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20030380.pdfDATE RECEIVED )C;L PERMIT EXPIRES CITY OF EDMONDS MEN USE PERMIT ZONE eq NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUITE/AP'T# ADDRESS 22_&2_1 OWNER NAME/NAME OF BUSINESS 6 6 Aq K/ (f 15 &Z PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS *7&f1i LID FEE S TESCP Approv Aw- PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW ,ad RqV CITY ZIP I TELEPHONE Street use Permit Raced EXISTING — PROPOSED lnsp@cWn Asquired Sidewalk Required '778 —1310-3 REQUIRED DEDICATION— FT UndeVound j��0+25- Wking required NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED — I - 13 I_a1(,yeKCe_, &A 2, YES No _W DDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE CITY ZIP TELEPHONE :> NAME CBLN ENGINEERING REVIEWED BY DAIE I ADDRESS .03 W FIRE REVIEWED BY DATE CITY ZIP TELEPHONE cc STATE LICENSE NUMBER EXPIRATION OAT CHECKE6 By I VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND REqD 0 POSTED 13YEs 3ko s SEPA REVIEW SIGN AREA Jg- HEIGHT 'MP PROPERTY TAX ACCOUNT PARCEL NO. ALLOWED PROPOSED a PROPOSED COMPLETE EXI . nj.OWED, 0 00?� 057 00 io IT. -3 EXP 1 ��%02 I PLUMBIN 7) NEW RESIDENTIAL G (MOECH 13 x 0 LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FEj ALLOWED PRoPo BED FRONT SIDE REAR FRONT L/R SIDE A DMON COMMERCIAL COMPLIANCE OR D OF USE 010121-ft AlAkZ&1159;�� '9*zi CHANGE 6EVIEWED f REMODEL MULTIFAMILY SIGN PARKING PLANNING pyl DATE RE0`D PROVIDED LOT AREA j ]- :;I� --7-1 "m 11! � 0 REPAIR gF�A G FENCE 110 CYDS 0 X_FT) DEMOLISH TANK [:] OTHER lAilQ2 GARAGE RETAINING WALL 0 F RE SPRINKLER ALARM CARPORT ROCKERY FIRE (TYPE OF USf, BUISI�%S Clf�.�CTIIVITY) EXPLAIN: CHECKEDBY TVPEOFQ9NST UCTION OCCUPANTO !Z NUMBER' DNUk(bM OF RITICAL. 11k, C&j OF WELLING 6 I AREAS 122 7AI e MGROUP INA OC P SPECIAL INSPECTION JAREA OCCUPANWT STORIES NITS MBER Lo REQUIRED 0 YES LOA7D DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D /7 L _07 Isr-A- IV VALUATION Description FEE Description FEE Plan Check /V35— I State Surcharge HEAT SOYRCE GLAZING % LCjT SLOPE % I q0 .4 07c, I __� ,Building Permit City Surcharge .1 vESTEP OATX: PLAN CHECI! Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PER16rr COVERS WORK TO 1= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOILWN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REG UIRE SEPARATE PERMISSION. Engr. Review PFRMITAPPLICATION: ISODAYS A. PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICAITT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit .4�3 IN INTEREST, AGREES TO INDEMNIFX DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES. "D AGENTS FROM ANY AND Fire Inspection Receipt ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY _,7 FROM THE qUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE IS, DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION., Recording Fee Receipt # N I HERE13Y 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 histher Deputy: and Fees are paid, and IN VIOLATION OF THE LA13OR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged In space provided. WORKMEN'S .,�ENSATION INSURANCE AND RCW 18.27. OFFIC14L.5 GN TURE qTE SIGNATUR(OWN,o OR AGE" DATE SIGNED (425) W-1 �31, _- 771 -02,20 DAT9 ENTION RELEASED By Off 1333 A/'; IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGAAL /FILE - YELLOW INSPEdTOR 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 0 M M M 0 80 C � x M M z CA on _1111 Lo M M 0-0) 0 0 Fn C 0) K 0) M 0 z 0 0 M FINAL PROJECT "PROVAL FORM TO: DATE: PERMIT COORDINATOR, BUILDING DIVISION z 9 0 m :q 9 55 � OM c MO 0 --lo 0 c: --i rl X M m z 0 -n n m m a 0 o C rl co M 0 Z 74 M z -1 x vi z 9 0 m RECORD OF INSPECTIONS size wawmeuT Ipt The Initials MT are Milton Rece porary contract Thompson, a tem A00uut inspector for the City. 