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20030710.pdfV_ - DATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION IER NAMENAMEADF BUSINESS NAME ADDRESS CITY NAME. STATE LICENSE NUMBER 51f W n ef ZIP ITELEPHONE N L U PERMIT EXPIRES USE PERMIT / ZONE 6(o NUMBER APT# ADDRESS 1pi 107011- Ault KI PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. I LID FEE S TESCP APIXO"d PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW P&M-A Required Street We Peffnit Req'd EXISTING - PROPOSED Inspectlon Raquired Sidewatit Required REQUIRED DEDICATION- FT UndWWVjW g r uIred 13 METER SIZE LINE SIZ RES PRV REQUIRED I YES13 NO 13 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE -fl'amallp _146 ENGINEERING REVIEWED BY FIRE REVIEWED BY DATE DATE 1 11 VARIANCE OR CU SHORELINEORADB# I INSPECTION BOND EXPIRATION BY REO'D POSTED Lf V7� 1 13YEs 13NO SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED , PROPOSED ALLOWED , PROPOSED EXP I 0 NEW UIRESIDENTIAL urp-LUMBING / MECH LOT COVERAGE REQUIRED SETBAC (Fr.) SIDE REAR PROPOSED SETBACKS ( ) FRONT L/RSIDE REAR ADDITION CL COMMERCIAL COMPLIANCE OR CHANGE OF USE ALLOWED PROPOSED FRONT I PARKING LOT AREA PLANNING REVIEWED BY DATE 9L REMODEL MULTIFAMILY SIGN RECatD PROVIDED REPAIR 0 GRADING CYDS FENCE ( _ X_Fr) REMARKS DEMOLISH TANK OTHER [i GARAGE CARPORT [:3 RETAININGWALL ROCKERY FIRE SPRINKLER FIRE ALARM (fYPE OF USE BUSINESS OR ACTIVITY) EXPLAIN: NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES 2- dgpvr— I DESCRIBE WORK TO BE DONE I NUMBER 44 1 12 A!k/_ /)/" r_0YA40J&1-- IA14JI I HEAT SOURCE PLAN CHECK NO: LOT SLOPE % VESTED DATE CHECKEDBY I TYPE ORNSTRUCTIQN J� IkC9Vq_' UUL;Ux"U fn V tfr GRO^4V SPECIAL INSPECTION REQUIRED [I YES REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D § VALUATION $ —1 Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical THIS PERMIT AUTHORLCES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURB$, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 180 DAYS PERMIT UMM 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 IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. 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. - Recording Fee I HEREBY ACK14OWLEDGE 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- CALL TION; AND IN Dg*Q,THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATIO"F TH� LA13OR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION WORKMEN'9, INSURANCE AND RCW 18.27. t _,tOMPENSATION ____ SIGNATU OWNER END DATE SIGNED 114-25) 771-0220 VftNftfk EXT 1333 Plan Chk. Deposit Receipt # Total Amt. Due Receipt # APPLICATION APPROVAL VI applicatiqA"ol a permit unfit signed by the ,AfICIaI of hls*r Deputy: and Fees are paid, and 'a"elpt IsppitrigiViogod in space provided. BY DATE IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I 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 ?1 i L . . z 0 M ITI M 0 -10 0 C= 3� x ITI M 0 n _n 3� IT11 M a (—J) 0 0 Fn 0. z z 0 ITI It All? CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMMAME,01' BUSINESS ADDRESS CITY ZIP I TELEPHONE -J FP ER 1,-5 mTExpRES USE ZONE PERMIT 00 N U M B E R JOB ADDRESS N PLAT NAMEISUBDIVISION NO. LOT No. LID NO. WIN I LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 1E5CP.App',=. RW P. . Strw Use Pormh Wd Inspecdo Roq*od EXISTING — PROPOSED S.d.. REQUIRED DEDICATION— Fr I Undw I Wktng required 13 METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED YES13 NO C3 zo REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE eS A , , — J�v ,01, , . � - - . - --L I NAME ZZ I— A�MSS G REVIEWED BY DATE ISO W EWED BY ZIP TELEPHONE DATE /4,/7-5 L AN 6 Ir W Ivaig VARIANCE OR CU SHORELINE OR AD" IN BOND 3T AU-155y ct REO'D 13YEs ONO IS POSTED SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED too EXP , NEW BIRESIDENTIAL 10005UMBING MECH LOT COVERAGE REQUIRED SETBAC PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR 0 ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY PARKING LOT AREA PLANNING REVIEWED BY DATE SIGN REO'D PROVIDED REPAIR 0 GRADING FENCE CYOS ( _ X FT) REMARKS DEMOLISH TANK o OTHER GARAGE RETAINING WALL F RE SPRINKLER CARPORT ROCKERY FIRE ALARM OWE OF -USE. BUSINESS OR ACTIVITY) EXPLAIIi-.-- YPE OFI*CSTRUCTION I Occut .NUMBER NUMBER OF tL/77V 7T y 3 OF r / DWELLING SPECIAL INSPECTION JAREA STORIES 2. [UNITS OCCUPANT DESCRIBE WORK TO BE DONE REQUIRED YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION RECVD 12 1414IJ VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN HECK NO: VESTED DATE Plumbing THIS PERMIT AUTHORMS ONLY THE WORK NOTED. THIS PERMIT COVER Mechanical S WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading SEPARATE PERMISSION. PERMITAPPLICATIOIL. 180 DAYS Engr. Review PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WjTHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection "APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, AS61GNS AND SUCCESOR6 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 Fire Inspection ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY Receipt 0 FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT $HALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE L-andscape Insp. Total Amt. Due 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 Recording Fee Receipt # GIVEN 18 CORRECT. 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 applIcaflon Is t a porml unt.11 signed by the TION: AND IN DOING THE WORK AUTHORIZED THEREBY. NO -PERSON WILL BE EMPLOYED CALL euljoijVfficial or his r Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING To FOR INSPECTION ("Iptls kn I ad In space provided. WORKMENS COMPENSATION INSURANCE AND RCW 10.27. SIGNMATU (a fNER-O ENT) DATE SIGNED OF GIG yLa mi 771-0220 FIE EASED BY A#ENT(o EXr 1333 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 ORIGINAL - FILE - YELLOW - INSPECTOR 04/02 PRESS HARD PINK -OWNER - GOLD -ASSESSOR ARE MAKING.5,CO GREEN - ACCOUNTING z 0 :1 0 M