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20030493.pdfI DATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNIER"EINAME OF BUSINESS 7 4fc) R , 5 �?' ? MAILING ADDRESS 5�0 c� ZAW CITY ZIP TELEPHONE �;,Adzft,A '7A I NAME ADDRESS CITY ZIP TELEPHONE NAME Chewo(etic LP ERMIT EXPIRES USE PERMIT ZONE Zoo - o NUMBER JOB ADDRESSJC::::Z ITE/7 PLAT NAME/SUBDIVISION NO. 7N 0. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Pannit Required Sireet Use Ponnit Raq'd EXISTING - PROPOSED Inapsailon Required Sidewalk Required REQUIRED DEDICATION- FT Underground Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I I YES13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE CBL # ENGINEERING REVIEWED BY FIRE REVIEWED BY ZIP TELEPHONE ct,/ r4 1 -7 DATE DATE W W IV _w_ VARIANCEORCU_ rSH;0RELINEORADBN I INSPECTION BOND NUMBER EXPIRAT107DATE EC RQQ'D POSTED 4 1 TNo V1 /A_ jE3YE§>k $ NO. E] NEW 0 RESIDENTIAL PLUMBING / MECH ADDITION COMMERCIAL COMPLIANCE OR 0 CHANGE OF USE REMODEL MULTIFAMILY SIGN REPAIR GRADING CYDS FENCE ( — X FT) 0 DEMOLISH 13 TANK OTHER ciGARAGE -1 RETAINING WALL 0 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS OR ACTWM EXP N: n4.4 I . =494 1 /11, --.Jvz,-v f %f �14;4 RITICAL NUMBER NUMBER OF If OF STORIES DWELLING (3 UNrr8 rAREAS NUMBER 14 DESCRIBE VWRKT0 BE DONE SEPA R IEW COMPLETE I EXEMPT EXP SIGN AREA ALLOWED I PROPOSED riclunp PROPO ALLOWED I SEI e�A g�=. LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (0 ALLOWED PIR7POSED FRONT SIDE REAR FRONT URSIDE REAR I/Va e_AAP"o PARKING REO'D I PROVIDED &*ZT 1 AREA PLANNING REVIEWED BY DATE 1, 10 V CHECKEDBY ITYPVF[OPSTRUCTON I C?T_+ OCCU96NT VV7 GROLF _ SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [I YES LOAD REMARKS 2 PROGRESS INSPECTIONS PER UBC 100/FINAL INSPECTION REO'D VALUATION s ;5 Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % I Building Permit City Surcharge PLAN CHECK NO: VESTED DATE pkn� 6);�5 M"M*ml W THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO L I= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading a 3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE t: SEPARATE PERMISSION. Engr. Review PERMrTAPPILICATION: IGO DAYS —iMrT LIMIT: 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 # Z,7 aq ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY 11 FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT $HALL NOT HE DEEMED MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due MS TO 0 NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- 11 411010% Z-3Z,9 — Recording Fee Receipt # I HEREBY 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 PLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- ' ��l EE M COM CALL This application Is not a permit until signed by the TION; AND I� I THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or histher Deputy: and Fees are paid, and IN VIOLATIO�NTHE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO I FOR INSPECTION receipt Is acknowledged In WORKM9'S MPENSATIO 'OANF�ANCE AND RCW 18.27. OFFICIALS SIGNATURE TE BIG (OWNER AG DATE SIGNPI) 'A'05) Vspacarovide - ()Q 771-0220 bATE ass7-7"s 'ATTENTION RET M 1333 1 4�//( 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 0 I I % I ,&,, I i a a I ,IDATE RECEIL 1. k,� PERMIT EXPIRES USE PERMIT