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20030988.pdfDATE RECEIVED 7— CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS MAILINd ADE*iE—ss / 0o (-T- S C- CITY ZIP TELEPHONE f1i'l/ cre-e ISO/ NAME ADDRESS CITY ZIP ITELEPHONE NAME C ADDRESS //0 '��> I I PERMITEXPIRES 'USE PERMIT ZONE (? dlp-( NUMBER '2 JOB .2q SUITE/APT# io ADDRESS T.�_61R q8_01 PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP APR7-�d� RW PernUt Required 8 Sir at Use Paffnit Roq'd EXISTING — PROPOSED 1.= Aequkod Sidewalk Required REQUIRED DEDICATION— FT UndwWmnd wiring rsqLAred METER SIZE LINE SIZE OF FIXTURES PRV REQUIRED 7. -1 YES C3 NO E3 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE Lia ENGINEERING REVIEWED BY ZIP TELEPHONE q jei� LICENSE NUMBER I "P. ATION CHEGM FtV P F �OWP �9: a TV.X 'A X. P� 4� NEW 0 RESIDENTIAL PLUMBING MECH ADDITION COMPLIANCE OR 1:1 ;5rocOMMERCLAL CHANGE OF USE REMODEL MULTIFAMILY 0=01 yX SIGN REPAIR GRADING CYDS Ei FENCE ( Fr) DEMOLISH TANK OTHER oGARAGE CARPORT [3 RETAINING WALL ROCKERY FIRE SPRINKLER FIRE ALARM (TYPE OF USE, BUSIN9PS OR ACTIVITY]i EXPLAIN: NUMBER NUMBER OF CRITICAL OF STORIES DWELLING UNIT$ AREAS NUMBER DESCRIBE WORI?TO BE DONE /,Ozjg // / — I 141,14df HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: VESTED DATE THIS PERMIT AUTHORIMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO It BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC 2 U 3 DOMAIN (CURBS, SIDEWALK6, DRIVEWAYS, UARQUEES, ETC.) WILL REG IRE t: SEPARATE PERMISSION. PERMIT APPLICATION: 180 DAYS —.MIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICAN-L 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 MODIF% WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CrrY8 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 AU114ORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR COPt OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S c�, ~NCE AND RCW 18.27. F_S_,GNATuRE964�va"oe7_ DATE SIGNED FIRE REVIEWED BY DATE DATE VARIANCE OR CU SHORELINE OR AOB# INSPECTION BOND REO'D POSTED I 13YES %NO $ — SEPA REVIEW SIGN AREA N HEIGHT COMPLETE EXEMPI ALLOWED PROPOSED ALLOWED PROPOSED _XP 7,1 � I �zo. 0 1-7 " [e-- IT .1 LOT COVERAGE REQUIRED SETBACKS (FY). �PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR ........................ � . , 1. . I . I . -_ I z BY DATE PARKING REQ`D I PROVIDED I LOT AREA PLANNING REVIEWED I REMARKS CHECKED By ITYP q0qWRU 10 0*1 OCCUPANT GROUP 8PECIALINSPECTION JAREK OCCUPANT REQUIRED [:] YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D 3 VALUAnON $ *700 Description Plan Check FEE 1W Description State Surcharge FEE Building Permit &0— City Surcharge Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Lai d-scape Insp. Total Amt. Due he) Recording Fee Receipt # Z2212 CALL FOR INSPECTION (425) 771-0220 APPLICATION APPROVAL This application Is not a permit until signed by the Building Official or his/her Deputy: and roes are paid. and receipt Is acknowledged In space provided. A4 1,4 RELEA§E BY E ATTEWION f Off 133 �4 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- rORIGIN14JILF - YELLOW- 'INSPE67OR 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 :i:9 55-1 a m c MO 0 80 c im MM m Z 0 -n In m m 0 vi 0 o Fn C M 0 Z M z z 0 m RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Si ocaprvl.doc.l:temp:bldg:fomasIO/OI gun 7,, lei I .PDATE RECEIVED) PAM pu\�A PERMIT EXPIRES *7 'ISE CITY OF EDMONDS PERMIT NUMBER CONSTRUCTION PERMIT APPLICATION JOB SU[nTE/AFT# 10 AIIR!�I,, -6 qR-02 OWNER NAMEINAME OF BUSINESS PAIM PLAT NAME/SUBDMSION NO. LOT NO, 7— LID NO. MAILINd ADdRESS LID FEE S 1,00 / I (� C 7- S' C- TESCP AP PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Perni"=ed CITY ZIP TELEPHONE Street Use Permit Req'd EXISTING — PROPOSED InspecdcmRaquired Sidewalk Required > REQUIRED DEDICATION— FT Undar� % Wifingrequired 13 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 13 NO 13 I z ADDRESS REMARKS A OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE CITY rELEPHONE NAPS: CBLN Ae--e ENGINEERING REVIEWED BY DATE N G" ADDRESS j-1,—tE CITY FIRE REVIEWED BY DATE 011-4 STAP'LICENSE NUMBER EXPIRATIO DATE C y VARIANCE OR CU SHORELINE OR ADS# INSPECTION BOND V P REO'D POSTED I 1 0 C3YEs $ IN SEPA REVIEW SIGN AREA I lb HEIGHT PROPXRTY TAX ACCO PARCEL NO. - UUMMETE EXEMPT ALLOWED IOPOSED ALLOWED PROPOSED co 1 - / �-o '7 '71 7 7 , I 21 I k I rv. EXP 4EW RESIDENTIAL PLUMBING/MECH LOT COVERAGE REQUIRED SETBACKS (Ff) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR ADDITION MMERCLAL COMPLIANCE OR -------- CHANGE OF USE I 0 REM06EL MULTIFAMILY SIGN 0 VA PARKING LOT AREA PLANNING REVIEWED BY DATE REOD I PROVIDED_ -- E GRADING F NCE FIEPAIR CYDs X_FT) REMARKS o OTHER 0 DEMOLISH TANK [3 RETAININGWALL FIRE SPRINKLER �bGARAGE CARPORT ROCKERY FIREALARM BUSIWS OR ACTIVITY)i EXPLAIN: CHECKED BY OCCUPANT TY= GROUP 44LIM&A � " BER OF CRITICAL UM L OWE ING AREAS SPECIAL INSPECTION JAREA OCCUPANT LOAD NUMBER REQUIRED DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC JOB/FINAL INSPECTION REaD % rAL Tel I VALUATION $ Description FEE Description FEE Plan Check State Surcharge U0 HEAT SQPRCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: ESTCO DATE. -7 y Plumbing Mechankial THIS PERMIT AUTIJORrAMS OW THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTV ONLX ANY CONSTRUCTION ON THE PUBUC DOMINN Dmmmys, MARQUEES, ETC.) WILL REQUIRE Grading 32 (CURBS, SIDEWALKS, I: ATE PERUISSION. 2. Engr. Review PERM11ITAPPILICATION: IGO PAYS PERLUT LIMn1 I YEAR - PROVIIIED WORK IS STARTED, WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT. ON BEHALFOF 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 # 23/f 3 ALL CLAIMS FOO DAMAGES OFWHATEVER NATURE, ARISING DIRECn ORINDIRECTLY:' FROM THE ISSILL&NCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALLNOT BE Landscapainsp. Total Amt. Due MED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE IT W ANY WAY THE C17YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # I HM13Y ACKNOWLEDGE THAT I HAVE READ TH 8 APPLICATION; THAT THE INFORM&ION APPLICATION APPROVAL GIVEN IS CORRECT! AND THAT I AM THE OWNEIR, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application 13 not a permit until signed by the CALL TIOM; AND IN DOING THE WORK J ORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or hisiher Deputy: and Fees are paid, and IN VIOLATION OF ItW LAO FI gCOOF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknovAedgad In apace provided. WORKMENS SR!P%Mq1; CE AND RCW 18.27. I RE ATE 0 CIALS q1 DATE SIGNED GNATURFII�z/ �81 1425) . 'NATU 7711-0220 RELEASED,- By LLew' DATE ATU'ha" E)Cr 1333 1—// / X, XNJ IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 114-4.1 k �� 1 4 It - A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ""ORIGIN�UJIUE YELLOW !INSPP-/CTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING