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20030751.pdf11 DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS Fb_1nt'E,�uj(_,rAs MAILING ADDRESS ;�901 - CITY ZIP LEPHONE JL I o (o - _�r74 tA o� NAME ADDRESS qar- P-��,+ws A,.. CITY ZIP TELEPHONE Se0,We__, Rt?)�C)9 NAME t- ON 6-X—rU 0 LF 12�p. U C ICBLI ADDRESS -2- W/ kL65!�fjm . CITY ZIP TELEPHONE STATE LICENSE NUMBER EX! LBOFFN F I . CHEC b - col 14 Jada Z. ROPER7Y TAX ACCOUNT PARCEL NO. �t7ro)�?v 0' aff"'ONEW 13 RESIDENTIAL E] PLUMBING MECH ADDITION COMMERCIAL COMPLIANCE OR 0 CHANGE OF USE REMODEL 2110MULTIFAMILY SIGN 0 REPAIR ig o FENCE %p2pCy DS X DEMOLISH 1:1 TANK OTHER IGARAGE 3 -1 RLTAININGWALL 0 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM _0 (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: 1?U4_-r__r- 01r !K - NUMBER NU14SER OF CRITICAL OF 'A DWELLING AREAS 1TORIES U N UNITS DESCRIBE WORK TO BE DONE PERMIT EXPIRES USE PERMIT ZONE NUMBER�&g�&- JOB ADDRESS Z 17NO PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required Street Use PSffnh RK'd EXISTING — PROPOSED Inspection Required Sidooralk Required REQUIRED DEDICATION— FT underground Wiring required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIR=_D YES 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE El W e�IC7 VANCE OR CU HORELINE OR ADS# SEPA REVIEW SIGN AREY IPLETE . EXEMPT ALLOWED . PR I 0 4)19_103 D TE Ul cc SPECTION BON3 REC .1 POSTz_D 'ES '0__SO 1 $ — I HEIGHT oi�o ALLOWED . PR SED LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBAI L A ALLOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE IFT)REIMARKS PARKING REO'D PROVIDED LOT AREA PLANNING REVIEWED BY DA)E . t < J, - C!UAA au-tew— 4-n ir HEAT S0VRjQE G NG % LOT SLOPE % 1V4h ob, I PLAN CHEC"Gi I VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 1160DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT; ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, 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 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." 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 CRY AND STATE LAWS REGULATING CONSTRLIC- 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 WORKMEN'S COMPENSATION INSURAN59-AND RCW 18.27. 81111111MAT11 I: n DATE SIGNED,,/ CHECKED BY ITYP O'F(;ONSTR4SION C009 CCUPANT 30149-iiiiiii" 111 GROU SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [] YES LOAD 1EMARKS 3ROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION !11 VALUATION $ I k* aaa $- 30. — Zb)5 7ssr � Description FEE DescriptIon IEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review PlanChk.Deposft Aj� Fire Inspection Receipt N I 011,11 X;;K A Landscape Insp. Total Amt. Due WL�- Recording Fee # I L CALL FOR INSPECTION 'A'35) 771-0220 EXT 1333 ___jRecelpt APPLICATION APPROVA. This application Is not a permit until signed bj Building Otficial or his/her Deputy: and Fees are F recelpt is acknowledged in space providec the Ud, and OFFI I NAT-QRE DA E R-EL BY AA!rE IiA 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 YE"�LCW-ft CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD-ASc 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING I z 9 z 0 =1 0 M FINAL PROJECT APPROVAL FORM z 9 0 m '49 US —4 am c ma 0 80 c 4 r. MM MZ 0 -n n M m a 0 0 M C ch rM c/) M 0 Z M I z z 0 m SSUES GRANT FINAL PROJECT APPROVAL RE -INSPECTED OUTSTANDING I Date Si ocaprvl.doc.l:tenip:bldg:formslO/oI dM DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OW14ER NAMEfNAME OF BUSINESS Fc;i ht Eaw'arAs LU, MAILING ADDRESS Q�:,, CITY ZIP JMLEPHONE saa4� I 1*2D(o-Z'74-b`A0 NAME Wc�>ex- +TkDrny5z)v--, Arc_W%+er_+:5 ADDRESS 4 1 L436 Ro�n+ws Ave.0-'*DLo0 CITY ZIP TELEPHONE Sje.o� Cie -344-51700 NAME. jCBL# . ADDRESS ;L SQ/ CITY ZIP TELEPHONE STATE LICENSE NUMBER -M I - ow - M"NEW RESIDENTIAL ADDITION COMMERCIAL REMODEL VMUL11FAMILY REPAIR D G YDS 0 DEMOLISH TANK oGARAGE RETAININGWALL ROCKERY CARPORT (ME OF USE., BUSINESS OR ACTIVITY) EXP "riUNITS NUMBER NUMBER OF OF DWELLING STORIES DESIZRIBE WORK TO BE DONE PERMIT EXPIRES PERMIT ZONE NUMBERJ,0,,'�,e!:� J013 ADDRESS 17NO __11AM PLAT NAME/SUBDIVISION NO. ] LOT NO. LID NO. LID FEE $ PU13UC RIGHT OF WAY PER OFFICIAL STREET MAP TEr.up APP-0 RW pem* Reclulked streat use Peffrift 1160 EXISTING — PROPOSED— inspoeWn fl6quked SWawalk Recluked R EQUIRED DEDICATION— FT Undeforound Y&Mllrecitgred 13 METER SIZE LINE SIZE 2F FIXTURES PRV REQUIRED YES13 NO 13 REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE I 9 % T, 1". 71010".. V 11 "1. E TE cc r6 7 7010 1,41 CHE C D E 7 IANCE OR CU - VHOREUINE On A- I SPEU I 1UN I REOM 1 YES POSTED EO $ mos . SEPA REVIEW SIGN AR % HEIGHT COMPLETE EXEMPT C 0 ALLOWED PR OSED 6 ALLOWED PROPOSED 0 0 X[ �Z� 7-7—T I LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT) C PLUMBING / MECH LL ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR JHA OR COMPLIANCE OR - .0.00009naw JE SE CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY D�TIE SIGN REOD PROVIDE I Wt,� oce FENCE an 0 ( X FT) REMARKS OTHER ;:� F RE SPRINKLER 0 FIRE ALARM J'".t ji %f0krF JFHECKED BY .4CONSTFILIUON OCCUPANT, CRITICAL ON&I Ill., GROUP AREAS JgA SPECIAL INSPECTION JAREA OCCUPANT. NumseAg-p REQUIRED 0 YES LOAD ...--IREMARKS I PROGRESS INSPECTIONS PER UBC IGO/FINAL INSPECTION REG-0 . . I �. . 1 A& 9"1 $ Description FEE Description FEE Liu I L_Lj_ Plan Check State Surcharge HEAT S01JR 11%j / I ff- Building Permit City Surcharge PLAN CH -C VESTED DATE O� = Plumbing Cq Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PIRWATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 2 DOEMN (CURBS, SIDEWALKS, DRIVIEWAM MARQUEES, ETC.) WILL REQUIRE 3 SEPAMTE PERMISSION. 9 Engr. Review PERMIT APPLICATION: IGODAYS I PERMIT LIMM I YM - PROVIDED WORK IS STAMM WITHIN iso 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 PlanChk.Deposh & 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 0 ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANICE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Total Amt. Due 7 DEEMED TO MOD1F%,WAlVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Receipt # RE Recording Fee— l HEREBY ACKNOWLEDGE THAT I NAVE,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 pennit 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 Official or hisiber Deputy: and Fees are paid, and receipt is acknowledged In space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. L DATE OFFIC I 0 E DATE 8113NED JA 1,4251 �,C "IGNA 1 .4 771-0220 ATTE LR EXT 1333 Y__ RELE'k j6ATE IT IS UNLAWFUL TO USE OR PCCUPY A BUILDING SMUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- r 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 1 11 z 0 0 M