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20030779.pdfI DATE FIECEIVEDPJ t�-i � o� ERMIT EXPIRES Lp -1 CITY OF MONDS Z NE PERMIT U fA I NILIMBERe��' y -- CONSTRUCTION PERMIT APPLICATION JOB SUITE/APTf ADDRESS &�to L 1,,, 1 U T OWNER NAMEINAME OF BUSINESS c.21 '-f, PLAT NAME/SUBDIVISION NO LOT NO. LID NO. MAILING ADDRESS' LID FEE $ A Ike a 5xi TIESCP Approved PUBLIC RIGHT Of WAY PER OFFICIAL STREET MAP RW Pefrnit Required Sir@ CITY ZIP TELEPHONE I U,.a=aq'dV* EXISTING (02 PROPOSED Inapec Sidewant Required 13 (0!ksl REQUIRED DEDICATION F1 underground Wiring required NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED LA A, re YES C3 NO 13 3 ffi c (ra ADDRESS REMARKS z 3 OWNERICONTRACTOR RESPONSIBLE FOR EROSiON CONTROWDRAINAGE CITY ZIP TELEPHONE =L NAME CBLN VVII 6.6 & ENGINEERING REVIEWED BY DATE CC ADDRESS 0 A06— e5. FIRE REVIEWED BY DATE Ic CITY ZIP TELEPHONE fly VARIANCE OR CU SHORELINE OR AD INSPECTION BOND STATE LICENSE NUMPER EXPIRATION W�TE A REO'D POSTED s Eliolsa,pc,o -A SEPA REVIEW SIGN AREA HEIG14T Q PROPERTY TAX ACCOU NT&§CEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , NEW RESIDENTIAL PLUMBIIS14M�FCH, LOT COVERAGE REQUIRED SETBACKS (9.) 1 PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT St R FRONT URSIDE REAR C OMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE El REMODEL 13 MULTIFAMILY SIGN PARKING LOT AREA P� �NNING REVIEWED BY DATJ RE PROVIDED D4 I REPAIR GRADING CYDS FENCE X FT) RE MW V-0,1 OTgER DEMOLISH TANK a at GARAGE RETAINING WALL FIRE SPRINKLER FIRE ALARM CARPORT ROCKERY —7JF AA &�"Ahg 6 (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: 659WO. 6&W. CHECKED BY 19WE OF CONSTRUCTION OCCUPANT 'GROUP lei? xvie NUMBER NUMBER OF CRITICAL OF /VIA DWELLING AREAS SPECIAL INSPECTION AREA OCCUPANT STORIES UNITS MBE FV4 REQUIRED [3 YES �LOAD WCAK TO BE DONE t REMARKS PROGRESS INSPECTIONS PER UBC 11081FINAL INSPECTION REG-D /0 At7YZn4z Y-) via VALUATION Description FEE Description FEE Plan Check 0 State Surcharge .4EAT SOURCE GLAZING % LOT OL OPE % Building Permit City Surcharge PLAN CHECK ]NO, VESTED DATE Plumbing Mechanical THIS PERMIT ALITHORMES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO III: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review 15 PERMrTAPPUCATION: ISODAYS PERMIT UMrP I YEAR - PROVIDED WORK 15 STARTED WITHIN 190 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIG NS 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 Landscapelnsp. Total Amt. Due ij & L 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 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- TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED This application Is not a permit until signed by the CALL Building Official or his/her Deputy: and Fpos are Dald, and IN VIOLATIONAOF THE LABOR COP OF THE STATE OF WASHINGTON RELATING TO _L_ FOR INSPECTION receipt Is acknowledged in spaclprovid4 J. WORKMEN'S %MPENSATION ITdRANQZyAND RCW 10.27. OFFICI IGN7j. 11 kTE NER 0 DATE SIGNED 1A99z% 771-0220 C kTE E SED BY ATTE ION M 1 3 1 1 M"11/m- IP21j, IT IS UNLAWFUL TO USE A BUILDING OR STRUCTURE UNTIL AA A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YEI I OW - INSP CIF( CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING CITY OF EDMONDS (425) 771-0220 FAX (425) 771-0221 121 5TH AVENUE NORTH - EDMONDS, WA 98020 Website: wwacLedmondsma.us GARY HAAKENSON MAYOR Re: Performance Bond # SL1235, Puget Sound Ear, Nose and Throat Group� 1h 21616 76 Avenue W, Suite 112, Edmonds, WA 98020 _Xg Dear Sir or Madam: The City of Edmonds hereby authorizes the release $2,200.00 from the above referenced Performance, Bond. All interested City departments have approved the release of the Performance Bond. Sincerely, Marie Harrison Senior Permit Coordinator cc: Wilcox Construction File UTemp/DST's/MasterLcttcrs/ReleasePerfonnance02/01 Incorporated August 11, 1890 Sister City - Hekinan, Japan N �g Z'g a z 0 m 715i ro � am c mo 0 —40 0 C: M mz ,C) --I 0 -n n Fn m C3 65 0 0 Fn C cl) K CO) M 0 Z ;u z z 0 m m k DATE REC T.EIVEo(?T lh�[PERMIT EXPIRES CITY OF EDMONDS USE PERMIT ZONE NUMBER(-��l 2.' CONSTRUCTION PERMIT APPLICATION JO SUITE/APTf ADLESS G L I Ifff U OWNER NAMEMAME OF BUSINESS r�2 LL to PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. 