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20030372.pdfU11111 DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OW;N�NAMEINAME OF BUSINESS P I? T �� I?er MAILING ADDRESS 5— 1/ 1"),19117 CITY ZIP TELE�HONE �-Olmarwj- ��) 1 -73 NAME ADDRESS CITY ZIP TELEPHONE NAME CBLN, W-1410fel- 0 7 to �o ADDRESS -?"pao ZIP TELEPHONE &1k4- 2&Z (/70-J STATE LICENSE NUMBER EXPIRATION DATE 4 �, W fli rc- . f 5 V, o e_- e o-, 2-- 14o ��i CTA NEW RESIDENTIAL PLUMBING / MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE 0 REMODEL MULTIFAMILY SIGN REPAIR GRADING CYDS FENCE X ( FT) DEMOLISH TANK OTHER GARAGE CARPORT RETAINING WALL ROCKERY FIRE SPRINKLER FIRE ALARM (rVE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: _145e, ft6f.16 NUMBER OF STORIES ,-- NUMBER OF DWELLING I UNITS CRITICAL AREAS NUMBER DESCRIBE WORK TO BE DONE r �t7 f PERMIT EXPIRES USE PERMIT ZONE 0 3 -7 NUMBER JOB S ADDRES L.�2� SUITE/APT# PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. 1 LID FEE $ —1 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved AW Permit Required Street Use Permit Req'd EXISTING — PROPOSED Inspection floquired Sidewalk Required REQUIRED DEDICr0N3 ON FT UnderWound Wiring requirod 13 METER SIZE R"Ofte CqOVVh F r e'FneuR t I"Mmee"W"" (3 f t0sed 4wel SytWelp REMARKS expam, ifin Fa04"qWfifflf2&MiN ion fanKs are qlL I OWNER/CONTRAC JUIY Code. ECDC 19.30.020(r FIRE REVIEWED BY DATE DATE VARIANCE OR CU SHORELINE OR ADBI I INSPECTION BOND PEOD POSTED 13YES 13NO $ SEPA FMMP— ' I _______IIEIGHT 'OMPLETj,jffiT.j ALL PROPOSED I �ALLIJWED OWED I or L *iit connd!rfinire rn LOT C VERA FIEVIUMEDISEMCP ALLOWED 14fter"M PARKING LOT ZREA LANNING REQ`D I PROVIDED1 T CHECKED BY ITYP 7z SPECIAL INSPECTION JAREA REQUIRED [3 YES REMARKS PROGRESS INSPECTIONS PER UBC 1108/Fl UR SIDE OCCUPANT GROUP OCCUPANT LOAD REaD C) Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % T Building Permit [tat City Surcharge TL5_.---- PLAN CHECK NO: VESTED DATE Plumbing 10-1 Mechanical THIS PERMIT AUTHORGMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLV. ANY CONSTRUCTION ON THE PUBLIC Grading 2 3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPILICATION: IBODAVS 06 PERMIT LIMM I YM - 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 Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY BE FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due NOR LimrT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.. Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THMAT HE INFORMATION APPLICATION APPROVAL GIVEN IS CORREM AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CrTY 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 histher Deputy; and Fees are paid, and receipt Is acknowledged In space provided. WORKMEWS COMPENSAT;l��NCE AND RCW 18.27. --- OFFICIALS� SIG4TURE ED SIG NA"RE OWN G DATE SIGNE f..._ffol t) e? (425) 11, - r:J-, Ilk e Z_� 771-0220 6 DATF,/ =� RELEASED ATfENTION 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 ul "I 1z z M % M, M M M lo C 0 `7111 M M Fn 010� CO) z --I 5 M0 I DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWANNAME/NAME OF BUSINE&q Pt? 72w1,17tar M LING A At D 7" CITY ZIP JTELE�HONE C01#110MI-f Z,�20 I LLol-73 0-11 NAME ADDRESS CITY ZIP ITELEPHONE NAME CBLN LJA�fc 0 1 /0 ADDRESS :0� ZIP TELEPHONE 2-9?- V-71 STATE LICENSE NUMBER EXPIRATION DATE I C 4WR�rc--x We e '-1, - 16 -OSI T PERMITEXPIRES j USE PERMIT ZONE NUMBER 0 37z JOB SUITE/APT# ADDRESS Mr L PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Pem* Requisecl Street use Peffnit RW EXISTING — PROPOSED y1rod d UIR%No REQUI a ON 1eXM ""!I METE UIRED is n of C�sn. NO 13 z REMAR OWNER/ .002044TOLIDRAMINAG REVIEWED BY FIRE REVIEWED BY B Jr L went NEW RESIDENTIAL PLUMSING/MECH ALLI�;ED PROPOSED I "FROWT_ SIE*)E ADDITION [3 COMMERCIAL COMPLIANCE OR 0 CHANGE OF USE REMODEL muLnFAmity PARKING 0 siaN RE110 I PROVIDED REPAIR 0 GRADING CYDS FENCE X FT) REMARKS 11 ( 0 DEMOLISH 1:1 TANK o OTHER GARAGE RETAININGWALL FIRESPRINKLER DATE DATE 11.1 OWED JOPOSEE PROPOSED SETBACKS (FT, FRONT LIR SIDE REAR AREA PLANNING REVIEWED BY DATE U CARPORT Lj ROCKERY Lj FIRE ALARM (TYPE OF USE. BUSINESS OR ACT71TY) EXPLAIN: CHECKED BY TYP CH OCCUPANT ft �6 j_ =CON6T I GROUP NUMBER NUMBER OF OF DWELLING CRITICAL AREAS kk P rLRECIALINSPECT16N AREA OCCUPANT LOAD STORIES UNITS NUMBER REQUIRED YES DESCRIBE WORK TO BE DONE jVj REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTIC L k. '-a ak 4 21 P 2 117 REGO VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge 45 PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORUMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO k: BE DOM ON PRIVATE PROPERTY ONLI ANY CONSTRUCTION ON THE PUBLIC Grading 2 DOMAIN (CURBS, SIDEWALKS, DRI[VEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. 1: Engr. Review a PEwiYAPPLicAmoN.- isoDAys PERMIT UMM I YEM - PROVIDED WORK IS STARTED WITHIN 160 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUdCESORS-, Fire, Review Plan Chk. Deposit IN INTER07, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS MOM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY Fire Inspection Receipt # FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapeinsp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REOUIREME;ff OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CffY`S ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPUCATION APPROVAL' GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF GIVEN 0 CORHEU A 'IA' ' Pj OM Y' THE OWNER. I AGREE TO CCMPiY WITH CITY AND STATE LAWS REGULATING CONSTRUC- HE NEI, I AG E � PL 1 To T OW R CALL This applicaWn Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, No PERSON WILL BE EMPLOYED 0 0, OR Building Official or his/her Deputy: and Face are paid, ar IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknovriedged In space pr"ded. ORKMENS COMIPEN!A�=CE AND RCW 18.27. W M a OMPE 11 OFFICIALS SIGi1`j&TURE ,I ATE SIG Rr;:,,7 OR DATE SIGNED e. 771-02,20 RELEASED NTION A WION 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 - IN! CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD-ASE 04/62 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z M M C M C M M 0 17 10 M M 0 0C r-n M z X Q) z 0 IT11