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20030466.pdf11 DATE RECEIVED q CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION PWNER NAME/NAME OF BUSINESS C-_ ks 1-1 —t2 .' C__ (z. MAILING ADDRESS Lt-9 ()I S e- (16 2-,-, d, f. CITY ZIP TELEPHONE Sc, WA 98 oz-41 L� z6 -39 a - 25� (-0 NAME ADDRESS CITY ZIP I TELEPHONE LPERMIT EX PIRES USE ZONE I PERMIT NUMBER c:2:C)�7` JOB SUITE/APT# ADDRESS MCL; CCA VVXor.\O(S. Wj5( PLAT NAM E/SU BDIVI SION NO. 77 LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TE5CP ApproV.d RW Permit Required C3 0 Street We Permit Req'd [3 EXISTING — PROPOSED Ins"etion Required 0 Sidewalk Required 0 REQUIRED DEDICATION— FT Underground Wiring required 0 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES C3 NO E3 z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE W NAME--- Ar A (ATIsa- L&M - ENGINEERING REVII EDIDAT ADDRESS T!;� hmia&L -7�9 C, FIRE REVIEWED BY DATA tu CITY ZIP TELEPHONE Ic 1-6 0 0 17 1 & --* -' . I . I STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY VARIANCE OR CU SHORELINE OR ADBN INSPECTION BOND POSTED C3yREQ'D C3 YE SEPA REVIEW SIGN AREA HEIGHT-W Q PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE ALLOW PROPOSED ALLO PROPOSED *a4+L4'01(000j50_L0'40 EXP 0 NEW RESIDENTIAL 0 PLUMBING MECH LOT COVERAGE REQUIFfED SETBACKS PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR ADDITION COMMERCIAL o COMPLIANCE OR Iva eAll-A-49 CAap� z I CHANGE OF USE 0 REMODEL 0 APARTMENT 21 SIGN PARKING . Cr LOT AREA PLANNING REVIEWED BY DATE REQ'D PROVIDED A!�rn�o>'- X '/' A L_ REPAIR 0 GRADING 0 FENCE X CYDS FT) REMAR,�S ig ed DEMOLISH 0 TANK 0 OTHER - �e'gv Orl ovew-eLe - z o GARAGE 0 RETAINING WALL 0 RENEWAL CARPORT K FIR ROC r Y I= (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: )'vra2jt9 CHECKEDBY TYPE OF CONSTRUCTION �COD OCCUPANT GROUP I I 0 NUMBER NUMBER OF CRITICAL OF DWELLING AREAS E SPECIAL INSPECTOR OCCUPANT n 0 U STORIES NUMBER JAREA REQUIRED 0 YES LOAD DESCRIBE WORK TO BE DONE /A N G r4 Cr 0 V 6 ie :S I p. F—WAU< REMARKS PROGRESS INSPECTIONS PER UBC 11061FINAL INSPECTION REQ'D GOLA1,Ii gr led 0/9,t- IV 44t4W11_ ye M I W' f 7- VALUATION FEE PLA2y?dbF HEAT SOURCE GLAZING % LOT SLOPE % BUILDING Sep PLAN CH!n VESTED DATE iz,19 PrU%MMz7_ MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT6ov,:nqWORKT0 t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADING/FILL DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. 6V STATE SURCHARGE W PERMIT APPLICATION: ISO DAYS I 93. PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS FEE -A SEE BACK OF PINK PERMIT FOR MORE INFORMATION rr'd!2 -APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS ENG. INSPECTION FEE IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY INSPECTION FEE RECEI FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT 0115,52 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE - 0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION., RECZZZ,[ X1 TOTAL AMOUNT DUE d ( 1�2 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICAMON AISPROVAL 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- This application is not a permit until signed by the CALL 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 COMPENSATION INSURANCE AND RCW 18.27. OF SIGINURE DATE IG U OW R AGENT) DATE SIGNED (425) SS PRELEP 771 -0220 DATEf —tillm to ATTENTION - EXT 333 I IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR 5/98 I SETBACKS:..� . . . . . . . . . . . . . . . FOUNDATION:— Footing ....... Wall ....... ..................... Pier/Porch ................. Retaining Wall 0 ........... M11 Slab -insulation PLUMBING:,, A rgrou d a n Und . .............. . Rough -in ... ................ 0 Commercial Final ... HEATING: 10 Gas Test .................... Gas Piping L ............ 1...,1:;.Equlpmer1t, 'Commercial Final ....... EXTERIOR SHEATHING NAILING ............................. FRAMING .. ....... ... ..... .. FIRST FLOOR FRAMING... INSULATIOW� .................... Floor Insulation ......... 