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20030781.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS '"44 it< /10 .4 MAILING ADDRESS CITY j ZIP j . ITELEPHONE Elm",,or 9,fci-? ��_577n NAME ADDRESS CITY S�A' ;AW OR E S S Ho Sox CITY LICENSE NUMBER ZIP [TELEPHONE ZIP TELEPHONE ROPE TAX ACCOUNT PARCEL NO. E-12 I-A-1 0 0 NEW )<RESIDENTIAL 11 ADDITION COMMERCIAL 0 REMODEL 13 MULTIFAMILY 1:1 REPAIR 1:1 GRADING CYDS DEMOLISH 11 TANK GARAGE CARPORT RETAINING WALL 1:3 ROCKERY M?E OF USE. BUSINESS OR LAIN: NUMBER e& OF N MBER OF DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE PERMIT EXPIRES U E ZONE PERMIT C) NUMBER JOB -SUITE/AP I T# ADDRESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S nscp AplfaveVd PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW PerwA Required Street Use Parmh RKd EXISTING - PROPOSED inspection Requited Sidewalk Required REQUIRED DEDICATION- Fr - Undwilround Wiring required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I I YES C3 NO 13 z I REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE I AWATER # SHALL BE ENGINEEFA %R P FIRE REVIEWED BY r1ol DATE DATE ul cc I rL VARIANCE OR cu SHORELINE 0 INSPE BOND REQ'D POSTED Iq in Er- c NO 1$ HEIGHT PROPOSED 1 L/ IL Cl EXP I - - QjUagilcIm I LOT COVERAM� "qb~AMA&6 tFT) PROPOSED SETBACKS (Fr.) _CS�106MBING / MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR COMPLIANCE OR CHANGE OF USE I PAR REVIEWED BY DATE KING LOT AREA PLANNING 06 SIGN REQ`D I PROVIDED FENCE ( X FT) REMARKS o OTHER 0 FIRE SPRINKLER FIRE ALARM CHECVX PEfF CINATRU 10 OCCUPANT ORO ;(I;g CRITICAL AREAS NUMBER SPECIAL INSPECTION- REQUIRED [3 YES jXhEA OCCUPANT LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D M $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE LAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPILICATION: 180 DAYS PERMIT ILIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection Ei 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 Receipt # IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE C11-Y OF EDMONDS, WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY NOT BE FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. TotalAmt.Due I _3. Receipt # Z�L' 021 NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee 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 THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a permit until signed by the Building official or his/her Deputy: and Foos are paid, and TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledge d In space provided. IN VIOLATION OF THE �LA,10�11E WORKMENS 63 "PSA NCE AND RCW 18.27. - OFELCIAL SIGNATURE DATE SIG E WNER DATE SIGNED (425) & P 771-0220 /bAT RELEASED bY ATTENTIOfl 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 GREEN - ACCOUNTING ARE MAKING 5 COPIES 04/02 PRESS HARD -YOU z 0 m 4 -n am a M a 0 30 C m m ,0 C _z 0 -n n "I m 0 6 Fn C 0 z z 0 m A FINAL PkOJECT APPROVAL FORM TO: DATE: PERMIT COORDINATOR, BUILDING DIVISION FIRE DEPARTMENT DATE- z 9 0 m =i =a m 0 80 X M M z g) --i 0 -n n m M a 0 0 M (j) M 0 Z z cl) z 0 m 2. .3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date si ocaprvl.doc.l:temp:bldg:fonnsIO/OI ATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS 1704 /,'� ;,q!1 MAILING ADDRES . OY14--e— s 1WZ)7_ , r 79-/Z. Z 7_15- CITY 4 TELEPHONE 1�o7eWv,oz 9,fLiz-,tP7 ��_57757Z� NAME ADDRESS CITY ZIP ITELEPHONE CB6 N ,"Ess IM 0 CITY Zip TELEPHONE LICENSE NUMBER EXPI ATE ri f7/;,0V"j y 4 PROPEBXY TAAX ACCO PABCEL NO 0 7ii� 7 N6 NEW )<RESIDENTIAL bKUMBING/MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE 0 REMODEL. MULTIFAMILY SIGN REPAIR FENCE 0 GRADING CYDS ( _ X_FT) DEMOLISH TANK OTHER 3 GARAGE CARPORT o RETAIN;NG WALL F RE SPRINKLER ROCKERY FIRE ALARM M?E OF USE, BUSINESS O��: NUMBER OF NUMBER OF DWELLING —STORIES UNITS DESCR18E WORK TO BE DONE I -- HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO * BE DOME ON PRIVATE PROPERTY ONLY. ANY ' CONSTRUCTION ON THE PUBLIC * DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC-11 WILL REQUIRE 3 SEPARATE PERMISSION. PERMIT APPLICATION: 180DAY8 PERIM I PROVIDED WORK IS STARTED WITHIN 180DAYS *13AjK!0;PIHK PERMIT FOR MORE INFORMATION -APPLICAPA 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 HERCITY 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 CONSTRUC- TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLAT E—THE E OF THE STATE OF WASHINGTON RELATING TO WORKMEN!ON 0 L�AS CE AND ACW 18.27. E-13WNIRA ZKNAA DATE SIGt4ED ZONE JOB ADDRESS PERMITEXPIRES PERMIT ko5_ NUMBER PLAT NAME/SUSDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit ReWired Street Use Permit Rsqd EXISTING — PROPOSED Inspection Required Sidewatli Required REQUIRED DEDICATION— FT Underground Wking required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I I YES 13 NO 13 z REMARKS I OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE is BY DATE FIRE REVIEWED BY lu A WATER SERVICE SHUTOW SHALL BE INSTALLED ON THE VARIANCEORcu L 1jA5"0X&MjE= BOND RE08NO S POSTED 3YES SEPA REVIEW I HEIG COMPLETE - EXEMPT I ALLO qrn ALLOWED . LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT SIDE REAR 9. 0. P UANT TO ECDC 9.30.020 P —A il ARwNG REO`D I PROVIDED HALL BE INSTALLED NEAR REMARKS CHECKED BY ITYPEfF C R ION OCCUPANT IT GRO SPECIAL INSPECTION- XREA OCCUPANT REQUIRED [] YES LOAD r REMARKS PROGRESS INSPECTIONS PER UBC 11081FINAL INSPECTION REaD WE VALUATION W11 $ . I I Description FEE Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection Description State Surcharge City Surcharge FEE Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Recording Fee Receipt # APPLICATION APPROVAL This applicatlon is not a penrit until signed by the CALL Building Official or his/her Deputy: and Foos are paid, and FOR INSPECTION receipt Is acknovAodged in space Provided. OFfr S,10 TURE 1-7 DAJE 1 (425) "& j 747'an Z�Laze_3_ 71 -0220 .ocnyv /DATE( ATTENTIOR Off 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL FILE YELLOW - INSPECTOR A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIF1 ORIGINAL CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD -ASSESSOR GREEN - ACCOUNTING 04102 PRESS HARD -YOU ARE MAKING 5 COPIES ------ ------ --