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20030778.pdfDATE RECEff T/A 0 �/ [PERMIT EXPIRES :�2�/ USE PERMIT CITY OF EDMONDS ZONE NUMBER CONSTRUCTION PERMIT APPLICATION OB ADDRESS "EMZ OPPER NAME/NAME OF BUSINESS f L')6-70-5&� jLdif PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS LID FEE $ 7/, PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Pamill Requ:18d J::0/6 11,9 //,:2i Sir.. Us. Perm , Req`d CITY zip TELEPHONE EXISTING PROPOSED Inspection Required Sidewalk Required [3 13 MIZIM)s &42(214 1271-iLedl- REQUIRED DEDICATION— Fr Underground Wiring required 0 NAME METER SIZE LINE 0. OF FIXTURES PRV REQUIRED YES13 NO 13 ADDRESS REJAA ER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE z z 1g2j5=,Ms CITY ZIP TELEPHONE NAME ICBL# YZ A f A D*1R "ES [SI CITY Zip TELEPHONE &-4 vm�!� STATE LICENSE NUMBER DATE CH KED BY PROPERTY TAX ACCOUNT PARCEE NO. NEW RESIDENTIAL ADDITION COMMERCIAL REMODEL MULTIFAMILY REPAIR GRADING CYDS DEMOLISH TANK GARAGE RETAININGWALL 13 CARPORT ROCKERY USE BUSINESS OR ACTIVITY) EXPLAIN: WOF PUB614i 69�� NUMBER OF lVlk STORIES NUMBER OF DWELLING ;V1 UNITS 4 DESCRIBE WORK TO BE DONE j j, . PLUMBING / MECH COMPLIANCE OR CHANGE OF USE rl SIGN FENCE X FT) OTHER 0 FIRE SPRINKLER FIRE ALARM ENGINEERING REVIEWED BY -4 "01-'1 f J` DATE FIRE REVIEWED BY DATE W cc r6 VARIANCE OR CU Sxs�ELINEOR ADBN 1. INSPECTION BOND (11(p REO'D -2 STIED 10 C7 V —OP— iq 'ONXEs 13NO I,. Q 00 BEIRA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP I )—< F__ , LOT COVERAGE REQUIRED SETBACKS (_q')_ PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED DINT SA§ REAF17rq' FRONT L/RSiDE REAR aj Vrag_�a-_ali` DA PARKING LOT AREA kPtAfkNING REVIEWED BY DATC I RECYD VIDED '�/q REMARKS fa _777- V,0 za - 14 (j, CHECKED BY ITYPE OF C:ONSTRUCTION COD.E. OCCUPANT -wk— GROUP CRITICAL 7y 1 6t)` AREAS SPECIAL INSPECTION JAKEA_ OCCUPANT NUMBER&—%y I REQUIRED [ LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D —1 A. 1/,,j k=Ln 1) it TAN RPMnV 1__nR C4 Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE __F____6LAZING 11 LOT SLOPE % Building Permit City Surcharge PLAN CHECKN VESTED DATE Plumbing �t Mechanical THIS PERMIT AUTHORMES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 2 DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPILICATION: 180 DAYS PERMIT UMrr 1 YEAR -PROVIDED WORK IS STARTED WITHIN 180DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFOR14ATION '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 2 EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND Fire Inspection fReceipt 1i IALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Total Amt. Due 9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' 11 Recording Fee Re eipt # I 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 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 LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space p�ovlded.. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. - . A OFFICIgAGN 81 T, (01 ATE SICP 0 ED 1A -3 ) x425 j Z, 771-0220 DAtE RE7L� D BY 1�11&TION Off 1333 1 4f IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE 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 0 m am C m 40 OC m m 10 z o -n -n mm a C-0) 0 0 Fn C CO) CO) M 0 Z z z 0 m a L A��, DATE R&CF&M— !e PERMIT EXPIRES USE PERMIT ZONE CITY OF EDMONDS NUMBER (:�&l zzr CONSTRUCTION PERMIT APPLICATION JOB L_ ADDRESS L IVE 7- M1 NAME"E OF BUSINESS _MER Ke LgLS1±2 PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. ) MAILING ADDRESS I -- PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP LID FEE S 7ESCP Approved RW PermA Required Sir" use Perm" R"'d CITY ZIP ITELEPHONE EXISTING — PROPOSED kmpecUon Required Gidewx* Required REQUIRED DEDICATION— FT undwWound Wiring required 13 NAME METER SIZE LINE OF FIXTURES ��7 PRV REQUIRED 1 � YES NO 13 ADDRESS RE AR NERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE CITY ZIP TELEPHONE NAME ICBL#, L .1 6WA&IK k2=2 ENGINEERING REVIEWED BY DATE 0 AD15RESS FIRE REVIEWED BY DATE CITY ZIP TELEPHONE -2 ? 0 170"41 —17,41- N BOND STATE LICENSE NUMBItif" 1`.� M(PIRATION �DATV. BY: VARIANCE OR CU INSPECTION EOST5 1 -CHWKEQ JXW8��KJJREQ'D $ a 4 V&Es 13NO ap SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEE WT. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED P POSED EXP , L PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (F%L PROPOSED SETBACKS (Fr.) NEW RESIDENTIA ALLOWED PROPOSED (54MNrr SM REAWR' FRONT URSIDE REAR A. Llr— - 2 ADDITION COMMERCIAL COMPLIANCE OR t-C), 0 CHANGE OF USE PARKING LOT AREA PLANVING REVIEWED BY D _,[:],,.REMODEL 0 MULTIFAMILY SIGN REap PROVIDED 3D I/ 0 FENCE GRADING X 0 REPAIR., CYDS FT) REMARMAme— '4--, I Q U 0 DEMOLISH ;K TANK OTHER GARAGE RETAININGWALL 0 FIRE SPRINkLER 13 CARPORT ROCKERY,, % FIOEALARM USE BUSINESWOR ACTIVTM EXPLAIN: , 0 CUPANT' ITyP!E MFO T Co 7&OF _�7 1 CHECKED BY N RUCTION GCR e= I OUP NUMBER NUMBER OF CRITICAL OF DWELLIINGI AREAS PECIAL INSPECTION AREA OCCUPANT LOAD UNITS NUMBE YES STORIES R REQUIRED [] WO KTOe DONE 91 REMARKS I . . INSPECTIONS PER UBC 108/FINAL INSPECTIONLREGID PROGRESS A . I.-. A h=^ -1 VALUATION. .1 A.. FEE FEE PlanCheck S u rc he State Surcharge Sta to % 4 EAT SOURCE GLAZING % LOT SLOPE % Building Permit Aqo u rc ar City Surcharge Cit YS I " PLAN CHECK N VESTED DATE Plumbing "-1. :�'- THIS PERMIT AUTHORIZES ONLY THE WORI(NOTED. THIS PERMIT COVERS WORK TO Mechanical t BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading ,U 2 DOMAIN (CURBS, SIDEIIYALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. n r. Re"V4 PERMIT A�� GAII 01Q i ) WORK ARM WITHIN 11110 DAYS PERMIT ILIMM I YEAR - PROVID EngiAnspection SEE 13ACK OF PINK PEr*Arr FOR MORE INFORMATION OR 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit 0 F 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 # TLY ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY BE FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapeinsp, L Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE JOCE N NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Receipt # Recording Fee TION I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL J]AND T OF GIVEN IS CORRECr, AND THAT I AM THE OWNER, OR THE DULY AUTHORtZED AGENT OF RU r C THE OWNER. I AGREE TO, COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a pernilt until signed by the OYE TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LA13OR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building Official or his/her Deputy: #0 roes are paid, and receipt 13 acknoModgod Inbrifici prPyided., WORKMEN'S COMPENSATION INSURANCE AND FICA! 18.27. 0,FMFICIAON& DA* sl Ni)- DATE SIONED (Q Sim. (42 MA �3 771-022%0 EXT 1333 RELEASE B t1f 1) 14, is UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAq'INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE - YELLOW - INSPECTd CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER - GOLD - ASSESSOR GREEN - ACCOUNTING 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES i z 0 0 m C m m 0 m m 6 Fn C C2 0 z 0 4 0 11711