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20030872.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS Via N Krs-rrA.rAa),( G-4�4pav-&./AN MAILING ADDRESS 13 5'ri 0 S a. 5D CITY ZIP TELEPHONE NAME ADDRESS CITY ZIP I TELEPHONE NAME CBL# ADDRESS 1511 L 4 U CITY ZIP TELEPHONE WA_ 1'/-)5 776 419-62 STATE LICENSE NUMBER EXPIRATION DATE I aEC� M uS t4s�'=> 10 ;;IL t::�- r-- 41-.-)q_o5 PROPERTY TAX ACCOUNT PARCEL NO. R -7 0 500 1 1'3 5 00 NEW [24RESIDENTIAL ADDITION COMMERCIAL REMODEL 0 MULTIFAMILY REPAIR [:] GRADING CYDS DEMOLISH 0 TANK GARAGE FIETAININGWALL ROCKERY CARPORT (TYPE OF USE, BUSINESS OR ACTNIM EXFJ�X_N: NUMBER NUMBER OF OF DWELLING STORIES UNITS DESCRI13E WORK TO BE DONE _N PERMIT EXPIRES - USE PERMIT ZONE NUMBER JOB SUITE/APT# ADDRESS 103--7 ct A LIE. S6, PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S TIES Z roved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Cpa itpRoquited Street L EXISTING — PROPOSED inspection Required Sidewalk Requited REQUIRED DEDICATION— FT Underground Wiring required El METER SIZE LIN OF FIXTURES PRV REQUIRED YES13 NO 13 z REMARKS OWNER/CONTRACTOR RESPON SIBLE FOR EROSION CONTROLIDRAINAGE GAS NPE TEST MUST BE BY FIRE REVIEWED BY DATE DATE U11 VARIANCE OR CU SHORELINE OR AD1111 I INSPECTION PBONDO REQ'D OSTE 13YEs 13NO $ SEPA REVIEW SIGN AREA I HEIGHT COMPLETE . EXEMPT ALLOWED . PROPOSED ALLOWED , PROPOSED LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) L Q14"UMBING I MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR 2 COMPLIANCE OR CHANGE OF USE PARKING W'�--UATE SIGN REaD I PRO %�e B, L vent connectors 916 FENCE X Fnr) ID REMARKS requirecli ain luell-IL111171 11,19 UPP OTHER PIP 815A.. IF Wd 151imm iff fe FIRE SPRINKLER FIRE ALARM CHECKED BY Co" IE OCCUPANT jTYP4Aj�%C9NSTRUqnON GROUP CRITICAL AREAS 'SPECIAL INSPECTION - OCCUPANT NUM ER JAREA REQUIRED 11 YES LOAD I ( 1 1-10,600 111 1( REMARKS 2 PROGRESSI LELb"EPECTION REO'D 9 Regardless of whether the water system rilnMec: or Z169d. evansion tanks are C L i;-r- C_ jc6 d_hd&-M_DC_ 1-913-00.00 C 0.:; &:c— 0 C) )- I F-'&r) 01 bek-ra- a ra" To tils $ 9�iz) Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit . City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t BE DONE ON PRIVATE PROPERTY ONVIlt ANY CONSTRUCTION ON THE PUBLIC Grading 2 Do LURQUEES, ETC.) WILL REQUIRE 3 MAIN (CURBS, SIDEWALKS. DRIVEWAYS, SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: ISO DAYS L PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 160 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, A13REES 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, AFUSING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapeinsp. 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.- Recording Fee Receipt # 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 APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRLIC- TION; AND IN DOINlOTHWORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED CALL This application Is not a permit until signed by the Building Official or his/her Deputy: and Foos are paid, and IN VIOLATION OF TH BOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided. WORKMEN'S COMP 8 ION INSURANCE AND RCW 18.27. I 0 1 LS DATE SIGNATURE (0?%bjCAGL?NTf)' DATE SIGNED (425) &SIGURE A I v 771-022 0 By RELEASED BY ATtOWTFON Off 1333 IT IS LAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FIXL INSPECTION HAS 13EEN 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 z 0 M M M 0 0 0 C: � r. M M z z 0 -n n M M 0 —0) 0 6 Fn M 0 z 0) z 0 1 0 M I IV 'TIDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEMAME OF BUSINESS MAILING ADDRESS 135oo sf:f, CITY ZIP TELEPHONE &=_ I -Lc- Vurt_ qeoo& I NAME ADDRESS CITY ZIP TELEPHONE NAME CBL# C ADDRESS CITY ZIP TELEPHONE r7 E. 0 ryl W(*� 141"577& '41S-6 STATE LICENSE NUMBER EXPIRATION DATE mwriji 4,-:>1 DLV--<- Al -;� q _o_5 I � PROPERTY TAX ACCOUNT PARCEL NO. Q -7 0`5 500 1 13 5 00 13 NEW 014RESIDENTIAL 611PLUMBING/MECH 0 ADDITION COMMERCIAL COMPLIANCE OR 0 CHANGE OF USE 0 -REMODEL MUL11FAMILY [3 SIGN REPAIR GRADING CYDS [3 FENCE X FT) DEMOLISH TANK OTHER GARAGE CARPORT 0 RETAININGWALL ROCKERY FIRE SPRINKLER FIRE ALARM WPE OF USE. austuEss OR ACTIVITY) EXPLMN: j�u 0 F "tA C,4, c_ l4aia-r NUMBER NUMBER OF CRITICAL OF STORIES DWELLING UNITS AREAS NUMBER DESCRIBE WORK TO BE DONE PERMIT EX PIRES USE PERMIT ZONE -.> - NUMBER JOB SUITEIAPT# ADDRESS e:," 0 -3 -7 PLAT NAME/SUBDIVISIO7 LOT NO. LID NO. LID FEE $ $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Parritil RequiteWd Street Use Permit Req'd EXISTING — PROPOSED Inspectio" Required Sidewalk Required REQUIRED DEDICATION— Fr Uroderground Wiringrequired 13 METER SIZE LINE SIZE -j NO. OF FIXTURES PRV REQUIRED ES13 NO 13 z REMARKS OWNER/CONTRACTOR RESCABLEP Fq!H0&V ___ - ___ ---a we. DATE FIRE REVIEv"&D1—bz1F q DATE W1 n n UU tU ___ _q VARIANCE OR CU SHORELINEORADS11 ANSPECTION BOND REOD I POSTED 13YEs 13NO SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT I ALLOWED PROPOSED ALLOWED PROPOSED, 1 =-XP , , , LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SI BE REAR FRONT LIRSIDE REAR DATE PA REQ`D ING fiLOT AREA �PLAJINING RMEW90 By T15AWD or en connectors CHECKED BY ITYP7 CONSTRUCTION Gqt: ulf�ur GROUP SPECIAL INSPECTION JAREA OCCUPANT LOAD REQUIRED [3YES I I . 0"fifimbar Owl or dowd VALtJAI IL)IM I I CL i_=r_ ' $ 6211,Alkc�'01` (ILL)m bN`--a 0041,0-b 1-0 r� I 2 0 12.10) 42� Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % G-Al-: I Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZIES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. t= - Engr. Review I jFPIan PERMrrAPPUCAT104: ISODAYS PERMIT ILIMI`11 I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION -APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review Chk. Deposit IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS DiE CITY OF x EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM;ANY AND Fire Inspection— Receipt 0 ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Total Amt. Due /95 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.' Recording Fee Receipt # _;4 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR DIE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL Thia application Is not a permit unfit signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF CODE OF THE STATE OF WASHINGTON RELATING TO Building Officizi or his/her Deputy: and Fees are paid, and FOR INSPECTION receipt 13 acknowledged in space provided. THPBOR WORKMEN'S COMP ELATION INSURANCE AND RCW 18.27. OfF19 ALS SIG KrURE DATE SIGNATURE (rjO AGIAM9 DATE SIGNED 1A0 1,425) -0 _3__ 771 -0220 RELFASED BY DATY Ike ATt"TrOva EXT 11333 --------- IT IS VOLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECLTIQN,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 I z 0 4 0 M q9 us � OM a M 10 0 C: !I M M M 10 0 ITIM a 5) 0 0 Fn a 0) X ch M 0 X z 0 M