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20030804.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION �R NAMEINAME 0 USINE�S CITY ZIP JTELEPHONE NAME ADDRESS CITY ZIP ITELEPHONE PERMIT EXPIRES /_/O I - - -) USE PERMIT ZONE NUMBER JOB SUITE/APT# ADDRESS PLAT NAME/SUBDIViSION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Pefintl Required 9 street Use Parm it Recid EXISTING — PROPOSED inspection R ad 13 ,�uir Sidewalk R q Ired 13 REQUIRED DEDICATION— FT Underground Wiring required 0 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 13 NO L3 z I REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE NAME ICBL# ANIyrull, P105 ADDRESS P_ 0, CITY 71:0 5' zip TELEPHONE I 13 e z i e vve VIA STATE LICENSE NUMBER EXPIRATION DATE NW-)OV MAVVej 0 5 J ljuqqL PROPERTY TAX ACCOUNT PARCEL NO. BY FIRE REVIEWED BY DATE DATE I '-." VARIANCE OR CU SHORELINE OR ADBO i INSPECTION BOND REO'D POSTED 13YEs 13NO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT ALLOWED , PROPOSED I ALLOWED . PROPOSED NEW RESIDENTIAL 1:1 PLUMBING / MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT UR SIDE REAR ADDITION 0 COMMERCIAL COMPLIANCE OR 1:1 CHANGE OF USE z <REMODEL muLnFAmiLY 0 SIGN PARKING IDED RE11D I PROV LOT ARM I PLANNING REVIEWED BY DATE 0 REPAIR GRADING CYDS o FENCE X ( FT) REMARKS DEMOLISH TANK OTHER 0 GARAGE CARPORT o RETAININGWALL ROCKERY o F RE SPRINKLER FIRE ALARM (TYPE OF USE. BUSINESS OR ACT E EX 'LAIN: M. T ry CHECKED 13Y 1 P S LICTION Y Cq ___ GRO , 7 OCCUPANTjZ, NUMBER OF I N UMBER OF CRITICAL DWELLING AREAS I k TZT SPECIAL 114SPECTION AREA -OCCUPANT STORIES UNITS M R NU BE I REQUIRE[ :S Es LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG-0 22 1 oil it e _e rr 1.4/je /o bf 4; 102- hL'I--C V A/ 4te 1-0 7 / /'R 2,1) VALUATION 3 1 $ —IJ Description FEE Description FEE OC2 Plan Check State Surcharge HEAT SOURCE T777 G % LOT SLOPE % Building Permit City Surcharge 114-) VESTED DATE Plumbing 61 . F_yp r"_ PLAN CHECK NO: P,-vb�( Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANV CONSTRUCTION ON THE PUBLIC Grading 2 DOMAIN (CUREIS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE :3 SEPARATE PERMISSION. Engr. Review PERUITAPPLICATION: 180DAYS 916 PERMIT LIMIT! I YEAR - PROVIDED WORK 15 STARTED WITHIN 100 DAYS Engr. Inspection ION SEE BACK OF PINK PERMIT FOR MORE INFORMAT '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 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 OF: ANY CITY ORDINANCE Landscape Insp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT 0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." zi Recording Fee Receipt # I HERE13Y 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 CONSTRLIC- CALL This application is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR_f,0DE OF HE STATE OF WASHINGTON RELATING TO FOR INSPECTION1 Building Official or histhor Deputy: and Fees are paid, and receipt Is acknowledged In space provided. WORKMEN'S COMPENSATI94�30PIANCE AN D RCW 18,27. OFFICIALS -WON BAT - SIGNATURE (OWNER OR )ATE SIGNED 1A9 j =(� lt:� 771 -0220 --ma—EaE bATE/ AITENTION Off 1333 IT IS UNLAWFUL TO USE OR 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 11111111 L z 0 i 0 M M C, M 0 M M 0 _n M M 0 0 Fn 0 z 0 M . . . . . . . . . . . . . . . . . . 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S)IOV1313S (13AOUddV 31Va U0103dSNI SNO1133dSNI JO GE1033H P1 0 . 1 6 RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION FR NAME11`4ME OF SI WuMzz�wz� rza*w -MAILING ADDRESS / ?5 e / q — cz) Qr-� I CITY NAME ADDRESS CITY ZIP [TELEPHONE �v 5 P��o USE ZONE - I PERMIT EXPIRES PERMIT jbo� NUMBER JOB ADDRESS ��RL cz7m pe- SUITE/APT# �f/� PLAT NAME/SUBDPASION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Appmed RW Permit Ro"ked Strom Use Portnit Wd EXISTING — PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION— FT UndOW&AW Wiring roqLArod METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 1 I YES13 NO 13 z REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE I N7AE ENGINEERING REVIEWED BY DATE ADDRESS V 10. 0. 3 FIRE REVIEWED BY DATE CITY 17>0750 zip TELEPHONE x Pez i e Pve v1,4 k/1 5, - 6 ff/ - -5 ER EXPIRATION DATE I CH VARIANCE OR CU S HORELINE OR ADB# INSPECTION 1$ BOND REQ'D POSTED 113YES flt%qqL 0/ OL --- 13NO W SEPA REVIEW SIGN AREA HEIGHT PROPERTY qT PARCEL NO COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED I 7hAC]OL MEXP , , , NEW ESIDENTIAL 0 PLUMBING / MECH XR LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) FRONT SIDE REAR FRONT URSIDE REAR ADDITION COMPLIANCE OR COMMERCIAL 0 CHANGE OF USE ALLOWED PROPOSED WREMODEL MULTIFAMILY 0 SIGN PARKING REQ`D PROV&% I 0 4V,)LI PJAN M"Ef I BY DATE h 11 REPAIR 0 GRADING X [3 FENCE CYDS _FT) I REMARKi---W1V11-- 6616M DEMOLISH 0 TANK 0 OTHER oGARAGE o RETAINING WALL 0 FIRE SPRINKLER FIRE ALARM CARPORT ROCKERY (111PE OF USE, BUSINESS OR ACTIVITY) EX2LAIN: .�—R�l CHECKED 6 y UCTIO N OCCUPANT 1 vpg-f GRO PV"5 NUMBER OF NUMBER OF CRITICAL DWELLING AREAS I I SPECIAL INSPECTION JAREA OCCUPANT STORIES ;�- UNITS NUMBER .4 REQUIRED 0 YES LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaO A )WAie- 5z p At Y AV" joz- #4 7 010� - VALUATION T4 r<-2---1 t 3 s-11115 Description FEE Description FEE Plan Check State Surch e HEAT SOURCET GLAZING LOT SLOPE % Building Permit City Surcharge —Fav PLAN CHECK NO: VESTED DATE Plumbing 11XIi Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading I 3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 1: SEPARATE PERMISSION. Engr. Review PERMITAPPUCATION: IGO DAYS PERMIT ILIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION ------ ----- 'APPLICANT N BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit IN INTEREWAGREES 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 MATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMrr. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due NOR LIMIT I N ANY WAY THE CITT8 ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' III . Recording Fee 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 In not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOP,"DE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building Official or his/Mr Deputy: and Foes are paid, and receipt Is acknowledged In space provided. WORKMEN$ COMPENSATI U"CE AND RCW 18.27. OF5GW37-SIGN DAT oo" SIGNAIAE (OWKER 011WA.. ATE SI NED 1A25) %-WK- ), Z )7 771-0220 jbATE7 ATTENTION EXT 1333 ------- IT IS UNLAWFUL TO USE OR 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 z 0 0 m C ma 0 -40 Or .� C : M 17114 10 z 0 TI m m 0—ca 0 0 C K mo� z z 0 1 0 m