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20030598 (3).pdfI DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OW91ffITT% MEINAME OF BUSINESS MAILING ADDRESS r9—j? 76' 7 4re— 1,sllo� aCITY ZIP TELEPHON9?06V , 1176 /7 I's 99b9b I _S_� — ��() NAME ADDRESS CITY ZIP I TELEPHONE ADDRESS CITY ZIP I TELEPHONE STATE LICENSE NUMBER CHECKED BY PROPEPIJTA& ,�CCOUNT F! PA CEL,�W. �3 600 30YOcl NEW ;4RESIDENTIAL PLUMBING ir MECH 0 ADDITION 0 COMMERCIAL o COMPLIANCE OR CHANGE OF USE REMODEL 0 APARTMENT C:1 SIGN REPAIR [3 GRADING CYDS 00 FENCE ( /4_�_ X FT) [3 DEMOLISH 0 TANK OTHER o GARAGE CARPORT 0 RETAINING WALL 11^�Wtnnv RENEWAL (TYPE OF USE, B Z909 NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE llda,4 �7 HEAT SOURCE PLAN CHECK] GLAZING % a 40 USE ZONE JOB PERMIT EXPIRES PERMIT NUMBERr&I E/APT# �2 ADDRESS,2 4�a 00 sees' gi� ? '01 jrifi� PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required 0 0 Streat Use Parmit Req'd 0 EXISTING - PROPOSED Inspection Required 0 Sidewalk Requited 0 REQUIRED DEDICATION- FT Underground Wiring required r1k METER SIZE LINE SIZ77. OF FIXTURES PRV REQUIRED YES E3 NO 0 ul REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE 0 z Lu ENGINEERING FIRE REVIEWED BY W DATE "eastwCmc VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND REO'D POSTED (:)YES [3 NO SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT ALLOWED . PROPOSED ALLOWED . PROPOSED LOT COVERAGE I REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR z PARKING LOT AREA I PLANNING REVIEWED BY DATE REO'D I PROVIDED I CHECKED BY TY ONSTRUCTION CODL OCCUPANT 000, q7 GROUP z-.' SPECIAL INSPECTOR JAREA OCCUPANT REQUIRED C] YES LOAD 0 REMARKS z PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D 6 A" A ;�A' 00 A LOP I A A� PLAN CHECK FEE LOT SLOPE % BUILDING DATE PLUMBING VALUATION FEE f-/ C:)i:;1` ;7c�_ 1 MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILL DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Aso", b IAI It SURCHARGE / PERMIT APPLICATION: 180 DAYS PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION L4 "APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS in ENG. INSPECTION FEE IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING 2 EDMONDS. WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND INSPECTION FEE ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY F M THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE RO RECEIPT DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE PLAN CHECK DEPOSIT 0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.. P P r" Try TOTAL AMOUNT DUE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPI ICATION 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 Foos are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO IFOR INSPECTION receipt is acknowledged in space provided. ,WORKMEN'S CSIP�ION INSURANCE AND RCW 18.27. IN ATUR DATE SIG A NER 0 DATE SIJ65NED (425) URE 0/ 771-0220 '00 ins, =D BY A§EbBY Dy'E A17ENTION EXT 1333 iE7 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 49& A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - IdSPEC1;R CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR 5/98 I I I jr-- I if P. o OF EDMONDS ,%3&?rrf,y /-/77e supMG EPARTMENT L rl.. wo T- :: ", ss nr)� ,9�-s OWNER A'PPROVED DATE: -62-Al- �DG. 0-,--Ir.IAL .Zx/'shvv* House Im rov r. h CAL. Z, 0010 rzk l4a OD W%14 1405 bATE RECEIVED - PERMIT EX PIRES USE PERM T4 CITY OF EDMONDS ZONE NUMOBIE CONSTRUCTION PERMIT