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20030750.pdfM DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINES; MAILING ADDRESS 7 1-7,44� CITY ZIP TELEPHONE NAME JEJ ADDRESS A CITY ZIP TELEPHONE NAME CBL# 111C ADDRESS 0 7 CRY ZIP ELEPHONE e STATE LICENSE NUMBER EX I CHECKED 0;11 PROPQRIYTAX ACCOUNT PARCEL NO. NEW 0 RESIDENTIAL ADDITION COMMERCIAL REMODEL MULTIFAMILY 1:1 REPAIR [j GRADING CYDS [:] DEMOLISH 0 TANK oGARAGE [3 RETAJNINGWALL CARPORT ROCKERY (TYPE OF USE. BUSINESS LP: M, 75NN NUMBER NUMBER OF OF DWELLING !12ms UNITS DESC WORK TO HE DONE _j /' .e A.11 A�14_ _t PLUMBING <D COMPLIANCE OR CHANGE OF USE SIGN FENCE x Fi) OTHER FIRE SPRINKLER F RE ALARM PERMIT EXPIRES USE PERMIT ZONE (1"6> NUMBER JOB SUITE/APT# ADDRESS 17 ( /� / PLAT NAME/SUBDIVISION NO. LOT NO. bd NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Perfrill Required Street Use Permit Raq'd EXISTING - PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION- FT Underground Wiringraquirad METER SIZE LINE SIZE NO. OF FIXTURES PAV REQUIRED YES 13 NO 13 z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE Lu cc E 'VARIANCE OR CU SHORELINE OR ADBN 6 ZI PECTION BOND I 20'D POSTED I S Is SEPA REVIEW SIGN AREAr HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP ),/ L+ 1'�o L.A LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR PARKING LOT AREA I PL�NNING REVIEWED BY DATE REQ`D I PROVIDED I A`31 CHECKED BY ITYPF UCTION cg)ee _ OCCUPANT CRITICAL 1 11 _" GROUP I AREAS SPECIAL INSPECTION JAREA OCCUPANT NUMBER REQUIRED 0 LOAD REMARKS . I I PRQPRESS IN�EECTIONS PER UBC IOS/FINAL INSPECTION, REQ-0 h Aezrl A / -9..;r) zvh-j*_- <- $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE 6' GLAZING % 1 — LOT SLOPE % Building Permit' City Surcharge PLAN CHECK NO: 7? VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONV4 ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPUCATION: 1180DAYS PERMIT UMTP I YEAR - PROVIDED WORK 15 STARTED 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 INDEMNIFX 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 on INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapoinsp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPR OWEN IS CORRECT, AND THAT I AM THE OWNER, on 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 fION; 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 1,0OR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION recolpt is acknowledged In space provided. WORKMEN'S COMPMCE AND RCW 18.27. 0 1 HUN HE DATE SIGNATURE DATE S)GNED 1A015) % 7, A !qljold 4.1 771-0220 -no n&TF T16N EXT 1333 RELEASE7 B IT IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL IL ) A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIqlNd-FILE YEiiOW-INS/ECT0 CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK-OWMER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING I p I I d d 1 9 I DATE REC �qfl EIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION NAMEMME OF BUSINESS ,at,- A Z4cf- MAILING CITY irol"t—_0 NAME ADDRESS CITY I.e' .94111;� ZIP I TELEPHONE ZIP EPA NAME S CBL N �� ADDRESS 7 CITY ZIP TELEPHONE Aai � e e Z VIX/ STATE LICENSE NUMBER EXPI�'? /)Y!M CHECKED BY �r PX0 6-f- RO S-T 0 / _ _ I A64- P rV'.%'0UNrT L NO. WCE�/ NEW 0 RESIDENTIAL PLUM13ING ADDITION COMMERCIAL o COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY SIGN REPAIR FENCE GRADING CYDS X FT) rOTHER DEMOUSH TANK GARAGE RETAININGWALL FIRE SPRINKLER L-11 CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS NUMBER NUMBE OF CRITICAL OF STORIES DWELLiR10 UNITS AREAS NUMBER 11[1k ESCBU: WORK TO BE DONE e -t &e A, A - HEAT SOURCE GLAZING % LOT SLOPE % (5A f I I PLAN CHECK NO: � — I VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC DOUNN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARNTE PERMISSION. PERMrf APPLICATION: 180 DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS BEE BACK OF PINK PERMIT FOR MORE INFORMATION *APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND PUCCESORS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFMCIALS, EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DE E TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CffYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION., I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION 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 CONSTRUd- TION; AND IN DOING THE RK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF 7 EIHUIEOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPE %!qn�RANCE AND RCW 18,27. SIGN�TURE gWfA DATE "NED J PERMIT EXPIRES -_ 6SE PERMIT ZONE NUMBER JOB ADDRESS & SUITE/APT# PLAT NAMEISUBDIVISION NO. LOT NO. 'Ltd NO. T_ LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW PwrrA Required Street Use permit R6qV EXISTING — PROPOSED— Inspection Raquired Sidewalt Required REQUIRED DEDICATION— FT underground Wirmu required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES 13 NO E3 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING REVIEWED BY DATE ,FIRE REVIEWED BY DATE �A`PIANCE OR CU SHORELINEORADB# ItjSPECTION BOND R 'D EQ POSTED Is Bike As BEIRA REVIEW SIGN AREA Ir r_—__HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP Ne �4 t'.:)o 0 LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR PARKING LOT AREA I PL�NNING REVIEWED BY DATE REO'D PROVIDED I IL _70SIA-1 — I CHECKED BY ITYPE (IF CONSTRUCTION C OCCUPANT GROUP SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [] YES I LOAD REMARKS I PRLWRESS INSPECTIONS PER UBC IGO/FINAL INSPECTION RECVD IV), 4=i Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection feceipt It Landscapelnsp. Tbtl4l A�nt. Due y947 Recording Fee [Rkeipi� #)-j I q This application is ri�a P(in% k�@ dl�Q by the CALL BuIldinaOfficial or his/her Deputy: and Fee's are paid, and IR INSPECTION 'T�Colpt Is acknowledged In epace provided. -4 0 DATE (425) ,771-0220 RELEASED"y ffAT EXT 1333 ._'. //// - 2/2 A) IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 2 A FINAL INSPECTION HAS BEEN MADE AND APPRPVAL OR A CERTIFI- OR LE YE�(OW-INSJECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 P�GVZNER GOLD -ASSESSOR GREEN - ACCOUNTING 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES