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20030425.pdf0 DATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMENAME OF BUSINESS MAILING ADDRESS I 0410 CITY ZIP TELEPHONE 27 __Z/f � z NAME ADDRESS —I— CITY ZIO TELEPHONE NAME Fi1c, r'614a"W 'T'vr' y 31;?;Le ClTy� ZIP �TE L e , E LICENSE NUMBER EXF C )ROPERTY TAX ACCOUNT PARCEL NO - NEW RESIDENTIAL ADDITION COMMERCIAL REMODEL MULTIFAMILY REPAIR GRADING CYDS DEMOLISH TANK GARAGE CARPORT RETAINING WALL ROCKERY (TYPE OF USE, BUSINESS OR N: �5w _ NUMBER OF STORIES NUMBER OF DWELLING UNITS DESCRIBE WORK TO BE DONE .4/ CBL # P,W7 LPERMIT EXPIRES W USE PERMIT ZONE NUMBER JW_7 JOB A.1 SUITE/APT# PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. I L D FEE S L PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Pormlt Required Street Use Permit Req d EXISTING — PROPOSED Inspection Required 13 Sidewalk Required REQUIRED DEDICATION— FT Underground wiring required METER SIZE LINE SIZE NO. OF FIXTURES RV REQUIRED 1 1 YEs 13 NO 13 iE 15 REMARKS OWNERMONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE . - FIRE MARSHAL "r'UO I bt IHESENT FOH I MIA P nIVR 1-1 tt, RLMOVAL, OR CAP ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE IATION�pi By A I Al VARIANCE OR CU SHORELINE OR AD110 INSPECTION -60-ND 1101/4015 REO'D I 13YEs 13NO 1$ POSTED S I SEPA REVIEW SIGN AREA HEIGHT C 0 M COMPLETE P L I EXEMPT ALLOWED PROPOSED I ALLOWED I PROPOSED X P EXP ME CH ID PLUMBING MECH Lol LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOW1 ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REAR C E 0 COMPLIANCE OR R z CHANGE OF USE F US E 0 P fl ARKING R—E A A PLANNING REVIEWED BY DATE SIGN REOD PROVI FENCE I ( _ X_FT) REMARKS o OTHER F RE SPRINKLER FIRE ALARM FCHECKED BY jTYP!:!!jMION 1(6pq OC CUPANT 1,:;? GROUP 1� CRITICAL r��_j AREAS SPECIAL INSPECTION OCCUPANT NUMBER II&A REG ( UIRED 0 YES JAREA LOAD REMARKS PROGRESS INSPECTIONS PER UBC 111110111111/11FINAL INSPECTION REO'D V Description Description FEE Plan Check State Surcharge HEAT SOURCE LAZING % LOT SLOPE % Building Permit City Surcharge PLM CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 11= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC a DOMAIN Grading :3 (CURBS, SIDEWALKS. DRIVEWAYS, MARauem ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 160DAYS CL PERMIT UMIr I YEAR - PROVIDED WORK IS STARTED 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 I 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 0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - Recording Fee Receipt # I HERE13Y 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 APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This applicaUon 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 COMPENSAT19tWAgRANCE AND RCW 18.27. OFFICIAUP SIG*TURE DATE SIGNA NERO A E A :E v6NED (425) //'�P) , A /7 I 771-0220 1-1 1 —DEE REILEASED ATTENTION 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- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 ORIGINAL -FILE YELLOW- INSPECTOR PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING � 11111110 z 0 M M M 0 0 a M 0 _Tl n MITI! 0 0 z V) M 0, z 0 M 11 0 0 FROM: -FINAL PROJECT APPROVAL FORM TO: DATE: ink DEPARTMENT DATE. a 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Sign, ocaprvl.doc.l:t=M.bldg:forpsIO/Ol z 0 m =i 9 am a mo 0 80 m MZ 10-4 co 0 -n n m m 0 0 0 M C cl) r. 0 mo -Z [7n X z z 9 0 m X 0 DATE RECEIVED -7-777 Lo 2 PERMIT EXPIRES USE PERMIT ZONE CITY OF E ONDS NUMBER CONSTRUCTION PERMIT APPLICATION JOB sunE/APT# ADDRES2L _S4 OWNER NAMEINAME OF BUSINESS ar7to/I PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. 15 MAILING ADDRE I f /. 0 "-7,n , 174pe 1-C., / - LID FEE $ TESCP APPIOV PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Perrrat Raqu stmet use Path Roo CITY TELEPHONE ZIP EXISTING - PROPOSED Ins pectson Required sidewit1k Required ;72;�,Z REQUIRED DEDICATION- FT , UnderGmund I "MI; UM 13 NAME METER SIZE LINE SIZE NO. OF Fliij�� PRV REQUIRED Y 1 ES 13 NO 13 I z ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE CITY Z10 TELEPHONE FIBE MARSHAL MUST BE PRESENT FOR CBL# NAME TANK FILL, REMOVAL, OR CAP f ENGINEERING REVIEWED BY DATE ADDRE "IF z o. 6fw FIRE REVIEWED BY DATE ul Mr.. CITY ZIP TELEPHONE f/7 M VARIANCE OR cu SHORELINE OR ADBP INSPECTION BOND STATE LICENSE NUMBER RATIONDATE BY REOD POSTED i[3YEs 1$ 2EXP OC / j� f L '31 ONO t. SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACQQUNT PARCEL NO COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED M 4�11b ?7y) Oaz 7 EXP , C M 0 NEW RESIDENTIAL PLUMBING/MECH 9 LOT COVERAGE REQUIRED SETBACKS iFT) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR COMPLIANCE OR 13 ADDITION COMMERCIAL CHANGE OF USE M M PARKING LOT AREA REVIEWED BY DATE 06 0 REMODEL MULTIFAMILY SIGN REQ`D PROVIDED 10 I GRADING FENCE X REPAIR CYDS FT) REMARKS DEMOLISH TANK OTHER IR 0 GARAGE RETAININGWALL FIRE SPRINKLER FIRE ALARM In CARPORT ROCKERY _0 M?E OF USE, BUSINE 88 OR=N: CHECKED BY OCCUPANT M M ITYP!,!MION GROUP NUMBER NUMBER OF CRITICAL OF. DWELLING AREAS SPECIAL INSPECTION OCCUPANT STORIES UNITS NUMBER JAREA REQUIRED LOAD YES DESCRIBE WORK TO BE DONE C0 M wl"Vle REMARKS PROGRESS INSPECTIO WFINAL INSPECTION REG'D C) z t�aln_e aNd C �,Al 71fiple 1 qW C,!OaF YKA11 Z711fct -f Vlt� -) drA,4r,11 f ;OLb VALUATION $ C#) Description FEE Description FEE z rge urcharge Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % rge 100� M Building Permit City Surchqarge 131 AN Il'uprif hIne VESTED DATE Plumbirin M�qhanlcal THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO ft BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading a 3 DOMAIN (CURSS, SIDEWALKS, OMMVAY% MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION:' 180 DAYS IL PERMIT ILIMM 1 YEAR - PROVIDED WORK IS STARTED WITHIN 160 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 BE FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT Landscapelnsp. Total Amt. Due 9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CnYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - Recording Fee I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION H By A DGE T I HAVE REAO �:T APPLICATION APPROVAL q GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF R E AND I AM HE 0, 0 C07 CT IS R7 THE OWNER. I AGREE M COMPLY WITH CnY AND STATE LAWS REGULATING CONSTRUC- T COMP WIT H CW E ER E 0 CALL This application Is not a permit until signed by the " TION; AND IN DOING THE WORK AUTHORIZED THEREBY NO PERSON WILL BE EMPLOYED I TH 01 U1 Bull r Deputy: and Fees are paid, and ding Oftial or hisibe is acknowledged In space provided. N VIOLATION OF THE LAA13OR CODE OF THE STATE OF WASHINGTON RELATING TO I V a TIO 0 T L 80 Co 0 Tj FOR INSPECTION rocelpt LERE WORKMIENS CO jSeff!��R�NCE AND RCW 18.27. OFFICIAL SIGTURE j DATE SIG ER D E ___ GNED 1425) -3 771-022 0 RELEASED DXrE ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL --A 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 GO LD-ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING