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20030514.pdfa DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEftWE OF BUSINESS ZZ�lj PERMIT EX I PIRES USE PERMIT ZONE NUMBER JOB SUITE/APT# ADDRESS &&2 &M926_� PLAT NAME/SUBDIVISION NO. LOT NO. L D NO. MAILING ADDRESS L�13 FEE S Amig: y2gy- PUBLIC RIGHT OF WAY PER OFFICIAL TESCP Approved STREET MAP AW Permh Required Street Use Permh "?"m -,-xff CITY ZIP TELEPHONE EXISTING — PROPOSED Wd Inspection Required Sidewatk Required 4�4_*_&y,gs 7-0 .13 27 REQUIRED DEDICATION— 'FO. Underground FT Wiring required 13 NAME METER SIZE LINE SIZE OF FIXTURES PRV REQUIRED I YES CI NO C3 z ;QL X73F,—tg�zo — — 15 ADDAESS REMARKS z z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE CITY ZIP ]TELEPHONE NAME CBL # L-12 ENGINEERING REVI BY E ADDRESS 71;�e 9 L11 03 CITY ZIP TELEPHONE 1 FIRE REVIEWED BY DATE LU Ix IEJ6 A*41ma-a—e— (::R&j "0 r -Z is - VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND STATE LICENSE NUMBER EX1111RATIONIOATE E KE 1 REO'D POSTED _�,OW OIL-- 1'e-j"OrP , 13YEs 13NO $ .+ '46 SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED _00 z;r -0-0 9. , , ,z:3 .317-03Y10 EXP f LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) 1:1 NEW RESIDENTIAL PIALIUMBING/MECH FRONT SIDE REAR FRONT LJRSIDE REAR ALLOWED PROPOSED 1:1 ADDITION r-J.,COMMERCIAL COMPLIANCE OR 0 CHANGE OF USE z PARKING LOT AREA PLANNING REVIEWED BY DATE CL 0 REMODEL ULTIFAMILY 000'M �_j SIGN REO`O PROVIDED I REPAIR [:] GRADING CYDS FENCE ( X FT) REMARKS - DEMOLISH 0 TANK OTHER GARAGE -1 RETAININGWALL 11 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE. BUSINESS OR ACTIViM EXPLAIN: CHECKED BY TYPFt CONSTRUCTION OCCUPANT 4�2 &674g5- 1 GROUP NUMBER NUMBER OF OF DWELLING CRITICAL An AS SPECIAL INSPECTIlbN JAREA OCCUPANT LOAD STORIES UNITS NUMBER REQUIRED [] YES DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 11081FINAL INSPECTION REaD VALUATION $ Description FEE Description FEE Plan Check I State Surcharge HEAT SOURCE _T____ZLAZlNG *4 LOT SLOPE % VESTED DATE Building Permit Plumbing City Surcharge PLAN CHECK 0- -&-a.= la-?$ Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 1= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 2 DOMIUN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. I: Engr. Review PERMIT APPLICATION: 1130 DAYS IL 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 On HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposli IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF 2 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 Landscape Insp. Total Amt. Due 9 DEEMED To MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 21 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt N 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 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 A&ORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE )F THE STATE OF WASHINGTON RELATING TO LABOR '0 FOR INSPECTION Building Otficial or his/her Deputy: and Fees are paid, and receipt Is acknowlocigod In space provided. WORKMENS COMPENSATION IVU�WE AND RCW 18.27. OFFICIALS SIGNATURE DATE al (OW DATE SIGNED 111125) lk-WK- Mo JA_ ?hk - /V-A -3 771-0220 1 W RZIL6kSED BY DATE ATTENTION 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 z 0 0 M M 40 0 C: :4 C M M z co 0 _n M M .0 0 rn 010 z 0 4 0 M I t G DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS MAILING ADDRESS .'//0 5-1-11, /",/C -A"W/ * CITY ZIP TELEPHONE L2=0/)� NAME J</7 trCe 4.LZ 3,10 CITY ZIP ]TELEPHONE erv*w'o a : ��/ S" 7 _r3 0 NAME Cat. ADDRESS A-V/0-7 - _4f,"'w f I-fl "t. CITY ZIP TELEPHONE PERMIT EXPIRES USE PERMIT ZONE NUMBER ADDRESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. I to FEE$ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7ESCP Approved RW Permit Required luw Use Peffnh Req'd EXISTING — PROPOSED inspection Required Sidewa* Required REQUIRED DEDICATION— FT Underground Wiring required 13 MET !E SI�E NO. OF FIXTURES PRV REQUIRED YES[3 NO [3 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE ENGINEERING REVIEW9ABY 01 *1 FIRE REVIEWED BY 7 111�03 DATE uj tmmm 64 — VARIANCE OR CU SHORELINEORAD611 INSPECTION I BOND STATE LICENSE NUMBER F 1 I REO'D POSTED `A6 19' � (_ � E3YEs 13NO is SEPA REVIEW � SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT A, LLOWED PROPOSED ALLOWED PROPOlIE13 2-7 6417 -00 17 32.7 03"1 -00- aO , I ,7 ,3 EXP NEW RESIDENTIAL P'Rku MBING / MECH LOT�5VERAGE REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT LIR SIDE REAR ALL*bWE PROPOSED ADDITION R11,COMMERCIAL COMPLIANCE OR 1:3 CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE IL 0 REMODEL MULTIFAMILY Pei SIGN REO'D I PROVIDED FENCE REPAIR GRADING CYDS X FT) REMARKS DEMOLISH TANK ER /0 0-11 �Rr GARAGE RETAJNINrM.L FIR = SPRINKLER 0 CARPORT ROCKEFff-, FIRE ALARM (TYPE OF USE. BUSINESS OR ACTIVITYl, EXPLAIN: CHECKED BY OF CONSTRUCTION OCCUPANT some ITYPE GROUP NUMBER OF NUMBER OF DWELLING CRITICAL AREAS SPECIAL INSPECTION I AREA OCCUPANT LOAD STORIES UNITS NUMBER REQUIRED [:] YES DESCRIBE WORK TO BE DONE �REMARKS I PROGRESS INSPECTIONS PER UBC 1 08/FINAL INSPECTION REaD $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE LAZING % LOT SLOPE % G Building Permit City Surcharge PLAN CHECK t1o. VESTED DATE Plumbing Mechanical THIS PERUrf AUTHORIZES ONLY IME WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPEM ONLX MY CONSTRUCrFION ON THE PUBLIC Grading 23 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. t: Engr. Review PERUrFAPPUCATION: 160DAYS PERUrr UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 160 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION ON BEHALF OF HIS OR HER SPOUSE, HEIRS, 'APP ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit E�, T. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF IN I= 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 Landscapoinsp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY, WAYTHE CITYB ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - Receipt # Recording Fee I HEREBY ACKNOWLEDGE THAT 1, HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORREC71 AND THAT 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 Ormit �ntll signed by the TION; AND IN DOING THE WORK 0 D THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABO AW OF THE STATE OF WASHINGTON RELATING TO R C;01x Building Official or hlMw Deputy: and Fees are paid, and FOR INSPECTION receipt Is acknowledged In space provided. S COMPENSATION ll�lu CE AND RCW 18.27. WORKMEN PN OFFICIALS SIGNATURE DATE al (OWN OR DATE SIGNED iA9 %425) 771-0220 S D DATE ATTENTION M 1333 7L 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 z 0 M =i -fl I