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20030740.pdf13 DATE RECEIVED YY4�� 1 1 PERMIT EXPIRES CITY OF EDMONDS USE/ PERMIT ZONE -7 P:-57 - NUMBER c-4Z /4 / 4-e� —61� / CONSTRUCTION PERMIT APPLICATION . JOB SUITE/APT# ADDRESS OWNER NAMEMAME OF BUSINESS S" (�� A__ PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. Ao �t 15 MAILING ADDRESS LID FEE S lo /4v& A/ YESCP AP '=. PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Parmlli'll Street use Permit Roq'd CITY ZI TELEPHONE 0 EXISTING - PROPOSED inspection Required Sidewalk Required REQUIRED DEDICATION- FT underground Wiring required 13 NAME METER SIZE LINE SIZT--[ OF FIXTURES PRV REQUIRED r) I YES13 NO 13 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE CITY ZIP TELEPHONE NAME CBL# ENGINEERING REVIEWED BY DATE ADDRESS FIRE REVIEWED BY DATE CITY ZIP TELEPHONE VARIANCE OR CU SHORELINE OR ADS# INSPECTION BOND STATE LICENSE NUMBER EXPIRATION DAT] CHECKED BY REO'D POSTED 113YEs 13NO $ SEPA REVIEW SIGN AREA HEIGHT %RTY TAX PROP ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , , I t NEW RESIDENTIAL PLUMBING MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE MULTIFAMILY REMODEL SIGN PARKING DEG] LOT AREA EWED By DATE PLANNING REVI REO'D I PROW REPAIR [3 GRADING FENCE 11 CYDS X FT) REMARKS 0 OTHER DEMOLISH rl TANK GARAGE RETAININGWALL FIRE SPRINKLER CARPORT 1:1 ROCKERY FIRE ALARM (TYPE OF USE. BU 88 OR ACTIVITY) EXPLAIN: M A,;i-_v2 -)-j.4,1 CHECKED BY TYPE CO STRUPTI OCCUPANT - 1 GROUP NUMBER N BER OF RT'CAL OWE s OF UM LILING AREA W STORIES UNITS N SPECIAL INSPECTION JAREA OCCUPANT REQUIRED LOAD 0 YES i DESCRIBE WORK TO BE 'ONE 0 REMARKS' PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION RECtO VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO ft 'HE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSICN. Engr. Review PERMITAPPLICATION: ISO DAYS CL. PERMIT LIMM I YEAR - PROVIDED WORK IS STARITED 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 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 MATURE, 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 Landscapelnsp. Total Amt. Due NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* as Recording Fee Receipt # 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- This application Is not a permit until signed by the CALL TION: AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided. WORKMEN'S COM %E4,MTION INSURANCE AND RCW 18.27. OF I S SIGNATU DATEy S��RE �(?INNEO DATE SPNED 1425) / 1 co 771-0220 'DATE RELEfCSE(fAY ENTION 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 -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 0 m am C m§ -4 OC m C Ica i. of mm C 0 z 0 0 m I QDbATE RECEIVED q1 PERMIT EXPIRES CITY OF EDMONDS USE ZONE PERMIT NUMBER CONSTRUCTION PERMIT APPLICATION juts ADDRESS 4_?Ie�2 SUlTE/AP`T# EINAME OF OMLSINESS U0 14 !1 Q; ho I PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS LID FEE $ /0 A hu a- /t/ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TIESCP MAPF�� AW Per a Street L CITY zi ELEPHONE a 7 1 EXISTING - PROPOSED REQUIRED DEDICATION- FT Inspection Required Sidewalk Required Underground mring required NAME METER SIZE LINE S17E_T�OF FIXTURES PRV REQUIRED $3 I I YESO NO E3 z_ ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE _279 &9� CITY ZIP TELEPHONE �baavl_ NAME ICBL# DATE I FIRE REV'IEWED M ATE ul cc CITY ZIP TELEPHONE IEL VARIANCE OR CU BOND STATE LICENSE NUMBER EXPIRATION DATE I CHECKED BY REO'D POSTED P, 10YES $ SEPA REVIEW SIGN AREA HEIGHT 2ROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED !I I Ge(l j2�' —1-.Vj � Cle5eW I _ EXP I I I NEW RESIDENTIAL rl PLUMBING / MECH COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR z REMODEL MULTIFAMILY [:3 SIGN PARKING REOD PROVIDED I LOT AREA PLANNING REVIEWED BY DATE I I IL REPAIR GRADING FENCE CYDS ( _x FT) REMARKS DEMOLISH TANK OTHER GARAGE FIRE SPRINKLER RETAINING WALL 0 CARPORT ROCKERY FIREALARM (TYPE OF USE, BU§*SS OR ACTIVITY) EXPLAIN: CHECKED �Y ]TYPE C STRUCT 0 C C U PA;NZT, '0�/142E;yj I - I GR 19 /)72� NUMBER CRITICAL NUMBER OF OF ES DWELLING AREAS STORI UNITS NUMBER W DESCRIBE WORK TO BE DONE SPECtALINSPECTION REQUIRED JAREA OCCUPANT LOAD JD'e'."" 0 /01 REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ-0 VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing THIS PERUrf AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Mechanical BE DONE ON PRIVATE PROPERTY ONLY. ANV CONSTRUCTION ON THE PUBLIC DOMAIN JCURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Grading Engr. Review PERMIT APPUCATION: .180 DAYS PERUrf UMrP I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection BEE BACK OF PINK PERMIT FOR MORE INFORMATION ;APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS 'Fea Review Plan Chk. Deposit N INTEREST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIAM EMPLOYEES. AND AGENTS FROM ANYAND Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMTE ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE LandscapeInsp. Total Amt. Due NOR LIMIT IN ANY WAY THE CTTVS ABILITY TO ENFORCE ANY ORDINANCE PROVISION., Recording Fee Receipt # 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 DUCY 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 TM AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is ackricrMedged In space provided. WORKMENS INSURANCE AND RCW 18.27. Ol`ffifL�LS SIGNATRVE DATE DATE SLONED (42 7714D22 0 'DATE SEW ATTENTION 1E. X' 11 " 13 3 3 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 - ACCOUNTING z 9 0 M M MH 0 C 5� IT! 0 In z 0 =1 0 M