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20030476.pdfk4s, DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS rx-)rC_ -7 LAOIF'kr_AP-� MAILING ADDRESS "710 CITY ZIP TELEPHONE Erit-4oKIDS NAME ADDRESS CITY ZIP ITELEPHONE NAME CBL# ADDRESS 4(oot S 1-_2-Akn,?L CITY ZIP TELEPHONE MKO10A lh(J 6W,,-'ALN `7 c1()D STATE LICENSE NUMBER ':6PZt,WWC071iJL EXPIRATION DATE 8/f/bf I CqECKED Mf PROPERTY TAX ACCOUNT PARCEL NO. 0 (D69 3oorn>�oogoo NEW RESIDENTIAL PLUMBING / MECH ADDITION [3 COMMERCIAL COMPLIANCE OR CHANGE OF USE 0 REMODEL 0 MULTIFAMILY SIGN REPAIR GRADING FENCE X CYDS ( _ FT) DEMOLISH rl TANK OTHER 0 GARAGE CARPORT [:] RETAINING WALL 0 FIRE SPRINKLER ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS OR ACTN" EXPLAJN: -3 F NUMBER OF NUMBER OF DWELLING I RITICAL AREAS I CUMBER STORIES UNITS DESCRIBE WORK TO BE DONE '5 f::'0g.'0Ae_r'- -REPLACE ktei,'�f — 0 V_ _E7�_ro % I LOrSLOPE % NO: I VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 180 DAYS PERMIT LIMM I YEAR . PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION *APPLICANT ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND 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 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - I HERESY 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- TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. DATE SIGPED (OWNER O%RAGENT) '7 /A, USE ZONE JOB ADDRESS _j_q Z_<3 PERMIT EXPIRES jy PERMIT NUMBER MUITE 0 PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required Street Uss Permit Roq'd EXISTING — PROPOSED inspection Required Sidewalk Required REQUIRED DEDICATION— Fr underground vvmng (.�4 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I I YES 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE 1YPe B or L vent connectors required on fuel -burning apP � ".4 FIRE REVIEWED BY DATE 0 z z I DATE Lu cc rL OR CU SHORELINE OR ADS# I INSPECTION PBONDO do-ege- I OSTE GAS PE TEST M 'jES09JNO $ SE k[) HEIGHT COMPL Ej MINE ED ED DIOR EXPMAFF 0 VITS F PROPOS LOT COVERAGE Eff (FT.T)PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED MAR FRONT LIR SIDE REAR I -. - _ I Z PARKING LOT AREA I PLANNING REVIEWED BY DATE REQ`D I PROVIDED I REMARKS CHECKED BY 17YPE NB�TRUON MUILIVAINIPP.2 GROUP I SPECIAL INSPECTION PAREA OCCUPANT REQUIRED M YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D VALUATION Description FEE Description FEE Plan Check State Surcharge Building Permit A City Surcharge - Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Recording Fee Receipt # CALL TI N I APPLICATION APPROVAL This pmqcation is not a permit until signed by the BuMflOfficial or his/her Deputy: and Fees are paid, and A, eirpisacknowloddBtWpjipacopLRIdAd. (425) --1 Will-, If NWAI WA nrf%,r-,mfk*0VAffA 771-0220 D BY D E U-11114IL" '11XA IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE NNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CE Fl- 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 I I RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS LAK1F'1AC-Al`q-- 15 MAILINd ADDRESS TL I r790 19(p-rw CITY ZIP TELEPHONE EOHOK1013 NAME ADDRESS CITY ZIP ITELEPHONE NAME 15p-etjKlAd CBL# ADDRESS 4(oo 1 8 154-, -PL CITY ZIP TELEPHONE - IUKOILA '98-103 lAiNo-ALK-790b STATE LICENSE NUMBER EXPIRATION DATE I CIECKE PROPERTY TAX ACCOUNT PARCEL NO. 00s*9 300c>C-1>00900 NEW RESIDENTIAL PLLIMBING/MECH ADDITION COMMERCIAL COMPLANCEOR CHANGIE OF USE REMODEL MULTIFAMILY SIGN REPAIR GRADING FENCE CYDS X DEMOLISH TANK OTHER GARAGE RETAINING WALL F RE SPRINKLER CARPORT ___ROCKERY FIRE ALARM (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: NUMBER NUMBER OF CRITICAL OF DWELLING I AREAS I STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE 'S Fbkl�JACZ —RE:? LACE 9 1 a a j Or% 2=.AC:1v4 it = a rr - -T-,% I =crr iiiiIIII -, a L 9�' 4i"a N 1 n A I E -"- i i a - 5 � - �. � SOURCE GLAZING % LOT SLOPE % iECK NO: VESTED DATE THIS PERMIT AUTHORIZES ONLYTHE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVIEVAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMrFAPPUCATIOM* ISODAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK t�RMIT FOR MORE INFORMATION �.'APPLICANIT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS "IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE C17Y OF .EDMONDS, WASHINGTON. ITS OFFICIALS, EMKDYIRES, AND AGENTS FROM ANY AND 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 MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION GWEN: is CORREC-11 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. TION; AND IN'DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OPJHE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKM I Ws COMPFNMTION INSURANCE AND RCW 18,27. Slj,�(O�WNER'dl`l iG�ENT) DATE SIGPED 05 1 FPERMIT EXPIRES USE PERMIT I)f ZONE NUMBER JOB ADDRESS C1 4 PLAT NAME/SUBDIVISION NO. L�D NO. L D FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved AIN Paraiii Required Street Use permit Roq'd EXISTING - PROPOSED-- - Inspection Required Sidewalk Required REQUIRED DEDICATION- FT UnderCround 7 required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES 13 NO 13 z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE on fuel -burning appliances In FIRE REVIEWED BY DATE VARIANCE OR CU "RATE N BOND EPOSTED cn ny n §11 SEPA REVIEW---.r.60 G .par COMPLETE. EXEMPT fi9M=FA12VWFWIii% . A ROPOSED LOT COVERAGE - I REQUIffffSMVft1(F"1F. ROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIA SIDE REAR T z PARKING LOT AREA PLANNING REVIEWED BY DATE REOD I PROVIDED I I CHECKED BY ITYPE C �ONSTRUPTION Ch E or, up PAN]?" GR U SPECIAL INSPECTION REQUIRED [3 YES AREA OCCUPANT LOAD__ REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REa VALUATION $ Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Recelpfr.# Landscapeinsp. Total Amt. Due z9 Recording Fee Receipt # CALL APPLICATION APPROVAL This spplication is not a permit until signed by the Bu1I#ffCkOM*1 or his/her Deputy: and Fees are paid, and IA05) 771-0220 IR Lrb BY DATE ATTENTION Off 1333 7V IT is UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE (N TIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CE Fl- 1-/ 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