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20030805.pdfDATE RECEIVED 1-M PERMIT EXPIRES USE 01=11511111or ; . .. IT ,-I, � � , V CITY OF EDMONDS ZONE NUMBER Z 2-- L- -, L JOB AIC IV SUITE/APT# CONSTRUCTION PERMIT APPLICATION ADDRESS OWNER NAMEINAME OF BUSINESS 6 '-r rlj PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS LID FEE S TESCP A PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RwPernon'i�uu., Z-00 Av /V Strew use Penn t aq CITY EXISTING - PROPOSED Inspectio Required ZIP TELEPHONE Sidewalk"Required REQUIRED DEDICATION- FT underground 7 7f Wiring required 13 4_a' 7 NAME METER SIZE LINE OF FIXTURES PRV REQUIRED 0 1 YES 13 NO 13 z ADDRESS REMARKS I z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE CITY ZIP TELEPHONE NAME CBIL N ENGINEERING REVIEWED BY DATE A D�Di 90 773:3 X 4 FIRE REVIEWED BY DATE uj CITY ZIP TELEPHONE x 1116__ 2-6 6 3 VARIANCE OR CU SHOR:EL�INE �ORADB I INSPECTION 1$ B�OND REQ'D STATE LICENSE NUMBER EXPIRATION DATE 1,,� 13YES T -2,1 V% �Ild_oq NO SEPA REVIEW SIGN AREA 11EIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALL70W!ED!+:PR�0P0S ALLOWED PROPOSED _16 0=0 065 000j-�_ , EXP NEW PLUMBING if MECH LOT COVERAGE REQUIRED SETBACKS (FT). PROPOSED SETBACKS (FT) EAR ALLOWE FRONT SIDE FRONT LIR :�,� E] ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE z REMODEL kMIULTIFAM SIGN PARKING REQVD I P ED LOT AREA PLANNING REVIEWED BY DATE GRADING REPAIR 1:1 CYDS FENCE X FT) REMAR� DEMOLISH TANK OTHER I GARAGE RETAINING WALL 13 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE BUSINESS OR ACTIV EXPLAIN' IT rc CHECKED BY ITYPE OF C STRUCTION OCCUPANT S N j 2 IL, p1r, Ka It'll k/i -Te GROUP MEA".�F% NUMBER NUMBER10F OF DWELLING CRITICAL AREAS it, 'TION AREA OCCUPANT STORIES -3 .1 NUMBER REQUIRED LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REQ'D T A__� +t AJ'C_ t-1) --I J CIO _Ln cico_ MC i CILA, I VALUATION '7-L A '�Ili $ 1 -1 Description FEE Description FEE Plan Check Ll 21::5 State Surcharge HEAT SOURCE LAZING % LOT SLOPE % Building Permit DCA City Surcharge PLAN CHECK NO: L� VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO k: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPUCATION: ISODAYS 116 PERMIT ILIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION -APPLICAK 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 2 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 CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' ,�zz A. Recording Fee Receipt # 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 TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED* Building Official or his/her Deputy: and Foos are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged In space provided. WORKMEN'S COMPENSAT5"URANCE AND FICA! 18.27. CZFFICIA DATf SIGNATURE (OWNER 0 AGENT) DATE: SZIGN D 5) ZIGNUIRE C? 1 771-0220 —RELEASE BY IDATE 7 ATTE14TION Off 1333 7 -�?, r' Vh IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL LE YELLOW. INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK'11OW ER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 1 0 M M M __I § 0 C: I z 1711 ITI z 0 M M 0-0) Fn CA ca M 0 V) z 0 q 0 M op I r-nRn OF INSPECTIONS 4 . DATE RECEIVED PERMITEXPIRES UUE PERMIT CITY OF EDMONDS ZONE NUMBER AV�_ )O�, CONSTRUCTION PERMIT APPLICATION JOB RESS SUITE/APT# ADD &0 — Z III 07711 NAME/NAME OF BUSINESS PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. 