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20030402.pdfDATE RECEIVED 1-2- CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMENAME OF BUSINESS A mep- ic-A 6zee_e,-ry1e 41-re-rza-r/ws MAILING ADDRESS 5-141-,5�-A Avf- 5 CITY ZIP TELEPHONE 4f_0VVW&xb 980M 1119S-_71;_-31V1'1 NAME ADDRESS CITY ZIP I TELEPHONE NAME ICBLN PERMIT EXPIRES S E USE N E ZONE 0 PERMIT NUMBER 0 B JOB SUITE/AK# D D R E S S ADDRESS s-lq - SAAitf-5 q8DW .50rit rbr-- L A T N fi PLAT NAME/SUBDIVISION NO. P LOT NO. L�D NO. L D FEE $ $ LIC I PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP P U B IREMARKS TES RW 1��AP '= PR 11. Street Use Peffnit Roq'd EXISTI Ni EXISTING PROPOSED Inspect1cm Required Sidewalk Required REQUIRED DEDICATION— FT Q 11 Undsovurld witting required METER SIZE LINE SIZE Of FIXTURES PRV REQUIRED I 7. YESC3 No 13 z 1 9 I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE I ADDRESS / P0. Box -s-,z 619 C ITY ZIP TELEPHONE Lym4lt�,ovo Ifalft ST&E LICENSE NUMBER EXPIRATION D E C ED f ,&_r r yA) C, o 7 7 c-4i 7 - If - 0 3 IROPERTY'TAX ACCOUNT PARCEL NO. L703-Z-A 00100100 NEW rl RESIDENTIAL 0 PLUMBING/MECH 1 ADDITION OMMERCIAL COMPLIANCE OR 3 )KC 0 CHANGE OF USE 11 REMODEL MUL11FAMILY S IGN 1:3 REPAIR GRADING [:3 FENCE CYDS ( _ X _ FT) DEMOLISH [3 TANK El OTHER EiGARAGE RETAINING WALL F RE SPRINKLER 0 CARPORT ROCKERY FIRE ALARM UWE OF USE. BUSINESS OR ACTIVITYI EXPLAIN: NUMBER OF NUMBER OF DWELLING CRITICAL AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE 'SIAJCI� S',A%&J dsmrieuml—I A 5112A-) ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE Ul IEL VARIANCE OR CUI SHORELINE OR AD13 INSPECTION BOND 13 �1[3YE�15 D POSTED S%01$ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWE PROPOSaE ALLOWED PROPOSED , 1:91A ty I / I EXP LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE BEAR FRONT LIRSIDE REAR ----------- /Va 61W4t,9P_ z PARKING LOT REA PILANNING REVIEWED D I JY ATE REQ`D — PROVIDED I - —_ I I - Mlth -3 1 -ZPR* rfi 6e P-vA -S # 4A f f I CHECKED BY 0 qTKk4 OCCUPANT ITYPE MN M__ GRO SPECIAL INSPECTION OCCUPANT REQUIRED [] YES I JAREA LOAD REMARKS PROGRESS INSPECTIONS PER UBC I 081FINAL INSPECTION REO'D 1-7;�, :510�V b4AJ61 494k 60 &IX04 Stilwitt" I j j] I � /_ Y_ 11 Depeription FEE Description FEE -Cheick State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % City Surcharge I - — Building Permit PLAN CHECK NO: VESTED DATE 11nu H7 Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC Grading 00, DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPILICAT11ON: 180 DAYS PERMIT LIMIT! I YEAR - PROVIDED WORK IS STAMMI) 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 laklin 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 HE Landscapelnsp. Total Amt. Due 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 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 hi0or 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. WORKMEN'S COMPENSATjPN.LNSUf1ANCE AND RCW 18.27. ATU CIALS BIG RE DATE SIGNATO��O DATE SIG)(ED (425) P I I �AN7�) 771-0220 AO MIR III I% Am- BED BY D PIC &#-NtION E)Cr 1333 7N �/ /, I J I I ,A // /,,, MS tMLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL IL`1 - LIO/ A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 01�16NAL-FILE YELLOW71 , CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -AS,' 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING t z 0 ca M N M 0 C:: 3! r. FTII Z 0 -n n MIMI aus R, ca CO) o: z z 0 IT! 7%, 'IDATE RECEIVED j PERMIT EXPIRES CITY OF EDMONDS 6SE PERMIT ZONE N U M B E R CONSTRUCTION PERMIT APPLICATION JOB SUrrE/APT# ADDRESS 51q 411 Avr5 50,4 r3l� z OWNE NAMEINAME OF BUSINESS P"fe—ICA An PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS LID FEE $ Ave 5 7ESCP Appromiad PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Requited C, ZIP TELEPHONE street use Permit Req 'dT EXISTIN�Q_—,.i�ROPOSEn inspection Required _2 SidewmakRoquired 0 Underground )4,W AX) S 7/;� ED DEDICATION FT REQUIR Witing required [3 NAME METER SIZE, -61ZE NO. OF FIXTURES PRV REQUIRED YES13 No C1 z ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBI. SION CONTROLIDRAINAGE 'V-A- CITY' ZIP TELEPHONE A- I NAME CBL# 134- or r e 4/ r o ENGINEERING REVIEWED BY DATE IX ADDRESS jP0. Bol FIRE REVIEWED BY DATE ^1' CITY ZIP TELEPHONE M out) 'f4 771471-1'_ S ACENSE NUMBER EXPIRATION DATE A- CpegKED VARIANCE OR CU SHORELINE OR ADB# IN PECTION BOND R POSTED 147oel r 7 7 cr" .7-/If-03 OYF 0 $ SEPA REVIEW SIGN AREA HEIGHT PROPERr1rTAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSEE) ALLOWED R D 7 �00 1 00100 , EXP MBING /MECH NEW ESIDENTIAL P MBING/MECH LOT COVERAGE REQUIRED SET13ACKS (FT.) PROPOSED SETBACKS (Fr.) AUOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE REAR I CE OR CEOR M M� �ESIDEJ C ADDITION CO ERCIAL G F USE US d� ON 0 REMODEL MULTIFAMILY PARKINP G REVIEWED Y BAT REOD PRNVIDED IGN I GRADING FENCE 1:3 REPAIR CYDS X FT) IL d DEMOLISH TANK OTHER GARAGE CARPORT RETAINING WALL ROCKERY FIRE SPRINKLER FIRE ALARM �M?E OF USE, BUSINESS OR ACTIVITY) EXPLAIN: le_4;4il WAI-K)AD UMBER CHECKED BY TYPE !Muf 1 OCCUPANT GROUP OF HUMBER OF DWELLING 'CRITICAL ' 0 1 AREAS OCCUPANT STO _LORIES UNITS NUMBER REQUIRED [:] YES LOAD DESCRIBE WORK TO BE DONE REMARKS rnuuncoS INSPE~ p_ER UBC I GO/FINAL INSPECTION REQ-D f)(TtUC)rci Akw 5 i2,u -r,4b,,o4 01-e '5'tA�J -rj+ L Le D W I A4 C. W_ e P?V M (9M*) SI�A) 6.41JCI 4tOA .60 baddi;oq 5iads4k-tv vALuAnON Dyc 1ption FEE Description FEE _-Chec; State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % I din - "" � ? T � City Surcharge PLAN CHECK NO: VE*IEO DATE ERM TMS PERMIT AUTHORIZES ONLY THE WORK ERurr COVERS WOAK T call t: U 01 BE DOME ON PRIVATE PROPERTY ONLY. U ONONTHEPUBLJJC =S. Grpdirig :2 DOMAIN (CURBS, SIDEWALKS, OR QUEES, C.)WILLREQUIRE IVEW ESt ark-S11, EM SEPARATEP ISS I N. — Engr.--Review Mr PU "Go PE! IrAP 'ION_ S ' �YDA�OAYS 14 1 IL RK PR BED I OVI PERMIT UMrP I VIE K STA AR IMSORE Enqr. I/ Ion 4pect I Tj SEE BACK OF PINK PERM$kR - I -9 S" E'R 'GNS SU' 'APPLICANT ON BEHALF OF HIS OR HER US EIR . IGNS SUCCESORS OU Fire "View Y_ rk� Deposit d*' HARM S TH' N A IN INTEREST, AGREES TO INDEMNIFX BE No AN HARM S THE Q % \pection" E L OYEES D AG MOM EDMONDS, WASHINGTON, ITS OFFICIALS, E PLOYEES D AG FROM ANY, AN / Fire Ins Receipt # NA UR IN E TLY OR IN S G C ALL CLAIMS FOR DAMAGES OF WHATEVER URE, SING ECTLY OR INO R FROM THE ISSUANCE OF THIS PERMIr ISSUAN OFT PERMIT SHAWN& BE IRE OF ANY CITY ORD1i"PE-' 0 Y 05 Lan.dscape'j�sp. Total Amt. Due 1 Z-1 %, 9 DEEMED TO MODIFY; WAIVE OR REDUCE ANY Rg 'a NY e EN 2 NOR LIMIlINIANYWAYTHE CrTYSABILITYTO FO ANY ORDINANCE P!:ISIOW =6-- liecording Receipt # I HERE13Y ACKNOWLEDGE THAT I H E READ TH19'APPLICATION; THAT THE INFOR"-TioN APPLICATION APPROVAL IS CORRECT. AND THAT I AM THE OWNER, OR THE DuLy AUTHORIZED AGENf'OF GIVEN Y WITH CITY AND STATE LAWS REGULATING CONSTRUC- THE OWNER. I AGREE TO COMPL -CAL 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 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. WORKMEN'S COMPENSA�� ACE AND RCW` 18.27. ,PUR� CIALS PlqNATURE D�TE I ATURE SIG DATE SIG E�70 1A9f--% ECIALS I /� 771-0220 6�FE By RE SED BY A/1/rT 1099 EXT 1333, / / rLAVWFUL / Z� IT TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL /is TIS A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- NAL - FILE YELLOW/lNeECTOR 4 CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 S� PINK - OWNER GOLD -AS SSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING