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20030747.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION POER NAMEMAME OF BUSINESS i:M \j 11) 1 HA—Wvc M NG-ADDRES q I q2-5- S j CJ CITY zip TELVHONE q 8"C;?Z YaY 7-,�;- 3S" 3 NAME ADDRESS CITY ZIP ITELEPHONE PERMITkEXPIRES USE PERMIT ZONE UM13E JOB SUITE/APT# ADDRESSq��S_ 14�0'At fls4j PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP ESCP Approved RW Permit Required Street We Permit Req'd EXISTING — PROPOSED Inapecdo" Required Sidewalk Required REQUIRED DEDICATION— FT undeforotirld Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES PnV REQUIRED 0 1 I YES C3 NO 1:1 5 REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE R NAli i*k CBL N AFFIDAVITS SHALL NOI DATE 'k4_VC_',a ENGINEERING REVIEWED Ot ACCEPTED 1.1 ADDRESS IF dL/5=' C-0 DATE ul FIRE REVIEWED BY a,' CITY L&P TELEPHONE 196(0 > e!22- 000 40 VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND STATE LICENSE NUMBER EXPJRATION DATE REO'D POSTED I X)W tLl 6:7 qjF9 c L 13YES 13NO $ HEIGHT PROPERTY TAX ACCOUNT PARCEL NO SEPA REVIEW SIGN AREA COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED 00 is , , EXP LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr.) 11 NEW RESIDENTIAL 14 PLUMBING/MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT LIFISIDE REAR COMPLIANCE OR 11 ADDITION COMMERCIAL 1:1 CHANGE OF USE z PARKING LOT AREA PLANNING REVIEWED By DATE REMODEL MULTIFAMILY [3 SIGN REO'D REPAIR GRADING [:] IENCE IYDS FT) nf whillhor The W219F SyStOM REMA Kf t nnan nr ClQSed. eXpAnSipn tanks arA DEMOLISH TANK o OTHER requited on all hot water tanks per GARAGE RETAININGWALL o F RE SPRINKLER CARPORT 13 ROCKERY FIRE ALARM Dry Code. E 19.30.020 (c) (ME OF USE, BUSINIES ACTIVITY]l EXPLAIN: CHECKED BY TYP CT Oq_, COM OCCUPA 444ig "?- �. q-7 GROUP -3— NUMBER I OF I NUMBER OF DWELLING CRITICAL AREAS 0 OCCUPANT SPECIAL INSPECTION— LOAD r STORIES UNITS NUMBER REQUIRED [3 YES DESCRIBE WORK TO BE DONE 2 REMARKS all) PROGRESS INSPECTIO YMN13P 108/FINAL INSPECTION RE 9 -(-Z:> 694:LS CAI:_�_ IrWA0W1W1Qji ILU UM AN= SERVIMSMMMM Ch& VIA4' SMAM BE INSTALLED ON THE coo VALUATION I I W47ERS INE BUILDING Lcrc&j -)IVA _h2aftunz , 0 4)" — mo Azw apayl:�� Description FEE Description FEE Plan Check State Surcharge RCE ILIS� GLAZING % I LOT SLOPE % VESTED DATE Building Permit Plumbing \17)U City Surcharge PLAN CHECK NO: Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERITY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 1 DOMAIN (CURBIS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. - Engr. Review PERMIT APPLICATION: 180DAYS L PERMIT UMM 1 YEAR - PROVIDED WORK IS STARTED WTTNIN 180 DAYS Engr. Inspection SEE 13ACK 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 I EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY Fire Inspection Receipt # — _19'� 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 2 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." n f) Recording Fee Receipt # )fAr I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPUCATION 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 TION, AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building Offlclal or hIsfher Deputy: and Fees are paid, and receipt Is acknowledged In space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. SSIG RE E SIG TURE (OVfE%.P_R AG.EMY - DATE S!PNED (425) A / /Yal e1-,7 771-0220 —REL661E 'CrBY DATLF Imzffiw;;�Lt AT-TENTION 1) 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 GREEN - ACCOUNTING 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES 0 a YbATE RECEIVED PERMIT EXPIRES USE T PERMIT ZONE Z CITY OF EDMONDS I NUMBEFO�W, JOB SUITEIAPT# CONSTRUCTION PERMIT APPLICATION ADDRESSqVz 3- / �0, PIMER NAME/NAME OF �ESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MIING-ADDRESS LID FEE S IMP I-Pr— SY i Cj PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW 'r., ".', Strom Us's Perm, C-" TELEPHONE EXISTING — PROPOSED Inspoction Rsquire'r'd SidswalkRequirod q2 Urdiorground q zip REQUIRED DEDICATION— Fr Wiring required 13 Y7, e]N'A,l NAME METER SIZE LINE OF FIXTURES PRV REQUIRED i YES C3 NO C3 z ADDRESS REMARKS OWNER/CONTRA&j&j?jPjI_T TRAMS&SEDRAINAGE OBSERVED BY CITY INSPECTOR CITY ZIP ONE ARIDAV95 SHALL NOT NAME. CB BE ACCEPTED If 1k6k ENGINEERING REVIEWED BY DATE 0 ADDRESS 4V� FIRE ][]WATE CITY PHONE TELE If S6#6- 1 c? 2 V71 (b, VARIANCE OR CU SHORELINEORADB11 INSPECTION BOND STATE LICENSE NUMBER EXPIRATION DATE I MY REQ'D POSTED iF I 13YES 13NO Is L-1-1: j SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL No. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED , , EXP LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) NEW RESIDENTIAL PLUMBING / MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE.. REAR COMPLIANCE OR 0 ADDITION COMMERCIAL CHANGE OF USE Sir PARKING LOT AREA I PLANNING REVIEWED BY DATE 0 REMODEL 0 muLnFAmwy 3N RE0`D OVIDED REPAIR GRADING FENCE X CYDS Fr) REMAR 01 whidifler 918 water SWOM lKiiell I& 0%ow DEMOLISH TANK OTHER OF a awl# wipjaillwon MW are requked an oGARAGE o RETAINING WALL F RE SPRINKLER CARPORT ROCKERY FIRE ALARM CRY Ckide. ECDC I 9,20gifi Ife-1 (rYPE OF USE, BUSINEsPjR ACTIVTM EXPLAIN: CUPA CHEC!�� :5 NUMBER 1 NUMBER OF CRITICAL - F DWELLING AREAS SPECIAL INSPECTION OCCUPANT JAREA STORIES UNITS NUMBER REQUIRED �LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108MINAL INSPECTION REG'D aus —fr-> L96LS (I Je,- � I is 4-01 oco Wvff VALUATION v —_ Ws"tim 622toR tots BE INSTAUM ON THE —*A_S1TEM=STHEB_UUW A,9;?,d ki2 Description FEE DescriptIon FEE Plan Check State Surcharge FICE 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 t: BE DOME ON PRIVATE PROPEMY ONLY. ANY CONSTRUCTION ON THE PU13UC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARIATE PERMISSION. Engr. Review PERMIT APPLICATIOM ISODAYS CL PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'AP ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit IN IT 2=E�T, 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 FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE 01: 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 CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Recording Fee LL Receipt # 1 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 TION: AND IN GOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR IN . SPECTION Building Official or histher Deputy: and Fees are paid, and receipt Is acknovAedged In space provided. WORKMENS COMFIENSATION INSURANCE AND RCW 10.27. 1, - - 0 fic LS SIGWPRE DVE (CaqR R DATE SIPNED (4 2 ro- ::SIGMTURE �A' 771-0220 LEAstday DATIf N %MIN 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 t z 0 d 0 M =iii I M C M C M M 0 _Tl "n M M Fn C C2 MO z CA z 0 q M