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20030525.pdffMPC1S DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION 0 ER NAME/NAM BUSINESS ,*z �n MAILING ADD�RESS ci ZIP TELEP IONE r-:na NAME CITY ZIP TELEPHONE NAME CBL # & e-� (,� Incl a.,t�k- ADDRE 06, 1 ZIP TELEPH qT !:0 N;E CT WALIC R ST E LICENSE NUMBER EXPIRAT 07 DATE ECKED M:Rl PROPERTY TAX—Ac 2 Af re, pin NEW RESIDENTIAL 13 PLUMBING / MECH ADDITION P" - 031�IAIL COMPLIANCE OR 11 CHANGE OF USE REMODEL MULTIFAMILY [:1 SIGN [2-REPAIR —1 GRADING CYIDS 0 FENCE ( X_FT) DEMOLISH [3 TANK _ OTHER GARAGE CARPORT RETAINING WALL ROCKERY FIRE SPRINKLER 0 BE, BUSINkSEefl ACTMM EXP FIRE ALARM 7 NUMBER OF STORIES a U NUMBER OF DWELLING CRITICAL AREAS U ITS UNITS NUMBER DESCRIBE WORK TO BE DONE !7 HEAT SOURCE GLA!NG % LOT SLOPE % PLAN CHECK NO: VESTED DATE ER 'IT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK To THIS P 1 0 3E ONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC DOAMN (CURBS- SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPILICATION: 180 DAYS 16 PERMIT UMIr I YEAR - PROVIDED WORK IS STARTED WITHIN Go DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICAK ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SU 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 D;RECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT HE DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINA14CE NOR LIMIT IN ANY WAY THE CrrYS 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 WrTH 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 WORKMEN'S COMPEN !�= NCE AND RCW 18.27. SIGNtURE (OWNER Ok�� . . - 0 -1 DATE SIGNED 42 PERMIT EXPIRES '&110 USE ZONE P PERMIT 111' i NUMBER JOB ADDRESS sUITE/AP`T# PLAT NAME/SUBDIVISION NO. LOT NO.' LID NO. -------- LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCF -Approved AW Pom91 Required EXISTING — PROPOSED Street Use Permit R&q`d InSIM110n Required REQUIRED DEDICATION --- � FT Sidewalic Required Underground METER SIZE LINE SIZE Mine required NO. OF FIXTURES PRV REQUIRED YES13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE BY FIRE REVIEWED BY DATE DATE 0 z ig lz VARIANCE OR CU SHORELINE OR ADBN — INSPECTION BOND' REQ'D POSTED DYES $ SEPA REVIEW COMPLETE EXEMPT UION AREA HEidFrr— ALLOWED PROPOSED ALLOWED PROPOSED EXP LOT COVERAGE ALLOWED a REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr.) PROPOSEID FRONT SIDE REAR FRONT UR SIDE REAR PARKING LUI AHEA I PLANNING REVIEWED BY REQ`D PROVIDED z DATE CHECKED BY ITYPE SPECIAL INSPECTION REQUIRED [] YES REMARKS ?k9GRESS INSPECTIONS PER USC 108/F &hA&",,)< ixitni qAw_�_ GROUP t OCCUPANT LOAD INSPECTION REQ'O $ 01 Description FEE Description FEE P Plan Check Ian Chec State Surcharge Building Permit Building P rD City Surcharge Plumbing Plumbing Mechanici Mechanical Grading Engr. Review Engr. Inspection . ......... Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Recording Fee Receipt # %J APPLICATION APPROVAL CALL This application is note permit until signed by the FOR INSPECTION Building Official or his/her Deputy: and Fees Oro Paid, and receipt Is acknowledged In space provided. 1A0 1425) DATE 771-0220 4101FFICIAVNAT 4F �JDATE TE IT IS UNLAWFUL. TONLISE OR OCCUPY A BUILDING OR STRUCTURE UNTIL r-A I I j -A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 ORIGINAL -FILE YELILOW- INSPECTOR 102 PINK -OWNER GOLD -ASSESSOR PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING I/ I q-ATERECEIVEO .D TE RECE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION I OWNER NAME/NAME OF BUSINESS MAILING ADDRESS CITY ZIP ELEPHONE 1 /4 1 z111'_; 7 71 NAME ADDRESS CITY ZIP TELEPHONE NAME &,rrv1j,=w_ ADDRESS CITr TELEPHONE Lq S1Z'P 12.643-24 4"S3 Coco EXPIRATIONDATE I_,o'CHECKEDS) NEW 11 RESIDENTIAL PLUMBING/MECH ADDITION 0" - 50 COWAVRMAL COMPLIANCE OR 1:3 CRANGE OF USE 0 REMODEL 1-1 MULTIFAMILY SIGN UkEPAIR GRADING CYDS o FENCE x FI) DEMOLISH TANK OTHER oGARAGE CARPORT RETAINING WALL ROCKERY FIRE SPRINKLER FIRE ALARM =N�SE A* AC" EXPLOP, NUMBER OF RIES P NUMBER OF DWELLING UNITS CRITICAL AREAS NUMBER DESCRIBE WORK TO BE DONE HEAT SOURCE I GLAZING % I LOT SLOPE % PLAN CHECK NO, VESTED 13ATE TH13 PERMIT AUTHORMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC DOMAN (CUFMo SIDEWALKS, DRIVEWAY8, MARQUEES, ETC.) WILL REQUIRE GEPARATEPERUISSION. PERMIT APPLICATION: 180 DAYS PERMIT UMM. I YEAR - PROVIDED WORK IS STARTED WITHIN 130 DAYS 993 BACK OF PINK PERMIT FOR MORE 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, 98 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 70 ENFORCE ANY ORDINANCE PROVISION.* I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION GIVEN IS CORRECr 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 EMPLJOYED I" VIOLATION OF THE LABOR CODr OF THE STATE OF WASHINGTON RELATING TO WORKMENS COMIPEN!:j!=CE AND RCW 18.27. — si(m4n.IRE (OWNER OkAGENTV __rDAjE SIGNED PERMIT EX PIRES 6764 USE PERMIT ZONE NUMBER OB SUITEIAPT# ADDRESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. UD FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESW Approved RW PmM RaquW I Sum Use PWM " EXISTING — PROPOSED Inspection Pleqtired Ckfevalk ReWIred REQUIRED DEDICATION— FT U WWg required M---- ETER SIZE � LINE SIZE NO. OF FIXTURES PRV REQUIRED e. It, 0�' it, -V Ith. I 115 YES 13 NO 13 z REMARKS I OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE Ic 1 1 1 11 1 VARIANCE OR CU SHORELINEORADBO INSPECTION BOND REQ'D I OyEs Ow POSTED 1. SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED LOT COVERAGE REQUIRED SETBACKS (FE) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LJRSIDE REAR BY, DATE PARKING REQ, ED LOT AREA '� I PLANNING REVIEWED - ? /_ 4-1 A. CHECKED BY I TRUCTION CaDj_ OCCUPAI`4P0 —Z Ty M+ GROUP r, _';0 SPECIAL INSPECT,( FAREA OCCUPANT REOUIRED [3YES LOAD REMARKS PRQGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REGtD Uji, `9 A. I I Ah f A�-r Ice W&R-d A- VAILUATION $ lul/ I Description FEE Descirlpition FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit A Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Recording Fee Receipt N APPLICA11ON API)ROVAL This application is not a permit untu signed by the CALL Building Official of Ns/her Deputy: and Fees are paid, and FOR INSPECTION rewipt is acknowledged In space providod, OFF NAT 0 TE 142C., A -.01" —A — / �lm 771-0220 REL DATE I- 010 .ATTENTI0 !t�� Off 1333 lb I IT IS UNLAWFUL VSE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I/ L03 I I A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIC31NAL - FILE YELLOW - INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER - GOLD -ASSESSOR 04/02 PRESS HARD -YOU A RE MAK ING 5 C OPIES GREEN ACCOUNTING z 9 0 M M C M 40 0 C i! I M 10 Z 0 -n '�" I Irn M 5i Fn C z 0 1 F5 M