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20030446.pdf,DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NME/NAME OF BUSINESS CV%er4 I MAILING ADDRESS 167c'�5 0!1+� ZIP A TELEPHONE �Anmr,�k %W L4 7,<--7 755- 1 q if NAME ADDRESS CITY ZIP I TELEPHONE 'I IM) 0e3 I PERMITEXPIRES I A —_ L USE PERMIT ZONE NUMBER C) JOB SUITE/APT# ADDRESS AFL k) PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 1110WNER/CONTRACTOR TESCP APPrW6d U AW Permit Required Street Use Permit 1100 EXISTING — PROPOSED— inspectwit Required Sidawalir Required REQUIRED DEDICATION— Fr Uncla(Wowd Wiring requW0 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I I YES13 NO 13 z REMARKS I RESPONSIBLE FOR EROSION CONTROL/DRAINAGE Or-- I NAME CBL# ym - ra Pluvv\Un� 1 ADDRESS J 143,30 hyrom Ave. Nor+k CITY ZIP TELEPHONE n A% 9 0 (331 vq _j / q0 ow(p — ;( STATE LICENSE NUMBER EXPIRATION DATE� EUR00*033W. 111120 PROPERTY TAX ACCOUNT PARCEL NO. 605.05:,C000 0 NEW RESIDENTIAL bi--PLUMBING / MECH 0 ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE 1:1 REMODEL muLnFAmiLy SIGN 1:1 REPAIR GRADING CYDS FENCE X FT) DEMOLISH 1:1 TANK OTHER GARAGE CARPORT -1 RETAINING WALL 0 ROCKERY FIRE SPRINKLER FIRE ALARM UWE OF USE, BUSINESS OR A;QFL NUMBER OF NUMBER OF DWELLING I RITICAL AREAS I CUMBER NA - STORIES UNITS DESCRIBE WORK TO BE DONE I/ ; 'i '� t ' ( * 1L%_LJ%, 1: JPW AXOR V� L BE INSTALLED FIRE REVIEWED BY DATE VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND REO'D 113YEs POSTED I ONO $ SEPA REVIEW 8'r A EA SIGN ARE4 ' R HEIGHT COMPLETE EXEMPT ALL04WED PROPOSED ALLO WED POSED , U RSUA TMO U m_ 605.2 I _XP - - - -*—. LOT COVERAGE W% SETBACKS (Fr.) ALLOWED PROPO ITHIRSIDE REAR L-4AS ff BNTM S rr B z BUMDING 2 PARKING REVIEWEDBY DATE 9 REO'D I PROVIDED I LOT AREA I PLANNING 116 CHECKED BY ITYPE N CpM OCCUPAN ut GROUP SPECIAL INSPECTION PAREA OCCUPANT REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REGZA %J $ C_A4 0-E f&WVVk._ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING 11 LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO, VESTED DATE Plumbing Mechanical THIS PERMIT AUTHOREMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC Grading DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMffAPPUCATION: ISO DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STAKED WITHIN 180 DAYS Engr. Inspection gt7h,,, 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 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 Landscapoinsp. Total Amt. Due I NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- - Recording Fee Receipt # 1 HERE13Y 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 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 COMPENSATPIqRNRANCE AND RCW 18.27. OWMLS IGN;A�U;RE TE SIGNATURE (OWNE;R OR�GE" N&1) DATE SIGPED (425) ir 7) ir bT4 Zu. 111/ft=&. k& 771-0220 - - daa a::' 6, r I RELE6 SED BY DATEf ATTENTION 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- 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 1 Z 0 M M C M 0 0 C M M z 0.TI .n M M 0 n CF 0� z z 0 M FINAL PROJECT APPROVAL FORM TO: — DATE: PERMIT COORDINATOR., BUIMING DIMION. z 9 0 m :q 9 r-n rn 0 80 m M Z (3: J) o -n n m m 0 0 0 rn (j) c/) M 0 Z r- X z z 9 0 m RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Sig ocaprvi.doc.l:hnp:bldg:formsIO/OI rD7ATE RECEIVED PERMIT EXPIRE USE CITY OF EDMONDS Zo E ZONE a0':2_ 0 NUMBER CONSTRUCTION PERMIT APPLICATION Jol� JOB SUITIVAPTO DRE D SS ADDRESS S11111 OWNER NAME/NAME OF BUSINESS 0) PLAT i'" PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. e r On/ MAILING ADDRESS f LID FEE S TESCP Approved tA c'�5 eq Av Q, PUBLIC Rl' PUBLIC RIGHT OF WAY PER OFFICIAL MEET MAP RW Penrat Ro**Sd CITY ZIP Street Use Permit RW EXISTING - PROPOSED kupselion Required Sidews* Required ��TELEPHONE 0 HU-175-14 Q REQUIRED DEDICATION- FT grequired 13 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I - YES13 NO 13 I ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE I I CITY ZIP ITELEPHONE NAME CBL# vy,(:)V,CA Rum&n!� ENGINEERING REVIEWED BY DATE ADDRESS �j PURSUANT TO ECDC 19.30.020 i423o Plrurorp Ave Nor+k FIRE REVIEWMME"MR130M, W= CITY ZIP TELEPHONE SHALL BE INSTALLED NEA�i__ e 9 __36Lj_jjq0 VARIANCEORCU Aft, STATE LICENSE NUMBER EXPIRATION DATE if FIEO'D POSTED i $ URoAR*QS3NA1 9 If, U SEPA REVIEW 'SIGN AREA' - - 1 1 V HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. ETE . EXEMPT I ALLOWED . PROPOSED' 'ALLOWED . PROPOSED [] NEW XRESIDENTIAL 0 ADDITION COMMERCIAL REMODEL MULTIFAMILY REPAIR GRADING CYD8 DEMOLISH TANK GARAGE CARPORT RETAININGWALL ROCKERY (rYPE OF USE, BUSINESS OR ACTlVl7M.EXPlAiN: NUMBER NUMBER OF OF DWELLING STORIES I I UNITS I DESCRIBE WORK TO BE DONE t&IrLUMBINGIMECH LOT COVERAGE ALLOWED PROPO COMPLIANCE OR CHANGE OF USE SIGN PARKING REOD PROM I I riFENCE ( X FT) REMARKS OTHER FIRE SPRINKLER FIREALARM REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT11 FR NT UR SIDE REAR xwlafq ft DATE CHECKED BY T I U NT N OCC PA 9, COV ITYPE GROUP nM I CRITICAL AREAS - r 11_z SPECIAL INSPECTION AREA OCCUPANT NUMBER NAIREQUIRED[] YES LOAD I REMARKS , I PROGRESS INSPECTIONS PER LIBC 108/FINAL INSPECTION REG'D . I insiall I" �%/ 9 1 VALUATION $ Doscription FEE Description FEE Plan Check State Surcharge GLAZING % I LOT SLOPE % I Lo�� Building Permit City Surcharge PLAN CHECK NO: VESTED DATE I Plumbing Mechanical — THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. ' 'PERMIT COVERSWORKTO t: BE DIDNE ON PRIVATE PROPERTY ONIX AM CONSTRUCTION ON THE PUBLIC Grading MX DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPUCATION:' 160 DAYS PERMIT ILIMM I YEAR - PROVIDED WORK 18 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 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 DEEMED TO MODIF� WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Aint- Due LA_.j NOR LIMIT IN ANY WAY THE CIT" ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # 4221":2 1 HERE13Y 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 TIGN; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building OMclal or hlsftw Deputy: and Fees we paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION recolpt Is acknowledged In space provided. RKMENS COMPEN 0 RCW 18.27. WO _!n?!MNRANCE AN OFAI11ALSWAIGN&AVURE D� TE SIGNATURE (OWNER OR GENT) f DATE SICZ3ED IAO 425) 771-0220 r RELEASED BY DATF/ ATTENTION 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 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