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20030814.pdf04A M& /) /C- I DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEMAME OF BUSINESS N 0 -F-- L, N 5�, 0 f,_11 MAILING ADDRESS I (o(yS2- '71 "T PL-A Cr- CITY ZIP TELEPHONE 17 L:�N9WLV_V 0"Pq 0,3712co - .6 NAME ADDRESS j&Z,o?2-*60_rq AV15- Cv. CITY ZIP TELEPHONE LoflomX: . 0a 40 11JA119: ZIP I TELEPHONE LICENSE NUMBER kOPERTY TAX ACCOUNT PARCEL NO. I 7_70qZ766SO q-rOO 19 NEW RESIDENTIAL PLUMBING/MECH 13 ADDITION COMMERCIAL P COMPL ANCE OR CHANGE OF USE REMODEL MULTIFAMILY REPAIR GRADING CYDS FENCE ( X FT) DEMOLISH TANK 0 OTHER [3 GARAGE CARPORT RETAINING WALL ROCKERY FIRE SPRINKLER FIRE ALARM (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: NUMBER OF NUMBER OF DWELLING I CRITICAL AREAS I 0� STORIES UNITS NUMBE DESCRIBE WORK TO BE DONE I HEAT SOURCE-_ GLAZING % LOT SLOPE % PLAN CHECK NO: THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PCRMn`fOVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC DOMAIN (CURBS, SIDEWALKS, ORMEWAYS, MARQUEES, FTC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPILICATION: 180 DAYS PERMIT UMrr I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFOPAATION -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, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE. 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 CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' I HEREBY ACIL94OWLEDGE 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 _ JCODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSaNON"ItQWNCE AND RCW 18.27. DATE SIGNED ,qll�7-o PERMIT EXPIRES USE PERMIT ZONE Cq NUM&� JOB ADDRESS tL 24 PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S !L'SCP Approved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required Street Use Parmh RaWd inspection Required EXISTING _gc!::f::::::�PROPOSED-- sidewalk Required 13 REQUIRED DEDICATION- FT Underground Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURE PRV REQUIRED YES E3 NO 13 REMARKS OWNERMONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ENGINEE-5ING �REVIE�VVEDBY I k6ma I FIRE REVIEWED BY DATE tu a, Iz VARIANCE OR CU SH�P��BAADB# I INSPECTION BOND 1 L ECI'D POSTED 1$ j45 CyEs ONO SEPA REVIEW SIGN AREK HEIGHT COMPLETE EXEMPT — ALLOY'lp ROPOSED EXP , LOT COVERAGE PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT UR SIDE REAR PARKING LOT AREA REVIEWED BY DATEt REQ`D I PROVIDED ]aG IREMARKS CHECKED BY TYPE U ION OCCUPANT GROUP SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [] LOAD REMARKS 2 PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG-0 I � 1 12 $ Description FEE Description FEE Plan Check State Surcharge Building Permit city surcqarge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt. Due Recording Fee R. 'pt # Receipt # CALL FOR INSPECTION1 (425) 771-0220 M 1333 APPLICATION APPROVAL This application is not a permit until signed by the Building OffiCial Or his/her Deputy: and Fees are paid, and receipt Is acknowledged In space provided. OIFI�� R A tD'B - Y_ - DAfE zvp/�/)v /A/L �4 A e -'4' Ab , JO,/I,/ IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 1 04&C:74z=" A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW-INSPECTd 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 11 0 11711 =i:%, 55 � S M 0 C � z . M M 10 _z 03� M M D—O) 0 o Fn C =2 0 Z. z 0 =1 0 M FINAL PROJECT APPROVAL FORM z 9 0 m :i:9 V5 —rl 0 0 M M z cn o -n n A m 0 6 0 o C ch c 0 rn 0 Z ;U z cn z 9 0 m RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Signature I:temp:bldg:fonns:ocaprvl 3/25/04 I 11 ODATE R�ECEIVED L�ja I vj PERMIT EXPIRES -_ ;4 f USE CC] z PERMIT CITY O� EDMONDS' ZONE NUMBE455&,'�j n�2ft JOB SUITEIAPT# CONSTRUCTION PERMIT APPLICATION ADDRESS OWNER NAMEINAME OF BUSINESS lq<)S4� PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS I L[Q.EUJ-- PUBLIC RIGHT 0 PER OFFIC:IA P ,A"MEELA _ / Pa., RequIred IT treat Pormft Req'd -71 `�T PL-A C-t=, (-0 4- f EXISTING PROP— CITY ZIP TELEPHONE I 061d 206 - yzo REQUIRED DEDICATION L-�(PNWXV A,) 037 41-1 . I I Wirtrig roquhred NAME METER SIZE ONE SIZE NO. OF FIXTURES PRV REQUIRED YES13 No 13 L2:r,- 64 &J ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE AviS- _&6/. 0 CITY ZIP ITELEPHONE ht= A0 fi&S EDIIONL)c ?a NAME CBLN 47 A// � .., f- I C%el ENGINEER Nil REVIEWED BY DATE cc ADDRESS -71 FIRE REVIEWED BY DATE ZIP TELEPHONE VARIANCE OR CU SH"gAjW INSPECTION BOND STAV LICENSE NUMBER EXPIRATION DATE CWKED 0 �OREQ'D POSTED i��+43 IZ 13NO Is SEPA REVIEW SIGN AREAr HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE , EXEMPT ALLOWED, 9P OSE OPOSED > 7. 7 0. qz 47 0 (5 1�6 0 0 A -3,_ EXP !new, NEW RESIDENTIAL PLUMBING/MECH LOT COVERAGE REQUIRED SETBACIRS (On PROPOSED BET13ACKS (Fri ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REA R COMPLIANCE OR z ADDITION COMMERCIAL CHANGE OF USE PARKING IDED LOT AREA. I P51 G REVIEWED BY REMODEL MUL11FAMILY OkliGN REO`D I PROV , .7 REPAIR GRADING FENCE X CYDS FI) REMARKS OTHER AMAMI 10*101% DEMOLISH TANK J;3 U 0 GAF!Ab� RETAINING WALL [3 F RE SPRINKLER amw cmpoi# ROCKERY FIRE ALARM 1W W momy= (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAJN: CHECKED BY ITYPE QM ION OCCUPANT C-41� (0 lam-, GROUP NUMBER NUMBER OF CRITICAL WT OF DWELLING AREAS A SPECIAL INSPECTION JAREA OCCUPANT STORIES UNITS 7 , 1 CI LOAD I I NUMBERfj&e- It.— j REQUIRED [3YES DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION RECVD A012 19 U I L- !22 arm' .61. VALUATION $ Description FEE Description FEE Plan Check,,,-" State Surcharge HEAT SOURCE GLA23NG % LOT SLOPE % T Building Permit City Surc"e PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUT111101111=6 ONLY THE WORK NOTED. THIS PEliUrv6OVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPILICATION: 1160DAYS 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. TOE 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 PERMM ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapeinsp. Total Amt. Due 41:� DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CffY`S ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION APPROVAL' GIVEN IS CORRECr 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 LABOR CQDE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION recolptisecknowted9odinepace provided. WORKMENS COMPENSfiT"UhtNCE AND RCW 10.27. OFFICI IGNATWE 11 ERI NT) DATE SIGNED 1495) 771-0220 'BY fb 'IE DAfE 717T ENTION EXT 1333 I /// /yv, //v " IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I I — A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW- INSPECTdR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING