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20030816A.pdfDATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS MAILING ADDRESS L tA-) CITY ZI TELEPHONE P > 2 NAME CITY ZIP ITELEPHONE NAME ICBL# ADDRESS USE ZONE JOB ADDRESS I PERMIT EXPIRES PERMIT NUMBER PLAT NAAIE/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved AW Pomft Required Street Use Permh Roced EXISTING — PROPOSED Inspection Required SidawL* Required REQUIRED DEDICATION-- FT Underground "r ul'u 13 METER SIZE LINE SIZE NO. OF FIXTUR PRV REQUIRED 1 1 =YES E3 NO 13 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE #.Af� . 11 — __ — 7:11 DATE %_1 Vh -FIRE..REVIEWED By DATE CITY TEL9MICIAE z VARIANCEORPU��- �_,MiOPIELINE701`1 ADS# ECTION BOND ,#W INSP STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY ;EO'D POSTED ONO AREA HEIGHT PRO PROPERTY TAX ACCOUK P !COMPLETE ".EXEMPT, ' AkILMED,' BED tOWED PROPOSED Lof iXiQtmet Rmulift &TO' �S (I)% dAPOSED SETBACKS (Fr.) R PLUMBING/ tj" FRONT NEW ESIDENTIAL W ".7 _0_ SIDE REAR -Olil , �"'l LIR PROPOSED, COMPLIANCIE OR COMMERCIA1. M ADDITION E3 CHANGE OF USE D E SIGN :, ": ), REMO MULTIRWILY " JH0 PARV DEL vll�io GRADING [3 REPAIR CYDS REMARKS OTHE DEMOLISH TANK IN, %,k cl WAGE MAININGVVALL.-I CARPORT _ai P E M.,;i,11 8 r ',I I Ilit (TYPE OF USE, BUSINES PAKr ',A 4� 17 occu GROU NUMBER RM I NUMM0111i 4 C or D AREAC L INSPE OCCUPANT U? LOAD TORIES FE34. DESCRIBE WORK TO BE DONE INAL INSPECTION REO'D lz< M a V, 547 FEE Description FEE fy 4 State Surcharge HEAT SOURCE GLAZNG % 0 LOPE! % uIldi er City Surcharge I A 1—,W- PLAN CHECK NO: VE§TED De 0 111~ echanical THIS PERMIT All.11THORIUMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURDS, SIDEWALKS. DRIVIEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERUrTAPPUCATIOW. 180 DAYS PERMfT LIMM I YEAR - PROVIDED WORK 13 STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION *APM ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit 111 AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF EDMOND . WASHINGrON. 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 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # Cx I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT� AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application Is not a permit until signed by the TiON; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED CALL Building Official or his/her Deputy: and Foes are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION -receipt Is acknovAedged In space provided. WORKMENS COMPENSATION INSURANCE AND RCW 18.27. OF I ATU DATE 1121 UR R AGENT) DATE SIGNED 'A-05) ( - DATE T 771-0220 RELEAdED 6 ATTENTION 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 I z 0 1 0 M W M M 0 0 C M M z 0 _n ic Irn M 0 —0) 0 o Fn C co) z V) ITI z I X z z 0 11 0 M I Ir 10 121 M DATE RECEIVED M 2� � Asa, PERMIT EXPIRES USE PERMIT CITY OF EDMONDS ZONE NUMBERA&f� JOB SyITE/APT# CONSTRUCTION PERMIT APPLICATION ADDRESS OWNER NAILEINAME OF BUS % )0 V �:N!286 PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. L MAILING ADDRESS LID FEE S TESCP AWWAd P PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW P*fffA Roquir 23L-1 C;>-4— Strw Use Per=Wdd IrspoeWnFloquired CITY Z TELEPHONE EXISTING — PROPOSED SklewAllw"p-ir UndKwwm L2 (,T- q 2 5-1v'72-1 REQUIRED DEDICATION— FT Wking requkvd 13 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED T I I YES13 NO 13 ADDRESS REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE -- /Ax/rair/ o)vp ZIP CITY TELEPHONE — NAME, CBL N REVIEWED BY DATE Z! DATE FIRE REVIEWED BY CITY ZIP TELEPHONE VARIANCE OR CU SHORELINEORAD1111 I INSPECTION BOND STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY REO'D POSTED I [3YEs 13NO $ SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NQ. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROP06ED Oq , , , EXP NEW RESIDENTIAL PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE PARKING LOT AREA REMODEL MULTIFAMILY SIGN REC?D I PROVIDED Alk IL REPAIR GRADING CyDS [3 FENCE X 0% 1 lob# REMARKS _FT) OTHER [3 DEMOLISH TANK aGARAGE o RETAINING WALL FIRE SPRINKLER CARPORT -ROCKERY FIRE ALARM -- (TYPE OF USE, BUSINESS, MIVnY) EXP, CHECKED BY TYPE C ISISTRUCTION OCCUPAT ,,j 71 GR c27-7 md5-- NUMBER NUMBER OF CRITICAL OF DWELLING AREAS SPECIAL INSPECTION AREA OCCUPANT I LOAD STORIES UNITS NUMBER REQUIRED [3YES DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 106/FINAL INSPECTION REaD �IAA� I VALUATION Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit T City Surcharge VESTED DATE PLAN CHECK NO: Plumbing Mechanical TWS 1PERMfIrAUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DOtJE ON PRIVATE PROPERTY ONLX ANY CONSTRUCIrION ON THE PUBUC Grading Dolir (cuRss, =EwAws, oniviEwAva, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPUCATION: 180 DAYS PERMIT UMM I YEAR - PROVIDED WORK 19 STARTIEU WITHIN 160 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION -APPUCANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SyCCESORS TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF Fire Review Plan Chk. Deposit IN INTEREST, AGREES 2 EDMONDS, WASHINGTON, ITS OFFICIAW, EMPLOYEES, AND AGENT11' , FROM ANY AND FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FIre Inspectl6n Receipt # !31 11 =CLAIMS M 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. T6tal Amt. Due --WA '?561 21 NOR UMIT IN ANY WAY THE CRYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - Recording Fee Receipt # W(!Qwg I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPUCATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF THE'QWNEFL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a permit until eigned 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 I I FOR NSPECT ON Building official or his/her Deputy: and Foos are paid, and receipt Is acknowledged In space provided. WORKMEN.6 COMPENSATION INSURANCE AND RCW 16.27. OFF 8 8 G Tu E,11' DATE RE R AGENT) DATE SIGNED AAY 771-0220 --DATE— RELEASED BY '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 GREEN - ACCOUNTING 04/02 PRESS HARD -YOU X�i MAKING 5 COPIES z 0 M ca M M 0 M ,0 z ca 0 .n M M 0 0 Fri Milo CO) z 0 M