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20030801.pdfI DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS 19/4 7- t1 0 t T r MAILING ADDRESS 1?1?2 (( e/ 5 W k�5 I CITY ZIP TELEPHONE tz 19 M 0 A119 S -7 -7 NAME PA ADDRESS CITY ZIP ITELEPHONE NAME - L4 Al IF (.4 A/ IV V-/ tivc CBLN .3 j ADDRESS I /V CITY ZP q'07 TELEPHONE q C' 16 STATE LICENSE NUMBER St4orLAIVI (210L EXPIRATION, DATE L( CHECKED BY PROPERTY TAX ACCOUNT PARCEL NO. 00-7-7(0-1 000 &V el 0 NEW RESIDENTIAL PLUMBING / MECH ADDITION 0 COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL 0 MULTIFAMILY 0 SIGN REPAIR FENCE CYDS 1:1 ( X. FT) DEMOLISH [3 TANK Lz MIV in 6 0 0 GARAGE [3 CARPORT RETAININGWALL FIRE SPRINKLER ROCKERY FIRE ALARM UWE OF USE. #"INESS OR 4CTWM EXPLAIN: NUMBER NUMBER OF CRITICAL OF DWELLING AREAS -y UNITS NUMBER STORIES ', , I I DESCRIBE WORK TO BE DONE ZnAa:� A/61V SW11%fM1/t'& i4oej L - - /I06L (,,MLft_f, 64jc4(0`M&*A, HEAT SOURCE GLAZING % LOT SLOPE % &Aj* I PLAN CHECK PLO: VESTED DATE THIS PERMIT AUT"ORIZES 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.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 180 DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 130 DAYS SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS I NTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF N Ip 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 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. DATE71ONED q q 4 PERMITEXPIRES_ m� USE ERFUT ZONE '/-LNUMBER ?L2.Z, (Q JOB SUITE/APT# ADDRESS PLAT NAME/SUBDIVISION 'NO, Lj@T NO. LID NO. LID FEE $ TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Perm" Requif6d Street Use Permit Rsq'd EXISTING — PROPOSED— Inspection Required Sidewalk Recluked REQUIRED DEDICATION— FT Undefgrotind __,squiredl METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 1 1 4--- YES13 NO REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE 0 — ' - I . , I % i -- - r (3 z -7 7/ C 21!F7 ENGINrFRING REVIEWED BY DATE co %w,- (0 ;:�%& to FIRE REVIEWED BY DATE Lu IM Iz VARIANCE OR CU SHORELINE OR ADEIN INSPECTION I BOND REO'D 113YEs POSTED wo_ 1$ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PRqP0 I I __XP LOT COVERAGE REQUIRED SETBACKS FT.) PROPOSED SETBACKS ALLOWED PROPOSED FRONT SIDE -IF FRONT LIRSIDE RE tqll&l I to'_1VW Ql�; rs 11 1 >as, I b PArKING LOT AREA, I PLANNING REVIEWED BY DATr= o REOD I PROVIDED 11 =X&III - .'f_' --ft 1, 1 — — — L'. 4 1 CHECKED BY SPECIAL INSPECTION JAREA, OCCUPANT -N ja REQUIRED [] YES LOAD VOC 50 REMARKS V PROGRESS INSPECTIONS PER UBC 1108/11FINAL INSPECTION RE0'O .1ol) AA - . � & — . — - - /)I-. $ L 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 # 4 Landscapelnsp- Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION 1A 1-425) 771-0220 APPLICATION APPROVAL This application is not a permit until eigned by the Building Offictal of his/her Deputy: and Fees are paid, and r9celpt is acknowledged in space provided. 0 F4410 ff I a E DATE 0 R I DATE H ED By ATTENTION EXT 1333 '191, IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 41MR&O, 2 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YFI I OW CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING It z 0 m q 9 V5 4 OM c Ma -.j 0 0 0 r .-I r. MM MZ m 13 U5 0 0 Fn C (j) m 0) M 0 z M z Cl) z 9 0 m 2. RE INSPECIM OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Si ocaprvLdoc.l:bn . p.-bWg:fonnsl0/0l I I .7— BAT =-PERRMIT EXPIRES USE PERMIT CITY OF EDMONDS ZONE N U M B E R CONSTRUCTION PERMIT APPLICATION OWNER NAMEIWE OF BUSINESS PA 7' M V (Tr MAILING ADDRESS 4(1 I jA Wes 7- CITY ZIP TELEPHONE -77&-lo NAME pA CITY ZIP NAME,—, JCBL . AJjF(1,fV' 1VW 1. IVC, t4 N 1 ADDRESS /V CITY zip TELEPHONE vvv(., ;A V; C7 I L1,75 - fd ?15" STATE LICENSE NUMBER EXPIRATION DATE it/.' f-2 1 OL TECKED BY s w tv rcA PROPERTY TAX ACCOUNT PARCEL NO. 00-7162 00(�! COO. 600 NEW RESIDENTIAL PLUMBING / MECH COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE REMODEL 0 MULTIFAMILY SIGN G I G o FENCE REPAIR 9 CYDS X FI) 0 DEMOLISH 13 TANK 0 GARAGE 0 RETAININGWALL 0 FIRE 60RINKLER CARPORT ROCKERY FIRE (ME OF USE. #LNPNESS OR JCTIVfM EXPLAIN: NU DER NUMBER OF M OF DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE JV — Poo L (^1A L It S CRITICAL AREAS NUMBER Pdoe, 1. — Q q (e r SUnVAPT# EJOB ADDRESS 2a -/j o-15- t7t PLAT NAME/SUBDIVISION NO. NO. LID NO. LID FEE $141 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP APPMOd RW Penrit Requw Stmet Use Pw" RWd EXISTING PROPOSED kwpecWn noquked Wows* Requirst! REQUIRED DEDICATION— FT Undagrouno VVWC requirisd METER SIZE INE SIZE NO. OF FIXTURES PRV REQUIRED 93 1 e'�' I ,, YESL3 _ NOA z REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE r 4 2�22 -221 — 0 z_NQINEERINU HhV1hVVk:L) t3y% R FIRE REVIEWED BY VARIANCE OR CU SHORELINEORADSO I INSPECTION 13OND i$ POSTED JE3REQD'/ YES WO SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PRqP0 , EXP LOT COVERAGE REQUIRED SErBACKS-LFT) PROPOSED SETBACKS ALLOWED PROPOSED FRONT SIDEmi, FRONT URSIDE RE I I — QV I o :,,a C�r PA NG LOT AREA PLANNJNG REVIEWED BY DATE f REO'D I PROVIDED 0 1 T-n) <W \1 C� .6.&- 4- e- R CHECKED BY SPECIAL INSPECTION JAREA UUUUPANF 7% REQUIR ED LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REaDfl'§q 0"n - - AA - . . &__ .- /;. I is cao Description FEE Plan Check HEAT SOURCE A _T_ GLAZING % LOT SLOPE % Building Permit PLAN CHECK NJD: VESTED DATE Plumbing Mechanica"I t: THIS PEIRMIT AUTHORIZED ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading DONIAIN (CURB% SIDEWALKS, DRIMEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPU CATION: 1110 BAYS PERMIT UMM I YEAR - PROVIDED WORK 13 STARTED WITHIN 180 DAYS Engr. Inspection DIED BACK OF PINK PERMIT FOR MORE INFORMATION 'APPUCANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS Fire Review IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscape Insp. DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Recording Fee FEE D escriptIon LE State Surcharge 6� City Surcharge Plan Chk. Depo Receipt # Total Amt. Due Receipt # 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 APPLICATION APPROVAL THE OWNER. I AGREE M COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC' CALL This application Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED BuIldIng 0111clai or Waftior Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION rgWpt Is acknaMadgad In space provided. WORIMENS COMPENSATION INSURANCE AND RCW 18.27. ATE OF a E E DATE SIGNED 2�j /I 1A'% SIGNATUREJOWNER 0 %-125) 7 -0220 _R DATE 71 E ED BY 33 '�IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL ATTENTION Off 13 *"If, is f A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - IN CArt OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER 001-D - AS=Rf(/_ GREEN - ACCO4 INTiNG 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES k z M M C M C M rn z 10.4 0 In M M Az Fn C V) z CO) 0 z z ITI