The URL can be used to link to this page

20030925.pdf6 DATE REOEIVEDO— 0-5 PERMIT EXPIRES USE PERMIT ZONE I Dq��S_ CITY OF EDMONDS NUMBE�aW5 CONSTRUCTION PERMIT APPLICATION JOB ADDRESS 00 j 1A �� SUITE/APT# VV,0,31 OWNER NAMEIN BUSINESS 1 8 PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILIN67 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP LID FEE $ TESCP Approved RW Pennit Required Street Use Permit Rsqd CITY ZIP TELEPHONE EXISTING — PROPOSED Inspection Required Sidewelk Required L6ad LL&gL REQUIRED DEDICATION— FT Underground Wiring required 13 NAME METER SIZE LINE S��7 OF FWURES PRV REQUIRED YES13 NO C3 ADDRESS REMARKS OWNER/CONTRA9TPft RX z INAGE A PRESSURE REGULATORVALVE WO CITY ZIP TELEPHONE I SHALL BE INSTALLED NEAR :fiffl F1!F011rr9FT_ NAME 77 A f 7\ AI ICBL# ADDRESS /�_ f q a LICENSE NUMBER EXPIRATION DATE me D�A � 3 An !, hf�Ab ITY TAX ACCOUNT PARCEL NO. f.1f r SO' E INEERING REVIEWED BYpURSUAM ID DATE A�=A �Q UPC 605.2 uTfv= BE INSTALLED OqAft FIRE REVIEWED BY W cc 71 LWE AS IT ENTERS THE B Dag VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND B y Y 13YEs ONO 1$ POSTED L SEPA REVIEW HEIGHT C C _ I ... , OMPLETE . EXEMPT A__ WED . PROPOSED NEW RESIDENTIAL _WPLUMBING if MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE 0 REMODEL muLnFAmiLy SIGN xREPAIR 0 GRADING CYDS FENCE c] ( X FT) [] DEMOLISH 11 TANK OTHER 0 GARAGE CARPORT -1 RETAININGWALL 0 ROCKERY F RE SPRINKLER FIRE ALARM (TYPE ICKUSE, BUBLNESIA 0 .9%CTIVljY) EXPLAIN: NUMBER NUMBER OF CRITICAL OF 4 DWELLING AREAS STOR3 U NUMBER DESCRIBE WORK TO BE DONE I E % HEAT SOURCE GLAZING % LOT SLOP PLAN CHECK NO: VESTED DATE THIS PERurr AuirHoRims 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. PERMIT APPLICATION: ISODAYS PERMIT UMM 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 INDEMNIFX 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 CITVS ABILITY TO ENFORCE ANY ORD114ANCE PROVISION.' I I HEREBY ACKNOWLEDGE 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. siamATuRrm A3wNER Off AGENTIA - N I DATE SIGNED7 LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR I I z PARKING LOT AREA I PLANNING REVIEWED By DATE REO'D I PROVIDED I L/ 4:4 " Ua CHECKED BY ITYPE OF CONSTRUCTION CODE OCCUPANT GROUP 0 SPECIAL INSPECTION JAREA MCCUPANT REQUIRED [:] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FiINAL INSPECTION REOD I $ -_ - I Description FEE Description FEE Plan Check State Surcharge Building Permit I City Surcharge Plumbing TV--/ Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt. Due Recording Fee Receipt # !2 CALL FOR INSPECTION 771-0220 APPLICATION APPROVAL This application Is not a permit until signed by the Building Official or his/her Deputy: and Foes are paid, and receipt Is acknowledged in space provided. INURE 0 E _DkFIC!,ALS BIG C4(425) 1 A' I AA EASED BY 6AT9 ATTENTION I I EXT 1 3 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 k z 0 1 0 M M M 0 —10 0 C �c M M .0 0 In M M 8 0) 0 Fn C C9 0 z 0 M FIN.,-tL P&OJECT APPROVAL Al RM TO: a 3. RE -INSPECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL Date Signature I:tenV:bldg:fonns:ocaprvl 3/25/04 z 0 m =i 9 OM c MO 0 80 c �c m MZ co) 0 -n n m M 065 0 r- 0 M C co c ch M 0 Z X z z 9 0 m I RECEIVED FPERMITEXPIRES USE PF:PRAIT CITY OF EDMONDS ZONE NUMBEW�L,V"'t,) JOB 00 S IT CONSTRUCTION PERMIT APPLICATION ADDRESS OWNER NAMEINjEfF BUSINEP PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. I-, ��sj ") MAILING7"j, Zj:::dUd� V� CITY ITELEPHONE NAME ADDRESS CITY ZIP ITELEPHONE NAME ADDFLEBS TELEPL wc j1OP M z x0m 9"k- I �Y; LICENSE NUMBER EXPIRA ST; W 3 NEW RESIDENTIAL ADDITION COMMERCIAL REMODEL MULTIFAMILY GRADING OYDS REPAIR C 0 DEMOLISH TANK 0 GARAGE RETAINING WALL CARPORT ROCKERY r EXPLAIN: 11YPE lyr. !USAEffl0&,M CBL N LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP APPrOVGC3 RW Parrrdt Roquired S"m Use Parmk RWd EXISTING - PROPOSED inspoction PAMuked Sldewa* Requked REQUIRED DEDICATION- FT Unds(Wound Wkingcoquiered 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 1 I YES C3 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE PURSMNI in huou IT-30.11120 is SHALL BE INSTALLED NEAR ENGINEERING REVIEWED BY DATE PURSUANT TO UPC 605.2 FIRE REVIEWED BY X WXT17 SWIM Elul us SHAM BE W9rMJM ON TM Tn"I TV" V%T&10% 7 __�N_SPECTION BOND BY VARIANCE OR CUI SHORELINE OR ADB# REO'D POSTED L, 10YES 13NO $ EXEMPT ALLOWED , PROPO ALLOWED PROPOSED SEPA REVIEW 'T SIGN AREA I HEIGHT COMPLETE BED ]EXP t:5� PLUMBING/MECH 0 COMPLIANCE OR CHANGE OF USE 0 SIGN 0 FENCE ( X_ FT) 0 OTHER 0 F RE SPRINKLER FIRE ALARM NUM'� NUMBER OF CRITICAL 4-OF �� DWELLING AREAS STO U NUMBER .. I I DESCRIBE WORK TO BE DONE I HEAT SOURCE GLAZING % I LOT SLOPE % PLAN CHECK NO: I VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUSLIC DOMAIN (CURBS, SIDEWALKS, ORMEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 150DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 100 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESURS 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, ARISINO 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 CnYS ABILrfY TO ENFORCE ANY ORDINANCE PROVISION.' I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION OWEN 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 WORKMENS COMPENSATQNZSURANCE AND RCW 18.27. rol LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR z PARKING LOT AREA I PLANNING REVIEWED BY DATE REO'D I PROVIDED 1 06 CHECKED BY [TYPE SPECIAL INSPECTION JAREA REQUIRED [3 YES INSPECTIONS PER UBC 1 OCCUPANT GROUP OCCUPANT LOAD INSPECTION REaD $ 1 Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt. Du e Recording Fee Receipt# i CALL FOR INSPECTION 1A00% 771-0220 APPLICATION APPROVAL This application Is not a permit until signed by the Building Otlicial or histher Deputy: and Fees are paid, and receipt Is acknowledged In apace provided. SIGNqURE D*E m000) �k� Ell /0, ' (t EASED BY bATt ATTENTION EXT 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. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING z 0 M M 0 M M z M M 01 X z z 0 M