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20030806.pdfDATE RECEIVED PERMITEXPIRES CITY OF EDMONDS u dE ZONE 9 PERMIT o�7 NUMBER "e Av� _'M -LI CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRESS Z,3 t z_ 1-1 7&tk 14ve b-) OWNER NAMEINAME OF BUSINESS PLAT NAME/SUBDIVISION NO. LOT NO. L D NO. MAILING ADDRESS LID FEE $ I I 7 TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Rw Permit Required CITY ZIP TELEPHONE Street Use Permit Req'd EXISTING n Required PRQPOSED JXd=Uired "I _14 REQUIRE Is Ito re j i ive- qK REQUIRED DOR17CAM -agrgEW wiring required 13 NAME METERSIZEW 06NFPA-1 k%.fXhhffiW0F9RB=IRED 7e 0 S11 MUST B11 CA?pjfi9Z NO ADDRESS REMAW z z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE a # /6 0 WAIM MBM 70 98 REMOM = 5 CITY ZIP TELEPHONE WSIR 1918 W= a ED -Se 4kc rlglo.-1 S_ 1/3- - 4S_00 em NAME CBLN -to Se,L 'E.A A- e,- IN 4 e _j L Ba ]DEMOS ENGINEERINGWVI�r LisT oN sAck. ADDRESS FOR INSPWTION SEQUMMMM FIRE REVIEWED BY DATE W CITY ZIP TELEPHONE IM, Skiprj;.'vit q0j I 1 -1-.9 (.-'C).3' 9." VARIANCE OR CU SHORELINE OR ADS# INSPECTION BOND STATE LICENSE NUMBER EXPIRATION DATE I CHgg,KEn. B, REO'D POSTED I 1E3YEs 1$ S6L F_NL )&QQj42.._ ONO SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED 0 C.) 0 n EXP , , LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) NEW RESIDENTIAL PLUMBING / MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE z PARKING LOT AREA PLANNING REVIEWED BY DATE REMODEL MULTIFAMILY SIGN REO'D PROVIDE I CL REPAIR GRADING FENCE X CYDS FT) REMARKS Ca DEMOLISH 0 TANK 0 OTHER GARAGE CARPORT [:3 RETAINING WALL ROCKERY FIRE SPRINKLER FIRE ALARM (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: ,or 910. - CHECKED BY OCCUPA uPh'Ic 71-en =,"e.r ITYPE GROUP NUMBER OF NUMBER OF DWELLING CRITICAL A AREAS - .- SPECIAL INSPECTION OCCUPANT STORIES — 2 UNITS /0 NUMBER JAREA REQUIRED [] YES LOAD DESCRIBE WORK TO BE DONE ' b,e,=,. b fA 44OX F:j ji" REMARKS PROGRESS INSPECTIONS PER USC 108/FINAL INSPECTION REO'D Al- 1�rn -S i'm "li §;:g , i, // /-Iy - ir r,,.- gge r , e ii, r e- J-1�70, 1 Description FEE Description FEE COW Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DOME ON PFUVATE PROPERTY OMLV. ANY CONSTRUCTION ON THE PUBLIC Grading 3 DOMAIN (CUIRSS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. It: Engr. Review PERMIT APPLICATION: ISODAYS I A 06 PERMIT LIUM I YEAR - PROVIDED WORK IS STARTED WffHIN ISO 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 2 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 Landscapelnsp. Total Amt. DUe f�z� NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - Recording Fee LRecelpt # 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 IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building Offictal or his/her Deputy: and Fees are paid, and receipt Is acknowledged In space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. OF41116 SIG�AIVRE DATE SIGNATURE (OWNEX9 GE )ATE SIGN (425) 771-0220 REL BY FA§E 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 Shoreline Bank 18350 Midvale Ave N. Shoreline, WA 98132 Donald G. SwefizeV.0 count #105001085 for n Frozen Fund Ac Re: Demolitio Demolition at 23124 76 'Ave W Dear Sir or Madam: ferenced 2,000 from the above re The Ce of Edmonds hereby authorizes the release $ ity ed, the release of ested City dePartments have approv All inter emolition Frozen Fund D Uan the Demolition Frozen Fund. Sincerely Fax;4253030634 Aug 5 2002 10;17 P.03 Labor and Industries AMIL NOTICE OF Industziat Hygiene C=VIW= ASBESTOS ABATENZNT CR4ocd addre� ad phone IV PROJECT munbers m page 2) THISN0710E MUST BE RECHWED NO UTER THAN 10 CALENDAR DAYS PRIOR TO THE START DA72 COWLETE ALL APPLICABLE BOXES — INCOMPLETE OR MLEGIBLE NO nCES WILL NOT BE ACCEPTED MAIL OR FAX TO THE REOIONAL OMCE — CIRCLE ON AMENDED N0710ES Nodw due: 07 1 03 / 03 Initial 0 AmecM C) Site Work Hours So 'Mo Tu We 7h Fr SA IM Swt daw 07 1 16 / 03 On Hold 01fHold 8100 " to.. I J X, �171 15 �10� Fmnacy P, 5:00 P, PMed Dan ad Woef. Hours must be LvAct CONTRACTOR PROPERTY OWNER CQIMWNMO C=trwWCwdfiwdonT=--b—a' OwnWx Agent 1070 0"fir Signature XA. ej�; complay wit PdntedNKV- Addmi IWI L40en Ave N Ph=@ NwAbor SUft ZEP+4 sherefte WA "113 Job SIM C.A.S. numba JOB SITE FACILITY Address Type 23124 78th Ave W Building Tkoom Age Size Name 40+ 1500 57— :j Remodel Demolition ISXdmo'ndo Z] RopOr ZIP + 4 