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20030362.pdfM DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMENAME OF BUSINESS Caifc_ t ciceF R MAILING ADDRESS /300 al. 57, CITY ZIP TELEPHONE sa*p_ t A ml� NAME ADDRESS CITY NAME F I / 649 n . JCBL ill ADDRE:p . 0. CITY ZIP TELEPHONE 2=6 A%6— --gel r?— vto STATE LICENSE NUMBER EXPIRAT19N DA71E NEW r4cKRESIDENTIAL ADDITION C REMODEL MULTIFAMILY REPAIR 0 GRADING CYDS DEMOLISH TANK oGARAGE RETAININGWALL CARPORT ROCKERY (TYPE OF USE. BUSINESS OR ACTIVTM 1_1�7 NUMBER NUMBER OF OF DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE Qbq 3 PERMIT EXPIRES USE PERMIT Z3. '0 ZONE NUMBER j JOB SUITE/APT# ADDRESS7d_� k al".; C_ PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S TESCP Approv*3 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required Street Usa Parynit Raq'd EXISTING — PROPOSED inspection Roquired Sidewalk Requirod REQUIRED DEDICATION— Fr Underground Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES13 NO 13 15 REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE I BY FIRE REVIEWED BY DATE DATE 11" VARIANCE OR CU SHORELINE OR ADBI I INSPECTION I BOND REO'D POSTED OyEs 13NO $ SEPA REVIEW S HEIGHT COMPLETE - EXEMPT LvamNi5rawa I ALLOWED . PROPOSED LOT COVE SETBACKS (Fr.) PLUMBING / MECH ALLOWED k=EF1L1T==A1aCFVWL/R SIDE REAR COMPLIANCE OR CHANGE OF USE PARKING LOT AREA I PLANNING REVIEWED BY DATE SIGN REOD I PROVIDED FENCE Fr) REMARKS 0 OTHER F RE SPRINKLER FIREALARM CRITICAL AREAS NUMBER 0104 V5 �_Woj a CHECKED BY TYWIPION Cn OCCUPANT ::1 GROUP K3 SPECIAL INSPECTION' JAREA OCCUPANT REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG-0 I Cf&A1 -7 mnes txrenw0eAlT VALUATION ,21vd Pi�kk C&ET - escription FEE Description FEE �_ - Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Sur charge P�, PLAN CHE VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. I= — Engr. Review 5 PERMIT APPLICATION: 180DAYS 116 PERMIT UMrP I YEAR - PROVIDED WORK IS STARTED WITHIN ISO 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 a 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 Landscapelnsp. Total Amt. Due 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." Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION APPROVAL' GIVEN IS CORREC-L' 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 13 not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF Tl:* ODE OF THE STATE OF WASHINGTON RELATING TO Building Official or his/her Deputy: and Foaa are paid, and FOR INSPECTION receipt Is acknowledged in space provided. WORKMENS CO SNANCE AND RCW 10,27. OFFICIALS S71NATUqE D TE at OR DATE SIGV.0 (425) E2��_ � Z21, 771- 0220 DATE' RELEASED BY Al 11:1114 1 ION off 1333 I 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 FINAL PROJECT APPROVAL z 0 m =i 9 m c MO 0 80 c Ic X M z 0 -n n m rn 0 0 0 c M 0 Z .1� X z z 9 0 m RE -INSPECTED UU-1bl"WINU 100u-DO Si Date------------------- ocaprvLdoc.I:WMP.bldg:for=10/01 I too, W I r PATE RECEIVED PERMITEXPIRES CITY OF EDMONDS USE PERMIT ZONE 7.,0-3 NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUfTE/APT# ADDRESS7eZ c 4 e OWNER NAUJUNME OF BUSINESS CIVA16- eUCAhF1? LILI 21p; 11, PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. 15 MAILING ADDRESS /3610 94 &qkee�� LID FEE $ TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW PormIt Re"Ired CITY— ZIP TELEPHONE 5 ea fe Street Una Permit FtaqV EXISTING — PROPOSED Inspocflon Mquired Sidawak Required REQUIRED DEDICATION— FT I Undffwmmd uIred 13 NAME METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED I ES13 NO [3 z ADDRESS REMARKS A) OWNEWCONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAQE CITY ZIO TELEPHONE `�Ti o CBL# ENGINEERING REVIEWED BY DATE W ADDRESS FIRE REVIEWED BY DATE ZIP rELEPHONE VARIANCE OR CU SHORELINE ORADB11 INSPECTION BOND STATEU_CEbISE NUMBER EXPIRATI9N DAJTE B REO'D POSTED [3YEs 13NO Is 6 COC /&DIR0 110110 71 ___L/r SEPA REVIEW SIGN AREA HEIGHT PROPERTY T COMPLETE , EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED CV0 b;;ii%m IAAMOLAI NEW RESIDENTIAL PLUMBING MECH L�r LOT COVERAGFIMI PROPOSED SETBACKS (FE) ALLOWED FRONT UR SIDE REAR COMPLIAISICE OR 13 ADDITION COMMERCIAL CHANGE OF USE ;�iki ii- OUMAL. OR CIAP 1:1 REMODEL mummmy SIGN P 046" 1 ' L&"9RKX I FLANNiNG REVIEWED BY DATE ROVIDEDT 1:1 REPAIR GRADING CYDS [3 FENCE X FT) REMARKS [3 DEMOLISH TANK OTHER oGARAGE o REWNING WALL [3 FIRE SPRINKLER -CARPORT ROCKERY FIRE ALARM UWE OF USE. BUSINESS OR ACTIVRY) EXPLAD;n CHECKED BY FrION c OCCUPANT 6Z TYU7!qW r�_L GROUP ke 4 NU SIR NUMBER OF CRITICAL t:z .2. L AREAS OF DWEL NG STORIES UNITS NUMBER SPECIAI INSPECTION' AREA OCCUPANT REQUIRED LOAD. [3 YES DESCRIBE WORK TO BE DONE lol REMARKS IMI)o PROGRESS INSPECTIONS PER UBC 1101111/171NAL INSPECTION RE= 11m AOL VALUAnON Qt re±4 $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHE�CK �NO, VESTED DATE Plumbing Mechanical TMS PERMIT WMROES ONLY THE WORK NOTEEL THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading DOUAIN (CURM, SIDEWALKS, DRINIEWAYS, MARQUEES, ETC.) WILI. REQUIRE SEPARATE PERMISSION. Engr. Review PERmrrAPmcATmm: isoms PERMIT UMrP I YfAR - PROVIDED WORK 18 STARTED WITHIN 190 DAYS Engr. InspecUon SEE BACK OF PINK PERMIT FOR MORE INFORMATION *APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEMS, ASSIGNS AND SUCCESORS Fire Review Pian 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 0 Ll:" J ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF IHIS 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 U341T IN ANY WAY THE CFTYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # I A&TA�/ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION I 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 eloned by the 'Building TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LA DE OF THE STATE OF WASHINGTON RELATING TO Official or hWher Deputy: and Feea are paid, and FOR INSPECTION receipt Is acknovdodged In space provided.. WORKMEICS CO I S CE AND RCW 18.27. OFFICIAL87Z at En on DATE Slaw 1A0 1,425) A g Aoj��_ 771-0220 RELEASED BY DATE' ATTENTION EXT 1333 ......... IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE NTIL 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 nocem Arr�Imn 04/02 PRESS HARD - YU A It- MAKINU 5 COPIEM