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20030759.pdfI DATE RECE12/, V I 4AL -11aiia I FPERR PERMIT EXPIRES�� CITY OF EDMONDS USE PERMIT ZONE. NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUITfE/Ala�# ADDRESS L OWNER NAMEINAME OF BUSINESS PLAT NAME/SUBDIVISION NO, LOT NO. LID NO. 5 MAILING ADDRESS LID FEE $ 1 0 Apu 5-y zvs PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7ESCP Approved RW Permit Required S I'd CITY ZIP TELEPHONE EXISTING — PROPOSED Inspectlon Required 13 Sidewalk Required 13 nderaround REQUIRED DEDICATION— FT iring req Ired 0 u NA*E METER SI E LINE SIZE NO. OF FIXTURES PRV REQUIRED YES13 NO 13 ADDRESS REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE CITY ZIP TELEPHONE NAME CBLN AI *7 ek? ENGINEERING REVIEWED BY DATE 0? SS FIRE REVIEWED BY DATE CITY ZIP TELEPHONE W1 ki k(11,611 - I - IN,, 5-2 VARIANCE 08 CU INSPECTION BOND SHORELINE OR ADBff tVE LICENSE NUMBER EXPIRATION _12ATE I ED REO'D POSTED - - f An 13YES 13NO $ SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNr PARICEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , , 13 NEW R� RESIDENTIAL PLUMBING/MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED FRONT SIDE REAR FRONT LIRSIDE REAR PROPOSED COMPLIANCE OR ADDITION [j COMMERCIAL 11 z CHANGE OF USE REMODEL E] MULTIFAMILY SIGN PARKING LOT AREA I PLANNING REVIEWED BY DATE REO'D I PROVIDED REPAIR [3 GRADING FENCE CYDS X FT) REMARKS 0 DEMOLISH [3 TANK OTHER GARAGE RETAINING WALL FIRE SPRINKLER 1:1 CARPORT ROCKERY FIRE ALARM UWE OF USE, BUSINESS OR ACT4 CHECKED BY 0 9CTION r OCCUPANT ITYPE 1 NUMBER NUMBER OF CR FTICAL _011;_-GROUP 0— OF DWELLING AREAS SPECIAL INSPECTION OCCUPANT -STORIES UNITS UMBER JAREA REQUIRED LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REO'D VALUATFON— Description FEE Description FEE Plan Check A. 9 State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % ji!!� I Building Permit Alwfu City Surcharge PLAN CHECK NO: VESTED DATE Plumbing -PERMIT Mechanical THIS AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, E TC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMrTAPPUCATION: 180DAYS PERMIT LIMM I YEAR - PROVIDED WORK 19 STARTED WITHIN 180 DAYS Engr. Inspection 0 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 2 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 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 CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt III I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION AP ICATION 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- ppli don Is not a permit until signed by the CALL 01 TION; AND IN OING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED D 1 B(Ildi el or his/her Deputy: and Fees are paid, and IN VIOLATION OF THE LABORaQU OF THE STATE OF WASHINGTON RELATING TO FOR ION r el Isacknow1odgedInspacajp-,id9d, WORKMEN'S COMPENSAyQU4QjURj%jCE AND RCVV 18.27. 1 IGN R E SIGALWNER OkAGFNI) )/10 ATE SIGNED 141225) A3 All— 2,4C - Z 3 771-0220 - - , RE EASED BY DATE ATTENTIUNT 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 PINK - OWNER GOLD - ASSESSOR 04/02 . PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 1 0 m :; =n, am C MO 0 a -40 C Ic MM m 10 Z 0 -n A fn- m 06 0 r- 0 M C co) C Cl) M 0 Z r- X z Cl) z 9 0 m 'Copy of CORRECTION NOTICE given. to owner/con,tractor by inspector. 2. 3. RE -INSPECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL Dat Si ocaprvl.doc.l:temp:bldg:fonnsIO/OI k'. 7 ? RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: 'A Footing ...................... Ilk Wall .............. ............. 