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20030536.pdfM DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS _fzQh&X=X \JAYX0j7-__ MAJLING ADDRESS -W LAt&re_J ZkL_,e_4- CITY ZIP TELEPHONE G 1�,�ko V-� NAME ADDRESS CITY ZIP ITELEPHONi NAME 7 Y—Faug- QPV%-&ra_VC:TTo,-) CBL aepmr S� ADDRESS loON kiaQ LA-) L t,) 1�� fNv V CITY ZIP TELEPHONE 1�0 STATE LICENSE NUMBER EXPIRATION DATE KVckk&C,"U(PPP to 1rdo4 PROPERTY TAX ACCOUNT PARCEL NO NEW RESIDENTIAL ADDITION COMMERCIAL MULTIFAMILY REPAIR [j GRADING CYDS DEMOLISH TANK oGARAGE RETAJNINGWALL CARPORT ROCKERY (FYPE OF USE, BUSINESS OR ACTNq EXPLAIN: 91%)WO1 A A-& _V% i��11 DWELLING � NUMBER N OF UNITS DESCRIBE WORK To BE DONE V-0 btP_0V_k0&0.Ae_ 1,)oj I-) TA PLUMBING/MECH ri COMPLIANrCE OR CHANGE OF USE 0 SIGN 0 FENCE ( _ X_FT) OTHER F RE SPRINKLER FIREALARM W_ � 13 1 1 PERMIT EXPIRES �1&_Z2Y USE ZONE PERMIT NUMBER2_0�0 - 053 JOB LL�z SUITE/APT# ADDRESS E_ PLAT NAME/SUBDMSION NO. LOT NO. LID NO. A LIDFEES PU13L]C'RI'GHT OF WAY PER OFFICIAL 'STREET MAP IESCP Approved AW Pan" R,.k. EXISTING PROPOSED stre at Use Peffnit Req'd Impaction Recluked Sidewalk Required REQUIRED DEDICATION— FT Undamround VAMpaquired 13 METEI SIZE NO. OF FIXTURES PRV REQUIRED I YES E3 NO 13 z KS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE IN"AWLIM, 99LA= FIRE REVIEWED BY DATE I , U rf VARIANCE OR CU SHORELINE OR ADB# INSPECTION— REQ'D 113YES PBOND OSTED No NO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED , EXP P;SIJA I . . J= I LOT COVERAG kMM FSE ED SETBACKS (FT.) ALLOWED PR ffrifq LIR SIDE REAR ZTIM 0 z TKW A ITEh=s. z PARKING I LOT AREA PLANNING R DATE ------ 19 1 REO'D I PROVIDED 06 CHECKED BY I TYPE Rff:q CRITICAL AREAS SPECIAL INSPECTION NUMBER REQUIRED 0 C YES tREMARKS JAREA 14 P J( PROGRESS INSPECTIONS PER UBC OCCUPANT GROUP 41 OCCUPANT LOAD I INSPECTION REO'D Description FEE Description FEE Plan Check State Surcharge ;H�EAT 4 GLAZING % LOT SLOPE % Building Permit City Surcharge P p LAN CHECK NO: VESTED DATE Plumbing 1: THIS PERMIT AUTHORMES ONLY THE WORK NOTED. THIS P E RMIT COVERS WORK TO Mechanical 2 BE DONE ON PRIVATE PIROPERiTV ONLY. ANY CONSTRUCTION ON THE PUBLIC :3 DOMAIN (CURDS, SIDEWALKS, DRWMAYS, MARQUEES, ETC.) WILL REQUIRE Grading I- SEPARATE PERMISSION. PERMIT APPLICATION: 180DAYS Engr. Review PERMIT ILIMIr I YEAR - PROVIDED WORK IS STARTED WITHIN IGO DAYS; SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection 'APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIF7X DEFEND AND HOLD HARMLESS THE CITY OF Fire Review Plan Chk. Deposft EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISIMG DIRECTLY OR INDIRECTLY Fire Inspection Receipt # FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT HE 9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due MIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION Recording Fee Receipt # GIVEN 13 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- APPLICATION APPROVAL TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL This application Is not a permit until signed by the IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN' 8 C MPEN 'URANCE AND RCW 10.27. FOR INSPECTION Building Official or his/her Deputy: and Fees are paid, and receipt Is acknowledged In space providod. . (OWN,7 AGE DATE SIGNED ._ V 7-6 - 03 (425) OFFICI fURE D 7 7;,V 771-0220 -mum N T", 1 TION_ EXT 1333 RELEASED BY 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 04/02 PINK -OWNER GOLD -ASSESSOR PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING Z 0 0 M OM C M 0 C M M rA 0 M M C R. r. r): M 0. z 0 41 0 M a PLUMBING� Undei6rouna 'jr��:'.",,i. 0 iclaVFinal', VY ....... 