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20030641.pdfI DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMFJNAME OF BUSINESS . ..1 - . I MAILING ADDRESS CITY NAME ADDRESS CITY P� ��r ZIP ZIP [TELEPHONE PERMIT EXPIRES USE PERMIT 4� ZONE fV I NUMBER Z1 I JOB ADDRESS SUIT /A sees PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7ESCP Approved RW permit Required Street Use Paffnft Fleti'd EXISTING - PROPOSED Inspection Required Sld&*slkR@quir6d REQUIRED DEDICATION- FT UndeVound Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 13 NO z REMARKS z Z OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLJDRAINAGE I NAMblk CBL # � ly ENGINEERING REVIEWED BY DATE ADDRESS CITY ZIP TELEPHONE FIRE REVIEWED BY DATE Lu 11rc STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY VARIANCE OR CU SHORELINE OR ADBN INSPECTION BOND POSTED I I Q I r3YEREO'D S 0 $EPA REVIEW SIGN AREA HEIGHT PROPERIY-TAX A 7 NT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED ��+ Uo L U1 QU 1___Q 11 !2 1 EXP y , NEW ADDITION RESIDENTIAL 0 COMMERCIAL =LUMBINA4NECH %4COMPL ANCE OR CHANGE A OF USE LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FROKr LIRSIDE REAR 1,jocko wo Cyy_xA_e__A4 5e z REMODEL )9rMULTIFAMILY SIGN CARKING LOT ZAREA PLANNI�q REVIEWED BY DATE RE -PROVIDED b, C�I/ , - 13 REPAIR DEMOLISH GRADING 0 CYDS 1:1 TANK FENCE x FT) OTHER ilwl Z 1- 0, REMARKI,,40 GARAGE -1 RETAININGWALL CARPORT 1:1 ROCKERY E OF USE, BUSINESS 01� (5 F RE SPRINKLER FIRE ALARM CHECKED BY TYPE OF CONSTRUCTIIN OCCUPANT NUMBER OF Z, IUMBER OF DWELLING I UNITS CRITICAL AREAS NUMBE GROUP —1HA__ 1/ 91 SPECIAL INSPECTION IW_ / OCCUPANT REQUIRED ' / t- Czj [] YES LOAD DESCRIBE WORK TO BE DONE le, :REMARKS i PROGRESS INSI 01113 PER UBC 108/FINAL INSPECTION REG'D A4469 91(7 J,�4Z 4" Ze & _.- �7 AA /I J - I . — /2-,ft 1 A -Nr� 1A . 0' Owe &OF10ov" d"Ielltkv6 6WIF VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: e,7_7 VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZE13 ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PU13UC Grading DOMAIN (CURBIS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPUCATION: 180 DAYS PERMIT LIMIT: 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 C17Y OF EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt N ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscape Insp. Total Amt. Due jq DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CnYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- - - Recording Fee Receipt # zfa] I HERESY 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 THJ�ILABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknovdodged In space provided. VSATNN INSURANCE AND RCW 18.27. WORKMENS FR, cl SIGN DATE BIG ENT) Ey IN DATE SIGN 1A 13 %425) 771-0220 B DATA By/ P-RELEASE Y/ %TTEtftIOW EXT 1333 & 17/// '(zd h IT IS UNLAWF& TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL Z44L-�v \,--( 4' A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- /0'R � �1 ILE - YELLOW IN! CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PNI<ct�_�EPI - GOLD -AS' 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 4 0 M BUILDING SEP - 2 2003 City of Edmonds Attn: Jeanninel Graf i on 9/21/03. According to the permit a picked up on 8/21/03, the permit will e xp re Unffirtunately, this do" not give me enough lead time to order the new windows and have them installed. I ordered the wind ows on 8/21/03, the same day I picked up the The windows mu st be manufactured and will not be ready for pick up until at permit. least 9/9/03. The earliest the installer is available is 9/18/03, which does not allow ore, I would like to request an enough time for installation and inspection. Theref extension of ten (10) days on the permit /0 DATE RECEIVED ERMIT EXPIRES FP I USE PERMIT CITY OF EDMONDS' I ZONE W) NUMBER CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS I- i I DMAILING ADDRESS -1 -7 q[01-,, if CI ZIP TELEPHONE NAME ADDRESS CITY ZIP TELEPHONE N ML A Qwk PY0,11 ADDRESS CITY ZIP TELEPHONE STATE LICENSE NUMBER CBL N EXPIRATION DATE I CHECKED BY C:3 NEW RESIDENTIAL .L-AAOMNWWMNNW. VffiraM.BIWW_WECH 0 ADDITION COMMERCIAL %—&4COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY 'A SIGN [3 REPAIR GRADING CYDS FENCE ( X FT) [:] DEMOLISH [3 TANK OTHER GARAGE RETAININGWALL 0 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE. BUSINESS _ UAIV" M T�T NUMBER NUMBER OF-` CRITICAL OF STORIES DWELLING UN98 AREAS NUMBER DESCRIBE WORK TO BE DONE 770 M H SOU GLAZING % LOT SLOPE % O'er PLAN CHECK NO: VESTED DATE TMB PERMIT AUTHORUMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC 2 DOMAIN, 4CUR8% SIDEWALKS, DRIVEVAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. PERMIT APPUCATION: ISO DAYS PERMIT UMM 1 YEAR - PROVIDED WORK IS STARTED WITHIN 1130 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF a EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE, ARISING DIRECTLY ORJNDIRECTLY 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 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - I HEREBY ACKNOWLEDGE THAT I HAVE R E 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 VIOLATIO 'LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S je n8AflBC INSURANCE AND RCW 18.27. 0 AInMATUh1f'&9A9R;8"GENn I DATE siGNER JOB ADDRESS sum 0 T PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ 1ESCPAPPMOCI PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Pennit ReWired Soem Use Pernift Req�d EXISTING — PROPOSED Inspection RequIted Sidewast Required REQUIRED DEDICATION— FT Un*wWourld Wiringrequirod METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I In YES CI NO -_ REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE I 1r." VARIANCEORCU SHORE INEORADB# INSPECTION REO'D A I BOND POSTED UYES W SEPA REVIEW COMPLETE EXEMPT SIGN AREA 0, ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED EXP I )/ LOT COVERAGE ALLOWED PROPOSED wo REQUIRED SETBACKS (Fr.) FRONT SIDE REAR t".,.10 PROPOSED SETBACKS (FT.) F LIR SIDE REAR z zo LOT AREA I PLANNINJ REVIEWED BY DATE,'Oj in. CHECKED BY ITYPE OF CONSTRUCTi_0 "i GRO H A.. uU'P^'R` I SPECIAL INSPECTION OCCUPANT REQUIRED [3 YES LOAD REMARKS PROGRESS INSPECTIONS PER UBCj108/FINAL INSPECTION REaD VALUATION IS a Aff 111,11ILL616 I mw Description FEE Description FEE Plan Check . .0� State Surcharge Building Permit ]'City Surcharge b. Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscape Insp. Total Amt. Due jq .000 Recording Fee Receipt # Zia'] APPLICATION APPROVAL CALL This applicitition Is not a perMIt Until 81W*d try th6 BuRdIng OMcIW or his/her Deputy: and Fees are paid, and FOR INSPECTION receipt Is acknovviodged In sp000 provided. C BIG 41 DATE (425) 771-0220' RELEASE9 BY I DA-�t A'17TEKION Al Z/ IT IS UNLAWFdL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- IG1qAL_;,FILE YELLOWIINSPE R CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINKI—OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 0 ITI M M8 -40 0 C M M 0 _n M M C (j) r, CO) M 0 z 0 -4 ITI