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20030913A.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNEjr)NAME"E OF BUSINESS .4 . j . i �j �111 ADDRESS CITY ZIP TELEPHONE NAME CBL# ADDRESS CITY ZIP PHONE T STATE LICENSE NUMBER EXPIRATION DAT7 CHECKED BY PROPERTY TAX ACCOUNT PARCEL NO. NEW VKRESIDENTIAL PLUMBING MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY 0 SIGN REPAIR GRADING FENCE CYDS FT) X 5<D&OLISH OTHER 0 TANK GARAGE o RETAININGWALL, o F RE SPRINKLER CARPORT ROCKERY ____FIREALARM UWE OF USE, BUSINESS O��LPJN: NUkAGE:&b d NUMBER OF CRITICAL 0 F DWELLING A EAS & UNIT8 NuMBER DESCRIBE WORK TO BE DONE PERMIT EXPIRES Z-"4- is ME PERMIT ZONE)e UMBE��j JOB ADDRESS SUITE/APT# PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP AP RW ParmitSd, Suest use Psrm eq d EXISTING — PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION— FT ndergound wumu'.qu. METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 0 �R E-INUR ION R YES13 NO 13 REMARKS OWNER/coorRA&mmroToLBipcmfnoMgMM * SIDE SEWER PAUST 1kill CAR= Am PROPERTY LINE * WATER MB=R 10 1113 REMOM . .0 1�tw.AT APNOM MW an alm FIRE REVIEWEc93B DwolsMow InpILWHWATE LO cc 0 ammisT ONIACK OF Joe CMD rL *W%vb VARIANCE 6R �670YEs BOND REO'D POSTED 13NO is SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED _XP , , LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR Z PARKING LOT AREA I I PLANNING REVIEWED BY DATE REO'D I PROVIDED REMARKS CHECKED BY ITYP= i COJ�E OCCUPANT 4/7:7 GROUP SPECIAL. INSPECTION JAREA OCCUPANT REQUIRED [3 YES LOAD REMARKS PROGRESS INSPECTIONS PER USC 11081FINAL INSPECTION REC?D 11 VALUATION Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE LAZING % LOT BLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED 13ATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLI ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WlLL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPILICATION: 180 DAVS PERMIT UNIM I YEAR - PROVIDED WORK IS STARTIED W11THIM 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 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE, 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 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - Receipt # Recording Fee L12 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVA 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 CONSTRLIC- 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 hIsfher Deputy: and Fees are paid, and � receipt Is acknowledged In space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. 81'" URE DATE SIGNAT7 (OWNER OR AGENTI DATE SIGNED/, (425) MILS .'V — f ")A f.,An 11 /j2/__h �of t2o 771-,02 DAT)t RELEAtEfbByi- C___� ATTENTION Off 133 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 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 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING APPROVED AS NWEO BY ENGINEERING Date: ;a i2b M m oz A 0 ry" C.M M < am M SLOP 14P/o -'N mom p t�an bt SIM" lr4r r Legal De�sc ption 1"susswim MOM CP 4"a"alm "a HMM ko MW cp IM MW at M" or us GMT =0 Mff cr TW= * cr MW 60M MACHMM COMI "M ACM "WCM A==" TO F"T PW=W IN cr F"IM AT FAM In IN wimomw =W", U#AHNWM EMM" ""T FORTM COWSM 10 7W tocMINCOVA" ............................ Vvnrltical Datum WAVD am "sw CH "No"" CUNM FUILOW VALMS FM A MR~ N LMAMD 0i " N?RVADWM CP rum C"AAM SW MUM IL GAD PMI ALW MM IM NMM CUM= =MM 4W Lot Coveraae UM AMA OCUAMPM WLLW FM LM C*votA= A& A PW%MffAM CP LM AMA 2%= Ught Cabdation FCW A wuo POW 0 DOW FCW C ow TW& 64M APPROvEl) BY PLANml4k. 9 I !04 1 (QDAT"�A C EE RE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME E OF BUSINESS 4 W MAILING ADDRES9'- CITY Zip ITELEPHONE NAME ADDRESS C17Y ZIP TELEPHONE NAME ADDRESS CITY ZIP ELEPHONE STATE LICENSE NUMBER EXPIRATION PROPERTY TAX ACCOUNT PARCEL NO. NEW >�r`ESIDENTLAL �DDITION COMMERCIAL REMODEL MULTIFAMILY GRADING 0 REPAIR, CYDS XEDEMOLISH'f [3 TANK GARAGE RETAINING WALL CARPORT ROCKERY (TYPE OF USE, BUSINESS OR LAIN: NUMBER NUMBER OF OF el. k I DWELLIN STOWE UNITS DESCRIBE WORK TO BE DONE CBL # PERMIT EXPIRES TSE PERMIT ZONEL2 4 NUMBE��j JOB ADDRESS SUITEIAPT# PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP App"rad RW ftarift RoWired EXISTING - PROPOSED Strout Us* PwMU RW MapectionFisqWred Sld&wa* Rewired REQUIRED DEDICATION- FT Underground Wirlrg required 13 METER SIZE LINE SIZE OF FIXTURES PRV REQUIRED FN0, YESD NO 13 z 5REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAJNAG E FIRE REVIEWED BY BY DATE DATE DATE CHECKEDBY I VARIANCEORC'U SHORELINEORADBN I INSPECTION BOND REO'D POSTED 113YEs ONO I $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT I ALLOWED , PROPOSED I ALLOWED - PROPOSED PLUMBING/MECH COMPLIANCE OR CHANGE OF USE 0 SIGN oFENCE ( _ FT) [3 OTHER FIRE SPRINKLER FIRE ALARM CRITICAL AREAS NUMBER ��_7 HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: VESTED DATE THIS PERMIT AtrrHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, WDEWALKS. DRAIEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. PERMITAPPUCATION: 180 DAYS PERMIT LJUM I YEAR - PROVIDED WORK 18 STARTED WITHIN IGO DAYS SEE BACK OF PINK PERMIT FOR MORE 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, EMPLOYEES, AND AGENTS FROM AW AND ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMfr. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY WAIVE On REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR TUE 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 LABOR CODE OF THE STATE OF WASN�GTON RELATING TO WORKMENrs'bOMPENSATION INSURANCE AND RCW 18.27. S1GkATuft r (OWNER OR AGENT) DATE SIGNED I 1A, 411 LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) A OWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR LL PARKING LOT AREA I PLANNING REVIEWED BY DATE REO'D I PROVIDED I REMARKS CHECKED BY TYPrCET OCCU GROU W7 T� SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [:] YES LOAD REMARKS PROGRESS INSPECTIONS PER UEC 108/FINAL INSPECTION RE*D is Description FEE DescrIption FEE Plan Check State Surcharge Building Permit C4 Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt N Landscapeinsp. Total Amt. Due Recording Fee Receipt N APPLICATION APPROVAL CALL R INSPECTION 771-0220 ThTs application Is not a permit until signed by the Building Officiall or his/her Deputy: and Foos are paid. &Ad -'fecolpt Is acknovilodged In space provided. Lws si TURE DATE 14 4CZA11 Cz9f RELF-Alfuroyf ATTENTION I M1 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL ORIGINAL -FILE YELLOW -INSPECTOR A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTIOWO,09 PINK-OMER GOLD -ASSESSOR GREEN - ACCOUNTING 04/02 PRESS HARD -YOU ARE MAKiNG 5 COPIES