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20030796.pdfI DATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMERME OF BUSINESS " F <:�'I" 4 ) me-, MAILING ADDRESS . . - 1� - 16-2_5-- q1k A-IIE- Aj CITY ZIP TEL PHONE 4,62, =Lq7�_c_, 7 '-- -n& 3� NAME ADDRESS CITY ZIP I TELEPHONE NAME W_Asx1q2L CBL# ADDRESS ZIP TELEPHONE MiK rzo& 2J-2- STATE LICENSE NUMBER )IRATION DATE LA—su I am 16 P R P OUNT PARCEL NO. 13 NEW RESIDENTIAL PLUMBING/MECH e-,-.% ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULnFAMILY SIGN REPAIR GRADING FENCE X CYDS ( _ FT) DEMOLISH TANK OTHER GARAGE CARPORT RETAININGWALL FIRE SPRINKLER ROCKERY FIRE ALARM (TYPE OF USE, BUSI�ESS OR ACTIVITY) EXPLAIN: P-erlae_li c,4?.,, NUMBER OF CRITICAL 02M Lie DWELLING AREAS UNITS NUMBER IVII+ DESCRIBE WORK TO BE DONE M/ % I LOT SLOPE % ECK NO: I VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 180 DAYS PERMIT UMM I YEAR - PROVIDED WORK IS 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 MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE cays ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* I HERE13Y 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 WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. & SI�NAIV (OWNER t 1A " WG DATE S19NED - 1_ 13 �' -3 1 1 PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB ADDRESS T7 -4 PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TIESCP Approved RW Permit Required Street Use Paffnk ReWd EXISTING — PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION FT UndeMmund Wiring required METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED I YES 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE FIRE REVIEWED BY AVITS SHALL NOT D 7TE BE ACCEPTED DATE z z uj 01 11 VARIANCE OR CU SHORELINE OR ADS# INSPECTION BOND REQ'D POSTED I .1 13YEs 13NO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSE D ALLOWED PROPOSED EXP I , I LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR z PARKING REVIEWED BY DATE R 0 EQ` LOT AR F A PLANNING I Or 02;�f;' expea =1 on all hot water tai D. ECDC 19,30.020 CHECKED BY ITYP)EP; 0 TRUCTION 7mr GROUP SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [:] YES LOAD REMARKS PROGREf�!MPeenONr,PBRAIMVV_IE,A,.L INSPECTION REQ-D TYpe B or L vent connertinir. $ Woo Description Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Fire Inspection Landscapeinsp. Recording Fee CALL R INSPECTION (425) 771-0220 EXT 1333 appliances FEE Description State Surcharge city Surcharge FEE Plan Chk. Deposit Receipt # Total Amt. Due Receipt # APPLICATION APPROVAL This application is not a permit until signed by the Building Otficial of his/her Deputy: and Fees are paid, and receipt is acknowledged In space provided. KSITURE D iil W9 6LASAED.1 DAT)f IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I 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 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 4 0 M =0fi M M H 0 r 52 K M M JD � z 0 _n M M a U5 0 0 Fn MO z I CO) z 0 --I 0 M RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS.; ............... ;FOUND�T,1104- . ................ *F boting ... Wall ........................... Z' O� Pier/Porch .............. 0: W Retaining Wall ........... 6b: Slab,insulation .......... ::q 9V 55 PLUMBIMG: Underground� .............. M Oli "Orcoidgh-lin .. ................... oc� C6m,ni6rc1jqI Final M 10 HEATING4��-. z �5 asTest .......... ......... ky" . I .................. Gas Piping "n -4 Equipment ................. I� I X M commercial Final rol Fn r E)(TERIOR SHEATHING - e NAILING .......................... FRAMING FIRST^ORj1fM ItA%.s I allA 1 119 AM i 9 FIDATE RECEIVED CITY OF EDIVIONDE CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS &L- F: MAILING ADDRESS 16--,?�- cYlk tJ CITY ZIP TELIPPHONF— t��RE61 -n&� 3E NAME ADDRESS CITY ZIP [TELEPHONE PERMITEXPIRES USE PERMIT ZONE NUMBER JOB ADDRESS M 97'11 IXAC PLAT NAMEISUBDIVISION NO. NO* LID NO. rT LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP ]ESUP APixaved AW Penrit Required Street Use Permh Raq'd EXISTING — PROPOSED insp6cuon Required Sidewalk Required REQUIRED DEDICATION— FT UnderWouM "Mg raq M E3 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 0 I YES 13 NO 13 Lc REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE NAME CBL N I ji-NIAlAkWA &&A&& a mootme AFFILIN3111411 411IMLL-Ijus W-k-91 Lie- -3 - ENGINEERING REVIEWED BY DATE ADDRESSI�.., t MUM um 4 /C-ci, FIRE REVIEWED BY DATE I TELEPHONE Dc— 4k 0 fPA-1 "zy"�� ?.Az VACV) STAIE LICENSE NUMBER PROPERLY TAX ACCO PARCEL NO, 7 Z) aZ'Z --"PIRATION DATE CMCKED BY VARIANCE OR CLI SHORELINE OR ADB# INSPECTION 1$ BOND REQ'O POSTED 113YEs 13NO SEPA REVIEW SIGN AREA HEIGHT COMPLETE , EXEMPT ALLOWED PROPOSED ALLOWED I PROPOSED EXP NEW %§LRESIDENTIAL PLUMBING / MECr LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE REAR PROPOSED SETBACKS (FT) FRONT LIRSIDE REAR COMPLIANCE OR [3 ADDITION COMMERCIAL 1:1 CHANGE OF USE REMODEL MULTIFAMILY 0 SIGN PARKINgessesseselmolsQU D REOD I PE: 11 REPAIR GRADING CYDS 0 FENCE X FT) REMARKS Is open 01, n DEMOLISH TANK 11 OTHER___ oGARAGE o RETAINING WALL F RE SPRINKLER I JAC&.- CARPORT ROCKERY FIRE ALARM M?E OF USE. BUSINESS OR ACTiVrM EXPLAIN: Jae r / 47ei0j C-4e, CHECKED BY JTYP;P/ NUMBER OF DWELLING MgF -f CRITICAL AREAS AYA SPECIAL INSPECTION JAREA UNITS NUMBER REQUIRED [:] YES DESCRIBE WORK TO BE DONE IF REMARKS 24 -01 6hether the, "�ter Wde . M I UCTION OCCUPANT GROUP OCCUPANT LOAD PER UBC 108/FINAL INSPECTION REG'D UMC 815.1.7 �-4- Ar.?,4�Aeeey,() svo Description FEE Description FEE Plan Check State Surcharge % .fE LOT SLOPE % Building Permit City Surcharge PLA CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO =E DOKE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading ti ATM N (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review W_-� 1W PERMITAPPUCATION: ISODAYS N%D- PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection W-6 SEE BACK OF PINK PERMIT FOR MORE INFORMATION -APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNSAND SUCCESORW Fire Reviow Plan Chk. Deposit 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 # 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 Landscapeinsp. Total Amt. Due i: NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION., Recording Fee Receipt IN 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 Building Official or his/her Deputy: and Fees are paid, and TICK AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION1 1 receipt I a ackncrModged In space provided. WORKMENS COMPENSATION INSURANCE AND RCW 18.27. LS SKONrURE DJ%TE SIGNAW (OWNER )6a� DATE S19NED E-V 'A05) It-TK- 0/11 02"JOL � �/o /,,4/ tV 771-02'20 ,,sr YE-- na ENTION /j M 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 4' A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE - YELLOW- INSPECTON� CATE OF CXCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER - GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUWING I z 0 4 0 M 7M In 0 -40 0 MM 10 Z 0 -n F., M M a 0 0 Fn C2ra In 0 z 0 I 0 ITI