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20030842 (2).pdfDATE RECE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION ER 7ME/NAMFCf BUSINESS a '�' MAY 14" M "h MAILING ADDRESS _2maj� NAME ADDRESS CITY NAME L'V &t r I'> ADDRESS STATE LICENSE NUMBER S L'O ZIP ZIP ITELEPHONE V I k'� 6j TELEPHONE 'ao� -L� E Pi X XTION DATE Z-0 CBL # [ QL77 IC) :��J P Q �Q 1013 ROPERTY ;AX ACCOUNT PARCEL NO. 00(_0<5 L2000 c'-') 00 re NEW RESIDENTIAL PLUMBING/MECH �_(COMPLIANCE ADDITION COMMERCIAL OR 1:1 CHANGE OF USE REMODEL MULTIFAMILY 0 SIGN REPAIR GRADING .YDS [3 FENCE X DEMOLISH TANK 13 OTHER GARAGE RETAININGWALL FIRE SPRINKLER CARPORT ROCKERY F RE ALARM OWE OF USE, BUSINESS OR ACTFV" EXPLAIN: S-EQ N U MMIR OF O!e� NUMBER OF DWELLING CRITICAL AREAS 4/hIV ST, UNITS NUMBER DESCRIBE WORK TO BE DONE � 3 1 1 PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB ADDRESS^7 J�/ jj�� L7�C taZ' S _V_ PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Requited Street Use Peffrill Req'd EXISTING - PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION- IFT Undergrouild WirIngrequired METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES13 NO 13 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE GAS PIPE TEST MUST BE OBSERVED BY CITY INSPECTOR AFFIDAVITS SHAL L NOT ENGINEERING REVIEWED BY HF; 111"P93MI7111 DATE FIRE REVIEWED BY DATE us cc I M VARIANCE OR CU SHORELINE OR ADBI I INSPECTION I BOND REO'D POSTED 13YEs 13NO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE , EXEMPT ALLOWED PROPOSED ALLOWED I PROPOSED EXP I . LOT COVERAGE REQUIRED S - ROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR z PAR I DATE FT) IREO'D REMAI Of ether the water are CHECKED BY I TYPE TH FT ON CODT% OCCUPANI,, JAREA GROUP Z SPECIAL INSPECTION OCCUPANT REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REO'D 9o-0-60 �f 1,--v /-"-L '� 1, L'I e--f4t' r_'�?_ 9 �0_ , I H-96T SOLLRCE GLAZING % LOT SLOPE % e4q ) I PLANICHECK NO: VESTED DATE a0sess THIS PERMIT AUTHORIZES 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 APPLICATION: 160 DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 100 DAYS SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANIG 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 CITTS 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 RELKfING TO WORKMEWS COMPENSATMJ� AISURANCE AND RCW 18.27. SIGNAT (OWNER =7-- DATE SIGNED )11 _/.0 7t44 0 lici-11A I 1'0T-)4)D VALUATION s,4-7q3,, spaces. UMC 815.1.7 Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt. Due t 11tr';Iq Recording Fee Receipt # CALL FOR INSPECTION (425) 771-0220 APPLICATION APPROVAL This application is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid, and .kecelpt Is acknowledged In space provided. OFF SIGNATURE DATE A A RELEASED ffYf' dATE C ATTENTION EXT 133 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 . . . . . . . . . . . . . . . . . ,1 4 RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SE*ACk6 ........... ........... 00NDATION; Footing...................... 'Wall ....... .................... Pler/Porch ................. Retaining Wall ........... Slab.Insulation .......... PLUMBING: .. ........... . Underground .......... Rough -In ................... iqoqpmOrc. LFM41 o6wLm. . . ......... t DATE RECI27L. 0 PERMIT EXPIRES U USE PERMIT CITY OF EDMONDS Z ZONE NUMBER CONSTRUCTION PERMIT APPLICATION 'INAI I JOB J SUITE/APT# ADDRESS �71) 1.21 4- 1 4-- '� EINAMEg BUSINESS 94 re; 1) ay jeit-1 9"V� PLAT NAME/SUBDIVISION NO. 6�) LID NO. MAILING ADDRESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP LID FEE S TESCP Approved RW PerrWl ReWirod Strool Use Perma AKd TEL EPHONE 2-4x rviA ffo Zip 1 M— -14 EXISTING — PROPOSED REQUIRED DEDICATION— FT Inspection RequIrod Sidewalk Roquked Undorgmund wmg req NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REOUMED 0z I I YES13 NO 13 ADDRESS REMARKS 0 1 WNER/CONTR RffiffaMETRAINAGE CITY ZIP TELEPHONE COINS CIOR n FIDAM SHALL 1101 NAME CBL# L'�) A L k k nrl)"� BE ACCEKED ENGINEERING REVIEWED BY DATE ADDRESS ,a), r--,� FIRE REVIEWED BY DATE cc C TELEPHONE zt4ov Dc' IEL VARIANCE OR C BOND STATE LICENSE NUMBER PI TION DATE CK D Y POSTED 2-toW-&J �-_7 1013 IMDI; SEPA REVII IGIG Alz HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALL 0 so V ED PROPOSED W 0 co'45 00a 6)0 , I EXP LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) NEW RESIDENTIAL PLUMBING MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR X—COMPLIANCE OR ADDITION COMMERCIAL 0 CHANGE OF USE z PARK LUI AREjA L NINGIEViEWED BY DATE -ridem REMODEL MULTIFAMILY SIGN REQ`D ass OT eller a water 1 GRADING X ci FENCE REPAIR CYDS ( _ _ FT) 6 N. REMARKS _r I d. 0. lank"I _10 DEMOLISH 1:1 TANK Ei OTHER an al hot War tanks City 0. ECDC 19.30.020 (C) m oGARAGE RETAINING WALL 0 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM j UWE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: CHECKED BY ITYPE=ON C DDrh I OCCUPAP GR NUMP4R NUMBER OF CRITICAL OF DWELLING AREAS A4W !n? SPECIAL INSPECTION AREA OCCUPANT 7- LOAD U ITS tVll+ ST UNITS NUMBER REQUIRED[] YES DESCRIBE WORK TO BE DONE I REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D. 9 ki _�4�, it :5!1 c3�e-zff ft—, --n 1 o, o VALUATiof IS UMC 815.1.7. Description FEE Description FEE Plan Check State Surcharge H T SowaCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLANICHECK NO: VESTED DATE Plumbing Mechanical THIS PERMrr AUTHORIZFS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONILM ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPUCATION: 180 DAYS PERMIT UMM 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 TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF Fire Review Plan Chk. Deposit IN INTEREST, AGREES EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Insoction Receipt # I ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OFTHIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Total Amt. Due DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Receipt # Recording Fee I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL C31VEN 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, NO PERSON WILL BE EMPLOYED IN VIOLAT!ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building Official or his/her Deputy: and Fees era paid, and �ecelpt Is acknowledged in space provided. WORKMENS COMPENSATIO� ,ASURA,N�M AND RCW 118.27. 0 F�FX)U IGNA�URE DATE SIG (OWNER Gl(" DATE SIGNED 1425) U kj e,' 771 -0220 RELEASED fiY-' I DATE NTIO t111 EXT 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-ACCOLINTING