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20030959.pdfDATE RECEIVED 0 [PERMIT EXPIRE Cily OF EDMONDS USE PERMIT ZONE 0 NUMBER* CONSTRUCTION PERMIT APPLICATION JOB Sul ADDRESS 0101 T4 2: OWNER NAME/NAME OF BUSINESS ZQI PLAT NAME/SUBDIVISION NO. T NO. LID NO. 7 15 WAILING ADDRES6- - - - I LID FEE $ TESCP APPOVIC! PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Perm" Requited Street Use Partnit RKd CITY ZIP TELEPHONE EXISTING - PROPOSED Inspection Requited Sidewalk Requited REQUIRED DEDICATION- FT UnderWound wiring required [3 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 01 �e id YES [3 NO C3 _I I E ADDRE68 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ZIP 13WE NAME Cal. 11 Aa YA& Ty ENGINEERING REVIEWED BY DATE cc ADDRESS CITY ZIP TELEPHqNE FIRE REVIEWED BY DATE uA cc Ir VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND STATEi 6CENSE NUMBER EXPIRATION DATE REQ'D POSTED 113YES' 13NO $ SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOURT PARCEL NO. ...... EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED 5 z , E_X_P VNEW RESIDENTIAL PLUMBING/MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) FRONT SIDE REAR FRONT L/RSIDE REAR ALLOWED PROPOSED COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE K z PARKING LOT AREA PLANNING REVIEWED 13Y DATE 06 REMODEL MULTIFAMILY SIGN RE OVIDED GRADING [3 FENCE X REPAIR CYDS FT) REMARKS 'So -/OTHER DEMOLISH [3 TANK GARAGE o RETAININGWALL 0 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM UWE OF USE, BUSINESS ACTIVITY) EXPLAIN: CHECKED BY TYPE OF CpNqTRUCTION OCCUPANT GROUP VN NUMBI!4 NUMBER OF f IV CRITICAL OF DWELLING AREAS SPECIAL INSPECTION OCCUPANT STORIES UNITS NUMBER JAREA REQUIRED [] YES LOAD BE D90e REMARKS PROGRESS INSPECTIONS PER USC 108/FINAL INSPECTION REG VALUATION $ Description FEE Description FEE Plan Check State Surcharge GLAZING % HEAT SOURCE LOT SLOPE % Building Permit City Surcharge PLAN CH 0 VESTED DATE Plumbing Mechanical THIS PERMIT AUTHO�[MS ONLY THE WORK NOTED. THIS PEnmrr COVERS WORK TO t: BE DONE ON PRWATE PROPEFITY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 3 -6. ETC.) WILL REQUIRE DOmAiN (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEE SEPARATE PERMISSION. Engr. Review pERMITAPPUCATION: ISO DAYS IL PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 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 INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection /00-- 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 Landscapelnsp. Total Amt. Due DEEM 0 TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE C[1YS 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 CORRECT6. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AG CRY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a permit until signed by the TION; AND IN DOI G THE RK 01 ED THEREBY, NO PERSON WILL BE EMPLOYED NG IN VIOLATION OF THE JAWiWo�_�DEICF HE STATE OF WASHINGTON RELATING TO FOR IN PECTION S Building Offlclal or his/her Deputy: and Fees are paid, and receipt is acknowledged In space provided. WORKMEWS CoMPE!PIATION INSURANCE D RCW 18.27. DATE, DATE SIGNED IA2 %.-5 7710220 -RELEASEQ ATTENfION ZCUPY EXT 1333 BY .0 IT IS UNLAWFUL TO USE O� A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAI,--FA YELLJ'IjS/EfCTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK-OW14ER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING SNOHOMISH HEALTH DISTRICT December 19, 2003 ENVIRONMENTAL HEALTH DIVISION 3020 Rucker Avenue, Suite 104 Everett, WA 98201-3900 425.339.5250 FAX: 425.339.5254 Deaf/Hard of Hearing: 425.339.5252 (TTY) Healthy Lifestyles, Healthy Communities RECEIVED Dear Mr. Cross: The additional information submitted in response to the letter of September 24, 2003 has been received and has been reviewed with the Rules and Re2ulations of the State Board of -Health, and with the policies of the Snohomish Health District. With the addition of the following, the plans are approved. 1 . All food service equipment must be listed by the National Sanitation Foundation (NSF) for its intended use. The Aroma rice cooker, (models # ARC -1024E and #ARC-1033E), were not found in the current NSF if listings. Intertek Testing Services (ETL) lists these units as being for household use. These units must be r eplac ed with NSF or equivalent listed equipment or documentation must be submitted which demonstrates NSF equivalency. Manufacturer names and model numbers for replacement units must be subn-dtted prior to the pre -operational inspection. Originally submitted manufacturer names and model numbers should be rechecked to assure the information submitted is accurate. 2. Plumbing must meet state and local codes. ire codes. 3. The ventilation system shall be installed and operated to meet applicable building, mechanical, and fi 4. Note: This facility has a limited amount of refrigeration equipment. No advanced preparation of foods that require cooling will be allowed unless a walk-in refrigerator is installed or other Health District approved cooling method is in place. A pre -operational inspection is required prior to opening for business. At the time of inspection the the food service establishment must be complete and all equipment must be in place. Incomplete construction of construction may result in a $143.00 reinspection fee. Contact the Food Program office a minimum of one J�. week in advance to schedule an appointment. This will ensure compliance with the Rules and Regulations -of Qf Holth for Food Service Sanitation. If there are any changes or additions to the approved layout or equipment, the Snohomish Health District must be notified. Please contact me if you have any questions. My office number is 425.D9.5250 Sinc Uely 12 ' PP *ealtlhi 0 Ro ert A. Ho nv on nta Specialist E Tz' ir m nvironmenta R dmb c :A Cl .ty of Edmonds Building Department Trung Nguyen, Owner 111IIIIIIIN �401 !141 Idu FINAL PROJECT APPROVAL FORM z 9 0 m =iii 65 ;� mo 0 80 c -4 r. X M MZ 10 c 0 -n n --I m m 0 0 0 M C 0) rl CA M 0 Z M z 0) z 0 m ocapml.doc.I:L-n�.-bldg:fOMSJO/o I I I 11 CITY 00 E'DMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS NO ADDRESS CITY — It /I ZIP NAME Ap I?L/a ZIP NAME ADDRESS Ago)( ZIP STATE LICEI J CBL#... 07 PERMITUPIRES USE PERMIT - ZONE NUMBER 9TV, JOB ADDRESS 0 SunFWTI1 PLAT NAME/SUBDIVISION NO. LiD NO. UD FEE S PUBLIC RIGHT PER OFFICIAL STREET MAP 7ES6 APW11d RW Pornift Raqukwl T I . StroM Use Peffnk Rsqd EXISTING — PROPOSED Inspoctionftquired SideWMAReWAred REQUIRED DEDICATION— FT Undwgmund VWMg requkod 13 METER SIZE LINE SIZE OF FIXTURES PRV REQUIRED YESO NO 13 z REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLJDRAINAGE I DATE _�EPH FIRE REVIEWED BY DATE I— M P jrE w Q a� z Aj C-----.:- — VARIANCE OR CU SHORELIINE5-R-ADB# INSPECTION BOND DIRATION DATE REO'D I I POSTED OyEs 13NO S SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP I I RedIDENTIAL [3 PLUMBING/MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR .12 ADDITION COMMERCIAL 'X COMPLIANCE OR CHANGE OF USE : PARKING LOT AREA ED BY DATE PLANNING REVIEW 13 REMODEL MULTIFAMILY SIGN REQ`D PROVIDED I REPAIR GRADING cyor FENCE X FT) REMARKS i��EDEMOLI§H TANK %.4c740THER ok, GATfAGE RETAINING WALL 0 FIRE SPRINKLER CARPORT ROCKERY FIREALARM 1AIN (ME OF USE, BUSINESS Oft ACTIVITY11 EXPLAIN I on HECKED BY E OF CPNJTRUCTION coo OCCUPANT GROUP ff NUMBk4 OF NUMBER OF DWELLING CRITICAL AREAS VN. SPECIAL INSPECTION OCCUPANT STORIES UNITS NUMBER JAREA REQUIRED YES LOAD BE DCW_,� REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD VALUAnON Description L FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % T Building Permit City Surcharge PLAN CHECM 2 r-4� VESTED DATE Plumbing Mechanical THIS PERMIT AuTHoizEs ONLY THE WORK NOTED. THIS PERMIT COVERS WORK To t: BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PU13UC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMITAPPLICATIOW 160 DAYS ERMIT ILIMM I WAR - PROVIDED WORK 18 STARTW WrrHIH 180 DAYS Engr. Inspection SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review -N!' Plan Chk. Deposit IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF I EDMONDS, WASHINGTON. 98 OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection J00 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 LiandscApe Insp. Total Arnt Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR UMrr IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - Recording Fee Receipt N I I HERE13Y ACKNOWLED6E THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GWEN is CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGRE E LAWS REGULATING CONSTRUC- I STAT CALL ThIs application Is not a permit until signed by the TION; AND IN DOING E WORK ORZEY1171DEREBY NO PERSON WILL BE EMPLOYED Buliding OfflcW or his/her Deputy; and Fees are paid. and Ik VIOLATION OF THE� 4-00DE OF *E STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is aanovviodged In space provided. WORKMENS COMPE�WTION INSURANCE.AND RCW 18.27. OF C SIG T IE DATE DATE SIGNED %. 771-0220 RELEASE BY E ION U=V 333 IT IS UNLAWFUL lU - A BUILDING OR STRUCTURE UNTIL 7-- A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - YELLOU. INSACTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 � �F PINK ER GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5. COPIES GREEN - ACCOUNTING z 0 0 M M Ma 8, C. �x MM to 4� Z 0 Irn M Fn C 0. 03 z 0 =1 0 IT!