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20030672.pdfa DATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS Airc 0 1/ Ch f f.S /V10 %j MAILING ADDRESS ' CeA)4C 10C PO A 00 )-e— CITY ZIP TELEPHONE �,A ?tV\^k CA 961,xsj L.3)zx-?-j)0j NAME ADDRESS CITY ZIP ITELEPHONE 0 PERMIT EXPIRES [P7E S E USE PERMIT N E ZONE 0 NUMBER;U'3-(.,)6-r2--_ 0 I JOB F" ;, A D D R E S ADDRESS ft% . SUITEIAPTO PLAT NAME/SLIBDIVISION NO. P LA T LOT NO. LID NO. LID FEE $ P US L I C PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved Rw F%rmit Required Street Use Peffnit Roq'd EXISTING PROPOSED— inspection Required Sidewalk Required REQUIRED DEDICATION— FT F — Underground wiring required METER SIZE LINE SIZE OF FIXTURES PRV REQUIRED ]--;0. YES E3 NO C3 REMARKS 0 OW R WNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE NAME j( e I _:� VIU I C111-4 �4_ OJUS a 14J ADDRESS CITY ZIP A/L 2110- t( TE�EPHONE /9573) 172-2— STATE LICENSE NUMBER EXPIRATION DATE Lx,* 10 PT 3 J,�bo PROPERTY TAX ACCOUNT PARCEL NO. -2 'W,4034D4 NEW 0 RESIDENTIAL PLUMBING / MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL muLnFAmiLY SIGN REPAIR GRADING [3 FENCE CN'DS X FT) DEMOLISH TANK OTHER [3 GARAGE RETAJNING WALL FIRE SPRINKLER PORT ROCKERY FIRE ALARM (TYPE OF USE. BUSINESS OR ACTI!W S+xAC* NUMBER OF NUMBER OF DWELLING CRITICAL 7ftr_1 AREAS STORIES UNITS cl Ll -A q NUM 4 DESCRIBE WORK TO BE DONE N &C e- '67'lcku-ms �Je_ & filice-e, 5 VV-44'e— k4rAj& 1-c-AA-ce— 2* HEAT SOURCE I GLAZING % LOT SLOPE % PLAN CHECK NO: a� --&5 —�— VESTED DATE THIS PERMIT AUTHORUMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONW. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEFS, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 180 DAYS PERMIT LIMIr I YEAR - PROVIDED WORK IS STARTED WITHIN 160 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 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 MODIF'4 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 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 V196410N OF THE LA13OR CODE OF TH15-,PTATE OF WASHINGTON RELATING TO WORKMEIM'D CQUEENSATION INSVIRANGE ANZI FtCW 18.27. DATE IGNE 47;_ 3 7.2-",3 ENGINEERING REVIEWED BY DATE 0 z F FIRE R IEWED BY DATE us FIRE R Ir - . --) — .07-0 VARIANCE OR CU SHORELINE OR ADBN INSPEdTION BOND REQ'De POSTED I acipr 113YES 121hels SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT I ALLOWED . PROPOSED I ALLOWED . PROPOSED LOT COVERAGE REQ IRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED ' FRONT SIDE REAR FRONT L/R SIDE REAR z PARKING LOT AREA I PLANNING REVIEWED BY DAT9 REO'D PROVIDED _1.� 6-RA.1064Z 71141ji. REMARKS CHECKED BY I TYPE OF GROUP ROUP"' SPECIAL INSPECTION AREA OCCUPANT OCCU REQUIRED [] YES rLOAD REMARKS PROGRESS INSPECTIONS PER USC 1108/FINAL INSPECTION REO'D $ �� 4l� I Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit yt Fire Inspection Receipt # Wig Landscapeinsp. TotalAmt.Due Recording Fee --TRecelpt # CALL FOR INSPECTION (425) 771-0220 EXT 1333 APPLICATION APPROVAL This application Is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid, and receipt Is acknowledged In space provided. OFFICIALS SIGNATURE AATE -IQe ,5vw) , q1 2-'- 0 I C) wLW '/; 7f DATE 4 j /)_� 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 51 M C I M_ 0 C �x MITI C) 4 -z 3� 0 n 3� M M C-0). G, C C2 0 z 0 I 0 M OF INSPECTIONS RECORD INSPECTOR DATE APPROVED ..................... FOUNDATION: Footing...................... . Wall........................... Pier/Porch ................. Retaining Wall ........... C) M Slab Insulation ............ PLUMBING: M, ............. Rougo,in .................. Commercial Final . ...... M 10 HEATING: z GasTest ............... (A Gas Piping . ............... Equipment Commercial' Final EXTERIOR SHEATHING,: NAILING: .......................... .... ... ..... C) ........... FRAMING FIRST FLOOR FRAMING. INSULATION ................... �.E"J.a Af :,DATE RECEII 2105 PERMIT EXPIRES' CITY OF EDMONDS USE ZONE PERMIT NUMBER CONSTRUCTION PERMIT APPLICATION C F,OWNEIR JOB ADDRESS C) ;L SUITE/APT# NAME/NAME OF BUSINESS A / -1 /1� I LI Now E/SUBDIVISION NO. LOT NO. LID NO. cc (I L j MAILING ADDRESS 10 CITY ZIP,,, ITELEPHONE (—,A ?61 (so 3);ZI3. 1) 01 NAME ADDRESS CITY ZIP NAME 1� I CBL - I L16- ADDRESS / _R 17 SV ti" Ave CITY ZIP L( A)W )v 11;L f �c / TE�EPHONE 22- 9*) �7 I STATE LICENSE NUMBER EXPIRATION DATE JK As- P -r 3 4�oo PROPERTY TAX ACCOUNT PARCEL NO. 1:3 NEW RESIDENTIAL PLUMBING / MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULPFAMILY SIGN REPAIR [3 GRADING CYDS FENCE X FT) DEMOLISH [3 TANK [3 OTHER [3 GARAGE Ei RETAINING WALL E3 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM UWE OF USE, BUSINESS OR A N: (� S h& CTTF 11 Ir '\ NUMBER NUMBER OF CRITICAL., I_ V-0 ) DWELLING AREAS A OF �JAJ STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE .P\&e /_,"Villes e LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP PUBLIC R TESCP ApPrOved RW Porrnat Required Strom Use Permit RKd X15TI G — PROPOSED Inspection Required Sidffm* Required LEXISTING EQUIRED DEDICATION— FT R R R 0 EQUI Undwitround Wiring requh'od S1 METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED YES 13 No 13 EMARKS R R M R S OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE JCC OW P ENGINEERING REVIEWED BY DATE FIRE JEWED BY DATE 'R If IANCE OR CU SHORELINEORAD11 INSPE6TION BOND I a — REO'D.,e I I POSTED EMP7 13YES ffhfl $ -- SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALL OWED PROPOSED EXP , 7tt LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR FRONT *tJR-,�IDE REAR PARKING LOT AREA REvI DATf- I PROVIDED I :�Nf VREO'D REMARKS CHECKED BY ITYPE OF SPECIAL INSPECTION AREA REQUIRED YES REMARKS PROGRESS INSPECTIld $ Description Plan Check HEAT SOURCE qG % LOT SLOPE % Building Permit PLANCHECKINO: g VESTED DATE Mechanical THIS PERMIT AUTHORMES ONLY THE WORK WyTED. THIS PERMIT COVERS WORK TO 1= BE DOME ON PRIVATE PROPERTY QNLX ANY CONSTRUCTION ON THE PUSUC Grading DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE t: SEPARATE PERMISSION. Engr. Review PERMITAPPLICATIOM' 1100DAYS PERMIT LIUM I YEAR - PROVIDED WORK IS STARTED WrTNIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION OCCUPANT GROUP B OCCUPANT LOAD KFWC RE01i FWEE Description FEE State Surcharge City Surcharge <7 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review PlanChk.Deposft I-T7,* IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS. WASHWGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # V47A ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY _ MOM 111E ISSUANCE OF THIS PERMIT. ISSUANCE OF T141S PERMIT SWILILMOT BE Landscape Insp. TotalAmt.Due 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 # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN - AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF IS CORRECT, THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application in not a pentnit unW signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY NO PERSON WILL BE EMPLOYED IN Vlq[2fiON OF THE LABOR CODE OF ��PTWATE OF WASHINGTON RELATING TO WnRICUMA MWENSATION INSU11W40E RC 18,27. FOR INSPECTION Building Officiall or his/her Deputy: and Fees are paid, and receipt Is acknowiodgod in 9 A pace provided. OFFICIALS SIGNATURE DATE GNE (425) _-jq 1110 ,Z3 a003 R71VI 771-0220 ELEA DATE M 1333 I IT IS UkAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I L- 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 MAKIN =PIES GREEN - ACCOUNTING See z 9 0 1711 =1 :n- 70 � rn M M IT! 10 z 0 M M C (j) C (a M C-) z 0 4 0 M