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20030620.pdfW DATE RECEIVED? CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS DAWD MAILING ADDRESS 2_15202 e /Z.-P &f- 4,,/ CITY ZIP TELEPHONE .— 1 77q-180c-- NAME ADDRESS CITY ZIP ITELEPHONE NAME ICBL# ADDRESS CITY ZIP I TELEPHONE STATE LICENSE NUMBER EXPIRATION DATE I CHECKED BY NO. NEW �i(RESIDENTIAL 11 PLUMBING / MECH ADDITION COMMERCIAL COMPLIANCE OR 1:1 CHANGE OF USE REMODEL MULTIFAMILY 0 SIGN REPAIR GRADING — CYDS FENCE ( �k� X FT) DEMOLISH TANK OZER ( �r or GARAGE CARPORT RETAINING WALL ROCKERY FIRE SPRINKLER FIREALARM (TYPE OF USE, BUSINESS OR ACTIVIM EXPLAIN: <-�� -�(-v 0 c/o - NUMBER NUMBER OF CRII ZAe W&O OF DWELLING AREAS 17), STORIES f-a UNITS NUMBER DESCRIBE WORK TO WE DONE. HEAT SOURCE GLAZING % LOT SLOPE % Building Permit PLAN CHECK R10:. VESTED DATE Plumbing ass Mechanical THIS PERMIT AUTHORIZES ONW THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLV. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 100 DAYS PERMIT UMTE 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 IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. I 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.' Recording Fee I KERE13Y 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- CALL TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION WORKMENS COMPENSATION INSURANCE AND RCW 18.27. rTURI�!rllZr , _/j DATE SIGNED I , _!;__03 (425) imign PERMIT EXPIRES USE PERMIT ft)2 ZON NUMBER Q JOB ADDRESS 6�/ ��,2 4w- &A S UITE/APT# Xk,�l 42 PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP IESCP Appl=, RW Par., . Street Use Parrvill R&q*d EXISTING — PROPOSED inspection Required Sidewalk Required REQUIRED DEDICATION FT UnderWound 13 Wiring required METER SIZE LINE SIZE OF FIXTURES PRV REQUIRED 0 J_�O, 1 YES 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE &MAkrr,',h A<,&VY161)11h1 A"5. PIRI, a REVIEWED BY FIRE REVIEWED BY DATE W cc VARIANCE OR CU SHORELINIEOR AD BI INSPECTION BOND REO'D POSTED 13 YES 13118, $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED ED PROPOS ALLOWED SED PROPO I _.XP LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR 43 Le NA IVA Cis 0 z PARKING I LOT AREA I PLANNING REVIEWED BY DATE I REQ`D PROVIDED 0% C- r . 7- CHECKED BY ITYPE 9F CONSTRUCTION CODL OCCUPANT GROUP e �3 e-7-7 /F-- SPECIAL INSPECTION AREA OCCUPANT REQUIRED [:] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 11081FONAL INSPECTION REG-0 $ - - I - Description FEE Description FEE Plan Check State Surcharge City Surcharge lPlan Chk. Deposit Receipt # Total Amt. Due— 5 _j�? _� Receipt # ? I — 42a= APPLICATION APPROVAL R This appli 11�0n 13 ot a permit until signed by the or Deputy: and Fees are paid, and r colot Is 5nedaed In epacp provide3q AMNTION 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- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES ORIGINAL - FILE YELLOW - INSPECTOR PINK -OWNER GOLD -ASSESSOR GREEN - ACCOUNTING a z 0 1 0 M C M N 0 C :� C A M IC) oil M 0 0 Fn C8 z z 0 0 M FINAL PROMCT APPROVAL FORM TO: DATE: PERMIT COORDINATOR, BUILDING DIVISION INT DATE — -------- FIREDEPARTME a Copy of CORRECTION NOTICE given to Ownedconftctor by u'sPwtor' I . 2. 3. ISSUES - GRANT FINAL PROJECT APPROVAL RE-INSpECTED OUTSTANDING Si- ocaprvLdoc.l:u=p:bldg:forMS10101 z 9 0 m :; --fl M c rn 0 80 -4 c K X rn M Z C) --I c 3: Cl) 0 -n n m m a U5 0 0 Fn C (1) c CO) M 0 Z z z 9 0 m ewt�-- -4 -1 -� - I * - , —. :! ; RECORD OF INSPECTIONS W W, M ILI P� m In m Fn c.): IT! FINAL APPROVAL FOR OCCUPANCY .................. 00 1) (o zo 0 ............. DATE �RECEIVED,, ,3 PERMIT EXPIRES CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION ,OWNER NAME/NAME OF BUSINESS �'QIA V1,D MAILING ADDRESS zio�e-)2_ Ave 4,1 CITY. ZIP TELEPHONE &vA 7741-I&C NAME ADDRESS CITY ZIP TELEPHONE F _T_ NAME CBL N 9EI ADDRESS USE - PERMIT I IUZ— ZONE !� NUMBER ( JOB ADDRESS ( �, / ��W2 4k SUITIVAPT# PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP=ed RW pe Susm Use Permh Rsqd EXISTING — PROPOSED Umpection FteqLdred Sidews* Requked REQUIRED DEDICATION FT UnderWmind Widng requW 13 METER'SIZE LINE SIZE I I NO. OF FIXTURES PRV REQUIRED 1___1 YES E3 NO 10 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE "WtIv'ri, A,�. %,VVIO-n /V1 M IM5. 0AU-, 11 REVIEWED BY DATE WrAl k V, L 0%;.;W XLf CITY ZIP 17� ONE STATE LICENSE NUMBER EXPIRATION DATE I CHECKED BY IPROPkM TAX ACM PAF199L 140. f M FIRE REVIEWED BY VARIANCE OR CU i 1 SEPA REVIEW COMPLETE , EXEMPT EXP W-01 DATE SHOR . ELINE OR ADB# INSPECTION BOND REOD POSTED 113YE GK Is SIGN AREA HEIGHT ALLOWED , PROPOSED ALLOWED , PROPOSED a d 0 NEW rt(RESIDENTIAL ....... PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT.) FRONT URSIDE REAR ALLOWED PROPOSED FRONT SIDE REAR I ADDITION COMMERCIAL COMPLIANCE OR 13 MA WA jig 0 2 CHANGE OF USE REMODEL MULTIFAMILY 0 SIGN PARKING REQ`D PROVIDED I!n PLANNING REVIEWED BY DATE I 06 REPAIR [3 GRADING CYDS MI FENCE f--N ( WVy— X FT) I 61 C, REMARKS 2�� V DEMOLISH 0 TANK EI M, Y,;, 1. i-7.3o. 43q. e-. 7- oGARAGE 0 RETAININGWALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (ME OF USE. BUSINESS OR ACTMTY) EXPLAIN: L /cj S10 00 a 0 y hall -z _0 CHECKEDBY I TYPE OF CONSTRUCTION OCCUPANT GROUP NUMBER OF C R rritcAe f�z:6 c) -Z OF DWELLING I AREAS 172 SPECIAL INSPECTIOW AREA occUPAT41 LOAD STORIES r_ UNITS NUMBER REQUIRED 0 YES DESCRIBE TO BE DONE iREMARKS I PROGRESSIN C RE170. '%MECTION I" I NEI I $ Description FEE Descri ption FEE Plan Check State Surcharge HEAT SOURCE 5�G % LOT SLOPE % k T Building Permit City Surcharge PLAN CHECK 10:. VESTED DATE 3 Plumbing NO L 42e 12� 1 -M. Mechanical THIS PEIRMIT AUTHOREMS ONLY THE WOnK NOTED. THIS PERMIT COVERS WORK TO t BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading DOUAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAOPILICATIOW. 168DAYS PERMIT LIMM I YEAR - PROVIDED WORK 10 STARTED WITHIN 160 DAYS Engr. Inspection SEE BACK OF PINK PERUIT FOR MORE INFORMATION -;APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit N INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Redbipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. tj Total Amt. Due 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.' Recording Fee Receipt :V�j I HEREBY A . CKNOWLEDGE 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 aWleaWn Is not a permit until signed by the TION; AND IN DOING THE WORKiAUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED BuH4Wg Offlaial or)dg4f Deputy: and Foes are paid, and IN VIOLATION OF THE LABOWCODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION I F�c*'PtlsqtknofaftedinsPacPP(mwegj WORKMENS COMPENSATION INSURANCE AND RCW 1 8. 2 7. OF I SIG U < E NATUR (OWN Ri DATE SIGNED nn 71 1111�!r 1425) .4 q II - 1— 1', - - I I A ATTENTION M 1333 V IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL qp,9 I C)Q I A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE le YELLOW - INSPECT&I CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER - GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING L