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20030463.pdfI DATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS MAILING ADDRESS AA A-,o NJ + 6,1 Ave Lj CITY ZIP ITELEPHONE e -a NAME 0 ADDRESS CITY NAME (Sekt,c ADDRESS STATE LICENSE NUMBER ZIP TELEPHONE CBL # 3/1 1 11( 1) . 1j,)OCA Ai_�e_A ZIP TELEPHONE ts,3 12_o� - EXPIYAJON DATE or 11ov d& 8GEW RESIDENTIAL ADDITION COMMERCIAL REMODEL MULTIFAMILY REPAIR GRADING CYDS DEMOLISH TANK 3 GARAGE CARPORT RETAININGWALL 0 ROCKERY (TYPE OF USE, BUSINESS OR AWFN%WrWLAIN: NUMBER NUMBER OF OF I DWELLING STORIES I UNITS DESCRIBE WORK TO BE DONE 7MPLIANCE OR [3 CHANGE OF USE SIGN FENCE l - X_Fn E:i OTHER FIRE SPRINKLER FIRE ALARM PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB ADDRE Ss/ffl �,' 07t - �2L Aqpz - - - UITE/APT# PLAT NAME/SUBDIVISION NO. LOT NO. LID No. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP APPMV@d RW Permit Required Street Use Permit R*Wd EXISTING - PROPOSED inspectkin Required Sidewalk Required REQUIRED DEDICATION- FT Underground WirIngrequired 13 METER SIZE Llhl��. OF FIXTURES PRV REQUIRED YES 13 NO 13 z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ENGINEERING REN11=111RUll IM %Hi%1 I Nli I I DATE FIRE REVIEWED BY DATE Id cc rL VARIANCE OR CU SHORELINE OR ADB# I INSPECTION BOND REO'D 1$ POSTED 1[3YEs ONO SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP I I , I LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR PARKING LOT AREA I PLANNING REVIEWED BY DATE REO'D I PROVIDED OCCUPANTr/_:5 -GRO CHECKED BY rrC '-_� CRITICAL / AREAS SPECIAL INSPECT16N AREA OCCUPANT NUMBER REQUIRED [] YES LOAD dPROGRESS REMARKS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % IBuilding Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO III: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 2 DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. III: Engr. Review PERMIT APPUCATION: ISO DAYS IL PERMIT LIMM I YEAR - PROVIDED WORK 18 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 N ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapeinsp. Total Amt. Due DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION., ffi . Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION PPU IfATION APPROVAL GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- Th! 9 CALL licoon Is not a permit until signed by the IIAGREE TION; AND IN OING THE WORK AUTHORIZED THEREBY, No PERSON WILL BE EMPLOYED Build 1 iaPr his/her Deputy: and Fees are paid, and IN VIOLATION OF THE 8 CQUE OF THE ST E OF WASHINGTON RELATING TO FOR INSPECTION r c plits acknowledged In space 9(oviodd. WORKMEN'S COMPEN E AND RCW 18.27. 0 L GN RE DATE DATE Sl H RE AGE ED 1A9 1,425) P r(FR Alro 771-0220 R #AWO V_ 15 DAW 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 -FILE - YELLON- 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 m DATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS M A C MAILING AnnRFAq CITY NAME ADDRESS CITY NAME ADDRESS STATE LICENSE NUMBER _gq-L- Aw W ZIP ITELEPHONE 9202-0 2-M --+ 1-3 - -3, 11 ZIP vJ00d AvQ. ZIP ITELEPHONE --I ry --I-& XqEW RESIDENTIAL ADDITION COMMERCIAL REMODEL MULTIFAMILY RE ,,9MR GRADING CYDS 0 DEMOLISH 1:1 TANK GARAGE RETAININGWALL CARPO ROCKERY (TYPE OF USE. BUSINESS OR LAIN: (nm_ NUMBER NUMBER OF OF DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE N PERMIT EXPIRES USE PERMIT Z ONE NUMBER.��La�� JOB ADDRES fiz UITE/AP`T# 10 PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP APPMV*d RW PsnTA R&WkW $treat Use Permit ReWd k EXISTING — PROPOSED hupection Required Sidewak Required REQUIRED DEDICATION— Fr Un&WW=A VIMC required [3 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 13 No 13 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE FIRE REVIEWED BY Ut: AURKED DATE 1 M VARIANCE OR CU SHORELINE OR ADUT—INSPECTION BOND p JE3 REQ'D POSTED I YES ONO S SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED , PROPOSED ALLOWED PROVOSED *AEXP LOT COIXRAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) o_C*MPLIANCE OR CHANGE OF USE I SIGN REOD 7f FENCE x Fr) kREMX OTHER ' FIRE SPRINKLER FIREALARM 0 FRONT SIDE REM FRONT URSIDE REM PLANNING REVIEWED BY DATE - P111— tj CRITICAL �j CHECKED BY M7 CA AREAS SPECIAL. INSPECTION JAREA NUMBER REQUIRED [:] YES REMARKS .92UPANT�� Ey G OCCUPANT LOAD PER UBC IDS/FINAL INSPECTION RECVD, $ r Description FEE Plan Check HEAT SOURCE GLAZING LOT SLOPE,% Building Permit PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMff ALITWORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC 2 Grading Erc.) w LL REQUIRE 3 DOMAIN (CURBS. SIDIEWALKS, DRIVIEWAYS, MARQUEES, 1 t: SEPARATEPERMISSION. Engr. Review PERUrTAPPLICATION. ISO DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERUrf FOR MORE INFORMATION 'APPUCANr. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS Fire Review IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMM ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. DEEMED To MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee 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 THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL Thl TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Bul IN VIOLATION OF THE LABOR-GDO OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION WORKMERS COMPENS��E AND RCW 18.27. a RE�7(0!,q AGE DATE SIZED dW" I � 2� A? 771-02 20 R ATTENTION r 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-. CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES Description FEE State Surcharge City Surcharge Plan Chk. Deposit Receipt # Total Amt. Due Receipt # 11;ATION APPROVAL Yon is not a permit until signed by the Or his/her Deputy: and Fees are paid, and s acknovirledged In space pt,4- AARE . _/1 IYIDATET ORIGINAL -FILE YELLOW- INSPECTOR PINK -OWNER GOLD -ASSESSOR rMFZ1:PJ ArPrU IMTIPJn NEEME