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20030534.pdfDATE CITY OF EDMONDS w CONSTRUCTION PERMIT APPLICATION OWNER ' NAMEINAME OF BUSINESS �-e MAILING ADDRESS lilh -P , , CITY ZIP TELEPHONE JAh11_'77,,,--_ j4 NAME ADDRESS CITY ZIP ITELEPHONE CBL N I- r11_1 . - 14-d' - -1 M DDRESS -3// S7_4,4/c" CITY ZIP TELEPHONE 9)s-:3- -,37/7 STATE LICENSE NUMBER EXPIRATION DATE I CHXKED BY PROPERTY TAX ACCOUNT PARCEL NO. 0 NEW RESIDENTIAL 0 PLUMBING/MECH ADDITION COMMERCIAL ts� COMPLIANCE OR �x CHANGE OF USE REMODEL muLnFAmiLy SIGN REPAIR GRADING CYDS FENCE 0 ( X FT) DEMOLISH TANK OTHER 1 GARAGE 3 CARPORT RETAININGWALL 0 ROCKERY FIRE SPRINKLER FIRE ALARM UWE OF USE. BUSINESS OR ACTIVITY) WILAIN: M NUMBER NUMBER OF CRITICAL OF DWELLING 4 AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECKAIO: VESTED DATE a — 1-5Q Z. E - essese THIS PERMIT AUTHORtZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC DOMAIN JCURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPUCATION: 160DAYS PERMIT UMrr 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE 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, 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 C17YS 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 WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. W (O� ER 0 DATE SIGNED 7 PERMIT EXPIRES USE PERMIT ZONE NUMBER"S— JOB su ADDRESS 0 0 PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7ESFP_;�_W_ Rw Permit Required Streal Use Permit Rscrd EXISTING — PROPOSED inspection Required Sidewalk Required REQUIRED DEDICATION— FT Underground wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I I YES [3 NO 1:3 z REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE ul 4�z VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND REO'D POSTED E3YEs ONO 1$ SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT ALLOWED . PROPOSED I ALLOWED a PROPOSED1 LLOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE REAR LOW I PARKING LOT AREA I PLANNING REVIEWED By DATE I R RECtD I PROVIDED t M R REA Ks CHECKED BY ITXEE. ON7RUCTION IC21 A ULAOUr�",!. GROUP SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [3 YES I I LOAD INSPECTIONS PER UBC 198tFINAL INSPECTION REO'D -4 A. A, �'z Description Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Fire Inspection Landscapeinsp. Recording Fee F --I f —7f / _- FEE Description FEE State Surcharge I City Surcharge Plan Chk. Depos Receipt # Total Amt. Due Receipt N cz— V :;p I APPLICATION APPROVAL This application Is not a permit until signed by the Building Official or histher Deputy: and Fees are paid, and receipt Is acknowledged In space provided. AIALS SIGTATURE DATE 01111� A i / I - IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CE CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES ORIGINAL - FILE YELLOW - INSPECTOR PINK - OWNER GOLD - ASSESSOR GREEN - ACCOUNTING 0 FINAL PROJECT APPROVAL FORM L-I - -,I. , ,-� I z 9 0 m =i 9 am c ma 0 80 c M M Z 0 -1 3: CA 0 -n n m M a 0 0 M C C/) r. (j) M 0 Z ;u -i z --I 3: cl) z 0 q 3 m RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date_--, Si- ocaprvi.doc.l:tcrW:bldg:fonris.10/01 y Q! 253 564 3233 P.02/04 TESTP.MKC CLZW: couja a Auan REPORT KUMER: 2t96ZC p 0 a" 1447 LAq TIM NUMMR-. 1360-2449 Dolem GA jQ722 IVATS: May 6.2W A below. SuLl=; Tar , samp Wu p6mlmd mid Idedfiflod bY ft efiost as ,rjwr 1FROMD1W.. a0auzZl" (pAr) rw Fkawl"Ity (pim tM.WW WMuaj Lq dbccW in liedeml DnLumni DM F? 1.70 od Wso ASTM D 2859. I %T S favcATION spo tjwhamd Aq@ 7�182""Tmc 01 7?. 3+ Im 1 soft 5191 - a 03 U in, 3+ in. PowbooO IRS COWfOud viol C;Won 04 3+ in. os 3+ ba. 06 3+ is. W7 3.1- il& 03 3+ iTL- 0 Flulwas I I Pum oveffill Roult &MIC powd.pul Flunmawlity Tn** APP I FIRE DEPARTMNT 'es, 10. Iradus savk -2 -4 2 RECEIVED JUL 15 20C3 PERMIT COUNTER t= GMUM OF APM* N TLY VJ94AL 3w"t a TEM AND JM WT WWM AND WR OUR ur"06AND PAWMAPM QN6V TO YWI 41 Un ONLy Op jHg GLwW To "WW THLY AM AM Ml:pWoWMoM Ca WAM ppgX=&, 7"M LlMM AND WKMIS AM POP M . AlRpqQRwwMNAPMVALl aMWaFj"k" oftwNauom To A"v MR WAAt. OUR I" OR %AAAFWTUNWviAQncUMpANCWT0RFUlW WeAT am wwm ff WA%b~M "M P. flp AJL-i4-2M3 ITA:09 C L n FLEWWARIN135 91Y. CITY COPY 'JUL-14-2003 10:35 ZENO'S FLOOR COVERING TzST IMPORT AUmm FluuccOVDAngs Cu"T. p 0 9" 1447 Dal= IUA 3UI22 253 564 3233 P.03/04 Moil, NUMUL 21862 IAS TLqr NUM33ER: 1340-2449 Dias 21.60 min 21.5 am 29.32 udn 1.4.0 wi Rpdmn 03 A23 min 0.75 A*=A(m (WrICAL IUDIA" FIX U2 0 TH W4ffo WlLYINDOTNE F OF MAWMV IDENT". OURUMMANDRIMMMAPPLYUNLT TO THF WXPLET13TOANDAM NOTNOM Ig CUM TO WWM THEY AK AM== AM THrJR a AM xvipaRls *M PON Ita UN MY of T, OR as" Ppo=M TNfqE jTTw A= Kffi"W%"rWAPfW*.LTHlRfPONTVAW ART"* l"LWl"ZWMTE3T'N3WR'M'h'u-My*Tp MINADYMMNOTO"EM I W CV"NWff*WTOANY0THMr 4p" Ry Am UrnMANUCUAMNLOURWAIS 014 rokM INFAM AAF NOY UNWA ANY CIROUMSPMeD TO 119 LQ VW Offl %w0MAT wwAWicft"n."ffl P103 A 91% sts-iA-�3� MAIM JUL-14-2003 10:35 ZENO'S FLOOR COVERING 253 564 3233 BERMES, W. #I I PVJWAUTP Ay f . ro, WX Ml 46 VAX 110 121 Thl MM VQM TZST WPORT AtPOWNUMBAL p n Ba L447 LAXMT piUMBIR: 1340-2449 GA 30722 DAM Wy 6,2002 ad tdor ro SWple wn submitted Twr nomun: swxs J)Dnffv (AM t0b w7dor=das&wWlnASTM Text Method E 662, 5 Smoke deaARY Of tUllag Wv rqiorhd bolow. D#Wkd dlu a ar ne rc%uth impm 2.5 WAIWOM $.I MV ou"M Furl: propm rummovolow: 117v poov, und" nm Wo of WdtT TZST MUMS: Ho VOTKW vlayl cmawwa n-ning mode Ass= 'MOW) 192 235 5p.;jfi, COW DadV N (Cx 192 gubmw A 4.13 MiA=g Dollft A) Erle 1 4 PM*At ot P. 04/04 ,DARCWTW,UbS&WSVINCrArROF?�GOA"Mq 0PA"ARINWIMHKA6 -ffiML"W'hTWv" )c O�u of- " cuag To WRDM MW AFF ADJAWW AM TdW OURU WMqWMMMA0P'LYO%Y Tmae U=ra *5 "Opom ARE FOR Im kx FMNEWRMVMwWMMAPM*04,TOgWQnT$A'o OF fAMAMPF100JUIS. r"M0M"XMDpTHghWZlWrl WRAOMI"O" V=jqA0VjRyWajv wE(ll9NW"FLKWl- C"UWAMN TO A"l C .AMOUR WAML 011R M". gpl OUR *jWQMAAKt N0TUNWANYGlf0AXWYMT05E LgMF4 - vw cup Wows AT wwKwiefWan-cam TOTAL P.04 9 , r7. qDATE RECEIV PERMIT EXPIRES sea CITY OF EDMONDS USE PERMIT ZONE NUMBER"S—e9yg�l CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRESS �Iq 00 3-VO PILZ 5) �PER NAMEINAME OF BUSINESS U16&110011�� UAa�o(__Pa4d, PLAT NAME/SUBDIVISION NO. Ise LOT NO. LID NO. MAILING ADDRESS I � I LID FEE $ OF WAY PER OFFICIAL STREET MAP TESCP APPMW �NBLICAGHT RW Permil Required CITY ZIP ITELEPHONE EXISTING PROPOSED Street Use Peffnh Req`d kupection Required Sidewalk Required ZZ5.