The URL can be used to link to this page

20030797.pdfA DATE CITY OF EDMONDS f CONSTRUCTION PERMIT APPLICATION OJVNI�R NAM 9 OF Bust Lh �7 t , /c/ MAILING ADDRESS 1 -7 ME- LJ CITY ZIP TELEPHONE U--6 q&& 49L NAME ADDRESS CITY ZIP [TELEPHONE NAME CBLN ADDRESS Wtd-#1-(3b4 CITY ZIP I TdLEPHONE STATE LICENSE NUMBER EFIPATIO� DATE C ED QY. W*ftleyq-71 O.F. 65:'. 40M I?RqkE�TY TAX ACCOUNT PARCEL NO. 06) (no zz5o NEW RESIDENTIAL JIN PLUMBING / MECH X ADDITION [3 COMMERCIAL COMPLIANCE OR 0 CHANGE OF USE E] REMODEL 1:1 MULTIFAMILY SIGN 1:1 REPAIR 0 GRADING FENCE X CYDS I FT) DEMOLISH 1:1 TANK E] OTHER GARAGE CARPORT I RETAINING WALL 0 FIRE SPRINKLES 1:1 ROCKERY FIRE ALARM (TYPE OF USE, BUSINES" ACTIVI'M WLAN: NUMBEPL NUMBER OF CRITICAL OF DWELLING AREAS STO UNITS NUMBER DESCRIBE WORK TO BE DONE Ti rei kc-e- &zA 7 1 f I/ i hc, h,, ) &,4jl dn I kT SOURCE GL40NG % LOT SLOPE % A4 1 1 CHECK NO: I VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLI ANY CONSTRUCTION ON THE PUBILIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 180 DAYS PERMIT ILIMIT! 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 INDEMNIF'X 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 LDEEMED 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 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 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. 1�3 P PERMITEXPIRIES USE PERMIT ZONE —07q-7 NUMBEL:2a-1 JOB ADDRESS -7qj 1 -7 'A C- iTEIAPT# 0 PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required 1 Stre. Use Parmft Racfd EXISTING - PROPOSED-- Inspection Required 13 Sidewalk Required 93 REQUIRED DEDICATION— Fr Underground Wiring required METER SIZE_j LINE SIZE NO. OF FIXTURES PRV REQUIRED I YESM NO 13 z REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE AFFIDAVITS SHALL NOT -- REVIEWED By BE ACCEPTED DATE FIRE REVIEWED BY DATE I VARIANCE OR CU SHORELINE OR ADBN INSPECTION 1$ BOND REO'D POSTED E3YEs 13NO SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT ALLOWED . PROPOSED I ALLOWED , PROPOSED LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR PARKING LOT AREA I PLANNING REVIEWED By DATE REO'D I PROVIDED 06 CHECKED BY JTY�� COELE OCCUPANT 97 GROUP e oe_r--, I SPECIAL INSPECTIOIT JAREA OCCUPANT REQUIRED [3 YES LOAD REMARKS PROGRESS INSPECTIONS PER LIBC 108/FINAL INSPECTION REO'" $ P Description FEE Description FEE Plan Check State Surcharge Building Permit_ City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due L2 Recording Fee CALL FOR INSPECTION 1A %-125) 771-0220 EXT 1333 APPLICATION APPROVAL This application Is not a permit until signed by the Building Official or histher Deputy: and Fees are paid, and receipt Is acknovAodgad in space provided. I L IQN URE RELEASED BY DATr IT IS UNLAWFUL TO USE (3ff 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 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING 1 z 9 0 M =i M M -48 0 C 5� C M 0 C 0 "n �z ITIM OMA 0 0 C W X z M DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OYVNI�R NAME OF BUSZ; 15 MAILING ADDRESS r7L/r7 -i M- A%, - CITY ZIP ? I TELEPHONE Q 1?,�& 2:y- NAME ADDRESS CITY ZIP NAME T! STATE LICENSE NUMBER E Wo'VH I IES q 7 1 C) 6 no CBL # 'HONE ' W967 ,TO ATIO DATE CHE( ;,Z 5: W.§� I r�v Flu 50 ('01,0-2.3400 nrl zzq.6 1 W-F' I PERMIT EXPIRES USE PERMIT ZONE NUMBE��:�5 —1,/ / V / JOB ADDRESS 1-7q1-7 -jjE�Avc ITE/APT# PLAT NAME/SUSDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Peln* ROW"d S..u., Pormh Req'd EXISTING — PROPOSED Inspecdon Required Sidew&* Required REQUIRED DEDICATION— FT underground Wiringrequirod 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I I YES13 NO 13 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE I ... WOW wwwaftow 69%rf DATE BE ACCEPTED FIRE REVIEWED BY DATE I U-1, - VARIANCE OR CU SHORELINEORADB# I INSPECTION I BOND BY REO'D POSTED r— I OyEs ONO S SEPA REVIEW SIGN AREA HEIGHT COMPLETE - EXEMPT I ALLOWED . PROPOSED I ALLOWED . PROPOSED NEW RESIDENTIAL PLUMBING / MECH x LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) FRONT SIDE REAR FRONT LIR SIDE REAR COMPLIANCE OR ADDITION COMMERCIAL . CHANGE OF USE REMODEL muLnFAmiLy SIGN PARKING LOT AREA PLANNING REVIEWED BY DATE REQ?D REPAIR GRADING o FENCE CYDS X Fr) REMARKS DEMOLISH TANK OTHER GARAGE o RETAINING WALL FIRE SPRINKLER CARPORT 0 ROCKERY FIRE ALARM (T%'PE OF USE. BUSINES 15fi ACTIV" EXPLAIN' CHECKED B Y CqpE OCCUPANT ITYPAM GROUP I �e �_ NUMBER— NUMBER OF CRITICAL —4 4 OF 7, DWELLING AREAS UNITS NUMBER STOftw I I SPECIAL INSPECTION7 AREA REQUIRED I OCCUPANT LOAD [3 YE DESCRIBE WORK TO BE DONE REMARKS P OGRESS INSPE CTIONS PER UBC 108/FINAL INSPECTION REGID 40 a n 1!5�- �7,a_f Z>/,v ft*'Ll VALUATION Lf —71—r $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % —,I� I Building Permit City Surcharge PM CHECK NO: VESTED 13ATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, UARQUEES, ETC.) WILL REQUIRE :21 t: SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: ISO DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WTTHIN 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 Plan Chk. Deposit IN INTEREST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF X EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # IALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE 9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapoinsp. Total Amt. Due 21'. NOR L1Mrr IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee I Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CCIRRECr AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPI.Y WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This applica0an Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building 01111clall or his/her Deputy: and Res are paid, and, IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknoy4edged In space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. SVIG ED SIG RE E 0 DAT IA95) 1/4 1 LS SI URE D IT 5�j (0 (0 L? WN 771-0220 RELEASED BY DAT T 10 N aCUPY M 1333 IT IS UNLAWFUL TO USE A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- OF31GINAL - 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