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20030846 (2).pdfku t DATE RECEIVED �/ L_7, [PERMIT EXPIRES CITY OF EDMONDS USE PERMIT ZONE NUMBER CONSTRUCTION PERMIT APPLICATION JO SUITE/APT# ADODRESS OWNER NAME! 15 V5 I < C 415�, 4 F_ F;?-- PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS LID FEE $ E4 MA P 1- F_ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TF.5GP Approved RW Peffnh Required CITY ZIP TELEPHONE — 0-D ID'S 02,- EXISTING PROPOSED--- ATI REQUIRED DEDIC ON FT Street Use Pennit Req'd inspection Required Sidirwalk Required W.) UndwDround mok) 4zz� I Wiring required NAME METER SIZE LINE SIZE NO. OF FITTURES PRV REQUIRED ifRkeo-TIQ YEs13 NO 13 SS (052, ALA) M_ REMARKS z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE CITY ZIP J,141 Al_� ITELEPHONE on ,j L--V 62fl, -714 Z--] NA�� JCBL! ENGINEERING REVIEWED BY DAT ADDRESS FIRE REVIEWED BY DATE CITY It ZIP TELEPHONE Lq/1 f f ff ) I VARIANCE OR CU SHORELINEORADBN INSPECTION BOND STATE LICENSE NUMBER EXPIRATION DATE I CREMP B (V 7z_ ..... REO'D P TED ------------- � OYES WO $ ------ I IL H HT PROPERTY TAX ACCOUNT PARCEL NO. 05 10 - b.. SEPA REVIEW COMPLETE XEM13T E>e SIGN AREA ALLOWED PROPOSED ALLOWEU;W;ij� OSED, . I --- ZL� I D_ L 004 4?, V:Z , C S" r%.p .2 9 EXP NEW RESIDENTIAL PLUMBING/ MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT.)].P80POSED CKS (FT.) FRONT SIDE REAR UJIIONT REAR ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE W1,116 80' lb! I z REMODEL MULTIFAMILY SIGN PARKING PROVIDED LOT AREA PLANNING REVIEWED BY D 7 REPAIR GRADING CYDS r9 o FENCE X FT) DEMOLISH TANK [:] OTHER E;49= W�CRQ Qa-6p�no C eAft"E6 [3 RETAINING WALL ci FIRE SPRINKLER CARPORT ROCKERY ---FIREALARM rrY01: OF USE BUSINESS OR ACTIVI'm EXPLAIN: 14, 1) CHECKED BY ITYPE Q940N,�TON 3�_ III OCCUPANT ?,--3 GROUP NUMBER OF -2— TN BER OF UM DWELLING 'rC L R AL q [�A EAS SPECIAL INSPECTION JAREA OCCUPANT LOAD STORIES Ul S NUMBER NUMB REQUIRED [:] YE DESCRIBE WORK TO BE DONE ADD CAR-FOV W/VeCe— qorv� REMARKS PROGRESS INSPECTIONS PER UBC I 06/FINAL INSPECTION REG-0 I /." I 0 HEAT SOURCE JLTNG % LOT SLOPE % / �z 1 10- Yf2 PLAI0HECK NO: 05— VESTED DATE 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. PEAMrTAPPLJCATION: 160DAYS PERMIT UMM 1 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, IT$ 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 HE I DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CrrY`S 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 PLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- To C(3MP 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 WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. SIGNATUT/,OW�NER I DATE SIGNED $ Descriptlon FEE Description FEE Plan Check Building Permit State Surch arge City Surcharge Plumbing Mechanical Ha Grading Engr. Review Engr. Inspection Fire Review PlanChk Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION IA-05) 771-0220 APPLICATION APPROVAL This application is not a permit Until signed by the Building Official of his/her Deputy: and Fees are paid, and receipt Is acknowledged In space provided. OFFICIALS SIGNATURE RELEASE9 BY DATE ATTENTION EXT I JJ IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL — , - _101:;1L- A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINJ(L-FA YELLOW- INSPEaroR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINIQ�OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING GARY HAAKENSON MAYOR ton on your ore are no permit. file. The City considers the final inspection to be one of the most importani inspections be complete: approval the following: nust conducted on a project In order to grant final ara numbers, guardrails, handrails, -close door, between g ge self smoke detectors, house rooms, safety stopp glazing, weather- ing, any and residence, egress from sleeping ese may gs etc. Of course not all of these g department requirements Engineerin hZIdni about th kinds of things apply to your project but it does give you an idea s cc specifically lete as well as some items that do not need to be ins ed such as: that must be comp etc. Please be advised permits expire one year from paint, carpet, moldings, wallpaper, he work, permits can be the date of issuance. If you will need more time to complete t a final renewed prior to expiration for one half fees. If the permit expires in '.der to renew the approval granted by the Building Inspector, full fees are required ourage to c your permit. This can be very costly to you and we strongly enc yol (s). Note: if more than permit expiration date and call for the required fina inspection one department is required to final your project, this is noted on your Job Card. z 0 i 0 m :q =n- U5 :0 0 M c M 0 80 c --I K X M m z 0 -n n � � ic m m 10 �� 0 0 Fn C cl) K 0) M 0 Z z z 9 0 m I �WPA7 RE IVED /M EXPIRES mmj FPERMIT r Z USE PERMIT ZONE CITY OF EDMONDS NUMBER CONSTRUCTION PERMIT APPLICATION JOB u,,,, ADDRESS qZ14 W At)tr( t)-r OWNER NAM PLAT NAME/SUBDrvisION NO. LOT NO. LID NO. LID FEE MAILING ADDRESS 92-4- HAP L F_ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7ESCP APPMVId RW Pofn-A RequWed EXISTING PROPOSED � S" Use Perm" 11160 'ad == 1b UnderlywW 99 CITY ZIP TELEPHONE llr2O REQUIRED DEDICATION FT VVWg req 13 NAME METER SIZE LINE SIZE NO. OF F06`UAE,9FT PRV REQUIRED a Mkl;�_TIQ *0 YES E3 NO 13 Z �V) I ADDRESS (f,�2, ALt)r-g:_,_ REMARKS OWNER/CONTRACTOR REIPO JBLE FOR EROSION CONTROLIDRAINAGE z CITY ZIP- r:::DMOKYD5� TELEPHONE -714-IIZI a* -A, er=� &D*z� 10- A 1A NA!qL� CBL# ENGINEERJNG REVIEWED BY DAT C C iE ADDRESS IpAj t:� PDRESS/ -ffRE REVIEWED BY DATE CITY -zip TELEPHONE rL STATE LICENSE NUMBER EXPIRATION GMEWWD BY OL I M I $ PROPERTY TAX ACCOUNT PARCEL NO. SEPA REVIEW SIGN AREA H HT COMPLETE EXEMPT ALLOWED., - PROPOSED ALLOWE 6SED EXP 0 NEW RESIDENTIAL PLIUMBING MECH LOT COVERAGE REQUIRb SET13ACKS (FT.) P OSEED tri.) ALLOWED PROPOSED FRONT SIDE REAR qT 5"521EAR r, 1 R'Str 1 COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE WI k , Zb fa 'DATE re 9 1, REMODEL MULTIFAMILY SIGN PARKING LOT AREA, PLANNING R EWED 1 PROVIDED . lov, "b. Q. 7 1 a'Ac"t'. 06 I FENCE 0 REPAIR GRADING X CYDS FMT) r9 OTHER 0 DEMOLISH TANK M) GMUMILk o RETAININGWALL cl FIRE SPRINKLER CARPORT ROCKFRY FIRE ALARM I[TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: CHECKEDBY .4ONSTRUCTION OCCUPANT ITYPEDF r\j GROUP NUMBER NUMBER OF R A C 'no L, OF DWELLING AREA S 2- SPECIAL INSPECTION OCCUPANT LOAD STORIES UNITS NUMBER JAREA' REQUIRED . . . DESCRIBE WORK TO BE DONE DID CA R_ F6 P, T V F_ C k- 170 r. REMARKS PROGRESS INSPECTIONS PER UBC 10IMNAL INSPECTION RECtEl. —A �!Z ly 0 LIV I M 611 "U An 0 N . . . . . . . . . . . . . . &2 Description FEE Description FEE Plan Check State Surcharge th HEAT 80 G % LOT SLOYE % Building Permit City Surcharge P05UHECK NO: VESTED DATE Plumbing 1_Q00, Mechanical 00 THIS PERMIT AUTHORMES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCnON ON THE PUBLIC Grading DOMAIN (CURBS. SIDEWALKS, DRIVIEVANS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. W. Review PERMIT APPUCATION. 1150DAYS PER= umm i YEAR - PROVIDED WORK IS STMMD WITHIN 100 DAYS Engr. Inspection SEE BACK OF PINK PERMff FOR LWRZLIN!P��'Tlok *APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEI . R49, ASSIGNS AND SUCCE I SORS Fire Review Plan.Chk. Deposit 51 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, ANSING DIRECTV( OR INDIRECTLY _eF3 _-tP FRO UANCE OF TH IS PERMrr. ISSUANCE OF THIS PERMIT SHALL NOT BE M THE ISS DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE ndscapelnsp. La Total Am. Due NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Be Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; A* 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 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 his/her Deputy: and Feet are paid. and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt 13 acknaMedgod In space pcqM*d. WONXMENS COMPENSA71ON INSURANCE AND RCW 10.27. OFFICIALS SIGNATURE DATE SIGNATUF E JOV�NER PR fgb' DATE SIGNED IA05) �ul �1 03 Ila �m 771-0220 RELEASEI?i0Y OAT E 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 CERTIFI. ORIGI01 F - YELLOW-INSPE OR 4 W,:,' CATE OF OCCUPANCY HAS BEEN GRANT ED. UBC SECTION 109 PINK-04ER - GOLD -ASSESSOR GREEN - ACCOUNTING 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES