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20030532.pdfI DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS _��dt A I M 14 -4 4) - MAILING A16DRESS CITY ilp [TECEPHONE NAME ADDRESS CITY ZIP B5 lil, NAME —F CITY ZIP TELEPHONE 1:713 1 1 &1 q PERMITEXPIRES 141 lbz:7- USE PERMIT Z 0 NE NUMBER"-J,,,'��eTl JOB SUITE/APT# ADDRESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP O�P_roved RW Permit Required Street Use pannit Req 'd EXISTING — PROPOSED InspectionRequirod 13 Sidewalk Required REQUIRED DEDICATION— FT Underground whing r ulr 13 METER SIZE_ LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES13 NO 13 is REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE REVIEWED BY DATE FIRE REVIEWED BY DATE I "I mnad'�! MJ-44> 205 - / /it — LmuALI VARIANCE OR CU SHORELINE OR ADBN INSPECTION BOND STATE LICENSE NUMBER EXPIRATION DATE 11161FCKED BY I 113YE�q REO'D POSTED 1$ I ONO A 12LI SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. f -2— COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED �/ AJ�Qge_ W__ EXP , , I NEW RESIDENTIAL PLUMBING/MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.)� FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT URSIDE REAR z ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED 13Y DATE 06 0 REMODEL MULTIFAMILY SIGN REO'D PROVIDED I I REPAIR GRADING CYDS FENCE ( _x FT) REMARKS DEMOLISH TANK OJAVR Kn'o P GARAGE RETAINING WALL 13 0 F RE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USINESS OR ACTIN!" EXPLAIN: I Islas! CHECKED BY TYPJE OF CO_WTRUCnON 1 C_W OCCUPANT "Kvr-2 GROUP ic NUMBER OF I N R OF DWELLING t CRITICAL AREAS SPECIAL INSP CTION JAREA OCCUPANT LOAD STORIES -NUMBER REQUIRED [] YES DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC IGOIFINAL INSPECTION REG'O r,&.%--,C DL14n/1 Old f"ar $ J ra!Q-r- i few 00:2E 1*.5 GAF -4c,.- c,6d4,k.y,Q Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING LOT SLOPE % IBuilding Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 13E DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 03 DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE 1= SEPARATE PERMISSION. Engr. Review PERMrTAPPIJICATION: 150DAYS 06 PERMIT LIUM 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 # 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 Landscapelnsp. Total Amt. Due 21 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee T_ 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- CALL This applicatIon Is not a permit unffi signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION ,Vcelpt is acknowledged in space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. OFF SIGN DATE SIGNATUR (OWNER R AGENT) DATE SIGNED 1A 11 %-125) 7j 771-022 0 —L g4l— fATEy RELEAStD AY ATTENT16N 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 SENSE I 5 z 0 0 M ca 0 M M 0 -48 OC 3! C M M 10 0 -n "n M M 8 ra 0 rn C9 0. z 0 tDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF Bust I' Nbtw 15 MAILING DREiSs CITY 71P TELEPHONE 67— Inv NAME ADDRESS ZIP TELEPHONE CITY NAME rl 1 CITY ZIP TELEPHONE 111— j< .0 EXI r;STATE ;U;ENSE UMBER 14-T T- OUIff CEL NO. 13 NEW RESIDENTIAL ADDITION COMMERCIAL 0 RE MODEL MULTIFAMILY kPAIR GRADING CYDS DEMOLISH [3 TANK GARAGE CARPORT RETAINING WALL ROCKERY ME OF US&.SUSINh- OR ACTIVITY)i EXPLAIN: NUMB: R NUMBER OF DWELLING OF 6 UNITS DESCRIBE WORK TO BE DONE R�: E uplown.31 EXPI E IT USE PERMIT ZONE NUMBER SLI J013 ADD:::j PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIG14T OF WAY PER OFFICIAL STREET MAP TESCP App'= W .M F ed stmet U60 Parmh M0 h%pKdon Flaquired EXISTING � PROPOSED -------- SWwalk ROWWod REQUIRED DEDICATION— FT Wd 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED E3 YES 0 NO REMARKS ACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE OWNERICONTR 1:1 PLUMBINGIMECH COMPLIANCE OR 0 CHANGE OF USE 0 SIGN FENCE X FT) F1 IRE SPRINKLER [3 FIRE ALARM CRITICAL AREAS NUMBE REVIEWED FIRE REVIEWED 13Y DATE DATE I 11C VARIANCE OVCU 17�SP_ECTION BOND SHORELINE OR AUUN REO'D POSTED j 13YES 13NO $ SEPA REVIEW SIGN AREA HEIGHT OP ALLOWED PROPOSED. ALLOWED PA COMPLETE EXEMPT i 71 EXP REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT) LOT COVERAGE FRONT SIDE REAR FRONT LIR SIDE REAR ALLOWED PROPOSED PARKING LOT AREA PLANNING REVIEWED BY DATE REDID I PROVIDED =HEAT SOURCE GLAZING LOT SLOPE % p LAN RCE==77E_ VE — 0 DATE LJ:CHE_CK NO: THIS PERMIT AUTHORaES ONLY THE WORK NOTED- THIS pFRMff COVERS WORK TO OF DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC IPJLVAya, MARQUEE DOMAIN (CURELS, SIDEWALKS, OF .9. ETC.) WILL REQUIRE SEPARATE PERMISSION - PERMIT APPLICATION: III0 DAYS IN ISO DAYS PERMIT LIMM IYEAR - PROVIDED WORK IS STARTED WITH SEE BACK OF PINK PERMIT FOR MORE INFORMATION .APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASS113NS AND SUCCESORS S TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE. CITY OF I EMPLOYEES, AND AGENTS FROM ANY AND ECTLY OT BE NANCE ISION., MATION CHECKED BY OF SPECIALINSPE, ION I I FCT REQUIRED [3 YES Description Plan Check Building Permit plumbing ---------- Mechanical Grading ---------- Engr. Review Engr. Inspection JCTION C 0 ANT CCUI GROUP wa --=;e OC UPANT FE! LOAD PER UBC I 08/FINAL INSPECTION Mail) I R FEE Description FEE State surcharge 'i—, /)I City Surcharge Plan Chk. Deposit Fire Review Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Recording Fee Receipt 0 AP LICATIOWAPPROVAL A b the I HERE E OWNER. OR THE OULf AGENT OF This PPlicatIon 15 not a permit unm sign 7 d CALL T Ina GNEN IS CORRECT; AND THAT I ANI Bultd To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- Q cW of Neftor Deputy*. and Fees 018 paid. THE OWNER. I AGREE' go THEREBY. NO PERSON WILL BE EMPLOYED ipt is acknowiodged In space PrOvIdOd- TION- AND IN DOING THE WORK AUTHOR12 SHINGTON RELATING TO OR INSPECTION SIG�AT DATE IN VjoLATION OF THE LABOR CODE OF THE STATE OF WA OFFI YRY WOIRKMEPI COMPENSATION INSURANCE AND RCW 18,27. SIG R AGENT) DATE SIGNED (425) 771-0220 RELEAS 0 Y EXT 1333 &TENTON U UPY A BUILDING OR STRUCTURE UNTIL IT IS UNLAWFUL TO USE OR OCC ORIGINAL - FILE , YELLOW - INSPECTOR MADE AND APPROVAL OR A CERTIFI- PINK -OWNER GOLD*ASSESSOR A FINAL INSPECTION HAS BEEN GRANTED. UBC SECTION 109 COPIES GREEN - ACCOUNTING CATE OF OCCUPANCY HAS BEEN PRESS HARD -YOU ARE MAKING 5 .04/02 ------- 5 z 0 4 0 M M rn 0 -10 0 C: � x M M z 0 _711 M 11711 0 Fn a 0) C CIO 0 CA z 0 0 M