'Date ftmha-Ad inount I TDATE RECEIVED 4 1 . /"- / �� _�, PERMIT EXPIRES CITY OF-EDMONDS USE PERMIT ZONE I C NUMBER CONSTRUCTION PERMIT APPLICATION JOB ADDRESS >/ SUITE/APT# OWNER NAME[NAME OF BUSINESS PLAT NAME/SUBD[VISION NO. LOT NO. LID No. MAILING ADDRESS -7&f4i ALP— it/ LID FEE $ TIESUP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP mv Permit Required Use Permit Roq'd CITY TELEPHONE Street EXISTING — PROPOSED Inspection Required Sidewalk Required &2A 4,25- 7 75 -810' 3 REQUIRED DEDICATION— FT Underilround — Wiring required —70. NAME METER SIZE LINE SIZE FIXTURES PRV REQUIRED OF F YES 0 NO 13 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ZI CITY P TELEPHONE se-,± I - 5 n NAME COL # 44 1. //A " ADDRESS il ENGINEERING REVIEWED BY - L� DATE t _"so CITY ZIP ta'j"Pamprimll Ilk - FIRE REVIEWED BY 6ATE STATE LICENSE NUMBER 0 NEW XADDITION REMODEL REPAIR 0 DEMOLISH 0 GARAGE CARPORT (TYPE OF USJE. f PARCEL NO. j:V LAvA,,,RESIDENTIAL COMMERCIAL MULTIFAMILY CYDS TANK 0 RETAININGWALL ROCKERY OR JTTIV17Y) EXPLAIN: I I - - I- 1W CHECKED BY VARIANCE OR cu SHORELINE OR ADB# INSPECTION RE I 113YES BOND POSTED n7 __� Ysko 1$ 00 SEPA REVIEW SIGN AREA 1/4- 0- HEIG14T COMPLETE EX Ir I t 17 ALLOWED PROPOSED XE OWED PROPOSED EXP 1 14---11 115-.3 7 PLUMBING t!�Hy COMPLIANCE OR CHANGE OF USE LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE ObAll< "o OV_ El SIGN FENCE FT) PARKING LOT AREA PLANNING REVIEWED BY/ RECID I PROVIDED RMARKS v , vvzj DATE OTHER ae:i: AOL, ,& or Y' WdA F RE SPRINKLER FIRE ALARM Cn- /.r2- a C-y—r--s i r NUMBER' NLRAER OF RITICAL L-(/ OF DWELLING 6 1 AREAS STORIES UNITS vie IER 7�_J) DESCRIBE WORK TO BE DONIE CHECKED BY ITYPE OF WNSTRUCTION C OCCU NT : 2.� I GROU SPECIAL INSPECTION JAREA OCCUP REQUIRED [:) YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTIC :R:E CO) - D A VCITI AO Itz"15 Description FEE FEE Irv. Plan Check --A f"bescription S N State Surcharge HEAT SO CE T SLOPE % . YR Building Permit City Surcharge C VESTEP DATf PLAN CHEC m=bn+6afg,. /.. In YL�� 0--oa 0 � Mechanical THIS PERMIT AUTWRtZES ONLY THE V - PA41T c6VERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. AM CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURDIS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPUCATIOW ISODAYS PERMIT UMM I YFAR -PROVIDED WORK 15 STARTED WITHIN 1800 S -1 SEE VIACKOF PINK PERMIT FOR MORE INFORMATION- -APPLICANT. ON-SEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit ACA IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF 17y_ EDMONDS, WASHINGTON,' ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY NOT BE FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL 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 Feo Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION H APPLICATION APPROVAL GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF GIV THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- THI CALL This application Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Tio IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO IN FOR INSPECTION Building Offlclal or his/her Deputy: and Fees are paid, and receipt Is acknoyAodged In space provided. WORKMEN'S ^�NSATION INSURANCE AND RCW 18.27. Wo P OFFICIAL4 at GMT URE D T WN OR AGE" SIGNATU QOWN54 BIG R DATE SIGNED (425) 17� 9-1) 71 20 7 -02 BY DAT9 RELEASED AMNTION 0S S awE3--p V-Qx\D Err 1333 FL IT IS UNLAWFUL TO SE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FIN_ HAS BEEN MADE AND APPROVAL OR A CERTIFI BEEN GRANTED. UBC SECTION 109 ORIGIN,11k:FILE - YELLOW'. INSPEC�OR PINK, OWNER CATE OF OCCUPANCY HAS - GOLD -ASSESSOR -4 04/02 PRESS HARD -YOU ARE MAKtNG-S'COPIES GREEN - ACCOUNTING &.100 rL. ; 11 , z 9 0 ITI =i 9 55 � a M C M8 40 0 C it K ITI M 46) 0 _71 ITI M a 0; 0 0 C 0 z z 0 4 0 ITI