20030700.pdfDATE RECEIVED
PERMIT EXPIRES
CITY OF EDMONDS
USE
ZONE PERMIT zyV
JM
NILIMBEF�CX
CONSTRUCTION PERMIT APPLICATION
JOB
OWNERINAME/NAME OF BUSINESS
SUITE/APT#
ADDRESS 6 74
/� I�u
(,-k ": , t'� , . -
PLAT NAMEISUBDIVISION NO. LOT NO7 LID NO.
MPULINU ADDRESS
=P
60Y 6
LID FEE $
PUBLIC RIGHT OF WAY PER IMP APP17
CITY ZIP TELEPHONE
OFFICIAL STREET MAP RW
.' U.. P
S I d
EXISTING — PROPOSED Inspectio Roquired
1Y t .2vc qv4- ;I? t
Sidawalk'Required
REQUIRED DEDICATION FT [3
NAME
WIrIngrequirad C3.
METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
YES13 NO E3
z
ADDRESS
REMARKS
9
z
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROQDRAINAGE
CITY ZIP TELEPHONE
SOC4 j(14 CBL#
ADD
-ENGINEERING REVIEWED BY DATE
/Iczw 4-tv-ara_ ke-, JU
�O 61, '0_1
mm'?z
TY ZIP NE
FIRE REVIEWED BY DATE
ell J.� e ITELEPHO
1�?/'gz' -R-,21S'7
STATE LICENSE NUMBER EXPIRATION DATE CHECKED j3Y
VARIANCE OR CUI SHORELINE OR ADBN INSPECTION No
So
]= _ k
RkED POSTED
113YES
PROPERTY TAX ACCOUffr PARCEL NO.
9MLO
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE EXEMPT ALLOWED PROPOSED &LOWED PROPOSED
EXP L!�< kZ-6-1.6 lq'k 114 /
NEW RESIDENTIAL PLUMBING/MECH
-I -666
LOT COVERAGE REQUIRE SET13ACKS (6.) PROPOSED SETBACKS (Fr.)
ALLOWED
ADDITION COMMERCIAL o COMPLIANCE OR
PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR
CHANGE OF USE
REMODEL MULTIFAMILY SIGN
I
PARKING LOT AREA PLANNING REVIEWE
z
FENCE
RE(YD PROVIDED
914W.42
REPAIR GRADING CYDS
X FT)
DEMOLISH TANK 077ES
0
JWRKS C_
4
GARAGE RETAJNING WALL FIRE SPRINKLER
CARPORT ROCKERY
FIREALARM
MW,VSE. BU4kES8 OR ACTIVITY) EXPLAINL.,,-
-4 �jte I
ECKED BY TYPE OF CONSTRUCTION OCCUPANT
NUMBER N=F CRITICAL
OF D
GROUP
sfz&-4Q - - :6
AREAS
UNITS NUMBER
ECIALINSPECTION JAREA kNT
DESCRIBE WORK TO BE DONE
REQUIRED [] LOAD
YES
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REED
-9
AA 4,4A
i
VAI I IATInN 1_0
Description FEE fDescription FEE
Plan Check State Surcharge
HFJ GLAZING % LOT SLOPE %
C
PLAN CHE VESTED DATE Building Permit Cit , y Surcharge
I M-.— 2 oj::� Plumbing Re Ir.
THIS PMMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Mechanical
t: BE DOME ON PRIVATE PROPERTY ONLX ANV CONSTRUCTION ON THE PUBLIC
a
DOMAIN (CURBS, SIDEWALKS, DRWEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading
1= GEPARATE PERMISSION.
11 Engr. Review
5 PERMITAPPLICATIOK- ISODAYS
CL PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit
IN INTEREST. AGREES TO INDEMNIFX DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND Fire Inspection Receipt # e)
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
LNFR' M THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT $HALL NOT BE
DEEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due
01
LIMIT IN ANYWAY THE CRYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee Receipt A
HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION Im-
GIVEN IS CORRE" AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application Is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL Building Official or hlsftr Deputy: and Fees are paid, and
IN VIOLAT ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
IC FOR INSPECTION receipt Is acknowledged In space provided.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
SIGNAYURE DATI URE DATE
AGE SKI IA13
A 5111111211 71-0220 2 *DE
rrrTION Off 1333
S) !t'A =UL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-0(
A26; 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
L
z
0
M
M
M
0
-to
0
M M
10 �5
_z
0 `7111
M M
0 rn
C
I C 490,
ITIO
z
M
z
0
4
0
m
=i:9
am
c
MO
0
40
c
m
MZ
0 -n
A
Fn m
0 V;
0 r-
0 M
a
M 0
Z
z
z
0
m