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20030439.pdfRECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS '9!Q<7:r.g Z_ L_ cze�: MAILING ADDRESS 11.2 V /a Aff�, CITY I ZIP ITELEPHONE NAME ADDRESS CITY NAME ADDRESS CITY 6C)02L)lN0_ STATE LICENSE NUMBER ZIP ITELEPHONE ZIP I TELEPHONE PROPEMY TAX ACCOUNT PARCEL NO. CBL # /&'7 NEW Dd RESIDENTIAL x-_r PLUMBING/MECH ADDITION COMMERCIAL COMPLIANCE OR 13 CHANGE OF USE REMODEL 0 MULTIFAMILY C] SIGN REPAIR GRADING 0 CYDS FENCE 13 ( X FT) DEMOLISH TANK 077 �,,e GARAGE RETAINING WALL FIRE SPRINKLER CARPORT ROCKERY FIREALARM (TYPE OF USE, BUSINESS OR ACTINTM EXPLAIN: /A NUMBER kUMBER OF CRITICAL OF DWELLING AREAS STORIES ,.0 NUMBER 9!9-q-7? DESCRIBE WORK TO BE DONE � PERMITEXPIRES Ziz�41 f4c" MONSOON UNION USE PERMIT ZONE �14 -3-6111) NUMBER AXL -//,? JOB SUITE/APT# ADDRESS joce; PLAT NAME/SUBDIVISION NO. LOT NO. L D NO. ptyfz Pik L:D FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required Street Use Permit Roq'd EXISTING — PROPOSED— Inspection Required Sidewalk Required REQUIRED DEDICATION— FT Underground Wiring required METER SIZE LINE SIZ�_�01: FIXTURES PRV REQUIRED YES13 NO 13 z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE W VARIANCE OR CU SHORELINE OR ADB11 INSPECTION BOND RE(LD I POSTED I 13YES AQNO $ — — SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED , :XP LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED JP FRONT L/R SIDE REAR PARKING I LOT AREA L��NNING REVIEWED BY DATE REO'D I PROVIDED I — [^/ , CHECKEDBY I TYPE DF CONsTnucnom CODE OCCUPANT GROUP 001 2 SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [:] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1011111MINAL INSPECTION REaD 1 .Q-7' x 8 " HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK. NM VESTED DATE $ Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge — zz9 3 Plumbing 61 t:) �� l ___1 Mechanical THIS PERMIT AUTHORMS ONLY THE WORK NOTED. THIS PERMST COVERS WORK TO t BE DONE ON PRIVATIE PROPER7V ONLY. ANY CONSTRUCTION ON THE PUBILIC Grading :1 TC.) WILL REQUIRE 3 DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, E I= SEPARATE PERMISSION. Engr. Review 15 PERIArTAPPUCATION: 160 DAYS PERMIT UMM 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 IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF 2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECUY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total . Amt. Due NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,' Recording Fee Receipt # 1A 4 1 HERESY 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 Th a application Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREDY, NO PERSON WILL BE EMPLOYED BuIIdIn19 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 apace provided. WORKMEN'S COMPENSATIO��URANCE AND RCW 18.27. 'A'35) OFFICIALS SIGNATrRLE DATE SIGNATURE (OWIAR 0�/GENT) DATE SIGNED 771-0220 'DATE RE ASED BY 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- ;WIGINAL - FILE - YELLOW`- INR(ECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER - GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING 77 0 MR oc. rn; 2 DATE NECEIV ED . . . . . . PERMIT EXPIRES USE PERMIT CITY OF EDMONDS ZONE NUMBER,, JOB SUITE/APT# CONSTRUCTION PERMIT APPLICATION ADDRESS OWNER NAME/NAME OF BUSINESS PLAT NAME/SUB15POSION NO. LOT NO. LID NO. MAILING ADDRESS LID FEE $ Ajc� AL)e 5 TESCP AP PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP MY f'8Mjjt=6d CITY ZIP TELEPAONE I Street Use Permh RWd EXISTING — PROPOSED IrApoction Required Sld&*a* Required -7q Underground REQUIRED DEDICATION— FT Wittrig requirW 13 NAME METER SIZE LINE SIZE NO, OF FIXTURES PRV REQUIRED 113 YES 13 NO 13 T 1; I ADDRESS REMARKS V z X OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE CITY ZIP , ETELEPHONE NAME CBL 11 -7 AA ENGINEERING REVIEWED BY DATE cc ADDRESS LO FIRE REVIEWED BYfj P9 DATE CITY ZIP TELEPHONE 7 a, �422-! o VARIANCE OR CU SHORELINE ORADB11 INSPECTION BOND STATE LICENSE NUMBER EXPIRATION DATE CWCKED BY REqD_ POSTED 1 I 1$ ::-:>6 enz<L�� 2 I 13 ES -WNO SEFA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED M-77m daE f 0 — — 0 'e ;?5 1 , X Q I EXP �.3 0 NEW t4 RESIDENTIAL 0 PLUMBIN0jmE.cH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) FRONT L/RSIDE REAR ALLOWED PROPOSED I ADDITION [j COMMERCIAL o COMPLIANCE OR CHANGE OF USE 51 PA RKING LOT AREA PLANNING REVIEWED BY DATE D4REMODEL U MU FAMILY U SIGN REO' PROVIDED —74C)g QL6,2.. A-aD 13 REPAIR GRADING FENCE CYDS X FT) REMARKS 0 DEMOLISH TANK [:IGARAGE o RETAINING WALL FIRE SPRINKLER FIRE ALARM CARPORT ROCKERY (TYPE OF US BUSINESS OR ACTIVITY) EXPLAIN: CHECKED PEPF CONSTRUCTION CODE OCCUPANT BY TY r.11q / /D ____'F_cRrnCA GROUP NUMBER NUMBER OF L OF ' DWELLING AREAS SPECIAL INSPECTION JAREA OCCUPANT STORIES UNITS NUMBER REQUIRED [3 YES LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REGrD 2 Q17 VALUATION Description FEE Description FEE �Ii�n Check ; ) <;>6�' State Surcharge HEAT SOURCE G % LOT SLOPE % Building Permit J,, City Surcharge PLANCH!:Lt VESTED DATE Plumbing 2�*e �Ia Mechanical THIS PERMff AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT C0VIEq6 WORK TO 1= BE DONE ON PRIVATE PROPERTY ONLX ANY CON67RUCTIION ON THE PUBLIC 2 Grading 3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: i60 DAYS PERMIT UUM I YEAR - PROVIDED WORK IS frrmMn INTTHIN 180 DAYS Engr. InspecUon 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 INDEMNIrY, 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 "IS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapoinsp. Total Amt. Due DEEMED To MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINAN CE 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 C31VEN 13 CORIMCT, 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 IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building OffIcIal or hisibor Deputy: and Face are paid, and receipt 13 acknovAedged In space provided. WORKMEN'S COMPENSATION CE AND RCW 10.27. '�WkURAN OFFICIALS SIGNATrRLE DATE SIGNATURE (OIR 01 LIGENI�l DATE SIGNED 1425) 771-0220 RE ABED BY I)ATE ATTENTION 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 - Fit E - YE1 I OW - IN ECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBG SECTION 109 PINK -OWNER - GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 4 0 M "A ii ro � 0 M C M —1 § 0 C: 32 C IT! ITIZ 0-4 z 3� 0 n rn M C: 0 z 0 1 0 M