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20030931.pdfI DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION " ME1NAJ)9F BU IAG ADDRW Z P ITELEPHONE � /,A/ I gle) 7,_� 9 2 AAM 1),/ ADDRESS,f 15 CITY zip TELEPHONE �_�zt ["z, �,q #—� ffA-ME A ICBLN ZIP TELEPHONE ;4A. C. �ENU&MBER EXPIRATICN PROPERTY TAX ACCOUW PARCEL NO. 17.6 NEW RESIDENTIAL ADDITION 1, EvceMMERMAL REMODEL MULTIFAMILY REPAIR GRADING CYDS DEMOLISH TANK GARAGE CARPORT RETAININGWALL 0 ROCKERY (TYPE OF BUSINES$OR ACTIV EXP NUMBER NUMBER OF OF DWELLING STORIES UNITS � 0 1 1 PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB SUITE/APT# z -7 6d o - d / �, z- . -'j, 4-rL_A_.Lt� PLAT NAME/SUBDIVISION NO. I LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required Street Use Permit RI'd EXISTING - PROPOSED Inspection Required [3 Sidewalk Required 13 REQUIRED DEDICATION- FT UnderWound wiring required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES13 NO E3 15 REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE I ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE Lu cc IZA VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND BY REO'D POSTED SEPA REVIEW SIGN AREA 113YEs 13NOIS HEIGHT — COMPLETE , EXEMPT ALLOWED , PROPOSED ALLOWED PROPOSED EXP LOT COVERAGE REQUIRED fs IMIka t P FROPUbW % I M-rLUMBING/MECH ALLOWED PROPOSED FRONT SIDE REAR FRO14T URSIDE REAR COMPL ANCE OR z A I I CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED 13Y DATE U SIGN RECfD I PROVIDED EiFENCE ( _X FT) REMARKS OTHER FIRE SPRINKLER FIREtLARM CHECKED BY TYPEJO&CON iA� A/ M. A C961CAL AREAS SPECIAL INSPECT116N -REQUIRED AREA NUMBER REMARKS PROGRESS INSPECTIO1 -_ V , /. I - /'—, , OCCUPANT GROUP OCCUPANT LOAD V PER UBC IGO/FINAL INSPECTION REG'D $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHE:2� VESTED DATE SMechanical Plumbing THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. t Engr. Review PERMIT APPLJCATION: 180 DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 160 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 INTERE�i. AGREES TO INDEMNIFX 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 NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIF'4 WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due 0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Recording Fee Receipt # I HERE13Y 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. AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a permit until signed by the TION; AND IN DIOING 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 his/her Deputy: and Fees are paid, and receipt Is acknowledged In space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. OFFICIALS SIGNATUI�E DATE SIGNATUR ADEN DATE S71GD 1A9r_"% 1,4401 �QWNER 771-0220 D*E R E BED BY -&r4ENTI 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-171117 - YE"ON-INSPECT04 CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING 0 0/_ r5d DATE RECEIVED,., CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION "V;EIW OF BUSIPM eol��r L L 0/ CITY ADDRESS ? ci E DD SS to 0 LICENSE NUMBER nww� I L4Wd::j.& - - C �- -V- ZIP TELEPHONE yl ;&�g 1-113 zip e' ITELEP14ONE )A=-24 6na 4-9 -7 A ICBL:# 1A. ZIP TELEPHONE 'go EXPIRATION DATE 0 �) I PERMIT EXPIRES .4 USE PERMIT ZONE NUMBER(:�Wj—,�,2 JOB SUITE/APT# PLAT NAME/SUBDIVI LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7ESCP Appro"d RW PorrM Required Street ties Permit Wd EXISTING - PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION- FT urxiftwmm Wiringrequired METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 13 NO 1:1 z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE BY FIRE REVIEWED BY DATE DATE VARIANCE OR CLI SHORELINEORADBO I INSPECTION I BOND BY I REO'D POSTED 1111 Ir If d-04 A6Q -7 fT 3 2 LOD z I CA11ma- I 13YEs 13NO $ SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWE--D PROPOSED ALLOWED. P�OPOSED :5'9-0 7to 210 le I , , C2 EXP NEW RESIDENTIAL 201LUMBING MECH_ LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR ADDITION 0011150MM ERCIAL COMPLIANCE OR 0 OF CHANGE USE REMODEL PARKING LOT AREA PLANNING REVIEWED BY DATE MULTIFAMILY SIGN REQ'D PROVIDED 0 REPAIR GRADING FENCE CYDS X_Fn REMARKS Aft 11 DEMOLISH TANK OTHER -9 V1 a 1A rwl IN I oGARAGE [:-]I RETAININGWALL FIRE SPRINKLER -W Mr RUNE a Map CARPORT ROCKERY FIREtLARM (TYPE 0 USINES&OR ACTIYTTY) EXPWNJ CHECKED BY TYPE CODE OCCUPANT MOSTRUCTION GROUP NUMBER NUMBER OF Oil, C OF STORIES DWELLING UNITS 41 rICAL AS VREAS NUMBER SPECIAL INSPECTION JAREA LOAD REQUIRED D= TO B)DONE VA I/ REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D V A V VALUATION Description f-EE Description FEE Plan Check State Surcharge i HEAT SOURCE i % LOT SLOPE % Building Permit City Surcharge PLANCH!M ,—e. VESTED DATE S7'4* Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 13E DONE OIt'PRiVATE PROPEM ONLY. ANYCONSTRUCTION ON THE PUBUC - s Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAX&.11111ARQUEES, ETC.) WILL REQUIRE SEPARATE PERUWA1111% Engr. Review PERMIT APPLICATION: 100DAYS PERMIT UUM I YEAR - PROVIDED WORK 16 STARTED WITHIN IGO DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'ArPLICANT; 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 NATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT HE Landscape Insp. Total Amt. Due 6 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. - Recording Fee Receipt # 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 Building Official or his/her Deputy: and Fees are paid, an IN VIOLATION OF THE LA13OR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknovirledged In space provided. WORKMENS COMPENSATION INkURANCE AND RCW 18.27. OFFICIALS &IGNAT DATE SIGNATU�NOWNEFI ?KAGE DATE SIGOD '425)' 771-0220 R BED BY DVE M 1333 rT IS UNLAWFUL TO'USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGFI�AL-_FILE - YELLOW -INS CT CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD-ASSESSOn 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING