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20030499.pdfI DATE RECEIVED It CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF 13USINESS k-tv I 0-f —'r rc. _4L t MAILING ADDRESS Z_k �_oq�o - -1 4veAve L, ti'T' CITY TELEPHONE 0'3 q�'4 6 '70 _ 7 J zip =AM E j cree de M-10 ADDRESS 74,� 1 ) — CITY ZIP TELEP�NE evelt r, —( �,�_o q q.� 711 - 3qVo NAME ICBL# LW07Mf1JF14iA*WA ADDRESS e1_4RP0_' 2fP" I TELEPHONE STATE LICENSE NUMBER PROPERTY TAX ACCOUNT PARCEL NO. 1"7o3j60o1V'3x00 E] NEW 0 RESIDENTIAL 0 ADDITION COMMERCIAL 0 REMODEL MULTIFAMILY 0 REPAIR GRADING CYDS DEMOLISH 1:3 TANK GARAGE CARPORT RETAINING WALL 1:3 ROCKERY MTE OF USE, BUSINESS OR ACTIV LAIN: 14�\l "T'lk D�00'X () /) YrrKri./lIt NUMBER OF NUMBER OF DWELLING 0 STORIES UNITS DESCRIBE WORK TO BE DONE re veie rf 1W arek f o M11d5d C��- PERMIT EXPIRES Za :!� I ' I on� USE PERMIT ZONE NUMBER(�& ADDRES�eS7 L,:� e� SUITE/APT# PLAT NAME/SUBDIVISION NO. LOT NO. L D NO. L:D FEES TES PA ,.p Pr PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP a W P 6'. Strain Use Permit Reqd EXISTING — PROPOSED inspecon RequIred Sidewalk Required REQUIRED DEDICATION— FT Undargrourid Wiring required 13 METER SIZE LINE SlZij NO. OF FIXTURES PRV REQUIRED YES C3 NO 13 REMARKS z 3 OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE I ENGINEERING REVIEWED BY FIRE REVIEWED BY VARIANWR SH BY COM ?E 0 STRETT TO DE LEWEV P I lltiftOPE TY LINE EXP PLUMBING / MECH LOTD� ALLOWE COMPLIANCE OR CHANGE OF USE PARI 0 SIGN REOD o FENCE ( X FT) REMARKS OTHER FIRE SPRINKLER FIRE ALARM 7 to e u DATE DATE 'W�WTION BOND REQ'D POSTED %1-T30PRIS �RSECA PSMAJE111 PROPOSED I 0% = 46910E@WBACKS (FF.) "SrAtMURSIDE REAR - —.-I- emu-#q,84P HAMWO"aw INSPECrION — CHECKED BY TYPE F CONS RUCT ON CODE OCCUPANT 1 GROUP 7�51 CRITICAL' — —C,-% AREAS - f) SPECIAL INSPECTION AREA 1 OCCUPANT Rr`q7�� 6 _tUMBE_LIT REQUIRED YES LOAD C. 0 REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD rU-ro v-%q3dA7,/ I 1=2 rA Ti VALUATION $ './rrk Ve�ft Description FEE Description FEE See 4 111" t o -rco 5 Plan Check Cl/\. � 64'd a4. State Surcharge HEAT SO RCE GLAZIN13 % LOT SLOPE % Building Permit AJ j City Surcharge Z&� VESTED DATE Plumbing PLAN CHE]lf :LZ;? Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK 'TO t: 2 BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON 'THE PU13UC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 100 DAYS CL PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION Plan Chk. Deposit 'APPUCAUr, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review 2 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 MATURE. ARISING DIRECTLY OR INDIRECTLY Total Amt. Due 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 Landscapeinsp. NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION .. Recording Fee Receipt III I. I HERE13Y 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 WORKMENS COMPENSATION INSURANCE AND RCW 18.27. PA (OvIp I DATE S!PNED upa ql?,qlo APPLICATION APPROVAL CALL This application Is not a permit Until signed by the Building Official or his/her Deputy: and Fees are paid, and R INSPECTION receipt is achnowtodged In space provided. 0 IALS SIGN URE ATE (425)4,0.4 771-0220 RELrAWD MY D*E 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 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 z 0 4 0 M (J)"A x M M OC � r. M Z 0 _n fn- m Fn CI K9 To z i! 0) z 0 M v IL -�Oo . I DATE RECEIVEI�,// PERMIT EXPIRES 4US�E PERMIT I ZONE j42 CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BU ESS, d MAILING ADDRESS D_oq�,() - 4VfAVf IS CITY j T ELE ZIP PHONE till'i IWO 0 036 %9 - 6-70 -7146 I'JAME L ?TOA, X^( Kf Of ADDRESS -7 �,g /3q& �,00 CITY ZIP TELEP �NE CVftt T I q8,�'Oq 7�1 - NO 0 'NAME CBL# ADDRESS CITY 4/4rO�' ZIPW I TELEPHONE STATE LICENSE NUMBER EXPIRATION DATE I CHECKED BY PROPERTY TAX ACCOUNT PARCEL NO. 9,7o3hoo3o)xoo 0 NEW 0 RESIDENTIAL 0 PLUMBING I MECH 0 ADDITION COMMERCIAL COMPLIANCE OR 0 CHANGE OF USE 0 �REMODEL 0 muLnFAmiLy 0 SIGN 0 REPAIR 0 GRADING CYDS 0 FENCE X ( FT) �DEMOLISH l 0 TANK 0 OTHER — oGARAGE, CARPORT RETAINING WALL 0 ROCKERY o FIRE SPRINKLER FIRE ALARM WOE OF USE BUSINESS OR ACTIVITY) EVPLAJN: A AIV 0040 3T1VCT-//?_ jr f-r NUMBER OF NUMBER OF DWELLING C) tRITICAL AREAS q 7, STORIES UNITS NUMBERM, DESCRIBE WORK TO BE DONE JOLI M g4(e 0- 4V I rdVt'(EL' if(RV WA (0M//0)C0 07v- TWO kv%Ck*V1" &Vol M f C) 0 WfTc' I frol e.-f k'ov'r "'t-Iflorti Lef—I Of ravold t-/,AIK- q Y o 4&ove �eri o4 %,o4ee- bowx (OA-1,14 1_14 Sre 647-Aed HEAT SOACE GLAZING % LOT SLOPE % MA ftl%R 0 PLAN CHEC VESTED DATE THIS PERMIT AUTHORGMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC DOMAIN JCURBS. SIDEWALKS, DRiVLVAYS, MMIQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMITAPPILICATION'. 180DAYS PERMIT LIMM I.YEAR -PROVIDED WORK IS STARTED WITHIN 180DAYS SEE MCK OF PINK PERMIT FOR MORE INFORMATION NUMBER '7 JOB SUITE/ L# ADDRESX_�'57 (�) i�� )&4 �1� 42�j PLAT NAMEISUBDIVISION NO. LOT NO LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TIESCP App"Wed RW Parrnit Required Street Use Perrnft Req'd EXISTING — PROPOSED Inspection Required Sidirwak Required REQUIRED DEDICATION— FT Underground Wifingroquired METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES 13 NO C3 f5 REMARKS z 3 OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE I ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE us VARIANX ORIUK go ZTINITgON BOND -0 STREIT TO BE CLEA 1MjEojEb9LS POSTED SEPA REIr SIGN AREA HEIGHT COMPLEO IWS W f1rR9WWqGMk PEDDXF , PROPOSED EXP PROPERTZOLRIN"13T t LOT#V ETBACKS (Fr.) ALLOWE art* SIDE REAR Pm Be, K INS LLED z - — ___ -1 1 9 PA INGI UITAIW WMDMZ 010W PROVIDED REQ`D 710, aM10 0'0'% SEs Di C)LITON INSPF=ON CHECKED BY JTY]�N CODE OCCUPANT GROUP SPECIAL INSPECTION _JAREA OCCUPANT REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REO'D VALUATION $ amml I MW Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection ftsese&� S 0 R S ON BEHALF OF HIS OR HER SPOUSE. HEIR-S, ASSIGNS AND SUCCESORS Fire Foview Plan Chk. Deposit ;APPLICANT, Y 0 F N INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF A N D EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # L E M Y ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY 'IT BE FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE IANCE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due ION . - NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Recording Fee Receipt # :z TION I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APP CATION APPROVAL :NT OF GIVEN IS CORRECT� AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF T UC R THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC" CALL This application Is not a permit until signed by the L OYE 6 TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED NG To IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO 0 FOR INSPECTI N Building 01111clal or his/her Deputy: and Foos are paid, and receipt Is acknovAeoged In space provided. WORKMENS COMPENSATION INSURANCE AND RCW 16.27. OPFI'AiALS SIGN TURE PATE NATUaft(OVINO ! "Un DATE S!PNED 0 20 771-02' h7y DOE RELEWD ATT ENTI E) ff f3d. 3 IT Is UNLAWFrL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL: 1 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CER 111-1- ORIGINAL -FILE YELLOW- INSPECTON_j-'r CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING WIND 1011 z 0 M M M 0 M M C 0 _n M M Cal C 0) co 0 CO) z 0 M