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20030951.pdfDATE REZ PERMIT EXPIRES (-0�210�r USE PERMIT CITY OF EDMONDS ZONE NUMBER soz'-5- JOB q5_f, p SUITEIAPT# CONSTRUCTION PERMIT APPLICATION ADDnESS.2 Lj() N NAMEINAME OF BUSINESS v- +- ) om V-) S 0 n MAILING ADDRESS '2- 6 t ' ":q -h% . I L,(-) CITY ZIP TELEPHONE fr/AW ci� m&-NAs qu— NAME ADDRESS CITY ZIP I TELEPHONE PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCIR Appemed MY Permit Requ:ed Suelm UB* Perm R*q'd EXISTING — PROPOSED— inspection Required Sidewalk Required REQUIRED DEDICATION— FT I UndwWmrid 1 wiring r 13 METER SIZE LINE SIZE NO. OF FIXTUREST—PRV REQUIRED YES 13 NO C3 z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE NAME CBL# Wks"-- E"' rg� V 1�� C) ADDRESS � S�- "Q()c CITY ZIP TELEPHONE STATE LICENSE NUMBER EXP'7 TION DATE CHEC El -7 100 q PROPERTY TAX ACCOUNT PARCEL NO. 509!ju- 4 1 D 0 0 6 (5 ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE LVARIANCEORCU SHORELINE OR ADBI i INSPECTION PBOND BY REQ'D OSTED 000, E3YEs ONO $ S SE EPA REVIEW SIGN AREA HE143HT C COMPLE OMPLETE . EXEMPT ALLOWED . PROPOSED I ALLOWED . PROPOSED NEW RESIDENTIAL PLUMBING / MECH LOT COVERAGE LOT ( LLOWED ALLOWED PROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE REAR PROPOSED SETBACKS (FT) FRONT LIR SIDE REAR I I ADDITION COMMERCIAL COMPLIANCE OR El CHANGE OF USE REMODEL munirAmii:y SIGN PARKING R D PROVIDED LOT AREA PLANNING REVIEWED BY DATE IL REPAIR GRADING CYDS FENCE X_ FT) kECf REMARKS DEMOLISH TANK 0 OTHER GARAGE CARPORT RETAINING WALL ROCKERY F RE SPRINKLER FIRE ALARM R (TYPE OF USE BU EBB OR ACTIVITY) EXPLAIN: 'S itffp NUMBER NUMBER OF RITICAL OF DWELLING AREAS STORIES UNITS DESCRIBE WORK TO BE DONE 000 K-*-M :1 . I IV) _HQAWAQ cicsle� I SME GLAZING % LOT SLOPE % 9 n I 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 PUBUC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMITAPPILICATION: 160DAYS PERMIT UMM I YEAR - PROVIDED WORK 15 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 NOR LIMIT IN ANY WAY THE CRYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." 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 EMPUDYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATIONJUBtYlANCE AND RCW 18.27. CHECKED BY ITYPEJ=N SPECIAL INSPECTION JAREA REQUIRED [] YES REMARKS PROGRESS INSPECTIONS PER UBC s �3-2_t-�,— DescrIpUlialn Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Fire Inspection Landscapeinsp. Recording Fee 0' CALL R INSPEC IQ=% % ul 771-OZ AtTENTION 333 FEE OCCUPANT GROUP OCCUPANT LOAD INSPECTION REGI'D A v!2 Description State Surcharge City Surcharge FEE Plan Chk. Deposit Receipt # Total Amt. Due Receipt # 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. BY DATE 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 a z 0 M :q:% 65 � M. M 0 -40 0 r 3� x M 10 C> z 0 In ;1 1 M M C.) V—) 8 Fn C2 x MO z 0 11 0 M I I . , I F I ,Owl& .1 IDATE RECEIVED LO /,/5/ V I ��l PIRES PERMIT EX USE PERMIT CITY OF EDMONDS ZONE NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUFMAPT# _Q_WNER NAMEA"E OF SUSIIJESS ADDRESS P .f,�C) b PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. e K_�_ ) MAILING ADDRESS LID FEE $ TESCP ApPrOved PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Pam* RGWVW r? street Use Pens RW TELEPHONE EXISTING — PROPOSED tropeedon Required CITY ZIP smawast neww F_L� q REQUIRED DEDICATION— Fr unftrwmw 96W 120&5q�oSU_3�2, WkMg roqtAred NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED II YES 13 NO 13 z ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLfDRAINAGE CITY ZIP TELEPHONE NAME WA-s�4 qwn CSLN ENGINEERING REVIEWED BY DATE ADDRESS FIRE REVIEWED BY DATE CITY ZIP TELEPHONE � I I-" 6-\t� 2-92-O&C-) 71 1E VARIANCE OR cu SHORELINE OR ADD# INSPECTION BOND STATE LICENSE NUMBER EXP TE CHE _qHECXED BY 'r q REO'D POSTED 13YEs ONO 1 "V&SHIESI-110011 _' $ SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED C>o��JW/ 000615-00 , , , EXP LOT COVERAGE REQUIRED, SETBACK$ (Fr.) PROPOSED S;;ac-Ks (Fr.) NEW PLUMBING / MECH ALLOWED PROPOSED FRONT , SIDE REAR FRONT LJR SIDE REAR k RESIDENTIAL 0 ADDITION 0 COMMERCIAL COMPLIANCE OR CHANGE OF USE I PARKING LOT AREA PLANNING REVIEWED BY DATE 0 REMODEL MULTIFAMILY SIGN REQ`13 PROVIDED I I I 0 REPAIR GRADING CYDS FENCE ( _ X_FT) REMARKS 0 DEMOLISH TANK o OTHER JIM r 119 1 I ARAGE o RETAININGWALL o FIRE SPRINKLER WWGIIIIIIIIIII 0 maw o,G CARPORT ROCKERY FIRE ALARM 0 crYPE OF USE, BUSIMESS OR ACTIVTM EXPLAIN: CHECKED BY OCCUPANT ITYPE GROUP NUMBER NUMBER OF CRITICAL OF DWELLING AREAS SPECIAL INSPECTION OCCUPANT STORIES UNITS NUMBER JAREA REQUIRED [3 YES LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RECVD V) Au ) %.f k 1/— 1149 AN :;p &-U T :, ( �� wabm ow I jC;,t7:)j ' r - . r n j:P ____7 _ , Pc-ly IRA, MAPML- -1 )Y--. VALUAnON V) +t3l (W,4,�Lj pS s DescrIption FEE Description FEE Ry lr_�_ Plan Check State Surcharge SOUP" G r LAZING % LOT SLOPE % Building Permit City Surcharge .PLAN C:HECK NO: VESTED DATE Plumbing Pin -v—, Mechanical THIS POWIT AUTHORMES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTV ONOt ANY CONSTRUCTION ON THE PUBLIC Grading S 3 DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 1: SEPARATE PERMISSION. Engr. Review 2 5 PiEnurrAppuc=om ieoDAys PERMIT UMM I YEM - PROVIDED WORK IS STARTED WITHIN 100 DAYS Engr. Inspection I SEE RACK OF PINK PERMIT FOR MORE INFORMATION 1APPUCANT, ON SEKALF 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, EMPLOVEES. AND AGENTS FROM ANY AND Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ANSING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapeinsp. Total Amt. Due DEEMED TO UODIFK WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CHYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' # Recording Fee Receipt - _7? _-z 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. 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 IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO OR INSPECTI BUHdIng omcW or Wsflw Deputy: and Foes are paid, and receipt Is aduurMedged In space provided. WORKMENS COMPENSATIO�PNSI:IlRANCE AND RCW 18.27. IALS BIG URE D TE,, SQMVM (O"ER AGEWV DATf IGIED (425) L 771-0 DATE' 6EASED BY AW FNT'ION 333 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 a z 0 0 m -1 _n 7A � am C mo 0 -40 0 r 3� C m 10 z 0 TI m M 75 rn 0) to M C) z 0) z 9 0 m