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20030594.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS 9Z-Vz-' CAVA, (��V-Fe_r MAILING ADDRESS r crr.x, ZIP ITE L L, I JZ'�ELPH]N cnyl "-twAnk) _' I NAME ADDRESS CITY ZIP ITELEPHONE ,11() � I I PERMIT EXPIRES US9 PERMIT ZONE C� NUMBER JOB SUITE/APT# ADDRESS V PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP AP 'ZV AW Parmittill ked Street Use Permit oq EXISTING — PROPOSED inspection Required Sidewalk Required REQUIRED DEDICATION— FT Underground Wiring required 13 METER SIZE LIN OF FIXTURES PRV REQUIRED YES 13 NO [3 z 15 REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE CBL 0 fj�rENGINEERING REVIEWED BY DATE Emommumm� FIRE REVIEWED BY DATE 1 T �31 9(p t fluNt: 1' '6' - 0 <t,61 0-1 STATE LICENSE NUMBER EXPIRA-PON DATE I C jq III PROPERTY TAX ACCO PARCEL NO. QO - -, Y - 9, Zi 2 NEW j�RESID�ENTIAL PLUMBING / MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE 13 REMODEL MULTIFAMILY SIGN GRADING FENCE XREPAIR CynS t — X FT) DEMOLISH TANK OTHER 0 GARAGE RETAINING WALL [3 FIRE SPRINKLER CARPORT ROCKERY ____FIREALARM (TYPE OF USE, BUSINESS OR ACTIVI'M 9WILAIN ked NUMBEA OF NUMBER OF DWELLING CRITICAL AREAS STORIPS UNITS NUMBERe DESCRIBE WORK TO BE DOME HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: 613 -31 Lo VESTED DATE THIS PERMIT AUTHORMES ONLY THE WORK NOTED. THIS PERMIT COVERS WOR770 BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN jCURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PFAMITAPPLICATION: IBODAYS PERMIT ILIUM. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK or PINK PERMIT FOR MORE INFORMATION 'APPLICAUL 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 CITYS 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- TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LkBQkCODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN$ COMPENSATOR V4URANCE AND RCW 18.27. DATE SIGNED b / ,?- -1� / D VARIANCE OR CU SHORELINEORADBN INSPECTION i BOND RIO D POSTED. 3 S YE 0 $_ — SEPA REVIEW SIGN AREA HEIGHT LETE , EXEMPT ALLOWED PROPOSED ALLOWED PROP S4ED EXP LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SID REAR 0 C 1 2 0 55 1 PAF� D LOT AREA I PLA-UNG Rg4W1ED_EFY REO'D T VIDED 16 -7 CHECKED BY I TYPE OF SPECIAL INSPECTION REQUIRED [3 YES GROUP OCCUPANT LOAD REMARKS I PROGRESS INSPECTIONS PER LIBC 109/FINAL INSPECTION REO'D Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due q& Recording Fee Receipt # APPLICATION APPROVAL CALL This application is not a permit until signed by the Building 01111clat or hlafher Deputy: and Foos are paid, and FOR INSPECTION receipt Is acknowledged in space provided. OFFICIALS SIGNATURE 0 E (A9 1,425) 771-0220 R E f / DATE 1 V99M WIN&ANYWARIATFAI W -6 gg= 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 NSPI6C CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0' 0 M M C MS 40 0 C � C M 10 � C _z CA 0 M M 0 0 Fn- C 0, z 0 M 0 M Wood 2960ON IN N LOT LINE STAKES MUST BE IN PLACE AT TIME OF FOUNDATION INSPECTION log evil APPROVED BY RE %,rl?~Trlqt CITY C01jDLAjL7 t.1 =,L]g ri IN34dO-GAM SS3WISM '!!� , I JUL 2 8 LLt") PERMIT WULOM eMwe24TW so qr 110 I a �D .DATE RECEIVED -7 PERMITEXPIRES I ' V 'Usff PERMIT ZONE CITY OF EDMONDS NUMBER CON9TRUCTION PERMIT APPLICATION JOB SUITEJAPT# ADDRESS SaOl 6 OWNER NAMEINAME OF BUSINESS PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. 4- 15 MAILING ADDRESS LID FEE S 7ESCP APPUNSCI PUBLIC RIGHT OF WAY. PER OFFICIAL STREET MAP FtW Permit R*quifad Street Use Permit Req'd CITY.W_ ZIP TE EXISTING - PROPOSED Inspectio Required '�FPHON% Sid&wa*nRequk*d 1 Underground C) 73 1 REOGIRED DEDICATION- FT IMg required NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YESC3 NO 13 ADDRESS REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE C3 ZIP TELEPHONE /VC 311E-= 1119 N 0 " — - — — — 401K I R4 E t) I 16Lal I ENGINEERING REVIEWED BY DATE I Cc oilTy ADDRUS_ eldrL 1717V 414+1 ht _5II�' FIRE REVIEWED BY DATE ILI ZIP TELEPHONE AVARIANCE STATE LICENSE NUMBER EXPI DATE CjW4qD BY OR CU ORELINEORADB# PISPECTION P2PND RP STED ,�ION P qq I �;L kD /16 YES 01 W M fbk SEPA REVIEW SIGN AREA 40, HEIGHT PROPERTY TAX ACCO PARCE NO. wwmvLE-TE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED z— EXP eQ Qn, , RSSI PLUMBING/MECH DENTIAL LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) NEW ALLOWED PROPOSED FRONT SIDE REAR FRONT UR Slog REAR COMPLIANCE OR ADDITION ct, MERCIAL CHANGE OF USE 0 0 1 'C"101 �2' 0 A q .. ALTIFAMILY REM08 SIGN _xs PA KING LOT AREA PLA�NG REVIEWED BY D f REQ`D PROVIDED arREPki"R GitADING FENCE wo C_ 104 ) - CYDS FT) X REMARKS OTHER DEMOLISH TANK oGARAGE RSTAINING WALL ci F RE SPRINKLER CARPORT ROCKERY FIREALARM ME OF USE, BUSINESS OR AC!rM VPLA�N ka&_� CHECKED BY TYPE OF Q0NSTR4CTION OCCUPANT GROUP V-Al NUMBM r OF CRITICAL NUMBE 0 r OF DWE#G AREAS I INSPECTION OCCUPANT SPECIA1 JAREA LOAD STORIES U1111 MBE R I REQUIRED [:] YES I - DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UIBC 108/FINAL INSPECTION RECYD VAILUAMON Description FEE Description FEE Plan Check e- State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % pow Building Permit City Surcharge VESTED DATE PLAN CHECK NO 31 U Plumbing Mechanical THIS PERMIT AUTHKMIZES OUWTHE WORK NOTED. THIS PERMFT COVERS WORK TO 1: BE DORE ON PRIVATE PROPOM ONLY. ANy CONSTRUCTION ON THE PUBLIC Grading a DOMAIN (CURBS, SIDEWALKS, DRIVEWAM MARGUEES, ETC.) WILL REQUIRE SWARATE PERMISSION. Engr. Review PERMrfAPPUCATIOft 100 DAYS IL PERMIT UMM I WAR - PRIMIDED WORK 18 STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF pim PERMIT FOR MORE INFORMATION NC BE OF HIS OR HER SPOLkIE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit -Its�APPUCA INTERIETGA 3R METO INDUANIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OFWHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY Fire Inspection Receipt # FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT 8 HALL NOT BE DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION., Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READTHIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECr AND THAT I AM THE OWNER OR THE DULY AUTHORIZED AGENT OF THE OWNqR. I AGREE M COMPLY WITH CRY AN6 STATELAWS REAULATING CONSTRUC- IM10,11MILLBEEMPLOY119 51 th ..This "14� pw"tiptu grippy a _LL 1011 'WVd fteis are paid, and = "Imm 'M TION; AND IN DOING THE, WORK AUTHOR EDrTH �Byjo )FTH dT %P IN, VIOLATION OF -THE LAQ2P-��OUE-D 7 E -WASHIN GTON RELATING Tp %CA . receipt I space provided. NSP ON - F6R ECW WORKMENS COMPENSATP-9 INIVRANCE AND RcW 18.27. OFFICIALS SIGNATURE b a S DATE SIGNED 1425) 771-0220 'R L E DATE ATTENTION EXT 1333 ME IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE PeCT CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR ""%4/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN -ACCOUNTING