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20030587.pdfI DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS MAILING ADDRESS CITY ZIP La NAME ADDRESS CITY NAWE 4nort-fill-14 kl�vd. IQI� g, STATE LICENSE NUMBER K ES( , Of- f 0 0'7 ( PROPERTY T&X ACCOUNT PAREE No. TELEPHONE ZIP ITELEPHONE 1:1 NEW *,RESIDENTIAL 11 ADDITION 0 COMMERCIAL 0 REMODEL MULTIFAMILY KREPAIR GRADING CYDS [:] DEMOLISH TANK ciGARAGE RETAINING WALL CARPORT ROCKERY (TYPE OF USE. BUSINESS OR ACT;W N: NUMBER NUMBEIR OF OF WELLING I STORIES UNITS DESCRIBE WORK TO BE DONE 0- HEAT SOURCE GLAZING % PLAN CHECK NO: CBL # I -Vor PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB ADDRESS sun NA /0- 4t Ic r PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCF Approved AW Per" Required Stroal, '-a Permit Reld EXISTING - PROPOSED inspection Requited [3 Sidewalk Required 11 REQUIRED DEDICATION- FT underground n r ulred 0 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I I I YES 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE REVIEWED BY DATE FIRE REVIEWEAPkMUnftWUL=RVALVE(WV) 1EPHONE SHALL BE INSTALLED NEAR VARIANCE OR Cu [7EffiWWkM4ABIP ON BOND (PIRATION DATE CHOCIM) JBY REO'D POSTED 13YEs 13NO LVE SEPA REVIEW SIGN AREA M S HEIGHT SED I At I OWED PROPOSED TE . EXEMPT I ALLOWED . PROPO LOT COVERAGE LOT ' REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) )<"LUMBING / MECH LLOWEC ALLOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE REAR I 13 COMPLIANCE OR USE P1 EgSUANT UPC 005.2 z CHANGE OF PARKING IWAM ser"CRY094WIFF DATE SIGN RE101D kREMARKS PROVIDED im BE INSTALI-ED ON THE o F NCE E I I r gg MING X FT) L114h AN OTHER FIRE SPRINKLER FIRE ALARM CHECKED BY I TYPE IC OCCUFAN I GROUP C ITICAL A I ARE n OCCUPANT R REAS SPECIAL INSPECTION AREA NUMBER REQUIRED 1:1 YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC IGO/FINAL INSPECTION RECID LOT SLOPE % VESTED DATE Description Plan Check Building Permit Plumbing Mechanical FEE FEE State Surcharge Description City Surcharge THIS PERMIT ALITHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I: DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading a DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMiTAPPLICATION: 180DAYS IL PERMIT 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, DEFEND AND HOLD HARMLESS THE CITY OF a EDMONDS, WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # IALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapeinsp, Total Amt. Due 161 9 DEEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 NOR UMIT IN ANY WAY THE crrys ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- X1 Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I 14AVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION API FROVAL 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 AUTHORIZED THEREBY, NO PERSON WILL BE EMPUDYEo Building offlcial or his/her 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'S COMPENSATI��.27. OFFIC NAT E D TE SIG �,I IRE (OWhI I NT) DATE SIGNED IA13 'k-WAr-5) 771-0220 I&MIRMN/A VASE BY DfkT E 91"ITNTION EXT 1333 iV 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 YELLON- 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 an inspection was City of Edmonds, Engineering Division inspection log indicates The e line installed did not meet performed on August 8, 2003. At that time is was noted th rrect fitting was of 18". Also, an inco City standards for minimum depth requirements andout has been installed at the connection to the water meter. (A Water Service Line H made. closed for your reference.) No further inspection requests were en proval for the ant final ap The City of Edmonds, Engineering Division, is unable to gr water line installation until the corrections nave been made. 1- U VILIS 0 %, to be exposed verify depth, as well as the connection at the meter. Please call 425-771- 0220,.ext. 1326 to schedule your Etigineering final inspection. I may be reached at 425- .771-0220, ext. 1338 should you have any questions. Sincerely, qJeanie McConnell Engineering Technician �.'�Ic!wperjhit file'#200'-'05'8'7' IncorPorcied August 11, 1890 TO: DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: FIRE ENGINEMRING DIVISION DATE—lki� il z 9 0 M :q --fl ra --ri am a Ma 0 --lo 0 C 3! c m z co) 0 -n n m M 0 0 0 M C co) ic 0) M 0 Z M z z 9 0 m ..................... FOUNDATION: Footing...................... Wall Pier/Porch ............ ...... 'Fi4ifni Vall ng ........... m .:Slab Insulation .......... PLUMBING: m �V, ............. -R h'I ............... oug m Comm I'a mrial Qrc W HE I": AT GasTest ......... .......... �Gas Piping . ................. Equipment IN, (4*WRECEIVED 16 1 IIRES � T771)�LV USE PERMIT CITY OF EDMONDS ZONE NUMBER 'M3'j21?_ CONSTRUCTION PERMIT APPLICATION JOB ADDRESS Sun`E/A� OWNER NAMENAME OF BUSINE V 4AD ct F rot PLAT NAME/SUBDIVISION No. LOT NO. LID NO. MAILING ADDRESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP LID FEE S TE5 APWOV*d RW UptPr1r," RZIred Street Use Pomft RW CITY ZIP TELEPHONE EXISTING — PROPOSED - kopection ft"uked Skjowalk ReWked REQUIRED DEDICATION— FT Undw9mund — 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED TYE NAME 1 I s ICv31 N�Oj 13 �13 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE M CITY ZIP ITELEPHONE ADDRESS P-0 i-d", CITY STATE LICENSE NUMBER R es( , qf= t PROPERTY TAX -ACCOUNT PARCEL NO. YWS d4w, CBL N ENGINEERING REVIEWED BY pURSUANT TO ECDC 19.30M ECNOG I NPELE R N R E =WE I G VIE PUR FIRE REVIEWED BY SHALL BE INSTALLED NEA&E THE wAm SHUTOFF TELEPHO,N Y VARIANCE OR cu SHORELINEORADB# INSPE ON IS BOND I REO EXPIRATION DATE BY 7D POSTED ONO SEPA REVIEW SIGN AREA 13YES E HEIGHT ET 7 E . EXEMPT ALLOWED PROPOSED I At 10 D , PROPOSED 0 NEW RESIDENTIAL 0 ADDITION COMMERCIAL [:] REMODEL MULTIFAMILY *KREPAIR GRADING CYDS 0 DEMOLISH TANK GARAGE CARPORT [3 RETAINING WALL ROCKERY ITYPE OF USE, BUSINESS OR ACTIV N: NUMBER NUMBER OF OF DWELLING STORIES UNIT$ DESCRIBE WORK TO BE DONE LOT COVERAGE REQUIRED SETBACKS (Fr) PROPOSED SETBACKS (FT) KPLUMBING / MECH ALLOWED PROPOSED em 6M LIR SIDE REAR I 0 COMPLIANCE OR A: tASERVICE S FF rc CHANGE OF USE PARKING sfu"W" ATE IL 0 SIGN REOD I PROVIDI"AS IT 1"S I= BUMDING o FENCE X FT) REMARKS OTHER 0 FIRE SPRINKLER FIRE ALARM CRITICAL AREAS NUMBER vdtir- Ize -M , d' HEAT SOURCE GLA23NG % LOT SLOPE % P LAN C H EC IKIN::O�: VESTED DATE THIS PERMIT AUTHORIZES OWY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MAROUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPILICATION: 1180 DAYS PERUff UMM 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 MATURE, 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- TIGN; 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 WORKMENS COMPENSAT19NAV $IONA RE (OWN��. —] DATE SIGNED CHECKED BY ITYPE 00 OCCUPANT)M y wrrtrt�� I C Orb GRO SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD EMS Mh 11 $ 1 Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review 19epasit Plan Chk. Deposit Fire Inspection Receipt # I Landscape Insp. Total An Recording Fee Receipt # CALL FOR INSPECTION I (42v% ( 771-0220 EXT 1333 kopUCATIONAPI fROVAL This appileawn Is not a permit until signed by the Building otoclai or 1110ef DOPUIY: and Res are paid, and receipt is acknowledged in space provided. -F - PUPE / PFFIC ;1NAT E ?A 1, A;1� RECEASE y BY DXTE IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 4 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW- INSPECTO CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR GREEN - ACCOUNTING 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES a z 0 1 0 M =i 9 rn M C: M ,0 0 -n '3"� 9 M M 8 CO) 0 1-n MO z 0 ITI