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20030895.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION ER NAMEINAME OLBUSINESS MAILING ADDRESS I -I w.), - n (vr)2 0-,A ef 6%w CITY ZIP rTELEPHONE NAME ADDRESS CITY ZIP ITELEPHONE NAME ICBLN CITY ZIP STJkTE LICENSE NUMBER PROPERTY TAX ACCOUNT. PARCEL NO. 0 NEW RESIDENTIAL ADDITION COMMERCIAL REMODEL MULTIFAMILY REPAIR GRADING CYDS DEMOLISH TANK oGARAGE CARPORT RETAINING WALL 13 ROCKERY OWE OF USE BUSINESS OR fff'" N: -) f) L I k`.0A IN-1 � 1 0_r*%jL.&_ 11.1 % . NUMBER NUMBER OF OF 4 DWELLING STORIES UNITS DESCRIBE Y40M\TO BE DONE & HEAT SOURCE PLAN CHECK NO: PERMIT EXPIRES�5�__4�2L > 1 11 UbE PERMIT 0gq ZONE '60 NUMBER JOB SUITE/APT# ADDRESS jjq-t4) St bi PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESUP AP re' Rw PenratIR k_ street use Per"It MOM. EXISTING - PROPOSED Inspection Required Sidewalk Requited REQUIRED DEDICATION- FT Undertiround wiring required 13 METER SIZE LINE SIZ�7. OF FIXTURES PRV REQUIRED YES NO 13 REMARK OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE in cc Ir VARIANCE OR CU SHORELINE Oil ADBII I INSPECTION I BOND BY REQ'D POSTED SEPA REVIEW SIGN AREA [3YEs 13NO $ HEIGHT COMPLETE . EXEMPT I ALLOWED . PROPOSED I ALLOWED , PROPOSED LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) PLUMBING / MECH ALLOWED PROPOSED FRONT SIDE REAR I FRONT LIRSIDE REAR I COMPLIANCE OR 0 z CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE SIGN REQ`D I PROVIDED CLI I FENCE I 0 X FT) REMARKS FIRE SPRINKLER FIRE ALARM I CHECKED BY TYPEr CONNUCTICIN CODE UL;UUl"AN I GROUP CRITICAL' AREAS 8PECIALINSPECTION OCCUPANT IN REQUIREE ]PROGRESS JAREA LOAD REMARKS INSPECTIONS PER UBC 100/FINAL INSPECTION REG-0 —r— — , r% 1�1_' I n C, ^ A zA _J_: k, ^ ef 92 LOT SLOPE % VESTED DATE Description Plan Check Building Permit Plumbing Mechanical FEE Description State Surcharge City Surcharge FEE THIS PERMIT AUTHORrZE6 ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I= BE DONE ON PRIVATE PROPERTY ONLY. AM CONSTRUCTION ON THE PUBLIC Grading 2 DOLMN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 180 DAYS PERMIT LIMM I YEAR -PROVIDED WORK 18 STARTED WITHIN 1180DAYS 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, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF 2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt N ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING 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 0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* zi Recording Fee # I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATIO14 APPROVA GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF THE OWNER. TO COMPLY WITH C17Y AND STATE LAWS REGULATING CONSTRUC- CALL This application is not a permit until signed by the .(AGREE TION; AND IN 90ING THE WQ"K THORIZED T)JEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATIONIOF THE LAOA CORE THg(fTATE OF WASHINGTON RELATING TO FOR INSPECTION Building Official or his/her Deputy: and Fees are paid. and receipt Is acknowledged In space provid9d. HSATI? WORKMEWS I;OMPE NINS ANq fCW 18.27. OF MIALS SIGNAT RE IG:ZE (OWN 0 1 E DATE SI G ED / (422511 yief 11' 2� 7A 771-0220 _r .7- 1 MENTON V M 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSF�ECTION 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 . ��A z 0 d : j , , - 0 M M M 0 C: M M Z z 0 M M 0 0 Fn C= MT A z 0 :1 1 1 0 M I RECEIVED I. . CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME "I 'ISINESS _DLAC _ MAILIN I oo<� — n ic� CITY ZIP ITELEPHONE L aolaA!J�� NAME ADDRESS CITY NAME Le4 ?) o ADDRNS -J A2,11� 1\3v- CITY K 1�jj — ZIP TELEPHONE T CBL # ZIP TELEPHONE I t �, -1 b 1�2 'N'1104.j 1 PERMIT EXPIRES 12127 U E PERMIT 0(?1'yt-_'_1 ZONE NUMBER -7_�i ] JOB SUITWAPT# ADDRESS 100 '-_-�)Ik) ,<:7A PLAT NAME/SUBDIVISION NO, LOT NO. LID NO, LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP APProVed AW Perm Required Street Us: Permit Raq`d EXISTING — PROPOSED Inspecdon Required Sidewalk Required REQUIRED DEDICATION— FT Underwound Wiring required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YESE3 NO 13 z REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE FIRE REVIEWED BY DATE DATE I - dt =tEIINUMBER I VARIANCE OR CU SHORELINE ORADB# INSPECTION BOND STfTE \NEXPIRA DATE CHECK BY REO'D POSTED I -1YEs Lee E 13NO $ SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , 0 NEW RESIDENTIAL PLUMBING/MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR 0 ADDITION COMMERCIAL COMPLIANCE OR 0 CHANGE OF USE I , 1:1 REMODEL MULTIFAMILY �i PARKINP CeD Q�E 11.,,P�PVIDED LOT AREA PLANIIING REVIEWED BY DATE I 0 GRADING [3 REPAIR CYDS FENCE FT) REMARKS 0 DEMOLISH TANK o GARAGE o RETAININGWALL F RE SPRINKLER CARPORT ROCKERY FIRE ALARM ITYPE OF USE BUSINESS OR EXPLAIN: r CHECKjjD BY TYPE f CONffRUCrI CODE OCCUPANT NUM13ER OF NUMBER OF DWELLING CRITICAL' AREAS SPECIAL INS�EOJION AREA NT STORIES UNITS NUMBER REQUIRED [3YE. LOAD DVCRIBE V40WTO BE 0 REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D Ef 1 7 1 0 tw\ Ay, aL) VALUATION Description FEE Description FEE Plan Check HEAT SOURCE GLAZING % LOT SLOPE % Building Permit C-50 LStateSurchargeE City Su rg City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORtEES ONLY THE NOTED. THIS PERMIT COVERS WORK TO h WRIK BE DONE ON PRIVATE PROPWIIV Ly. MY CONSTRUCTION ON THE PUBLIC 't L ;YS, Grading 32 DOMAIN (CURBS, SIDEWALWkDl M MARQUEES, ETC.) WILL REQUIRE TE PI SEPjq TE PERMISSION. Engr. Review PERMIT UVTIOPL' ISO DAYS PERMIT LIMM I WAR - PROVIDED WORK IS STARM.D WTTHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 4PLICANT, ON BEKW OF HIS OR HER SPOUSE, HEIRS, ASiIGNS4hD SU8biSOR6 !, Rre-Rev.iew 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,THkPERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapainsp. I Tojal Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITVS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* A. sss- Recording Fee Receipt # LRI �pt :# I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPUCAT16N APPROVAL GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE R REE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- WME CALL This application Is not a permit until signed by the 14.,AG TIOVANO ING THE D RESYNO PERSON WILL BE EMPLOYED IK E' Building Official or his/her Deputy: and Fees we paid, and IN VIOLATION16F THE A It ED Tl� TATE F WASHINGTON RELATING TO L FOR INSPECTION receipt Is acknovAedged In space provId9d. ",INS AN a WORKME?fS JOMPEYS CW 18.27. ATIF ��Ij A OF IALS SIGN�T, IIE E IGNATrjb"j OyEr Zj� DATE SIG ED 771-0220 R_ELfASED DATE[ BY AX Et N EXT 1333 TO USE OR OCCUPY A BUILDING OR STRUCTURE-UNTIL— S U! L. A FINAL INS:CTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE - YELLON-INSPECTOJ CATE OF OC PANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR oil 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 m C m 0 -10 0 C 3� r, J m m z 0 _n _n m m 006 0 0 rn C MO z 0) z 0 1 0 m A