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20030896.pdf13 �I r% I DATE RE EIV j)fi (� ve�� CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION IN MEIN OF BUSINESS q i7 OVIVII-S Vye MAILING A DRESS .q CITY ZIP ITELEPHONE NAME ADDRESS CITY ZIP ITELEPHONE NAME P f?/ 0 PWAIQ J A) ADDRESS 4 Y 4) / -7 49r 14 Vj& L& CITY ZIP TELEPHONE 9;4..L,L,4.,L 1AA W—n-M 11-t2,5-: STATE LICENSE NUMBER CArM 'etwo C-PCW PROPERTY TAX ACCOUNT PARCEL NO. 010-6-322 6,07- -W's - [:] NEW RESIDENTIAL 0 ADDITION COMMERCIAL REMODEL MULTIFAMILY REPAIR 0 GRADING CYDS DEMOLISH 1:1 TANK GARAGE -1 RETAINING WALL 0 CARPORT ROCKERY (TYPE OF USE, BUSINESS OR A 71)2' D_ NUMBER OF NUMBERI-1,01' Ll NG LL IN EL OWWE j_1 STORIES UNITS UNITS TO af DONE >_' ake'44-j'ag CBL # 0 PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB (5r ADDRESS ID— SUITEgT, ��? _G V PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ TESCP Approited PU13LIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required Street Use Permit Req'd EXISTING — PROPOSED inspection Required 13 Sidewalk Required 13 REQUIRED DEDICATION— FT Underground Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 13 NO 13 f5 REMARKS Z z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE I ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE Lu cc I M F4t-3 -- 2d 62- VARIANCE OR CU SHORELINE OR ADBII INSPECTION BO'ND 5DATE ] =CHECKED BY I REO'D POSTED OYES ONO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT I ALLOWED . PROPOSED; I ALLOWED , PROPOSED LOT COVERAGE REQUIRED SE%A&S (FT) PROPOSED SETBACKS (Fr.) PLUMBING / MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE REAR I COMPLIANCE OR z — 0 CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE SIGN RECID I PROVIDED FENCE ( — X—FT) REMARKS OTHER F RE SPRINKLER F! RE ALARM CHECKED,By iTYPE�QrOiNMST6�1—ON C06E 0 OCCUPANT GROUP CRITICAL AREAS SPECIAL INSPECTION [AREA OCCUPANT NUMBER REQUIRED E] YES LOAD REMARKS 0 PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D Ad Or I A Aj— I K 9, -40 n I AM a Ler, _jj 1,/� fJF)( F O.0 rRim jga Description FEE Description FEE .0 -rd q a,,,r P�awi 14 LWV Plan Check State Surcharge Stat, H 9UR 77 mzhe=&�]Z. d P % F. Building Permit jDe City Surcharge City , - I VESTED DATE Plumbing A 0 PLAN CHECK NO: Mechanical C�20 THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMrr COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 23 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Engr. Review SEPARATE PERMISSION. PERMIT APPLICATION: 180 DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 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, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF a EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND Fire Inspection Receipt # CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY IALL FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Total Amt. Due 1�3t) 9 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.* X1 Recording Fee Receipt # 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 COMP1YWrrHff AND TATE LAWS REGULATING CONSTRUC- '1 S CALL This application Is not a permit until signed by the Building Official or histhei , Deputy: and Fees are paid, and DOINGM JK AUTHI , TION; AND IN ED THEREBY, NO PERSON WILL BE EMPLOYED I OF WOR K ATE OF WASHINGTON RELATING TO IN VIOLATIO E '130 F1 CODj(OF THE ST FOR INSPECTION receipt Is acknowledged In space provided. WORKMEN-? Jvs�_Ipx'r ION NS�^NCE AND RCW 18.27. 11 OFFICIALS SIGNATUR TE FL SIGNATU 0 DATE SIGNED (425) PA , V.1) W ATTENTION V110C "KIT11 771-0220 M 1333 RELEASED By bATE I I C IT IS UNLAWFUL TO USE OR OCCUPY h OUILUING On a I RUG A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGIN . F;ILE- YELLOW - INSPECTO I CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK N GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES G EEN - ACCOUNTING also z 0 M M C M C3 0 -40 0 C �2 C M IT! 10 !� 0 -n n M ITI 0 0 Fn C C MO W z z 0 1 0 IT! Edmonds WA 98202 a studor vent. ject: Request for a vWince to histall Sub RECEIVED NOV 19 2W3 DEVELOPMENT SERVICES CTR. CITY OF EDMONDS wl RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS .................... FOUNDATION: Footing...................... Wall.......................... zi Pier/Porch ................. 0 Retaining Wall ........... Slab Insulation .......... PLUMBING: m m M % fv DATE RECEIVED RES PERMIT EXPI CITY OF EDMONDS USE PERMIT ZONE NUMBER 2 003 - a5cl JOB ADDRESS SUITEF� V CONSTRUCTION PERMIT APPLICATION OWNE 17MERibU OF BUSINESS 'VennIts vy(e PLAT NAME/SUBDIVISION NO. I LOT NO. LID NO. LID FEE $ MAILING ADDRESS 55tvSkl&,ra, n PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING — PROPOSED REQUIRED DEDICATION— FT TESCP Approved ed Street Use Pennit Reqd Inspectlo Required CI SidewaUr"Required 0 Undergromd Widno required 13 CITY --LAW4 ZIP I W; IMI TELEPHONE WS- 07- NAME METER SIZE LINE SIZE I NO. OF FIXTURES RV REQUIRED I YEPs 13 NO 13 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE CITY 21P ITELEPHONE NAME CBL? _oq1011oflow-6 I & q ENGINEERING REVIEWED BY DATE ADDRESS 14'f 01"7 140 #!W A VA W FIRE REVIEWED BY DATE ul 8 CITY UA 9VZIP rtAil" Oki 020 TELEPHONE LW - 70 2- a & 7- VARIANCE OR CU SHORELINE OR ADB# 13YEs. INSPECTION REO'D ONO POSTED 1$ BOND ST .6M LICENSE NUMBER CEXPIRA�n DA E Ar / 0 G- PC ^&Z g;— CHECKED BY SEPA REVIEW EXP SIGN AREA ALLOWED , PROPOSED HEIGHT ALLOWED , PROPOSED PROPERTY TAX ACCOUNT PARCM NO. 06 613"-40402. __W3 NEW RESIDENTIAL PLUMBING / MECH COMMERCIAL COMPLIANCE OR ADDITION CHANGE OF USE REMODEL ULTIFAMILY 0 SIGN LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT.) PROPOSED FRONT SIDE REAR SETBACKS (Fr.) FRONT L/RSIDE REAR z PARKING LOT RECrD PROVIDED I I AREA PLANNING REVIEWED BY DATE 'REPAIR GRADING [:] FENCE "'. , - CYDS X �'Fr) — = — — REMARKS fl E T 11 IN , 4�, DEMOLISH TANK Ei OTHER M GARAGE RETAINING WALL 0 FIRE SPRINKLER, CARPORT ROCKERY FIREAWM UWE OF USE, BUSINESS OR AJI'm EXPLMN: 1 1) ft ) � I ..., CHECKED BY ITYP NS CT ON CODE oo OCCUPANT QROLIP !3 NUM13ER NUMBER OF ;CRITICAL OF .. � A DWELLING 'AREAS RIES UNITS NUMBER DESCRIBE WORK TOjj DONE Q aascf4afdo oft&Ae k14,C h e Vi' SPECIAL INFRECTION' AREA REQUIRED [] YES U LO y REMARKS NS 04 PROGRESS INSPECTIO usc Iffl) %,vk ra Ak-&j 4sheie 4oc-d-clo-A& VALUAT15T s, 1.1 -1 L e. Ao ,.Mir F4 M_ ZIA' 1;� owi 14 Td -fj1dV q Check State Surcharge --THEM ZLW I mu'MAL Wim k—ildingPermit City Surcharge P1 ON V,�PTED DOT Plumbing A -30 0 THIS PERMIT AUTHORIZIES ."THI` ERM OVE kk TO ;U%t Mechanical t: BE DONE ON RPIRIV KF U ON TH E DOMAIN (CLI %I A pp UEES, C L-REQUIRE 3S Grading 1rV0SqR#rTEPf ION ,jIr t: I 2 Engr. Review IN S.I f5l X'1,PEAkrirAP 40MON: l8p6AYS e:-.. PERMIT PJJOVIDEP WOR wol TftRTEDWtrHIN ISO DAYS P111K PERMIT FO "FORMATION Engr. Inspection A e- 6.0 '1 W �, \ 'HEIRS, ASSIGNS AND SUCCESORS *APPLICAUL ON'QqkULF OF HIS OR HER SPOUSi, OF Fire Rev�,�\ 1-.� Plan Chk. Deposit IN INTEREST, AGREES TO INDEMNIFX DEFEND AND HOLD HARMLESS THE CITY a EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANYAND Fir�lqpedtiarj,i� 'j Receipt # IALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, APJSING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE \ - la-Rd_s��pe �n�p. Total Amt. Due 9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE V. 01 NOR LIMIT IN ANY WAY THE CnYS ABILITY TO ENFORCE ANY ORDINANCE PROVISIOZ,, Reczirq:qq F�Z Receipt # I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFO.RMATION APPLICATION APPROVAL GIVEN IS CORRECT; AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED A, NT OF, THE OWNER. I AGREE TO COMPLY AND STATE LAWS REGULATING CO3jTR u CALL This application Is not a perMit until signed by th RK AINIH TION; AND IN DOING& Wo IZED THEREBY, NO PERSON WILL BE EMPLOYg IN VIOLAT1101 E%SOR COD OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building Official or his/her Deputy: and Fees are pai'do and receipt Is acknowledged In space provided. WORKMENiryOM ION INS CE AND RCW 18.27. _,PRYA . TE OFFICIALS SIGNATUREL_ — SIGNATU 1_[�ATE SIGNED 1A95) M. �q� 7 771--�220 RELEASED By DXTE ENTION " E)Cr 1333 IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINA� - FILET - YELLOW - INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWN - GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GRE I EN - ACCOUNTING 6