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20030360.pdfDATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION O�� 0i;4/WM;:F BIESS L ODE fLs'c- 0 MAILING ADDRESS T -712. Lf (56 114 S—i. S. We CITY ZIP I TELEPHONE 9%.2-t. j4)S-Tf2.-SS08 NAME ADDRESS PERMIT EXPIRES USE PERMIT ZONE 7—N U M B E R JOB ��UITE ADDRESS 1 al�� PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESFPAPPr=. RW Permit R d EXISTING PROPOSED Sir at use Permit Raq'd lna=n Required REQUIRED DEDICATION FT Sidewalk Required 13 Underoround Yfirtrig required 13 METER SIZE LINE SIZE NO. 0 FIXTURES PRV REQUIRED YES 13 NO 13 z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE CITY ZIP TELEPHONE NAME CBL �.E ENGINEERING REVIEWED BY IfATE ADDVESS,�' '3 1 FIRE REVIEWED BY DATE us IC CITY TELEPHONE 1z 4zAkwldob� qg3l VARIANCE OR CU SHORELINEORADBN INSPECTION BOND LICENSE NUMBER EXPIRATION DATE C REQ'D POSTED io I 13YEs 13NO YLY'I't�t4 L 21 gi /zip SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. I T— COMPLETE EXEMPT ALLOWED , PROPOSED ALLOWED , PROPOSED C>as I 3b 00co 2-an --z' EXP LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) /19UEW RESIDENTIAL PLUMBING I MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR (3 COMPLIANCE OR 13 ADDITION COMMERCIAL CHANGE OF USE PARKING LOT AREA I PLANNING REVIEWED BY DATE 13 REMODEL MULTIFAMILY SIGN REOD I PROVIDED 1:1 REFAIFI GRADING CYDS FENCL x 2c&* REMARKS ( — — 11 DEMOLISH TANK OTHER 0 GARAGE RETAINING WALL FIRE SPRINKLER CARPORT 0 ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS 0 PLAIN: CHECKED BY i TYPE prZONSTVC7116N occup GROU el� pk:�_ NUMBER NUMBER OF CRITICAL U*i OCCUPANT OF DWELLING AR SPE IAL INSPECTION AREA STORIES U NL pop- :)q LOAD NITS REQUIRED [] YES DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REG-0 VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE LAZING % LOT SLOPE % City Surcharge Building Permit PLAN CHECK NL�— VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPLICATION: 180DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION APPUCANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review N INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CI1YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION., Recording Fee 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- CALL 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 WORKMEN3,e0W%SATION INSURANCE AND RCW 18.27. V R, SIGNANdE (OVV DATE GNED 1A 13 %425) UIAG� 4t 34 03 771-0220 kTTENTION EXT 1333 Plan Chk. Deposit Receipt # Total Amt. Due Receipt# APPLICATION APPROVAL ikapplicalIon is not a permit until signed by the ucW or his/her Deputy: and Face are paid, and 1pt Is arknow*ged in space provided. 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 ANATuae7 I N DATE U&INA, I I 1?_� ORIGINAL. %5.,0' YELLOW - ASPECTO PINK -OWNER - GOLD -ASSESSOR GREEN - ACCOUNTING J� I CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWtROfA:MIN7 BJESS 41_ tj DEP-se 0 MAILING ADDRESS T14 712- Lf I _G 110— '�a. S, W, CITY ZIP ITELEPHONE E-DmoA)Q.S 9,9oz(, 1415-742.-SS08 NAME ADDRESS CITY ZIP ITELEPHONE Ll PERMIT EXPIRES _L1 USE ERMIT ZONE 17—PNUMBER jOI3 � ( I 3;jA, rYT6# ADDRESS PW NAME/SUBDIVISION NO. LOT NO. LID NO. UD FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP IFSCP Apploved RW "" "." EXISTING PROPOSED Strest Use Peffnft Req�d InspacUon Roquirad REQUIRED DEDICATION x:::::::: FT Sidswalk RequM UndwWound W=g FQqW— METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YEs13 NO 13 z I REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE N ME A Cat. !� I MOL ENGINEERING REVIEWED BY ,4ATE ADJU� JS�lh FIRE REVIEWED BY DATE CITY TELEPHONE P qk3al J Iz: d&5- 746-6115, _71 VARIANCE OR CU SHORELINEORADB11 INSPECTION BOND JnUCENSE NUMBER EXPIT REQ'D POSTED OyEs 13NO $ SEPA REVIEW SIGN AREA HEIGHT PROPE TAX ACCOUNT PARCEI �VMrLrIC PROPOSED ALLOWED PROPOSED RTY EXEMPT ALLOWED W 1 37J 0c4ao�i , , , .5 EXP &.AIF LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) AL PLUMBING/MECH NEW >(RESIDENTIAL ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR or-% COMPLIANCE OR 1:3 ADDITION COMMERCIAL CHANGE OF USE PARKING LOT AREA I PLANNING REVIEWED BY DATE REMODEL MULnFAMILY SIGN REQ`13 REPAIR GRADING FENC2. CYDS ( , x 2o.T Fr) REMARKS AASIMI [�:3 DEMOLISH [3 TANK OTHER J— U IWO' oGARAGE [:I RETAININGWALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM I[TYPE Of USE, BUSINE Ss 0k:!MPLAIN: . CHECKED BY ITYPEAFTIONSTR occup UCTION GROUq� 19 NUMBER NUMBER OF CRITICAL OF DWELLING AREAS SPECIAL INSPECTION JAREA OCCUPANT LOAD ST61RIES UNITS N IEQ REQUIRED [3YES DESCRIBE WORK fO BE DONt REMARKS FEVC.&C PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REGfD Wooplao dr I ve VALUATION $ Description FEE Description FEE Plain,theck State Surcharge HEAT SOURCE GLAZING% LOT SLOPE % Building Permit City Surcharge PLAN CHECK Nh VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I= BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC 2 Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMrr APPLICATION. 180 DAYS PERMIT LIMM 1 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 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Recelpt_#____I- 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 Landscapeinsp. Total Amt. Due NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # Ma I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION _1L APPLICATION APPR L 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 j n Is not a permit until signed by the '"ON; AND IN DOING THE WORK AUTHORIZED TVIEREBY. NO PERSON WILL BE EMPLOYED a fiff== Ws/her Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION 7 Ipt Is ackn6w*god in space provided. WORKMEN' :��SAT�DN INSURANCE AND RCW 18.27. 0 1 NATU 'DATE BIG:] DATE�IGNZD (425) '2 771-0220 RELEASED Y ATTENTION Off 1333 ' -- 1 6 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL JT. /jj/,i"/l - A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - Ft YELLOW -7 CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER - GOLD -AS! 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN -ACCOUNTING