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20030504.pdf4 PERMIT EXPIRES �DATE RECEIVED CITY OF EDMONDS USE PERMIT 9 ZONE 'tn� .- NUMBER Li CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRESS U 21.� �' OWNER NAMEINAME OF BUSINESS PLAT NAME/SUBDiVISION NO. LOT NO. LID NO. MAfL_14G W 6bRESS LID FEE $ 7ESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required 0 Street Use Permit Rsqd cii�52_ 31-4 Aw;� NORTii ZIP EXISTING — PROPOSED Inspectio Required Sidewalk'Required ITELEPHONE Underground REQUIRED DEDICATION— Fr Wiringrequired NAME METER SIZE LINE SIZE F�O, OF FIXTURES PRV REQUIRED (3 ESE3 NO 13 M ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE z CITY ZIP ONE NAME St. #1 services ENGINEERING REVIEWED BY DATE F-6F, FIRE REVIEWED BY DATE CITY ZIP TELEPHONE M U16EZffISPI124 VARIANCE OR CU SHORELINEORADB# INSPECTION BOND RA CHECKED BY STATE LICENSE NUMBEft EX)I no DATE REO'D POSTED 14 j OyEs 13NO SEPA REVIEW SIGN AREA HEIGHT \0, PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT A' 111 POSED ALLOWED PROPOSED RSH , .6 ZQ 7 Q126 450 EXP A i P% NEW RESIDENTIAL PLUMBING MECH LOT COVERAGE IV SETBACKS (Fr.) ALLOWED PRC?AW IDE REAR RVITREMML, MICAPP COMPLIANCE 08 ADDITION COMMERCIAL CHANGE OF USE z PARKING LOT AREA PLANNING REVIEWED BY DATE MULTIFAMILY E] SIGN REO'D PROVIDED IREMODEL 0 REPAIR 0 GRADING FENCE CYDS X FT) REMARKS OTHER DEMOLISH TANK 0 GARAGE RETAININGWALL 0 FIRE SPRINKLER FIRE ALAnM CARPORT _ROCKERY (TYPE OF USE. BUSINESS OR ACTIVITY) EXP CHECKED By OCCUPANTq "47-22— ITYP=STR.UP GROUP NUMBER NUMBER OF CRITICAL DWELLING OF AREAS N.4-- SPECIAL INSPECTION OCCUPANT STORIES UNITS NUMBER JAREA REQUIRED LOAD DESCRIBE WORK TO BE DONE REMARKS REG'D PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION VALUATION $ S-T. I Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORRES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 2 DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. 1: Engr. Review 15 PERMIT APPLICATION: 180DAYS 06 PERMIT LIMM 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 a EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # 9bi: ALL CLAIMS OR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY - FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapeinsp. Total Amt. D Lie 9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 2 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVA L 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 This application Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building Offlcial or his/her Deputy: and Foes are paid, and IN VIOLATION OF THE LABQELCODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknoydodgad In space provided. WORKMEN'S COMPENSAYA �NNCE AND RCW 18.27. OffIC L SI ATUBP.,4 ATE SIGNATUVRE(0 ER 0 DATE GNED IA35) -71JA WAGEtNMT,/ 10 0 771-0220 RELEASEd-BY-DiftE ATTENT164 Off 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 TO: z 9 0 m :4 T, M M C3 0 0 c m m z 10-4 c 0 -n n m m 0 0 0 M C co c ch rn 0 Z z cn z 9 0 m 3. -R-E-INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECTAPPROVAL . ocaprvl.doc.l:temp:bldg:fonns6/98 RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing....................... Wall.................. z Pier/Porch .................. 01 Re aining Wall t ......... Imulation ........ PLUM13ING: m Underground ....... q7DATE ;RECEIVED '[PERMIT EXPIRES J USE CITY OF EDMONDS ZONE PERMIT CONSTRUCTION PERMIT APPLICATION JOB NUMBER OWNER NAME/NAME OF BUSINESS ADDRESS )qv SUITE/APIT# A-vt 1;7j;'ADjnjR T-()f)Mj'c" PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7ESCP RW Pe ad cl*52— 3rd AV4� NGRTH Street Use Parrnh Rsqd ZIP EXISTING — PROPOSED Impaction Required Sidewalk Required fVT REQUIRED DEDICATION— FT UnderWourid --F-D QlWefi� 11125Q20 NAME METER ellgi fdiE Wiringrequired OzOF FeURES PRV REQUIRED YES13 NO 0 z ADDRESS REMARKS 0 NEFUCONTRACTO R RESP6/NqlBf1'F'fM_1RO-S'ON CONTROLJORAINAGE CITY ZIP TELEPHONE NAME JCBLN T'-wipur-av s vices r'.Lj er ENGINEERING RFV7 DATE .'�4U RIESS -7 E. �t? F_ FIRE EVIEWED BY DATE 4� ITY ZIP TELEPHONE 011 LOLF-a nbel I rA. STATE LICENSE NUMBER Va5 By- VARIANCE OR cu WED BOND EXqIRATIOV D!�I�, CH-EMO '�.'R ADB# INSPECTION REO'D POSTED SEPA REVIEW, HT PROPERTY TAX ACCOUNT PARCEL NO. COMPL PT ? L-ho 0 .. ' PROPOSE F.2 12 Q (a -0 EXP .1 .! 0 NEW RESIDENTIAL PLUMBING/MECH LOT COVERAGE REQUIRED SETBACKS,(FT.) PROPOSED SETBACKS (FT. ED PROPO ALLOW = SED FRONT SID SIDE REAR DI 3 ADDITION COMMERCIAL COMPLIANCE OR z CHANG YR7`3- 7" E OF USE "EDBY DATE 2 REMODEL MULTIFAMILY PARKING L 0 SIGN RECrD I PROVIDED :Ni'i REPAIR 11 GRADING CYDS o FENCE NMA ST BE PRRSENT FOR X Fn REMARKS DEMOLISH 11:71 TANK 0 OTHER TA JR CAP GARAG E RETAINING WALL FIRE SPRINKLER CARPORT 13 ROCKERY FIRE ALARM (IYPE OF USE. BUSINESS OR ACTIVITY) EXP R NUMBER OF TICAL P DWELLING __2�5 CHECKED BY TYPE OF =NS�W 70—c—CUPA NUMBE 7/A( GROU OF STORIES UNITS AS 4RMUL4 OCTION AHLA UUtoUrANI DESCRIBE WORK TO BE DONE ABER REQUIRED YES LOAD EMAR PECT12NS PER AMC I 08/FINAL INSPECTION REaD 47 VALUAnON $ Description FEE Description FEE Plan Check State Surcharge HEA1 GLAZING % LOT SLOPE % / . ...... I Building Permit City Surcharge 4 PLAN CHECK NO: VESTED DATE Plumbing /&2 Mechanical THIS PERMIT AUTHORMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC-) WILL REQUIRE Grading SEPARATE PERMISSION. Engr. Review PERMITAPPLICATION: 160DAY8 PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN iso DAYS SEE 0 ACK OF PINIK PERMIT FOR MORE INFORMATION Engr. Inspection *APPLICANT ON BEHALF'OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCcESORS Fire Review PlanChk.Deposft IN IWEREST AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Rece ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE _22 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due NOR LIMIT IN ANYWAY THE CrIY8 ABILITY TO ENFORCE ANY ORDINANCE PROVISION., M— Recording Fee 1pt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN 13 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 CONSTRU APPLICATION APPROVAL CALL This application is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building OMcW or his/her Deputy: and Foos are paid, and IN VIOLATION OF THE LABOILC DE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION WORKMERS COMPEN:$A receipt Is acknowledged In space provided. _�3 �NSCE AND RCW 18.27. SIGNATURE 0 - [DATTE 710GNED IA05) OFFIC I L 81 ATLI PATEI Ile %-WF- 1 7// / 14 : ?-> 771-0220 RELEASED BY D&E ATTENTIOV/i-a 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 ORIGINAL FILE YELLOW- INSPECTOR 04/02 PINK -OWNER - GOLD -ASSESSOR PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING