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20030733.pdfI r4A DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION 190 NAMEINWE OF BUSINESS MAILING ADDRESS Z9_45!� -, 2A,_&,j1U NAM�j 11V 111T77 ADDIIESS / gq / �5- - / �;f CITY be aa NAME Wd 0 A6DRIESS i0VI-Irl R04 CITY �ZXAI*Od4i�! STATE LICENSE NUMBER 0 \ /F, A 0 /J. �Ll- axrr- ZIP TELEPHONE 01. — S —2;7 ,�V,!5r. _arr4 zip ITELEPHONE PERMIT EXPIRES USE PERMIT ZONE NUMBER —&12 JOB SUITE/APT# ADDRESS PLAT NAME/SUBDIVISION NO. _TLOT No, LID NO. LID FEE 6 TESCP APPrOftd PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Peirnit Required Street Use Peffnit Wd EXISTING - PROPOSED inspection Required Sidewalk Required REQUIRED DEDICATION- Fr Wiring requLred METER SIZE LINE SIZE ff. OF FIXTURES PAV REQUIRED YES 13 NO 13 9 REMARKS z OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE -ME 0-6)!filzam 40ENM, j� CBL # I ENGINEERING REVIEWED BY DAYE G 1 F /v -3��. ZIP TELEPHONE FIRE REVIEWED BY DATE PARCEL -NO. ADDITION COMMERCIAL REMODEL MULnFAMILY REPAIR GF1AQING .2,20 CYDS PDEMOLISH TANK GARAGE RETAJNINGWALL CARPORT ROCKERY (TYPE OF USE BUSINISS �El,p OR ACTIVIM EXPLAIN: 4�< NUMBER NUMBER OF or DWELLING STORIES 2-1 UNITS DESCRIBE WORK TO BE DONE IV r—zd 5 Fk I_dxv r_,0P,_.r/jy n IN TE CHIECKED SY. V A I N C VARIANCE OR CU '"A E SHORELINEORADB# INSPECTION BOND 7,.,,' 1 REO'D STED I 1$ 7 13YEs ]SLNO _.�o S E P A SEPA REVIEW SIGN AREA HEIGHT C M P L 0 E COMPLETE 0 EXEMPT ALLOWE13 PROPOSED ALLOWED PROPOSED EXP Xp , U-PLUMBING / MECH LOT CC LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) LLOWED ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR oCOMPLIANCE OR 513�, CHANGE OF USE LAM 0 SIGN IfARKING LOT AREA PLANNING REVIEWED BY DA Cr I REQD PROVIDED ra I 4 r F:NCE - X-FT) REMARKS OTHER FIRE SPRINKLER FIRE ALARM CHECKED BY 17YPE OF CONSTRUCTION c OCCUPANT /I A,\ I CRITICAL 6AM I j�� I W A SPECIAL INSPECTION JAREA OCCUPANT N REQUIRED LOAD [I YEs REMARKS ]PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION R-ECT113 Descirlotion FEE Description FEE Plan Check State Surcharge H T SOURC GLAZINCL% LOT SLOP Wmt[ 1 11-106 e�? �K Building Permit City Surcharge P -AN CHECK NO: /), STED DATE Plumbing VE ;4.1;& Mechanical /4:9 1 ____ --- - THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO k: BE DOME ON PRWATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC :1 Grading 3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. FTC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 180 DAYS xx PERMIT LIMIr I YEAR - PROVIDED WORK IS STARTED WITHIN 160 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATIOH ;A N BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS PPLI=T0 Fire Review Plan Chk. Deposit N INT 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 INDIRECTLY 9 FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapoinsp. 1/576 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Total Amt. Due NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.g ov Recording Fee Receipt # z 1,3q I 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 This application Is not a permit until signed by the I OUING TION; AND I DO HE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and roes are paid, and TI IN VIOLATIO 0 THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknovdadged In space provided. 1104OF WORKMEN' ENSATION INSURANCE.VD RCW 18.27. WE OFFICIAL&WIQUATURE DATE BIG E 0 AGE DATE SIG 1A %_W25) 771-0220 ®R 6 6 1 1: iATE OF ATTENTION Off 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 41 L /IF/ A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - INVECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD-ASSESSOR_A 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING Y�j W Ir 11 i z 0 d 0 m am C ms 10 Or� � C, m m 10 0 5n! 9 m M a vi. Fn MO z z 0 q 0 m = ff in !11�1�1 3. Maximum Elevation Allowed: --laverage grade) 25' �A; 4. Reference Point Elevation Shot to House: (datum elevation) + S33 (grade to transit level line shot to house) Total: C) 7. Actual levatio (reference point elevation) cV, e (measurements from nAbd #6) Conclusion: (actual) is greater/ sth4nI4APO (allowed); therefore the house is/ is not over the height requiremetpr ECDC 16.20.30 requirements LATEMMUILDINGWISCHeight CalculationGrading Verification Worksheet.doc a RE -INSPECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL Date si ocaprvl.doc.l:tenip:bldg:formsIO/OI z 0 4 0 m -4 -, H 10 rn c m 0 10 0 C -49 X rn m Z 0 _n n m M a 0 o C c co) M 0 z W z 9 0 m q I DATE RECEIVED PERMIT EXPIRES CITY OF EDMONDS USE PERMIT ZONE NUMBERA�_--� CONSTRUCTION PERMIT APPLICATION JOB SUnVAPT# ADDRESS L / OWMNE OF BUSINESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS LID FEE $ TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW POM* ReqUffed Stroo Use Perm" Recrd CITY, ZIP TELEPHONE EXISTING — PROPOSED Required 6U -;71 REQUIRED DEDICATION IAMP�� METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED V #z7-. A11412. YES E3 NO E3 I z �ADDESS V, ra)�r /w REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIORAINAGE I CITY ZIP. ITELEPHONE 1000br,4144ZZ-4Z Flij A! L, NAME CBL# ENGINEERING REVIEWED BY DffE AdDRtSS bFIRE REVIEWED BY DATE CITY TELEPHONE cc M MzP Id ZA-114-11"Q f- _W Oki ;11.�/ . STATE LICENSE NUMBER EXPIRATION TE CH ED BY &CK VARIANCE OR CU INEORADB# INSPECTION BOND REO'D POSTED 10YEs I 2? )j i q 'r RNo s SEPA REVIEW SIGN AREA HEIGHT 9 PROPERTY TAX ACCO . PLkRCEL 7A i I,- " 5,0 Aae,97 '9 �06 COMPLETE I EXEMPT ALLOWED -PROPOSED ALLOWED PROPOSED MI& I I I C-Ap- EXP a b I &E; MONEW PLUMBING/MECH LOT COVERAGE REQUIRED SETBACKS.(Fr.) PROPOSED SETBACKS (FT.) 0 QefESIDENTIAL. ALLOWED FRONT SlbE - REAR FRONT L/R SIDE REAR PROPOSED ADDrno�.' COMMERCIAL COMPLIANCE OR CHANGE OF USE I.- � I 5,20, REMO,0tL MULTIFAMILY SIGN FfARKING LOT ARE� PL4NNINQ-AEVIEWED BY DAT REQ`O PROVIDED I 1160120 Rq' G NG. FENCE MR Ma CYDS X_FT) _64 REMARKS [:]'j6EMOUSH TANK OTHER E RETAININGWALL o. FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM E OF USE BUSI OR ACTIVI'M EXPLAIN: 'TC CHECKED BY TYPE OF CONSTRUCTION 915M.dCCUPANT T: _.qROUP NUMBER NUMBER OF DWELLING OF UNI TS STORIES Z_ CRMCAL I SPECIAL INSPECTION JAREA OCCUPANT. REQUIRED LOA YES DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REC?D, h r-41 th Y1 'VALUATION 33: z Description FEE Description FEE Plan Check State Surcharge z 0 R LOT SLOPE Building Permit e?g City Surcharge a�� IT! PLAN CHECK NO: VESTED DATE Plumbing Mechanical 2 TMS PERMIT AUTHORMES ONLY THE WORK NOTED. THIS PERMff COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLI ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVIEVAYS, MARQUEES, ETC.) WILL REQUIRE Grading SEPARATE PERMISSION. Engr. Review .PERmnr0PucATiott iwDAys PERMIT LLMM I YEAR - PROVIDED WORK 13 STARTED W11THIN 100 DAYS Engt., InspectionIM0 SEE 8ACKOF PINK PERMIT FOR MORE IMMMATION 70C FIre Review Plan Chk. Deposit, 'APPLICANT, ON BEHALF OF WS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCEWRS 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 INDIRECTLY THE ISSUANCE OF THIS PERMrE ISSUANCE OF THIS PERMIT SHALL NOT BE LXhdscape Insp. Total Amt. Due DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 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 AP 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 until signed by the TION; AND O'NO .. E WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Offictal or histher Deputy: and Fees are paid, and IN VIOLATIO �OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided. WORKMEN ENSATION INSURANCE 16.27. 1 - t --' —_ FFICIA OFFICIAL%Xm4"ATURE DATE a AG DATE BIG 7 -0220 71 Y RE DATE ArMNTION EFT 1333 4 IrRE q11 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL " 24JA A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A QERTIFI- EC To ORIGINAL.'FILE-- YELLOk-INS ECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER - GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE -MAKING 5 COPIES GREEN - ACCOUNTING