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20030793.pdfq�4wb�151d DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS MAILING ADDRESS I Y5--F3 tilato CITY ZIP T161 EPHONE W# NA D'ft 60 RESS 1 CITY ZIP ITELEPHONE NAME CBL# - 5,114/4/y Juxib'd ADDRESS CITY ZIP TELEPHONE )qg- AIIVJV jV)_5--761-3e1Y STATE LICENSE NUMBER EXPIRATION DATE I �ECK .:r01V,A1YJ6?7CJA1R 91161,0)-ift, NEW RESIDE14TIAL 7K4gEP*MECH A DITION COMMERCIAL COMPLIANCE OR D x CHANGE OF USE REMODEL MULTIFAMILY SIGN REPAIR 13 GRADING CYOS FENCE X FT) DEMOLISH TANK OTHER GARAGE RETAINING WALL FIRE SPRINKLER CARPORT ROCKERY FIREALARM (TYPE OF USE, NESS OR ACTIVrM EXPLAIN: gust NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES UNITS___ zd� NUMBER DESCRIBE WORK TO BE WhIE d)1r_zL1 �fc_ 1015,plk# 'e.4f 11, hN0,0C0PV ffA-h,0Zj1W PIP 4!�: All 1A, k4e HEAT SOURCE GLAZINP % 09 1 SLOPE % 6 All ,,, /I J,7 VESTED DATE PLAN CHECK NO: 2— THIS PERMrr AUTHORIMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLZ APIY CONSTRUCTION ON THE PUBLIC DOMAIN (CURDS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 180 DAYS PERMIT UMIr I YEAR - PROVIDED WORK 18 STARTED WITHIN 180 DAYS SEE BACK 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. 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 MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS 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 REGULATING CONSTRUC- TION; AND IN DOING THE WORVUX, ED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LAQW,1 '911 FTHE TATE OF WASHINGTON RELATING TO WORKMENS COMPENS&TffN INEZZE AND RSCW 18.27. DATE PERMIT EXPIRES I ( 2 1 L USE PERMIT C-) -�2 ZONE NUMBER _ -) JOB SUITE/APT# ADDRESS .2 1 5_// " 1W fir k- 40 44 P'A V� Ley. PLAT NAME/SUBDIVISIOM NO. NO. LID NO. LID FEE $ TESCP Apprafdd U PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Requited Street Use Permit R*0 8 EXISTING — PROPOSED inspection Required Sida*a* Required 8 REQUIRED DEDICATION— FT Underwound 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 13 NO REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE DATE IJAII W cc 0 /`7 Z0,3 0. NCE OR CUt F75bT S ELINE OR ADBN INSPECTION see BOND I , te�� _I REO'D i3yEs ErNo POSTED SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , , 0 , LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR A4. PARKING REO'D PROVIDED I LOT AREA PLANNING REVIEWED BY 'A DATE 37D I A42T 0j 9"et REMARKS CHECKED BY 17YPIOFCONSTRUCTION I 9GDj" I OCCUPANT SPECIAL INSPECTION JAREA d;(T� _7 OCCUPANT/ LOAD REQUIRED [] YE ffjIEMARKS I BPROGRESS INSPECTIONS PER UBC IOWFINAL INSPECTION REG'D COT— — 0 A �O� A— I—% % - — __ $ 2EL 1;1 Description FEE Description] FEE Plan Check State SurEcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Dneposh Fire Inspection Receipt III Z2 YE Landscapelnsp. Total Amt. Due Recording Fee j =eipt N R CALL FOR INSPECTION %-Tr- 'A'05) 771-0220 APPLICATION APPROVAL This application Is not a permit until signed by the Buliding Offtial or his/hor Deputy; and Fees are paid, and receipt Is acknowledged In space provided. OqF�No DATE I A 10116101 —PIGEAErE6 ny I DATE1* ATTE14TION Off 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL L A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL�FI'L`E YELLOWINSPL—OR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING �f z 0 M =i:fi M M f- 0 A In 6i rn z 0 4 0 M z 0 0 m =i:fi 55 � Ma 0 80 c � M m mz ,C) —1 CO) 0 -n m M 0 Fn 0 o Fn C co) 3:0) M 0 Z .4� M 0 z z 0 q ?5 m ocaprvi.doc.l:temp:bldg:forms6/98 M, 777-, Occupancy established by this cort q Ificate: I Dwelling Units: **N1A:a* I No.,Storigs: I BISI Type Construction: VN Sprinkle Basement: No Maximum Occupant Load �7** (Per I.I.B.C. 1002) Room capacity signs, when required.,, -must remain posted at all times. Own or of Building: Welcome Market'lhc,,LAddress: 626i-Reato'-Ay-griue -Buena Pa& CA 90620 THE Everchamplon HAS BEEN INSPECTEDAND APPROVtD AS1CdI&LYING'-'WITH THE REQUIREMENTS OF THE 1997 EDITION OF THE UNIFORM BUILDING CODE AS ADOPTED BY THE CITY FOR THE GROUP AND DPJISION'OF'OCCUPANCY AND THE USE FOR WHICH THE PROPOSED OCCUPANCY IS CLASSIFIED. Issued this 8th day of__QjWMMr 2003 CWF BUILDIWOFFICIAL This carok4m shall be pmed In a cw*Ocmx put*c am aid shea not be wnoved, mutated or obscured and " be mainwned In legible condition at afl Ornes. Any change d occupancy or use requires a b0ding pannit and a now Cwtircete d OwVancy Issued by Me aty of Edmonds WIding 01111dal. V IMIrmal 'Vd MM 19 1. mm-M MM: I I 5, jfDATE RECEIVED 0,2 PERMIT EXPIRES CITY OF EDMONDS won PERMIT ZONE NUMBER CONSTRUCTION PERMIT APPLICATION JOB Sul ADDRESS 57// Hlw,# y 0�1 L tp I OWNER NAMERME OF BUSINESS I/ 1&7#01V 46 PLAT NAMFJSU13DMSION NO, LID NO. MAILING ADDRESS LID FEE S _�M TESGF AP Z11V PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW PsnM R&Wk%. Seem Use PIRTnit CITY ZIP jT1fLFPHONE tnapecdo uIred EXISTING — PROPOSED R4q 61dwalk"ROWWOd -7F�7 Y;Wl zd REQUIRED DEDICATION— FT UWWWOMA OrInumquW NA METER SIZE LINE SIZE NO, OF F1XrURE8 PRV REQUIRED z MADDRESSI YES 13 NO REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE iCITY ZIP TELEPHONE NAME t 117 ENGINEERING REVIEWED BY "DATE ADDRESS N zi M&MALF ALI Af Ff DAT CITY ZIP TELEPHONE /0 /7 ja3 0 3V M VAJANCE OR Cull I SrhEUNE OR INSPECTION BOND CKED dTATE LICENJA NUMBER EXPIRATION DATE I PKE OYES EMM 0 POSTED REO'D f ?7 AM 911.6L40 51 Pj"P FMT NT PAR SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSE�� . ALLOWED PROPOSED M EXP , C: M -4 0 LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) 0 NEW RESIDENTIAL ECH ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR *SPM COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE x AA(_ M 00[)Et� MULTIFAMILY SIGN PARKING LOT AREA PLANNING REVIEWED BY DATE PL REQ`D DED PAR o4v 1. CL FENCE q1FtEPAIF$ GRADING CYDS X Fr) 370 — REMARKS nrl OTHER 0 'DE40USH 0 TANK %gu iv i r =0ERT'. o RETAJNINGWALL FIRE SPRINKLER ALARM 0 POCKERY FIRE "9 CW USE. WSINESS OR A rIVITY) EXPLAIN: CHECKED By TYP OF)CONSTRUCTION OCCUPANT Pa" 18 MA GROU!U M M -NUMBER NWUM EMGIF CRITICAL OF AREAS SPECIAL INSPECTION JAREJ OCCUPATI 0 Fn STORIES UNITS NUMBER LOAD REQUIRED[] YES T C DESCRIBE WORK TO BE DO a aft EMARKS gpud PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION'REiii), Iti5rh4l 3 PA11<5 catlArr5AS:�. 04 0 ? �2 494W—, of all 04 y VALUATION z 1V,0A1 4 iw/z scirlptlon 1A1 9 4 r- 1h6 Do FEE Description o FEE 11V. .r 0 171 k,,411 Wf& / f I "'/J APA APA .4U4d0% ,I Plan Check State fSurcharge 141A;419 —L;;7— URCE GLAZIN9 SLOPE % jty S rgo urcharge Building Permit 4176 city surc PLAN CHECK NO: r1a VESTED DATE Plumbing Mechanical TWS PER[Mrr AUTHOREZES ONLY TKF WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PIUVATE PROPERTY ONIX ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURDS, SIDEWALKS, DRIVEWAY% MAMUEES, ETC.) WILL RWUIRE SEPARATE PERMISSION. t: Engr. Review PERmrr APPLicATKIN. mo nAys PERMIT ILIMM I YEM - PROVIDLO WORK IS STARTED WITHIN 180 DAYS/' Engr. Inspection BEE BACK OF PINK PERMIT FOR MORE INFORMATION "APPLICANT, ON 0 1 EHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit lf�o IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND H HARMLESS THE C"Y OF OLD - EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLDVEES, AN6 AGE NTS FR , OM ANY AND Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE,'ARISING DIRECTLY OR INDIRECTLY ISSUANCE PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE FROM THE OF THIS DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CRY ORDINANCE Landscapainsp. Total Amt. Due I NOR LIMIT IN ANY WAY THE CrTTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recordin Receipt # g Fee I I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPUCATION: THAT THE INFORMATION PA 0 �W��,Ov 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- 9,60 - CALL-VVY3 This application Is not a parrdt until signed by the TION; AND IN DOING THE WORIP EBY, NO PERSON WILL BE EMPLOYED .�R�TEHETHER IN VIOLATION OF THE LAW. STATE OF WASHINGTON RELATING TO aunding OMcW ot Wsftw Deputy: and Face we paid, and FOR It4 PECTION racelpt Is acknowriodged In space prawrlded. WORKMENS C04PEN,4KN lNa]FU;a AND RCW 18.2-1. t1t 0 DATE kid Past N a E DATE SI�7aD A /6/0 220 LEASED By ATTENTION:!512- L#,(,kAr I( EXT 1333 OM PBUL � IT IS UNLAWFUL TO USE OR OCCUPY OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL"OR�A CERTIFI- ORIGINAL INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBCa9CTION'!00,. PINK - OWNER GOLD - ASSESSOR 04/02 PRES�WARD- ARE MAKING 5 COPIES GREEN - ACCOUNTING lel�u