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20030442.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWN NAMEIUAME OF BUSINESS MAILING ADDRESS ?5 '7 CITY ZIP TELEPHONI�A L4 45) U6 MVTz ADDRESS CITY ZIP NAME - - a - . - I - . - - I - ICBL# ADDRESS CITY ZIP I TELEPHONE WL2 1 1 PERMIT EXPIRES UBE PERMIT ZO NE ( LA eD(i� NUMBER 2 JOB ADDRESS 7VM SUITE/APT# PLAT NAME/SUBDIVISION NO. 7NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required street use Pernift Roqd EXISTING - PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION- FT Undergrowd Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRY REQUIRED is I YESC3 NO 13 3 REMARKS z z OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE I BY DATE FIRE REVIEWED BY DATE Lu cc I M 9 I STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY PROPERTY T ACCO PARCEL NO. VARIANCE OR CLI SHORELINEORAD111 I INSPECTION BOND REO'D - POSTED I E3YES S50 $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE I EXEMPT ALLOWED , PROPOSED . ALLOWED , PROPOSED 1EXP is NEW RESIDENTIAL PLUMBING I MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR o COMPLIANCE OR 0 ADDITION COMMERCIAL CHANGE OF USE I 3115-% T z z S� 7-5 57/ii;j —77- 46 z REMODEL MULTIFAMILY E] SIGN PARKj�j IT ARFA I PLANNING REVIEWED BY DATE REQ`D 0 z � 810 1 GRADING FENCE X 0 REPAIR CYDS FT) REMARKS [:] DEMOLISH TANK K!1Q_<'K oGARAGE RE7AINING WALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF 13USINESS OR ACFMM EXPLAIN) 4�;Pff CHECKED BY ITYPE OF CONSTRUgrION CQPE.- OCCUPAN _Z Vit GRO P NUMBE NUMBER OF CRITICAL L OF DWELLING AREAS Z— SPECIAL INSPECTION ARIEA_ Peck OCCUPANT im- LOAD STORIES UNITS NUMBER IQ5_ REQUIRED 04 [] YEs 1 2- DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 1108JFINAL INSPECTION REQ'D +0 Wt-4-k <- 1--^ >�U t-AV VAWATION 1_u y a f7li rL ID , (n, - -1 __.t $ 'Eju5z' Description FEE Description gE Plan Check 0 State Surcharge 0 HEAT SOURCE GWING % SLOPE % OVID I-L-0 I df Building Permit City Surcharge PLAN CHECK NO: VES ED DATF 5)1 1V'103 Plumbing Mechanical THIS PERMIT AUTHORMES ONLY THE WORK NOTED. THIS PE&rr CO;ERS WORK TO 1: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 2 :3 DOMAIN (CURBS, SIDEWALKS, DRIVIEWAYS. MARQUEES, EfC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERUITAPPIUMATION: 160DAYS PERMIT U54M I YEAR - PROVIDED WORK IS STARTED WITHIN 150 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS A P P Fire Review Plan Chk. Deposit 71a. IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF N -I I EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND E D M 'I Fire Inspection Receipt # A ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY L L PERMIT SHALL NOT BE '002.,2 F FROM THE ISSUANCE OF THIS PERMTE ISSUANCE OF THIS R 0 Landscapeinsp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE D EEI LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Recording Fee Receipt # L&Z I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION I HEREB APPLICATION APPROVAL GIVEN IS CORRE" AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH C17Y AND STATE LAWS REGULATING CONSTRUC- TH 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 VI - OLATION OF THE LA13OR CODE OF THE STATE OF WASHINGTON RELATING TO Building Official or his/her Deputy: and Fees are paid, and FOR INSPECTION receipt is acknowledged In space provided. WORKMEN'S C INSURANCE AND RCW 18.27. OFFIPIALS SIONATURE OAT SIGNAT Y V�NE�RGE" DATE SIGN D (4-25) S-4 1-02 0 ReAfE AZ I ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL S.- f Vj I I A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CEFITIFI- ORIGINA - Fll_.�)- YELLO4 - INdECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK AQWfCR - GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 4 APPROVED BY PLAI NING Lj 6o 4v OrN OP J" t woe w W.- 01") 0 0 <9 10 OS. I rk If.4 .. fSA I 0 77- a p I qDATE RECEIVEWD CITY OF EDMONDS LPERMITEXPIRES U6E PERMIT ZONE NUMBER /—JJD:3 Ann CONS RUCIIONP RM1111A PLICA11014 Ann RESS -71 -fh z$U11C11% W L' 13V OWNEINAMEINAME OF BUSINESS PLAT NAMEISUBDIVISION NO. LOT NO. '&.2 LID NO. MAILING ADDRESS LID FEE S -.-) � 3 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP AP RW Pemilt=od Street Uu PuMN Wd CITY ZIP TELEPHONE I EXISTING — PROPOSED Inepectio Required SbdowatknRequired S., 77z� j REQUIRED DEDICATION— FT — UrAerw—w Wift reqtdred 13 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED ts I I YES 13 NO 13 Z ADDRESS REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE I CITY ZIP NAME ADDRESS CITY ZIP - — STATE LICENSE NUMBER I.. Arl-�� PROPERTY T7)ACCO PARCEL NO NEW RESIDENTIAL ADDITION COMMERCIAL REMODEL MULTIFAMILY REPAIR GRADING CYDS DEMOLISH TANK uGARAGE [3 RETAINING WALL CARPO ROCKERY _ (TYPE OF LLSF, BUSINESS OR ACTIVTM EXPLAIN' C_ V e-0 -tt 0 V� C� NUMBER NUMBER OF OF DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE 50 , I d I G x F +0 be- eve K W k - ICBL# In. - CHECKED BY PLUMBING I MECH COMPLIANCE OR CHANGE OF USE SIGN oFENCE _x Fr) FIRE SPRINKLER FIRE ALARM CRITICAL 'F AREIA, S UM NUMBER K' I t 24, FIRE REVIEWED BY DATE W cc IE VARIANCE 08 CU SHORELINEORADEIM INSPECTION BOND REQ'D POSTED I I 13YES L31<0 $ SEPA REVIEW SIGN AREA HEIGHT I COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED "Xp , 1 0 , oc . LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REM FRONT UR SIDE REAR 5 7.5 'YZJ. -7Z 3�4�. >totj PARKING LOT AREA 3 I PLANNING REVIEWED BY DATE C6 REO'D PROVIDED IV I CHECKED BY OF CONSTRUCTION C4E OCCUPA ITYPE GROUP I 1�000' SPECIAL INSPECTION fAt REQUIRED [3 YES JAI;;�,,f & ]OCCUPANT LOAD REMARKS D PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REa �il h I VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLIA G % SLOPE % "M 0 *T 0 T Building Permit City Surcharge P '5 VESIED PLAN CHECK NO: A111- ff '_J51117703 Plumbing Mechanical THIS PERMIT AUTHORUMS ONLY THE WORI WORKTO It BE DOME ON PRIIVATE PROPERTY ONLX ANY CONURUCTION ON THE PUBLIC 23 Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERUrrAPPLICATIOP& 160BAYS IL PFi,turrUiAmi�YeAR-PRovioEDwonkissTAR*iiwrrmik ISODAYS Engr. InsoDdion SEE 13ACK OF PINK PEMIT 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 FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due I NOR U 4W WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - Em 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. -1 AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This applicatlon Is not a permit until signed by the TION; AND IN"DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or hislhar Deputy: and Foes are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is ackncrModged In space provided. WORKMENS C 0"SATION INSURANCE AND RCW 18.27. 1 OFFIPIALSLS19NATUR DATf SIGNATU .1 WNER AGENT) DATE SIGN4,13 Ll (4225) k)W /I , b'Z '�i& 4a. .1771-0220 __3 6FEL E AT� -17ENTION Al V 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- ORIGIN�i - FILI�/ I YELLa - INdECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -%QWNIfR - GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 q 0 M -4 -n 55 � 0 M C M 40 0 C I z M M z O"n n M M 0 _0 0 0 Fn C9 C" z z 0 11 0 M