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20030628.pdfI DATE RECEIVE:� PERMIT EXPIRES USE PERMIT CITY OF EDMONDS ZONE NUMBEFJ� CONSTRUCTION PERMIT APPLICATION .10 S E/APT# ADBIRESS 1?1433z�ff OWNER NAMEINAME OF BUSINESS ILI 'f3q�s' OP. A 5-�O V%(2, Te3,",n owy., PLAT NAME/SUBDIVIW4 Nq LOT N�� LI NO. _S I FEE $ MAILING ADDRESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP W. -74!�,7.'i(435' TESCP AP "o RW Perm t P 471, ed CAU -%,r �J330 z I O*S 'q+. S. Street Usle P-ennit "90 CITY "ZI TgLEPHONTTLC- 4V%"W EXISTING — PROPOSED Inspectio Required Sidewalk"Required 0 _1 REQUIRED DEDICATION— FT Underground imnngr uked 13 NAME METER SIZE LINE SIZE NO. OF FIXTURES RV REQUIRED YEPS 13 NO 13 ADDRESS REMARKS OWNER/CONTRAeR RESPONSIBLF4FOR EROSION Cq�Z04RAINAGE z re !�� 'S ( a—c 0 �'l Lr CITY ZIP ITELEPHONE I NAME M ADDRESS 0 kj8O?:� VAOkn0g— 1A) a --- CITY ZIP TELFPHONE 4-L5— 74 1-851 to F.TKM STAtE LICENSE NUM13ER EXPIRATION PAjET7RMDd P NT.f ;r,y r3e)160 NEW RESIDENTIAL ADDITION COMMERCIAL I!a.PEMODEL MULTIFAMILY t REPAIR [3 GRADING CYDS DEMOLISH 11 TANK [3GARAGE RETAINING WALL 0 CARPORT ROCKERY (TYPE OF USE, BUSM71WOR VIM NUMBER OF 100 NUMBER OF DWELLING STORIES UNITS DESCRIBE WORKNTO BE DONE V 13 PLUMSING/MECH COMPLIANCE OR 13 CHANGE OF USE [3 SIGN IFENCE 3 ( _ X_FT) [:] OTHER [:3FIRE SPRINKLER FIRE ALARM CRITICAL AREAS NUMBER,!:00 U, Lai% DATE FIRE REVIEWED BY DATE ta cc Im VARIANCE OR CU SHORELINE OR ADS# INSPECTION REQ'D PBONDO STE SEPA REVIEW SIG14 AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , , LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR FRONT LJR SIDE REAR PARKING LOT AREA REVIEWED BY DATE REO'D PROVIDED �P;INING a wilu la--- :;"A ",:q- . W I " CHECKED BY IT** OF CONS7 CCUPANT r 1 R 0 U P N I AR%VIQ OCCUPANT SPECIAL INSPECTIO LOAD REQUIRED 0 YES REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D Description FEE Description FEE Plan Check State Surcharge It/ SV T`5�14G% LOT SLOPE % Building Permit City Surcharge HEAT SOURCE PLAN CHECK NO: VE ED DATE Plumbing Mechanical THIS PERMIT AUTHOREMS ONLV THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPILICATION: 180 DAYS PERMIT LIMM 1 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 ANYAND Fire Inspection ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapeinsp. 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 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. CALL TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABq"ODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION WORKMENS COMPENSATIWNSVRANCE AND RCW 18.27. DATE SIGN Ag�( 6- fA9 '425) 19 -�3 771-0220 ATTENTION EXT 1333 1' Plan Chk. Deposit Receipt # Total Amt Due Receipt # OCATION APPROVAL Won Is not a perrn�, undI1FsIgnr b' the I or his/her D ut e. - . �.Id..nd IiacknowleciX lyn'space7/vIdod. !To BY I JDAI t: IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 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 1 A t . , d .1, treAm A f d I.At At ..... . � A,. t t A, 4 I I I It :9 10 I 0, M. 0 A 'DATE RECEIVE I U LPERMIT EXPIRES USE PERMIT CITY OF EDMONDS ZONE 121 NUMBE CONSTRUCTION PERMIT APPLICATION JOB S U E/APT# ADDRESS j!j! OWNER NAMEINAME OF BUSINESS I PLAT NAME/SUBDIV If NO 71 LOT N Llif NO. JFEE MAILING ADDRESS Ufq - $ -75011. -)r,, 2. 10-"' PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP RW Po=.Cf ,-A# EXISTING — PROPOSED stnm use Peffnk Wd 1napwUon Raqul-d SidawA Raquired CITY -,Zip T9LEPHONdftL4 0-\ 5'eA'N' o'\j 14 1.5 0 __5 -Z REQUIRED DEDICATION— FT UrAergmund Wiftg requIred NAME METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED '3 I YES 13 NO 13 z I ADDRESS REMARKS OWNER/CONTRAnR RESPONSIBL!4FOR EROSION C=04RAINAGE Aik V11f __ S (QC 0 wly' "fe NAME NZ)o u_w_y-� e_ ENGINE'MING REV ED BY DATE Ic _jh& ADDRESS \2S90__1 wc"� FIRE REVIEWED BY 4�DLATE Lu CITY ZIP TELEPHONE 1 If Wy,j,-\,j-qooj 1&)%-7 q-Z T- '7141-135 1 (., VARIANCE OR CUI SHORELINE OR ADB# INSPECTION BOND LICENSE NUMBER EXPIRATION DAIE ED REQ'O POSTED 113YES 1$ -N 5*0 SEPA REVIEW SIGN AREA HEIG P 0 COMPLETE , EXEMPT ALLOWED , PROPOSED ALLOWED , PROPOSED EXP 1:1 NEW REsIDENTIAL PLUMBING MECH LOT COVERAGE_ REQUIRED SETBACKS (Ft.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR 0 ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE EMODEL I— muLnFAMILY __j SIGN PARKING. LOT AREA PLANNING REQ`D I PROVIDEI) REVIEWED BY DATE 0&XrJA2Q&2Tl4ajQ2_;,. REPAIR GRADING CYDS o FENCE x FT) R&AW DEMOLISH TANK OTHER (a olii!krp WILL CQr =21 GARAGE RETAJNINGWALL FIRE SPRINKLER ' FIRE ALARM 9 CARPORT ROCKERY V" F-A I W-1-M (TYPE OF USE; 81.19111IMS OR ACTIVIT14 EXPLAIN: - CHECKED BY OF CONSTR i�� OCCUPANTA InI Iq A NIL W — -GROUP I NUMBER - OF 10 NUMBER OF DWELLING I CRITICAL AREAS 7PECtAl. IN SPECTION e -VqW OCCUPANT LOAD STORIES UNITS N U M 8 E R JAREA_IW REQUIRED [] YE DESCRIBE WO010TO. BE DONE,.:` . ots :REMARKS n%jU§ESS INSPECTIONS PER UBE 108/FINAL INSPECTION RECtD. -;IIIA.& U It-A")g VP%L.VMI RAIA >� 1.� 0 z Description FEE Description FEE Plan Check State Surcharge SU z 0 HEAT SOURCE GLAZING % LOT SLOPE% qdy Surcharge ?5 1 Building Permit 1115 M PLAN CHECK NO: VESTED DATE Plumbing Mechanical TMG PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I: BE DONE ON PRIVATE PROPERTY OULM ANY OONSTRUCfION ON THE PUBLIC Grading 2 3 DOMN (CURBS, SIUVALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSIOU. Engr. Review PERMIT APPLICATION:. iso DAYS 0. PERMIT LIMM I YEAR - PROVIDED WORK 18 STARTED WITHIN 180 DAYS Engr. Inspection SEE WWK 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, IT$ 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 PERMrT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapoinsp. Total Amt Due T 0 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION., Recording Fee Receipt # R( I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION P APP 'P CATION APPROVAL C 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 CONIF CALL 19 aw n Is not a permit until s15F bpyWth is" !C- ED TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSOP I g' or hisfiter D ty: and Fe . do and 9 f4 IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHIN( I G TO FOR INSPECTION Ic f acknowledminspacq Ided. , WORKMENS COMPENSATION INSURANCE AND RCW 18.27. ! GN E R OR AGENT) DATE SIGN�p 1A* %-125) 0A1 /X 15 144 05 771-0220 EA Y ATE ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI, ORIGINAL"FILE YELLOW* INSPECTOR V CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 GREEN - AICOUNTING PRESS HARD -YOU ARE MAKING 5 COPIES