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20030897.pdfI DATE RECEIVED 10 �2_GJD3 PERMIT EXPIRES USE PERMIT CITY OF EDMONDS ZI E (�L Z�, NUMBER &2Q.?- /' JOB SUITE/APT# CONSTRUCTION PERMIT APPLICATION ADDRESS NAMEINAME OF BUSINESS PLAT NAMEISUBDIVISION N __7LOT NO. LID NO. r — o MAILING ADDRESS 2-CL CITY I F_VM��S! _ NAME ADDRESS CITY NAME C c)vk ADDRESS (Co��o ?f,�A.V, 1\ CITY �Aj STATE LICENSE NUMBER !�_�x �co 2, PROPERTY 14X 'ACCOUNT PARC Qu LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP AP _T RW Parmh=ed ZIP TELEPHONE EXISTING — PROPOSED Street Use Permit Roq'd InspectIonRaquired Sidewalk Required .2q? REQUIRED DEDICATION— FT — Undo ground Wldn'g required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I I I YES 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLMRAINAGE zip TELEPHONE BY DATE FIRE REVIEWED 13Y DATE W cc ZIP TELEPHONE rJ6 40: L NO. NEW [�]�RE IDENTIAL ADDITION COMMERCIAL Co REMODEL 13 MULTIFAMILY REPAIR 0 GRADING CYDS DEMOLISH [:] TANK oGARAGE o RETAINING WALL CARPORT ROCKERY UWE OF USE, BUSIN SS OR ACTIVITYII EXPLAIN: i co-,')' f (.452�: - _Me�ts NUMBER NUMBER OF f 0 F DW�ELLING 4 STORIES t DESCRIBE WORK TO BE DONE 3 X311-j %-Jt- I I VARIANCE 01; CG--T—SHORELINE OR ADBN INSPECTION I BOND I TION DAT�Ef CH KED BY Hal 1 REO'D IS POSTED 43 113YES WO SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEM13T ALLOWED PROPOSED ALLOWED PROPOSED , I IV.A Ave 15-the EXP PLUMBING LOT COVERAGE ALLOWED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (FT) FRONT LIRSIDE REAR PROPOSED COMPLIANCE OR 0 CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE SIGN REO'D PROVIDED I I Wf_ I FENCE X Fr) REMARKS OTHER AOa- 0.1 - FIRE SPRINKLER FIRS ALARM CHEC��E OF CQNSTRUJQTION COIA OCCUPANT 17 GROUP CRITICAL AREAS SPECIAL INSPECTION 'JAREA OCCUPANT NUMBER REQUIRED LOAD REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REG'D c Ck6bL\%r3r-Avr\U $ Description Plan Check HEAT SOURC T GLAZING % LOT SLOPE % E Building Permi t , — - PLAN CHECK N VESTED DATE 2L_::�L'6 Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLM AM CONSTRUCTION ON THE PUBILIC Grading DOMAIN (CURSS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION- Engr. Review PERMITAPPUCATION: 160DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION FEE Description FEE State Surcharge city surcharge '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 IALL C!JUMS FOR DAMAGES OF WHATEVER MATURE, ARISING DIRECTLY OR INDIRECTLY Fire Inspection Receipt # FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE 9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due 21 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Receipt # -7 Recording Fee I 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 until signed by the TION: AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LAD DE OF THE STATE OF WASHINGTON RELATING TO a FOR INSPECTION Building Oificial or his/her Deputy; and Fees we paid, and receipt Is acknowledged In space provided. �INSU CE AND RCW 18.27. WO��COMPENS M SU SA 0 L N D E GNATURe,j OR GENT) DATE SIGNED 1 IAOJ 1.4,25 1) 7 L.3 1 771-0220 RELEA ATTE14TION Off 13313 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL %" A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- I 0 1 YELLOW. INSPECTOR �QWIIWR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPI GREEN - ACCOUNTING ES z 0 q 0 M 0 DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION TnErE OF BUSINESS A , --� - -I. t- - e— — r I -% — k r MAILING ADDRESS 22-00c� __IbAn�\ CITY ZIP la)M�L&s . S e NAME ADDRESS CITY NAME C ,�L I f", C L�N ADDRESS �Q ?A4N.VN CITY ,2.- V7-c:51 ZIP TELEPHONE C LN ZIP TELEPHONE STATE LICENSE NUMBER LC��QDCM- PROPERTY _UX ACCOUNT PARCEL N( DATE PERMIT EXPIRES USE PERMIT 'ONE NUMBER 20t�,3- JOB SUITE/APT# ADDRE SS 22jDC6 lo"Nw— W-, PLAT NAME/SUBDI`VISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP IESCP mproved RW parmil RaWirad s"m u-, Permit 1`1*0 EXISTING — PROPOSED humdon risquirad Sidewalk Required REQUIRED DEDICATION— FT wkwWound Wkingrawl"O 13 METER SIZE LINE SIZE NO. OF IXTURES PAV REQUIRED YES 0 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE ENGINEERING REVIEWED BY DATE NEW [�_ RE IDENTAL PLUMBING X (0 .0 ADDITION �]E COMMERCIAL Co COMPLIANCE OR 1:1 CHANGE OF USE [j REMODEL MULTIFAMILY 0 siGN 1:3 REPAIR GRADING CYDS [3 FENCE X FT) T) 0 DEMOLISH TANK OTHER rGARAGE RETAININGWALL FIRE SPRINKLER —I CARPORT ROCKERY FIRE ALARM (ME OF USE, BUJINESS OR ACTA16-M EXPLAIN: me�6* i (.Z 1011*_1 NUMBER TN�MBEROF CRITICAL OF STORIES NG . �f --e AREAS NUMBER DESCRIBE WORK TO BE DONE a I. % f, -- ( I - - I N\ 0 HEAT SOURCE GLAZING % LOT SLOPE % 64K 1 PLAN CHECK VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. P ERM IT AP Is U CATI&P 160 OA6 PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 150 DAYS SEE BACK OF PINK PERMIT FOR UORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYkES. AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE.ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF. THIS PERMIT 814ALL NOT HE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITY$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORREC-P 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- TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOAX.QDE OF THE STATE OF WASHINGTON RELATING TO WORMEITtlICOMPEN =CE AND RCW 18.27. PfGNATUR OR �GENT) DATE SIGNED FIRE REVIEWED BY DATE W IE I Iz VARIANCE-& CU SHORELINE ORADBN I INSPECTION BOND REQ1D jc3YES GWO POSTED SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED, _XP , IVA , 4, LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR W, 0 04 , - 411—, .,r7 PARKING L!7LANNING REVIEWED BY DATE REO'D PROVIDED I REMARKS 1.oAAo_A_ jpAca- 02 . _143, CHECKED "PE OF CQNSTRUOTION OCCUPANT )W4�2� GROUP SPECIAL INSPECTION AREA OCCUPANT REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Review Engr. Inspection Fire Review Plan Chk. Deposit nre inspection Receipt # Landscape Insp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION 1425) 771-0220 APPLICATION APPROVAL This application Is not a permit until signed by the Building omciai or his/her Deputy: and Fees are paid, and receipt is arknovAedged In space provided. - ____ OMN DA E )_71 0 R"'E L E 8 ATTENTION M 1333 IIZ966 i IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- __OF/A�_Fll /- YELLOW - INSPECTOR R CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OW14 R - GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 0 M PH 0 0 -40 0 C 3! z M 10 z O� Fn C Cal z 0 0 M