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20030633.pdfDATE RECEIVED � o I PERMIT EXPIRES 44 / USE PERMIT 2�Z'9' 2 ZONE _ 0 62 CITY OF EDMONDS NUMBER JOB SUITE/APT# CONSTRUCTION PERMIT APPLICATION ADDRESS -1-70T L cA-) OWNE NAME/NAME OF BUSINESS _!,052b .(,R VC I PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. / Ze A lfleA /44, MAILING ADDRESS LID FEE S TESCP ApprDvfd 2, PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Partnit Required Street Use Peffnit Rsqd EXISTING — PROPOSED inspection Required ZIP EPHONE S ewalkRequired (;2,6 -IM2 U=Qround kil o /L) 7 U REQUIRED DEDICATION— FT Wiring required 13 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I I YES13 NO 13 ADDRESS REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROIJORAINAGE CITY ZIP TELEPHONE NAME /4,� CBL# UAAJfk_ ':��XFMQ_-2 11 ENGINEERING REVIEWED BY DATE ADDRESS I FIRE REVIEWED BY DATE CITY ZIP PHONE VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND STATE LICENSE NUMBER EXPIRATION DATE CHECKE BY REQ'D POSTED 113YEs 13NO S I BEIRA REVIEW SIGN AREA HEIGHT PROPEF47Y TAX ACCOUNT PARCEL NO. COMPLETE EXEM 1WAjfPWQ0$SaOWED PROPOSED �B—*�ICE DFF , W, Irm ICE S , EXP A KS FT.) LOT COVERARHAL RftbMWMhW - A ETBAC ( NEW RESIDENTIAL PLUMBING MECH ALLOWED PRfR ftsf;rm TM flaw SIDE REAR COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE z PARKING LOT AR REVIEWED BY DATE REMODEL MULTIFAMILY SIGN REIYD I PROVIDED GRADING FENCE X REPAIR CYDS FT) REMARKS DEMOLISH TANK ;R1-_0_T8!14S1S —(— GARAGE Ej RETAINING WALL FIRE SPRINKLER Pm3mm Te fle9le 19,30.02-0 CARPORT ROCKERY _13 FIRE ALARM AAA= (TYPE OF USE, BUSINESS OR ACT LAIN: CHECKED BY n- W&ANT ITYPE!1�10TWX NUMBER NUMBER OF - -I CRITICAL _jjFROUP DWELLING AREAS SPECIAL INSPE OCCUPANT OF r^ CTION LOAD IRREA STORIES UNITS NUMBER REQUIRED r DESCRIBE WORK TO B D014F REMARKS PROGRESS INSPECTIONS PER LIBC 108/FINAL INSPECTION REQ'D 'V.1 "C W M4 - la, 4 L VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit VESTED DATE Plumbing City Surcharge PLAN CHECK NO: Mechanical THIS PERMIT AUTHORGMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading :3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE t: SEPARATE PERMISSION. Engr. Review PERMITAPPUCATION: ISO DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION 'APPUCAK ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review PlanChk.Deposft I 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 Landscapeinsp. 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 A I 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 TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and IN VIOLATION _QE THE LABOR 50DE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknoydedged In space provided. WORKMEITS?OMP%NSATION W89RANCE AND RCW 18.27. OFFICIALS §1IGNAT RE DA 7 J SIGNATUR OWNE A D E�ISIGP�q / 7, / 4?1e�! 771-0220 RELEASED BY DA'W' KT"NTION 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 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 . .. z 44 C. 1 S'9 11 CITY OF EDMONDS 121 5TH AVENUE NORTH * EDMONDS, WA 98020 - (425) 771 -= - FAX (425) 771-0221 Website: wwd.edmondsma.us DEVELOPMENT SERVICES DEPARTMENT Planning * Building - Engineering August 27, 2003 Kenneth D. Marvel 6526 170'h PI SW - Edmonds, WA 98026 RE: Permit # 2003-0633 / New Water Service Line Permit Dear Mr. Marvel, GARY HAAKENSON MAYOR In completing our monthly audit of issued permits I discovered that we'charged you incorrectly for the Water Service Line Replacement permit. The actual fee should have been $105.00 and we took in $95.00. The total amount due to the City is $10-00. If you could please mail o.T drop by a check/cash in the amount of $10.00 and reference permit #2003-0633 we can take care of this matter immediately. If you have.any questions please don!t hesitate to contact me at 425-771-0220. Sincerely; J- r1a Theresa a.mbaugh Permit Specialist Incorporated August 11, 1890 0 Sister Citu - Hekinan. Janan 0 a T- FINAL PROJECT APPROVAL FORM TO: DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: FIRE DEPARTNIENT DATE MASS SM z 0 m :q 9 am a ma 0 --lo 0 c: M m z 0 -n n --I x M m 0 0 0 M C c) 9 co M 0 Z M z z 9 0 m 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Si ocaprvl.doc.l:temp:bldg:fomisIO/OI RECORD OF INSPECTIONS m IM. Nil 10 Fn 4 EF_q RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION EfINAMEINAME OF BUSINESS ,Of��A/dZef_� 0 - 1k4,dR V6 I — MAILING ADDRESS '� s�l a ;Pv-7'X CITy, / ZIP TFLEPHON PERMIT EXPIRES 64ZZ USE ZONE PERMIT NUMBER JOB ADDRESS LO _S) 2 b — I —70 f)Lsu'rvAFr# Lo PLAT NAME/SUBDIVIISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESGP ApPrOV00 RW PsrrM Rowifed Strom Use Pofmh PAqd EXISTING — PROPOSED Inspoctim RoqWrod SW_ 4- Ur4orground 4:tcl 14, 0 /v L REQUIRED DEDICATION- FT ww"gro0m 13 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 1 YES E3 No E3 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE CITY NAME I\j ADDRESS CITY STATE LICENSE NUMBER ZIP ITELEPHONE ZIP I TELEPHONE NEW RESIDENTIAL ADDITION COMMERCIAL REMODEL MUL11FAMILY REPAIR GRADING CYDS 0 DEMOLISH TANK 0 GARAGE o RETAINING WALL CARPORT ROCKERY �'I,.E (ME Or USE. BUSINESS OR A!r NUMBER NUMBER OF OF DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE CBL # DATE I CHECKED BY REVIEWED BY DATE FIRE REVIEWED BY DATE I I VARIANCE On CU SHORELINEOFIADB# I INSPECTION I BOND pMUAM 16 REO'D POSTED 4VqM,aL,) SEPA REVIEW CO.IPLETE EXEMjP8:fl AMOVffIR 200 EXP "%ASff LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOI PLUMBINGiMECH ALLOWED PROPOSED FRONT SIDE REAArRFRONWT COMPLIANCE OR OMPLIANCE OR CHANGE OF USE G PARKING LOTG7 SIGN REQ`D . PROVIDED kREMARKS r C FENCE X FT) REMARKS PURSIJA= APRMMpXGU 0 FIRE SPRINKLER 3fl= BrTN_.� FIRE ALARM CHECKED BY I TYPE OF CO1qSTRUqTION CRITICAL I — AREAS SPECIAL INSPECTION JAREA NUMBER N /A__ REQUIRED [:1 YES ]REMARKS or -..%an SS INSPECTIONS PER UBC I HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: VESTED DATE THIS PERMIT AUTHORIZES OW THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY OHLX ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, FADEWALKS, DRIVEWAYS. MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 1180DAYS PERMIT UlArP I YEAR -PROVIDED WORK IS STARTED WITHIN 1130DAYS BEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON SEKALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS 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 OFWHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS,PERMrr. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MWFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CrM ABILITY TO 64FORCE ANY ORDINANCE PROVISION.' I HME13Y 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' TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION 49 THE LABOR QQDE OF THE STATE OF WASHINGTON RELATING TO WORKMENS GOMPEN8ATIONJNSURAHCE AND RCW 1827. PROPOSED 3ETBACKS (Fr.) I SIDE REAR PATE NEAR 7 s000000' CCUPA C G CR 0 U PPA OCCUPA LOAD INSPECTION REQ'lDfl VALUATION $ Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge T17— Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit E-1 Fire Inspection Receipt # S 153 Landscapeinsp. Total Amt. Due CIS-0— %::b Recording Fee Receipt # ��4 CALL FOR INSPECTION (A9 1,425) 771-0220 EXT 1333 APPLICATION APPROVAL This application Is not a permit unw signed by the ettuding oMclad or Noftw Deputy: and reas are paid, and receipt Is acknowlecigod in space provided. DAT OFFICIALS 9IGNATURE E IlEagL C-_!v/ qO� RELEASED BY DAlt IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CEnTIFI- 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