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20030919.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION MAILING ADDRESS —7S[57 2=1-2�_K SW 601+f 2e CITY ZIP ITELEPHONE IF.-Amoras W& qwa!�77,4-762z> NAME _.— I I - - A J ADDRESS 15 1 .5u e+e ZIP FTELEPHONE NAME S ADDRESS �64 5*K CITY a.— Ik ZIP TELEPHONE _j1A WigWap LA-7.—\ 4�Z.J 11--lb STATE LICENSE NUMBER MRATION ATE CHECKED BY e6l; 61165 I PROPERTY TAX ACCOUNT PARCEL NO. E"d_ '5_6vq NEW 0 RESIDENTIAL %PLUMBING / MECH ADDITION O—S:OMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY SIGN REPAIR GRADING CYDS FENCE ( _ X_FT) 0 DEMOLISH TANK o OTHER GARAGE CARPORT RETAINING WALL ROCKERY F RE SPRINKLER FIRE ALARM (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: !&e-- C a_— oil � — k- NUMBER OF 2- NUMBER OF DWELLING ft CRITICAL AREAS I STORIES UNITS NUMBE DESCRIBE WORK TO BE DONE -6-3 USE ZONE 6- JOB HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: 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 (CUR13% SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 180 DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 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 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 NO IMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* !T� I H ACKNJODGE T I HAVE READ THIS APPLICATION; THAT THE INFORMATION G1 E CDR AN&DAM THE OWNER, OR THE DULY AUTHORIZED AGENT OF W YWT R. E TO WITH CITY AND STATE LAWS REGULATING CONSTRUC- M I I T IN THEIWO UTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED 1 0 1 13 N E 80 DE OF THE STATE OF WASHINGTON RELATING TO C , 'TI 0 AK SATI CE AND RCW 18.27. 0 In E SIGNED t A ��Ap PERMIT EXPIRES PERMIT NUMBER r-&79q PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP APPfOvtd AW Perm" Required SIreft Uge Perrnh Rocfd EXISTING — PROPOSED Inspection Required 13 Sidewalk Required 13 REQUIRED DEDICATION— FT Underwvjnd Mine required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 1 I YES 13 NO 13 z REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE I SH=FF SILALL BE FIRE REVIEWED BY DATE I -. rL VARIANCE OR CU SHORELINE OR AD1111 INSPECTION BOND REO'D I POSTED 1$ 13YEs 13NO $EPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED :xP , , , LOT COVERAGE REQUIRED SETBACKS (Fr.), PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR z By DATE PARKING REO'D I PROVIDED I LOT AREA I PLANNING REVIEWED I REMARKS A PRESSURE REGULAMRVAI.VE 0= V SHALL BE INSTALLED NEAR CHECKED BY ITYPE&ONSTRUCTIO OCCUPANT fl— 2 GROUP A SPECIAL INSPECTION FAFMA7 OCCUPANT REQUIRED [3YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'O j . --I. —ft— — — e _A.'^ A.— A ��l -01 $ - Description __J FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge t5 Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscape Insp. Total Amt. Due Recording Fee Receipt # CALL FOR INSPECTION (425) 771-0220 EXT 1333 APPLICATION APPROVAL This applicatIon Is not a permit until signed by the GuitoWill Official or his/her Deputy; and Foes era paid. and i�celpt Is acknowledged in space provided. tAS N&AT,,, DATO U—E V -ED -B Y 134E 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 ITT I DATE RECEIVED i4VA PERMIT EXPIRES CITY OF EDMONDS USE PERMIT ZONE NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRE= OWNER NAMEINAMqOF BLP�ESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS LID FEE S _20�� PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7ESCP App"rad RW Permit Required Street Use permit Reqd CITY ZIP '-fTELEP1�19NE EXISTING — PROPOSED Inspection Required Sidewalk Required P&0�125 )7A -2020 REQUIRED DEDICATION— FT — underWound widing required cl -EEAr"OnAs NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED r Arc � lien �s I YESE3 NO 13 o I ADDRESS 15"" 6 sui+e REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE z z (PEA Ave PUMUMr TO UPC 605.2 _elMaji; CITY ZIP ITELEPHONE <�0020 LA25ti-r?S-153o A WX1R% SMICH SHUrOW =ALL IRE 01=11 LMD QW,=M NAME LDM AS IT ENTERS THE BUILDWO DATE te-C ENGINEERING REVIEWED BY ICI ADDRESS 65A &w- sul'�e 3:76 im wpm FIRE REVIEWED 01 m rCITY __x^&0A oj�9zlp (26� a L7V0 TELEPHONE E4 -Z-5) -11410 j u r STATE LICENSE NUMBER EVIMT19N QATE I CHECKED BY VARIANCE OR CU SHORELINE OR ADBN INISPECTION REQ'D T BOND POSTED 0-ii mdt -V- q 73 A oAl 6 -11.65 OyEs ONO 0 S --I PROPERTY TAX ACCOUNT PARCEL NO. SEPA REVIEW COMPLETE- EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED 00S — acq —0640A , I EXP NEW RESIDENTIAL. PLUMBING I MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT, LIRSIDE REAR ADDITION %—COMMERCIAL COMPLIANCE OR 0 CHANGEOFUSE 11 REMODEL 0 MULTIFAMILY SIGN PARKING REQ`D LOT AR PLANNING REVIEWED BY DATE 0 PROVIDED 916 I UA TO ECDC 19.30.020 SUA P S, P I REPAIR GRADING FENCE CYDS El ( X FT) REMARKS A; S U 1KC b. DEMOLISH TANK OTHER J, Rig Ib-I-ST-A-11—SID bm#R, TM WATM SHUrOFF GARAGE RETAINING WALL 0 FIRE SPRINKLER FIREALARM CARPORT ROCKERY (TYPE OF USE, BUSINES13 OR ACTIVITY) EXPLAIN: CHE�KED BY TYP;E�VONSTRUCTIO COE )E OCCUPANT (_e I I ; ' I" C_ .1 2 GROUP NUMBER.. 'br-. NUMBER OF DWELLING IV CRITICAL AREAS SPECIAL INSPECTION A LOAD ,2- STORIES UNITS NUMBER REQUIRED [3 YES 0ESCRQE WORK TO BE DONE 10C,* 1, holk, 4 REMARKS I.-Ce JPIVMbl'l)� e3 (A,,+ PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REO'D VALUATION z ITI Co z 9 0 Description FEE Description Plan Check State Surcharge HEAT SOURCE -F-717-0 NG % LOT SLOPE % Building Permit VESTED DATE Plumbing Mechanical City Surcharge PLAN CHECK NO: THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PEBMIT COVERS WORK TO t . BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading X DOMAIN (CURBB, SIDEWALKS, DRWIEWAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERUFTAPPLICATION: ISODAYS PERMIT ILIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPU ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit I Nf=T. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF 9 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt III ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERM17. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapainsp. Total Amt. Due DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NC�R-LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - Recording Fee Receipt # IH ACKNO EDGE I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL G E CDR AND AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF E R. I ET WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a permit un III signed by the IN TH 0 THORIZED THEREBY, NO PERSON WILL BE EMPLOYED I N E BOR DE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Bu!Wg OfflcW or hl"er Deputy: and I ;sea are paid, and I l#colpt In sollun owledgod In space provided. 0 C CE AND RCW 18.27. NAT DATV SIG 0 DATE SIGNED fA 13 5) 411h 1 MjT =j 771-02 20 __3ED BY D4E —a—LEA ATt9"ON Off 1333 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. U96 SECT;PN 109 PINK -OWNER GOLD -ASSESSOR GREEN-ACCOUWING 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES