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20030668.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS W6,66 ;AILING ADDRESS 7-IL17-9 J Z-17y ZIP TELEPHONE 2 �j NAME ADDRESS CITY ZIP ITELEPHONE NAME CBLN iks�v"-M ADDRESS — '&V -A, CITY TELEPHONE AIL,L- STATE LICENSE NUMBER EXPIRATION DATE PfECRIP17-a A- 6 4-,D L_ &SOO -L & J D�;_ ID'I (11(0 PROPERTY TAX ACCOUNT PARCEL NO. - j ZF (PIRES PERMIT E) Usk PERMIT ZONE NUMBER JOB SUITE/APT# ADDRESS ZlIq PLAT NAMEISUBDIVISION NO. LOT NO. LID NO LID FEE' $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved Rw Permit Required Street Use Parmit Wd EXISTING — PROPOSED Inspection Required Sidewalk Required REOUIRED DEDICATION— FT I Underground Winn required 13 METER SIZE LINE SIZE NO. OF Fly�U -,—PR"EQUIRED 77 1"1--& O.-.1-PACM11 ESJO NO 13 OUR REMARkS VUCIIIA - - I OWNEjCSgt& LM21ffffifg A L.711641,60=0 — 1- UDRAI AGi 1 1 NEW RESIDENTIAL PLUMBING/MECH DRION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY SIGN REPAIR GRADING CYDS FENCE X ( FT) DEMOLISH TANK OTHER GARAGE RETAININGWALL F RE SPRINKLER z CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN' NUMBER NUMBER OF CRITICAL OF DWELLING STORIES AREAS I NUMBER 0- DESCRIBE WORkfTO 13E DONE S_r VNIV4— C-,j (4�vj k &f,-- 0 u-r 0 og-ge— i-"nau U-0LIgia I h S-A�� 14tor LIoLbtlk ii4 I FIRE OR cu )A REVIEW COMPLETE . EXEMPT . ............. DATE )r L vent wnnect"8 on fuel- 119 HPPfI_dAT_E spaces. UMC 815.1.7, 7 Ug=WQRA -N3PEtYMM-r—_BOND REOD POSTED M10YEs ONO Is SIGN AREA EIGHT ALLOW LOWE PROPOSED Ut hai, Water 4,affief th DtD OnTIrW4T— E h,t Water Mn - __ �#%A 1A PUS%D JiET KS (Fr.) I INT 1 SIDE REAR L_--JATE CHECI(ED BY 111116, j;I I =( *' fffflq- UP a ladl I SPECIAL INSPECTION URVII10 villLn"61 "1156CUPiNT ?", EPTEIl LOAD REQUIRED [] YES P F®RE 4 CC REMARKS PROGRESS INSPECTIONS PER UBC IGO/FINAL INSPECTION REO'D $ It I Description FEE Description FEE Plan Check I State Surcharge I HEAT SOURCE LAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing I -A) 9,1i -,7y( Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO k: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC Grading 2 DOMAIN (CURSS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. k: Engr. Review PERMIT APPUCATION: ISODAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 160 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS 'EDMONDS, Fire Review Plan Chk. Deposit IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF 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 Landscape Insp. 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." I Recording Fee Receipt # 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 crTy AND STATE LAWS REGULATING CONSTRUC- CALL This application 13 riot 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 Foes are paid, and IN VIOLATION OF THE . OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknovdodged In space provided. WORKMEN'S COMPEN INSURANCE AND RCW 18.27. 1 OFFICIALS�IG TURE DATE SIGNATURE (OWNER OR DATE SIGNED kt k (4 25) 7 fix 2"Z 771-0220 irrz ATTENY1014C7 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 I p RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ...................... FOUNDATION: Footind ............ ............. 'Wall .......................... Pler/Pdrch ................. Rebinind.Wo ........ Sla!�lrls.vat?66 .......... PLUM!E�NG: UnclOrground ........... .............. o rhe a Oal.,,,.... C m rcl I m HEATING:, DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS 6: t- 1-7- A r3F -T-V-I 666 MAILING ADDRESS 9 9 1,j r-j. Ave CITY ZIP =TELEP7H0NE fA C-1- 40, NAME ADDRESS CITY ZIP ITELEPHONE NAME CBL # ADDRESS 'F>V CITY TELEPHONE AtcL� q2G-7+`�-SOD STATE LICENSE NUMBER EXPIRATION DATE A6e�,DLGS0j07Z6J Dr:,- a TAX ACCOUNT PARCEL NO. a NEW ef RESIDENTIAL [j AnDITION'. COMMERCIAL �'REMODEL MULTIFAMILY REPAIR GRADING CYDS DEMOLISH [3 TANK, GARAGE CARPORT RETAININGWALL ROCKERY ME OF USE, BUSINESS OR ACTIVTM EXP�A NUMBER ER OF BL�LING OF �LSTORIES DTESCRIBE WORKFro BE DONE MR PERMIT EXPIRES U PERMIT 'ZONE NUMBER �1i ' 0.1 '� 0A_ Joyi. , " ' SUffE/APT# ADDRESS Z ljoq q2x, PLAT NAME/SUBDFVISION NO. LOT NO. LID NO. LID FEE S PUBUC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP AppmVed RW PorrNt Required Stmet Uu Ponnit Wd EXISTING — PROPOSED Inspection Required &Wpvralk Required REQUIRED DEDICATION--..womeow-rr"-w--wowwmoo ri lk� — — JPRV REQUIRED S13 NO 13 CONTROLIDRAINAGE L)Alt:k mo a or L Vellt Is F1 E 1401 I_ ;Ailftfi lob4C DATE I V44ITNCE OR CU INSPECTION BOND REO'D POSTED OyEs 13NO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT I ALLOWED . PROPOSED 'I ALLOWED . PROPOSED LOT COVERAGE REOU PLUMBING / MECH ALLOWED COMPLIANCE OR ri CHANGE OF USE tj4i�wfl Reciardle Oil SIGN o FENCE x _ FT) PA REO'D It% REMARKS1 " Code. 'op T go n all tU OTHER FIRE SPRINKLER FIREALARM dREMARKS CHECKED BY ITYPEtW T -cRrnCAL AREAS /V)4- NUMBER --REQUIRED [] YES GAS P1 �� V"A-- CAJ te.,Vj h tv�-' , Is. 0 (_ -T Uj DA.V-- P1 Pf t,14= (?= r110(U (6t)[-_h4A �el h6_60-ae 1 J!5IM VS -_ - Description FEE Plan Check RWM KS (Fr.) RCSySatTE . C REAR are ELY- Al Per OCCUPANT LOAD Description FEE State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge 15 PLANAHECK NO: VESTED DATE Plumbing 0�1 - Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC 23 Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: IGODAYS PERMIT LIMM 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 Plan Chk. Deposit 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 NATUM ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF.THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS'ABILRY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # 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 sIgnod by the TION: AND IN DOING THE A THEREBY, NO PERSON WILL BE EMPLOYED LD Building OfkW or h13/hor Deputy: and Fees are paid. and VORIZED L R OF THE STATE OF WASHINGTON RELATING TO IN VIOLATION OF THE R AjN FOR INSPECTION recolpt Is acknovdodged In space provided. WORMENS COMPENSA NS CE AND RCW 18.27. NS V OFFICIALS71G4URE DATE IGNATUR E( ER OR DATE SIGNED 1425) -1 , =kEINT) L 771-0220 I ATTENtIO14 L/ EXT 1333 _ e--k= 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 YELLON-INSPEQTOR PINK -OWNER GOLD -ASSESSOR GREEN -ACCOUNTING I z 0 q 0 M om C M N 0 C �c M M 0 *T1 'N M M a V; 0 0 Fn C9 0 z 0 4 0 M