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20030602.pdf�Px' 5- 05'oo WIlCeY, C-&�5H DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OTjy7E/NAME OF BUSINESS 0 le 1_1� bour A+ MAILING ADDRESS r& 0 W CITY TELEPHONE E:Amc , d a 19 0 1 1z NAME ADDRESS CITY TELEPHONE USE ZONE JOB ADDRESS PERMIT EXPIRES _L41_(-4f PERMIT NUMBER& 3 S1JITE/APT# PLAT NAME/SUB DIVISION NO, LOT NO- LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP APPr0v0d RW Permit Required EXISTING AL16t PROPO __—V Street Use Permit R&q'd inspection Required Sideovalk Required REQUIRED DEDICATjQN__0 FT Und----4 Wiring required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED IJ 4. 1 1 1 ( YESE3 N REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE 13 z I NAIM CB . 010 AALfh a" I ENGINEERING REVIEWED BY DATE 1 -10 11 Af A- FIRE REVIEWED BY DATE ul q -50Y CITY aA-) TELEPHONE OA to 6 0 U �3 7 �5'9 VARIANCE OR CU SHORELINE OR ADB# INSPECTION REO'D 113YES 13NO 1 BOND POSTED $ STATE LICENSE NUMBER EXPIRATION DATE NWW-170am to 4 fCKE Y 4 SEPA REVIEW COMPLETE EXEMPT EXP SIGN AREA ALLOWED PROPOSED IV /�r HEIGHT I PROPO ALLOWED BED ;4 PROPERTY TAX ACCO CEL-W. 1:1 NEW [j RESIDENTIAL PLUMBING / MECH )< COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE REMODEL MULTIFAMILY SIGN LOT COVERAGE ALLOWED PROPOSED IVA REQUIRED SETBACKS (Fr.) FRONT SIDE REAR A PROPOSED SETBACKS (Fr.) FRONT URSIDE REAR Ai A PARKING REOD PROVIDED 48- LOT AREA P�LANNING �REMVIEWE:DfIBAY DATE FENCE REPAIR GRADING CYDS ( X FT) REMARKS DEMOLISH TANK OTHER E GARAGE RETAINING WALL FIRE SPRINKLER CARPORT 0 ROCKERY FIRE ALARM (TYPE OF IJSE. BUSINESS OR ACTIVITY) EXPLAIN: h?'dAl-ki cjjges,� CHECKED BY I TYPE OF CONSTRUOW -4 c6F() OCCUPANT GROUP NUMBER OF STORIES NUMBER OF _rCRITICAL DWELLING UNITS 0 — AREAS NUMBER 04 17, le SPECIAL INSPECTION JAREA REQUIRED [:] YES OCCUPANT LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REO'D eVW)A_ G�- 4y /in ri V1 Lif, 41h,'Jx�n U V=j 0 C_ejT� ye LO, h VAILUATION $ J le- f- Description FEE Description FEE Plan Check State Surcharge HEAT SOU RCE GLAZING % LOT SLOPE % A/A A/A Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing .01 L Mechanical THIS PERMIT AUTHORLEES ONLV THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC :X3 DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMITAPPUCATION: ISODAYS Grading Engr. Review 06 PERMIT ILIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection 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 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 Fire Inspection Landscapeinsp. Receipt # Total Amt. Due 0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- zi Recording Fee Receipt # 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 CONSTRLIC- TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LA OF THE STATE OF WASHINGTON RELATING TO APPLICATION APPROVAL CALL This application Is not a permit until signed by the Building OfficW or his/her Deputy: and Foos are paid, and FOR INSPECTION receipt Is acknowledged In space provided. WORKMEN'S COMPEN N RANCE AND RCW 18.27. SIG]�� DATE §IJINED (425) 9fPeIAL S GNIAJ;URE DITE A�. ATTENTION 771-0220 EXT 1333 RELIIASED BY —PATE IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CEFITIFI- 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 z 0 =1 0 M M M 0C M M 0 _n In M M 0 0 Fn C (j) M 0 X z z 0 0 M I x wilc6r,. DATE RECEIVED PERMIT EXPIRES q.DATE RECI USE PERMIT CITY OF EDMONDS ZONE NUMBERWO3 ob 02- TION F [0740N R 07 JOB SUITEIAPT# UCTION P CONSTR ERMIT APPLICATION ADDRESS) C) R NAME/NAME OF BUSINESS " I. , , k —114 1 1 1 a PLAT NAMEISUBDIVISION NO. LOT Nb. LID NO. Ut I MAILING ADDRESS CITY �IP ITELEPHONE zT.iT ADDRESS CITY /zip ITELEPHONE ADDR7b, CITY . E R u, STATE LICENSE NUMBER bm )��, I m —r NEW RESIDENTIAL ADDITION )97,60MMER CIAL REMODEL MULTIFAMILY REPAIR GRADING CYDS 0 DEMOLISH TANK [3GARAGE RETAINING WALL CARPORT ROCKERY OWE OF PSE, BUSINE OR ACTIVITYI EXPLAIN: NUMBER OF 2L NUMBER OF DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE IC,V-1krnK_ L I I % . 0 C C_ �c I I le CBL Nj�tj e 'R 'I I <jkl 15 DATE CKE U01 — �<PLUMBING / MECH COMPLIANCE OR CHANGE OF USE SIG14 FENCE X FT) OTHER FIRE SPRINKLER FIRE ALARM CRITICAL AREAS NUMBER r i ri k. , I#, HFAT BOURCE GLAZING % LOT SLOPE % A/ A I— "/\ /V.11� CHECK NO: VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC D01MN (CURBS, SIDEWALKS. DRIVEWAYS, IIIIARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 180 DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT. ON BEHAI F OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND 8 UCCESORS IN INTEREST. AGREES TO IND ' EMNIFY, DEFEND AND HOLD HARMLESS THE CITY (jF' EDMONDS. WASHINGTON, ITS'OFFICIALS, EMPLOYEES. AND AGENT$ FROM ANY AND 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 REPUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION., I HEREBY ACKNOWLEDGE THAT I HAVE R&D 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 LAqPR%QODE OF TH� STATE OF WASHINGTON RELATING TO WORKMEICS COMPENSATONINGYRANCE AND 13CW 18.27. '0 LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP APPr0v*d RW P@nY* Required EXISTING A/ 12c' PROPOSED street Use Permit Roo Inopwdon Required Sidewalic Required REQUIRED DEDICATION— FT Underground VAMg required METER SIZE LINE SIZE NO. OF#XTURES PRV REQUIRED )— - I k I I YES13 N O> REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE DATE (3 z IV � -1 FIRE REVIEWED BY DATE tu cc VARIANCE OR CUI SHORELINE OR A111111 I INSPECTION BOND REO'D POSTED 13YEs 13NO 1$ SEPA REVIEW SIG�AREA HEIGHT COMPLETE EXEMPT ALLOWED ROPOSED ALLOWED , PROPOSED EXP I �) I J:!-., lzrq LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) 'ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR I . A/A j�f./A I /V /4 PARKING LOT AREA LANNING REVIEWED BY DATE REO'D . I.,PR IDED I ]P AOV CHECKED BY ITYPE OF CONSTRUPMN Ugs OCCUPANT I Co. 0 GROUP SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RE(VD $ % I VVIIIIIII IIIIIIIIIII1111RE - DescrIptlon FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing 12n 001 Mechanical Grading Engr. Review Engr. Inspection firiii Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION fA9 1425) APPLICATION APPROVAL &%mrhis application is not a permit until siwied by the Building Official or his/her Deputy: and Res are paid, and receipt is acknomMedged in space provided. qfNetALS IGNA URE DITEj ATE RELEASED BY L111 Al-17ENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE ANDL.APPROVAL OR -A CERTIFIm- 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 a z 0 m rn m 8 § a