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20030589.pdft I DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMENAME OF BUSIN?!� MAILING ADDRESS AIC S-r CITY ZIP ITELEPHONE f0Rff1*_S NAME ADDRESS CITY f I ZIP ITELEPHONE PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB SUITEIAPT# ADDRESS (62 2 e — z1_V_fE1 nommus� PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESGF APPCOVW RW PerMit R6qUI"d Street Use PeffnK Wd EXISTING — PROPOSED Inspectlon Required Side*a1kRaquired REQUIRED DEDICATION— FT UnderwmW WIM9 roquirod 13 METER SIZE LINE SIZ�_]�OF FIXTURES PRV REQUIRED YES 13 NO 13 REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE I NAME CBL# F, ko ENGINEERING REVIEWED BY DATE ADDRESS;0 , 0�... 7 f% ow _ . FIRE REVIEWED BY DATE toll CITY ��-tffp ZIP TELEPHONE STATE LICENSE NUMBER EXPIFLITIONRATE VARIANCE OR CU SHORELINE OR ADBN, INSPECTION 1$ BOND REO'D POSTED 113YES ONO SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAXICCOUNT PARCEL.N0. COMPLETE EXEMPT ALLOWED PROPOS ED ALLOWED PROPOSED , . , , EXP [j NEW P�IRESIDENTIAL PLUMBING/MECH LOT COVERAGE REQUIRED SETBACKS (Ft.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED 1911136 FRO L/R SIDE REAR ADDITION COMPLIANCE OR 0 COMMERCIAL CHANGE OF USE FFT a, z REMODEL 1:1 MULTIFAMILY SIGN PARKING L#11�40 'E 06 RECID I P CAP' ROVIDED ILL, REPAIR 0 GRADING CYDS FENCE ( X_FT) REMARKS DEMOLISH TANK T' _ OTHER oGARAGE RETAININGWALL 0 FIRE SPRINKLER CARPORT ROCKERY ____ _____FIREALARM (TYPE OF k8E, BUSINE88 OR A LVFWN: It- 7-AAF(_" b aM 0 - 6 CHECKED BY 10311111911511111 ON OCCUPANT 'GROUP IfA -1" r�' lmmr !IF__4 NUMBER OF NUMBER OF DWELLING I CRITICAL AREAS I SPECIkL INSPECTION JAREA OCCUPANf STORIES UNITS NUMBER I . 0� REQUIRED [] YES LOAD DESCRIBE WORK TO BE DONE 30 61 REMARKS PROGRESS INSPECTIONS PER USC 1108MINAL INSPECTION REG'D Ronto q4 KPA76rfe M?!tr-( bACPHI-1 Ad/f VALUATION a I $ er '� Description FEE Descriptlon FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLM CHECK NO: VESTED DATE Plumbing Mechanical TNis PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLM ANY CONSTRUCTION ON THE PUBLIC Grading 2 WILL REQUIRE 3 DOMAIN (CURDS. SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) SEPARATE PERMISSION. Engr. Review PERMITAPPIIJCATION: 1180DAYS PERMIT UMM I YEAR - PROVIDED WORK 16 STARTED WITHIN 180 DAYS Engr. Inspection BEE BACK OF PINK PERMIT FOR MORE INFORMATION -APPLICAK 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 EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY NOT BE FROM THE ISSUANCE OF T141S PERMIT. ISSUANCE OF THIS PERMIT SHALL Landscapelnsp. Total Amt. Due DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY C17Y ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Recording Fee pt # I HEREBY 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 AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid. and IN VIOLATION OF THE LApOXCWE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknovAedgod In space provided. WORKMENS Co��N INSUJ�Cj AND RCW 18.27. OF IGNj(rUR DATE I S �NATU NER 0 AGEN' IGNATURE DATE S191NED 771-0220 RELEASED By Dfft ATTENTION 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 iv ]U'Npkju ;Ex%,%jgjvj% 2. 3. RE.]NSpEcTED OUTSTAN Date ocaMLdoc.j:wmp.bjdg:formsl0/0l ISSUES - GRANT FINAL PROJECT APPROVAL Si 0 z 9 0 m :;:H m c Ma 0 80 c �c m mz 0 -n n � � ic m m a V5 0 o Fn C 0) rb ch MO Z z z 9 0 m I rn A 13 RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSIN?iq -re Z7 M MAILINGADDRESS _Ae Sr 6 3 a CITY ZIP TELEPHONE F.,�DPor/*3 4��&14101 11;y-a20-�? ADDRESS CITY NAME ZIP ITELEPHONE CITY zip df IP STATE LICENSE NUMBER CBL PERMIT EXPIRES' USE ZONE PERMIT C!58q NUMBER JOB SUITVAPT# ADDRESS � �E A i PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Tesco —Approved RW Permit RatpAred SUM Use PenrJl RWd EXISTING — PROPOSED--- impection Required Sidwm* Required REQUIRED DEDICATION— FT Underground WdIrigrequiretl 13 METER SIZE LINE Sl��7, OF FIXTURES PAV REQUIRED YES 13 NO C3 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE —1, fw%-$ 1 ENGINEERING REVIEWED BY DATE TELEPHONE FIRE REVIEWED BY DATE VARIANCE OR CU SHOREUNEORADBN I INSPECTION BOND EXPIF47TION)DATE 1[3 REO'D POSTED /m # 1/ 3 r?(Twa YES ENO I IS NEW RESIDENTIAL ADDITION COMMERCIAL 0 REMODEL 11 MULTIFAMILY REPAIR GRADING CYDS 0 DEmouSH ATANK oGARAGE CARPORT o RETAININGWALL ROCKERY (ME OF USE. BUSINESS IR A, N:. NUMBER !�JMBER OF SEPA REVIEW DIUM ^nC#% I HEIGH. COMPLETE , EXEMPT ALLOWED , PROPOSED ALLOWED PROPOSED EXP LOT COVERAGE PROPOSED SETBACKS (FT1 0 PLUMBING/MECH ALLOWED PROPOSED FIWWkM , FRONT LIR SIDE REAR o COMPLIANCE OR 3T BE PRESEN� FOR CHANGE OF USE PARKING ATE ,TANrLfjLFLEA SIGN RECID I PR lqy.CAPD o FENCE x FT) REMARKS OTHER FIRE SPRINKLER FIRE ALARM CHECKEDBY TYPEahC ON OCCUPANTI,'-) GROUP CRITICAL., ,*R-r AMC K'3 ffm OF ELLING AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE Pam? Aw dn? 20 '16 6, Lh�_m ae 7A111r, &C AT N Ll Ilo e F Vt, /v AWAV oi A P L�Ld,9-e /V I- le LOAD REQUIRED [3 YES REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge 1UN—CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMFT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS. SIDEWALKS, DRIVIEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPLICATION: 160 DAYS PERMIT UMM I MR - PROVIDED WORK IS STARTED WITHIN 100 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE 1"FORMATION N BEHALF OF FOS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit ;API= AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF N jT0 EDMONDS. WASHINGTON. ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OFWHATEVER. NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. 'ISSUANCE OF THIS PERMIT,SHALL NOT BE DEEMED TO MOD". WANE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapainsp. Total Amt. Due NOR LIMIT IN ANY WAY TH1f_ CITY'$ ABILITY TO F14FORCE ANY ORDINANCE PROVISION. - Recording Fee Receipt # 1U, 6 1 1 HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT, AND THAT I AM THE OWNER, C49 THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATIMG CONSTRUC- CALL This application Is not a permit until signed by the TION; AND IN DOING THE WOR AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED 30 Building official or hlslhar Deputy: and Fees iftre paid, and IN VIOLATION OF THE OF HE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknovdedged In space provided. WORKMEN'S CO CE AND RCW 18.27. 6 DATE S!FNED 1425) 0)", ,ffLGIALSISIG . UR DATE I F, 771-02AW%f RELEASED BY ATTENTIOR EXT 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'-ASSFSSOR 04/02 GREEN - ACCOUNTING PRESS HARD -YOU ARE MAKING 5 COPIES z 0 m m C m 40 0C �C- m 0 Z 0 _n m m DMA 0 0 Fit C (1) C CO) M 0 0 m