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20030852.pdfI DATE RECEIVED v,010 0 9 9 d=-� �4k L PERMIT EXPIRES USE PERMIT CITY OF EDMONDS 11N NUMBER CONSTRUCTION PERMIT APPLICATION JA00BRESS SUITE/APT# OWNER NAMENAALDF BUSINESS C PLAT NAME/SUBDIVISION NO. N NO. P LID X% e? & MAILING ADDRESS LID FEE S TESCP Approved CV5 - Q 11 d 7/ 5—.9 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP AW Permit Required Use Street Permit Reqd CITY EXISTING — PROPOSED Inspectio Requited ZIP TELEPHONE Sidewalk"Raquired REQUIRED DEDICATION— FT UndarWound fl� 00, gO olow Whingrequirod cl NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 7'5Z I I YES13 NO C3 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE h)8/0 0� )01 CITY ZIP TELEPHONE fAe- ninr �Jltx&Aulle J�:L %01 1'Wq8)-&bd1 UUTO-11-11 L. TEST MUST BE OBSERVED BY CITY WSPECTOR NAME C2.c :A00 I NOT 00411niptroNd WI4j;W1 Le(VI(I-s ENGINEERING REVIEWE15 NY OATE ADDRESS BE ACCEPTED FIRE REVIEWED BY DATE g CITY ZIP TELEPHONE 0111 tf&k Wq law 3 M VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND STATE LICENSE NUMBER EXPIRATION DATE I CHE BY REO'D POSTED 113YEs /100_11U, Af 13NO o6a SEPA REVIEW SIGN AREA, HEIGHT PROPERTY TAX Acc 3 d COMPLETE , EXEMPT ALLOWED , PROPOSED ALLO ED , PROPOSE 2 51TPV4_& EXP LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr.) NEW RESIDENTIAL UP MING f MECH A5 ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR ADDITION [R/COMMERCIAL ri COMPLIANCE OR I z CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE— REMODEL 1:1 MULTIFAMILY 0 siGN REQ`D PROVIDED I I I L REPAIR 0 GRADING FENCE X CYDS ( _ FT) REMARKS DEMOLISH 11 TANK OTHER oGARAGE [3 RETAININGWALL F R SPRINKLER CARPORT ROCKERY FIRE ALARM (MP �AOF USE, BUSINESS OR ACTIVrM EXP N CHECKED BY TYPr-ADFA0 4181TA OCCUPANT AA(ZZT: 7eriaw� r yj GRO (In C b t I AREAS SPECIAL INSPE dN 4RE OCCUPANT NUMBER 'LIMBER OF CRITICAL r1f A OF [DAIELLING4! STORIES LIN NUMBER REQUIRED [] YES LOAD L ITS OV DESCRIBE WORK TO BE DONE eVjkMj!gAS w, (e REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REQ'D &Ad VALUATION Description FEE Description FEE Plan Check State Surcharge HEAT SOURrE_7 GLAZING 11 LOT SLOPE % Building Permit VESTED DATE Plumbing City Surcharge PLAN CHECkNO- U 2 41eerz Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 32 DOMAIN (CURBS. SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 180DAYS IL PERMIT LIMM I YEAR - PROVIDED WORK IS STAJMO WITHIN 160 DAYS En*gr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND S . UCCESORS Fire Review 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 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 Insp. Total Amt. Due NOR LIMIT IN ANY WAY THE CITYS 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 This application Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPUDYED Building Otricial or his/her 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 INSURANCE AND RCW 18.27. OFFICIALS SIGNATURE ATE 8je�ATURE ( A DATE SIGNED 1425) "EO gG 4AN 771-0220 RELEMED BY TIO I ON EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL '(C�OR A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW-INSP 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 _77— A IDATE RECEIVED I0 , '0 90 CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAM"F BUS�ESB —Pcr M MAILING ADDRESS -6diid 715c;-- 16% cl ITELEPHONE Zip aou NAME ADDRES�.) CITY ZIP TELEPHONE Wci,APAUAle Wa -,")sol _kjxLjC�-w' NAME 00ftjftjj0(jj�j V146 ODR S 0905-15dtid?i ZE CITY ZIP 01 TELEPHONE 3 STATE LICENSE NUMBER EXPIRATION D6TE 794 cai, rriu7n,T PAA A i MU. 0 NEW 0 RESIDENTIAL epLUMBING/MECH64f 0 ADDITION BIC OMMERCIAL COMPLIANCE OR 1:1 CHANGE OF USE REMODEL 13 muLnFAMILY 1:1 SIGN REPAIR 0 GRADING CYDS [3 FENCE X_FT) DEMOLISH TANK OTHER GARAGE RETAININGWALL FIRE SPRINKLER CARPORT ROCKERY FIREALARM UYI�LQF USE. BUSINESS OR ACTIVITY) EYPLVN: NUMBER OF , NUMBER OF DWELLING A CRITICAL A EAS STORM , 8 UNITS NRUMBER DESCRIBE WORK TO BE DONE 0." HEAT SOURCE __61AZING % LOT SLOPE % T PLAN CHEC"O- VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION. 180 DAYS a. PERMIT UMIr 1 YEAR - PROVIDED WORK 18 STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION APPUCANr. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS N 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 PERMrE 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 CITY'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 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 WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. 'q1*ATURE OfAG&T?) DATE SIGNED /_W./ III).X-63 PERMIT EXPIRES USE_n PERMIT ZONE(.f� NUMBER JOB Syf ADDRESS AC5 7 ) Y" PLAT NAMEISUBDIVISION NO. LO� LID NO. I LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TREW3=F=WW Street Use Pesmit Req'd EXISTING — PROPOSED— trispectionflKWred Sidewalk Required REQUIRED DEDICATION— FT Underwmand [3 Wiring required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES E3 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE CIO" DATE Run Z' FIRE REVIEWED BY DATE ui 0 0 VARIANCE OR CU SHORELINE OR ADB11 INSPECTION BOND REO'D POSTED I DYES 1QN0$ 0 SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED , M _XP , C= M LOT COVERAGE REQUIhED SETBACKS (Fr.) PROPOSED SETBACKS:(FT) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR IL M R PARKING REO`D PROVIDED�l LOT AREA PLANNING REVIEWED BY DATE 10 I z REMARKS tomm CHECKED BY P OCCUPANT M M GROUP 7 SPECIAL INSPE TI NfZAREA C OCCUPANT REQUIRED [3YES LOAD C: = REMARKS M C), PROGRESS INSPECTIONS PER UBC I GO/FiNAL INSPECTION REaD VALUAnON. $ Description FEE Description FEE X 9 Plan Check State Surcharge 0 IT! Building Pcrmft City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Recording Fee Receipt # APPLICATIONAPPROVAL CALL This application Is not a permit until signed by the Building Olfictal or his/her Deputy: and Fees are paid, and FOR INSPECTION receipt Is acknowledged In space prmWed. OFFICIALS 8113NATURE ATE / 51ZA 1425) 771-0220 RELEMED BY D ItE 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 YELL�ONINSP �CTO CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING