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20030420 (2).pdfa DATE REC�IVE7, 410-3 9 USE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESA cmf' ZIP TELEPHOJE Le0':4q?_S7(,qu -700 NAME ADDRESS / 71 U-��7 t LC ZIP TELEPHONE 4 61-1 e'Jf_15_r I LL;�51 7 NAME CBL #L4(�;� LK A 'bRESS D ZIP TELEPHONE STATE LICENSE NUMBER EXPIRATI D KED )7 L NEW 0 RESIDENTIAL PLU ADDITION COMMERCIAL E] co, REMODEL MULnFAMILy 0 SIG REPAIR GRADING CYDS FEN 13 DEMOLISH 11 TANK OTH oGARAGE -1 RETAINING WALL [I 0 FIR CARPORT ROCKERY FIR (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: NUMBER NUMBER OF CRITIC OF DWELLING ;f1A AREAS i R UNITS NUMBE MBING / MECH MPLIANCE OR GE OF USE N REO'D I PROVIDED CE — x_FT) REMARKS ER E SPRINKLER E ALARM PERMIT EXPIRES PERMIT NUMBER 72D JOB sul�� ADDRESS �14erc 0 PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCIP APp'-:- RW Permit Street use P:rrn,, .q"T EXISTING — PROPOSED inspection Required Sidowa*Rsqulrad REQUIRED DEDICATION— FT Underground WkMg required 13 METER SIZE LINE S1 7E OF FIXTURES PRV REQUIRED I YES13 NO 0 z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE REVIEWED BY DATE FIRE REVIEWED BY DATE I I If DESCRIBE WORK TO BE DONE HEAT SOURCE GLAZING % LOT SLOPE % —_ --- I — - I PLAN CHECK NO: I VESTED DATE WARIANCE OR CU SHORELINE OR ADBI INSPECTION BOND REQ'D I POSTED I 13YEs 13NO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP I , LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR DATE PARKING LOT AREA PLANNING REVIEWED BY CHECKED BY CONSjTUCT!QN OCCUPANT IrAfE GROUP -A SPECIAL INSPECTION AREA OCCUPANT ,REQUIRED [:] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REG-0 $ I— __ DescrIption FEE � DescriptIon FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Recording Fee _[R pt # CALL FOR INSPECTION 0 [A (425) 7 1-022 ATTENTION EXr 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 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES THIS PERMIT AUTHIORRES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMITAPPLICATION: ISO DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS 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 BE 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." I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION GIVEN 13 CORRECT, AN THE OWNER, OR THE DULY AUTHORIZED AGENT OF T OWNER. I AGR�E D THAT'kM H AgI SETEATENLAWS HE _ _ TO COM .. IT CITY �R ry, 0 P REGULATING CONSTRUC- TION; AND DOIN THE WOf1K AUTHORIZEE ERSON WILL BE EMPLOYED IN VIOLATION OF, HE OF TIrWSTATE OF WASHINGTON RELATING TO I WORKMENS '0 / NSAVff95 C _ E j ACE A)M RCW 18.27. NER 0 NT) DATE I qc .ICATION APPROVAL -ation Is not a permit until signed by the it or hisftw Deputy: and Foes are paid, and �s acknowledqQ11 in space provided. �ATURE DATE. BY ORIGINAL - FILE YELLOW - INSPECTOR PINK - OWNER GOLD - ASSESSOR GREEN - ACCOUNTING 2 Z' 0 d 0 M M M —4 0 �x M M z O"n ca 6 Fn 0 z 0 M FINAL ROJECT APPROV FG- -L%l TO: z 0 m 'A T, M Ma 0 --40 0 c: -4 E = M M z 0 -n n -4 x m M 0 vi 0 o Fn C 0) E cl) M 0 Z z (j) z 9 0 m 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Si ocaprvl.doc.l:teup:bldg:for=10/01 r� Ti I 'DATE REC CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATIOD OWN511 NAMENAME OF USIN 15 MAILIN po SS . 3. Lox crix, ZIP ELEPHO qZ;E (40 62-0 -X A N M ZIP TELEPH( gk= NAME atyl&74 Col AD RESS /7fZ r-) 'L0 PERMITEXPIRES 12J 1 �P� mmw� USE Z NPR PERMIT 0 NUMBER JOB ADDRESS SU77 PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S TESCF Appmed PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Pemilt flewWed P*Imlt Wd EXISTING — PROPOSED Impwuon n*qWW Sldewa* Requked REQUIRED DEDICATION— Fr UndwWMW WWgrequked Li METER SIZE LIN�� NO. OF FIXTURES PRV REQUIRED I YES C3 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE /_ I CBL #= BY DATE FIRE REVIEWEDBY DATE CiRy zi TELEPHONE 6��e_ C" (f-opir -I cf?— 5— 7 �e— VARIANCE OR CU SHORELINE OR ADB11 I INSPECTION BOND STATE LICENSE NUMBER EXPIRATI N OAT REO'D POSTED I I U-1 0 If 13YEs ONO $ yl E'de c z 0 y 470M - SEPA REVIEW SIGN AREA HEIGHT PRO EXEMPT ALLOWED PROPOSED ALLOWED BED PROPO EXP� 0 NEW RESIDENTIAL PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FE) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REAR COMPLIANCEOR ADDITION COMMERCIAL 13 CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE [j REMODEL 1:1 muLnFAMILY [3 SIGN REO'D PROVIDED 0 REPAIR CYDS FENCE x FT) REMARKS tEMOLISH OTHER TANK 3 GARAGE RETAINING WALL FIRE SPRINKLER CARPORT 13 0 ROCKERY FIREALARM 11TYPE OF. USE. BUSINESS OR ACTMM EXPLAIN: CHECKED BY E CONS LICTION OCCUPANT UW 'dAglo , �.t RO P to MBERA. NUMBER OF CRITI-C j DWELLING AREAS PECIAL INSPECTION' OCCUPANT JAREA STORIEf UNITS NUMBER REQUIRED LOAD DESCRIBE WORK TO BE DONE ( �REMARKS PROGRESS INSPECTIONS PER UBC 11081FINAL INSPECTION R D �Vf eel Z �? VALUATION I Laul"L r 11! 11 $ Description FEE Description FEE z 0 1 4 Plan Check State Surcharge 0 HEAT SOURCE f2l A71LM Ot 01 ^.. I M I Building Permit 0--12 -"Ir 2 - I — City Surcharge PLAN CHECK NO: — VESTED DATE Plumbing Mechanical THIS PERUIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC 2 Grading U 3 DOLMN (CURBS, SIDEWALKS, DRIVEWAYS, MMUEES, ETC.) WILL REG IRE t: SEPARATE PERMISSION. a Engr. Review PERMIT APIPUCATIOW., 100 DAYS PERMIT UUM. I YEAR - PROVIDED WORK 18 STARTED WffHIH 180 DAYS Engr. Inspection SEE BACK OF PINK PERUrf FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS MAD 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 On REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due NOR LIMIT IN ANY WAY THE C47YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Fli Recording Fee Sceipt # I HER-EBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVE IS CORRE"- AND THAT I AU THE OWNEq, OR THE DULY AUTHORIZED AGENT OF UER. THE I AGR5E TO COM WITH CITY STATE LAWS REGULATING CONSTRUC- CALL a [cation Is not a permit until signed by the W Do TH TION; AND W UgIN rHE ORIZED 'ERESY, NO PERSON WILL BE EMPLOYED h W of Mm Deputy; and Fees are paid, and IE IN VIOLATION k E OF T STATE OF WASHINGTON RELATING TO 0 1 1 jEl FOR INSPECTION ec pt Is acknovAodq& in space provided. WORKMENS C S R * N CE CW 18.27. AL G URE DATE T BIGNA� DATE SIGNED 142 'M 1) JR ;1 /16 �(ER 6- /& 771-0220 A D BY DAfE AWENTION 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 HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING ----------