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20030385.pdfM I 'I DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION (Iry !!AME CT_ STATE LICENSE NUMBER ZIP TELEPHONE ZIP . ITELEPHONE CBL 11 1161004- 71P TELEPHONE [PERMIT EXPIRES Usif PERMIT ZONE N UMBER JOB ITWFrl# ADDRESS 'e�� A LID NO. PLAT NAME/SUBDIVISION NO. LOT NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TEsur Approved RW Perm" Required Penn, "I' EXISTING — PROPOSED inspection Required Sidewailt: Required REQUIRED DEDICATION— FT Underwound Wiringfequired Ell METER SIZE LINE SIZE OF FIXTURES PAV REQUIRED 1 7. YESD NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE us Ic I M I VARIANCE OR CU SHORELINE OR ADO# I INSPECTION BOND : ., EXPIRATION DATE CHECKED BY I REQ`( POSIED ROPERTY TA-X AC90 NEW RESIDENTIAL ADDITION COMMERCIAL REMODEL MULTIFAMILY ��REPAIFI GRADING CYDS [:] DEMOLISH TANK oGARAGE CARPORT o RETAININGWALL ROCKERY OWE OF USE. BUSINESS OR ACTINTM EXPLAIN: NuURFA — -*2 1 NUMBER OF OF III STOFIIES6+_U� DESCRIBE WORK TO BE DONE 113YEs 21wa Is __ SEPA REVIEW COMPLETE EXEMPT 0 SIGN AREA, ALLOWED PROPOSED HEIGHT ALLOWED PRO $ED X P EXIS i [3 PLUMBING / MECH COMPLIANCE OR 11 CHANGE OF USE LOT COVERAGE LL ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR 'PROPOSED SETBACKS IFT.) FRONT L/R SIDE REAR PARKING REOD I PROVIDED LOT AREA PLANNING REVIEWED BY 0 SIGN [3 FENCE ( X FT) REMARKS OTHER FIRE SPRINKLER FIRE ALARM CHECKED BY ITYPE OFPC U ,AVW �0 OC r CRITICAL 3t" — 5 IGR AREAS SPECIAL INSPECTION JAREA occupANT NUMBER REQUIRED [] YES LOAD REMARKS ]PROGRESS INSPECTIONS PER USC 1108/FINAL INSPECTION REO'D %V/, pie f 0 gw I is LOQLN acm— I I -_ I 'A DescAption FEE Description FEE joz Plan Check qj-4 State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHE.%N VESTED DATE Plumbing h2. L2�� ::I_ Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading a TC.) WILL REQUIRE 3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. E SEPARATE PERMISSION. Engr. Review rPlan :Depowsft PERMIT APPLICATION: 180 DAYS ERMIT LIMM I YEAR - PROVIDED WORK 16 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 Chk. 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 # IALL CLAIMS FOR DAMAGES OF WHATEVER MATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE 9 MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDI NANCE Landscape Insp. Total Amt. Due DEEMED TO NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE AW ORDINANCE PROVISION.- Recording Fee Receipt N I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION -06IVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE IAWS REGULATING CONSTRUC- TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED CALL This application Is not a permit until signed by the Building Official or his/her Deputy: and Fees 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 COMPENSATISO-1 ,._JURANCE AND RCW 18.27. sl E DATE SIONAIVRII (0, 1 0 11 DATE SIGNED 1425) V"'Ab, e)13 771-0220 MRE 13--/ D 18 Y DATE ATTENTION off 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 - IIN 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 I LDhTE RECEIVED PERMITEXPIRES UAf PERMIT ZONE _A �t CITY OF EDMONDS I . NUMBER CONSTRUCTION PERMIT APPLIC zo*)— el Xr— �"ie 41h 14:2'. STATE LICENSE NUMBER ZIP TELEPHONE ZIP 01 TELEPHONE ZIP TELEPHONE P;0_4 o I FROPERTY TAX A 0 PARCEL NO. NEW RESIDENTIAL ADDITION COMMERCIAL REMODEL MULTIFAMILY XRERAIR GRADING CYDS DEMOLISH 13 TANK GARAGE o RETAININGWALL CARPORT ROCKERY ffYPE OF USE. BUSINE88 OR ACTIVITY) EXPLAIN: NUMBEI`Ij��NUIAIBER OF Of )WELLING LTORIES NITS DESCRIBE WORK TO BE DONE ZOO JOB ADDRESS V51F "<�— PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. I LID FEE PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TREVsCP8P=*d St"t Use Peffnk Reced EXISTING — PROPOSE?) tropwUmfloquiM Sidewalk RequiNd REQUIRED DEDICATION FT UndwWound VAMg requInW 13 METER SIZE LINE SIZE OF FIXTURES PRV REQUIRED I 7. YESE3 NO 13 z REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE 11 ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE RON DATE ED By CHECKED BY VARIANCE OR CU SHORELINE OR ADBO V I INSPECTION REO12ee BOND !2,SPD I 7- 13YES 4!E1W S SEPA REVIEW COMPLETE EXEMPT SIGN AREA ALLO,,W.EOPROPOSED HEIGHT ALLOWED PROPOSED EXP PLUMBING / MECH oCOMPLIANCE OR CHANGE OF USE LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT LIRSIOE REAR PARKING REQ`0 I PROVIDED LOT AREA IPLA IEWE0 BY OAJE NNING REV SIGN CL FENCE X FnQ REMARKS OTHER HD QW6419 FIRE SPRINKLER FIRE ALARM CRITICAL AREAS NUMBER HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHEM� VESTED DATE THIS PEmrr AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONIX ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CUIRIM SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERmrrAPPucATioN:' im DAYS PERMIIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 100 DAYS SEE BACK OF PINK PERMff FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS. WASHINGTON, rrS OFFICIALS, EMPLJOYEES. AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS.PERMrr. ISSUANCE OF THIS PERMIT%PHALL NOT BE DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILrrY TO ENFORCE ANY ORDINANCE PROVISION.' I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVE is CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE 9jER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- TIGN; 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 WORKMERS COMPENSAT15WMURANCE AND RCW 18.27. DATE SIGNED SV470:=V'�" 1 e)3 CHECKED BY TYPE OF iq0WRUqTION 1CO OCCUPANT I IGROUP. In M SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [:] YES LOAD M 0 REMARKS INSPECTION REGID PROGRESS INSPECTIONS PER UBC 108/FINAL Eon Description FEE besciriptIon FEE Plan Check qj State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscape.Insp. Total Amt. Due 15b7 R�cordlng Fee Receipt # CALL FOR INSPECTION 1A0 1,425) 771-0220 EXr 1333 APPLICATION APPROVAL This application Is not a permit unul signed by the Building 0111clall or his/her Deputy: and Fees are paid, and receipt Is acknowledged in space p(ovided. FC SN1W#fiE DATE W& 4 6 BY DATE IT 10 UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL " 4 (_!!� L_� A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW- INS(ECT& CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR GREEN - ACCOUNTING 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES P'l