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20030836.pdfDATE RECEIVED I CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS Weshe�,ec:� —FrA_veA �LAILING gREs`Sj jdL i ()S- J ()o 7W ACP- -1jo f ry-1 ryLw� CITY ZIP Lo NE MMAC ITELEPHO NAME ADDRESE CITY NAME ZIP CBL N USE ZONE JOB ADDRESS ,e I ZIP TELEPHONE �M�610' _A& STAIt'LICENSE NUMBER EXPIRATION DVE I CnECKED ABYY 1100"04 NEW RESIDENTIAL PLUMBING / MECH ADDITION OMMERCLAL XC COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY SIGN REPAIR GRADING CYDS FENCE X ( _ FT) DEMOLISH 0 TANK OTHER GARAGE CARPORT RETAININGWALL ROCKERY ci FIRE SPRINKLER FIRE ALARM (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLA#J: M NUMBER NUMBER OFNIA I CRITICAL OF DWELLING AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO; VESTED DATE THIS PERMIT AUTHOR&MS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPUCATION: 180 DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICAUL 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 MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' I HEREBY 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 INSURANCE AND RCW 18.27. ONATIURE (OWNER OR AGE" DATE SIGNED Ahu bf(2_, +<� L -re 7/�A/l ZP_?, PERMIT EXPIRES PERMIT NUMBER:� /M C06 cial):?! PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required Street Use Peffnh Req'd EXISTING - PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION- FT Underground Witing required METER SIZE LINE SiiiT. OF FIXTURES PRV REQUIRED YES13 NO I3__ z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE W 01 Ir VARIANCE OR CU I SHORELINE OR ADB# "tf AAA". P. INSPECTION I YES ED 13NO POSTED 1$ BOND SEPA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED _.XP , LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Ft.) FRONT SIDE REAR At. PROPOSED SETBACKS (FT.) FRONT LJRSIDE REAR tc z PARKING REO`D LOT AREA IPLANNING E REVIEWED BY DAT IL j V'm"" '&,vmv_ L..:uAva ft>& tai- -is Z3107 — I CHECKED BY ITYPE 9AA?9N ;TRrCVTIO #F_/ OCCUPANT GROUP SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [:] YES LOAD REMARKS -3� PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD] ! I a L Description FEE Description FEE Plan Check LState Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Receipt # Recording Fee APPLICATION APPROVAL CALL This application Is not a permit unfit signed by the Building Official or his/her Deputy: and Fees are paid, and FOR INSPECTION receipt Is acknowledged In space provided. )FF LS SIGNATURE a DATE (425) 11 - 7�4r�, b 771-0220 it SED BY f DATY EXT 333 59 1A0 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 -INSPECTe(R CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR 04/02 GREEN - ACCOUNTING PRESS HARD -YOU ARE MAKING 5 COPIES z 0 1 0 M M M 0 C :L M C _z 0 _n _n M M 0 Fn C C9 0 z 0 M 0 r FINAL PROJECT APPROVAL FORM TO:c%W DATE: "PERMIT COORDINATOR, BUILDING DIVISION FIRE DEPARTMENT DATE ENGINEERING DIVISION DATE- munsm a Copy of CORRECTION NUKILUE glVen TO OwnerlcOnuldutuF uY LubFu%,"JL 2. 3. RE_INSpECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL Date. Si ocaprvl.doc.l:temp:bldg:fonnsIO/OI z 0 m =i 9 vi --I 3: OM c ma 0 0 c im mm MZ 0-4 0 -n n m M 065 0 0 [7 n C 0 r. CA M 0 Z ;u -q z z 9 0 m (7) T7) RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing. ...................... Wall .............. .............. Pier/Porch ................. Retaining Wall ........... ol Slab Insulation .......... -PLUMBING: M: Underground ............. C M Rougli-in ................... Commercial Final ..... AL lj�ATE RECEIVED I CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEftWE OF BUSINESS We,s+4x_+c -Troc_ve_1 MAILING gRESSj iij oo'FA Pule- -13 C) Wrlyqpla� CITY zip TELEPHONE F4 ry, 0yjj �6 qgoQo 06-115-71`4-1) NAME ADDRESS CITY ZIP CSL N USE ZONE JOB ADDRESS 1 .7 17/3,,, 7A f I PERMIT EXPIRES PERMIT NUMBEW,_..