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20030833.pdfDATE RECEIVED �11% /;7 7 Z4, - _� I PERMIT EXPIRES 1 1 CITY OF EDMONDS -1 Usit PERMIT ZONE NUMBER CONSTRUCTION PERMIT APPLICATION Jo ADDRESS SUITE/APT# — jyr/c "�AMENAME OF BUSINESS 07. A A MPAW I= PLAT NAME/SUBDIVISION NO. UOT'NO. LID NO. 15 _1q) MAILING ADDREs PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP LID FEE S TESCP Approved MY Permit ed Requ:', street Use Parm ZIP TELEPHONE 4 NoAll 7�o 700 EXISTING — PROPOSED REQUIRED DEDICATION— FT Inspection Required Sldevratk Required Underground Widng required 13 NAME METER SIZE LINE SIZE 7. OF FIXTURES PRV REQUIRED YEs13 NO 13 ADDRESS REMARKS z OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE I CITY ZIP ITELEPHONE CBL N ENGINEERING RGjmMWT TO ATE cc AkOPPAS A PRESS URE RE G UL ATOR VALVE 0" 1/9 AV vwln� NO USA& FIRE REVIEWED DATE Lu By THE WATER SHUrOFF MM ZIP TELEPHONE ENSE NUMBER EXPIRATICIN DA�E ON_ VARIANCE OR CU SHORELINE OR ADBN INSPEMION BOND REO'D POSTED OyEs 13NO $ SEPA REVIEW SIGN AREA HEIGHT PROPEWY TAX ACCQUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED I , a) '69 EXP NEW ��ESIDENTIAL VrPLUMBING/MECH LOT COVERAGE PU t8QW"ST&&1P0A D&Q11PoSED SETBACKS (Fr.) L/R SIDE REAR ALLOWED PROPqf %RLOW COMPLIANCE OR ADDITION COMMERCIAL 0 CHANGE OF USE IMT7 M101111AT T 1102 z dN TM_ PARKING DATE AgWPrf1qt*WR-0R4G REMODEL MULTIFAMILY [3 SIGN REOD PR%Aj GRADING FENCE X 0 REPAIR 0 CYDS Fr) REMARKS OTHER DEMOLISH 1:1 TANK oGARAGE -1 RETAINING WALL 0 FIRE SPRINKLER 0 FIRE ALARM CARPORT ROCKERY (TYPE OF USE, BUSINESS OR EXPLAIN: CHECKED BY TYP154F��66WCRU CTION OCCUPANT 4,)P<- GROUP NUMBER NUMBER OF CRITICAL OF DWELLING AREAS �L SPECIAL INSPECTION OCCUPANT RIES UNITS UMBI STO NUMBER ILI JAREA LOAD REQUIRED [3 DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD V&UAnON $ Deacriptlon FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTE D DATE Plumbing Mechanical THIS PERMIT AUTHORLTES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t BE DONE ON PRIVATE PROPEMY ONLY. AM CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPIUCATION: INDAYS 06 PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 100 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 FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapoinsp. Total Amt. Due DEEMED TO MODIFY; WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION., 0 NOR LIMIT IN ANY WAY THE Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL 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- CALL This application Is not a permit unfit signed by the T11ON; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or histher Deputy: and Fees are paid. and IN VIOLATION OF THE LAD ODE OF THE STATE OF WASHINGTON RELATING TO Oy' C' FOR INSPECTION receipt Is acknovdodged In space provided. WORKMENS COMPENS VANSURANCE AND RCW 18.27. k___ --- OFELq!ALS.,SIGNATURE DATE SIG,NATIRW(OWNER 0 0 DATE Sl NED L6 771 -0220 LEA!w6 al DATV ATTENTION M 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 z 0 0 M =i OM C M q 0 0 C: � 3: M .0 Z In O� 0 0 Fn Cm C CA CA z 0 1 0 ITI k RE-INSpECTED OUTSTANDING ISSUES - GRANTFINAL PROJECT APPROVAL Date Sign, ocaprvl.doc.l:temp:bldg:fonnsIO/OI z 0 1 0 m OM a M 0 0 -40 0(- �c m m 10 � z 0 m M a 0 o C cl) c cl) M 0 -zi Fn w ri 0) z 0 m I DATE RE� L PERMIT EXPIRES USE PERMIT F�___Cl TWOFEDMONDS ZONE NUMBER CONSTRUCTION PERMIT APPLICATION OWNW" AMEINAME OF BUSINESS _'A'AA4,,AW A IGE-4 G ADDRESS MP3 0 7,0,4� D4A QLUX_ q hZIP TELEPHONE7 6 L45- 470/10 fizN01AI, 1k, A�l 7a NAME I ADDRESS CITY ZIP TELEPHONE 74 rn dgwa6fir� AD Ckmu� ZIP TELEPH ONE N ENSE NUMBER EXPIRAT119N PO A I * 'T I ) 06y,,3 _"rP9 j 0 'NEW 0 ADDITION REMODEL 0 REPAIR 0 DCMOLISH oGARAGE CARPORT UWE Of USE, I NUMBER OF STORIES DESCRI;F;OR; ESIDENTIAL COMMERCIAL MULTIFAMILY [] GRADING CYDS 0 TANK RETAININGWALL ROCKERY S OR ACTA(TTYI EXPLAIN: NUMBER OF DWELLING UNITS _6E DOME JOB ITEVAPT# ADDRESS 0/ 't At PLAT NAME/SUBDIVISION NO. WNO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approv0d AW Partrit R*qulrod streat use Palm" Roo EXISTING — PROPOSED inspection R"Wred SidewsA RequWad REQUIRED DEDICATION-- FT Underipamd YVWg requirod METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES E3 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE CBL it PURSUATITT T() ECDC 19.30.UZO L4?LO ENGINEE RWMffMW0ffiffWP %' -- IATE SHALL BE INSTALLED NEAR FIRE REVIEWED BY DATE OF I Wx VARIANCEORCU ] SHORELINE Oil ADB11 I INSPECTION I BOND REO'D POSTED 13YEs ONO 6 SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED ,PROPOSED ALLOWED PROPOSED :xP UPC 5.2 V LOT COVE TM SED SETBACKS (FT) PqPLUMBING / MECH ALLOWED p log PTM URSIDE REAR COMPLIANCE OR B CHANGE OF USE PARKING— --I LOTAREA 1PLANNINGREVIEVIEDDY DATE 0 SIGN REQ`D PROVIDED FENCE ( _ X_FT) REMARKS OTHER FIRE SPRINKLER FIRE ALARM I CHECKED BY OCCUPANTV(2 ITYPWCCTION I ro OR f_____? CRITICAL AREAS SPECIAL INSPECTION JAREA ]REMARKS OCCUPANT NUMBER Aik REQUIRED [] Yr zs LOAD PROGRESS INSPE!(�'11`11[ 1 1111 L 11bal FIOMMFMN RECVD I I I = A 11111 HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: VESTED DATE THIS PERMIT AUTHOREZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON pRrVATE PROPERTY ONLV. ANY CONSTRUCTION ON THE PUBLIC DONUUN (CURBS, SIDEWALKS, DRWEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERurrAppucxhoN- 1 - w oas PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN ISO DAYS SEE BACK OF PINK PERMIT §PR MORE INFORMATION 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNSAND SUCCESORS IN INTEREST, AGREES TO INDEMNIF% 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 SHALLNOT BE DEEMED TO MOD" WAIVE OR REDUCE ANY RE(JUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITY$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' I HEREEN ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION G N - AND THAT I AM THE OWNER , OR THE DULY AUTHORIZED AGENT OF IVE IS CORRECT. THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRLIC- TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LA NLCODE OF THE STATE OF WASHINGTON RELATING TO WORKMENG COMPEN:?# INNJRANCE AND RCW 10.27. SIkNAT# DATE SjI3,NED j 1) 6 1A VALUATION $ Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge j46 Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscape Insp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION 1A rj %-1251 771-0220 APPLICATION APPROVAL This appilcation is not a permit untu signed by the Building Official or his/her Deputy: and Fees we paid, and receipt is acknoiMadged In space provided. OEEICIA1.S. IGN F URE ATE " 'U"r 0 1 (W I Lvxd/�__. I—R-E 4W 6 DATI ATTENTION LA I UJ IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGIN& -FILE YELLOW - INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 1 . . PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU AFfE MAKING 5 COPIES GREEN - ACCOUNTING ..... . .... . .. ..... z 0 M M M N OC 5� x M 0 W C — z 0 _w * �T, rn M 0 Fn C co) ic a z 0 4 0 M