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20030619 (2).pdfLAW DATE RECEIVED _7 CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION 01 V NA�Eft" F BU 0, a MAILING ADDRESS C-�p t CITY PP - I TELEPHONE G7 NAISI&V4 ADDRM U NA wnqg ct�4 0'pwaj 9 NAME cc ADDRESS zip STATE LICENSE VMnB PROPERTY TA)l ACCC!AP2TE60 NEW RESIDENTIAL ADDITION OMMERCAL REMODEL MULTIFAMILY REPAIR GRADING CYDS DEMOLISH TANK oGARAGE CARPORT RETAINING WALL ROCKERY WRE in USE. BD(IINESS OR ACThOMLW,�AIN: NUMBER OF STORIES NUMBER OF DWELLING UNITS DESCRIBE WORK TO BE DONE HEAT SOURCE I GLAZING % mnx "DO -2, — se PLUMBING/MECH COMPLIANCE OR CHANGE OF USE XSIGN FENCE ( — X — Fr) OTHER FIRE SPRINKLER FIRE ALARM I CRITICAL AREAS NUMBER r,) eh 2:k - LOT SLOPE % PERMITEXPIRES LITE PERMIT ZONE NUMBER C4� JOB I SUITEIAPT# ADDRESS wal 1/1 f+ PLAT NAME/SUBDIVISION NO.JLOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCF Approved RW P4fmtl Requited .tram Use Permit Req'd EXISTING — PROPOSED Inspection Requited Sidewalk Required REQUIRED DEDICATION— FT 1 Underground I vv,nn,,,,qww METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES E3 NO 13 REMARKS z OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE OALL:�6_9_ AN W,_ 1WS0v;tm0M . 6WIJV�17_ WI LL_ ENGINEERING REVIEWED BY DATE e>151ZW3 as FIRE REVIEWED BY DATE 19 VARIANCE OR CU SHORELINEORADBN I INSPECTION BOND r-4 f,�./REQ'D E3NO1$ POSTED . VcKEs SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT A LOWED PRM1 LOWE L ED PROPOS EXP COVERAGE EMLOT PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR ---------- FRONT LJRSIDE REAR PARKING LOT AREA NING REVIEWED BY REO'D I PROVIDED 1 1"11 W / — REMARKS CHECKED BY I TYPE OCCUPANT GROUP SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REO'D VALUATION Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge PW1 CHECK NO* 0-3 -31 Q I VESTED DATE Plumbing I CQ Mechanical THIS PERMIT AUTHORMES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC DOMAIN Grading :3 (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 1:_ SEPARATE PERMISSION. 2 I PERMITAPPUCATION: Engr. Review 180DAYS 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 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # 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 MOOIFX WAIVE OR REDUCE ANY REQUIREMENr OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCEANY ORDINANCE PROVISION.' Recording Fee j 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 APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH C17Y 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 V)PLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELAIING TO FOR INSPECTION receipt Is acknovdodged In space provided. WO"EN'S COMPENSAT19MRAI�CE AND RCW 18.27. OFFP�S SIGN T RE j DATE SIGI�MOFI DATE SIGNED '2f (425) —1 4 wArL � , a 03 771-0220 ME c A By )ED WE 7— lp� Alff EXT 1333 LA UL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 ORIGINAL - FILE YELLOW - 14`S�EAR PINK - OWNER GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING -14", Ar. 41 I �ATERECEIVEO CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWItMEEINAM OF BU I%A MAILING ADDRESS % e7�)-O,k' K CITY '— (-� TELEPHONE t-&m A& T&A �U-Tl � -2:��' L IOWA', NAME ADDRESS L L. ZIP 9tj PERMIT EXPIRES 0 PERMIT ZONE NUMBER C<e� :� JOB SUITE/APT# ADDRESS V1 5�_ PLAT NAME/SUBDIVISION N NO. LID NO. 0-7 LID FEE $ TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW PerrM Requirad Street Use Psm* Wd EXISTING — PROPOSED inspection Required s&d**iw nequkad REQUIRED DEDICATION— FT Undswgmund Witingrequirod 13 METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED YES[3 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE �ALL �VOE_ rl N (kL- I WS09CUOIJ . OW WIL W1 LL L # ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE W f �I TELEPHONE W IE� NEW RESIDENTIAL I ADDITION AKCOMMERCIAL REMODEL [j muLnFAmiLy [j REPAIR [:] GRADING CYDS DEMOLISH 0 TANK GARAGE RETAININGWALL CARPORT ROCKERY (TYPE Ff USE, BOPINESS OR ACTeffnD WLAIN: fhg:f z-r 2:A&Y'aev�'_ NUMBER OF STORIES NWUMBM OF 0 ELLING UNITS DESCRIBE WORK TO BE DONE (2-) —C VNC, tj M kTION DATE C BY VARIANCE OR C0 SHORELINEORADB# I INSPECTION BOND 1r6 r*,�REQ'D Is POSTED L2��d P4 . InES 13NO SEPA REVIEW BIG EA HEIGHT -21 COMPLETE EXEMPT AkLOWED �Cg. LOWED . PROPOSED 411V , EXP 9 COMR4 M fz!r In , idt PLUMBING/MECH LOT COVERAGE I---- , mft-d"9�MCKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FR IDE REAR FRONT URSIDE REAR COMPLIANCE OR ""-NVNM""UMWAWAM --s-sesse..... o CHANGE OF USE PARKING I LOT MIGN E RE OD PROVI�D AREA REVIEWED BY , J�ZG 0 FENCE + sommumm X FT) REMARKS [:3 OTHER -1 FIRESPRINKLER 1 :1 FIREALARM CHECKED BY I TYPE =10 OCCU NT GROU PPA CRITICAL AREAS SPECIAL INSPECTION OCCUPANT NUMBER hic REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC I GII/FINAL INSPECT102N RECVD ir-move,Wy a)&RW VALUAnON I FEW $ Description FEE Description— FEE ge Plan Check State Surchar = HEAT SOU!:___]_ GLAZING 11 LOT SLOPE % Building Permit 17,0 City Surcharge /5.0001 PLAN CHECK NO: 0a - '31 VESTED DATE Plumbing kDe-5 -000 THIS PERMIT AUTHORIZES ONLY THE WORK NOTIED- THIS PERMIT COVERS WORK TO Mechanical BE DOME ON PRIVATE PROPERTY ONLY- ANY CONSTRUCTION ON THE PU13UC DOMAIN Grading (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERmnrApoucATtow isocAys PERMIT LIMM. I YEAR - PROVIDED WORK 18 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 EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT $HALL NOT BE DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT 01: MY CITY ORDINANCE Landscapains p. Total Amt. Due NOR LIMIT IN ANY WAY THE CffY`8 ABILITY TO ENFORCE ANY ORDINANCE PROVISION." - , -WO Recording Fee ecelpt # I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GrVEN1 18 CORRE" AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL Tigs application Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHIOaIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or tdOer Deputy: and Fees are paid. and IN VJQLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION recolpt Is acknowledged In space provided. WO"EN'S COMPENSATWIRIANCIE AND RC1W 10.27. OFF.IP'S S1G;N4ATRE DATE SIGJ�RE a(OWN OR C DATE SIGNED IA 0102% Mal A '?--S 0:3 771-0220 R I BED BY I sees %TT4MI N EXT 1333 QATE I 'V 71'P'W1j'W IT I&MILAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL E WU 4Z 0/. &12'.� 2 1 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- IGI - ' f OR NAL-FILE YELLOW- INSPEC(OR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD -ASSESSOR 04/02 GREEN - ACCOUNTING PRESS HARD -YOU ARE MAKING 5 COPIES z 0 0 M '4 : R M M M M 9z 0 M M 0 0 Fn C (j) M 0) . :. M 0 z 0 4 0 M