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20030695.pdfI C4 DATE RECEIVE�, CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMENAME OF BUSINESS 3, CD kJM^,, a [,\j&�� CITY ZIP I TELEPHONE L'.< L6 J A 26 U0J i a NAME ADDRESS CITY ZIP ITELEPHONE NAME ADDRESS ell ilia 17k' CITY,' ZIP STATE LICENSE NUMBER PROPERTY TAX ACCOUNT PARCEL NO. I CBL TELEPHONE 93 PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB SUiTEjAPT# ADDRES��'J,,� PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TFSCP App, Aw Pr.4 "=ad Street Use Peffnit Roq�d EXISTING — PROPOSED Inspection Floquired Sidewalk Required REQUIRED DEDICATION- FT I Underground 13 METER SIZE LINE SIZE :S PAV REQUIRED YES13 NO 13 z REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE REVIEWED BY DATE FIRE REVIEWED BY DATE 1 11 r- -/ ;- 'A I/ _/ VARIANCE OR CU —*,HO ELINEORADB# I INSPECTI ON BOND EXPIRATION E CKED I CHECKED BY E 15�__ FIT EMQ I POS TED - FIT YaR $ fLu SEPA REVIEW SIGN AREA N HEIGHT COW&ETE EXEMPT AL WED PROPOSED ALLOWED PROPOSED 7 &0a M. W — 14'- -7-51, '41 . EXP Q� %% — I H C INGIMECH JE LOT COVERAGE REQUIRRED SETBACKS (FT)' PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FROM OR LIANCE OR S GE OF USE PARKING t=EA REO'D PROVIDED LAL%4NING REVIEWED BY D Al X FT) REMARKS .3 PRINKLER ALARM NEW RESIDENTIAL PLUMB COMP ADDITION COMMERCIAL CHAN REMODEL MULTIFAMILY IGN F REPAIR GRADING CYDS ENCE DEMOLISH TANK 0 OTHEf oGARAGE RETAININGWALL [:3 FIRE S CARPORT ROCKERY FIRE (TYPE OF US OR N: )5 NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES I M& I NUMBER DESCRIBE WORK TO BE DONE HEAT SOURCE I GLAZING % I LOT SLOPE % PLAN CHECK &0.*,ft VEST�D DATI� THIS PERMIT AUTHOnIZES ONLY THE WORK NOTED. THIS PERMIT JfOVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: ISO DAYS PERMIT UMIr 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 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 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 VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. 8 WM��Wd rip '..,,�AGENT) DATE SIGNED CHECKED BY ITYPUF CONSTP,UCTION CODE OCCUPANT GROUP SPECIAL INSPEC:,7niQNAR1iA OCCUPANT REQUIRED [I YES LOAD REMARKS 1PROGRESS INSPECTIONS PER 1.11810108MINAL INSPECTION RE 'D I Description FEE Description State Surcharge FEE Plan Check Building Permit City Surpharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt. Due Recording Fee Receipt # �7i CALL FOR INSPECTION I -Tr- 1Aq5) 771-0220 APPMATION APPROVAL This application Is not a permit until signed by the Building omcisi or his/her Deputy: and Fees are paid, and receipt Is acknowledged in space provided. OPE'ALS S" ATURE 71 ki ZAA i /) /A.4 �J) .1 '1 /['E 6,d14etDT=e9Yg64*'�L D TE RE J ATTENTION Off 1 33 h3i IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL T—///,/ 2/,? mk I '�ILE A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- L_41GINA - YELLOW! INSftCTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -'OWNER - GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING 1 M DATE RECEIVE PERMIT EXPIRES PERMiT ZONE NUMBER CITY OF EDMONDS JOB 4!�&_ 19 _10 CONSTRUCTION PERMIT APPLICATION ADDRES��j Bull 0 A OWNER NAME/NAME OF BUSINESS LID NO. C-4 PLAT NAME/SUBDIVISION NO. LOT NO. LID FEE $ MAILING ADEIRESS "'P PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP w d R street so erm I Inspec,don ReqWred CITY Zip TELEPHONE EXISTING — PROPOSED 51dowalk Requirad Undargrotmid 9,;- REQUIRED DEDICATION_ Fr WWg required 13 e- 1,JA OJ )0j. ETER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED NAME z YES 13 NO 13 ADDRESS REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE CITY ZIP TELEPHONE CBLj NAME ENGINEERING R E WEVIEDBY C-31 ic ADDRESS z: FIRE REVIEWED BY DATE Lu 0 Ic CITY ELEPHONE ZIP IT P:? PECTION BOND VARIANCE OR cu ORELINEORADB# INS STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY LAPT RE%2 POSTED 10 001bYES_#19%Q $ "SIGN AREA, HEIGHT SEPA REVIEW- D PROPERTY TAX ACCOUNT PARCEL NO. co EXEK!PT _QSED -.ALLQWED PROP ALLOWED PROPOSE 7M I 0M EXPY ji,.�4_-,f� 1 f a 60 7ieO w5lit"71 — il , REQUIjRD SETBACKS (k)l PROPOSED SETBACKS (FT) M PLUMBING/MECH LOT COVERAGE "0Wi%-4""L_LE.A.R. 1 -4 § I ': NEW RESIDENTIAL ALLOWED PROPOSED FRONT WDE REAR 0 COMPLIANCE OR ..... ADDITION COMMERCIAL CHANGE OF USE PARKING LOT AREA 1Y.I.VNING REVIEWED BY DIES,/ M MULTIFAMILY SIGN REOD PROVIDED q_�j �!�MqDq� �, _w NwAb All C_ [3 FENCE z REPAIR GRADING CYOS X FT) REMARKS OTHER DEMOLISH 0 TANK 0 RETAJNINGWALL 0 FIRE SPRINKLER GARAGE CARPO ROOKERY FIRE ALARM "n VYPE OF US BUSINESS OR ACTIVITY) EXPLAIN: CODE OCCUPANT CHECKED BY TYtf,.PF CONSTIlUCTION GROUP cm. I ff ..w M NUMBER NUM13ER OF CRITICAL SPECIAL INSPECTION JAREA OCCUPANT OF DWELLING AREAS STORIES UNITS NUMBER REQUIRED YES LOAD DESCRIBE WORK TO RE DONE REMARKS" ic PROGRE19S INSPECTIONS PER USC I 08/FINAL INSPECTION REaD 211. VALUATION $ Description FEE Description FEE Plan Check State Surcharge LOT SLOPE % A!2b^ 0 HEAT SOURCE GLAZING % Building Permit City Surpharge M VESTED Plumbing PLAN CHEC:L Mechanical IT AWERS WORK To ED. TH 8 PEAM THIS PERMIT AUTHORIZES ONLY THE WORK NOT HE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading N DOMIAIN (CURBS. SIDEVALICS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE :3 SEPAMTEPEMISSION. 9 Engr. Review I PERMITAPPLICATIOW. 111110DAYS 96 PERMIT LIMM I YEAR - PROVIDED WORK 18 STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION Fire Review Plan Chk. Deposit -&ppiifAhrrON HALF OF HIS OR HER SPOUSE, HEI ASSIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY CF EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection # ;01- ALL CLAI Ms FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMFE ISSUANCE OFNHIS PERMIT SHALL NOT BE I Landscapelnsp. lRecelpt Total Amt. Ducal DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Ipt # Receipt # Recording Fee ce I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPUCATION; THAT THE INFORMATION APPUCATION IPR20�VAI C31M IS CORRECT: AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE.TO COMPLY WITH CITY AN D STATE LAWS REGULATING CONSTRUC- AL 'This application is not a permit until signed by�tha Building omcW or hlsftw Deputy: and Fees are paid, and TION; AND IN DOING TilE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO F I SPECTI N receipt Is acknooriedged In space provided. WORKMEWS COMPENSATION INSURANCE AND RCW 16.27. URE *T F LS SIGN E E ATE SIGNED IA9 771-C )220 RE E ATTE NTION &A&YI �O Lk�IDB '504" Vo EXT 133 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUMTEtUNTIL fINSACTOR A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- GIN FILE YELLOW CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PRESS HARD -YOU ARE MAKING 5 COPIES --bWNER GOLD -ASSESSOR PINK GREEN - ACCOUNTIN 04/02