01, Pier/Porch ................. Retaining Wall .... Slab, Insulation .......... PLUMBING: A�e Underground .......... Rough -In ..... .............. Final ...... -,Commercial t All: MUW 4V (I 6L110___.. CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSTS Ak-" -1&2 — W), MAILING ADDRESS CITY ZIP TELEPHONE ADDRESS it I PERMIT EXPIRES U.9 USE PERMIT 4 ZONE j NUMBER JOB SUI`IPAP�# ADDRESS PLAT NAME/SUBDIVISION NO. LOT"k. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 'FESCP XP__Pr0V8d RW Permit Rectulred Street Use Permit R*(Vd EXISTING — PROPOSED ImpectionfleciLdred SidrotM Re"Ired REQUIRED DEDICATION— FT Underwound WIMg required METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED YES [3 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE CITY ZIP TELEPHONE NAME CBL# A,n ENGINEERING REVIEWED BY DATE AD7S FIRE REVIEWED BY DATE or" ZIP TELEPHONE vka 3,2 _5*% VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND MWE LICENSE NUMBER EXPIRATION REO'D POSTED TEWED 1; OyEs 13NO $ rjn1 5231 SEPA REVIEW SIGN AREA HEIGHT PRbPEFrrr TA AcCouNr PAR�Mt_ NO. - COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , , NEW 9L RESIDENTIAL Iff PLUMBING I MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (170 ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REAR C MPLIANCE OR ADDITION COMMERCIAL 0 0 CHANGE OF USE REMODEL MULnFAMILY SIGN PARKING REQ`0 I PROVIDED PLANNING REVIEWED BY -D;kTE LOT ARVk IL REPAIR 0 GRADING CYDS o FENCE X FT) REMARKS t EqMr OTHER DEMOLISH TANK n oGARAGE RETAINING WALL FIRE SPRINKLER 0 FIRE ALARM CARPORT ROCKERY (ME OF USE, BUSINESS OR ACTIY4!� CHECKED BY N OCCUPANT ITYPE KZff 1?zt2/-C7_ GROUP 43 L NUMBER NUMBER OF CRITICAL OF DWELLING AREAS SPECIAL INSPECTION — PANT — occu STORIES UNITS NUMBER REQUIRED [3YEs JAREA LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD Lot, le -sr - VALUATION Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE CLA23NG % LOT SLOPE % Building Permit City Surcharge 25 PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORINS ONLY THE WORK NOT M-. THIS PERMIT COVERS WORK TO 1= BE DOME ON PRIVATE PROPERTY ONLV ANY CONSTRUCTION ON THE PUBLIC Grading a :3 -WAYS, MARQUEES. ETC.) WILL REQUIRE DOMAIN (CURBS, SIDEWALKS, DRIVE t: SEPARATE PERMISSION. Engr. Review PERMITAPPLICATION: 160DAYS PERMIT LIMIr I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION I Plan Chk. Deposit APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review N 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 NATURE, ARISING DIRECTLY OR INDIRECTLY ::OF Total Amt. Due FROM THE ISSUANCE OF THIS PERMFE ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. 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 # � Cfo �AAY I UAVC OCAn TUIC ADDHI-ATItNU THAT THE INFORMATION I rw_nc nu� i GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF At' Lift I I IV Arrrt%jvj%L. tionl3notapennitunfilaignedbythe THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- TION; AND IN DOING THE WORK AUTHOR1790 THEREBY, NO PERSON WILL BE EMPLOYED CALL B I ppII c or hi0or Deputy: and Fees are pald, and IN VIOLATION OF THE LABORJGQ� OF THE STATE OF WASHINGTON RELATING TO FOR ION to el isacknow1odgedinspace'r*10, WORKMEN'S COMPENSAP�"&QLIRAJI _fE AND RCW 18.27 1 IGN E SUN -N�_ SIGNAI�JRE (OWNER 0 AG DATE SIGNED (425) 771-022U RE EASED BY DATE ATTENTION W 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL .41 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE - YELLOW - INSPECTOV41 CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING