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20030743.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS GGY To MAILING ADDRESS CITY ZIP TELEPHONE NAME ADDRESS CITY NAME ADDRESS CITY Eli QCC__Kft_ STATE LICENSE NUMBER PROPERTY TAX ACCOLINT PARCEI ZIP ITELEPHONE ZIP NEW SIDENTIAL ADDITION COMMERCIAL REMODEL MULTIFAMILY REPAIR GRADING CYDS DEMOLISH 0 TANK GARAGE RETAINING WALL 0 CARPORT ROCKERY MTE OF USE. BUSIN999,DR ACIk" EXPLAIN: CfA2z44---4fAr_ NUMBER NUMBER OF OF DWELLING I STORIES UNITS DESCRIBE WORK TO BE DONE HEAT SOURCE GLAONG % PLAN CHECK NO: CBL N PERMIT EXPIRES Fus PERMIT ZONE NUMBER JOB SUITE/APT# A q 4&1 � Lo, DDRE SS PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE $ TESCIR Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP FIW Pennit Required Street Use Peffnit Reqd EXISTING PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION— FT Indsigmsrid Wiring required 13 METER SIZE LINE SIZE PRV REQUIRED YES13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE FIRE REVIEWED BY DATE W cc I M I EL-3 VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND POSTED ION DATE I REO'D . C]YEs 13 SEPA REVIEW COMPLETE EXEMPT SIGN AREA —_ HEIGHT ALLOWED PROPOSED ALLOWED PROPOSED EXP LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) G / MECH 53,"PLUMBING/MECH ALLOWED PROPOSED FRONT :SIDE REAR FRONT LIRSIDE REAR ANCE OR COMPLIANCE OR EOF USE CHANGE OF USE PARKING LOT AREA PLANNING EVIEWED By DATE 0 SIGN REOD PROVIDED FENCE 1:1 nE 101 1 X FT) FT) REMARKS GAS PIPE 0 OTHER UOURVI: -ED BY CI I Y Hrda-rclu I 21[ft-r Uft FIRE SPRINKLER AFFID IN nu I [3 FIRE ALARM CRITICAL AREAS NUMBER \.k LOT SLOPE % VESTED DATE CHECKED BY TYPE 0 OCCUPANT GROUP SPECIAL INSPECTION 1PROGRESS LOAD REQUIRED [] YE JAREA REMARKS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D VALUATION $ Description Plan Check Building Permit Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBUC Grading I DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE I SEPARATE PERMISSION- Engr. Review PERMIT APPILICATION: 180 DAYS PERMIT UMM 1 YEAR - PROVIDED WORK 18 STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION FEE Description FEE State Surcharge 7/-)— 1 City Surcharge I i�37_ I 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS Fire Review Plan Chk. Depostt Receipt # IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF I EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY EEI 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. t Total Amt. Due Receipt NOR LIMIT IN ANY WAY THE CITYS ABIL17Y TO ENFORCE ANY ORDINANCE PROVISION." Recording Fee 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 until signed by the Building Official or his/her Deputy: and Foes are paid, and TION; AND IN DOING THE WORK AUTHORIZED THEREBY NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WAS14INGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. -le--,-,,L F ALS SIG URE DATE SIGNATURE (OWNER OFfKGENT) ) DATE SIGNED IA93 14REEA9SED lzr 771-0220 BY ATTENTION 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 D4/02 PRESS HARD -YOU ARE MAKING 5 COPIES PINK -OWNER GOLD -ASSESSOR GREEN - ACCOUNTING 1 4 71" I �—77. 7 7" '�, �,OATE RECEIVED 01 PERMIT EXPIRES Ubt: PERMIT CITY OF EDMONDS ZONE NUMBER 7 CONSTRUCTION PERMIT APPLICATION JOB SUTIVAPT# ADDRESS qll& - OWNER NAMEINAME OF BUSINESS Z19 7 &-.1)' Guy-na Gvwle�y'ra PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. T MAILING ADDRESS LID FEE $ 7ESCP App"ried 1-t PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Pertnit Roquited Strom Use Permh Fteq'd CITY ZIP TELEPHONE EXISTING - PROPOSED Inspectlon Requlrocl Sid&"k Required -7"7!jq REQUIRED DEDICATION- FT UnderWound uIew "n2�u' ' It lu V S PR\V NAME METER SIZE LINE SIZE NO. OF FIXTURE REQUIRED S C 7YES 13 NO C3 I z ADDRESS REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE CITY ZIP TELEPHONE vent colINEMRS pdredft NAME CBL# m*eaftd Mpg= UMC R15.1.7 UA&&2L ENGINEERIN REVIEWED BY DATE jqQq Lgd4 C FIRE REVIEWED BY DATE Us CITY ZIP rTE�lPiPHkINE IMZ F.UevftA� 91 1411 7io VARIANCE OR CU SHORELINE OR ADBN INSPECTION BOND STATE LICENSE NUMBER EXPIRATION DATE C KED REO'D POSTED 1113YEs 13NO $ 6 SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCO P4RCEL . COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED C , EXP NEW '�I'f__:�NSIDENTIAL O"PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) REAR ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE COMPLIANCE OR ADDITION COMMERCIAL A CHANGE OF USE REMODEL MULTIFAMILY PARKING "IT AM Wrh DATE SIGN REOD PROVIDEJ o FENCE OB niffm 13 REPAIR GRADING 9 1 CYDS REMARKS Will I ( - X FT) 1#01AST116" All AqP DEMOLISH TANK OTHER A DMM 519 1111,1116111m nW I GARAGE RETAININGWALL FIRE SPRINKLER 'FED CARPORT ROCKERY FIRE ALARM "E OF USE, BUISINIM&OR ACTPfM FXP1 AIN- CHECKED TYPWONSTRUCTION OCCUPANT BY A GROUP 'NUMBER NUMBER OF CRITICAL 'OF 0 OWE AREAS SPECIAL INSPECTION OCCUPANT I JAREA STORIES e'-Z UNIT NUMBER REQUIRED [] YES LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC I GO/FINAL INSPECTION REG'D fsa QL tau --esj� $ DescriptIon FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % IBuilding Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PIERMIT AUTHORCMS ONLY THE WORK 1410TED. THIS PERurr eovrrRS WORK TO t: BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC 2 Grading :I DOUAIN (CUIRBS. SIDEWALKS. DRIVEWAYS, UARQUEES, ETC.) WILL REQUIRE t: SEPARATE PERMISSION. Engr. Review PERMFfAPOUCATION: 150 DAYS PERMrr UUM I YEAR - PROVIDED WORK 19 STARTED WffHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERUrf 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 R r FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PE -41 SHALL NOT BE Landscapelnsp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY OR13INANCE NOR LIMIT IN ANY WAY THE CrFY`8 ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' � Recording Fee Receipt # I HEREBY ACK14OWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION '"EREB) GIVEN 18 CORRECT. ANo THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF GIVEN APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a permit until signed by the ION, AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED T M Building Official or his/her Deputy: and Fees are paid, and U OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged ln�spaca provided. LINVIOLATION WORKMENS COMPENSATION IUURANCE AND RCW 18.27. R IAL URE DATE SIGNATURE (OWNER OrENT) D;ATE SIGNED 14215% MREfD (Nm_ 9 z.z L-Al % 771-0220 ML DATE ATTENTION 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. IN6PECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER - GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING 5 z 0 M =4 9 a � 0 M C 4 M_ Or M 10 C z In 00 MM W Fn C (0) z C9 M 0 z 0 M