- REQUIRED DEDICATION— FT _rO. UrxlerWaund I wmg required 13 NAME METER SIZE LINE SIZE I OF FIXTURES I PRV REQUIRED YES13 NO 13 ADDRESS REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE CITY ZIP TELEPHONE WAOS r1Y o 3 ENGINEERING REVIEWED BY DATE CC ADDRESS FIRE REVIEWED BY DATE CITY ZIP TELEPHONE 37/7 FED SY STATE LICENSE NUMBER EXPIRATION DATE CHfF ED BY VARIANCE OR CU SHORELINEORAOB# INSPECTION RECID BOND POSTED 26 13YEs ONO S -AC60t a&,aQz10*c0j 2 ztzZ.2- SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , [3 NEW 13 RESIDENTIAL PLUMBINGIMECH LOT COVERAGE REQUIRED SETBACKS (Fr.) REAR PROPOSED SETBACKS (FT.) FRONT LIRSIDE ALLOWED PROPOSE13 FRONT SIDE REAR 0 ADDITION COMMERCIAL X_ COMPLIANCE OR CHANGE OF USE -PARKING LOT AREA EWED BY DATE PLANNING REVI 0 REMODEL... MULTIFAMILY SIGN REQ`O PROVIDED REPAIR GRADING FENCE CYDS X FT) REMARKS. DEMOLISH 0 TANK OTHER 0 GARAGE RETAJNINGWALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE. BUSINESS OR ACTIVIM EXPLAIN: J�kCHECKED I A :� BY STRUCTION co yl / OCCUPANT GROUP M�L NUMBER OF NUMBER OF DWELLING CRITICAL AREAS TNUMBER SPECIAL INSPECTION JAREA OCCUPANT STORIES UNITS REQUIRED [] YES LOAD DFOCRIBE WORK TO BE DONE REMARKS PROGRMS INSPECTIONS PER UBC 108/FINAL INSPECTION RE D I AJ/J, -4 4 a Description Z V Z FEE Description FEE -Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CREC VESTED DATE Plumbing t" Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLI ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PEFUSSION. 2 Engr. Review PER ITAPPLICATIOW 180DAYS PERMIT LIMM I YEAR - PMROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMTION 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Depos; IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS. WASHINGTON. IT$ 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 Landscapelnsp. Total Amt. Due 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.' Recording Fee L Receipt # I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GWEN 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 CALL This application Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED k Building Official or his/her Deputy: and F-003 are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO TIC F R' IINSP TION receipt Is acknowledged In space provided. WORKMENS COMPENSATION INSURANCE MO RCW 18.27. 'SP IL-1k G 0 ALS 81 URE. DATE S 8;/T SI R DATE SIGNED 5 W, d 7 0 ------ RFCEA-' Y 13 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 ORIGINAL -FILE YELLOW. INSPECTOR PINK -OWNER GOLD -ASSESSOR 04/02 GREEN - ACCOUNTING PRESS HARD -YOU ARE MAKING 5 COPIES z 0 M