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20030375.pdfDATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION =RESS / S Ile o5- 1j'k -, ZIP TELEPHONE rnfidds 7� NAME ADDRESS PERMIT EXPIRES -LLV-rl �ej 22.. 1 1 � -L� USE PERMIT ZONE NUMBER JOB SUITE/APT# I ADDRESS soe4' PLAT NAME/SUBDIVISION NO, LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved Rw Per" Requif street Use Pennit EXISTING — PROPOSED inspection Requirw Sidewalk Required REQUIRED DEDICATION-- FT underwound %we raciuirad METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 13 I YES CI NO E3 21 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE CITY ZIP TELEPHONE _! 11? it: MUST BE FIRES NI EDP NAME CBL ANK FILL. REM 0114, OR (%AP C�4 ENGINEERING REVIEWED BY DATE ENGINE ADDRESS V'0'e0x31j'1Pr DATE ul ;' FIRE REVIEWED BY FIRE F CITY ZIP TELEPHON1 go6-5cf rL Sga-ff EXPJRATIOY DATE CHE KED B V IA BOND REO'D POSTED 1I.M.KU'r nM M I I SHORELINE OR ADB# INSPECTION 1$ 113YES STATE LICENSE NUMBER F/LCOC/MOW A LA A �3 ( I 13NO SIGN AREA HEIGHT __ .'. - - — — — SEPA REVIEW I COMPLETE . EXEMPT I ALLOWED , PROPOSED I ALLOWED , PROPOSED] LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS NEW RESIDENTIAL PLUMBING / MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR I I COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE — PARKING LOT AREA PLANNING REVIEWED BY DATE REMODEL 1:1 MULTIFAMILY SIGN RE11D I PROVIDED I 0 GRADING FENCE REPAIR CYDS ( X Fr) REMARKS 0 DEMOLISH 1� TANK OTHER oGARAGE o RETAINING WALL 0 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS OR AC15M*. f CHECKED CONSTRU9MON Y OCCU PA GROUP I NUMBER OF CRITICAL OF DWELLING AREAS NUMBER 71 SPECIAL INSPECTION AREA T OCCUPANT LOAD STORIES UNITS NUMBER REQUIRED [] S )7YES DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RE gal. _f Ack—ClAfN 2%r "?-/ffl'0tf _57AUC IRA(- AlvURPAIM&E VALUATION EM2 hAarf me A4 $ _.�nl AW atA AsmeA� ze &6_111d tx Description FEE Description FEE Plan Check State Surcharge — [City HEAT SOURCE GLAZING % LOT SLOPE % Building Permit 145, Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBUC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 1= SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 180 DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICAK 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, EMPLOYEE% AND AGENTS FROM ANY AND Fire Inspection Receipt # a ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY THIS PERMIT SHALL NOT BE Amt. Due f—r) [ FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF Landscapelnsp. Total :I DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE - NOR LIMIT IN ANY WAY THE C17YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # rAZM I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL by Me GIVEN IS CORRECT; THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- 7 plicau0n CALL 8 g Is not a pe(mit until signed let or histher Deputy: and Fees are paid, and TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABQB=DE OF THE STATE OF WASHINGTON RELATING TO f F I Is acknowledged in space provided. FOR INSPECTION �T - WORKMEN'S COMPEN!��INSUFnEE AND RCW 18.27. 1 URE DATE DATE �9`NED (425) 'l-c'i A) M'O�w 771-0220 RE D B UAIG ATTENTION Off 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLCW- INSPECTOR A FINAL CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 ARE PINK -OWNER GOLD -ASSESSOR MAKING 5 COPIES GREEN ACCOUNTING 04/02 PRESS HARD -YOU 0 I FINAL PROJECT APPROVAL FORM TO: DATE: 0 2. .3. RE-INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Si omprvLdoc.l:tm�p:bldg:fw=lO/01 z 9 0 m -4 --fl -: X4 M c M 0 0 c M M Z g) --I c J) 0 -n n m M 0 0 0 M C co) K (1) M 0 Z X 0 z z 0 m 4 . M I 10 9 I 111151111111 1 RECEIVED,-11Y DATE �4 1 04 0 1 01 1 PERMIT EXPIRES CITY OF EDMONDS UQQ ZONE PERMIT -NUMBERa)�:3_n:05 CONSTRUCTION PERMIT APPLICATION JOB ADDRESS j sunE/APT# 50e;ll OWNE INESS // PLAT NAME/SUBDIVISION NO. NO. LID NO. AIL M ING ADDRESS Sir/ 7 PUBLIC RIGHT OF WAY PER OFFICIAL STREET fAAP LID FEE $ TESCP APPrOV90 RW PermAt Rewired C171ZIP ITELEPHONE I -013 EXISTING — PROPOSED REQUIRED DEDICATION— FT StmejugoPermhR Id inspection Required sidwalk Required UndwWotrA Wiring req*0d 13 NAME METER SIZE LINE Sli� NO. OF FIXTURES PRV REQUIRED A A YESO NO 13 ADDRESS A/A REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE CITY fl zip ITELEPHONE r- I rr-% NAMEF CBM TANK FILL, REMOVAL, IOR r-AP-__ ENGINEERING REVIEWED BY C A1FSS FIRE REVIEWED BY DATE CITY ZIP TELEPH spa* FN160`�q -3 i;? 0 VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND STATE LICENSE NUMBER E TIC DATE REQ'D POSTED I 1 7xP1,,z..,,,,x2 Flicocloe-4V OYES ONO $ - PROP N lj:� SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED I V EXP , , , LOT COVERAGE REQUIRED SETBACK$ (Fr., PROPOSED SETBACKS (Fr.) 1:3 NEW RESIDENTIAL PLUMBING / MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY SIGN PARKING REQ`D PROVIDED LOT AREA PLANNING REVIEWED BY DATE REPAIR GRADING FENCE CYDS E: ( X _ FI) REMARKS DEMOLISH TANK OTHER GARAGE RETAININGWALL FIRE SPRINKLER CARPORT ROCKERY F RE ALARM mall (TYPE OF USE, BUSINESS OR AG��: I CHECKED BY COFNISTRUqTION OCCUPA76 'NUMBER ITYPE OR NUMBER OF CRITICAL OF LLING AREAS OWE I SPECIAL INSPECTIOINAREA OCCUPANT STORIES I I NUMBER REQUIRED [3 YES LOAD DESCRIBE WORK TO BE DONE 2 cml, REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD 9 AJP Y740 c 7- 7L//n AL-Ak M_ d hut 1K 57AC/C !a RA L Pd1v MR F 7'44 ou E MON VALUA VIVIII bj6_1_bmW aIL71 — Ry A e,,& VP/I, I &C( P, *//e A $ A e§,IA CAO 69LEW Description FEE Descriptlan FEE MADE Plan Check State Surcharge HEAT SOURCE GLAZING % I LOT SLOPE % VESTED DATE Building Permit 1113lumbing City Surcharge PLAN CHECK NO: TmomrTAtirnioRtme (Amy 1%E woRx NorrED.: THIS PEmmrr COVERS WORK T9 ........ r DOm ON PRIVATE PROPERTY ONL1 ANY CONSTRUCTION ON THE PUBLIC ,RF Grading DOMAUN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQU SEPARATE PERMBSION. Engr. Review PERMIT APPUCATIOM' 160DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT. 014 BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit IN INTEREST, AGREES TO INOEMNIFT, VEFENO Mu nu EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND Fire Inspection Receipt 0 ALL CLAIMS FOR DAMAGES OF WHArEVER NATURE, ARISING DIREC-nY 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 CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION," Recording Fee Receipt # I HEREBY ACIQ40WLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVE IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL P A N TL D Y BE "CE 0 N , T ON T OF R C U YE To tic LY WITH CITY AND STATE LAWS REGULATING CONSTRUC. "IcaWn is not j pennit iji�tli signed by the THE LNER I AGREE TO COMP a CALL' Q W., hloor Deputy: and Faso are paid, and TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Pt I... N IN VIOLATION OF THE LAO E OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION knowtodgod In space provided. WORKMERS COMPENSA INSU CE AND RCW 18.27. 10"TURE DATE DATE SIPNED iA9 !11=0 NE R NT) 1,424 5APzAn 771-010 r DATE ATTENTION EXr 1 3 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 9 0 m