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20030761.pdf13 DATE RECEIVED N CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION 0 NAMENAME OF BUSINESS 15 MAILING ADDRESS ..,,,,]TELEPHONE <t) (IN ck� _11 _71 1�1 4. a"T 14, (�j I ADDRESS CITY ZIP ITELEPHONE NAME ICBLN qCITY ZIP TELEPHONE L) I I STATE LICENSE NUMBER EXPIRATION DATE I CHECKED BY IROPERTY TAX ACCOUNT. PARCEL NO. '!!) _.� —7 0 --al 9-6 1 oe-1. NEW RESIDENTIAL PLUMBING / MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY El SIGN REPAIR [3 GRADING CYDS r] FENCE ( X_ FT) DEMOLISH TANK OTHER EGARAGE l RETAININGWALL 13 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM F U E, BUSINESS OR ACTIVFM EXPI AIN: — ss� NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES UNITS NUMBER DESC --A HEAT SOURCE I GLAZING % . LOT SLOPE % PLAN CHECKUP:— — 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 PUBUC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 180 DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICA1`9 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 MATURE. 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 CITTS 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 REGULAYING 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 INSURANCE AND RCW 18.27, SIGNATURE 711 OKGENT)) CIO _AGNED . 1: r_ v-,I;;njc>:�� DATI� Al'TE!"I IT IS UN A FINAL CATE OF 04102 12 PERMIT EXPIRES OSE PERMIT ZONE NUMBER61')D 3 JO'3 SUITE/APT# ADDRESS PLAT NAME/SUBDIVISION NO. JJOT NO, LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved AW PAS rn" Required EX STING - PROPOSED Street Use Pornrift Req'd Inspection Required Sidewalk Required REQUIRED DEDICATION- FT Underground Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES E3 NO 13 0 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE z ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE Lu 0 4 VARIANCE OR CU SHORELINE OR ADBO INSPECTION BOND REO'D POSTED M DYES 13NOI$ _n SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED , EXP M LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT, SIDE REAR FRONT URSIDE REAR In 0 0 is 5! PARKING LOT AREA PLANNING REVIEWED 13Y DATE 9 06 REO`D� PROVIDED M I M I0 REMARKS 0 -n CHECKED BY ITYPE STRUCTION M2 OCCUPANT GROUP Irn M SPECIAL INSPECT16N AREA uccurml- REQUIRED YES LOAD 0 REMARKS PROGRESS INSPECTIONS PER USC 108/FINAL INSPECTION REO'D M 0 VALUATION $ Description FEE Description FEE ca Plan Check State Surcharge z Building Permit City Surcharge M Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscape Insp. Total Amt. Due Recording Fee _[Receipt # APPLICATION APPROVAL CALL This application Is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid, and FOR INSPECTION receipt Is acknowledged In space provided. OFFICIALS SIGNATUUE DATE 1A91,41saw5) 771-0220 ADATE EXT 1333 ;7 f . It. :.-z TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I L-F TION HAS BEEN MADE AND APPROVAL OR A CERTIFI- U I OFIIG�INAL-FILE Yi��CVV- INSPECTOR ANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING JIF lor .................. AC)Nvdn000 UO:f IVAOUddV IVNI:l .......... snO3NVll33SIIAJ NOIl 33dSNI,IVIO.3dS ON1711VISIM301:1133HS, uollelnsul 6uil!ao ............ uolloinsul-ileM ......... uolleinsul jool:j . S, ................ NOLLVlnSW;vi- ;x "-DNIWVU:i ii66-14 1 sul.4 ................. DNIWVH:l:.: .......................... DNIIIVN ONIHIV3HS HOIU3lX3 lk PULA IV 10jewwoo", ........... ...... juewdinba— ................. 6uldId SBO .. . .................... :DNIIV3H ....... . IVUW Plojewwoo 41 ............... ul-ti6nobi ............... punoi lopun :DNiewnld ........... . uopejnsuI.qeIS�: nem llem.Dulum ................. 40JOd/AOld .................. ...... ................... 6ulloo-A :NOIIVC]Nno:i ..................... . 41913S (13AOUddV 31VO U0133dSNI SNO1133dSNI:io auo3qu 3 LAER 7 ,qPDATE RECEIVED 'Scrub- PERMIT EXPIRES eo� C-3 1 BE PERMIT ZONE CITY OF EDIVIOND� JOB NUMBER C surmi A CONSTRUCTION PERMIT APPLICATION T-DDRESS U) OWNfR,1NAM1EfNAME OF BUSINESS PLAT NAMEISUBDIVISION NO. T NO. LID NO. <71- — -UA LXY Ili,." �L k- MAILING ADDRESS I / 1�- attik-o 11 6 - cl;ix JIP TELEPHONE NAME ADDRESS CITY ZIP I TELEPHONE LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Ap;= 'R'W' CF1srrrM Sftat Use Permit Ple0d EXISTING — PROPOSED trapocdon FWqWred Sidewak ReWired REQUIRED DEDICATION— FT UndwWMW Yfiftcaquirod METER SIZE �l NO. OF FIXTURES PRV REQUIRED I YES NO 13 REMARKS OWNEWCONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE NAME CBL# ENGINEERING REVIEWED BY DATE RODRESS FIRE REVIEWED BY DATE CITY ZIP TELEPHONE d STATE LICENSE NUMBY EXPIRATION DATE I CHECKED BY PROPERTY TAX ACCOUNT PARCEL NO. 4x-3 t 00 NEW 0 R ESIDENTIAL -- PLUMBING M.ECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL. MULAFAMILY. SIGN 0 RER�R 0 GOADING CYDS E o F NCE X FT) 0 DEMOLISH 0 "K OTHER GARAGE CARPORT o RETAINING WALL ROCKERY FIRE SPRINKLER FIRE ALARM 01, YF USE. BUSINESS OR ACTIVITY) EXPLAIN: 1 _ .- - VARIANCE OR Cu SHOFIELINEORADB# I INSPECTION 1$ BOND FIEQ*D POSTED 13YES ONO SEPA REVIEW HEIGHT CO 'T ALLO )BED I ALLOWED . PROPOSED LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR I PARKING LOT AREA I PLANNING REVIEWED BY DATE REQ`D I PROVIDED I REMARKS CHECKED BY OCCUPANT GROUP LNUtABER NU,1, BER 8F!.1 STORI ES NUMBER OF DWELLING U NITS CRITICAL AREAS NUMBER SPECIAL INSPECTION AREA REQUIRED [3YES .1. OCP.YPKNT DESCRIBE WO* TO BE DONE kWRKS A PROGR0%iNSPf&I0NS PER INSPECTION REGtD I CJ04 lam MR r 9 Aff " M us am M" -SwAk� /;�&I, - ;A1 0 7 HEAT SOURCE GLA23NG % LOT SLOPE % PLM CHECK 110: VESTED DATE Owes THIS PERMIT AUTHORM 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 PERMIS.8110N. PERMITAPPLICATION: 180 DAYS PERMIT UUM 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE SACK 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, -TTS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. AMSING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE I DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CrrrS ABILTTY 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 CONSTRUC- 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 WORKMENS COMPENSATION INSURANCE AND RCW 18.27. 1 - SIGNATURE (4711 OCGENT)) DATE ;4GNED nlo- A"') vr— I 1�>l D —3 IT IS UN*Y A FINAL CATE OF 01 04/02 VALUATION 1W III V NNW $ Description FEE Description Plan Check State Surcharge Building Permit City Surcharge Plumbing &:zz Mechanical Grading I Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection_ Receipt # Landscapeinsp. Total Amt�.Due 7 X J 0 Recording Fee Receipt # APPUCATION APPROVAL This apiplIcAllon Is not a permit until signed by the qAL ' L Building OMcW or his/her Deputy: and Fees are paid, and F�R INSPEICTION receipt Is acknowtedged In space provided. OFFICIALS SIGNATUI�� DATE 1A&3 . .5) rio a 771-0220 R o qj I ADATE Off 1333 _2 f / /(I rM ;7N nllf'71113C "KIT11 lu uzpr- Un ULOLAUrT 1% OVILL0114%3 Un 01 TION HAS BEEN MADE AND APPROVAL OR A GERTIFI- ORIGINAL -FILE YELLOW- INSPECTOR ANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING to RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS ,C*re— j3 We s-r MAILING ADDRESS 47 4 1:), 1-7 Hf 4 ve- We CITY ZIP PHONE 1309) 52 3 -1.2 00 NAME ADDRESS CITY ZIP TELEPHONE E B�L — Ato W-AL.; ��7113 � , , ADDRE S 1341/44 Ave '04VIV CITY ZIP )-,,j(LEPH6jE I Ir .,9 1 qfle� 419,14 -lot -7 STATE LICENSE NUMBER EXPIRATION DATE CHWKE5 '5L4-t"rj.