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20030673.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION FR NAME/NAME OF BUSINESS I f I MAILING ADDRESS 7 CITY Ir CIL44. NAME ADDRESS CITY NAME ADDRESIJ CITY STATE LICENSE NUMBER 12411 USE ZONE JOB ADDRESS2,re PERMIT EXPIRES ;ERMIT NUMBER Vt t 71 10 Li WSUBDIVISION NO. LOT NO. LID NO. I LID FEES S1 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required ZIP TELEPHONE EXISTING — PROPOSED 1 Street Use Permit Req'd inspection Required 13 REQUIRED DEDICATION— FT 2.1 02 Ce 19S_ Sidewarx Req ked 13 Undertirmound Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ZIP ITELEPHONE I TELEPHONE EXPIRATION [] NEW B"RESIDENTIAL 1:3 ADDITION Ey"REMODEL COMMERCIAL MULTIFAMILY 0 REPAIR GRADING CYDS 11 DEMOLISH TANK IGARAGE I CARPORT RETAININGWALL ROCKERY UWE OF USE, BUSINESS OR ACTIVITY]l NUMBER OF STORIES UMBER OF WELLING 2 DESCRIBE WORK TO BE DONE Cal. # ENGINEERING REVIEWED BY FIRE REVIEWED BY ICHECKED BY VARI"t"! 1314MMM I I wn-to lbor & ALLU " CLP rnur X_ Py VC IR PLUMBING / MECH I OT COVERAWM00y *104-OW ALLOWED (MOM&I LP �tl [YFBV I COMPLIANCE OR CHANGE OF USE IfEll NG Aill"ffif% 111,111TIC SIGN w—R K, F REO'D PROVIDED1 tREMARKS A FENCE I X. FT) I 07qER [j FIRE SPRINKLER FIRE ALARM CHECKED BY I TYPE CONSTR CTION CRITICAL AREAS SPECIAL INSPECTION JAREA NUMBER REQUIRED 0 YES I REMARKS PROGRESS INSPECTIONS PER UBC DATE DATE its cc OND I ZINU 1$ 111, ma"rFmiT ALLOWED . PROPOSED "qul) SETBACKS (Fr.) j3tM L/R SIDE REAR L__ z By DATE OCCUPANT GROUP OCCUPANT LOAD I INSPECTION REO'D VALUATION $ Description FEE Description FEE Plan Check State Surcharge _V35 HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Mechanical 13E DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN Grading (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) VALL REQUIRE SEPARATE PERMISSION. — Engr. Review ILI PERMfTAPPLICATION: ISO DAYS PERMIT ILIUM 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 ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY Fire Inspection Receipt # 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 Landscapoinsp. Total Amt. Due -o WA-1 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* .' - _N�_ — Recording Fee Receipt # 1_��-74? 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 APPLICATION APPROVA_ I: 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 CALL This application Is not a permit until signed by the IN VIOLATION OF -THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMENS FOR INSPECTION Building Official or hls/he(Doputy: and Fees are paid, and receipt Is acknowledged in space provided. 0"SATION INSURANCE AND IjCW 18.27. BIG NE - A AG DATE SIGNED (425) CIALS E OFFI SIGNATUR 771-0220 ATTENTION EXT 1333 ELEAStolf I DATf IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL _W . -- A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 4 W 0=9 GINAL.- FILE YELLOVZPE70 CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 41tK-OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING RECORD OF INSPECTIONS jo c .1A .12 rn'. c 13 C7�13ATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLOCATION ER NAMENAME OF BUSINESS e,� I I I MAILING ADDRESS __ 7;�Oq_ 17/ Sr CITY ZIP �TELEPHONE ,V/ 206 NAME ADDRESS CITY NAME ADDRESS CITY STATE LICENSE NUMBER ZIP ITELEPHONE CBL N ......... . PERMIT EXPIRES 9�& USE PERMIT ZONE NUMBER (n3 10 JOB SUIT /APT# ADDRESS 71 Cl PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Ap=sd RW Pam* Street Use Permit RWd EXISTING — PROPOSED Inspwction Required Sidewsbc Required REQUIRED DEDICATION— FT UnderWound Wiring roquired 13 METER SIZE LINE SliT-1-70. OF FIXTURES PRV REQUIRED I YES 0 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE C" ST BE FIRE REVIEWED BY DATE 10 TELEPHONE CEPrED VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND EXPIRATION DATE CHECKED BY REO'D POSTED I 10YEs ONO 1$ SEPA REVIEW SIGN. AREA HEIGHT COMPLETE , EXEMPT ALLOWED , PROPOSED ALLOWE13 , PROPOSED EXP NEW E3*RESIDENTiAL. PLUM13ING I MECH LOT guru irri VAnPnqFF:nq - E10A ALLOWE RFIOPOSfo FRONT SIDE REAR FRO ��l rKq E REAR I 1� CC ADDITION 0 COMMERCIAL COMPLIANCE OR r_1 Obtain Electrical Pe!Tt ftm 9 0 CHANGE OF USE 63'*'REMODEL MULTIFAMILY SIGN 0 PA 11 REOD POOR D D 06 GRADING CYDS FENCE REPAJR 0 ( _ X_FT) REMARKS 0 DEMOLISH 0 TANK 1:3 OTHER 0 GARAGE [3 RETAININGWALL [3 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM ME OF USE, BUSINESS OR ACTIVITY) EXP r. V CHECKED BY OF CONSTRLICTION OCCUPANT C# ITYPE GROUP g NUMBER ER OF OW OF UMELLING T7UN RITICAL AREAS t SPECIAL INSPECTION AREA OCCUPANT LOAD 'STORIES, -Ovke ITS tA I NUMBER REQUIRED _S YES DESCRIBE WORK TO BE DONE f REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD HC( CIL e�d Zj 1964h Z& VALUAnON $ WWI q f2i'LUT5 Jr PV Description FEE -Description FEE _60. Plan Check kZ2 State Surcharge q, HEAT SOURCE --r-GLAZING % LOT SLOPE % VESTED DATE Building Permit Plumbing City Surcharge PLM CHECK NO: Mechanical TM8 PERMIT AUTHORIZES ONLY THE WORK NOTM THIS PERMIT COVERS WORK TO BE DM ON PRIVATE PROPEM ONLX ANY CONSTRUCTION ON THE PUBLIC Giading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PFJIMffAPPUCA710N. IGO DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. lnspecflon 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 INDEUNIFY, 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 MATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE 18 SUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT HE DEEMED To MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due -ntl NOR LIMIT IN ANY WAY THE CrPrS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." -7 Recording Fee Receipt # 1 HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION AP R GIVEN IS CORRECr AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLIA. WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a permit until signed by the TIOW. AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OFIHE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building Official or his/her De": and Foos are paid, and receipt Is acknowledged In space provided. WORKMERS Y"SATION INSURANCE AND RCW 18.27. DATE OFFICIALS SIGN4TURE DAT 25 SIG A NT) E SIGNED A 1A9 LIM 771-0220 WELEAS bATif U" ATTENTION EXT 1333 ;`ik, IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSOECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- GINAL - FILE YELLOW- I�SPEC40 CATE OF OCCUPANCY HAS BEEN D. USIC SPCTJDP. 109 4"PINK-OWNER GOLD -ASSESSOR _9RANT i GREEN - ACCOUNTING AESS'HA '�Y AKING 5 COPIES 04/02 RD OU AREW z 0 1 0 M =i --fi ca a M C M -18 0 C: c M M z 0 -n n M M 8 a 0 Fn C8 z z 0 i 0 M