17, EXTERIOR SHEATHING n _!NAILiNd ....... ............... .......... FLOOR FRAMING... -FIRST INSULATION . . . . . . . . . . . . . . . . . . . . . I DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION VNER NAME/NAME OF BUSINESS 3 MAILING ADDRESS TELEPHONE CITY zip NAME CITY ZIP ITELEPHONE NAME r_-V-0U9_ C RePA-ilf-Si ADDRESS 10 cpt k%F 0 LAj t\ 01�5 f* \k-\CL%\j LE - CITY ZIP I TELEPHONE I DkWlt-Sk 9'9 2�F`11 (0 K X_kOO) to 0? STATE LICENSE NUMBER 0:11 PROPERTY TAX ACCOUNT PARCEL NO. NEW ADDITION REPAIR [:].DEMOLISH 43GARAGE CARPORT r- M?E OF USE. OU RESIDENTIAL COMMERCIAL MULTIFAMILY GRADING CYDS TANK RETAININGWALL ROCKERY OR ACTIVfTY1 EXPLAIN: lw-kf -� I C 0-0 i� NUMBER NUMBER dF OF 016VELLING STORIES UNITS DESCRIBE WORK TO BE DONE M F00 It M, '7 1 1'�' PLUMBING I MECH COMPLIANCE OR CHANGE OF USE SIGN rj FENCE ( — X—FT) OTHER SPRINKLER oFIRE FIREALARM PERMIT EXPIRES la 1 76-S. PERMIT I ZONE NUMBER JOB __7 _V' - ADDRESS r / 1 11 // //�, // , <, J — SUMAFT# PLAT NAME/SUBDIVSION NO. LOT NO. LID NO. LIDFEE$ PUBLIC'R1'GHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW ftrffM Required Street Use Permit Wd EXISTING — PROPOSED InspectIonfloquired Sidewalk Flaquiroc! REQUIRED DEDICATION— FT UndwWWW VAringroquired METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES 13 NO 13 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE APUSSUREREGULATORVALVERW FIRE REVIEWED BY TM WATM SHUTOFF DATE ul cc M VARIANCE OR CU SHORELINEORADB# I INSPECTION I BOND RECI'D POSTED 13YES ONO S SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT ALLOWED . PROPOSED I ALLOWED . PROPOSED ' LOT COVERAGE gJEED SETBACKS (Fr.) LOWED p LIR SIDE REAR AL 4 f.AW I S PARKING W 7XffVAj)jN&TE RECYD I PROW F"4"w CHECKED BY OCCUPA!�� JTYPE2�/j GROUP 1270 CRITICAL AREAS SPECIAL INSPECTION ]REMARKS OCCUPANT NUMBER JAREA REQUIRED LOAD ROGRESS INSPECTIONS PER UBC 100/FINAL INSPECTION RECfD HEAT 4OURCE I GLA23NO % LOT SLOPE % a b (I A'S I PLAN CHECK NO: VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMITAPPLICATION: IGO DAYS PERMIT LIMrRI YEAR - PROVIDED WORK 18 STARTED WITHIN ISO DAYS SEE BACKOF 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 C4AIMS 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 THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPIY WITH CFTY AND STATE LAWS REGULATING CONSTRUC- TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABQJLCODE OF THE STATE OF WASHINGTON RELATING TO WORKMENS COMPENSAVOR4MURANCE AND RCW 18.27. D E SIGNED AT 7-ig 03 Description FEE Description FEE. Plan Check State Surcharge Building Permit City Surcharge o__ Plumbing 100� Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION 1421122% 01 771-02,20 EXT 1333 APPLICATION APPROVAL This application Is not a permit unfit signed by the Building Official or his/her Deputy: and F0801 ate paid, and receipt Is acknowledged in space provided. OF FICW* SIGqURE %TE I -711 S11) R RELEASED BY DAT 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 GREEN 04/02 - ACCOUNTING PRESS HARD -YOU ARE MAKING 5 COPIES 0