APPLICATION. JOB SUITE/APT# ADDRESS OWArRWA �EAIAME OF 13USINESS NO. LID NO. PLAT NAM E/SUBDI VISION NO. ;_s �� 7, cc MAILING ADDRESS LID FEE $ TIESCP Approved CL3 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required 3L371:51 7 Street Use PemX Roq'd o E) CITY ZIP T EXISTING — PROPOSED Inspection Raquked 0 ELEPHON��6/ Sidewalk Roq Ired E3 Underground u JU1070 REQUIRED DEDICATION------=. FT Wiring required E3 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 13 NO C3 z ADDR E SS REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE .,CITY ZIP TELEPHONE NAME ENGINEERING 5WIEWE9PATE 0- ADDRESS W FIRE REVIEWED BY DATE CITY ZIP TELEPHONE 0 I '0 VARIANCE OR CU SHORELINE OR ADS# INSPEC ION BONI EXPIRATION DAT ECKED BY P STATE LICENSE NUMBER REQTD POSTED OSTI 0 (3 YES (3 NO I 37N 7 SEPA REMEW q)GN AREA HEIGHT Q COMPLETE EXEMPT ALLOWED POSED ALLOWED PROPOSED PROP TA2LACCOUNT PARCELbIO. P PRO D703�3 00 60o FmP VERAGE REQUMED S�&BACKS (FT.j'j PROPOSED SETBACKS (FT.) R I ESIDENTIAL A L6T C6 FRONT SIDE REAR FRONT URSIDE REAR 0 NEW PLUM91NG MECH ALLOWED PROPOSED COMPLIANCE OR z I ADDITION 0 COMMERCIAL tol . CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE 0 REMODEL APARTMENT RE:QD PROVIDED SIGN `j GRADING :ENZ, I M 0 REPAIR 0 CYDS ei, X FT) M DEMOL!SH TANK 0 OTHER 0 A1111111-4ft- P1 FT c3 GARAGE 0 RgTA'NING WALL C:] RENEWAL CARPORT R CKERY 0 (TYPE OF USE, BU�Iqgss 'OR ACTIVITY j EXPLAIN: CHECKED BY TYPE CONSTRUCTION Cup� GROU 747 0 c (A W NUMBER NUMBER OF CRITICAL R' AREA OF DWELLING AREAS SPECIAL IINSPECTO AREA OCCUPANT LOAD o UNITS REQUIRED 0 YES, STORIES NUMBER PE.SC.RIBE WORK TO BE DONE REMARKS 2_ %. PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D nz hlx/ (a 4 SOf 7e Gz VALUATION FEE z PLAN CHECK FEE m AAT SOURCE GLAZING % LOT SLOPE % BUILDING PLAN CHECKJNOL. VESTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHq THE WORK NOTED. THIS PERMIT COVERS WORK TO �t . r _%99SLY BE MVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DONEOt GRADING/FILL DOMA�;IlllWki& SIDEWALKS DRIVEWAYS; MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. ARGE 1 PERMIT APPLICATION AU , IMAM 06 IITlq1_YEAR - PROVIDEDWOFIK IS yi" PERMIT LIN , T 0� ENG.-PIEVIEVLFEES... SEE 4AtK OF PINK-"!T IF0RUe§k i ak EN& IN93ft-01ON FEE ASSIG AND - rCFSnR 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS N-S IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY Or, LANDSCAPING EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND INSPECTION FEE ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE RECEIPT FROM DEEMEDTOMODIFY, WAIVEOR REDUCEANY REQUIREMENT OF ANY CITY ORDINANCE PLAN CHECK DEPOSIT 0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANYORDINANCE PROVISION.* TOTAL AMOYI�T DUE 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 Building Official or his/her Deputy; and Fdas are paid. and TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYE6 IN VIOLATION OF THEI-ABOR CODE OF THE STATE OF WASHINGTON RELATING TO AND RCW 18.27. 0 FOR INSPE&I N receipt is acknowledged in space kovided. ORKMEN'S ION INSURANCE CIALS S,�TATURE DATE IALS AT SIG RE 0 ER 0 AG T) DATE SIjNED iLo (425) '0220 3) Aftef Zia f=d 771 RASEDSB"Y R ASED BY ATTENTION EXT 1333 IIII) IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-022 I ,,��,j 1 � 1, A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE - YELLOW - 1&13F(1�01:1 CATE OF OCCUPANCY HAS BEEN GRANTED. U13C SECTION 109 FAX PINK - OWNER - GOLD - ASSESSOR 519B