20030395.pdfI
6m6 xw� DATE RECEIVEP---1
' '
LA21L�l
LPE R MIT EXPIRES
USE E PERMIT
CITY OF EDMONDS ZON
is C, NUMBER 2M3 039S
CONS PERMI APPLICATION
OWNER NA INAME OF BUSINESS
ADDRESS
JOB — su��#
1CO 1(0
Z &e'oe 5"
PLAT NAMEISUBDIVISION NO. LOT NO. LID NO.
MAILING ADDRESS I
--------
A02 47 J-4/00
LID FEE S
TESCP Appl=
PUBLIC RIGHT OF WAY
PER OFFICIAL STREET MAP RW P.'.ft 8
CITY ZIP TELEPHONE
Street t
EXISTING — PROPOSED Inspection Required
Slde*alk Required
:2wr-
REQUIRED DEDICATION_ FT Underground
NAME
WiringiequLred El
METER SIZE LINE SIZE NO. OF FIXTURE; REQUIRED
YEPRV
SI3 NO 13
ADDRESS
REMARKS
z
OWNER/CONTRACTOR RESPONS113LE FOR EROSION CONTROL/DRAINAGE
CITY ZIP
7% 07,44/Vd 9,v*e-
NAME
CBLN
9c
ADDRESS
ENGINEERING REVIEWED BY DATE
z
UJI
CITY ZIP TELEPHONE FIRE REVIEWED BY DATE
0
STATE LICENSE NUMBER EXPIRATION OAT VARIANCE OR CU SHORELINE OR ADB# INSPECTION
D B BOND
REQ'D POSTED
j
—S_ KNO $
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE , EXEMPT ALLOWED PROPOSED ALLOWED ROPOSED
EXP
=i 9
M
ca
ffl"NEW RESIDENTIAL PLUMBING/MECH
13
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.)
ALLOWED
M
—4 0
0
ADDITION MPLIANCEAia-
9101c'-O
MMERCIAL
PROPOSED FRO Out REAR FRONT L/RSIDE REAR
I
0
z
0 C
GE F USE
PIP 4ig-A4
_; , I W I
X
REMODEL MULTIFAMILY SIGN
PARKING LOTAREA PLANNING REVIEWED BY DATE 4
REO'D I.PROVIDED
I
rn
REPAIR GRADING FENCE
CYDS
PIP PIC—,
10
x FT)
RE7RKj
DEMOLISH TANK OTHER
e-k- hml
GARAGE RETAINING WALL FIRE SPRINKLER
CARPORT
O"n
ROCKERY FIRE ALARM
kew I.-L.
M �
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
1
W il--4,14 -W
E 1!rjr a
—F
— "s
CHECKED TYPE OF 1OP7, D 0 CCUPANT
45�71
�.T S -ORO
M rn
NUMBER NUMBER OF CRITICAL
OF
P
". —1
I DWELLING
STORIES AREAS
NUMBER
SPECIAL INSPECTION OCCUPAt!,,
Fn
DESCRIBE WORK BE DONE
LOAD
REQUIRED [I YES 1,31
C G)
REMARKS
M 0
C
PROGRESS INSPECTIONS PER ILIBC 1108/FINAL INSPECTION REQ'D
VALUATION
z
$
Description FEE Description FEE
z
0
I
0
M
Plan Check
State Surcharge
HEAT SOURCE GLAZING% LOT SLOPE %
Building Permit City Surcharge
PLAN CHECK N VESTED DATE
Plumbing
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Mechanical
t: BE DONE ON PRIVATE PROPERTY ONLIt ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
Grading
SEPARATE PERMISSION.
PERMIT
Engr. Review
APPLICATION: ISO DAYS
PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK
Engr. Inspection
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
I
EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM 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
9 DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscape Insp. Total Amt. Due
NOR LIMIT IN ANY WAY THE C17YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
Recording Fee L Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
,41VEN 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 LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREGY, NO PERSON WILL BE EMPLOYED
This application Is not a permit until signed by the
CALL
IN VIOLATION OF THE LABOR CODE F THE STATE OF WASHINGTON RELATING TO
WORKMENS COMPENSAT
Building Official or his/her Daputy: and Fees are paid, and
FOR INSPECTION receipt Is ackn(rMedged In space Provided.
C D RCW 18.27.
HE OWNER JGENT)"��— SIGNED
1A 03 OFFIQIALS SIGNATURE DATE
771-0220 (?RfLEAMW
ATTENTION
DATE
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-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORIGINAL - FILE YELLOW - INSPECTOR
04/02 PRESS HARD -YOU ARE
PINK -OWNER GOLD -ASSESSOR
MAKING 5 COPIES GREEN - ACCOUNTING
CITY OF EDMONDS
1215TH AVENUE NORTH* EDMONDS, WA9M (425) 77i-o2m -FAX (425) 771-Ml
Website: www.c1.edM0rK18.VV9LU8
DEVELOPMENT SERVICES DEPARTMENT
Planning 9 Building 9 Engineering
C. 10
GARY HAAKENSON
MAYOR
-ee
pre-existing non -conforming barrier fi
The purpose of this letter is to confirm that the
parking space located nearest to 5th Avenue may continue to be utilized as 1he designated
space for your business. Even though a painted asphalt sign exists, a barrier ftee sign
space. The riew sign may be free-standing or
must still be installed at the head of the
I �A 16ainAmn+ f,%,r Aata;lc
attached to u exterior wall ot itt, building. Please re to enc va
I request that the sign be installed within ten (10) days date of this letter.
The existing space does not conform to current code therefore, if in the future the City
receives a formal citizen's complaint regarding the inadequacies of the space, I will
contact you and require that the space be altered to current code within a very short time
fi-ame.
Lastly, in order to withdraw your current application please submit a written request to
my office. We apologize for the confusion regarding this matter.
If you have any fiirther questions, please feel free to contact me during City business
hours at 425-771-0220 extension 1226.
Sincerely,
01W*;FT
Jeannine L. Gra
Building Official
Enclosure
Incorporated August 11, 1890
Hekinan, Japan
Sister City
05ROSI-11
6M
r777777t!
T'r
41
1.q
TO:
a
3.
---RE-INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
ocapvl.doc.l:temp:bldg:forms6/98
z
9
0
m
=i T,
Fn ;I
OM
c
MO
0
-f 0
c
M
M z
co
0 -n
n
m M
0 V5
0
o Fn
C ch
m (n
M 0
Z
M
z
co
z
9
0
m
t .
I
'DATE RECEIVE5.j
PERMIT EXPIRES !2z _iQ5
U PERMIT
CITY OF EDMONDS I ZONE LF -*' NUMBERZt Y)
4CIL, _-5-
CON�T��IERMIT APPLICATION
OWNER ::,�E OF �SUSI!ESS
j /
to & f, , WA 9 S,
MAILING ADDRESS
CITY zip ITELEPHONE
f& 2
NAME
ADDRESS
CITY ZIP ITELEPHONE
NAME dk,
ADDRIESS'
CITY
STATE LICENSE NUMBER
CBL N
ZIP I TELEPHONE
EXPIRATION DATE I CHECKED BY
-424,1 &;ft 0 0 2,9 - 0 0
[ff'NEW
RESIDENTIAL
PLUMBING/MECH
0 ADDITION
9101CO, MMERCIAL
MID
NGE OF �USE�
�C--F�
0 REMODEL
rl MULTIFAMILY
0 SIGN
REPAIR
-A
GRADING CYDS
[:] FENCE
X FT)
0 DEMOLISH
TANK
OTHER
[3GARAGE
[3 RETAINING WALL
FIRE SPRINKLER
CARPORT
ROCKERY
FIRE ALARM
(ME OF USE, BUSINESS OR ACTWM EXPLAIN:
NUMBER
NUMBER OF
RITICAL
OF
0
RESCRTORIES
DWELLING
U NITS
AREAS
NUMBER
Cl IBE WORK TO BE DONE
6
f
'MALY U&e,."
HEAT SOURCE GLAZING % LOT SLOPE %
PLAN CHECK NPI // VESTED DATE
THIS PERMIT AUTHORMES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC
DOMAN (CURBS, SIDEWALKS, DRIVEAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATIOM 1180DAY8
PERMIT UM1r I YEAR - PROVIDED WORK 19 STARTED WffHIN 180 DAYS
SEE BACK OF PINK PERUrF 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, WASMISIGTON, ITS OFFIC11M, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVEil NATURE, ARISING DIRECTLY 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
NOR LIMIT IN ANY WAY THE CITVS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DUVI 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 COD"f THE STATE OF WASHINGTON RELATING TO
WORKMEWS COMPENSAUQN1MRfiPWC9)�ND RCW 1111.27.
DATE SIGNED
JOB
ADDRESS
U
PLAT NAME/SUBDIVISION NO.
LOT NO.
LID NO.
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP AP
RW P*ffrdt= ed
Street Use Pemvft ReWd
EXISTING - PROPOSED
kapecdon Required
Sidews5c Required
REQUIRED DEDICATION- FT
1 underWourul
VVM9F uIred
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
I
I
I
YES13 NO 13 z
REMARKS
I
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
W^4 llyd
49AYe- 4&�ftbW-
oe� dA_e&* A# &,& I I 1A 0 OJ
0 A4 14— Ade**,,v f r
C 64/1 Ifolt
&V
ENGINEERING REVIEWED BY
DATE
FIRE REVIEWED BY
DATE
ul
z
VARIANCE OR CU
SHORELINEORADBI
INSPECTION
BOND
RE
13YEs 7ko
POSTED
SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE
EXEMPT
ALLOWED
PR OPOSED
ALLOWED
PROPO BED
_XP
,
IW
LOT COVERAGE
REQUIRED SETBACKS (Fr.)
PROPOSED SETBACKS (FT)
ALLOWED PROPOSED
RON1 SIDE REAR
FRONT LIRSIDE REAR
PAR
REOD PROVIDED
LOT AREA
I PLANNING REVIEWED BY DATE %
&
c14 6 z4p L:g i,5 1
CHECKED BY ITYPIE OF! C94STRUC91OW
SPECIAL INSPECTION =OW"4e UUAUrArV
LO D
REQUIRED [] YES 131
REMARKS
PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REG'D
— - Mmummm
Description
FEE
Description
FEE
Plan Check
State Surcharge
Building Permit
C Nt Surcharge
1-5-
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Plan Chk. Deposit
Fire Inspection
Receipt 0
Landscapelnsp.
Total Amt. Due
Recording Fee
CALL
FOR INSPECTION1
4425)
711-0220
APPLICATION APPROVAL
This application Is not a permit until signed by the
Building Official or histher Deputy: and Fees are paid, and
receipt Is acknowledged In space pcovided.
OFFIQLALS SIGN URE DATE
DATE
ATTENTION "T I Li
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 GREEN - ACCOUNTING
PRESS HARD -YOU ARE MAKING 5 COPIES