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20030845.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS 7jhqW_VWt&A MAILING ADDRESS I '-�-:30 CITY TELEPHONE L�OW �L2,'3- 7 7 Zip NAME ADDRESS CITY ZIP NAME BLN j,;),-j—j ADDRESS I *�)& I 1� 0 6 rp CITY TELEPHONE kLV46�Ke) q,9,z,AIP3_q ILN�-7g-lRe-30 STATE LICENSE NUMBER - . ATE I CHFXKED BY PROPERTY TAX ACCOUNT PARCEL NO. 2—:1 q,, 00 NEW [3 RESIDENTIAL A PLUMBING / MECH ADDITION COMMERCIAL 04 o COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY SIGN REPAIR GRADING rynS FENCE X FT) ( DEMOLISH TANK OTHER oGARAGE o RETAINING WALL 0 F RE SPRINKLER CARPORT ROCKERY FIREALARM (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: NUMBER NIAMBER OF CRITICAL OF DWELLING AREAS I A114- Ej��W STORI rl- ,e/j - UNITS NUMBER DESCRIBE WORK TO BE DONE g re �� Ida, =A 0- IGLAZING % I LOT SLOPE % NO: I VESTED DATE FPERMIT EXPIRES USE PERMIT NUMBERW>40�r— JOB SUITE/APT# ADDRESS PLAT NAME/SUBDIVISION NO. L;T NO. No. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7ESCP Approved RW Perm: RaquI.16d S. Us Pam, Roq' d EXISTING - PROPOSED inspection Required Sidewalk Required REQUIRED DEDICATION- FT Undemround Witing required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES13 NO 13 z REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE I DATE BE ACCEPTED FIRE REVIEWED BY DATE W cc rL VARIANCE OR CLI SHORELINE OR ADB# I INSPECTION D REO'D I POOOSNTED 113YEs ONO S BEIRA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , , I LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT QRSIDE REAR z PAR ING P�mmpwro 6Y4 D A REQ0 i L PR Ip WYCA ul uplem -- P Ised. expanninn tanks lfri en or REMARK required on all hot waterjanks 1killy U011e. ECDC, 19.30.020(c) CHECKED BY ITYPE 7 �SRU ION COU OCCUPANT GROUP 19-A SPECIAL INSPECTION OCCUPANT REQUIRED YES JAR LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REG'D $ r Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge /'115 Plumbing Mechanical THIS PERMIT AUTHORIZES ONLV THE WORK NOTED. THIS PERMIT COVERS WORK TO 1: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC 21 Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPLICATION: 180DAYS IL PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 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, ITS OFFIC!ALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE, ARISING DIRECTLY OR INDIRECTLY I 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 Landscapeinsp. Total Amt. Due NOR LIMIT IN ANY WAY THE CI1YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL 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 1 This application Is not a permit until signed by the TION; 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 LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided. WORKMEN'S COMPENSATION IRSURANCE AND RCW 18.27. --- j lz� �f I LS E DATE SIGNfURE (C&NER 04'AGE!Nj) DATE SIGNED (42511 ME&. LO 771-0220 4A*TE I - HLILLANN ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTiFl- 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 0 M M C: 4 M_ 0 C E2 C M M 10 � z 0 _n M M 055 0 o Fn C2 z z 0 4 0 M n : RECORD OF INSPECTIONS , 7 , .8m 6 RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMENAME OF BUSINESS 15 MAILING ADDRESS CITY ZIP TELEPHONE P, i� Ct 7 7 q 3 NAME ADDRESS 1/05 PERMIT EXPIRES USE PERMIT ZONE NUMBERC�o JOB SUITE/APT# ADDRESS PLAT NAME/SUBDIVISION NO. LOT No. LID NO. 4- LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCF AP RW Parrrit =ad Street Use Permit Rocfd EXISTING — PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION— FT I Underground 8qw r ulred 13 METER SIZE LINE SIZE NO. OF FIXTURE; REQUIRED (2 I YEPRV S [3 NO E3 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE ZIP TELEPHONE GRAS FIPE TESf MUSf Of 17. (in INV 9%kvw IUD NAME F1 fff WOOR E�b 5 ) jCBL# r(ffW - FIDAVITS SPJU UnT ENGINEERIN—F-WeWELM?.... DATE ADDRESS BE ACCEPTED 40D FIRE REVIEWED BY DATE Ul CITY TELEPHONE ME q zip 1?` 9634 -7 -7 � t, STATE LICENSE NUMBER r-30 13 S Pq U a �:z a n f DATE n1 a — (Izl^(f CHAP ED BY VARIANCE OR CU I SHOREL.INEORADBO REO'D I INSPECTION 1$ 13YEs ONO BOND POSTED HEIGHT SEPA REVIEW SIGN AREA PROPERTY TAX ACCOUNT PARCEL NO. 2-:1 C),�) ,A 10 0 qw COMPLETE EXP , EXEMPT ALLOWED , PROPOSED ALLOWED , PROP08EO 13 NEW ADDITION RESIDENTIAL COMMERCIAL PLUMBING/MECH COMPLIANCE OR CHANGE OF USE LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE REAR PROP08EO SETBACKS (Fr.) FRONT LIRSIDE REAR PARKIIJ& L dft INNED By DATE U REMODEL Lj MULTIFAMILY Lj SIGN REaD In "Willml REPAIR GRADING CYDS [3 FENCE X I R FT) REMARKS VV 11tj _111-111-AW lull 0 DEMOLISH 1:1 TANK OTHER oGARAGE RETAININGWALL o FIRE SPRINKLER* CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS OR ACTIV" EXPLAIN: 1!2& CHECKED BY TYPE 0 0 ST RUCTIO CODE OCCUPANT -2fA.S GROUP NUMBER NUMBER OF CRITICAL a OF. DWELLING AREAS SPECIAL INSPECTION OCCUPANT M STORIEa�/r] UNITS NUMBER JAREA REQUIRED [3 YES LOAD DESCRIBE WORK TO BE DONE REMARKS IEPR20201 Y) I n ei 04 L -f�j f n !::�i C e�f, NO: r ,01 1315/ cOo _�j 141 pf�l LOT SLOPE % VESTED DATE is open or reauVe- Description Plan Check Building Permit Plumbing FEE oW, expansion ton I hot water tankg p, DO 19.30.020 (c) Description State Surcharge City Surcharge 17C .0 E aM alTM rviec"anicas THIS PERMIT AUTHORIMS 9"LV THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WiLL REQUIRE SEPARATE PERMISSION. Engr. Review PERmrTAP0ur_ATiON: 1160DAYS PERMIT ILIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION Plan Chk. Deposit -AppUCANT, ON BEHALF OF HIS on HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review 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 # ALtCLAIMS R 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 Landscapelnsp. Total Amt. Due NOR UMIT IN ANY WAY THE CITY`S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee I HEREay ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION APPROVAL OWEN 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 ipplicallon 16 not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Offlclal or hL-4her Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION F—Iptisaeknovdedged In space provided. WORKMENS COMPENSATI RANCE AND RCW 18.27. Ft L SIG RE DATE SIG RE (OWNER OR(AfEffrf DATE SIGNED (4- 2 5) I %,, to 110-3 771-0220 � &_=4, 44� _—RELEASO"OFY DATE I Mff 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR ST RUCTURE UNTIL 1 - A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - INSPECTO 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 .04 0 M M 80 C :� r. M 10 z 0 _n n Irn M 0 C z Q) M 0 M z V) z 9 0 M