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20030401.pdf4 6 0 DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEVNAME OF BUSINESS yo+kw6 . �&E "LING ADDRESS C /Oa A vt �s CITY ZIP TELEPHONE otovta� -i's 1i R J2 NAM ADDRESS I)Ae CITY, .�Zlp TELEPHONE 1�e�44, A I`WbI4�5- Irl jv,� e-,, ;3 �Q Kf, ADDRESS --rif _30�, & Av-e- S CITY A ZIP TELEPHONE STATE LICENS NU�BER EXPIRATION DATE,,Ar=WR VhMGnLo $ _). )OL ai 0 _ C) PROPERTY TAX ACCOUNT PARCEL NO. Cff'NCW OOOORESIDENTIAL 2000PLUMBING I MECH ADDITION E] COMMERCIAL COMPLIANCE OR 1:1 CHANGE OF USE REMODEL MULTIFAMILY 0 siGN REPAIR CYDS FENCE 1:1 ( — X—FT) DEMOLISH TANK 1:1 OTHER WAARAGE o RETAINING WALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS OR ACTIVITY) LAIN NUMBER OF %KIMSER OF DWELLING 1RITICAL AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE Ij eV..� HPT SOURCE I 95ING JC) -A nT SLOPE PLAN CHECK NO: A-% en STEfb DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPUCATION: 180 DAYS PERMIT LIMM I YEAR . PROVIDED WORK IS STARTED WITHIN ISODAYS SEE BACK OF PINK PERMIT 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, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT HE DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CRYS 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 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 VIOLAT ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN! NSATION INSURANCE AND RCW 18.27. DATE SIGNED 3 -2Y -0 PERMIT EXPIRES USE PERMIT ZONE NUMBER e�� OC/O JOB 11 t-7/7H SUITE/APT# ADDRESS Ila AW '50 PLAT NAMEISUBDIVISION 610. LOT NO. LID NO. -2 LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING. (1) 6 TESCP Approved RW Permit Required street use Pelmit Roqd Inspectio ' Required 13 PROPOSED- SidewalkReq Ired 13 REQUIRED DEDICATION FT Undstgrowd Wiring required 13 METE[ SIZS LINE SIZE NO. 01�F XTURES PRV EOUIRED 113 z 13 k YEO NO REMARKS z z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE e*)-namullse e-) Ontv, tb10j:bW eE) FIOAL ff-NGINEERING REVIEWED BY D,�T E Lam: F EVIEWEBY a 3 DATE rL RIANCE OR CU SHORELINE OR ADB# INSPECTION BOND REO'D POSTED 13YES $ SEPA REVIEW SIGN AREA HEIGHT COMPLET , EXEMPT *1 ALLOWED PROPOSED — I --- ALLOWED PROPOSED EXP - I SY4-6115' LOT COV9_RAGE REQUIRED SETBACKS' (FT) PROPOSED SETBACKS (Fr.) ALLOW92 PROPOSED C-0 C> FRONT SIDE REAR I F r LIR 61DE Iq . XR ;A 2P I - .,a PARKING I LOT AREA REQ`D I PROVIDED,0 CHECKED BY ITYPE SPECIAL INSPECTION JAREA OCCUPANT I REQUIRED [] YES 45�v_rgr_ A* LOAD PER UBC 108/FINAL INSPECTION REQ'D F&2E-A'4 $ gN j01 viff r 4-, 1 Description FEE Description FEE Plan Check f53 State Surcharge Building Permit 9-W IPW City Surcharge Plumbing Mechanical W— Grading 2-10— Engr. Review 6 0, Engr. Inspection 1Xf%0 - ZA/ Fire Review Plan Chk. Deposit Fire Inspection Receipt N Landscapelnsp. Total Amt. Due Recording Fee Receipt N CALL FOR INSPECTION 1212 5) 771-0220 APPLICATION APPROVAL This application is not a permit until signed by the Building Official or his/her Deputy: and Face are paid. and receipt Is acknowledged In apace prgvidod. f - 0 WLS NATUFW, DATf jr 7 . `7b R BY i. KATE ATTE14TION Off 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 1z 10 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE J" 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 I VIA z 0 M :q:fl 55 � M ME 80 C -1 r. X M M 10 z 0 _n MM 055 0 0 Fn C (n V) p z V) z 9 0 M Height Calculation/Grading Verification Worksheet -C Pem2it M Address: Date: 6- , r w MEMO TO: FROM: FINAL PROJECT APPROVAL FORM TO: DATE: PERMIT COORDINATOF� BUILDING DIVISION FIRE DEPARTMENT DATE—___� z 9 0 m =i =n- M c M 0 0 c MZ ID --I c 0 -n ,n m M a 0 0 M C 0) m ca M 0 z z 9 0 m 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Si ocaprvl.doc.l:tenip:bldg:formsIO/OI ... ........ m I [FATE RECEIVED 10V) �7, PERM1T-EX0iR'ES CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS :5e-> -j-,; 'I MAIL114G ADDREdS V� CITY ZIP ITELEPHONE OW01-J-, WA 9--0201 NAME x - C �- A o ADDRESS 9SI5 Z)Ae 9TY, A MAMC e Do ADDRESS god, CITY zip zo TELEPHONE 5Awaviis �d-S-3 STATE LICENS NUMBER EXPIRATION )0 L� av h gcL> -)-o PROPERTY TAX ACCOUNT PARCELNO. 00441A��,�% 00G-0Cq-0.3 W1 [2rNEW Ca'O'RISIDENTIAL 1905-LUMBING / MECH ADDITION [j COMMERCIAL COMPLIANCE OR CHANT OF USE REMODEL MULnFAMILY 1-1 SIGN REPAIR CYDS FENCE X FT) DEMOLISH TANK OTHER (goodARAGE RETAININGWALL [] FIRE SPRINKLER CARPORT RdCKERY FIRE (TYPE OF USE, BUSINESS OR ACTIVITY) EVLAIN: 0& NUMBER of: "WOMBER OF DWELLING CRITICAL AREAS STORIES UNITS NUMBER -j C, DESCRIBE WORK TO BE DONE I USE PERMIT ZONE NUMBER JOB ADDRESS �,400 �7 70 A '5 08uITE/APT# PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. ��_ C -LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP ID 6 DOSED TESCIR ApproVed RW Permit Required Street Use Permit R8Q1d InepeeWn Requhred EXISTING P Sidawalt Required REQUIRED DEDICATION N FT UntlerVound Wiring required 13 METE SIZ,5 a[ LINE SIZE NO. ��FiXTURES PRV PEQUIRED Rd C3 z _I YEgn NO _13 REMARKS OWNERMONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE FWAL ENGINEERING REVIEWED BY DATE I -h-. cff I mm�:r 611.zq 163 A FI REVIEWEII BY VAI h W i# /,) �7) . — Ic w — %.-/ L./—,./ AN 1 /0 /� SHORELINEORADB11 I INSPECT16N REO'D OYES3" -' BOND POSTED 1$ REVIEW COMPLETE EXEMPT AL-LOWE OSED PROP__ HEIGHT ALLOWED PROPOSED , -XP LOT COV6AGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT.) ALLO�45 PROPOgp FRONT SIDE REAR j?DE F g2 -7. .5 PARKING LOT AREA PROVIDED tPV qE4WBYj CHECKEDBY I TYPE OF LQNSIRUCTION UrAPr, -W 71 .. ROU SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [] YES 15z52-:5 LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION uo c OL VALUATION DeScriptlon FEE Description FEE Plan Check State Surcharge OURCE At nPF 75NI I S T -i e; Building Permit City Surcharge A5 /7 12 VE DATE PLAN CHECK NO: -1�71 n `!� Plumbi ng Mechanical THIS PERMIT AUTHORMES ONLY THE WORK NOTED. THIS PEnirr COVE S WORK To ON THE PUBLIC — k: BE DONE ON PRIVATE PROPERTY ONLY ANY CONSTRUCTION Grading Vol 23 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) V61LL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPLICATIOW. 1180DAYS PERMIT L11MIr I YEAR - PROVIDED WORK IS STARTED WITHIN 100 DAYS Engr. Inspection 1)500 - SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION — -APPILICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS -Y Fire Revi6w Plan Chk. Deposit IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE Cn OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # V/11 ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY 1V-1§a FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapeinsp. Total Amt. Due I !3 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINAN CE 0 -NOR LIMIT IN ANY WAY THE CfY8 ABILITY TO ENIFORCt ANY ORDINANCE PROVISION." 21 Recording Fee Receipt # - A HEREBY ACKNOWLEDGE THAT IbIVE READ THIS APPLICAiION; THAT THE INFORMATION APPLICATION APPROVAL GWEN IS CqWCT; AND THAT I THE OWNER, OR THE DULY AUTHORIZED AGENT OF -THE OWNER. j AGREE TO.COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a permit until signed by the TION: AND INY)OING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building OfflcW or his/her Deputy: and Fees are paid. and - receipt Is acknovAodged In space pr"ded. WPRKME�A�NSATION INSURANCE AND RCW 18.27. BIG 10 0 DATE SIGNED 14251 OFFjCM7)PNAT7P. DATV "1 //? j 771-0220 Ark --dATE ------- EXT 13:33 BY ATTENTION-',`40, Leize1j,' C13 Y I(Jo IT IS UNLAWFUL TO USE OR OCCU Y BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI7, ORIGINAL -FILE -'YELLOW- INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER - GOLD -ASSESSOR 04/02 PRESS HARD -Y1 G 5 COPIES GREEN - ACCOUNTING z 0 m m C M m z 0 n m m 0 Vi 0 6 Fn a H : MO z 9 0 m