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20030827.pdfa -n DATE RECEIVED elzu*s 14 CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION )WNER NfME/nE OF BUS ) A ^ '!�ESS 15 MAILING ADDRESS I -o Pj 0 10 CITY L-6mici M03 NAME ADDRESS CITY f f ) _(47 TELEPHONE -7 7-f — ISI I ZIP ITELEPHONE PERMITEXPIRES, Z7112WA&I Z USE -;7PERMIT ZONEC&1e_-4 < - JNUMBER/I I JOB 'C�f�pr' detg 1-f"'�tvr SUITE/APT# ADDRESS 60 10 'LWM&) PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Perm wit Requi( Street Use Permit R A EXISTING — PROPOSED InspftWn Required Sidewslit Required REQUIRED DEDICATION— FT Undergmund Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE NA —LW— i��S (10 CBL ENGINEERING REVIEWED BY DATE ADDRESS V zm CC, FIRE REVIEWED BY DATE M —6-6dg CITY ZIP TELEPHONE ZMAIA.A0 VARIANCE OR CU I SHORELINE OR ADB# I Ak%rnAVP- 113YEs INSPE 'ON RE07D ErNo BOND POSTED Is STAXE LICENSE NUMBER )N DATE KED Y ao :1 10'r SEPA REVIEW COMPLETE , EXE -7 EXP SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. r NEW RESIDENTIAL PLUMBING MECH ADDITION COMMERCIAL COMPLIANCE OR 1:3 CHANGE OF USE REMODEL MULTIFAMILY SIGN REPAIR GRADING FENCE CYDS ( X_ FT) LOT COVERAGE ALLOWED PROPOSED At& REQUIRED SETBACKS (FT.) FRONT SIDE REAR AfC PROPOSED SETBACKS (Fr.) FRONT L/RSIDE REAR I /V& PARKING LOT REQ`D I PROVIDED AREA PLANNING REVIEWED BY DATE o3 REMARKS DEMOLISH TANK 0 OTHER GARAGE RETAININGWALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, "SINESS 0 !0 ACTIVrM EXPLAIN: —FAREAS CHECKED BY ITYPE OF CONOTR!ICTI /z-- 4 7 OCCUPANT GROUP C NUMBER NUMBER OF ITICAL OF DWELLING STORIES UNITS Nil R_ AIN SPECIAL INSPECTION JAREA REQUIRED 13 YES OCCUPANT LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC IDSMINAL INSPECTION REQ'O. VALUATION $ V Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORMES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMrrAPPUCATION: 180DAYS PERMIT LIMIT: 1 YM - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION Grading Engr. Review Engr. Inspection 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF x EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND IALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY Fire Review Plan Chk. Deposit Fire Inspection Receipt # A, � '1' P/li FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE !3 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due Lag_�i 21 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION G GIVEN IS CORREM AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF I' T THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- H TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED TI( IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO IN APPLICATION A L CALL This application Is not a permit until signed by the and Building Official or his/her Deputy: and Fees are paid, FOR INSPECTION receipt Is acknowledged In space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. I SIGNATURk 7(0W ER DATE SIGNED 81( _W) 103 1A9 O�FFF ULS SIG�A �RE DATE 1,425) - I 771-0220 R -SED BY ATTEOPIN IT IS L N F IL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL jl� WF Off 1333 A FINAL NSP CTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOVI-INSP06TOR CATE OFSUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... Wall.......................... Plor/Porch ................. 0: Retaining Wall ........... Slab Insulation .......... PLUMBING: m Underground............. Roudh-In ................... NOATE RECEIVVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER,NfM f"E OF BUS2ESS MAILING ADDRESS 0 _? 10-to Aj ',b24761 CITY , 2115 1 TELEPHONE LA-MOM05 %mal4w�-77-1-IS11 NAME CITY ZIP TELEPHONE NALW---% k!6z,56 tt .5��t-j (90 Cat. N ADDRESS V 44—, 7 CITY ZIP z#1A1kLiVj.__ TELEPHONE 14z§__77S_1e /0 ST LICENSE NUMBER -.!EXPIRATION DATE PROPERTY TAX ACCOUNT PARCEL NO. NEW 0 RESIDENTIAL PWMBING MECH 0, ADDITION COMMERCAL COMPLIANCEOR CHANGE OF USE REMODEL MULTIFAMILY SIGN REPAI I R GRADING CYDS o FENCE X FT) DEMOLISH TANK OTHER GARAGE RETAININGWALL 0 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, WNESS go ACTWM EXPLAIN: NUMBER NUMBER OF ICAL CRZI DWELL AREAS ING AM I UNITS _FN R Allf DESCRIBE WORK TO BE DONE 1Wd4V'1,6 awit, V ��rjAj — /%o V. :2)�7&1 V PERMIT EXPIRES USE ZONEC&/P- -4 —)YPERMIT 2 ld!�' I INUMBER/) 60 J013 ADDRESS SO 10 ell-101" SUITE/APT# iW76J /01 PLAT NAME/SUDDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Ap RW Flefffa =9d EXISTING — PROPOSED street use POM-A ROO Inspection RaqWrod Sidwalk Requitstl REQUIRED DEDICATION— FT underground W= g requulrmw METER SIZE. LINE SIZE I I NO. OF FIXTURES PRV REQUIRED YESO NO 13 REMARKS 4 1 OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLJORAlNAGE ENGINEERING REVIEWED FIRE REVIEWED BY DATE DATE 1 I r6 VARIANCE OR CU SHORELINEORADB* INSPECTION BOND 1 Allif ,,, 0, 4vo. REQ& I r3YES No POSTED $ oo-ob I 1 SEPA REVIEW SIGN AREA "EIGHT COMPLETE EXE ALLOWED PR OPOSED io ALLOWED PROPOSED�._ V7 1+1,5 10 Ix" - EXP .4 - .. LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REAR 144, 1V41 PARKING LOT AREA PLANNING REVIEWED BY DATE REQ'13 PROVIDED 01A 103 REMARKS CHECKED BY ITYPE OFC N TRUCTIO COQ� OCCUPANT GROUP 7�9*7 IC/ ./S SPECIAL INSPECTION AREA OCCUPANT REQUIRED [:] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REGfD $ 1 Description FEE Description Plan Check State Surcharge FEE HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical 421 il4a� t: THIS PERMIT AuTHonms ONLY THi WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLI ANY CONSTRUCTION ON THE PUBLIC DomAim (cuRos, SIDEWALKS. DfiriEwAys. MARQUEES, ETC.) VALL REQUIRE REPARATE.IPERMISSION. PERMIT APPLICATION: 180 DAYS Grading gngr. Review Engr. Inspection PERMIT UMM I YEAR - PROVIDED WORK 18 STARM WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION "APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS Fire Review PIanChk.DeposIt /he IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF 91 EDMOND% WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND AUCLAMSZR OZMAGESTOF TMEVER1 NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE- CE OF HI= IT. SSUANCE OF THIS PERMIT SHALL NOT BE 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. - 'Fire Inspection t . I Receipt # I LxWscape In I Sp. Total Amt. Due = Recording Fee Receipt # I HERESY 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- 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 WORKMENS COMPENSATION INSURANCE AND RCW 18.27. CALL FOR INSPECTION 1A9 1,425Y 771-0220 This application Is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid, and receipt Is acknovAodged In space provided. OFFA;�S SlGrTYRE DATE SIGNATURk(OIVER OP4�006ENT)," DATE SIGNED BED BY DATE ATTERtION EXT 1333 7747,/ 1. /,� -, IT IS LIN F L TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL W SP LU A FINAL SP CTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF PANCY HAS BEEN GRANTED. UBC SECTION 109 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES ORIGINAL -FILE YELLC%W.INSPSCTOR PINK -OWNER GOLD -ASSESSOR GREEN - ACCOUNTING " 1 z