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20030523.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUIESS V_kv�Avef�_ �o �\" C ot� MAILING ADDRESS -) ?-,, FA t� - mf�ftovj CITY ZIP ITELEPHONE F-WoO NAME ADDRESS CITY ZIP ITELEPHONE NAME �'BL N DI-SOA it qlq_ ADDRESS t�ks CITY ZIP 1 TELEPHONE 2�0160 - 07 5 21 STATE LICENSE NUMBER EXPIRATION DATE 0L-SoA1F*7,"A (� - 4 -031 ((r) PROPERTY TAX ACCOUNT PARCEL NO. Izz:7- 0 Or.> -3 02,.- PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB ADDRESS PLAT NAME/SUBDIVISION NO. LOT No. LID NO. LID FEE S _j PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESci- Approved RW PsrNt Required Street Use Permit Reqd EXISTING - PROPOSED inspection Required Sidwalk Required REQUIRED DEDICATION- FT Underground Wiring required METER SIZE LINE SIZE NO. OF FIXTURE� __PRV_A=UIRE I- YES 13 ING FIRE REVIEWED BY NEW RESIDENTIAL LL( 0 PLUMBING if MECH ALL( ADDITION COMMERCIAL COMPLIANCE OR 1:1 CHANGE OF USE 0 REMODEL MULTIFAMILY 0 SIGN 1:3 REPAIR _j GRADING CYDS [REG [:3 FENCE X ( _ FT) REV 0 DEMOLISH 0 TANK 1:1 OTHER oGARAGE [:] RETAININGWALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESQM A N: 1_� M NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES UNITS I NUMBW'4,, DESCRIBE WORK TO BE DONE k SLObLb USEM04K W1 _W� F-Ir 0V-rL_!_Ej:S --rD k&Vg 't-1 4TIO 95i2VI FAk C-R 1— HEAT SOURCE GLAZING % I LOT SLOPE % PLAN CHECK NO: I VESTED DATE THIS PERMrr AUITHORIMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONUK ANY CONSTRUCTION ON THE PUBLJC DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 150DAYS PERMIT ILIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE 13ACK OF PINK PERMIT FOR PADRE INFORMATION '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 VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMENS COMPENS5Ifl�RANCE AND ACW 18.27. siGNxruVjOWNER DATE SIGNED LOT jjhjC 815. BEACCEPTED of Whether DATE pler QVI D M Electri al Permit from tate Labor & Industries D U 2 KS (FT.) EC REAR I )ATE 0. CHECKED BY ITYPE I 'ff �flOCCUPANT Vs� "filON C71 GROUP A, SPECIAL INSPECTION AREA OCCUPANT REQUIRED OYES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 109/FINAL INSPECTION REG'D Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt. Due '00 Recording Fee Receipt # 3114 CALL FOR INSPECTION 142 771-0220 EXT 1333 APPLICATION APPROVAL This application Is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid, and receipt Is acknoModged In space provided. OFFICIALS !PNjrURE DATE RELEASE11 BY DRTE IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I- 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 M M C M 0 80 C M M 0 _n M M 0 o Fn C 0) M z 0 0 M 7 Ai. I If -DATE REC RECEIVED -DATE PERMIT EXPIRES USE PERMIT ZONE CITY OF EDMONDS NUMBER CONSTRUCTION PERMIT APPLICATION JOB U V I �nlA" ADDRESS OWNER NAMENME OF BUSINESS Y- k� �-A �-,g �- i� A- PLAT NAMEISUBDIVISION NO.' LOT NO. LID NO. MAILING ADDRESS L) \,q LID FEE $ It PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TIESCIR Approved RW ParrrJt Required mmit Rsq'd CITY zip TELEPHONE MING ZROPOSED ven connectors TDOr �. vent oquired u bo�,A 6 5 2_"�j D r I j— EQ D C0ATrO,,..—_,,_.... �". 1"'a .I-m 111 g1eq od 13 NAME IZE on SIZE UTEj' spwk& REG UIRED 0 11 eat�LINE YES NO 13 ADDRESS OWNER1CO="WrTj3T2Mjj3r_ IFEM RAINAGE W11- CITY ZIP TELEPHONE BEERVED BY CWI INM -HEID-AMLIS I I NCL— NAME BE AGE, ENGINEERING REVIEWED BY DATE CC ADDRESS 15 A I?-- VJ #0\ V1 z FIRE R ftWeSS of whether the water slfflm CITY ZIP TELEPHONE Is opmor dosed, manslon tanks are 0 m DATE VAR I A 7"Gired H PVR% td NO OSTED STATE LICENSE NUMBER EXPIRATION D i-SOA�k1m4k 1)1-4-031 GUY city codro CDC 19.30.Mpj ONO If s I PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE XEMPT E ALLOWED PROPOSED A LLOW PROPOSED m (D os 0 3 15,0 EXP C: m NEW RESIDENTIAL PLUMBING/MECH COMPLIANCE OR LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT LIR SIDE REAR C [j ADDITION COMMERCIAL CHANGE OF USE m m REMODEL MUL11FAMILY 0 SIGN PARKI OM 0 Rptlefi* Ir des z o FENCE REPAIR GRADING. CYDS X—FT) REMARKS OTHER DEMOLISH r3 TANK 13 0 In [3 GARAGE RETAINING WALL F RE SPRINKLER CARPORT 0 ROCKERY 1:1 FIRE ALARM 12 OWE OF USE. BUSINIESQM PLAIN: CHECKED BY TYPE 01[ON90 Cyj OCCUPANT GROUP m M IL NUMBER OF NUMBER OF DWELLING CRITICAL AREAS PA. SPECIAL INSPECTION ]AREA 'PION OCCUPANT LOAD 0 F 0 n STORIES UNITS NUMBW REQUIRED [] YES C= DESCRIBE WORK TO BE DONE 1114 STA �/L- A I 0-ri REMARKS PROGRESS INSPECT12ELPER 6BC 108/FINAL INSPECTI N REUD M 0 IvAfAAL, (,,rA(, IWwrc,61 A owo 0 W_ C� GAS Rksem�W\Nj r_.ms riEtt4(j- ID A i3wt�_ i-151-15P 1�0vIPM6r47 CA 0 �,6 Ws Description FEE Description FEE z Plan Check State Surcharge 0 HEAT SOURCE GLAZING % LOT SLOPE % BuildingPermft City Surcharge m PLAN CHEC VESTED DATE Plumbin 9 s, e '319 Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading X DOMAIN (CURBS, SIDEWAM, DRIVEWAYS, UMQUEES, ETC.) WILL REQUIRE t: SEPARATE PERMISSION. Engr. Review 2 9 PM11T APPUCATION:' 180 DAYS 06 PERMIT UMM I YEAR - PROVIDED WORK 16 STANFED WITHIN 160 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION �-WkMk. ON BEALF OF 1-18 dR HER "BE, HEIRS. WIGNS AND 861 : "�RS HOLD HARMLESS THE 3TY OF Plan Chk. Depoo IN INTEREST, AGREES TO INDEMNIFY; DEFEND AND EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # AIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY ALL CL *THIS PERMIT SHALL NOT BE FROM THE ISSUANCE OF PERMIT. ISSUANCE OF THIS DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due NOR LIMIT IN ANY WAY THE CITY$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Ri 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 Y61TH CITY AND STATE LAWS REGULATING CONSTRUC- CALL 'ROVA V at" ed This application is not a permit unt.11 signed by the Building Officiall or his/her Deputy: and Fees are pnW, and r . a d F 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 FOR INSPECTION vj1d receipt Is acknovAedged In space provided. WORKMEN'S COMPEN!!2!!22�RANCE AND RCW 16.27. I _ BIGNATU,P4OWNER E DATE SI NED 1A0 .%e k7-5) OFFICIALS P1!PNfrURE PATE - - 771-0220 RELEASED BY DATE ATTENtION 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-INSPEM GOLD-ASSEM CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PiNK-OWNER - ACCOUNTING GREEN 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES