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20030832.pdfI I—' co— DATE Z 0/1/0,5 USE CITY OF EDMONDS ZONE JOB CONSTRUCTION PERMIT APPLICATION ADDRESS OWNER NAMEfNAME OF BUSINE t7h ft " cl a < Pr*-, ( I (I I PLAT NAME/SUBDIVISION NO. MAILING ADDRESS �al` Ot :1L ';T, f� tot CITY ZIP C� pox - TELEPHONE I - NAME -D 7D RESS TELEPHONE NAME CBL N D 88 00, CITY ZIP TELEPHONE STATE LICENSE NUMBER EXPIR11ON I)hTE k7BY �2140- PROPERTY TAX ACCOUNT PARCEL NO... [3 NEW 13 RESIDENTIAL PLUMBING/MECH COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE 0 REMODEL IJULTIFAMILY 6RADING [j REPAIR CYDS X Fr) OTHER [3 DEMOLISH 13 TANK riGARAGE [3 RETAINING WALL FIRE SPRINKLER CARPORT ROCKERY FIREALARM ITYPE OF USE, BUSINESS OR ACTIVITY)i EXPLAIN: e&N L NUMBER OF NUMBER OF CRITICAL WELLING AREAS 0 STORIES NITS NUMBER DESCRIBE WORK TO BE DONE -) I I uAl I PERMIT EXPIRES PERMIT N U M B E R SUITEIAPT# LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required 01 Street Use Pannit Roqi�d EXISTING PROPOSED inspection Required Sidewalk Required REQUIRED DEDICATION------ FT UnderWound I Winne requir 13 METER SIZE I LINE SIZE NO. OF FIXTURES PRV REQUIRED 43 YES E3 N z I REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE loctrueM C�;,540 AWWAIW (4s I F 5 U'l LA' -%'A a " I A 6iha A ". b rd S S I HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK VESTED DATE THIS PFRMff AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY OINLX ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 180 DAYS IL PERMIT LIMM I YEAR - PROVIDED WORK IS STARIED WITHIN 111110DAYS SEE BACK OF PINK P RMIT FOR MORE INFORMATION )E '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 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 NOR LIMIT IN ANY WAY THE CITYB ABILITY TO ENFORCE ANY ORDINANCE PROVISION. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRE"- 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 CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATOWI"CE AND RCW 18,27. NATURE (OWNER OR DAIE SYRNED if ec. noili. .7 VrAva ENGINTIEERING REVIEWED BY - MONSOON 6d FIRE REVIEWED BY DATE r16 VARIANCE OR CU SHORELINE OR ADB# I INSPECTION RECrD PBOND OSTED r3YES,214O s SEPA REVIEW SIGN -AREA HEIGHT COMPLETE EXEMPT ALLOWED POSED PROa 41 _71, ALLOWED PROPVED I IW&b I f5 iiapp V,_" :_XP LOT COVERAGE REQUIRb SETBACKS (FT), PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR lvg"4;2�— 1 /Vo cl?4'" z PARKING PLANNING REVIEWED, BY DATE REG' IDED h5�� I VAA -3 REMARKS CHECKED BY I TYPE 3rjCZN;STRUCTION C OCCUPAW) GROUP " SPECIAL INSPECTION JAREA OCCUPANT REQUIRED REMARKS PROGRESS INSPECTIONS PER USC 108/FINAL INSPECTION REG'D S is $ i Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing AD15 AA'0sufi'n Am. Mechanical Grading Engr. Review Engr. Inspection Fire Review PlanChk Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt. Due 100 Recording Fee Receipt # _Ws",6 CALL FOR INSPECTION 1A9 %425) 771-0220 APPLICATION APPROVAL This application Is not a permit until signed by the Building Olficial or histher Deputy: and Fees are paid, and receipt Is acknowledged In space provided. A I URE DATE 412 A 4 LE ED BY DgE-�_4 ATTENTION Off 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL /zz�d A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - APECVR 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 4 0 M M C M —48, 0 r 3! C M M 10 j 2 0 _n n Irn M a 75 0 0 Fn C2 0 z V) z 9 .IUL z 0 i 0 m :i ii m c MO 0 -40 OC 4c m mz cn 0 -n n m M a 0 o C cl) c C/) M 0 Z z CD z 9 0 m 0 9 PERMIT EXPIRES . rJOaATE RECEIVE16, Ummd USE PERMIT ZONE CITY OF EDMONDS NUMBER Jo SUITWAPT# CONSTRUCTION PERMIT APPLICATION ADDRESS 3,-7 OWNER NAMENAME OF BUSINESS �e PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS t1j,_ GT, :0 (c)I CITY 1 TELEPHONE 00 'IC D NotOD . zip I Of,-% 33 NAME _0 — J# ADDRESS TELEPHONE NAME D PA S16 0 S Vic), fbo)L 3 ZIP TELEPHONE 9� 64_� 1 711 STATE LICENSE NUMBER EXPI i R)TION7TE 0 0 PROPERTY TAX ACCOUNT PARCEL NO- 11 NEW [j RESIDENTIAL ADDITION COMMERCIAL REMODEL !�znFAmiw RFPAJR IT GRADING CYDS DEMOLISH TANK [3 GARAGE RETAINING WALL CARPORT ROCKERY (rYPE OF USE, BUSkWSS OR ACTIVITY) EXPLAIN: h V 01 — U 1� t *, OnE L LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP ZSC Apt= RW Ppe fffo street use Pens Reqv EXISTING PROPOSED Inspection Required REQUIRED DEDICATION-m—"ff FT Won* RequhW Underwaind g required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I I I YESO NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE . - - - — - . '_ N - - ___ _. I __ - J., N fE BY 0 'PLUMBING/ MECH COMPLIANCE OR 0 CHANGEOFUSE I IGN [�FENCE X _ Fr) OTHER FIRE SPRINKLER FIRE ALARM NUMBER. NUMBER OF CRITICAL OF WELLING )0 AREAS 'STORIES UNITS NUMBER DESCRIBE WOR15 TO BE DONE U M 'I FIRE REVIEWED BY DATE LIS 1Z VARIANCE OR CU SHORELINEORADBJI INSPECTION BOND A Am *p, qYE S`%�o I R POSTED SEPA REVIEW SIGWAREA HEIGHT COMPLETE EXP , EXEMPT ALL13WED 120it , PROPOSED. -Ma ALLOWED III f , PROP7ED 5 fmi IN LOT COVERAGE REQUAD SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR I lvama'",rde_ RECY PARKING AREA I PLANNING REVIEWED By DATE &' I . F6o'l a% n a - i f) e�i oin ', b �,a s s I 01 HEAT SOURCE I GLAZING % LOT SLOPE % PLAN CHECK N6,3 I;� VESTED DATE TMB PERMIT AUITHOREMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPILICATIOW. 180 DAYS PERMIT UMM I YEAR - PROVIDED WORK 16 STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPUCANT, 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 NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFV: WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CRYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVE IS CGRRECr AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE UR. 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 WORKMERS COMPEN!:��CE AND RCW_ 18.27. JWNATURE (OWNER OR ftfM / I DATE SPNED I REMARKS CHECKED BY QF CONSTRUCTION C57 OCCUPAn ITYPE W&A GROUP SPECIAL INSPECTION OCCUPANT REQUIRED [3 YES JAREA LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD Adb. Aft, 141 21111=3 C: 0 =0 11111 VALUATION, $ W1111 NMI NEW Description FEE Description FEE Plan Check bo State Surcharge Building Permit City Surcharge Plumbing AM, /00 Mechanical Grading Ertgr. Review Engr.Inspecflon Fire Review Plan Chk. Deposft= Fire Inspection Receipt # 00937 Landscapeinsp. Total Amt. Due I KOO Recording Fee Receipt # 41rpermR unW Aigned by the CAW'., This application 1sq0 -are paid, and BAding OMW �fA1014r D":'and Oda iR INSPECTION rewipt IS 96knowledged In spaCe Provided. OFE BIG "JURE DATE fA /,4,,A X JI'm hzg4v 1L11 1 771-0220 LE' ED'SY VT E 0 ATTENTION 09133 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- O;IGINAL - FILE YELLOW - 14SPECVR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING