PROGRESS INSPECTIONS PER UBC A/ lia-zi- 1 0 X L WG" Ez DATE 0 OCCUPANT LOAD INSPECTION REG'D VALUATION Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing A�/ Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMrTAPPLICATiON: 1180DAYS IL PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 160 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICA1`9 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 Inspec o Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY 1 4, FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE La�ds;z;jirp, Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 NOR LIMIT IN ANY WAY THE CITY$ ABIL17Y TO ENFORCE ANY ORDINANCE PROVISION.' zi - Rec&illng Fee 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 CITY AND STATE LAWS REGULATING CONSTRUC- CALL This applicatIon 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 his/her Deputy: and Fees are paid, and receipt Is acknowledged In space provided. WORKMEN'Srffll�SATION INSURANCE AND RCW 18.27. OFFICIALS $IGNATVRE DATE SIGNATUR NER R DATE SIGNED (425) S-ZD- 03 7 7 1 - 042) 2 0 rg RELEA___ ATTENTION EXr 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 t z 0 q 0 M M 0 0 0 C: --I r. X M M Z ,C) c 0 -n n M M a V5 0 0 Fn C CA C 0) M 0 z z 0 M