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20030835.pdf6 �OIS rW ANP A0 1A Is DATE RECEIVE�.. PERMIT L EXPIRES CITY OF EDMONDS USE ZONE PERMIT -NUMBER STRUCTION PERMIT APPLICATION JOB IT IT APT# ---CON ADDRESS . L OWNER NAMEINA161E SINESS 4::�" n PLAT NAMEISUBDIVISION NO. LOT NO. LID Q0. V :� MAILING A132 5 LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP AMOVed RW Permit Required Street Use Permit R&WON CIT� EXISTING — PROPOSED Inspection Required Sidews* RequIrw k�ELEPHONE ;70 —L'� REQUIRED DEDICATION_ FT UWsfWMxxI Wiftgrequired 13 WAME METER SIZE LINE SIZE NO.0 XTURES PRV REQUIREk ki I YEs13 NO z ADDWS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ZIP TELEPHONE cBL# L06 ENGINEERING REVIEWED BY DATE ADDRE§f 'Is-2 /0 zy-v"' Xlf� CITY ZIP TELEPHONE FIRE REVIEWED BY C DATE U1 STATE LICENSEf NUMBER EXPIRATION DATf C%CKED BY VARIANCE OR CU SHORELI ORADBN i INSPECTION BOND REQ'D POSTED I &qzD-5LC_qe %0 d &* 1C I MYES ONO $ '14 SEPA REVIEW SIGN AREA:. HEIGHT I PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED I 0or 0 ni EXP NEW RESIDENTIAL PLUMBING / MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Ft.) PROPOSED SETBACKS (Fr.) FRONT SIDE REAR FRONT LIRSIDE REAR COMPLIANCE OR ADDITION f 1;3�MMERCIAL CHANGE OF USE `1EMODEL MULTIFAMILY SIGN PARKING LOT AREA PLANNING REVIEWED BY DATE 816 REO'D I PROVIDED o FENCE §IREPAIR GRADING CYDS ( — X—FV) REMARKS - [:] DEMOLISH TANK OTHER oGARAGE RETAINING WALL o FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM ME! BE. BUSINESS OR ACTNT EXPLAIN: 4-1414 /- CHECKED BY TYPE E.60 RUCTION C E OCCUPA/7 924 0 At ORO V15-01 NUMBER NUMBER OF CRITICAL OF DWELLING AREAS 11A I SPECIAL INSPECTION AREA OCCUPANT LOAD STORIES UNITS NUMBER REQUIRED [3 YES 80�,2_f DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RECIID 9 W IV A JIA--A-A MlDdL IfA V/ et.0 C VALUATION Lo $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOJOLOPE % & Building Permit City Surcharge PLAN CHEC&NO: VESTED DATE Plumbing ..ILI I �Lll Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 1:: RE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading :1 DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PIERMITAPPLJCATION: IGO DAYS PERMfT UMIR I YEM - PROVIDED WORK IS STARTED WIITHIN IW 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 �s- Plan Chk. Deposit IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY L 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 Landscape Inspi. Total Amt. Due &NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' __ Recording Fee Receipt # 1 HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPMAI 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- CALL This application is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, 140 PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and IN VIOLATION OF THE LABO CO OF THE STATE OF WASHINGTON RELATING TO 0 FOR INSPECTION receipt Is acknowledged In space provided. WORKMENS COMPENSATIDI&NC4CE AND RCW 10.27. _ - ___ 'd - F IA ON DATE SIGNATURE (OWNER 09XGV, fp�� tDAT SI D FIX 1425) 771-0220 'hELEA IfATE --1- ATTENTIOtytr M 1333 1hetIA'— Io,-m: IT IS UN=TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAI flAtS BEEN MADE AND APPROVAL OR A CERTIFI- I ORIGIt - �Fl YELLOW IINSPECA�10�R, CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 E�FRI . GOLD - ASSESSOR PIN�_-. R __ 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES ACCOUNTING FINAL PROJECT APPilOVA FORM z 0 0 m 'A :n- V5 :0 a M c m 0 0 c 3: M m 10 z 0 -n n m m 065 0 0 Fn C (j) m ca M 0 Z f- z co) z 9 0 m Li DATE. REC&AD CITY OF EDMONDS ' ;,i"',C,ONSTRUCTION PERMIT APPLICATION F1 OW7MNERMNMIMEINAME OFRUSINESS 1 1-7) 1 A !�� Z � 22 �j PERMIT EXPIRES 1000RARY NUMBER JUD ADDRESS22 SLL:� .5- &a (— / PLAT NAME/SUBDIVISION N LOT NO. LID NO. V LD ,PRESS LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP IESCP AP RW Ponrit ;ELEPHONE EXISTING — PROPOSED Inspoedw RequM SidewalkRowk9d 70 —0 REQUIRED DEDICATION— FT UndmVaM VAMgmqulred METER SIZE LINE SIZE 02F XTURES PAY REQUIRED -eoI2 --7 YES [3 NO REMARKS OWNER/CONTRAGI*Ah&&"j2.&ROSION CONTROL/DRAINAGE LA ZIP ITELEPHONE CB ENGINEERING REVIEWED BY DATE MoPi�W_iA'XACCOUINT PARCEL NO. I b0le [3 NEW 13 RESIDENTIAL [j ADDITION tLICOMMERCIAL REMODEL MUC11FAMILY GRADING REPAIR CYDS DEMOLISH [3 TANK GARAGE CARPORT o RETAJNINGWALL ROCKERY PM QF%USE, BUSINESS OR ACTIV E)WLAIN: A/4 NUMBER NUMBER OF OF STORIES 1, _I DWELLING UNITS Ali j DESCRIBE WORK TO BE DONE zv� &I I\ WJW FIRE REVIEWED BY DATE Cr 77 VARIANCE OR CLI SHORELINEORADBO INSPECTION BOND '�L Ohm REO'O POSTED DYES 13NO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , . LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS jeT.) PLUMBING/MECH �*LLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE� REAR COMPLIANCEOR, CHANGE OF Usk j_1 PARKING LOT AREA' PLANNING REVIEWED BY DATE IL SIGN REQ`D PROVIDED c3 FENCE X FTj REMARKS OTHER oFIRE SPRINKLER FIREALARM CHECKED BY TYPE 2140NFTRUCTION OCCUPA I I GROUP' CRITICAL ARM SPECIAL INSPECTION ARE N OC CUPANTj�L:,.�.'... NUMBER REQUIRED YES., M LOAD: cp"- n 'AVa4M-_4iVA,T- IREMARKS J D 5 $ LVA 2o (Z_ Description FEE Description. Plan Check State Surcharge HEAT SOURCE GLAZING % LOTSLOPE % Building Permit City Surcharge VESTED DATE PLAN CHEC&NQ, Mechanical THIS PERMIT AUTHORIZES ONLY AK NOTED. THIS PERMIT covEns wonk: To BE DONE ON PRIVATE PROPERTY OHLX ANY CONMUCTION ON THE PUBLIC Grading BOMAIML (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERANI%SION. PERMITAPPLICATION: 1188DAYS Engr. , Review PERMIT LIM111 I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF, PINK PERMIT �""Ti . Engr. Inspection fOR MOREty 9N FAM 0 FEE �APPLIC�NTION'Slii4ALF 0; HIS OR HER �POUSE; HA�ASSIA AND SUCOESORS Fire RevieW Plan Chk . Deposit IN INTEREST, AGREES TO'INDEMNIFY, DEFEND ANO!,00ILD HAAMLESS THCOITY OF EDMONDS, WASHINGTON. IT$ OFFICIALS, EMPLOYEES AND AGENTS FROWANY AND Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY MOM THE ISS UANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape ln�p. . / TQ(aj;A6tmt. D u :e�ffM NOR LIMff IN ANY WAY THE CITY$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt 0 Ito �m I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPUCATION OW APP VA—L GIVEN IS CORRECTI AND THAT � AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- bALL This application Is not a permit until signed by the TION: AND IN DOING THE WORK AUTHORIZED T�OEBY jN0 PERSON WILL BE EMPLOYED BuildLing ONcielpr No id Fees are paid, and IN VIOLATION OF THE LABO OF THE STATE Of WASHINGTON RELATING TO FOR,,IN�056 Tim : < ovided. re �z WORKMENS COMPENSATIO N CE AND RCW 18.27,, �F �i NA7* DATE [A 0 W.GNATURE (OWNER 0 G D 1 0 7-4. A_ 771-0220 REL9i*I ATTENTftyr Off 1333 IT IS UNLAWFL)E TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 04/G2 PRESS HARD -YOU ARE MAKING 5 COPIES 61,7Y71161) I E - YELLOW!INSi EcTOR 3REtN . - ACCOUNTING �FS 'CTOR R E GOLD -ASS �OR W z 0 0 M :; --n- 55 �, a C: M 8 C ji z M M4 10 �z I 4 CO) 0 _n '5"� 1 M M q C9 ic z 0 0 M