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20030715.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION ,NAMEINAME OF - BUSINEV Z!5� P �t Z'Wwop MAILING ADDRESS _elogd'l CITY ZIP [TELEPHONE 4 -Eke 1V—"-40 NAME ADDRESS CITY ZIP ITELEPHONE NAME ICBL# K r,— '__ Z !��i ADDRESS /97 d'I e��/ CITY ZIP TELEPHONE STATE LICENSE NUMBER EXPIRATION DATr, cue fyA Vx/-1 _Id�d 5/1 UV NEW M—RESIDENTIAL ADDITION COMMERCIAL 0 REMODEL MULTIFAMILY 0 REPAIR GRADING CYDS [] DEMOLISH TANK EiGARAGE RETAININGWALL CARPORT ROCKERY (TY USE, BUSINESS 9P ACTPOA EXPLAIN: .PJ.QF NUMBER NUMBER OF OF DWELLING STORIES _I UNITS DESCRIBE WORK TO BE DONE 0 1'0"eo�e 0, vop�LUMBING / MECH COMPLIANCE OR CHANGE OF USE SIGN FENCE ( X FT) OTHER FIRE SPRINKLER FIREALARM 0. CRITICAL AREAS NUMBER % LOT SLOPE % -3 PERMIT EXPIRES ZONE PERMIT NUMBER JOB SUITE/APT# ADDRESS Lf�ol A,) PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Part Required Street Use Permit Req'd EXISTING — PROPOSED Inspectin" Required Sidewalk Required REQUIRED DEDICATION— FT Undo'gm-d Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 1 1 YES13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE_______ FIRE REVIEWED BY DATE I Ir VARIANCE OR CU SHORELINE OR ADB11 I INSPECTION I BOND REO'D POSTED [3YEs 13NO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT ALLOWED . PROPOSED I ALLOWED . PROPOSED LOT C EBW 13 or U ED SETBACK (FT.) ALLOWED pRoposgo reqw] -0 �e�' IL R 0WfDjW%& on fuel -burning u L/R SIDE R plimcm In z r PAR REO'D 11ROVIDED4 AR11"t10lN N= SY1.7 DATE CHECKED BY ITYP C ION OCCUPANTA3 Cffl— ORO z 4 SPECIAL INSPECTION AREA OCCUPANT REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REO'D $ r Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge A5, PLAN CHECK NO: --------- VESTED DATE Plumbing Mechanical 7A THIS PERMIT AUTHORIMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO k: BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC 2 Grading :3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERUTTAPPUCATION: ISO DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICAK 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 Flre Inspection Receipt # 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 Landscape Insp. Total Amt. Due 0 NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - Recording Fee Receipt # /I HERE13Y 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 This application is not a permit unfit signed by the TION; AND IN DgLU9_IHE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and IN V F TH9-DMSQ ODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged in space provided. KMEITS CO��CE AND RCW 18.27. DAT OFF 1 �!M7S r Sit U R E ��URE (OW(ER OR�PfNT) DATE SIGAD j (425) . 7G/Nj oe '4 771-0220 RELEAStO_BY A&E ATTRTI N EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 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-ASSESSO 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING 2 I= I I in .?,,,4;DATE RECEIVED I I I -!I- I LL a W�-: PERMIT EXPIRES I � �� CITY OF EDMONDS A E PERMIT ZONE NUMBER CONSTRUCTION PERMIT APPLICATION JOB ADDRESS IVOI &)tl SUITE/APT# cluktic no 01101KIC007 PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS 7A PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP /_// LID FEE $ 7ESCP Approved RW Pa It Required 04le 14r Stmet U"as Pdrink Roo CITY EXISTING — PROPOSED ZIP TELEPHONE Inspectim R&qL*W Sidewalk RaWlted e REQUIRED DEDICATION FT Utidergrourid Wirkigivicitilrad 13 PRV REQUIRED NAME METER SIZE LINE SIZE NO. OF FIXTURES ES E3 NO C3 ADDRESS R -0 NAGE CITY ZIP ONE NAME JCBLN ENGINEERING REVIEWED BY DATE ADDRESS z FIRE REVIEWED BY DATE ZIP TELEPHONE IC M el VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND STATE LICENSE NUMBER EXPIRATION D7 REQ'O POSTED IMYES 1$ EINO I 1�kf ADCAL I PROPERTY TAX. ACCOUNT PARC L ETE EXEMPT ALLOWED PROPOSED ALLOW4EDOPOSED 2X/0) B L connecto M on venj ors EXP M§ L 1&ftqVdHA Im ftbMWIT CKS (Fr.) ESIDENTAL DING MECH V . "SI NEW C!rs W"1P**LU`M SM UMCEVIS.WNT LUIR 11 REAR I 0 C 5� 1: COMPLIANCE OR ADDITION 0 COMMERCIAL A de CHANGE OF USE z ; M M PARKING LOT AREA PLANNI NG REVIEWED BY DATE 0 REMODEL MULTIFAMILY 0 SIGN REO'D PROVIDED 13 10 z I FENCE REPAIR 11 GRADING CYDS X FT) REMARKS OTHER DEMOLISH 0 TANK om 0 GARAGE RETAINING WALL FIRE SPRINKLER E] CARPORT ROCKERY FIRE ALARM UYP USE, BUSINES�S?7 0 YM) EXPLAIN: OCCUPANT o4 CHECKED BY ION GR MINES M M NUMBER NUMBER OF CRITICAL OF DWELLING AREAS SPECIAL INSPECTION OCCUPANT I I 0 Cr JAREA STORIES UNITS -NUMBER REQUIRED [j YES LOAD DESCRIBE WORK TO BE DONE 0 N.— REMARKS 01 PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION RECV0 VALUATION $ z Ilk Description FEE Description FEE 0 -4 Plan Check State Surcharge 0 M SOURCE GI.AZING 11 LOT SLOPE % Building Permit City Surcharge 5, - - .r � PLAN CHECK NO: VESTED 13ATE Plumbing q — Mechanical 7A THIS PERMIT AUTHORKMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I= HE DONE ON PRIVATE PROPEM ONLX AM CONSTROCTION ON THE PUBUC Grading DOMAIN (CURSS, SIDEWALK8, DRIVEWAYS, MARQUEES, ETC.) WILL REQUHIE t: SEPARATE POWISSION. Engr. Review PERMIT APPILICATION: 180DAYS PERMIT UMM I YEAR - PROVIMD WORK IS STARTED WITHIN 180 DAYS Engr. Inspection BEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT. ON BEHAIY OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review Pian Chk. Deposit IN INTEREST, AGREES TO INDEMNIFX DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICtALS. EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OF WH&EV9R NATURE, ARISING DIRECTLY OR INDIRECTLY NOT BE FROM THE 18SUANCE OF, THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL Landscapelnsp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY C17Y ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION APPROVAL GIVEN 18 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 This application Is not a permit until signed by the TION; AND IN D E WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and QjN2_UL aTATE no WASHINGTON RELATING TO Cno 1pJQ05:f%Tinm rocelpt Is acknovAodged In space provided. IN 1jimidn 1UN Or Iniz I.AwMil, .. .1 In. ENS COMPYNS�1190,16SURANCE AND RCW 18.27. OFF1 LS IGN DA . �UR �E j RE r(OR;0XR�?&MT DATE SIG D (42 771-0220 /I)ArE ATTERiTION Off 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 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 -ACC OUNTING