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20030953.pdfDATE RECEIVED PERMIT EXPIRES USE PERMIT CITY OF EDMONDS ZONE NUMBER JOB SUITE/APT# CONSTRUCTION PERMIT APPLICATION -.Ca rk A �_115 _� 7-j (- OWWR NAMEINAME 9F BUSINgSS Koberf mc Aide, PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAIL NG ADDRESS LID FEE S TESCP Approved -2 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW PerrrA Requited Street Use Permit Req'd EXISTING — PROPOSED Inspection Required q NAME ADDRESS CITY ZIP NAME BL# W �6 h C ADDRESS ZIP TELEPHO14E 2-4r e 2 thdo STATE LICENSE NUMBER EXRIRATLQU DATE C ED ,!y LVA-SH I e�5 q-1 10131 2, PROPERTY TAX ACCOUNT PARCEL NO. oe>'s 55 Llbonnc-S'6n 0 NEW X�RESIDENTIAL KPLUMSING/MECH ADDITION 0 COMMERCIAL COMPLIANCE OR 13 CHANGE OF USE REMODEL 11 MULTIFAMILY SIGN GRADING FENCE REPAIR 11 CYDS ( _ X_FT) 0 DEMOLISH 1:1 TANK 0 OTHER EiGARAGE [:] RETAINING WALL FIRE SPRINKLER CARPORT ROCKERY FIREALARM (TYPE OF US BUSINP3 OR ACTIVITY) EXPLAIN: NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE (\_�[ �__ Z-- /400 '-D (191 Q:� - ti,&�h 43 602 b� roat4e�) I I n5 Q 6 ro b ML I'L Q rCb K-'�- dr) 0_�v A. Yk ( (_� HEAT,TIE GLAZING % LOT SLOPE % 0 PLAN lbHECK NO: VESTED DATE THIS PERMIT AUTHORMES ONLY THE WORK NOTED. THIS PERUJT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUSUC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE PERMIT APPUCATION: 180DAYS PERMIT LIMM I YEAR - PROVIDED WORVC IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR PADRE 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 CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." 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 g04 OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATIONJMURAINCE AND RCW 18,27. DATE SIqNED 1-41 --� /63 REQUIRED DEDICATION N 13 z YES 01 =-NGIWAMMI WO By DATE unbeated space& INIC 815.1.7 FIRE DATE us Ir 11: VARIANCE OR fM.1ETfSrTA2j PRHTON BOND lag' POSTED RL —99 Aftacoln nv mw 1 9 EIS SEPARRdW11111111116- 0 MJ4fA_W§%—' HEIGHT COMPLETE - EY.EMWmvJ&tw~Doimm(isEMal-TALLOWED . PROPOSED LLOT COVERAGE MM811RMrbTTBACKS_(FT) I PROPOSED SETBACKS (Fr.) I ALLOWED PROPOSED I FRONT SIDE REAR FRONT L/R SIDE REAR LOWED P PARKING LOT AREA I PLANNING REVIEWED BY DATE REQ`D PROVIDED M REMARKS CHECKED BY ITYPE OFJII�M I CQDE occupmjr� GROUP 9_7 SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 106/FINAL INSPECTION REG'D, VALUAnON s ri, 2 no :711 Description Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Fire Inspection Landscape Insp. Recording Fee INSPECTION 1A0 x425) 771-0220 EXT 13ii" FEE Descriptlon 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 ding Official or histher Deputy: and Foes are paid, and receipt Is acknowledged in space providell N:I S SIGN W 4) kSED BY bATj IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTILk A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFIA,��'--' 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 I= I E12D PERMIT EXPIRES :� USE PERMIT CITY OF EDMONDS ZONE NUMBER ��Oe 5r—b �r-A JOB SUITE/APT# CONSTRUCTION PERMIT APPLICATION ADDRESS OWUR NAMEINAI�E 9F SUSINfSS r-) 7 , k I PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. Rob.�rr mc MAILING ADDRESS LID FEE S PIDATE REC TESCP APPrDVW PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW PefffA Rewir -2- 1 S-$ S streft use Peffnu%qA ZI EXISTING — PROPOSED InspwW Raquired D-1 - P TELEPHONE SidirwaMnRequired qREQUIRED DEDICATION— FT ur4wwound 'NAME METER SIZE LINE SIZE FN( wwg m0red I YESW NO 13 ADDRESS CITY ZIP ITELEPHONE NAME Wjk-Sh BL# ADDRESS cv- Vx Kiz., zip TELEPHONE 12-0(.0 _7 d:) STATE LICENSE NUMBER EXFIIRATH�B DATE Y r Wk-s" 1 -15 PROPERTY TAX ACCj3UNT PARCEL NO. 0 NEW kPIESIDENTIAL KPLUMBING MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MUL11FAMILY SIGN GRADING REPAIR CYDS FENCE ( _ X_FT) DEMOLISH TANK o OTHER [3 GARAGE Ei RETAINING WALL CARPORT ROCKERY FIRE SPRINKLER FIRE ALARM (TYPE OF UW- lEkUSINF&S OR ACTIVTM EXPLAIN: NUMBER NUMBER OF CRITICAL OF DWELLING AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE 14c, b (V I nq C*6 6 M n IQ "".- C;W K-W —(V-s -1HEAT URGE GLAZING % LOT SLOPE % 043- - I I — PLAN CHECK NO: I VESTED DATE THIS PERMIT AUTHORUMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURSS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. PFRUITAPPLICATION: 160DAYS PERMIT ILIMIR I YEAR - PROVIDED WORK IS STARTED WITHIN 160 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 CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' 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 C17Y AND STATE LAWS REGULATING CONSTRUC- TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR 903* OF THE STATE OF WASHINGTON RELATING TO WORKMEN1 COMPENSATIONAMUR#NCE AND RCW 18.27. DATE SI?NED DATE FIRE REOW-57-- Vent ConneetOrS DATE 1,ype B _or L stn'011suces Is SEPA4wmw" SIGN AREA HEIGHT COMPLETE . EXEM7PT' ALLOWED . PROPOSED I ALLOWED , PROPOSED LOT COVERAGE REQUIRED SETBACKS (FT.) I PROPOSED sETaAcKs (Fr.) ALLOWED PROPOSED FRONT SIDE REAR RONT URSIDE REAR PARKING IT DATE 5 40W M"f emit 06 REOD I PROMME.411sm an Aba�. CHECKED BY ITYPE OF T U N CQDE oucurArp, I GROUP "F SPECIAL INSPECTION AREA OCCUPANT REQUIRED [3 Yr LOAD REMARKS I PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REG'D $ r? Description Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Fire Inspection Landscapelnsp. Recording Fee /-CALL ti INSPECTION 1111135) 771-0220 EXT 13i3 FEE Descrilptlan State Surcharge City Surcharge FEE Plan Chk. Deposit Receipt # Total Amt. Due Receipt # Ll��260 APPLICATION APPROVAL This application Is not a permit until signed by the ding Official or his/her Deputy: and Fees are paid, and receipt Is acknovAedged in space provlde�. I BY IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIk - 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 C M OC M C 2 0 M M Fn C 0 z 0 M