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20030460.pdfL1 DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS _)0ilf,L __ 1 /1)76 15 MA11ING ADDRESS q I O-A CITY ZIP TELEPHONE tz�Aws qk1)'W1M2_77V NAME ADDRESS U I CITY ZIP ITELEPHONE PERMITEXPIRES USE PERMIT ZONE NUMBER JOB UITE/APT# ADDRESS L1 D—V\ AC,�s PLAT NAME/SUBDIVISION NO. "TNO. L D NO. L�D FEE $ 7ESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW PerrrA Required street u-, Parmh Req'd EXISTING — PROPOSED Inspecdon Required Sidewas; Required t3 REQU ED DEDICATION— FT I d rF%.-- Irb Ir VArtng required 13 1 PRV REG IIRED r Lj METE 91411' �E. NE S& uc ireq vq on fuel burning app jo, E3 0z IREMA IX, spa MC 8153. Ills ftu OWNE CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE Vnegarojess of whether the _T NAME CBL # W-arO Puff sed, expansion tanks a-"' Z' lrlanfl�fld An . re &V110 E N G I N n�X_7W AM W M'B'R 11 11101 water tanks per DATE ss - Ode. ECDC 19.30-020 (c) Zk66 —1AeyMV1z-e,, FIRE REVIEWED BY TELEPHONE Zip V6 U 711x-p Ze2- V700 R, =�ffl_ P:ED VARIANCIbbc ilwTV 'SFkF&LlfdIW4D BOND STATE LICENSE NUMBER DATE C POSTED 98 By C1 APb^ Ty IRLIKUMA' U-.-Y" SEPA REVIff i 775s, rk ' ;HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE , E FX FRUTO EN LOWED , PROPOSED a � , PT11 0TAL 7 0 ?qL90 I EXP E ACC "En NEW RESIDENTIAL PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT.) 9010 X COMPLIANCE OR ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR ADDITION COMMERCIAL CHANGE OF USE REMODEL PARKING LOT AREA I PLANNING REVIEWED BY DATE MULTIFAMILY SIGN REOD PROVIDED REPAIR GRADING o FENCE I I — CYDS X FT) REMARKS 0 DEMOLISH TANK OTHER GARAGE RETAININGWALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS ACTWM §P(PLAIN: CHECKED BY TYPE OF!= OCCU,�PANT� P GROUP MMBER NUMBER OF CRITICAL 0 5 OF DWELLING A SPECIAL INSPECTION JAREA CUPANT STORWA UNITS N REQUIRED [] YES LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER USC IGO/FINAL INSPECTION REQ'O VALUATION $ L Description FEE Des riptIon FEE Plan Check State Surcharge SOUR HEAT y CE GLAZING % LOT SLOPE % Building Permit City Surcharge PLOW CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUT14ORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO ft 'NE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLJCATION: 150DAYS Engr. Review PERMIT LIMM 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 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, WAP4E OR RE13UCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due 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 GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF I)CATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- hi a pilc on 15 not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL Bui I I or his/her Deputy; ago roes are paid, and IN VIOLATION OFTHE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION re I Is acknowledged In s#ce provided. WORKMEN'S COMPENSAD�SURANCE AND RCW 18.27. OF I SIG E (0/ DATEf MSIG RE (OWN AG DATE SIGNED (425) k_4� 1/05 Z= ��&3 � 771-0220( BY DATE rMENTION '7 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 k . 1. z 9 0 M RECORD OF INSPECTIONS INSPECTOR DATE APPROVED ''SETBACKS . ...................... FOUNDATION: ft ..... ......... oo Ing ....... Wall:... ..................... Pier/Poich ............... Wall ------ -------- M I Slab Insulation . .......... A -ni �PLUMBING Mf UrLdergroui M �,i 01 ....... C.), ............. C', felal-Fina ...... 7� M HEATING: GasTest .................... Gas Piping .................. . Equiprfidnt ............... Commercial Final ....... r EXTERIOR SHEATHING NAILING........................... ic, ev: -�FRAMING ....................... DATE RECEIVED I PERMIT EXPIRES j �') USE PERMIT CITY OF EDMONDS ZONE NUMBER JA_� JOB SUITEIAPT# CONSTRUCTION PERMIT APPLICATION ADDRESS OWNER NAMEA"E OF BUSINESS �Zj D-* At PLAT NAME/SUBDIVISION NO. ] LOT NO. LID NO. �OCK= AL21 lSdll MPdING ADDRESS LID FEE S TESCP —APM— Street Use Peffnit Req�d 0 71 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Peffnit Required CITY EXISTING — PROPOSED Inspection Required ZIP TELEPHONE Swew&* Required Underground tz� d 4f nas W ar. 11� Eli REQUIRED DEDICATION— FT Wftg required 13 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED . __ 1� 40 Fill F ADDRESS REMARKS� %"WOO V11 V . 1`1 RICO 1M. 3yalem OWNER/C )jF3=Rqy CITY ZIP req*W on d, ": t r tank� oer r'%U6. 0%-.J NAME wtkl) CBL# Do A RESS I ZIP 4 *1�� .re _ ffiyj TELEPHONE 7,0j 7- V700 STATE LICENSE NUMBER EXPIRATION DATE PROPERTY TAX ACCOUNT PARCEL NO. 0 NEW RESIDENTIAL PLUMBING / MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY SIGN REPAIR 0 GRADING CYDS FENCE X Fri 0 DEMOLISH TANK OTHER GARAGE o RETAINING WALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (ME OF USE, BUSINESS OR A IVffY) PxPLAIN' �UMBER OF NUMBER OF DWEL�LING CRITIC 7L AREAS STORIES NUMBE DESCRIBE WORK TO BE DONE 0. cuut; 11930.020 (c) �NGINE R IEWD ffir L Vent ConneCtOrb DATE NG INE R: nallind fill ftill-burnina appUmcm In ; I lb FIRE Ijyj&Ud SpaCM UMC 5 -L-IDATE FIRE R VARIANCE OR CU SHORELINEORA DB 11 INSPECTION REO'D 13YEs 13NO BOND POSTED is SEPA REVIEW HEIGHT COMPLETE EXE 0 tLjfED , PROPOSED :.XP 08 I LOT COVERAGE ETBACKS (Fr.) ALLOWED SIDE REAR PROPO PARKING RECVD I PROVIDED I LOT AREA PLANWIRG-RIANWED BY DATE I CHECKED BY ITYPE OF CONSTRUCTION UILA;Urml GROUP SPECIAL INSPECTION JAREA OCCUPANT REQUIRED LOAD YES REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION RE= DTLj !j;j_'_V \3. $ netv aa2_7a Description FEE Description FEE I COF Plan Check State Surcharge HEAT 80�LRGE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBUC Grading DOMAIN (CURSS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE t: SEPARATE PERMISSION. Engr. Review PERUITAPPUCATION: 160DAYS PEnurr uum i YEAR - PROVIDED WORK 18 STARTED WITHIN ISO DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPUCANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit I I pl' IN INTERE" AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, IT$ OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # Re, ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Total Amt. Due -5 0 T t DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 21 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION .. - —b Recording ee Re, Receipt 0 LML I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION AT ION APPROVAL GIVEN IS CORRECP, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF Y WITH CITY AND STATE LAWS REGULATING CONSTRUC- THE OWNER. I AGREE TO COMPL hi CALL n Is not permiLiintil signed by the aeputy: 40 Fees TION, AND IN DOING nIE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO 8 FOR INSPECTIOk (6 or Wher are paid, and Pt is a r#d*yroyided. WORKMEITS COMPENSATION INSURANCE AND RCW 18.27. OF C IV, SIG, DAT RE (OWNE( R DATE SIGYED (425) &� N-7 78IGNA =AO a4 y JA 4.4 t Mq M 771-0220 a 'V� DATE ATfENTION e!�l EXT 1333 1716.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 GRMTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING IME a I