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20030936.pdfM DATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS -r+-7- 15 MAILING ADDRESS qq CITY ZIP ____ITELEPHONE NAME ADDRESS CITY ZIP ITELEPHONE NAME RT1_fW1> ADDRESS CITY ZIP TELEPHONE &P I aft- IWOL 90&-7?fP-0qJLffl STATE LICENSE NUMBER EXPIRATION DATE I GHECKED BY. PROPERTY TAX ACCOUNT PARCEL NO. PL-1 NEW RESIDENTIAL 7 ADDMON COMMERCIAl REMODEL MULTIFAMILY REPAIR GRADING CYDS DEMOLISH TANK oGARAGE RETAININGWALL CARPORT ROCKERY UWE OF USE, BUSINES9 OR ACTIVITY) EXPLAIN: 60mang—Q "I NUMBER NUMBER OF OF DW LUNG STORIES a UNIETS D ,Wj1BE WORK To BE DONE HEAT SOURCE GLAZING % 01 AU 9%U=nV PLUMBING / MECH COMPLIANCE OR CHANGE OF USE SIGN o FENCE x FT) OjnR r.e < Ajf 10, FIRE SPRINKLEFF FIRE ALARM CRITICAL AREAS NUMBER LOT SLOPE % VESTED DATE PERMIT EXPIRES USE PERMIT ZONE d- NUMBER JOB SUITE/APT# ADD2� PLAT NAMEISUBDIVISION NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved MY Pairrilt Requited Street Use Parmit RWd EXISTING — PROPOSED inspection Required Sidewalk Required REQUIRED DEDICATION— FT Underwound Wiring required METER SIZE LINE SIZE OF FIXTURES PRV REQUIRED YES 13 NO 13 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY ATE Ld 'C�? VARIANCE OR CU SHORELINEORADB# INSPECTION BOND REO'D POSTED 1$ 1E3YEs 13NO SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOS ED ALLOWED PROPOSED EXP , , , LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR FRO NT UR SIDE REAR PARKING REO'D I PROVIDED I LOT AREA I- PLANNING REVIEWED BY DATE REMARKS CHECKED BY PE OF CONSTRUCTION I CODE GROUP A-3 SPECIAL INSPECTION JAREA__ OCCUPANT REQUIRED LOAD REMARKS PRGGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D Description FEE DescriptIon FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Mechanical THIS PERMIT AUTHOREMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. A14Y CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, E To.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 180 DAYS PERMIT UMIr I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit ;A NPI=RE T AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, "iHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND I Fire Inspect on A% 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 MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due NOR LIMIT IN ANY WAY THE CRYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee 1 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 Foes are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 10.27. FI IA - IG AT DATf qIG TURE (OWNER OR.A� DATI SIGNED 1425) 77%1-0220 __76ATE RE ED BY ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL jzj/ I/ A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - (NSPECIDPI CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING il 197TV A T Dun Tvrlrr A UDDInv A W. 1pnDW4 z 0 q 0 m "A :6 us :0 0 M c MO 0 80 c M MZ m M 055 0 r- 0 M C M 0 Z r- z z 9 0 m I I to 4 I�- It, I , It I .......... DATE RECEIVED EPERMIT EXPIRES USE PERMIT CITY OF EDMONDS ZONE NUMBER JOB SUITWAPT# CONSTRUCTION PERMIT APPLICATION ADDR::2 / OWNER NAMEINME OF BUSINESS 2�Cr// Z PLAT NAMEISUBDIVISION NO. LOT N4. LID NO. L22rFn it ro r-H— MAILING ADDRESS LID FEE 4 TESCP Apprfted PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW PernVt R*WW*d IOLLA q _Sj -c-0 lo-:; $net Use Penn* RUN CITY It EXISTING — PROPOSED kupeclMn W&ed ZIP ELEPHONE Slcfews& RaWked REQUIRED DEDICATION— FT Urodxwound wwgrequired NAME METER SIZE LINE SIZE I NO. OF FIXTIJRES PRV REQUIRED YES 13 NO 13 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE Iiwi CITY ZIP TELEPHONE ARIM NAME CBL[ ENGINEERING REVIEWED BY DATE ADDRESS &I OD 'BY Z FIRE REVIEWED DATE CITY TELEPHONE ZIP V6 VV . , - VARIANCE OR CU SHORELINE OR ADS# FINSPECTION BOND STATE LICENSE NUMBER EXPIRATION DATE REO'D POSTED 1,3Y ES [3NO1$ 9THODD-X 02'�DL, 19 Q-2, Q SEPA REVIEW SIGN AREA HEIGHT PROPEFRY TAX ACCOUNT PARCEL NO. EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED !j00 , EL)20 _30 EXP IT11 M -4 0 LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) NEW RESIDENTIAL PLUMBING MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR COMPUANCE OR ADDITION COMMERCIAL I t CHANGE OF USE BY DATE 0 31 M PARKING LOT AREA PLANNING REVIEWED 0 REMODEL muLnFAmiLy REGID I PROVID SIGN ED M 10 GRADING FENCE REPAIR CYDS X FT) REMARKS C z > OPER 0 DEMOLISH TANK [3 GARAGE [:3 RETAININGWALL 0 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM ME OF USE. BUSINES4 OR ACTIV9Y) EXPLAIN: 10 -n CHECKED BY PE OF CONSTRUCTION CODE OCCUPANT (Pr)-o-Wee 1 292n t (CL I GROUP MITI NUMBER Num BER OF 0 1 CRITICAL SPECIAL IN§PECTION AREA OCCUPANT OF WELLING AREAS j NUMBER LOAD § rn STORIES UNITS REQUIRED [3 1 .1. YES DESCRI81 To BE DONE C: ic REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RE(WD. 15�151:nn 1A _�Jmz- M �2 0 VALUATION ca Z, 0 M Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permft City Surcharge PLAN CHEC VESTED DATE Plumbing Mechanical THIS PEMIT AUTHQRCMS r WORK NOTEM THIS PERMIT COVERS WORK TO CONSTRUCTION ON THE PUBLIC BE DOME ON PWATE PROP ONLX AM Grading DOMAIN (CUIPAS, SIDEWALKS, DRIVIEVAYS. MARQUEES, ETC.) VALL REQUIRE '02PARATEVERMISSION., PER11111TAPPLICATION: 180DAYS PERMIT UMM I YVAN - PROVIDED WORK IS STARTED WITHIN 100 DAYS lnann�flnn BEE BACK OF PINK PERMIT FOR MORE INFORMATION 9j. 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SLI'CCESQRS - Review Fl0e. 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 CL4VM8 FOR DAMAGES OF WHATEVER MATURE, ARISING DIRECTLY OR INDIRECTLY OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE FROM jrHE ISSUANCE DEr JOPTO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due NOR Ljff IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee Receipt # 2f I HERESi ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN 10 CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORMED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This applIcation Is not a perrrAt unto signed by the TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLJ�TION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building OMeW or Waftw Deputy: and Fees are paid, and receipt is acknovvledgod In space pravided. WORKMENS COMPENSATION INSURANCE AND RCW 16.27. ; 1 IA to TURE (OWNER OR Q3 1A I-WAII 35) K;'_ 77 -0220 1 By __AMTE AIN ATTENTION M 1333 A.',4124 IT IS UNLAWFULTo USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL z &�r V A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL, - FILE YEI LON - 4-ppc(nR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN -ACCOUNTING