6 o., yodtctf _jfyyv%&0,jyt ,j, Art �. >-7 15 MAILING ADDRESS LID FEE $ I TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required Av IV ;zo,� R80 Street Use Permit EXISTING - PROPOSED Inspection Required Sidewstk Required ZIP2.0 ITELEPHONE REQUIRED DEDICATION- FT Undworound qVo +;Z f- 7 7r 5-..;-7o Wmg re uW 13 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES13 NO 13 z ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE Stub CITY ZIP LONE _U JuLif fi; CBLN 1* fie .000 ENGINEERING REVIEWED BY DATE CC AD Be 7 73:3 t FIRE REVIEWED BY DATE PITY TELEPHONE zip F6 (24;7/ 7 7 S40RELINEORADL3.N. INSPECTION D IIIANCI IRCLI I am - STATE LICENSE NUMBER EXPIRATION DATE Y REQ'D OYES 1$ wo 2. 1 .3hdo SEPA REVIEW SIGN AREA HEIGHT fROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOS ALLOWID PROPOSED EXP , LOT COVERAGE REQUIRED SETBACKS (FT. 1�. PROPOSED SETBACMIFT) rl NEW PLUM13ING MECH AL4.OWED p FRONT SI COMPLIANCE OR :�,� rl ADDITION rl COMMERCIAL CHANGE OF USE Z PARKING LOT AREA PLANNING REVIEWED BY DATE �.O'�OEMODEL REaD 0 0 k=MULTIFAIAWY SIGN P ED GRADING FENCE R X FT) CYDS REMARI:�� OTHER....., DEMOLISH TANK IAOE�, RETAINING WALL p GAP [] FIRE SPRINKLER .CARPORT, L_J ROCKERY FIRE ALARM j _CW_UM,BU?INES8 OR ACTIV EXPLAIN: INS CHECKED E OF COPSTRUCT BY TYP k�(C , ION OCCUPANT /y j ? A All col-7, _C i(t, jp' GROUP "C L _4nAz `NU NUMBER F CRITICAL 0 ELLING AREAS SPECIAL INSPECTION AREA OCCUPANT A#� LO AD '11000f6a �L!Nffs R NUMBE .,REOUTD�M 11: 1 1 YES DE TO BE DOME ,§CRIB; WORK REMAR:KS r ON,REQ'D N, ORQGRESS INSPECTIONS PER UBC 108/FINAL INSOECTI 4r L T ii0fal.-ap— fv(&LL� VALUATION A—S $ e) Description FEE Description GSC" FEE Plan.Check State Surcharge t s� HEAT SOURCE GLAZING % .1.9,1 4LOPE % I Building Permit ED City S Urc City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AWwonIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DOME Olt PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC . Grading DOMAIN (CU SIDEWALKS, DRIVEWAYF; UARGUEI;P. ETC.) WILL REQUIRE :21 SEPARATE PERMISSION. &,i - r , Engr. Review PERmrrAPpucA1noN. isoDAYS PFAMIT IUIMM`1� VEAR -PROVIDED WORK IS STARTED WffHiN 190DAYS Engr. Inspection BEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASS I 19NS AND SUCCESORS Fire Review Plan Chk. Deposi�- ''IN INTEREST., AGREES TO INDEMNIFX DEFEND AND HOLD ilARMLESS THE CITY OF EDMONDS. WASHINGTON, rTS OFFICIALS. EMPLOYEES, AND AGENTS FROM'AN�AND Firig Inspection, R elpt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY FROM SSUANCE OF THIS PERMIT. ISSUANCE'OF THIS PERMIT SHALL Not BE Landscapelns Total A t. Due A15 DEEMED TGIAODIFN: WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE P. J NOR LIMIT IN ANYW�Y THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Recel�i # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS iPPUCATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWINER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a pormit until'signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED 114 VIOLATION OPTHE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO Building Official or his/her Deputy: and Fees are paid. and FOR INSPECTION receipt Is ackncrMedged in space provided. ,"URANCE AND RCW 18.27. WORKMEN'S CqMPENSA9 I OFFICIA SIGN URE DATI SIGNATURE lkiER AGEftn D�TE S105ED (425) 7/, /-z 771-0220 RELEAs 11 ATTENTION EXT 1333 7E /E I/A, ff IT IS UNLAWFUL TO USE OR OCCUPY A BUIL G OR STRUCTURE UNTIL FINAL INSPECTION HAS BEEN MADE AND PPROVAL OR A CERTIFI- ORIGIN;AL-111LE - YELL -INSPECTOR Vgp CATE OF OCCUPANCY HAS'BEEN GRANTED. BC SECTION 109 PINK - ER - GOLD -ASSESSOR 04/02 GREEN - ACCOUNTING PRESS HARD -YOU ARE MAKING 5 COPIES a, 3 1 Z 0 0 IT! M M 0 0 M IT! 0 0 _n n In M a ra 0 o Fn C (j) Q 0 Z Z 9 0 in