The URL can be used to link to this page

20030651.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION ER NAME/NAME CIP BUSINESS ADDRESS 1 0 1 ZIP I TELEPHONE NAME ADDRESS CITY ZIP 11 K, TELEPHONE I I " ST 0 K) TELEPHONE ev---7 ten x6jo WA ctelopol low 0 &-_%v!� STATE LICENSE NUMBER EXPIRATION DATE 01011515KEUISY 44 11165_� ftc PROPERTY TAX ACCOUNT PARCEL NO. 2q0.12)a3 (n4n9j9-_11n 0 NEW 0 RESIDENTIAL ADDITION COMMERCIAL R EMODEL 0 APARTMENT 0 REPAIR 0 GRADING CYDS 0 DEMOLISH 0 TANK o GARAGE 0 PIOETAINNG WALL Z CARPORT R CKnRY (TYP I E PLA (A US NUMEfER_ NUM6E_R OF 0 OF DWELLING 01 STORIES UNITS DESCRIBE WORK TO BE DONE HEAT SOURCE GLAZING % PLAN CHECK NO: ,,�PLUMBING / MECH o COMPLIANCE OR CHANGE OF USE rl SIGN FENCE ( _ X _ FT) OTHER C:1 RENEWAL CRITICAL AREAS NUMBER LOT SLOPE % DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. IM uj PERMIT APPLICATION: 180 DAYS PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 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 2 EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND 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 MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION." 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- TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LAB_9&,CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEMS COMPENSATM INSURANCE AND RCW 18.27. AE [PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB ADDRESSI(,,, SUITE/APT# PLAT NAME/SUBDIVISION NO. VOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required Street Use Permit Req-d EXISTING - PROPOSED inspection Required Sidewalk Required REQUIRED DEDICATION- FT Underground Wiring requited METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I I YES 0 NO 13 ;-EMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING FIRE REVIEWED BY VARIANCE OR CU I SHORELINE OR ADB# REVIEWED/DATE DATE 16 1 INSPECTION BOND REO'D POSTED YES (:) NO Lu M M SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP I , , LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE REAR z z z PARKING LOT AREA PLANNIN13 REVIEWED BY DATE 1 :5 REO'D I PROVIDED I I 016 I SJA.AjA AtrE14TION IT IS UNLAWFUL TO US UPY A BUILDING OR S A FINAL INSPECTION 133aEE MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY AS. N GRANTED. UBC SECTION 109 5/98 CHECKED BY GROUP 1 W SPECIAL INSPECTOR' JAREA OCCUFANT/ REQUIRED [3 YES LOAD REMARKS a z PRQJGRESS INSPECTIONS PER UIBC 10811FINAL INSPECTION RE01D a Co VALUATION FEE BUILDING PLUMBING MECHANICAL GRADING/FILL ENG. REVIEW FEES ENG. INSPECTION FEE LANDSCAPING INSPECTION FEE PLAN CHECK DEPOSIT RECEIPT . .............. TOTAL AMOUNT DUE RECEIPT APPLICATION APPROVAII CALL This application is not a permit until signed by the Building Official or his/her Deputy: and Foes are paid. and FOR INSPECTION receipt is acknowledged in space provided. DATE FRICIAL (425) C. 771-0220 RELEASED BY uAl r EXT 333 771-02211 FAX ORIGINAL -'FILE YELLOW - INSPECTOW PINK - OWNER - GOLD - ASSESSOR IM 6 FINAL PROJECT APP TO: z 9 0 m =i'ii U5 � 0 m c ma 0 80 c Ic 3: M m Z w 0 -n m M 0 0 0 M C ca ic ca M 0 Z r- z CD z 0 m RE_,NSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date si ocaprvl.doc.l:tnV:bldg:fomlslO/01 1164NO# 6 . ^04 "7�77 7 rFv I E RECEIVED 'PERMIT EXPIRES as Al CITY. OF EDMONDS CONSTRUCTION PERMIT APPLICATION MN, E/NANE BUSINESS AWtobb UM MAILING ADDRESS Wo W bcw�y&_ - CIzY . . I — ZIP FELEPHONE NAME ADDRESS I CITY ZIP ITELEPHONE 6b ac, 101 M ADDRESS TELEPHONE rn WA Q 66 0 1 15Y) STATE OtENSE NUMBER EXPIRATION PATE G"Emm" -a ;j PROPER`rYTAx ACCO NTPARPELNO. O'RESIDENTIAL PLUMBING MECH COMPLIANCE OR IDJION COMMERCIAL o CHANGE OF USE A66PEL 0 APARTMENT 0 SIGN R CP�EPAIPI 0 GRADING 0 FENCE CYDS x FT) 0 OTHER 0 DEMOLISH 0 TANK 0 GARAGE 0 RETAN'NGWALL 0 RENEWAL CARPORT ROCK =Ry %!TYPE F S . BYSINPSS OR AC TY) N: ICE VP NymdER_ NUMBER OF CRITICAL OF DWELLING I AREAS 0 STORIES UNITS '_ NUMBER rDESCRIBE WORK TO BE DONE ;01 V.. t PERMI I ZONE NUMBER JOB SU ITE/A ADDRESSJ( PLAT NAME/SUBDIVI SION NO. LID NO. VOT -LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCIP Approved 0 RW Permit Required 0 Street Use permit Rtq'd D EXISTING — PROPOSED Inspection Required 0 Sidewalk Required 0 REQUIRED DEDICATION— FT Underground Wiring required f_1 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES C3 NO 0 ZE REMARKS E OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE 0 z Lu ENGINEERING REVIEWED/DATE FIRE REVIEWED BY DATE. w VARIANCE OR CU SHORELINE OR ADBN INSPECTION- BOND REO'D POSTED Q YES 0 NO SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED, PROPOSED EXP I , LOTCOVER AGE REQUIRED SETBACKS (FT.) C PROPOSED SETBACKS (n) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE REAR z z PARKING REQ'D PROVIDED E BY DATE iT13 K! I tMIRE) PANA Phim 7c� 2-- 'GROUP' IA07 CHECKEDBY TY ION E OCCU SPECIAL INSPECTOR' JAREA OCCUPANT/ REQUIRED YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D 0 A6&Z y kUZ>_-P L-J/ �Fwl I, J 0a 4 VALUATION FEE HEAT SOURCE GLAZING % LOT SLOPE % �UILDING PLAN CHECK NO: VESTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY. THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPjERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADING/FILL DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 180 DAYS PERMIT LIMIT: I YEAR - PROVIDEQ,WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES SEE BACA OF PINK fE!VIT FOR M9R9jNF2RMATION j -APPLICANT O� 13EHXL OFHISOR F4SPOUSE,H*S'.,XSSIGNSANI)SUCCESORS'- A CITY OF fN�. I�SPI��TION SEE. - IN INTEREST. AGREES;fQ INDEMNIFt. DEFEND AND'HOLD HARMLESA THE EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS #ADM ANY AND -LANDSCAPING INSPECTION FEE ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY RECEIPT. FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT DEEMEDTO MODIFY. WAIVE OR REDUCEANY REQUIREMENT OF ANY CITY ORDINANCE 0 NOR LIMIT IN ANY WAYTHE CITY'SABILITYTO ENFORCE ANYORDINANCE PROVISION." RECEIP TOTAL AMOUNT DUE I �ff� I- X-3i 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION A FiPLICATION 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 RELATING TO FOR INSPECTION Building Official or hisfiner Deputy; and F005 are paid. and receipt is acknowledged In space provided. IN VIOLATION OF THE LABgAjCODE OF THE STATE OF WASHINGTON WORKME MPENSAA INVRANCE AND RCW 18.27. N'S CO DATE SIGNA 0 DATE S NED (425) 4AT LN LAAE 771-0220 RELEASED BY DATE TION' EXT 333 TIO IT IS UNLAWFUL T( R :)USEcR0 CUPYABUILDINGORSTRUCTU u "4�t 771-0221 A FINAL INSPECTION HA BE MADE AND APPROVAL OR A CERTIFI- T_ ORIGINAL IL YELLOW - INSPEC O� CATE OF OCCUPANCY H N G�R�ANTED. UBC FAX 5198 PIN,,,, GOLD ASSESSOR nil_