CITY OF EDMONDS ZONE NUMBER JOB ITT CONSTRUCTION PERMIT APPLICATION ADDRESS OWNER"ENAME OF BUSINESS + PLAT NAME/SUSDIVISION NO. LOT NO. LID NO. ',MAILING ADDRESS LID FEE $ 7ESCP AP PUBLIC RIGHT OF WAY PER &FICIAL STREET MAP Aw Parmit=6d SUM Use Peffnit Raqd CITY ZIP TELEPHONE EXISTING - PROPOSED Inspection Required! Sidewalk Required REQUIRED DEDICATION- FT Underground Wking required 0 NAME METER SIZE LINE SIZE NO. OF FIXTURES L PRV REQUIRED' YESM NO Cl-- ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE CITY ZIP TELEPHONE NAME CBI_# DATE CAW. o4tAI. ENGINEERING REVIEWED BY ADD SS Z, FIRE REVIEWED BY DATE 0 d CITY ZIP TELEPHONE V6 Cw1p4 -7 ,e; 0 VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND M STATE LICENSE NUMBER EXPIRATION DATE 66� REQ'D POSTED AC13YE§><No s SEPA REVIEW SIGN AREA HEIGHT PRO COMPLETE , EXEMPT ALLOWED PROPOSED ALLOWED , PROPOSED 0) PERTIJAX *CgUNT PARCEL NO. /V41 0 M 5 :&a! C4 Ot-n DC—jW EXP LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FO M NEW RESIDENTIAL PLUMBINGIMECH ALLOWED PF19POSED FRONT SIDE REAR FRONT LIRSIDE REAR —4 § ; , : 1 0 COMPLIANCE OR A gSIOD A,#,? z ADDITION COMMERCIAL CHANGE OF USE PARKING T aT AREA PLANNING REVIEWED BY DATE REMODEL MULTIFAMILY SIGN RECrD PROVIDED M __j I I 0 GRADING CYDS FENCE X FT) R OTHER �IERAJR k- —4,, ke 00 EMOUSH TANK ly-o revle-Vllrel? GARAGE RETAININGWALL FIRE SPRINKLER 0 CARPORT�% 0 ROCKERY FIRE ALARM In (TYPE OF U��, B�SINESB OR ACTIVITY) EXPLAIN: TYPE OE CO[ISTR CHECKED BY UCT113N C017 OCCUPANT GROUP M M NUMBER *UMBER OF CRITICAL OCCUPANT 126) OF DWELLING AREAS SPECIAL INSPECTION JAREA a IES aCk2W UNITS NUMBER REOUIRED [3 LOAD TO-9 YES X Fn DESCRIBE wQkK To 6E DONE C: REMARKS C ?3 Q PROGRESS INSPECTIONS PER USC 1108/FINAL INSPECTION REaD 0 �4�4eoalolc -ti— /��. _5644r VALUATION VIELL L z $ r:Dj to" co 11169aption FEE z State Surcharge Plan Check 0 HEAT SOURCE GLAZING % LOT SLOPE City Surcharge M Building Permit T VESTED DATE PLAN CHECK NO: pwff&l"- 4 Mache"1`10121 THIS PERMIT AUTHORIna OWTHEWORK NOTED. -THIS PERMIT COVERS WORK TO D. BE DO"E ON PWATIE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURB21, SIDEWALKS. DRrAVAY8. MARQUEES, ETC.) WILL REQUIRE Grading SEPARA1111 PERMISSION. Engr. Review PERMIT APPLICATION: 1110 DAYS PERMIT UUM I YEAR - PROVIDED WORK 18 STARTED WITHIN i8a DAYS Engr. Inspection SEE BACK OF PINK PERMIT Fort UORE INFORMATION 1APPUCANT, 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 Landscapelnsp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE OPLO NOR LIMIT IN ANY WAY THE CrTTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # �zz 5z9L I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION L GIVEN IS CORRECr AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVA THE OWNER. I AWE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- TFa application is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED CALL Building 01111cial or his/her Deputy: and Fees are paid, and IN VIOLATION V THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In �Uco Wrovidodi WORKMEyS 90MPENSATK�IANFMRANCE AND RCW 18.27. OFFICIALS SIGNATURi SIGN47tP,1((OWNE IAO JRI'AG DATE 3N x, 9,-VM.5) En - �- r) 0220 RELEA ATE z� x./ =,f 1 9 �Mzmj 771- ATTENTION M 1333 /0C/ 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