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20030394.pdfq DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER 7EINAME OF BUSINESS 11"r x/ —,— /_ z,&, MAILING ADDRESS CITY ZIP NAME ADDRESS CITY ZIP NAM CBLN J&.; VT-, ADDRESS � XO L/ P-e- CITY ZIP TELEPHONE d 5- STATE LICENSE NUMBER EXPIRATION DATE CH CKED B .�joltr# 14- .r 15-) M -j-- 4 PERIMITEXPIRES USE PERMIT ZONE NIJIMBjaAa2,� _e�8 JOB SUITE/APT# ADDRESS,��,,Z aef� PLAT NAME/SUBDIVIGrION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP App'� RW Permit R-U.'- Street Use Permit Req'd EXISTING — PROPOSED— Inspection R*qui(ed Sidwalk Required REQUIRED DEDICATION— FT nderground king required CI METER SIZE LINE SIZi Z. OF FIXTURES PRV REQUIRED YES 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE BY FIRE REVIEWED BY DATE DATE LU VARIANCE OR CU SHORELINE OR ADBI I INSPECTION 1$ BOND REO'D POSTED 13YEs 13NO SEPA REVIEW SIGN AREA HEIGHT COMPLETE - EXEMPT ALLOWED . PROPOSED I ALLOWED . PROPOSED Rf NEW 001RESIDENTIAL 20*"PLUMBING/MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REAR 1:3 ADDITION COMPLIANCE OR 13 COMMERCIAL CHANGE OF USE I z 11 REMODEL 13 MULTIFAMILY SIGN PARKING LOT REO'D PROVIDED I I AREA I PLANNING REVIEWED BY DATE 1:1 REPAIR GRADING o FENCE 1:1 CYDS X FT) REMARKS 1:1 DEMOLISH 11 TANK OTHER oGARAGE RETAINING WALL o FIRE SPRINKLER 1:1 FIRE ALARM CARPORT ROCKERY (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: CHEC;;D OF CQ10SX UCTION CODE occum,,& GROU NUMBER OF NUMBER OF DWELL NG CRITICAL AREAS 40�j _7BYTYPE —(/,A) SPECIAL INSPECTION q OCCUPANT f !f LOAD STORIE�� NUMBER YF JAREAIVIA REQUIRED [:] S U4 '0 76 DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO-0 doz- X/_ VALUATION '6z 24A ZA�e�L/Z he di cav's I & Description FEE Description FEE Uh 'tdjg2jj 0 A,4lA4tVAf J Plan Check &A9 State Surcharge 66��? HEAT SOURCE - _ f r GUZING % - LOT SLOPE % Building Permit 7M City Surcharge 6-- - 71 0101 CHECK NO: VESTED DATE Plumbing I Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 2 3 DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE t: SEPARATE PERMISSION. 2 Engr. Review 15 PERMIT APPLICATION: 160DAYS CL PERMIT ILIMM I YEAR - 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 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 Landscapelnsp. Total Amt. Due 14 511 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE * NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - Recording Fee Receipt # I HEFIE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APFSROVAL 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 011icial 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 sp-%ce provided. WORKMENS - COM!j��SATION INSURANCE AND RCW 18.27. OF�1.�QWATURE ATE SIG RE NE GEN DATF SIGNED 1A1.2 v.425) 01 771-0220 R BY DATE A'ffENTION M 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. INsPe6TOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING 77, RECORD OF INSPECTIONS INSPECTOR DATE APPROVED k SETBACKS ..................... FOUNDATION: Footing...................... Wall.... ........ !..1.1 ........... Pier/Porch ................. I Ing Wall ............ R ean m; Slab Insulation .......... PLUMBING: �,v fn Underground .......... m 3 Rough -In ................... Commercial Final ...... m ;'i"'HEATING: 10 Z11 t,''Gas as ............. T t 55 Gas Piping ................. Equipment ................. commercial, Final: ........ m M ,EXTERIOR SHEATHING NAILING . .......................... ;:FRAMING: ..: ........... : ............. 0 FIRST FLOOR FRAMING.... . J."'DATE PERMIT EXPIRES DATE RECEIVED 1� . I , I USE 01=0"IT ZONE 61 CITY OF EDMONDS 14 � ,,- NUMB�R�M 'A CONSTRUCTION PERMIT APPLICATION OWNER N;E/NAME OF BUSINESS —h/ // 6:- Z ZZ46� A WdAt MAILING ADDRESS >3 41 1116- CITY — &/,A , ZIP JTELEPHON9-0�4' '9-za 5464xlflle!5� M-4.1 1'z h If -.:? d:IK-31 NAME ADDRESS CITY ZIP ITELEPHONE J'// 4A I- - -foea-A owlew CBL W / ADDRESS k-A- P > �Lo q per— e;rr C ZIP TELEPHONE tn<21 Irl To- >P& 26") 432-ff tv r 1551 STATE LICENSE NUMBER EXPIRATION DATE I CH CKE 4/jid 3�w NEW eRESIDENTIAL ADDITION COMMERCIAL [3. REMODEL MUL11FAMILY [j REPAIR GRADING CYDS [] DEMOLISH TANK oGARAGE CARPORT RETAININGWALL ROCKERY WRE OF USE, BUSINESS OR.ACTIVTM EXPLAIN: NUMBER NUMBER OF OF STORIE;&M'5A DWELLING I DESCRIBE WORK TO BE DONE I -OD I JOB Y9 SUITEIAPT# ADDRESS/ PLAT NAMEISUSDIV]SiON NO. LOT NO, LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCF APPMV@a Rw Panrot Requir Street Use Perrnh:d EXISTING — PROPOSED Wdpecdon Required Side"It R*Wlred REQUIRED DEDICATION— FT g required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YESM NO C3 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE VARIANCE OR CU SHORELINEORADBN I INSPECTION I BOND REO'D POSTED E3YES EINO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED , PROPOSED ALLOWED , PROP0112D EXP I . LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ff"PLUMBING / MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR COMPLIANCE OR CHANGE OF USE PARKING_a7qT A EA ] tj�N�ING REVIEWED _BY DATE M Fab, % 11 L_j SIGN o FENCE ( — X—FT) nr_wu 1 rn REMARKS OTHER I F RE SPRII KLER FIRE ALARM CRITICAL AREAS NUMBER CHECKED BY I TYPE OF CQUJMRUCTION CODE I OCC q-7 GROMI& I f SPECIAL INSPECTION JAREJ,? PANT f '614 -r occu REQUIRED [] YES AA7q I., LOAD q4REMARK8 2 PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REaD A e3 &Aes-C a-VALUATION X.2 /,'A'-,# X,4 AAX,'JA,'Y 11d. 16 -7 -7hA I AX0 Description FEE Description FEE Aloof . uhld&,emo A4Av1w,-!i I Plan Check State Surcharge HEAT SOURCE 1_:74 2 7 —daZING % LOT SLOPE % Building Permit VESTED DATE Plumbing I City Surcharge Zg5 PLM CHECK NO: Ma Is Mechanical THIS PERMIT AUTHOREMS ONLY THE W RK NOTED. THIS PERMIT COVERS WORK TO 13E DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: lea DAYS PERMIT LIMM -1 YEAR - PROVIDED WORK 18 STARTED WrHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT. ON -BEHALF OF HIS OR HER SPOUSE, HEIRS, A�SIGN'IS' 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 ANU Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE, ARISING DIRECTUY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscape Insp. Total Amt. Due DEEMED TO MODIF'K WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Recording Fee Receipt # I HERE13Y 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 THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- 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 WORKMENS CO"SATION INSURANCE AND RCW 18.27. siGNI(ginE R GE �r DATri SIGNED APPLICATION APPROVAL CALL FOR INSPECTION This application Is not a permit Until signed by the Building Official or hi0or Deputy: and Fees are paid, and receipt Is acknowledged In space provided. OFEIMU4494NATURE PATE 1AID 771-0220 By DATE ATTENTION M 1333 A / A IA4, 6h:- in IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ZZ71— ORIGINAL - FILE YELLOW - INSP9&OR 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 1171 =i :n- as � 0 M C M 0 -40 0 M z �9ca 03 n i2 C M M 0 ai 0 0 FT, ! c 0) a rj) M 0 0) z 0 `1 0 M