1-1- 7 ATE RECEIVED a m &(4 [PERMITEXPIRES . b" PERMiT CITY OF ISVIVIONDS zu A E NUMBER JOB SUITE/APT# CONSTRUCTION PERMIT APPLICATION ADDRESS ; , - C C _�c " , � \� j C, , , -) T, L: I 1 0 or'. J 4 OWNER NAME/NAME OF BUSINESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. '6 11- L_ " (� k s t- 1 CC MAILING ADDRESS LID FEE S ul TESCP Approved E3 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required L-�C:l uf Street Use permit Req'd lnspect�on Req ired CITY. ZIP TELEPHONE EXISTING — PROPOSED Sidews it Requued 0 Lk LA_ REQUIRED DEDICATION— FT Underground Wldnif requited 0 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 0 YES E3 NO 13 t vul ADDRESS REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE z z a z CITY ZIP TELEPHONE NAME.,-. Ar A LAIE& 1,6M - ENGINtERING REVIEWED/DATE M ADDRESS V, FIRE REVIEWED BY DATEI w CITY ZIP TELEPHONE M 0 VARIANCE OR CU SHORELI;E OR ADBN OPECTION I BOND E N U M B E R EXPIRATION DATE CHECKED BY -s;;p REQ'D o#- POSTE 0 YES 10*9b SSPA REVIEW IGN AREA HEIGHT PROPERTY -TAX ACCOUNT PAR FD ! LAO. COMPLETE E�� A�Lp PROPOSED ALLOWE91 PR o o oz� 6 qowl fh.7.551 /q, r 09- I A EXP LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) 0 NEW 0 RESIDENTIAL E] PLUMBING MECH ALLOWED POSED FRONT SIDE REAR FRONT UR SIDE REARP ADDITION Cz COMMERCIAL c3 COMPLIANCE OR e- X, If, I ol Ala e-Ara"n IV OF USE z CHANGE DATE PARKING T LOT AREA I PLAYNIP REVIEWED BY 0 REMODEL C] APARTMENT cm SIGN REO'D I PROVIDED I -r r-1 7 ;119A3 0 GRADING FENCE 0 REPAIR CYDS 0 ( — X FT) R 74 1��_> A*ca ck er r4 /,X 0 DEMOLISH TANK OTHER 13, 1 a ve-*-- 4 cc e s WALL 0 o GARAGE 0 R.ETAIN RENEWAL CARPORT* R E;2 (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: 3N COD OCCUPANT CHECKEDBY I TYPE OF CQNaTRUCTI! z&rz_zQ4a_ ?I GROUP N:�DV6WV tU NUMBER NUMIJEROF CRITICAL, -OCCUPANT--�- `OF DWELLING AREAS SPECIAL INSPECTOR- -IAREAi;- 0 LOAD STORIES UNITS NUMBER REQUIRED C] YES DESCRIBE WORK TO BE DONE G 14 0 V REMARKS Lj A L;< PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REQ'D 5 0 0 D C- f IJ L 6- T fr? r- j:) Cj L Z) 5 C� ct,-. d -A 4 VALUATION FEE.,, PLAN);?!�F HEAT SOURCE GLA21NO % LOT SLOPE % BUILDING 17"' PLAN CHE VESTED DATE PMMMIN�G- 1 MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT dOVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC GPIADINGIFIL� DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETCs) WILL REQUIRE SEPARATE PERMISSION. t: STATE SURCHARGE 171.6v PERMIT APPLICATION: 160 DAYS LIMIM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS M11&.-REWE-W SEE BACK OF PINK PERMIT FORMOKINFORMATION APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS ENG. INSPECTION FEE IN INTEREST, AGREES TO IN LANDSCAPING DEMNIFY� DEFEND AND HOLD HARMLESS THE CITY OF 5 EDM NO . ASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND INSPECTION FEE ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT AW FROM THE ISSUANCE OF THIS PERMIT. RECEIP7) DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 OVISION.' NOR LIMIT IN ANYWAYTHECITY'S ABILITY TO ENFORCE ANY ORDINANCE PR TOTAL AMOUNT DUE RECE7 FZZL I I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION AP13110VAL GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF This application ia not a permit unli igned by the THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL 0 1 TION;ANDIN OING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building Official orh s1hor Dopu. eas are paid. and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION racoipt is acknowledged In space provided. WORKMEN'S C2� ,e 0 Fiel CC; DATE ,kNSATION INSURANCE AND RCW 18.27. IG ATUPx&.L1kWNmjR AGENT) ATE SIGNED (425) 771-0220 RELEAS BY RE UNTIL -.o Al'TENTION EXT 333 ol', IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCT& 771421?l za.. A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- I ORIGINAL -FILE - YELLOW. INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109' �AX PINK -OWNER - GOLD -ASSESSOR