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20030952.pdfI DATE RECEIVED /ep— -0.5 !2 - 1 1 FP ERMIT EXPIRES ff . USE 101=0111,111IT --I CITY OF EDMONDS ZONE NUMBER Ao"'('):�— JOB SLIITE/APT# CONSTRUCTION PERMIT APPLICATION ADDRESS 119 6e, C1 2)3 OWNER NAMEINAME OF BUSINESS SH I 12-Le7q <�4�ck r S PLAT NAMEISUBDIVISION N T NO. LID NO. MAILING ADDRESS 0-7 LID FEE $ TESCP Wpr0v*d jjWq 9S3 rd PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Parn9t Requif6d J" Street Use Permh Req'd CITY EX STING InspectlonRaquired ZIP C1 L tCTL -'�52 L42-5 ;AME ADDRESS CITY ZIP ITELEPHONE NCIS V JCBLN ADDRESS u) CIA ZIP TELEPHONE STATE LICENSE NUMBER EXPIfIATION DATE q/2-/o5- MHEC D BY WA-fH-(Q2216& PROPERTY TAX ACCOUNT PARCEL NO VIC U NEW kRESIDENTIAL PLUMBING / MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULnFAMILY SIGN REPAIR GRADING Cyos FENCE ( X— FT) DEMOLISH 13 TANK OTHER [3 GARAGE -1 RETAININGWALL CARPORT 1:1 ROCKERY FIRE SPRINKLER FIREALARM (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: NUMBER NUMBER OF CRITICAL OF WELLING AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE —1yVS+ir'd1 -P'(P 12L S -R4ta� Kt+-r tc 4T S RCE GLAZING % LOT SLOPE % CHECK NO: VESTED DATE THIS PERUrr AUTHORIZES 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: ISO DAYS PERMIT LIMIr I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE 13ACK 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 �DIEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CIIYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - I HERE13Y 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 Wq"U'HORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE OR COD'6 OF THE STATE OF WASHINGTON RELATING TO WORKMEWSCOMPENS�b?N INSUFPCE AND RCW 18.27. SIGUAT)IRE (OWN A N-11f DAT PIGNIPD L C't"� j Z70, 1 Xe3 REQUIRED AWS 'I --PRJ REQUIRED 0 jeS YES NO 13 z 1 z CONTROL/DRAINAGE gardless of whether the water open or closea, expansion_ fal 106 CW9. ECDC 19-39-020 (C) FIRE REVIEWED BY DATE cc V6 re7I Cj; 0 dl:IOR1f=T0FWAPr-WftSION7i, BOND I I OSTED u]red3ituel-b"*,."iljllg�d"N"SlsimI "5� CO L�Wr S EXP %Wltz A'a. 1�1) '.PRW0`PO`s`ED ..' ALLOWED OPOSED LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) ALLOWEGASCpVE TEMOT Rft FRONT L/R SIDE REAR r-n nip M611 LUI MIT ku I Is DATE RECID WMITS By SHhLL NOT I REMARKS CHECKED BY SPECIAL INSPECTION REQUIRED 0 YES OCCUPANT,q, GROUP OCCUPANT LOAD IREMARKS I PROGRESS INSPECTIONS PFA UBC 1106/FINAL INSPECTION REG'D § R VALUATION $ qladslq — L Description FEE Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Fire Inspection Landscape Insp. Recording CALL R INSPECTII (425) ( 771 -odz6 AYTENTION 0 \, —EXr 1333 Description State Surcharge City Surcharge FEE Plan Chk. Deposit Receipt # Total Amt. Due Receipt # APPLICATION APPROVAL This applicallon Is not a permit until signed by the ding Olficlall or his/her Deputy: and Fees are paid, and receipt Is agknowlodged In space provided, BY 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 am C: m 8C �2 C m 10 R 8 0 'TI n mm 0 C K M z 0 m 11 %voll 4W �1., "4 k YDATE RECEIVED jr"P,, PERMIT EXPIRES 0 USE PERMIT CITY OF EDMONDS ZONE NUMBER ��002 �, JOB SUITE/APT# CONSTRUCTION PERMIT AOPLICATION ADDRESS 1 19 t)6 C1 R)-�) r 1 %c— OWNER NAMEINAME OF BUSINESS SH11P—Le:q '��4—ea r r) S PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS LID FEE S TESCP APPMW PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP R*qUired Lo I ms! %. Perm4 Ftoq'd z5v TELEPHONE fa C1 EZIP14) q215- &M NAME ADDRESS CITY ZIP ITELEPHONE COL N "CAI%k r-q Ll ��4 V ADDRESS 2—VXD in k Cj t..� ZIP TELEPHONE 4q, / rzzXp 2-92- Y'76 STATE LICENSE NUMBER EXPIRATION DATE HEC 0 BY Wks-wQct-710L 'WiL05- rz�; PROPERTY TAX ACCOUNT PARCEL NO S I U_ 00L/ �x 56 "FT_Lq�j 0 NEW kFIESIDENTIAL MBI PLUMBING/MECH . nr: ADDITION o COMPLIANCE 08 COMMERCIAL CHANGE OF USE 0 REMODEL MULTIFAMILY SIGN 0, REPAIR GRADING CYDS FENCE X FTi DEMOLISH TANK 0 OTHER GARAGE CARPORT RETAINING WALL ROCKERY FIRE SPRINKLER FIRE ALARM OWE OF USE. SUS17IMS OR ACTFV" EXPLAIN: NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE CKS. is .*VMT�S RCE G1,112ING % LOT SLOPE % 14T _ _ I PLAN CHECK NO: I VESTED DATE THIS PERMIT AUTHORIZES ONLV THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRNEWAYS, UARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERIArrAPPLICATIOlt 180DAVS PERMrf ILIMM 1 YEAR - PROVIDED WORK IS STARMED 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 FROWANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT $HALL NOT BE 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.' I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION GIVEN 6 CORRE" 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 WORKVKHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE L58bR COM OF THE STATE OF WASHINGTON RELATING TO WORKMERS COMPENSA/.0N INSLIFINCE AND RCW 18.27. 7 RE (OWN M7A DATEqI 0 t�L: �Ik � A I GN73 k3 M E�*Wor &I PRIIF REQUIRED No E3 RE Im—S OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE �e_awd ICU of whether the water.qdOm is open or doW, 19)(P8111510n MF= tuc -A-- NGINE 11 hot irr LDATE Code. ECDC 19-30-020 W FIRE R DATE CU Je B ED EXP LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE HEAR FRONT LIRSIDE REAR I z PARKING OT WE DATE REC013 PROVID43LL Tt51 R REMARKS I" - ___ I CHECKED BY ITYPE =C N CjE7 OCCUPANT,0 A CK C GRO S SPECIAL INSPECTION JAREA OCCUPANT LOAD rREQUIRED [j YES 3UII R M EMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD VALUATION I s '5 Cat .541, Description Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Fire.inspection Landscapeinsp. Recordingffle-- CALL (425) 771-92, cWTI, EX 1 13 FEE r_441i,�, 11 Description State Surcharge City Surcharge FEE Plan Chk. Deposit Receipt # Total Amt. Due )(257 Receipt # Qa APPLICATION APPROVAL This application is not a permit until signed by the ding Official or Welher Deputy: and Fees are paid, and receipt Is a;knowledged In space provideq f BY IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I ./- I A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW- INSPECTOR VP&I CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR Lth GREEN - ACCOUNTING 7 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES 9 z 0 M M IT11 C. z M M ,0 9z 0 _TI M M D_ o Cft 0 Fn C z 0 4 0 ITI