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20030784.pdfDATE RECE [PERMIT EXPIRES CITY OF EDMONDS USE Pe'- PERMIT ZONE P_ -4- 71) NUMBERfQ9,1-15�,"Z,? CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRESS [0, Q OVYNT NA4E/NAME OF 001NESS PLAT NAME/SUBDIVISION 140. 1: "T. LID NO. LID FEE S MAILING ADDRESS TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Parmll Required EXISTING - PROPOSED Slreat Use Permh 880 Inspection Required 13 zip TELEPHOh 3, % 1 -7 -7 4. I-S- I REQUIRED DEDICATION— FT Sidewalk Required 13 Unde(Wound Wiring required 113 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES13 NO 13 z ADDRESS REMARKS z z U OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE CITY ZIP TELEPHONE NAME Cat. ENGINEERING REVIEWED BY DATE ADDRESS r\ ED 7 DATE— A-) Lu M. ZIP TEL EPHON( STATE LICENSE NUMBER EXPIRATION DATE NCE OR Cute, �r SHO?L1fkORADBN INSPECTION REO'D 13OND POSTED 0 4:)E4 kc: Q)"Av)— 13YEs &;Kb s SEPA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT - ALLOWED PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. EXP , , NEW RESIDENTIAL PLUMBING I MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT LIR SIDE REAR COMPLIANCE OR ADDITION 93-,C*'OMMERCIAL 1:1 z CHANGE OF USE PARKING REOD PROVIDED LOT AREA PLANNING REVIEWED BY DATE 2'0^REMODEL MULnFAMILY 0 SIGN IL GRADING [3 FENCE REPAIR CYDS x Fr) 7 2&M-43 REMARKS W-M OTHER DEMOLISH [j TANK [3 GARAGE RETAININGWALL FIRE SPRINKLER CARPORT MID 0,-ARrts-' L4� ROCKERY FIREALARM A L4.1a."A CrYPE OF USE. BUSINES �YCTWM EjPLAIN- 042cwi-c�L C-� c:e— AvJez) CHECKED BY XF SPN_STRucnON CIE -7 OCCUPANT C7jfA 64C. GROU .. P _MBER 1 OF STORIES JOE NbMBER OF' DWELLING UNITS CRITICAL AREAS NUMBER SPECIAL INSPECTION JAREA OCCUPANT LOAD REQUIRED 04YES gc-5 17 og DESCRIBE W01 TO DONE REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REG-D. L/y r P r I N, n AC__L' VALUATION $ Description FEE Description FEE Plan Check PCitySurcharge State Surcharge HEAT SOURCE GLAZING % L LOT SLOPE % Building Permit PLAN CHEICKNO: VESTED DATE jA4Aa17AoV7s Plumbing 72 Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NCrFED. THIS PERMIT COVERS WORK TO t BE DONE ON PRIVATE PROPERTY ONLY. AM CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CUR13S, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPILICATION: ISO DAYS CL PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICAK 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 MONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY k Receipt # f fit 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 0 NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION, Recording Fee Receipt # 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 APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application Is not a permit until signed by the TION; AND IN DOING THEJ��THORIZEO THEREBY, NO PERSON WILL BE EMPLOYED CALL Building Official or his/her Deputy: and Fees are paid, and IN VIOLATION OF THE AD t%cnRE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowiodged In space provided, WORKMENS COMPENOTION INSU+CE AND RCW 18.27. SIGNATURE ( W R OkAGEN%/ DATEP9NED IAO 0 AALENAT ATE %425) *D 771-0220 ED BY TE A,'TTE�A'dn Off 1333 IT IS Uh USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL VWF SF (TO A FINAL S CTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW - NSP CTOR 0 CUI CATE OF 0 CUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING MENE z 0 M M M -is 0 C: M M _z 0 _n In M M Fri 0 z 5 M F TO: ocaprvl.doc.l:temp:bldg:fonus6/98 z 0 m =i 19 m c mo 0 80 c Ic 3: M M Z 10-4 Ca 0 -n n m M 0 0 0 M C (j) c CA M 0 Z .A X z z 0 1 F) m 4 . INSPECTOR DATE APPROVED SETBACKS .......... * ........... FOUNDATION: Footing.................... ;,Wall ....................... - .... Pier/Poich ............ Retaining YVall ........... M Slab Insulation .......... PLUMBING:' Underground ........ M 0. t t, Rougl�-ln ............. Commercial Final ........ it its, CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OVfNEP NAME[NAME OF S INESS L�_ C -1--huf bc)r _M0kre__ MAILING ADDRESS (A) - '-.J zip TELEPHONk/-� Z.!� C&r^0f-\d/_1 NAME ADDRESS CITY NAME 45(-Y\ . "- ADDRESS . I gso ZIP ITELEPHONE .&FVP r-1 r\ <Dc�� lb 5 I `*-1,T I PERMIT EXPIRES i-7/ ��6czj,, USE C4GF Per PERMIT 1 . to� ZONE R-4--7cj NUMBER 79V JOB ADDRESS /o(D W SUITEJAP`T# PLAT NAME/SUBDIVISION NO. L"N . LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TEGGP Approved RW Pamot Required Street Use Permit Rsqd EXISTING — PROPOSED Inspection Required Sidraslit Flaquired REQUIRED DEDICATION— FT Undergrotind Wiringrequired 13 METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED YES E3 NO �C3 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE - / Q_ QC" C1 'S r— ENGINEERING REVIEWED BY DATE I Fr cc zip TELEPHONE4 Z:S� IEL q%'6Q6 NCE OR CUff SHO LIOEORADB# INSPECTION I BOND STATE LICENSE NUMBER EXPIRATION DATE I CAECKED BY REO'D 1$ POSTED 01PU ACCA 13YEs Wo HEIGHT PROPERTY TAX OUNT PARCEL NO. NEW RESIDENTIAL ADDITION 00 20000MMERCIAL', 9ROREMODEL A muLn , FAMILY REPAIR GRADING , CYDS DEMOLISH TANK 0 GARAGE RETAININGWALL 13 CARPORT ROCKERY (TYPE OF USE. BUSINESSPPCTIVITY) LAIN: !3��et2,71 C:P r -" ce- -11WOOER NUMBER OF OF STORIES DWELLING&, UNITS DESCRIBE WOAK TO BE DONE a HEAT SOURCE PLAN CHELC"O: SE REVIEW COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED BED PROPO EXP %0-**- , , NC LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) 0 PLUMBING / MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT IJRSIDE REAR COMPLIANCE OR W� CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE SIGN REQ`13 PROVIDED 1 I !2 2!'� !2 FENCE —1 -REMARKS few" (f -70 — Ulu oil, J, X FT) ol OTHER tjo FIRE SPRINKLER FIRE ALARM LL.&x CHECKED BY TYPE 19F qqN§TRuanON 4 CIE -7 OCCUPANT Vj �ZfAi I GROUP f7 C:�ITICAL AREAS SPECIAL INSPECTION JAREA OCCUPANT NUMBER REQUIRED I e6l qcf LOAD t7og GLAZING % SLOPE % I VESTED DATE REMARKS PROGRESS INSPECTIONS PER UBC I / 46 V 6 ex VALUATION $ I C/))= --ft 11 Description FEE Plan Check Building Permit Plumbing INSPECTION REQD State Surcharge City Surcharge FEE J Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO HE DOKE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN.(CURBS, SIDEWAM. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. t: Engr. Review PERMIT APPLICATION: 1180DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review A�) Plan Chk. Deposit hk, Deposifit— IN INTEREST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection t ff Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY OF ISSUANCE OF THIS PERMIT SHALL NOT BE FROM THE'ISSUANCE THIS PERMIT. Landscapelnsp. I. Due Total Amt. Due DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CFTYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- _[Rejceipt Recording Fee # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRE" 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 applicatlon Is not a Pe rinit unlill signed by the TION; AND IN DOING THeE ORIZED THEREBY. NO PERSON WILL BE EMPLOYED 0 IN VIOLATION OF BOR E OF THE STATE OF WASHINGTON RELATING TO THE 804 FOR INSPECTION1 Bull ding Official or his/her Deputy' and Fees a to paid, and recelpt Is aCknovAedged In space provided. T U � WORKMEN'S COMPEN9 TION INWSUNCE AND RCW 18.27. 0 1 AL SIGNATURE " �AGEN7)/ DATE KNED log 1A25) M�= 771-0220 L ED BY Fit' A71 Olt* Off 1333 IT IS UN TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL —T-1 Tol' VWF A FINAL S CTION HAS BEEN MADE AND APPROVAL OR A CERTIVI- C ORWINAI. - FILE - �ELLOW - NSP CTOR CATE OF 0 CUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING k seen rim z 0 0 M =i:W ra � am C rn 0 0 S M Niz n M rn a 0 o Fn C8 ic MO Z� z z 0 q 0 ITI