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20030535.pdfI DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS MAILING ADDRESS 0J5;1r(, CITY ZIP TELEPHONE 45 9 mo �j P _< I NAME ADDRESS CITY ZIP ITELEPHONE PERMIT EXPIRES 1 1 L it) t — USE PERMIT ZONE NUMBER os JOB ADDRESS + LLC - 1qV1 SUITE/APT# PLAT NAME/SUBDIVISICIN NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP YESCIP Approved RW permit Required Street Use Paffnit Req'd EXISTING — PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION— FT Undarground Wiring required METER SIZE LINE SIZE I I NO. OF FIXTURES PRV REQUIRED YES 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE NAME i CBIL N V;;'e4;T r-mereff'recf1owu 17, 1 G 11 ENGINEERING REVIEWED BY DATE ADDRESS -79 15 , h,). G-7 15�i CITY ZIP TELEPHONE 96)61-oP4 -164-0-166 STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY - F �- 7 9 -'5 T F f:'l 0 08 R/ox- (0 NEW RESIDENTIAL PLUMBING / MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY x SIGN REPAIR — GRADING CYDS FENCE ( X FT) DEMOLISH TANK OTHER GARAGE CARPORT RETAININGWALL ROCKERY 0 F RE SPRINKLER FIRE ALARM (TYPE OF USE. BUS_INESS_ORACT1Vn[Y),EXfLAIN1:. I M NUMBER v NUMBER OF F CRITICAL OF DWELLING AREAS U 4 STORIES qeoo!!� NITS NUMBER DESCRIBE WORK TO BE DONE -r;� �F_'x 1!5'Tj �d L' J lr--.., 0 1 ag HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: VESTED DATE THIS PERMIT AUTHORMES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC DOMAIN (CUR13S. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 180DAYS PERMIT LIMM I 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 CnYS 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 T OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AgSlErN COMPLY W CITY AND STATE LAWS REGULATING CONSTRUC- TIOA: AND IN NG TH ORK A TH IIZEC THEREBY NO PERSON WILL BE EMPLOYED ILAT;e. IN VIC 10 OF THE 1 0 C BE 9f THE STATE OF WASHINGTON RELATING TO COM 1 R911 WORKM . EN' COMPENS$N I Kttt AND RCW 18.27._ A_� _0�/��j WE S7 SIGNATtl"�OR tAGE IG�ED '0 FIRE REVIEWED BY DATE ::52!!L L�_ ) r- 03 VARIANCE OR CLI SHORELINE OR ADB# I INSPECTION 1$ BOND REO'D POSTED [3YEs 13NO SEPA REVIEW SIGN AREA HEIGHT COMPLETE I EXEMPT ALLOWED , PROPOSED ALLOWED , PROPOSED. EXP LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR z PARKING LOT AREA PLANNING REVIEWED BY DATE REO'D I PROVIDED J REMARKS I CHECKED BY Typ� �CJSTRUCTION CODE OCCUPANT I lAn 1r, 50 GROUP M) SPECIAL INSPECTION AREA OCCUPANT REQUIRED [3YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1108/1'INAL INSPECTION REO'D Description FEE Description FEE Plan Check tate Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Recording Fee Receipt CALL FOR INSPECTION (425) 771-0220 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 acknoModgad In space Provided. SIG T E DATE (,4K41 17 'V- I tn� to ZA —Ilqlp nl_� B�EdS'�'_t4 I I DATE ATTENTION I/ - 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 TO: DATE: PERMIT COORDINATOR, BUILDING DIVISION —FIRE.DEPARTMENTDkTE —ENGINEERING DIVISION DATE- -----PLANNING DIVISION DATE KIAMIM -S 7-A70/0 folAof- PROJECT AA&2WC&--d&2 ADDRESS— 5;-s (0 PERmrr.#Q-b143- &4h'M,5r ---."B# —DATE INSPEC DESCRIPTION OF WORK TO BE INSPECTEDA—IQA(P�tf A field ection was conducted to determine compliance with approved plans. Final approval denotes that Insp tj ��r6 are' objecti ns no o from the above signed Department to the granting of H*%, --Final approval of the described work erformance Bonds associated with the project may be released PC- /--Orz —P GRANT FINAL PROJECT APPROVAL GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED .___--FAELED FINAL INSPECTION - OUTSTANDING ISSUES 2. 3. __RE_INSpECTED OUTSTANDING ISSUES. GRANT FINAL PROJECT APPROVAL ocaprvl.doc.l:temp:bldg:for=6198 z M =i:fl M C M 0 80 C 1 r. X M M Z 10-1 z -4 X Cn 0 -n n M M am- 0 0 Fn Co MW MO M z W z 9 0 M I q CATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME(NAME OF BUSINESS MA12LGWC612 MAl-Ae�Prz MAILING ADDRESS 6;P' CITY ZIP TELEPHONE 45 12 _< I NAME ADDRESS CITY ZIP ITELEPHONE NAME CBL# 0 F::)K1&rt0-rECT10k))U1 1A ADDRESS -791;- is). Ly-7 CITY ZIP TELEPHONE _TEI -164 45; ci on, STATE LICENSE NUMBER EXPIRATION DATE T7,-�'e--TF el 0-3-C, Cu" -9 PROPERTY TAX ACCOUNT PARCEL NO. NEW RESIDENTIAL ADDITION COMMERCIAL REMODEL MUL11FAMILY REPAIR GRADING CYDS DEMOLISH TANK [3 GARAGE CARPORT E3 RETAINING WALL ROCKERY r OWE OF USE, BUSINES 014 ACTIV_" EXPLAI r:\,-1 :0 6MI NUMBER MBER OF OF �ELLING DESCRIBE WORK TO BE DONE fK5 1!;;." 0 6 1 e re - 5x I L::� 1 1 PERMIT EXPIRES USE PERMIT ZONE NUMBERWLLS-35 JOB SUnT-:/APT# ADDRESS q'V4 L_ PLAT NAMEISUBDIV`ISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7ESCP ApprOM RW PeffrAt R"Wrod SU" use POMIN ROO EXISTING — PROPOSED Inspwtson 1"Wred ffidewa* RoWired REQUIRED DEDICATION— FT Undwomund Wiring requinw 13 METER SIZE LINE SIZE I I NO. OF FIXTURES PRV REQUIRED YES 0 NO 0 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING DATE FIRE REVIEWED BY DATE ul cc 66 03 tV?ARIANCE OR CU D BY SHOREUNEORADB# I INSREE(71ON )D BOND POSTED OyEs ONO IS $EPA REVIEW OMPLETE . EXEMPT C COMPL SIGN AREA ALLOWED . PROPOSED I HEIGHT ALLOWED , PROPOSED I LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) LOT COVERAI 0 PLUMBING/MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT LJRSIDE REAR 9 LLOWED PRO, COMPLIANCE OR 0 2 CHANGE OF USE 9 PARKING LOT AREA PLANNING REVIEWED BY DATE 0 SIGN REGYD I PROVIDED rl FENCE LREMARKS L_J ( X FT) _ _ OTHER FIRE SPRINKLER 0 FIRE ALARM CHECKED BY I TYPE CO STRUCTION CODE OCCUPANT CRITICAL K)14� P3 9:2 GROUP M I AREAS SPECIAL INSPECTIOJNA—RE OCCUPANT NUMBER REQUIRED [:] :S LOAD ]REMARKS I PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION RECtO 99 vr_-r -95;;Irla UL-> tv) 11_71L -5T01 I HEAT SOURCE I GLAZING % LOT SLOPE % PLAN CHECK NO: ()?2 -L�2E VESTED DATE THIS PERMIT AUTHORLMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROpEITrV ONCK ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC -)WILL REQUIRE SEPARATE PERMISSION. ERM APPLICATIOW 180 DAYS PERWT LIMir I YEAR - PROVIDED WORK 15 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, APJSING 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 A131UTY TO ENFORCE ANY ORDINANCE PROVISION.' I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN 18 CORRECT, AND THAT I A" TM OWNER OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AM COMPLY WITH, rry AN6 STATE LAWS REGULATING CONSTRUC- TION; 01 THE WORK AJU15HPIMED THEREBY. NO PERSON WILL BE EMPLOYED ANDIN r D TI IN VIOLATIP�of HE CqD THE STATE OF WASHINGTON RELATING TO CC WORKMEN' COMPEN N IN E AND RCW 18.27. SIGNATU��RJ�W�E �.�DAT�E SIG D Description FEE Description FEE Plan Check e7A� State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt III Landscapelnsp. Total Amt. Due Recording Fee Receipt 0 CALL FOR INSPECTION 771-0220 APPLICATION APPROVAL TWs oppficatkm Is not a permit unM signed bY the EMIding OftW of hisrher Deputy: and Fees are pald. and recAlpt Is acknowledged In spaCS PfaMOd. 0 Fm sia AT =M, ' L f f DATE ATTENTION V - M 1 33 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL t 1 / 0 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