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20030892.pdfDATE RECEIVE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF B S EBB qeql'z�. MAILING ADDRESS CITY ZIP ITELEPHONE NAME ADDRESS CITY --kA M E ADDRESS q6'1-1 fac&lla. - STATE LICENSE NUMBER ZIP TELEPHONE CBL oby CA on I ZIP TELEPHONE VA- EXPIRATION DATE I MECKED BY PROPERTY TAX ACCOUNT PARCEL NO. .066�16-�-000() 0 NEW 0 RESIDENTIAL 0 ADDITION COMMERCIAL REMODEL MULTIFAMILY REPAIR 0 GRADING CYDS DEMOLISH [] TANK GARAGE CARPORT o RETAINING WALL ROCKERY (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: -\ t"" -4 '-� . e r-3 tiv I 0 N4-% NUNiBER NUMBER OF OF DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE -1 HEAT SOURCE GLAZING % PLAN CHECK NcOb; PLUMBING / MECH COMPLIANCE OR CHANGE OF USE SIGN 0 FENCE X FT) i - - OTHER 5 _I I PERMIT EXPIRES USE PERMIT ZONE NUMBER 11'�'77—j9M'j JOB 7-TAL,17- SUITE/APT# AD PLAT NAME/SUBDIVISION NO. T NO. LID NO, r LID FEE $ I PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP App'= RW Parrmt R tract Street Use Peffnh Rsqd EXISTING - PROPOSED Inspectlo" Required Sidewalk Required REQUIRED DEDICATION- FT Underground Wiring required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES13 NO C3 z REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ENGINEERING REVIEWED BY DATE Fr REJJ BY Ill -2 DA7 ul 11 0. CE OR CU SHORELI OR ADBN INSPECTION BOND 7 REO'D 10YEs POSTED 1$ 13NO SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , , I LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRON T LIR SIDE REAR I PARKING I LOT AREA I PLANNING REVIEWED BY DATE I REQ`D I PROVIDED 63k FIRE ALARM CHECKED BY ITYPE OF CONSTRUCTInN Hit _04�s OCCUPhW GROUIS CRITICAL AREAS 0 SPECtALINSPECTISN t11EA AR OCCUPANT MBER REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC IGO/FINAL INSPECTION REG'D VALUAnON $ 0 Description FEE Description FEE Plan Check State Surcharge 4,5D LOT SLOPE % VESTED DATE Building Permit Plumbing City Surcharge 57, tV 05 C 0 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 2 3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPLICATION: 180DAYS M. PERMIT LIMM 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 SUCCESO FIS Fire Review Plan Chk. Deposit IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF 2L EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY Fire Inspection Receipt # Ic ALL CLAIMS FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Total Amt. Due 1.4 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE :341.., 0? 0 NOR LIMIT IN ANY WAY THE C1 iYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- x Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION P" APLICATION APPROVAL - AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF GIVEN IS CORRECT, 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 IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building Official or his/her Deputy: and Fees are paid, and receipt Is acknowledged In space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. OFFICIALS SIGNATURE 9ATE SI5N#URE (OWNEI DATE SIGYD I %-rlr- 'A'35) 71 'I'll Im- - I , I : ///,3 _5 Lmm=mw� 771-CI220 "WLEA DATE A'ffENTIPN M 1333 :& IT IS UN601fFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL . A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- OR�44 -FIL� YE(LOW.i4-SPECTOR �tNER CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 P GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING k 0 M M 0 C � z ". ' M C _z 01 In M M co _Fn C z 0 M FINAL PROJECT APPROVAL FORM TO: DATE: -ZA 04 MEMOTO: PERMIT COORDINATOR, BUILDING DIVISION k RE -INSPECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL Date__, Si ocapryi.doc.l:temp:bldg:formsIO/OI z 9 0 M q9i 55 :-r' OM c Ma 0 80. c --I C 3: M M Z o -n A � E2 ic m M 0 vi 0 0 Fn C co) c co M 0 Z r- z 0) z 9 0 m 17) RECEIVE)l CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OW NER "EftWE OF BUS SS Ne ve �) <,, f M m ('A �1 0.4 N� ta MAILING ADDRESS �� 160 o -�6 CITY ZIP TELEPHONE Z: MA lff�0= CITY ZIP ADDRESS q0-11 Ale CAIIY ZIP TELEPHONE _STATE LICENSE NUMBER 079-TLEQCfq61— 10 PROPERTY TAX ACCOUNT PARCEL NO. [3 NEW RESIDENTIAL ADDITION COMMERCIAL R EMODEL 0 MULTIFAMILY [3 REPAIR GRADING CYDS .[3, DEMOLISH TANK ME CAR FIT 0��j AqTAINING WALL ROCKERY ME OF USE, BUSINESS OR ACTIVITY]l EXPLAIN: NUMBER OF "ILI NUMBER 0 DWELLING STORIES DESCRIBE WORK TO BE DONE MAE Cal. # ZONE JOB c� LPERMITEXPIRES PERMIT SUITE/APT# PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP AP W ., - S sto R 'd EXISTING — PROPOSED— Inspecuon Required SidewalkReWlmd REQUIRED DEDICATION— FT Ur4erWound Wftgfoqukw 13 METER SIZE LINE SIZE NO. OF FIXTI IRES PRV REQUIRED I YES 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE BY DATE It R7r/ BY DAT ku 77o3 M BOND DATE -LIj'E OR ADB# INSPECTION REQ'D POSTED Vi SIGN AREA I E3YEs I 13NO 1$ HEIGHT COMPLETE .-EXEMPT I ALLOWED , PROPOSED ALLOWED , PROPOSEDI PLUMBING I MECH EiCOMPLIANCE OR CHANGE OF USE SIGN FENCE ( — X—FT) OTHER Zk FIRE ALARM CRITICAL AREAS NUMBER LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR z PARKING LOT AREA I PLANNING REVIEWED BY DATE [RECrD I PROVIDED I I ?c n, V) " -� - tAf -� , "-'Y)jn A Alto a 116 lakll I CHECKED BY PE OF CONSTRUC7]PN r mfc IT TION AREA REQUIRED [:] YES REMARKS PROGRESS INSPECTIONS PER UBC $ e a U Description FEE OCCUPPY GROUj5h OCCUPANT LOAD INSPECTION RE0q'D Description FEE IM Plan Check State Surcharge HEAT SOURCE /GLAZING % LOT SLOPE % city Building Permit Surcharge / PLAN CHECK VESTED DATE Plumbing C,0 Mechanical THIS PERMrr AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 1= BE DOME ON PRIVATE PROPERTY ONLY ANY CONSTRUCTION ON THE PUBLIC Grading 2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SIMARATE PERMISSION. Engr. Review 15 PERMITAPPLICAMW ISODAYS ERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMrT FOR MORE INFORMATION ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit ;APPUCANT. N INTEREST, AGREES TO INDEMNIF% DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALd, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # 42,'�JA4? ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY r ... 3M 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 CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee 1 I HERE13Y 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 unlit signed by the TIOW. AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/har 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 9ATE SIGNATURE (OWNEPOfi AdIENT) DATE SIGNED �7 1A 03 771 -0220 R LEA 8 DATE ATTENTI ILAM EXT 1333 TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- OR%� - FILE YELOW - 16ECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 P NK-eOWNER GOLD -ASSESSOR 04/02 GREEN - ACCOUNTING PRESS HARD -YOU ARE MAKING 5 COPIES z 0 m am C M C m m a —z 0 M m M a- 0 0 Fn C V) z z 0 m I : . L. -