nTTAWTTTV n1F ARREST05 TO BE: rl REMOVED 0 ENCAPSULATED C3 Outdoon CO FftwWofing CONTROLMEASURES a Pape,om callinS C3 Duo pmw Nes. pres, anclarm Wnp & Duo CAD 0 V,%T Giove bq We mc&oa shm vinyl C3 Rwftg C3 MW enelmn M!PA V"num O,M�. C3 Other Cridedbuders Manuel madwa quaft Hnen fam C3 Othc C3 Other C3 max Pipe inswation C3 Cansem abowspips RESPIRATORY PROTECTION C Air cell pipe Inin,ladon 13 Mudded p%w In& 1/1 mask APR C3 Type C cw1nucas flow E3 DaWnsIduct 1"sule0on C3 Duct two Full ft* APR Type C prewn demind C3 Other C3 Odw [3 PAPR OdLer F413-M-M notice of in=t of ubcatos abacmwt project 11-01 R E C E I V16"pin go to http://www,w'wLPv/f=81 MAR 3 1 2004 DEVELOPMENT SERVICES CTR. CITY OF EDMONDS Fox:4253030624 Aug 5 2003 10;16 P.02 P. 2/2 JUL 07 081MI PUGE7 SOUND CLEAIN 200302403 mm w- �- z 0 0 m X m ma 0 0 m M z V) 0 -n n Fn m a vi 8 R c (j) c co) M 0 X z CA z 0 m RE:CEIVED I MAR, 3 1 2004 .��fJVICES CTR. I)FVELOPMENI . CITY OF EDMONDS FINAL PROJECT APPR FORM RV�A-L z 9 0 m :; 9 ro --ri am c MO 0 80 c �c m mz 10 -1 0 -n n i m M a 0 0 M C MO Z .A z -1 3: CD z 0 i 5 m 2. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL. Date- S, owmi.doc.l:te�op:bldg:formslO/01 40k. DATE RECEIVED PERMIT EXPIRES I CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OW`��EREINAME OF BUSINESS OAAlA 6 - '; W e g' -z e C�'_ MAILING ADDRESS I f 7 11 (,�I Ad f-J, CITY ZIP Is 41) Irf tic NAME _S_e f r 4 'T%+h. 1, ADDRESS CITY _Se(01" NAME k' Ah e2 d I ZIP cfglo.3 Z> el t- ADDRESS I -) i ?_ I L CITY ZIP S�pf(j;)VI qirn 3 STATE LICENSE NUMBER if- LF_NL goo1v ,q PROPERTY TAX ACCOUNT PARCEL NO. e Aj. TELEPHONE 2-06 - zz�- TELEPHONE 7-06- ICBL# TELEPHONE '2 r-) I, - 7- 7- ef 4 0 EXPIRATION DATE US7E L', PERMIT ZONE NUMBER JOB SUITE/APT# ADDRESS Z3tz-'-/ 76't6 4Lc 0 , PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW PenrAt Required stre I Permit RWd EXISTING PROPOSED— Inspecton Required Sldew&A Required REQUIRED DEDICATION— FT underground Wiring roqL*ed 13 METER SIZE LINE SliTj OF FIXTURES PRV REQUIRED I � YES13 No C3 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE I ir! VARIANCE OR CU SHOREUNEORADBII I INSPECTION BOND By REO'D POSTED.. I I 13YEs 13NO is SEPA REVIEW SIGN AREA HEIGHT ;4COMPLETE . EXEMPT I ALLOWED . PROPOSED I ALLOWED . PROPOSED NEW RESIDENTIAL PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) LIRSIDE ALLOWED PROPOSED FRONT SIDE REAR FRONT REAR I COMPLIANCE OR ADDITION COMMERCIAL z CHANGE OF USE 0 REMODEL, [3 MULTIFAMILY SIGN PARKING LOT AREA PLANNING REVIEWED BY DATE REOD I PROVIDED REPAIR GRADING FENCE CYDS X FT) REMARKS TANK OTHER :EMO 13 ARAG RETAINING WALL FIRE SPRINKLER ROCKERY FIRE ALARM (TYPE OF USE, 13USINESS OR ACTIVITY) EXPLAIN: / CHECKEDBY TYPE kiF CONSTRUCTIOtl OCCUPANT Plee 7v1_4jA ht;),m e T GROUP NUMBER NOMBER OF CRITICAL OF DWELLING AREAS 4_4-/// STORIES UNITS /0 1 OCCUPANT SPECIAL INSPECTION JAREA LOAD NUMBER REQUIRED [] YES DESCRI13E WORK TO BE DONE -Z> -e A_fA '-)c 1:ji/i" a REMARKS z PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REaD ale.& r'. e Zq VALU $ b) S (A f' (4 4�70 0"C'9, Description FEE Description FEE ,io Flan Check State Surcharge HEAT SOURCE GLA23NO LOT SLOPE % B6jIdlng Permit City Surcharge PLAN CHECK NO: VESTED DATE Plu�bing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DOME ON PRIVATE PROPERTY ONLX AW CONMUCTION ON THE PUBLIC a Grading DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEES, FTC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERmITAPPLIcAnow iodms PERMIT UMIr I YEAR - PROVIDED WORK 19 STARTED WITHIN 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 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 Landscapelnsp. Total Amt. Due I D0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDI NANCE PROVISION.* -,or Recording Fee Receipt # q,7 I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRE" AND THAT I AM THE OWNERs 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 hisftief Deputy: and Foos*aro paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided. 'S C MPENSATION INSURANCE AND RCW 10.27. RKMEN'S OF S SIG A�TYRE DATE SIGNATURE (OWNE_RqR E DATE SIGNf-D 1A.0.5) 771,0220 RELEASED BY DATE ATTENTION M 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNVL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - INSPECTO 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 M M 0 C: M M C _z 0 M M 0) z M