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20030811.pdfM DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION I OWNER NAMWOdR OPWSINErsk I [PERAMIT EXPIRES USE PERMIT ZONE NUMBER JOB ADDRESS ��11 SUITE/APT# " I PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAIMS ,si I LID FEE S U& TESCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required I - Street Use Permit Reld rELEPHONE 'PROPOSED Inspectlo" Required Sidewalk Required Csa��qozlf,pw I a,,�2A -wi- REQUIRED DEDICATION— Fr Underoround Wiring required NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES E3 NO C3 z E ADDRESS REMARKS z z OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE CITY ZIP TELEPHONE NAME 17 �T� CBL I 14DENGINEERING REVIEWED BY DATE ADDRESS us FIRE REVIEWED BY DATE CITY ZIP cc IE OJELEPHONE VARIANCE OR CU SHORELINE OR ADB#. INSPECTION BOND STATE LICENSE NMBER EXPIRATIOI`A DATE- Y REO'D POSTED 13YES ONO. $ C112 � U )ITIA t SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL N 0, COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED -7-1(yj 2400 1 , , EXP - LOT COVERAGE REQUIRED SETBACKS (ft) PROPOSED SETBACKS (Fr.) NEW RESIDENTIAL PLUMBING / MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR ADDITION COMMERCIAL x COMPLIANCE OR CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE 0 REMODEL [:] MULTIFAMILY SIGN REOD PROVIDED I I 1:1 REPAIR [3 GRADING 0 FENCE CYDS X ( _ _FT) REMARKS 1:1 DEMOLISH TANK [:] OTHER GARAGE RETAINING WALL 0 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM UWE OF USE, BU§J.NES�LOR ACTIVITYI EXPLAUN: CHECKED BY OCCUPANTiA GROUP NUMBER OF NUMBER OF DWELLING CRITICAL AREAS SPECIAL. INSPECTION JAREA OCCUPANT LOAD STORIES UNITS NUMBER REQUIRED YES DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER USC 1108/FINAL INSPECTION REQ'D /1 Air -a A It- 0 4A $ DescrIptIon FEE Description FEE Plan Check State Surcharge HEAT GLAZIN13 % LOT SLOPE % SOURCE T Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORMES ONLY THE WORK NOTED. THI S PERMIT COVERS WORK TO t: HE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMI'TAPPLICATION: 1130DAYS IL PERMIT LIMM 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 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 cz� FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapeinsp. Total Amt. Due 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.' efte 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 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 Fees are paid, and IN VIOLATION OF THE LABOH—GODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided. WORKMEN'S COMPEN No RCW 18.27. L I URE E SIQKA311W DATE SIGNED 1A It"25) AZz:,L2 /0 - Afl� C93 771-0220 ELI!ASEfQ ATTENTION Off 1333 DAIE "I, �, 7 k ), / IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- g.&, NAL FI YELLONJINSPE40R CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 P�qNXZOZAES GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING lu M DATE RECEIVE PERMIT EXPIRES T USE PERMIT CITY OF EDMONDS ZONE NUMBER CONSTRUCTION PERMIT APPLICATION JOB ..m ADDRESS rOWN'ER Mao OUPSINESi q q PLAT NAME/SUBDIVISION NO. LOT AD. LID NO. TELEPHONE RPM WN M. wa[e -a f, " �Wrj I MT-TFZ CITY NAME ADDRESS CITY ZIP TELEPHONE CBL 0 10 Pr_R IP 2,IYELEPHONE I NEW RESIDENTIAL D [j DITION COMMERCIAL x REMOPEL muLnFAmiLy OREPAIR 0 GRADING CYDS DEMOLISH TANK GARAGE [3 RETAININGWALL CARPORT ROCKERY ,OWE OF USE, BUSINESS -OR ACTIVITY11 EXPLAIN: NUM DER OF ..::, f ,PTORIES NUMBER OF DWELLING UNITS DESCRIBE WORK TO BE DONE f) 4 [3 PLUMBING / MECH COMPLIANCE OR CHANGE OF USE SIGN FENCE X FT) OTHER FIRE SPRINKLER FIREALARM CRITICAL AREAS Adjqo' NUMBER HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBILIC DOAMN (CURBS, SIDEWALKS, ORSVIEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERmITAPPLicAmom iboDAys dL PERMIT ILIMM 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 INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS. WASHINGTON. IT$ OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, AFUSING 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 CnYS ABILITY TO ENFORCE ANY ORDINA14CE PROVISION." I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; T14AT 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 LABQD.Q0DE OF THE STATE OF WASHINGTON RELATING TO WORXMENS COMPE NSA 91== 0 RCW 18.27. DATE SIGNED LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP prov0d 131 RW PerrM RaWltod Strum U" Pormit 14*0 EXISTING — PROPOSED hupection Required 8Wma1kR@qulmd REQUIRED DEDICATION FT UndwWwwl Wiring rsqtgrad METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIORAINAG REVIEWED BY FIRE REVIEWED BY DATE DATE cc M VARIANCE OR CU SHORELINEORADB# INSPECTION BOND I REO'D POSTED I 13YEs 13NO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED , LOT COVERAGE REOWRED SETBACKS (Fr.) PROPOSED SET13ACKS (rr.) ALLOWED PROPOSED FRONT SIDE HEAR FRONT LJRSIDE HEAR BY DATE PARKING REO'D PROVIDED 1.06TARdEMAPLANNINGI REVIEEWED . RE MARKS CHECKED BY ION OCCUPANM =NSIM mad GROUP SPECIAL INSPECTION OCCUPANT REQUIRED [j YES JAREA LOA REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD FEE fA— ov- Description FEE Description 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 Recording Fee Receipt # - CALL FOR -INSPECTION (42;jj 771-0220 APPLICATION APPROVAL This application Is not permit until signed by the Suflding offlclal or his/her Daeputy: and Fees are paid. and receipt Is acknowledged in space provided. URE ATE /0 -fIELEASEQ BY DYE ATTENTION Off 1333 /_I IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 1jP1INjALWF EE YELLOW JINSPEITOR 1 . � ER CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PI - ER GOLD - ASSESSOR 04102 GREEN - ACCOUNTING PRESS HARD -YOU ARE MAKING 5 COPIES