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20030880.pdfI r 14" L I DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS ffZW,q 14*6ZP Xlc- H"M 71 _Wc/ MAILING ADDRESS f _22SV/ MV�' 9 dj # FTY ZIP TELEPHONE w4. ;V0 2-1 zo,�,-34gy NAME ADDRESS CITY ZIP ITELEPHONE LPERMIT UPIRES Usi PERMIT ZONE g NUMBER JOB SUITE/APT# ADDRESS Qet lez PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ TESCP Appr;;;T PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required street Use Permit AGO EXISTING — PROPOSED Wipection PAquired Sidewalir Required REQUIRED DEDICATION— FT uncism- 9 METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED I YES C3 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE 0 z NAME CBL # _11yWN411aveL SAW Co. ENGINEERING REVIEWED BY DATE IX ADDRESS /.74 /,� /-/IV — ly FIRE REVIEWED BY DATE CITY ZIP TELEPHONE ",z rZ jV* qpjLoj� el I VARIANCE OR CU SHOREUNEORADB# I INSPECTION BOND STATE LICENSE NUMBER EXPIRATION DATE CHECKE0 BY — I..j REO'D POSTED 1 Is %wTMxe_o 0 PaVr-S UNO SEPA REVIEW SIGN AREA , HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED .-ALLOWED PROPOSED EXP kNEW RESIDENTIAL 1:3 PLUMBING/MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FE), PROPOSED SETBACKS (Fr.) FRONT SIDE REAR FRONT LIRSIDE REAR COMPLIANCE OR ADDITION KcoMMERCIAL 1:1 CHANGE OF USE z REMODEL MULTIFAMILY IGN PARKING LOT AREA PLANNING REVIEWED BY DATE REQ`D PROVIDED REPAIR 0 GRADING FENCE X CYDS FT) REMARKS OTHER DEMOLISH TANK oGARAGE RETAINING WALL 0 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS OR A V 7 CHECKED BY N OCCUPANT MEXPI)�j ITY=CT GROUP NUMBER NUMBER OF CRITICAL OF DWELLING AREAS 'SPECIAL INSPECTION OCCUPANT ST RIES UNITS_ NUMBER JAREff REQUIRED [] YES LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER USC IGO/FINAL INSPECTION REQ'O WImu- za4At1*v,&1&P dWA(r-t- ZV774s &N R&ZW44� L4// `,644 Jr/?A/-f 6# roqz:_ S�fficco ",Cc- I%IA4f /,000 VALUATION $ Description FEE Description FEE Plan Check State Surcharge HEAT SOUIRC= 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 BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMA114 JCURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 180 DAYS UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE 13ACK OF PINK PEFIMIT FOR MORE INFORMATION 'APPUCANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit JOE' 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 PERMM ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapainsp. Total Amt. Due DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE I 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 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 unfli 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 TH OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknovAedged In space provided. WORKMENS COMPEN I CE AND RCW 18.27. OFF IALS SI NATURE DATE FF 'ALS SI NATURE SIGNATURE (OWN R DATE SIGNED 10,400.5) - -3 21 b 771-0220 - E S By E &ASEDBY R D ATTENVW EXT 1333 A 4 R �17122 IT IS UNLAWFUL TO USE N OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL FILE YELLOW - IN6PECTOR 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 4 0 m 'A -"fl 55 ;1 OM c ma� 0 80 c -4 C MM m Z 0 -n m M a 65 0 o Fn C (j) c Cl) M 0 Z X z z 9 0 m PIT M ,7 1*-'--'----'---- RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF DZESS ?ACI 3,5 MAILING ADDRESS .22s-// HWX ?17 CITY ZIP TELEPHONE tz�omp#ixfl NAME ADDRESS CITY ZIP TELEPHONE NAME 1iV76*V47'1o#41 Sld7lvro. ADDRESS . CITY ZIP TELEPHONE CBL N 3/to �-j Nei PERMITEXPIRES, USE PERMIT ZONE SM NUMBER JOB SUrTE/APTf ADDRESS Qr+* /// PLAT NAME/SUBDIVISION NO. LOT NO. UD NO. /LID FEE 9 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP V I F-5 MV =0d Street Use Permh Wd EXISTING — PROPOSED I twofit Rectum REQUIRED DEDICATION— FT Iffirin, r-q *t 13 METER SIZE LINE SIZE I 1--WO. OF FIXTUIREA/ PRV REQUIRED YEsI3 NO 13 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE ENGINEERING 52"ED BY DATE 'D FIRE REVIEWED BY DATE getz-71r 4VA - f -P A-4 VARIANCE OR CU SHQREUNEORADB# IN ECTION BOND STATE LICENSE NUMBER I EXPIRATION DAT�,I_ CHECKE0 REQ`D POSTED W 13NO Is SEPA REVIE_W____V SIGN AREA il HEIGHT OPOSED PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE , XEMPT ALLOWED ..ROPO ED ALLOWED PR *81 a 1-9 - tit I EXP dj�New RESIDENTIAL PLUMBING/MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED,SETBACKS (FT.) FRONT-. SIDE REAR PROPOSED SETBACKS (FT) FRONT LIRSIDE REAR 0 ADDITION KCOMMERCLAIL COMPLIANCE 9A. CHANCE 01�-�SE ..... REM66EL MULTIFAMILY S IGN PARKING REO'D PROVIDED LOT AREA PLANNING REVIEWED BY DATE CL REPAI R GRADING CYOS FENCE X_Fr) REMARKS DEMkLISH TANK 0 OTHER GARAGE. CARPORT RETAININGWALL 13 ROC RY FIRE SPRINKLER 1:1 FIRE ALARM _M?E Dr, USE, BUSINESS O!�Lm CHECKED BY cqqri� OCCUPANT GROUP UMBER JUBER OF CRITICAL N J OF DWELLING AREAS r & & SPECIAL INSPECTION -JAREXF OCCUPANT STORIES UNITS NUMBER REQUIRED YES LOAD, DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER USC 100/FIN-RECVD Wff,4t L 114 Al /* &P cl�-Mvkr-t- 1Z 7799-C f (PAI 7rRZt- cc 0 j4-h'C<_ vy-A 4, /Wo �kLUATION /�p IN �Z ARAAf $ Description FEE Description FEE Plan Check 1,20 State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical TMS PERMIT AUTHOREZE8 OMY THE WORK MYTED. THIS PERMIT COVERS WORK TO I= BE DORE ON PRIVATE PROPERTY (MIX ANY CONSTRUCTION ON THE PUBLIC Grading 111 wi R R 3 DOMAIN (CURB$, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) LL EQUI E SEPARATE PERMISSION. 9 Engr. Review PEaurrAppu6mom: looms PERMIT LIMM I YEAR - PROVIDED WORK 16 STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION Plan Chk. Deposit -APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGINq AND 6UCCESOli.9. -Fire Review IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # VVM ALL CLAIM$. FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY r . Total Arrit Due FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. --t9— 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 - I i Recording Fee Receipt # I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN 18 CORRECT; AND THAT I AM THE OWNER, ORTHE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC' This application Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED CALL Building Offlclal or hisfher Deputy: and Foes are paid, and IN VIOLATION OF THE LABO C DE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt ItLaeknovAodged In space provided. 5 iTW WORKMEITS,COMPEN Art NCE AND RCW 18.27. OF IALS 81 NATURE DATE a RE (OWN DATE SIGNED 11110 %425) 771-0220 I-RELEA ED B PAtE ATTEN*W off 1333 AA IT IS UNLAWFUL TO USE OCCUPY A BUILDING OR STRUCTURE UNTIL f f 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 GREEN ACCOUNTING 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES z 0 M 2M L_ 8 7'i M -40 0 a M M I0 z Vie 0 M M 0 R, C M 0. z 0 0 M