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20030369.pdfI DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAiME/NAME OF BUSINESS 6 L-cx> S MAILING ADDRESS '72 ai vi CITY ZIP ELEPHONE 201T f,poQ&IQ(� Wp( NAME ADDRESS CITY ZIP ITELEPHONE ARM& /0 PERMIT EXPIRES USE PERMIT ZONE 40 ��D e� NUMBER JOB SUITE/APT# ADDRESS /A 2 / LAT NAME/S PLAT NAME/SUBDIVISION NO. T NO. LID NO. LID FEE S P B C U LI I To UBLIC RIGHT OFF WAY PER OFFICIAL STREET MAP TESCP Approvad RW Pafn-At Required Slider Use Palm" Req'd E IS I X T XISTING PROPOSED LREQUIRED Inspection Required Sidewalk Required Q 1 IC U DEUDICATION_ FT undeforound Widng required 13 M SIZ METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES E3 NO 13 z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE NAME CBLO ENGINEERING REVIEWED BY DATE S 5 3o T- S vj FIRE REVIEWED BY DATE CITY ZIP TELEPHONE M I=v%t L51) ,"P I i-2S -7 -7 -L STATE LICENSE NUMBER EXPIRATION DATE VARIANCE OR cu SHORELINE OR ADBN INSPECTION BOND REQ'D POSTED 113YEs I 22gf — ORO s SEPA REVIEW SIGN AREA HEIGHT T8K ACCOUNT PARCEL NO. COMPLETE EXEMPI ALLOWED PROPOSED ALLOWED PROPOSED t�PROPERTY LlY. -3 y f2 r Z =L.QQ , 0 2 , = EXP NEW RESIDENTIAL PLUMBING/MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) REAR ALLOWED PROP15SED FRONT SIDE REAR FRONT L/RSIDE oADDITION _e COMMERCIAL COMPLIANCE OR OF USE f& Zo S' P9 NZ. z CHANGE PARKING DATE eREMODEL MULTIFAMILY SIGN REOD PROVIDED LI IT AREA PLANNING REVIEWED BY 06 GRADING FENCE 2- 7- I & 51157 REPAIR CYDS ( X REMARKS DEMOLISH TANK — —FT) OTHER Meat GARAGE RETAININGWALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM UWE OF USE, MN SS OR ACTIVTM EXPLAIN: _-ITYPE 7CCUPANT r-j CHECKED BY OF —7 ff CE _WCTION GROUP NUMBER NUMBER OF CRITICAL M OF DWELLING AREAS SPECIAL INSPECTION JARtA OCCUPANT STORIES UNITS REQUIRED [3 YES LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 100/FINAL INSPECTION REG'D 9 jaWC-L vSM il-o V i 1PIan u5zll 16� Descaiptlan Check M V'"%A I k�llln FEE Descridion FEE State Surcharge "g,PURCE LOT SLOPE % Lllr_� ir 1:=1 I er, a I �k Building Permit j City Surcharge PLAN CHECK NO- VESTED DATE Q�.L� Plumbing Mechanical THIS PERMIT AUTHORMES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 3 DOLUUM (CURBS, SIDEWALKS, ORNEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: ISO DAYS 06 PERMIT LIMIT: 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 A512D 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 # CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY IALL 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 A14Y WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee Receipt # A A-7,/J "z 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 Building Official or histhot Deputy: anti Foos are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided. WORKMENS COMPENSATION INSURANCE AND RCW 18.27. ---- DA O(� BIG RE (OWNER 0 G DATE SIGNED 1425) �IALNIAE c),3 I o 771-0220 DREL ED B Y DArE ATTE-FATION M 1333 ;Y IT is UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 111m 6.jz� Oct A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -'FILE YELLCW-ASPECT�� CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING SEM t 7o%oaconoo vvj nc:nn nUT rn/77/Qn 7 74 4# DATE RECEIVkD lo-3 A& [PERFMAIT EXPIRES CITY OF EDMONDS USE ZONE �? 5 PERMIT , 1� NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUIFTE/A.P./ ADDRESS OWNER NAMEINAME OF BUSINESS 6 cuy=ls L_oos PLAT NAMEISUBDIVISION NO. LOT NO. UD NO. MAILING ADDRESS LIO FEE $ -77-!a M &I TESCP AP PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Perrrit= ad CITY" ELEPHONE 9 EXISTING — SUM Use Permit RaqV PROPOSED hup9cdon Required! Sidewalk Required REQUIRED DEDICATION— FT Underground MEN qm- WVmgroqtkvd 13 -NAME, METER SIZE LINE SIZE NO. OF FIXTURES PAV REQUIRED YEs13 NO 13 ADDRESS REMARKS -7. OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE CITY ZIP TELEPHONE MUNN CT NAME CB�# VVIVIF-661ED &.004. t- cajApew-1 ENGINEERING REVIEWED BY DATE ADDRESS lo T11 < r S FIRE REVIEWED BY CITY ZIP TELEPHONE cc rL J-7S — -7 -7 STATE LICENSE NUM13ER EXPIRATION DATE C VARIANCE OR CU SHORELINE 08 ADB# INSPECTION BOND REQ`D POSTED 113YES SNOII$* ` as Mop -.1. Is p 20 SEPA REVIEW H SIGN AREA EIG PROPERTY TAIL ACC_, PARCEL NO. EX�( ALLOWED PROPOSED ALLOWED P OF D, a k- 0 EXP 11� "(/,I. NEW A. RESIDENTIAL 0 PLUMBING / MECH A LOT COVERAGE ALLOWED PROpqsE� REQUIRED SETBACK EfTBACWFT.) FRONT Slog FlUrL FRONT UR SIDE REAR jj'ADDITION COMPLIANCE OR COMMERCIAL 1-1 35 f/. W 2 ISI NZ. z CHANGE OF USE &t �`REMODEL MULTIFAMILY [:3 SIGN PARKING REQD PROVIDED L PLANNING REVIEWED BY 0 ATE 06 REPAIR GRADING pi'FENCE CYDS 2-I DEMOLISH X _ TANK OTHER FT) REMARKS R^,M JU W, [3GARAGE 0 RETAININGWALL FIRE SPRINKLER eel. CARPORT ROCKERY FIREALARM t! 0 (TYPE OF USE. 88 OR ACTIV" EXPLAIN: CHECiiD BY]TYPE 0 CTION UPANT, F GROUP 1 4u 7%7 ii, NUMBER. I NUMBER OF CRITICAL OF STORIES I DWELLING AREAS ITS LIN NUMBER SPECIAL INSPECTION REQUIRED AR9_ OCCUPANT LOAD DESCRIBE WORK TO BE DONE REMARKS SPECTIO PROGRESS INSPECT`IONS PER UBC I 08/FINAL IN N REGl`D -.0 2SL�11 yl�g= t a LIP! m6u - D1�74 A22 aef., YALUATION $ Description --- 1% ( FEE Descrip(lon FEE I Plan Check State Surcharge HEAT SOURCE QLA71 LOT SLOPE !�, Aig; I _7 0 ��10 Building Permit City Surcharge VESTED,DATE PLAN CHECK NOi,:F Plumbing go .t:L THIS PERMIT ALITHORMES ONLY THE WORK NOTED. THIS PERmrr,covEris WORK To Mechanical t: 02 DOHE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC 2 Grading 3 DOMAIN (CURBB, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMI'll'APPUcAno": ISODAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAVa 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. De'posk 05-rn 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 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 Landscapelnsp. Total Amt. Due NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PRO VISION.' Recording Fee Receipt # 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 APPLICATION APPROVAL THE OWNE(`L I AGREE TO COMPIY WVfH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a permit until signed by the TION; AND W DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building OMcW or his/her Deputy: and Fees are paid, and IN VIOLAIJON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged In space prpyided. WORNMENS COMPENSATION INSURANCE AND RCVV 16.27. TUREi SIG N O�A DATE SIGNED 077, (425) OTCIAL NAT AE. D vis ;R " :I 771-0220 �V5( u3_ 1 M sa- RELE BY 4 ArMNTION EXT 1333 /,,7ED IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 4 L A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGIN&.FILE - YELL9W-I SPECT9A CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOI? - SESSon L.. 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCX)NLr1NQ