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20030545.pdfI DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF OU13INEIIS "ILI ca I eA-4 MAILING ADDRESS % a P�Q CITY zip TELEPHONE F ,Ar)j.(MjS qtp ,p I 4J96�-771-,;e NAME ADDRESS CITY NAME M E - ADDREia CITY STATE LICENSE NUMBER PROPERTY )4%ACCY 'op ZIP TELEPHONE CBL # TELEPHONE ZIP EXPIRATION DATE I CHECKED BY [3 NEW RESIDENTIAL ADDITION COMMERCIAL REMODEL MULTIFAMILY REPAIR 0 GRADING CYDS DEMOLISH TANK oGARAGE RFTAININGWALL CARPORT ROCKERY (TYPE 0 USE, BU§PSS OR ACPITY) EXPLAIN: 34/=_ 6alaw — NUMBER NUMBER OF OF )WELILING .ST1 NITS DESCRIBE WORK TO BE DONE , &-fa ok t,N- - -, & ill Lnji PLUMBING / MECH COMPLIANCE OR CHANGE OF USE S113N FENCE ( — X_ FT) OTHER FIRE SPRINKLER PRE ALARM PERMITEXPIRES USE ZONE PERMIT NUMBER JOB ADDRESS 117 SUITFJAPT* 6)6,0141)l C, /TV(, mo� PLAT NAME/SUBDIVISION NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP ApPrOved RW PerrM Required Sum Use Permit Roq�d EXISTING — PROPOSED Inspection R*qL*od Sidewshr Required REQUIRED DEDICATION— FT UnderWound w1mg required 13 METER SIZE LINE SIZE 70. OF FIXTURES PRV REQUIRED YES13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE REVIEWED BY DATE FIRE REVIEWED BY DATE LU W 0 -VA—RIANCE OR CUI SHORELINE OR ADB# INSPECTION BOND REO'D 113YEs POSTED 1$ (03NO SEPA REVIEW SIGN AREA HEIGHT COM13LETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP I , I LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR DATE IKINC PAR I REO'D PROVIDED LOT AREA I PLANNING REVIEWED BY 06 CHECKED BY ITYPE OF CONSTR COOE E)UE;Url GROUP CRITICAL AREAS SPECIAL INSPECTION EA OCCUR . NUMBER REQUIRED 0 YES LOAD REMARKS I PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REaD A01/124- /V erN Description TEE Description FEE af, — 5V 41 ()o chwip- Jm gagi&k- r1q, � TbLMLnd7 Plan Check State Surcharge H9T —SOURCE GLJONG % I LOT I&OPE % Building Permit 30 1 City Surcharge PLAN CHECK NO: VESTED DATE Mechanical THIS PERMIT AUTHOF12ES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading M DOMAIN (CURW, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. t Engr. Review PERMIT APPLICATION: ISODAYS PERMIT UMM 1 YEAR - PROVIDED WORK IS STARTED WITHIN 18D 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 -6 FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE Landscape Insp. Total Amt. Due X5 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITVS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- # Recording Fee I Receipt I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL - AND THAT I AM THE OWNER . OR THE DULY AUTHORIZED AGENT OF GIVEN IS CORRECT, THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC. CALL This application Is not a permit until signed by the 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 FOR INSPECTION Building Official or his/her Deputy: and Fees are paid, and receipt is acknovitiodged In space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. OFFICIALS SIGNATURE DATE BIG= AGENT) DATE SIGNED 7-2116_13 771-0220 IRELEASE DATE ATTENTION M 1333 IT IS UNLAWFUL TO USE OR OCCUPXBUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- OR GIN &LILE - YELLOW - INSPEC(OR CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109 PZ NER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 9 0 M :4 T, M 4 0 C M ,0 Z M F. M C) z 0 -4 0 M Li7,7 M- I I q,;DATE RECEIVED A PERMIT EXPIRES is USE PERMIT ZONE CITY OF EDMONDS . NUMBER JOB /APT# SUITE CONSTRUCTION PERMIT APPLICATION ADDRESS //7 �aL OWNER NAME/NAME OF BUSINE SS %, PLAT NAMEISUBDIVISION NO. LOT f4b. LID NO. 16 00.01 eA.4 MAILING A13DRESS LID FEE S TUC PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Flo Wed RW e)W rw-azc. Ay'� S"M Use Parrith Rwtd CITY zip TELEPHONE EXISTING — PROPOSED inspection Required Sidewalk Required REQUIRED DEDICATION— FT UnderWound Wkirg roquk*d 13 NAME METER SIZE LINE SIZE f NO. OF FIXTURES PRV RE13UIRED YES E3 NO 13 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLJDRAINAGE CITY ELEPHONE NAME CBL# F 19ul,%w 1 ENGINEERING REVIEWED BY DATE ADDRESd_ z FIRE REVIEWED BY DATE 0 CITY ZIP TELEPHONE IEL —4 VARIANCE OR CU S ORELINE OR ADB# INSPECTION BOND M STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY REO'D OSTED 10YEs is 13NO SEPA REVIEW SIGN AREA HEIGHT ALLOWED PROPOSED ALLOWED PROPOSED PR MPT OPE ACC L COMPLETE , EXE , EXP M LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) NEW RESIDENTIAL PLUMBING MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR 8 9 C ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY -DATE REMODEL 0 MULTIFAMILY SIGN PROVIDED M REPAIR GRADING o FENCE CYDS X FT) REMARKS ZL DEMOLISH TANK [:] OTHER 6-41,1 - 17AW b*/ :2 0) . GARAGE RETAINING WALL [3 FIRE SPRINKLER ROCKERY FIRE ALARM CARPORT i do 0 'n OM QrbOSE. BUMPSG;o4T-ACr"X(PLA1N.-1�� t"�� :. I*".- ;A JtL.. CHECK!ED BY WOE IF COASTRU N IC loccu ki- 7— M M 'JE GRO NUMBER CRITICAL UPX. NUMBER OF OF DWELLING AREAS SPECIAL INSPECTION JAREA OCCUPANT LOAD C3 0) 0 0 rn STORIES NUMBER REQUIRED UNITS n C: C* DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 1 08/FINAL INSPECTION REaD 6 M C)_1 arr and 4�11011_ /V wLnia MA20 vALtfAnON AL $ Description FEE Description FEE on -eqiCjinj Plan Check State Surcharge __4 0 HEAT GLAZING % I LOT 41LOPE % Building Permit 30 C it If M PLAN CHECK NO: VESTED DATE V =30M Mechanical THIS PERMIT AUTHORMFS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPEM ONLX ANY CONSTRUCTION ON THE PUBLIC - Grading 2- 52 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE t: SEPARATEPERMISSION. PERMIT APIRUCATIOW 1160DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 100 DAYS Engr. Inspection SEE BACK OF PINK PEnmff Fort MORE INFORUATION ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit ;APP N I=Eii, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS. WASHINGTON, ITS OFFICIALSi EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt N I CLAIMS FOR DAMAGES IF WHATEVER 11, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapeinsp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE Crrr8 ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # 2jL0 C/ I HERE13Y 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 0TY AND STATE LAWS REGULATING CONSTRUC- This application Is not a permit until signed by the CALL TION; AND IN DOING THE WORK AUT14ORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Offlclal or Nether Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknovAodged in space provided. WORKMEN$ COMPENSATION INSURANCE AND RCW 18.27. OFFICIALS SIGNATURE DATE SIGNA DATE SIGNED (42, =EE��AGENT) JV 3 771-022 0 ELEASED DATE ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPYdAFBUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFi- ;R,�Gl FILE YELLOW - I INSPE&OR'_ I/ CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 P NKC�6WNER GOLD - ASSESSOR 04/02 NG 5 COPIES GREEN ACCOUNTING PRESS HARD -YOU ARE MAKI