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20030834.pdfM ql,eW(Al /11AW,6�_ DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME[NAME OF BUSINESS Q.%.,\!�nc I .A MAILING ADDREQO 1'� CITY I zip ITELEPHONE NAME Do�>,,Q I ADDRESS 12-910 WF_ CITY ZIP TELEPHONE L,j;n� I r7lu; i If. non �A,25—tikl-u_ NAME CBLN NSPv-, �:-,(e_ Pc&c_A-�(x, OW 11W ADDRESS CITY ZIP TELEPHONE NIA�n WN 99 _I 1,53 6611-1 STATE LICENSE NUMBER EXPIRATION DATE PROPERTY TAX ACCOUNT PARCEL NO. 0 NEW RESIDENTIAL PLUMB 11 ADDITION MMERCIAL COMP ACO CHAN( 1:1 REMODEL [3 MULTIFAMILY SIGN 1:1 REPAIR GRADING FENCE CYDS DEMOLISH 1:3 TANK OTHER EjGARAGE RETAININGWALL FIRE S CARPORT ROCKERY FIRE ME OF USE S EBB OR ACTIVITY) EXPLAIN: NUMBER NUMBER dF' CRITICAL OF DWELLING AREAS STORIES UNITS A&A INUMBER DESCRIBE WORK TO BE DONE I INGIMECH LIANCE OR E OF USE — X—FT) PRINKLER ALARM HEAT SOURC�_T GLAZING *4 LOT SLOPE % PLAN CHECK NO' VESTED DATE M:� — ��/ THIS PERMIT AUTHORIMES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 180DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION "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 E 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 CI1Y$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION., I HERE13Y 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 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 INSURA14CE AND RCW 18.27. SIGNATURE (OWAR 0 DATE SIGNED JV, 0 __11 PERMIT EXPIRES 6SE PERMIT ) -� ZONE NUMBER ;Z�j 1) JOB AW W SUITEIAPT# ADORES PLAT NAMEISUBDIVISION NO. LOT)16. LID NO. LID FEE $ 7ESCP Approved PuBuc RIGHT OF WAY PER OFFICIAL STREET MAP Aw PeIrm Required Stre. Use Peffnit Reld EXISTING — PROPOSED Inspection Required sidewalk Required REQUIRED DEDICATION— Fr Wiring required METER SIZE LINE SIZEI NO. OF FIXTURES PRV REQUIRED YES 13 NO 13 z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE Us M VARIANCE OR CLI SHORELI ORADBN INSPECTION -BOND REQ'D POSTED 113YEs 13NO Is SEPA REVIEW SIGN AREA HEIGHT COMPLETE , EXEMPT ALLOWE15 , PROPOSED ALLOWED I PROPOSED _.XP LOT COVERAGE REQUIRED SETBACKS (IT). PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR PARKING LOT AREA PLANNING REVIEWED BY DATE REO'D I PROVIDED I I IL CHECKED BY TYPE F CONSTRUC OCCUPANT GROUP SPECIAL INSPECTTI AREA OCCUPANT REQUIRED LOAD REMARKS I PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D se Description FEE Delacriptlon FEE Plan Check State Surcharge Building Permit City Surcharge Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # X2_194;W Landscapelnsp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION (4.25) 771-0220 APPLICATION APPROVAL This application is not a permit until signed by the Building Official or hi3ther Deputy: and Fees are paid, and receipt Is acknowledged In space provided. Q�Lr it . IGN (71URE DATP 7,19 7,,tEA—sE—.Wr--/ — i ZATE _T 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 FI -AL PROJECTAPPROVAI FORM z 9 0 m I. OM c mo 0 80 c --i C MM MZ 10 -1 0 -n m M 0 vi 0 0 Fn C (J) c 0) M 0 Z M z Cl) z 0 m Opp" VIER DATE RECEIVED PERMIT EXPIRES SE CITY OF EDMONDS ""' (1— (�— NUMBER 25�-9—IXJW CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRES NAME"E OF BUSINESS (4`t,ACkn!� PLAT NAMEISUBDIVISION NO. LID NO. 15 MAILING ADDRESO LID FEE S 116 2-so E yo'144 Vj \Aj 14 to * TESCP ApWvi*d PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Per" Required ZIP EPHONE T-L� Street Use Pofmft Wd EXISTING — PROPOSED Inspection Rsquirsd Sidmalk Required WA 96s1z 7 251- S4%-Id REQUIRED DEDICATION— FT Underground Wiringrequired NAME METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED 1 1 *4" YES 13 NO 13 ADDRESS REMARKS 12-610NE OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE CITY ZIP 11ELEPHONE Invi ' un q-z - q NAME BLN oUign pflAck-�o" OW ENGINEERING REVIEWED BY DATE ADDRESS 4_7 I la s*C-S&A tQ1VI FIRE REVIEWED BY DATE CITY ZIP TELEPHONE I hu.6ACO Wk 99001 1 'A 5:� 65 6-15) 5 VARIANCE OR CU SHORELINE ORAOB# INSPECTION BOND STATE LICENSE NUMBER EXPIPATION DATE CH KED BY REO'D POSTED a )15 r- t 4 F f I 1 0 1 '2 - (- H 13YEs 13NO S SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. PROPOS PI 10POSED COMPLETE EXEMPT ALLOWED ED ALLOWED , EXP NEW RESIDENTIAL PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR COMPLIANCE OR ADDITION MMERCIAL ACO CHANGE OF USE 'WED REMODEL MULTIFAMILY SIGN PARKING BY REOD PROVIDED LOT AREA [PLANNING REVik DATE GRADING o FENCE REPAI I R CYDS X—FT) REMARKS DEMOLISH TANK OTHER 0 GARAGE RETAININGWALL FIRE SPRINKLER 0 CARPORT ROCKERY FIREALARM WME OF U SS OR ACTN" EXPLAIN: CHECKED BY ITYPE OF CONSTRUCTION COrjE OCCUPANT GROUP NUMBER NUMBER 60' CRITICAL Ui — -W—j OF DWELLING AREAS V1.4 7 SPECIAL INSIDE, OCCUPANT STORIES UNITS NUMBER !e LOAD REQUIRED [3 YES DESCRIBE WORK TO BE DONE r c- I tx—c.. \,\eckas j�or �qr\W- REMARKS PROGRESS INSPECTIONS PER LIBC I 06/FINAL INSPECTION REGtD J\A Q(WQ W%go,\'t VALUATION Ll Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % I Building Permit City Surcharge PLAN CHECK NC)L VESTED DATE Plumbing e!;?:� Mechanical THIS PERMIT AuTwnizEs omy THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPEM ONILX ANY CONISTRUMON ON THE PU13LJC Grading DOMN (CURBS, SIDEWALKS, DRIVIEWAYS, MAMEES, ETC.) WILL REQUIRE SEPARATE PERNIISSION. Engr. Review PERMIT APPLICATUM .180 DAYS PERMIT UMrP I YEAR - PROVIDEVINORK 18 STARM WITHIN 100 DAYS Engr. Inspection SEE BACK OF FINK 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 C17Y OF EDMONDS, WASHINGTON, I'TSOFFICIAL.S. EMPLOYEES, AND AGENTS FROM ANYAND Fire Inspection Receipt # dig ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY 61-1 R FROM THE ISSUANCE OF 111111 PERMIT. ISSUANCE OF THIS PE MIT SHALL NOT BE LandscapeInsp. Total Amt. Due B DEEMED To MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY M ENFORCE ANY ORDINANCE PRIYASION." Recording Fee Receipt # 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION x APPLICATION GIVE IS CORREM AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE 9WINER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC_ This application Is not a peffnit iAN Wood by the CALL TION;IANO IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building OMW o(tdsftr Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR -INSPECTION recelpt Is wAnow1odged In space provided. �Ij WORKMEWS COMPENSATIONt!�,SURANCE AND RCW 18.27. 0 CIALS �I' P SIGNATURE R IG DATE SIGNED 075 MHE 47;77i� 771-0220 —RELEASE-016— 45ATE7 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 04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING