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20030916.pdf13 DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS MAILING ADDRESS PL-A,,� CITY ZIP ELEPHONE E�23C&A 9&:)-o LE17(1—ws NAME ADDRESS CITY ZIP ITELEPHONE NAME CBL# %F —orr—e-s ZWC- 10— n/ Anf/ ADDRESS I )- `43 I+W �A C? I CITY ZIP TELEP ONE of goiz �;jq 0 11 1 STATE LICENSE NUMBER EXPIRATibN DATE CHECKED B7 i+Ajej-4 rur cii 9 q N R PROPERTY TAX ACCOUNT PARCEL NO. 0 NEW RESIDENTIAL PLUMBING / MECH ADDITION COMMERCIAL COMPILIANCE OR CHANGE OF USE REMODEL MUL11FAMILY 0 SIGN REPAIR GRADING CYDS FENCE ( X FT) DEMOLISH TANK OTHER GARAGE RETAININGWALL FIRE SPRINKLER CARPORT ROCKCRY FIRE ALARM (TYPE OF USE, BUSINESS OR ACTWM EXPLAIN: 0 s -IF- R NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE f,(V_9ryh-(_ &0.:9. F-&APWA-Q.C- j6dxL1\ 0.0111 HEAT SOURUE GLAZING % LOT SLOPE % 6-fts -_ I I PLAN CHECK NO: I VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLZ ANY CONSTRUCTION ON THE PUSILIC DO&WN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, E-11C.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 1180DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR PADRE 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 ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE 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.* I HERESY ACK14OWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION 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- 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 WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. 9=;aF_ SIGRATURE (OWNERIO AGfW DATE SK:F4ED e-/O "�3 PERMIT EXPIRES E E PERMIT ONE _,17 NUMBER JOB SUITE/APT# ADDRESS(,,Q) t�q PLAT NAME/SUBDIVISION.�� LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved AW Permit Required Street Use Peffnft Rsq'd EXISTING — PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION— FT Undertiround WIMg required METER SIZE LINE SlZi7NO. OF FIXTURES PRV REQUIRED YES 13 NO 13 REMARKS OWNER/CCINTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING REVIEVVE BY'—" DATE BE ACCEPTED FIRE REVIEWED BY DATE VARIANCE OR CU SHORELINE OR ADS# I INSPECTION I BOND REO'D POSTED 13YEs ONO $ BEIRA REVIEW SIGN AREA HEIGHT COMPLETE . EXEMPT ALLOWED . PROPOSED I ALLOWED . PROPOSED 113 z 15 1 LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR PARKING LOT AREA PLANNING REVIEWED BY DATE REO'D I PROVIDED I I IL REMARKS CHECKED BY SPECIAL INSPECTION 'JAREA REQUIRED 13 YES OCCUPANT GROUP ;e OCCUPANT LOAD REMARKS PROGRESS INSPECTIONS PER LIBC 108/FINAL INSPECTION REO'D 9 1 11 $ F Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspeclion Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapelnsp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION 1A 1-125) 771-0220 EXT 1333 APPLICATION APPROVAL This application is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid. and receipt Is acknowledged In space provided. URE DATE &DAT RELEASED BY IM 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 uolleinsul jool:j, ................ Nourinsi '$*DNIWVU:l UO Isum 01:1 ........... ....... DNIWVU:i .......................... DMIIVN,:.� 0NIH.LV3HS.UOIU3"1 Bu 1 1:4 jolojewwoo, P ............... tuawdlnb3 �LL ............. Ouldid ME) . .................... ISRI SPE) :DNIIV3H, ui ................... ul-qBnoW ..... . .......... ot, punojDjep,un ;t— oo I I.... :DNiewnld .......... uolp qnsul qejS tu a ........... lium Buiumew ................ 40JOdPOW .......................... Ilem .......... ....... :NOUVGNno:j mlovens, 03AOUddV 3IVa U0133dSNI SNO1103dSNI:10 CIU033H DATE RECEIVED 11---IIPERMIT EXPIRES PERMIT r��CITY OF EDMONDS NUMBER CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS MAILING ADDRESS '>1&0q 8)-- CITY ZIP IT ELEPHONE q�o:).(j KW &_� -7 7 (9 NAME ADDRESS CITY ZIP ITELEPHONE NAME CBLN V_AVr_C_*'S xwc_ ADDRESS 14u 77'), CITY ZIP —=E F_ va&&rr- OL34 gjq-() 11 STATE LICENSE NUMBER EXPIRATION DATE I CHE HtAXi-A E L-r 4? 9 q N 14 L' ?2 PROPERTY TAX ACCOUNT PARCEL NO. 0 () 0000 () Q () 0 BY NEW RESIDENTIAL PLUMBING / MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY SIGN REPAIR 0 GRADING CYDS FENCE X Fn DEMOLISH TANK OTHER GARAGE cARPoFrr Ei RETAININGWALL ROCKERY FIRE SPRINKLER FIRE ALARM (TYPE OF USE. BUSINESS OR ACTIVTM EXPLAIN: S IF. P. #4 NUMBER NUMBER OF CRITICAL OF DWELILING AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE EJOB SunVAPT# ADDRESS,�Q) PLAT NAME/SUBDMSION NO. OT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP APPro"d RW PermA Required Su" Use Peffrift Rocfd EXISTING — PROPOSED Inspectlo" RaqukW Siderwatli Required REQUIRED DEDICATION— FT Underground Whingrequir'sil METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 1 I YES 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ENGINEERING REVlfMIYdPF6W5 0 sip seseezes"" "%F* DATE BE ACCEKED FIRE REVIEWED BY DATE Ic 1 VARIANCE OR CU SHORELINE OR AUBM INSPECTION BOND REQ'D 113YEs POSTED 13NO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , , , LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR PARKING LOT AREA PLANNING REVIEWED BY DATE 916 RECI'D I REMARKS 1. / . — I I I CHECKED BY JTYP),,O�)ONSTRUCTION 1CO GROUP OCCUPANT SPECIAL INSPECTION 'JAREA OCCUPANT REQUIRED LOAD REMARKS PROGRESS INSPECTIONS PER UBC 11N/FINAL INSPECTION RECI'D Fao X L_�j - FU PA2 VALUATION Ritg__91� $ ,q/9, &oo R.2-ru '5 t=t.P_g;F0(_ Description Wzo0i 10 Plan Check HEAT SOURCE GLAZING % LOT SLOPE % Building Permit 4XIN—S PLAN CHECK NO: VESTED DATE Plumbing TIjIS PERMIT AUT"ORIZES ONLY THE WORK NOTED. THIS ;PERIArrCOVERS WORK TO Mechanical BE DONE ON PRIVATE PROPERTY ONLX ANIf CONSTRUCTION ON THE PUBLIC i U 6 1 WILL Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review YS PERMIT APPLICATION; 130 DAYS ITH PERMIT UMFr I YEAR - PROVIDED WORK IS STARTED WITHIN 100 DAYS Engr. Inspection SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION FEE Description FEE State Surcharge ro I City Surcharge /6- E S 0 R S -APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit T Y 0 F IN INTEREST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF r Y A N D EDMONDS, WASHINCITON. ITS OFFICIALB. EMPLOYEES, AND AdENTS FROM ANY AND Fire Inspection Receipt If E M Y ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE:ARISING DIRECTLY OR INDIRECTLY 0 BE FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE NCE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapolnsp�. Total Amt. Duo NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION." dOr Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATIO NAPPROVAL T GIVEN IS CORRECT� AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENW THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a permit untIl signed by the D Building Official or his/her epuly: and Feei are paid, and PLOY 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 receipt Isacknovirledged inspeco provided. WORKMENS COMPENSATIOtl_INSURANCE AND RCW 18.27. A loci TURE DATE DATE 8 IA05) %-WK- I 771-0220 -RELEASED BY DATE/ EXT 1333 IT"16 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 ------------------ Z, 0 0 M =i I-" M MH 0 C � K M M 10 � o -n n� �z mm 0 f—J) 0 0 Fn C (1) C): 03 z 0 M