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20030709.pdfDATE RECEIVEDfl 1z I CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS CITY, ZIP TELEPHONE ADDRESS CITY ZIP ITELEPHONE NAME ICBL# ADDRESS CITY ZIP I TELEPHONE STATE LICENSE NUMBER EXPIRATION DATE I CHECKED BY TAX JILL NEW "SIDENTIAL PLUMBING / MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY SIGN 0 REPAIR GRADING CYDS FENCE X "116(FTI ( 0" _/ DEMOLISH 13 TANK OTHER oGARAGE CARPORT o RETAINING WALL ROCKERY FIRE SPRINKLER FIRE ALARM frYPE OF USE, BUSINESS OR ACTIIVITIO�F NUMBER NUMBER OF RITICAL OF WELLING AREAS NUMBER STORIES UNITS /& DESCRIBE WORK TO BE DONE HEAT SOURCE GLAZING % I LOT SLOPE % PLAN CHECK NO: �Z j I I VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIll COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. AJJY CONSTRUCTION ON THE PUBILIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPILICATION: 180DXfS PERMIT LIMM 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 CI7YS 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 WORKMEN2=ION INSURANCE AND RCW 18.27. SIG7?R1j0�WNERGE!y' le7 TE 7 D17 DA 1(),3 ' I I PERMIT EXPIRES :21 Ll i GE ZONE PIS_(o PERMIT NUMBER JOB ADDRESS __7) SUITE/APT# PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved AW Permit Required Street Use permit Req'd EXISTING — PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION— FT UndeMmund WMit required METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED I YES13 NO 13 REMARKS OWNERMONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDMINAGE I A - i i ' i lr� I -V- rl— I Ll W z I tu Ir III VARIANCE OR CU SHORELINEORADB# I INSPECTION REQ'P OyEs ;9Q I BOND POSTED $ — SEPA REVIEW SIGN AREA HEIGHT COMPLETE E7 ALLOWED PROPOSED ALLOWED PROPOSED I , /' =-XP & LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR 5 Ali /1 Al2�7-62'144M_L_97-- 0*:,-_ PARKING LOT AREA PLANNING REVIEWED BY DATE RE4YD I PROVIDED1 — _ . �f j — 01% 1 j IL I lVo4- --�-v exeeteg 9 " I CHECKED BY ITYPE SPECIAL INSPECTION JAREA REQUIRED 0, REMARKS PROGRESS INSPECTIONS PER UBC I VALUATION Description Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Fire Inspection Landscapelnsp. Recording Fee CALL FOR INSPECTION IA05)%-WIN- 771-0220 FEE AITENTION Off 133 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 OCCUPANT GROUP OCCUPANT LOAD INSPECTION RECII�'D Description FEE State Surcharge City Surcharge Plan Chk. Deposit Receipt # Total Amt. Due 65— Receipt # 29LZ_7� JCATION APPROVAL 7 au is not a permit until signed by the 0 11 r isjfh.r Deputy: and Foes are paid, and I. 1.11nowledge4lo space provided. ORIGINAL - I FILE,) YELLOW -ASPEC'TOR PINK - OWNER - GOLD - ASSESSOR GREEN - ACCOUNTING z M OM C M 0 C 3� El M M 10 � z 0 _n n M M a ro 0 Fn W W M 0 Z. z M APPROVED BY PLANNING pmaw-lf b. �2 fS PIT Y 'D INS 'EXISTIN6 uS E. WiRo i-A uvs TIN& In-ts 11"CE //OUSE 04 "V,6,6Vq&A1N6- PpopagTy eFence must be located on private P . roperty. 14 .0 *Property owner responsible for determining property lines.. *Do not enclose or prevent access to 9MY"City maintained fitcilities. 42 01 a 40 / qE1rN7— 1 1 q V,4; So. 6wAIM M Al . ......... . &Ess L 163q _IpAl /4 C FINAL JECT APPROVAL FORM TO: DATE: — MEMO TO: PERMIT COORDINATOP" WELDING DIMION HEM DEPARTMENT DATB----------� FROM: 0 2. 3. REINSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL. Si ocaMLdoc.l:twV:bWg:formslO/01 z 9 0 m q:ii a; —1 3: om c mo 0 0 c mm MZ 10-1 0 -n n m M 0 0 0 M C 0 r. ca M 0 Z 3: z z 9 0 m . ..... ..... DATE RECEIVED PERMIT EXPIRES USE PERMIT CITY OF EDMONDS ZONE NUMBERA 03 - JOB SUnVAPT# CONSTRUCTION PERMIT APPLICATION ADDRESS 5 OWNER NAME/NAME OF BUSINESS 111A I/ PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP LID FEE S TESCP Approved RW ParmA RaWked & St" Us@ pamit WdT CITY� ZIP TELEPHONE EXISTING — PROPOSED InspoctionRoquired Sidawalk Required R EOUIRED DEDICATION— FT Underground Wking required 13 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES E3 NO 13 z ADDRESS REMARKS OWNEWCONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ripr P7(mi TAmt&L ON CITY ZIP ONE NAME EERING REVIEWED BY rjATE I b ADDRESS L4A I�J 'eir-W, ? FIRE REVIEWED BY 'DATE ul -. I CITY ZIP TELEPHONE STATE LICENSE NUMBER PIRATION DATE TAX ACCOUNT PARCEL NO. CHECKED BY NEW SIDENTIAL 0 PLUMBING/MECH ADDITIO�' [3 COMPLIANCE OR COMMERCIAL CHANGE OF USE REMODEL MULTIFAMILY SIGN [3 REPAIR GRADING FENCE CYDS X 4&FT) DEMOLISH TANK OTHER oGARAGE 0 RETAINING WALL 0 FIRE SPRI14KLER CARPORT ROCKERY FIRE ALARM OWE OF USE, BUSINESS OR ACTIV NUAER NUMBER OF CRITICAL OF DWEL LING AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE I VARIANCE OR CU SHORELINEORADB# I INSPECTION I BOND REQP . POSTED MYES JWQ $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE E;7 ALLOWED. I PROPOSED ALLOWED PROPOSED EXPJ LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SET13ACKS (Fr.) ALLOWED PROPOSED FRONT' , SIDE REAR FRONT LIRSIDE REAR .3-05" AlOeA.- � e&=_=- :11.15 'j- /4f ArP1_L4jZj=9 - PARKING LOT AREA PLANNING REVIEWED BY DATE� 06 REO'D _!!�OVIDEDJ, I A M149 —I%V e—:K e CHECKED BY OrNSTRUCTION CqPFn OCCUPANTW ITYPE e GROUP SPECIAL INSPECTION OCCUPANT JAREA REQUIRED [3 YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D I A A�k I a I% I IMMM M'. , —J! Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: er) VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 1= BE DONE ON PrdVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading a DOMAIN (CURSS. SIDEWALKS, DRIVIEWAYS, MARQUEES, ETC.) WILL REQUIRE :3 SEPARATE PERMISSION. Engr. Review PERMITAPPILICATION. 180tkAYS AL PERMfT ILIMM 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 Fire lieview 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 NATURE, ARISING DIRECTLY OR 114DIRECTLY 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.' Receipt # Recording Fee 1 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 3 6 11 /Tk appi6l is not a permit unfit signed by the find TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED THE STATE OF WASHINGTON RELATING TO 11CH ffier Deputy: and Fees are pfid, odgqo epaca provI,0.ed-L) FOR INSPECTION IN VIOLATION OF THE LABOR CODE OF WORKME��ION I�NSURANCE AND RCW 18.27. , 0 "1 LS U E b T E SIGfIlk,�oWN!E47 'd GE7ffn DATE SIGNED (425) �16r, -02 771 20 D T17, ATTENTION EXT 1333 jL.,ASAE1 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL YELLOW -ASPEC4TOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR 04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 M M C M 43 0 -40 0 C: 3! z M IT11 to z 0 _n 3m� 9 M M a C-0 0 o Fn 0 z 0 4 0 M