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20030519.pdft DATE RECEIVED 7 PERMIT EXPIRES USE PERMIT CITY OF EDMONDS ZONE NUMBER aa CONSTRUCTION PERMIT APPLICATION JOB ADDRESS W iv, OW1,1169LMEINAME OF Bu ss PLATPfME/SU LOT NO. LID NO. I MAICING A .PDRESS iA 4) Milk PUBLIC RIGHT OF WAAER 01 L STREET MAP LID FEE $ 7ESCPAP o RW PsrrNtPRf=*d Permit Req'd Ci T�Y�� ZIP EXISTING — PROPOSED Street Use Inspection Required sidewalk Required ITELEPHONE REQUIRED DEDICATION— FT Underground Infirkrigraquoso 13 NAME METER LINE SIZE NO. OF FIXTURES PRV REQUIRED YES NO 13 z ADDRESS REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE CITY ZIP TELEPHONE ft—M—vw fl5 omey_ NAME ADDRESS ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE CITY ZIP TELEPHONE STATE LICENSE NUMBER VARIANCE OR CU SHOIIELINEORA13BI I INSPECTION 1. BOND CHECKED BY REQ'D POSTED I 13YEs 13NO SEPA REVIEW SIGN AREA HEIGHT ROPERTY TAX APQ IT PARCEL NO. 0 00 oo COMPIL E EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED 00 '049 , , EXP N EW RESIDENTIAL rl PLUMBING/MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT URSIDE REAR ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY SIGN PARKING RE01D I PROVIDED LOT AREA PLANNING REVIEWED BY DATE 9 REPAIR GRADING CYDS FENCE ( 70 jj_jV FT) REMARKS r n [3 DEMOLISH 0 TANK OTHER — a 61.1%x 0 GARAGE o RETAININGWALL 0 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE. BUSINESS OR AMM� CHECKED BY OCCUPANTE, /. - %'\ ITYPE I -GROUP NUMBER OF NUMBER OF DWELLING CRITICAL % AREAS nB,,d?q SPECIAL. INSPECTION JAREA OCCUPANT LOAD STORIES UNITS NUMBERL_.jQj REQUIRED 0 YES DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 1108/11FINAL INSPECTION REQ�D e exi_rfWa VALUATION $ Dewription FEE Description FEE Plan Check State Surcharge HEAT SOURCE _F___`LAZ1NQ % LOT SLOPE % Building Permit City Surcharge PLAN CHEC;!20- VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading 2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE :3 SEPARATE PERMISSION. t: Engr. Review a 15 PFRUITAPPLICATION: 150 DAYS 11 PERMIT uum 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 # LC S 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 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE ABILITY TO ENFORCE ANY ORDINANCE PROVISION., 1 h6s� 21 NOR LIMIT IN ANY WAY THE CI1YS 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 AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This CALL si7cauon Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Build*ffl at or his/her Deputy: and Fees are paid, and IN VIOLATIO LA13OR CODE OF THE STATE OF WASHINGTON RELATING TO , FOR INSPECTION el I Is acknowledged in space pr_"d, el I I WORKMEN' OMPE IN = CE AND RCW 18.27. 0 Is I �TURE ATE SIGNA WNE§ OHVAG DATE SIG)IED '425) ZIA 3 16 a 771-0220 !VEk0i) By A DATE AnfNTION 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 - ASSEsson 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING FINAL PROJECT APPROVAL FORM z 0 m =i :H 65 ;1 OM c MO 0 80 c M MZ 1c) o -n In m M a 0 0 M C (1) 9 ca M 0 Z 7-1 ;u z 0) z 9 0 m 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Si ocaprvi.doc.l:tenip:bldg:fonnsIO/OI In Vmivp a) A-,- sp f 41; ri, I I fN 6.1 . arip 1 4 0 OATE RECEIVED V sassalissaij PERMIT EXPIRES USE ZONE PERMIT2� CITY OF EDMONDS NUMBER CONSTRUCTION PERMIT APPLICATION JOB sunVAPT# ADDRESS Y� OWNSRNAMEINAME OF BUSMSS UnCO WUVL1NW1b 0 )IIA CIrjt00j ZIP ITELEPHONE U04 2 nz_ '_U NAME ADDRESS CITY ZIP ITELEPHONE NAME CBL# ADDRESS '. 191 CITY ZIP I TELEPHONE STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY PROPERTY TAX [T An PARCEL NQ 0 00 9 CIO DO: o4 NEW, RESIDENTIAL PLUMBING / MECH JADDMOR COMMERCIAL COMPLIANCE OR CHANGE OF USE 1:3 REMODEL 1:1 MULTIFAMILY E N Sir REPAIR GRADING CYOS FEN FT) DEMOLISH -1 TANK E CTHEV� GARAGE CARPORT RETAININGWALL ROCKERY cl FIRE SPRINKLER FIRE ALARM (TYPE OF USF_ BUSINESS OR A��N: NUMBER OF NUMBF _R OF DWELLING CRITICAL AR EAS ST RIES —UNITS NUMBERO� DESCRIBE WORK TO BE DONE i PLATgE/SU N LOT NO LID NO. 1A LAffl- LID FEE $ PUBLIC RIGHT OF "'AYWOR 4AP TESCF APFWMdd RW ftrrMt Required '"M Use Parmh RWd EXISTING — PROPOSED trapscuen Required Sidewalk Required REQUIRED DEDICATION— FT UndwWourW WIMgrequired 13 METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED I--- YES 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE HEAT SOURCE GLAZING % LOT SLOPE % PUkN,CHECK O�' VESTED DATE A THIS PERMIT AUTHORrAMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. LTC.) WILL REQUIRE SEPARATE PERMISSION. PERMITAPPLICATION- 180 DAYS PFRUIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE 13ACKOF PINK PERMIT FOR MORE INFOR�I[ATION '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 HEREBY 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 VIOLAT ONEELABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMENI ! = INKRANCE AND RCW 18.27. RMNAMISk-JAWN1561 nWiGEN5 I I DATE SIGNED FINIGINEERING REVIEWED T FIRE REVIEWED BY ___1 110 105, DATE UJI M VARIANCE OR CU SHORELINEORADB# INSPECTION BOND REO'D I POSTED I E3YEs 13NO $ SEPA REVIEW SIGN AREA HVIGHT_ COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , LOT COVERAGE REQUfIRED SETBACKS (Fr.), PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE Rr III ilk BI 111 PARKING REO'D PROVIDED 1,01 Eli 06 "A M . .eiM REMARKS CHECKED BY TYPE :MRr3TiON OCCUPANTV9 I j 174 -GROUP SPECIAL INSPECTION AREA OCCUPANT LOAD REQUIRED [:] YES REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REGrD Description Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Fire Inspection Landscapelnsp. Recording Fee CALL IFOR INSPECTION 1A10 ,k-125) �:"771-0220 EXT 1333 FEE Description FEE State Surcharge 4�, — I City Surcharge Plan Chk, Deposit Receipt # Total Amt. Due Receipt # APPLICATION APPROVAL tap on I I nUl signed by the 'a Perm u v M t fi I., hl=, Dputy:tand Fees are paid, and t ti. Is acknowledged In space prqj4dVd. 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 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES il f /q BY DATE ORIGINAL -FILE - YELLOW -INSPECTOR �KV/ PINK -OWNER - GOLD -ASSESSOR GREEN - ACCOUNTING