�K!� 131 PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Porn* ReW116d Street Use Parmit Raq'd EXISTING — PROPOSED inspection FwqLgm Sidewalk Required REQUIRED DEDICATION— FT UnderWound WW9 recitAred 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 0 I YES 13 NO 13 N REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTFIOLJDRAINAGE I REVIEWED DATE c>q7w- %'S; f 1-169 _ tg'f 6.ff'a FIRE REVIEWED BY DATE cc ZIP TELEPHONE rL 7)4A A" :Z*zl BOND ECKED BY STAItLICENSE NUMBER EXPIRATION 1)012E� ECKED BY VARIANCE OR CU SHORELINE OR ADB# INSPECTION EQ'D POSTED Aml*%. Aye- IMeEs 13NO -7,a IdIg 22 �_ L Y.Y $ H EIGHT I C a. PROPERTY TAX ACCOUNT PARCEL NO. SEPA REVIEW SIGN AREA COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED 9 , as V44 AW -7 , I EXP C NEW RESIDENTIAL PLUMBING MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR CE OR COMPLIAN,M 1:1 ADDITION XCOMMERCL4kL 1:3 CHANGE OF USE AF& W. 9 PARKING LOT AREA PLANNING REVIEWED BY DATE REMODEL MULTIFAMILY SIGN REO'D I PROVIDED I I 10, 1 N6 22h REPAIR GRADING FENCE CYDS [3 ( X FT) REMARKS < 2-X07 OTHER DEMOLISH TANK 100 " A—ve, Ld. oGARAGE RETAINING WALL FIRE SPRINKLER CARPORT 0 ROCKERY FIRE ALARM (TYPE OF USE. BUSINESS OR ACTIVITY1 EXPLAIN: TIP I r-P%VW-L N61FN" CHECKED BY ITYPE 0) CTION OCCUPANT y-7 GROUP - NUMBER NUMBER OF RITICAL OF DWELLING CAREAS A/j SPECIAL INSPECTION 1�2 JAREA OCCUPANT STORIES UNITS NUMBER J� REQUIRED 13 YES JLOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REC?D sh VALUATION 001 F3 I I 111111fir-661 bow Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE T GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO, VESTED DATE —1 ;?. ;�? L Plumbing !z Mechanical THIS PERMIT AUTHORMIS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURSS, SIDEWALKS, onriLVAYS, MARQUEES. ETC.) WILL RCOUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: ISO DAYS PERMIT LIMM 1 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 ? EDMONDS, WASHINGTON. IT$ 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 PERMrr. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED M MODIFY; WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Amt. D J, 4 J/ A NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE NY ORDINANCE PROVISION.- 02'A Recording Fee Receipt # r!!Z HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION S APPLICATION APPROVAL GIVEN IS CORRECT6 AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application is not a permit until signed by the Building Official or Warner Deputy: and Fees are paid, and 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 FOR INSPECTION receipt Is acknowledged In space provided. WORKMEWS COMPENSATION INSURANCE AND Flow 18.27. LI OFF LS SIGNATURE DATE S GN TUR (C DATE SIGNED jGNATURE (OWNER NT) (425) S'ld 1110 M�" _�'% 771-0220 y ED Y E/ ION Off 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 14 - INSPECTdR A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR GREEN - ACCOUNTING 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES k a Sea I z M Rig 0 0 M M (j) 0 _1111 M M 0 Fn C [j) fflo� z 0) z 0 M