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20030555.pdfTDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NA OF BUSINESS ,/- - - Z 11FA 4 NAME ADDRESS CITY ZIP I TELEPHONE NAME ICBLN PERMIT EXPIRES USj_ PERMIT ZONE NUMBER Aa3 joB SUITI ADDRESS P4-,7n.,O�; PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required Street Use Permit Raq'd EXISTING - 'PROPOSED Inspection Required Sid&watk Required DEDICATION- Fr Underground REQUIRED Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I 0 1 YESE31N'O 13J REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE REVIEWED BY DATE DATE us IRE REVIEWED BY cc CITY z1g* T -_LE PHONg1r BOND POSTED VARIANCE OR CU SHORELINEORAJ INSPECTION TfATtE LICENSE NUMBEIT ON 0 H REO'D .A::r. I SIGN AREA [3YEs ONO 19 HEIGHT 1 11 SEPA REVIEW PhOPERTY T ACCO NO. COMPLETE I EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP LOT COVERAGE REQUIRED SETBV PWSED SETBACKS (Fr.) NEW jjeESIDENTIAL PLUMBING MECH ALLOWED PROPOSED FRONT SIDEIW f-MLSIDE REAR COMPLIANCE OR MUST BE' REsE 0 ADDITION COMMERCIAL 0 CHANGE OF USE ---- I I bOCR PARKING L"13% K+ft. %D 1:1 REMODEL MULTIFAMILY 0 SIGN REaD PROVIDED 6AIP [3 FENCE 0 REPAIR GRADING CYDS FT) REMARKS 0 DEMOLISH ,.*TANK OTHER ED GARAGE ING WALL FIRE SPRINKLER CARPO [3 RETAINRY RT ROCKE 0 FIRE ALARM (TYPE OF USE, BUSINESS OR ACT N: CHECKED By ITY INS I r I ��zc a_> NUMBER NUMBER OF CRITICAL OCCUPANT OF DWELLING AREAS SPECIAL INSPECTION AREA LOAD STORIES UNITS NUMBER REQUIRED [3 YES DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REO'D VALUATION Description FEE DescriptIon FEE Plan Check State Surcharge .—VEA—T SBURtE 3LAZING Y. LOTts1hpt Building Permit City Surcharge PLAN CHECK NO: VESTED 13ATE Plumbing I I Mechanical THIS PERUFT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLY. ANV CONSTRUCTION ON THE PUBLIC Grading I DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. Engr. Review IF PERMIT APPLICATION: 1130DAYS PERMIT UMM I YEAR -PROVIDED WORK IS STARTED WITHIN IBODAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 1APPLICAK ON BEHALF OF HIS OR HER SPOUSE, HEIRS, AS -SIGNS AND SUCCESORS Fire Review plan Chk. Deposit IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF 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 Landscape Insp. Total Amt. Due 0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' =I — Recording Fee Receipt # I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAI- GIVEN 19 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 until signed by the Building Official or hisfhor Deputy: 16, d Foos are paid, and E EBY, NO PERSON WILL BE EMPLOYED TION; AND IN DOING E WORK, 'RZ R IN VIOLATION OF THITE_ C; ;4STATE OF HINGTON RELATING TO LABOR TE F FOR INSPECTION receipt is acknowledged In space provided. 0 WORKMEN��o�piA-nn RCW 118.27. 7 1425) OFFICIALS S U DIV E 7/216� SIG DATE S % __ � 771-0220 i S DATE/ - REL16:4ASED "�N A 7 EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDIN:70R STRUC'TURE 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 ACCOUNTING ARE MAKING 5 COPIES G4/02 PRESS HARD -YOU FINAL PROJECT APPROVAL FORM TO: z 9 0 =i:ii vi -4 10 m c MO 0 80 c ic MM MZ 10-4 0 -n n m m 065 0 r- 0 M C 0) c cl) M 0 Z z z 9 0 m 2. 3. RE-INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Si ocaprvLdoc.l:temp-bldg:fo=310/01 op ;g rT m r 0 c RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS I NAME ADDRESS CITY ZIP ITELEPHONE NAME,:,�F jCBL# TELEPH,ONF,- r PERMIT EXPIRES — USF1 PERMIT I ZONE NUMBER �Lo JOB ADDRESS tjulf7� YOWP,�� C;2v PLAT NAME/SUBDIVISION NO. T NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP OM 7FiEVsc*=8d Stmet Use permit Req'd EXISTING — PROPOSED inspection Fisquired Sidc*s* ReWired REQUIRED DEDICATION— FT underground WMg requVod METER SIZE LINE SliTj I NO. OF FIXTURES PRV REQUIRED YES 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE By DATE REVIEWED BY DATE 111 I IM, VARIANCE OR CU SHOFIELINEORADB# I INSPECTION I BOND REO'D POSTED 13YEs 13NO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE - EXEMPT ALLOWED . PROPOSED I ALLOWED . PROPOSED NEW ;k<SIDENTIAL PLUMBING/MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR I I ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE BE 1=10= alklanLIA 0 REMODEL MULTIFAMILY 0 SIGN PARKING REQ'D DED PROVI LOT AREA fIFEMARG MM OrEAML DATE , �p 'A f MENT FOR o REPAIR GRADING CyDS [3 FENCE ( X FT) REMARKS -T CAP DEMOLISH -4-TANK OTHER oGARAGE RETAININGWALL 0 F RE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS OR A N: CHECKED BY TY ION OCCUPANT I GROUP NUM13ER OF NUMBER OF DWELLING CRITICAL V4_ AREAS SPECIAL INSPECTIC OCCUPANT STORIES UNITS NUMBER REQUIRED [] YES LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REaD $ Description FEE Description FEE Plan Check State Surcharge VOT SCURCE 0-0, GC4bNG LOUPPE %_ Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIII PERMIT AWUTHORUES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE Off PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CUM, SIDEWALKS. DRIVEWAYS. MARQUEES. ETC.) WILL REQUIRE SEPARATE PFRMISSIOPL Engr. Ravi PERMIT APPLICATION:' 180 DAYS PERUIT UMM 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, DEFENMAND HOLD,tiARMLESS, THE CITY OF EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLbms, AND AGENTS MOM ANYtAND Fire In6p'ectlon &17M Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY I FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE 'Landscape Insp. Tbtal Amt. Due DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CRYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee j,Recelpt # I HERESY 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 until signed by the TION; AND IN DOING THE WORK AUTLIORIZED FiERESY. NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: end Fees are paid, and IN VIOLATION OF THE LABOR e60 OF THP! STATE OF RELATING TO FOR INSPECTION receipt Is ack"edged In space provided. 7HINGTON WORKMEIT�COMPE WCj AbIb RCW 18.27. OFFICIALS S�ON U D E SIG DAT 8 (4-25) 7/ /�ht 7o�_ 72, 771-0220 RELEASiDiff"T DATE/ 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 '04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 q 0 M