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20030964.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNE; NAMEINAME OF BUSINESS MAILING ADDRESS f-001 4,44�.em Ae- .QITY - ZIP ITELEPHONE STATE LICENSE NUMBER T-c-d"e- � ZIP CBL III It. a )ee e,.,l �x ZIP TELEPHONE Sgs -)ca -7 -7/,6 PERMIT EXPIRES PERMIT 7USE ZONE NUMBER 303 - - 0q JOB SUITE/APT# ADDRESS 3/0 PLAT NAME/SUBDIVISION NO. LOT NO. LID No. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Ap RW Parmltpllzv"*d Street Use Permit Req'd EXISTING — PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION— FT UnderWound Wking required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED 1 L YES13 NO C3 z REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE W cc V6 VARIANCE OR CU SHORELINEORADBI I INSPECTION I BOND By REO'D POSTED I E3YEs 13NO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED 10 51 :580 70000_z.:�O/ 0 EXP NEW RESIDENTIAL M�MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR COMPLIANCE OR ADDITION COMMERCIAL 0 CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE REMODEL MULTIFAMILY SIGN REQ`D I PROVIDED I REPAIR GRADING CYOS FENCE X FT) REMARKS DEMOLISH TANK OTHER EGARAGE RETAINING WALL FIRE SPRINKLER l FIRE ALARM__ CARPORT ROCKERY _ ITYPE OF USE, BUSINES CTIV" LAIN: CHECKED BY TY Of COINSTW19N COME OCCUPANT -Mr— rrvr- 9 �e CRITICAL GROUP iwd CIO 0 NUFABER NUMBER-bF OF DWELLING AREAS SPECIAL INSPECTION OCCUPANT LOAD STORIES UNITS NUMBER JAREA REQUIRED DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D as VALUATION Description FEE Description FEE Plan Check State Surcharge EAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing nri Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Iz BE DONE ON PRIVATE PROPERTY ONLV. ANY CONSTRUCTION ON THE PUBLIC Grading 2 DOMAIN ACURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 31 SEPARATE PERMISSION. Engr. Review PERMITAPPILICATION: ISO DAYS AL PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICAUL 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 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 I IZ6 9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY C17Y ORDINANCE 0 NOR LIMIT IN ANY WAY THE C17YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee Receipt # I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APP R GIVEN IS 0 RECT, 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 Fees 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 18.27. 0pMIA(A2jlGNATUR DATE ER DATE SIGNED Sol? (425) Q"A,4�14 P, 09 / 9 3 771-0220 'RELEASE BY DATE A-ff ENTIOfy/ M 1333 ;/ ' '--.4 ALP IT IS UNLAWFUETO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL , I " /`Y/ A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- NAL - LE - YELLOW . ASP1516TOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - - NER - GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING I DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION I OWNER NAMEINAME OF BUSINESS MAILING ADDRESS I ,1)0/ PITY ZIP jTIjEPHONE 5N/,� / r/06 -723 //36) ADDRESS �Vle. 5 -4p ZIP ITELEPHONE 15 .]'W- I PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB SUrrE/APr# ADDRESS 3/0 PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. I LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7REW5CPaffAf0PtiR=1rsd Street Use Peffrilt Raq'd EXISTING — PROPOSED trispectlan Required Sidewalk Required REQUIRED DEDICATION— FT I UndwWourld vyumg required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES13 NO 13 z REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE NAME CBLN 6A ENGINEERING REVIEWED BY DATE ADDRESS V f ^32-) (--) 91L ��111'4:2�,y —FIRE REVIEWED BY DATE 1 CITY ZIP TELEPHONE IE W "4 LA1,4 J00 -7 VARIANCE OR CU SHORELINEORADSM I INSPECTION 1$ BOND STATE LICENSE NUMBER EXPIRATION DATE CHgpfi% BY REO'D POSTED OyEs 13NO 4-L wpmo Z4AVV SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED SC 76000z3oz 0 C-) I , I losses LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) NEW RESIDENTIAL PL MBI MECH SIDE FRONT L/RSIDE REAR ALLOWED PROPOSED FRONT REAR 0 o COMPLIANCE OR ADDrnO I N COMMERCIAL CHANGE OF USE PARKING LOT AREA LANNING REVIEWED BY DATE IL JZ� REMODEL MULTIFAMILY SIGN REOD I PROW Moft A Orrn- FENCE 11 RE'PAIR GRADING CyDS ( X FT) REMARKS tim RLE I 1:1J OTHER DEMOLISH 0 TANK GARAGE RETAINING WALL FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM E. BUSINEST, A EXPLAIN: CHECKED BY ITYPg Of: CONSTWION C012E OCCUPANT GROUPI:s 1hW %AM1 00� NUMBER NUMBER OF CRITICAL — OF DWELLING AREAS SPECIAL INSPECTION OCCUPANT JAREA STOR ES UNITS NUMBER REQUIRED [] YES LOAD DESCRIBE WORK TO BE DONE — REMARKS z PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REGID 0 rAtC 4e j 01 VALUATION At�' 94 >000' $ Description FEE Description FEE e r, r,4 - A. Plan Check 1 State Surcharge HEAT SOURCE GLAZING % LOT SLOPE Building Permit City Surcharge 6 Rio PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DOME ON PRIVATE PROPEITTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPUCAT10?& ISO DAYS PERMIT LIMM I WAR - PROVIDED WORK IS STMMD WITHIN 180 DAYS Engr. Inspection SE9 BACK OF PINK PERMIT FOR MORE INFORMATION Plan Chk. Deposit BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS, Fire Review ;APIPLI=TON N NT AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF ANY AND EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM , Fire Inspection Receipt # ,k.. ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR WDIRECTLY.. FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE-00 THIS PERMIT SHALL NOT BE Landscapainsp. Total 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." 7d Recording Fee A-i I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION 77777A--PPuq4 :60N APPOOVAL 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- TWli OWICAt rill 'Wai;gd by tha 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 T NSPECTION Buildinb OMcW Or hWher Deputy: aAd ". v , * , mcilpi Is a . are paid, and cknovriodged In sp- ovided. WORXMEWS COMPENSATION INSURANCE AND RCW 18.27. nt 9FFICIA 7.. L, . cf, I 821G�( E R DATE SIGNED (425) , MNATUy %0EP 77*0220 -P RELEASE910Y DATE ATTENTIO N/ 1333 IT IS UNLAWFUr TO USE OR OCCUPY A BUILDING OR PTRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFL,- LE" 'YE OR NA- ILLOW KSK14TOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 011N�K NER GOLD - ASSESSOR 04/02 U PRESS HARD -YO'* AQ GREEN - ACCOUNTING' AKING. 5 COP IES',- , ..4;