=,YHj32jK4 09/0. 0y) 0 NEW RESIDENTIAL IWPLUIMBING / MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REM06EL 0 MULTIFAMILY 0 SIGN 0 REPAIR 0 GRADING CYDS [3 FENCE X ( FT) rl DEMOLISH TANK Ei OTHER oGARAGE CARPORT RETAININGWALL ROCKERY FIRE SPRINKLER FIRE ALARM _UA ORACTIVn AN'. OWE OF,USF,-:P NUMBER OF. NUMBER OF DWELLING CRITICAL AREAS [NUMBER STORIES UNITS DESCRIBE WORK TO BE DONE SI-4" gslc lawril.4 �9�2 [%ft PERMITEXPIRES USE PERMIT ZONE NUMBER4d045-tl,�Ml JOB SUITE/APT# ADDRESS —7 1 0 1517 Sq- LOT NO. LID NO. LID FEE S IES- Appl=ed PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW 'rr. , Sum Use Perrrvit Req'd EXISTING — PROPOSED InspecUon Required SidewaW Required REQUIRED DEDICATION— FT Underoround WMij Fq ed METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I I I YES13 NO 1:1 z REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLMRAINAGE GAS PIPE TEST MUST BE MEZ "7- -7f AFFIDAVII31HALL"NOT ENGINEERING REVIEWED BY RE 1CCEPTIN) DATE FIRE REVIEWED BY DATE VARIANCEOR CU SHORELINE OR ADBI INSPECTION BOND REO'D I POSTED 13YEs 13NO S $EPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED1 :XP , LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACK& (FTY ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR z PARKING LOT AREA I PLANNING REVIEWED BY DATE 06 REO`D I PROVIDED CHECKED BY ITYP ECUN51 UU!lUrN LIULPC .-W GROU Z SPECIAL INSPE( OCCUPANT REQUIRED LOAD REMARKS PROGRES�&NN.ISP,,ECTIONS PER UBC I 08/FINAL INSPECTION RECtO VALLIA1104. . T%max"I A*-CP W $ KkVM4- Description FEE Description FEE Plan Check aekse 30- State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUT"ORMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO HE DONE ON PRIVATE PROPERTY ONLX ANY COMMUCTION ON THE PUSUC Grading DOMAIN (CURDS, SIDEWALKS, DRIVIEWAYS, MARQUEES, ETC.) WILL REQUIRE 4., Sipylfut E PEAWST9"...: 40 5ngr. Riww.. PERMITAPPUCATION: 160DAYS PERMIT ILIMM 1 YEAR - PROVIDED WORK is STARTED WrrHIN ISO DAYS Engr. Inspection SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION City Surcharge 20— -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 OR INDIRECTLY - FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapeinsp. Total Amt. Due SV22. DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." I - Recor ding Fee 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 This application is not a permit until signed by the THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL ."� .. �M — w^r1f Al rrHORlZED THEREEN NO PERSON WILL BE EMPLO D Bulldlng Officiall or his/her Deputy: and Fees are paid, and I ul�; IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTI N ,-)receipt is acknowdodged In space Ix WWed. WORKMEf?S COMPENSATION INSURANCE AND RCW 10.27. S SIG ATPRE DATE SIGNATURE OR AGENT) DATE SIGNED (425) roric j fo3 771-0220 .,� _k —R—ELUSE71fdY z�t /bATE/ MW ATTENT109' 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 z 0 4 0 M :q:fi 65 3� M M 0 10 C 3: rn M z ca 0 _n n 11TI M a 5i 0 0 Fn cr 0 z 3� ca z 0 4 0 11TI