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20030399.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION ER NAMEINAME OF BUSINESS 6 e- 4 /1/1 @�: 0 ��kt_ f t rw kai&w ING ADDRESS CITY 111A NAME —ADDR-ESS CITY ADDRESS to. 0, &t< CITY STATE Ut:ASE NUM139R AWOE-PPLO-5-150A PROPERTY TAX ACCOUNT PARGM ZIP 11fLEPHONE ?a.W &2_5) 7-1 Ll - 41":5 Sk ZIP Cal. N 11 ZIP TE HON NP j.EP E 7 A 569-1313 EXPIRATION DATE I cC PEI 9*k1 3-1-6.5 WOO' NEW RESIDENTIAL ADDITION COMMERCIAL REMODEL MULTIFAMILY REPAIR 0 GRADING CYDS DEMOLISH 11 TANK GARAGE CARPORT -1 RETAININGWALL 1:1 ROCKERY (TYPE OF USE, BUSINESS,,WCT NUMBER NUMBER OF OF DWELLING STORIES i UNITS DESCRIBE WORK TO BE DONE e -i r O'W-An"2. USE ZONE JOB ADDRESS A& I PERMIT EXPIRES PERMIT NUMBER.g PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE_$ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCIR AP AW Pern'4=4d Street Use Permit Wd EXISTING — PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION- FT Underground Wiring required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES13 NO (3 z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE FIRE REVIEWED BY DATE DATE W Cr VARIANCE OR CUI SHORELINE OR ADBI I INSPECTION 1$ BOND REO'D POSTED DYES 13NO SEPA REVIEW IGN AREA HEIGHT COMPLETE . EXEMPT ALLOWED . PROPOSED I. ALLOWED . PROPOSED PLUMBING I MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR I FRONT LIFISIDE REAR I COMPLIANCE OR CHANGE OF USE — z PARKING LOT AREA PLANNING REVIEWED BY DATE SIGN RECID I PROVIDED I o FENCE X FT) REMARKS FIRE SPRINKLER FIRE ALARM CHECKED BY ITY2 CRITICAL 14 AREAS SPECIAL INSPECT I NUMBER /V/T- I REQUIRED M YES A OCCUPANT GROUP ) OCCUPANT LOAD REMARKS I PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D - /A "15-firn Am I &r-- A 'A at he If k," A/2, 1 A& t $ - . I Description FEE Description FEE Plan Chock State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing se Mechanical THIS PERMrr AUTHORMES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTV ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOLWH (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE t: SEPARATE PERMISSION. 2 Engr. Review PERMITAPPLICATION: SODAYS PERMIT UMM I YEAR - PROVIDED WORK ISISTARTED 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 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 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 A0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.. — Recording Fee Receipt # I HEREBY 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 hisfher Depuly: and Fees are paid, and IN VIOLATION OF THE LAEIOB.GQDE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknovAedged In space provided. WORKMEN'S COMPENSAT;gW'INS=CE AND RCW 10.27. OFFICIALS SIGNAT?14�RRE ER OR E DATE SIGNED .16 F" M� 1 IA-3 J'.5 ye 7t; � 4dg!�O_ 6 —4—,03 771-0220 — Wg'11 F IDA'It'i� I- - 1111111 R EASED) BY Af ENTION ' 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- 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 0 0 M M C 0 C M C z 0 M r C z 0 0 M a ;'DAM REOEIVEI�,,// '4 L. -J PERMIT EX PIRES USE PERMIT V CITY OF E NDS. ZONE NUMBER42&:i�� CONSTRUCTION PERMIT APPLICATION JOB ADDRESS SUnVAPT# ER E/NAME OF BUSINESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. ADDRESS LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP ApPrOved AW P*m* ReWired Street Use ParmN R90 CITY ZIP ITFLEPHC�NE 1020 &2�277 L/ 41:5 Sk EXISTING - PROPOSED REQUIRED DEDICATION- FT frap"1w R*qLdred SidawmA Requk*d UndwgraM WkMg requM NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES C3 NO 13 ADDRESS REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION COUTROLfDRIUNAGE CITY ZIP TELEPHONE NAME CBLN AA dersoll ENGINEERING REVIEWED BY DATE ADDRESS P. 0,f elox, 024250 FIRE REVIEWED BY DATE CITY ZIP TEj.EPHONE VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND STATE LZOASE NUMBfR EXPIRATION DATE 1 REQ'D , I 1$ POSTED 3-1-0.5 OyEs 13NO _I SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOU 159 ILETE EXEMPT ALLOWED , PROPOSED ALLOWED I PROPOSED EXP NEW RESIDENTIAL X 0 PLUMBING MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SET13ACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL 0 MULTIFAMILY SIGN PARKING LOT AREA PLANNING REVIEWED BY REO'D PROVIDED DATE 9L I REPAIR.. 14 GRADING CYDS o FENCE X FT) REMARKS .�E3 DEMOLISH TANK _ OWT real I oGARAGE [3 RETAINING WALL CARPORT ROCKERY FIRE SPRINKLER FIREALARM (ME OF USE. BUSINESS LAIN: CHECKED BY )p ION 'PION NUMBER 14, NUMBER OF CRITICAL 'OF DWELLING AREAS �STORIES Lyt�' UNITS NUMBER DESCRIBE WORK TO BE DONE 7e-- oi r a Af e Poig 1121-2-c "4 ilea SPECIALINSPECTI N AREA OCCUPANT REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1108/1FINAL INSPECTION RE&D L,.1f_kfi111 Af-'f I k1r_-1i'A k lia $ Description FEE DescriptIon FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES OMY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading 2 DOMAIN (CUPM, SIDEWAM, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. 9 Engr. Review PERMITAPPLICATIOlt 1100DAYS PERMIT ILIMFF I YEAR - PROVIDED WORK IS STARTED WITHIN 160 DAYS Engr. Inspection SEE BACK OF PINK PFRMIT FOR MORE INFDRMATION 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit IN INTEREST. AGREES TO INDEMNIF% DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # ALL CLAIMS rOR DAMAGES OF WHAo EVER MATURE, ARISING DIRECTLY OR INDIRECTLY SHALL NOT BE FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT La ndscapainsp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Receipt # Recording Fee I HEREBY 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 WffH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a permit until signed by tho TIOft AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE ?DE OF THE STATE OF WASHINGTON RELATING TO Building Official or his/her Deputy: and Foos are paid, and FOR INSPECTION receipt Is acknovirledged In space provided. WORKMENS COMPEN INS CE AND RCW 18.27. OFFICIALS/ SIGNATYRE D SIG"6.q)WNER O�R �E�_, D:ATE S71GNED (425) 771-0220 RELEASED BY ATFENTION 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- INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HAR D - YO U ARE MAK ING 5 CO P I ES G REE N -A CCOUNTING