15 MAILING ADDRESS' LID FEE S A oa 1-56 1�' i 7ESCP Ap=od PUBLIC RIGHT Of WAY PER OFFICIAL STREET MAP Aw NfInn CITY zip TELEPHONE I Street Use Ps-" EXISTING (0�? PROPOSED Inspection R1.2" Sidewalk Required 4 rvm 6 t? of'6-0 zi� ez;' - !&(asl REQUIRED DEDICATION— FT Unditroround Wiring required___[] NAME METER SIZE LINE S I ZE NO. OF FIXTURES PRV REQUIRED 2&1 LA ffit4 - AV -CH f wAgfsr I -- — YES C3 NO 13 I z ADDRESS REMARKS L.,,,j OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE eta n-5e CITY 'r I ZIP TELEPHONE �Irq :z rz2w 0 1201, NAME CBL# 4/1-66y, CC- At '�z' BY ENGINEERING REVIEWED DATE CC.ADDRESS ale 41'rLb-b AUe - FIRE REVIEWED BY DATE CITY ZIP TELEPHONE C,1 VARIANCE OR CU SHORELINE OR ADS INSPECTION BON STATE LICENSE NU ER EXUATION BITE 4b- . . I POSTED ' M0 I RE Ll >kEs 13NO POO SEPA REVIEW SIGN AREA HEIG PROP ERTYTAX ACCOUNT&OCEL NO. ....... COMPLETE EXEMPT ALLOWED ALLOWED RO PROPOSED In JXA EXP In NEW 0 RESIDENTIAL PLUMBIN LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT� COMPLIANCE OR ALLOWED PROPOSED FRONT S FRONT UR SIDE REAR .' I — a a � I owt%j #NieR-b 2F� <i-�" z ADDITION 99 COMMERCIAL 13 CHANGE OF USE - REMODEL MUL11FAMILY 1-1 SIGN PA REVIEWED BY DA4 RKING LOT AREA PI.AW!ING REatD PROVIDED GRADING [3 FENCE REPAIR CYDS X FT) RE IZERpe" DEMOLISH TANK _jr 'GARAGE FIETAININGWALL FIRE SPRINKLER 0 CARPORT ROCKERY FIRE ALARM CrYPE OF USE. BUSINESS OR ACTIV" EXPLAIN: "Ere - Qed. rzooe 4&ALfA4 C I-IA11 C, CHECKED BY POPE OF CONSTRUCTION OCCUPANT 'GROUP NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIE- #*VIA I UNITS MBER& SPECIAL INSPECTION JAREA OCCUPANT LOAD 8 - , - !A91 REQUIRED YES DESCR18E.WOOK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD Al ,YEAT SOURCE GLAZING PLAN CHECK NIIX THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPEMY ONLY. ANY CONSTRUCTION ON THE PUBLI 2 C 3 DOMAIN (CURBS, SIDIEWAUCS, DFINEWAYS, MARQUEES, EfC.) WILL REQUIRE t: SEPARATE PERMISSION. 12; PERMITAPPILICATION- innnavS ,PERMIT UMM I YEAR - PROVIDED WORK 15 STARTED WITHIN 180 DAYS SEE BACK OF PINK PERVAIT FOR MORE INFORMATION LOT SLOPE % VESTED DATE VALUATION Description Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection FEE Description State Surcharge la City Surcharge FEE 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS 0 R S Fire Review Plan Chk. Deposit IN INTEREST, AGREES TO INDEMNIFY; DEFEND AND HOLD HARMLESS THE CM 01 Y 0 F M EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND A N 0 Fire Insoktian. Receipt # 77WT ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY C TL Y FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE 'T BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE kNICE Landscapelnsp. Total Amt. Due NOR ILIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- ION Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION P'TION APPLICATION APPROVAL IT OF 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. TRUC_ CALL This application Is not a permit until signed by the )YED TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building Official or hisiber Deputy: and Fpes aare paid, and G To IN VIOLATIONAOF THE LABOR CODf-0F THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In spiclprovid WORKMEN'S C?MPENSATION IN)VAANQ�,AND RCW 18.27. OFFICI 'GiL E SIGN ATUIA ER BAT :SIED (425),.... q I IT. 1A 'dA �t=l .9, A) ZO 15 771-0220 t -4 OESED BY TE ATTEATION En 13:�,� IT IS UNLAWFUL TO USE A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 ORIGINAL FILE YELL Ec-ro& ,OINK - OWNER GOLD ASSESSOR �.l 04/02 K� PRESS HARD -YOU ARE M G 5 COI GREEN ACCOUNTING S, z 0 0 M M M§ C= IT11 10 0 -1111 ITI M a vi 0 0 C4 ITI 0 z z 0 M