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20030993.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS MAILING ADDRESS Z-2--sit- "U" CITY erwylooDs NAME ADDRESS CITY NAME OL2lefJ, ADDRESS .411 to _5 -2s r CITY STATE LICENSE NUMBER USE ZONE JOB ADDRESS I PERMIT EXPIRES PERMIT NUMBER SUITE/APT# )5.�nno t'j PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S qq PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP R;SCF AP =6d Trw Permit Street Use permit Wd ZIP T ELEPHONE EXISTING — PROPOSED Inspection Required Sidewsk Required 2 REQUIRED DEDICATION— FT underground 10 U WirIngroquired 13 METER SIZE LINE_SIZE NO. OF FIXTURES PRV REQUIRED I I YES 13 NO 13 z I REMARKS I OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ZIP ITELEPHONE M BY DATE I) I Tie- � 105- FIRE REVIEWED By DATE us TELEPHONE . <__ . ti /- _a? for 145"1 S' - Ir - I VARIANCE OR cu SHORELINE OR ADB# INSPECTION BOND EXPIRATION DATE CH r Do,-.r=r% 1:1 NEW 0 RESIDENTIAL ADDITION COMMERCIAL REMODEL MULTIFAMILY 0 REPAIR GRADING CYDS DEMOLISH [3 TANK GARAGE CARPORT RETAINING WALL ROCKERY (TYPE OF USE. BUSINESS OR ACTIV" EXPLAIN: &eegf & NUL40ER NUMBER OF OF DWELLING STORIES 0 DESCRIBE WORK TO BE DONE Dybs EINO $EPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED , EXP PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (FT.). PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LJRSIDE REAR I COMPLIANCE OR z CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED. BY DATE SIGN REC?D I PROVIDED I o FENCE FT) REMARKS [3 OTHER CHECKED BY ITYPE CRITICAL AREAS SPECIAL INSPECTION . NUMBER I REQUIRED [3 YES GROUP/j OCCUPANT LOAD REMARKS PROGRESS INSPECTIONS PER U13C 11081FINAL INSPECTI N REG'D f%V'0C'a--M M RO AR G Ks RESS'NI Description FEE Description FEE Plan Check State Surcharge 6,0 HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge ILq- 1 7 f./ PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORMES 0NW THE WORK NOTED. THIS PERMIT COVERS WORK TO 1: BE DONE ON PRIVATE PROPERTV ONLX ANY CONSTRUCTION ON THE PUBILIC 2 Grading DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: ISO DAYS —IMIT LIMM I YEAR - PROVIDED WORK 16 STARTED WITHIN 100 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. D;wd IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF i5w 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 -9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due 21 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION., Recording Fee Receipt # _55;0� I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL 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- 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 LAq90MqDE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknawledged In space provided. WORKMEN'S COMPENSATIP TSUPfNCE AND RCW` 18.27o I OFFICIALS SIONATURE DATE SW9 "TE (OWNER DATE SIGNED 1A10 It-W&S) 14 ) 10-3 74 1 771-0220 -1 ALE a DATE ATTENTION Off 1333 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 - INSIDE CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 _R PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING THIS IS TO CERTIFY THA Robert A. Tjaden while a current employee of the Authorized-Pyro-chem Distributor: R T Hood Duct Services, Inc. has attended a requisite training class to install, maintain, test, inspect, and service Monarch Industrial Fire Extinguishing Systems as outlined in the Installation, Maintenance, and Service Technical Manual. INI k" It t 'CH tri PCO8161(t) z 0 i 0 m =i 9 ro � am c mo 0 80 c M m z co 0 -n n M M 0 V; 0 r. 0 M co) ca M 0 Z- 17n �D- z V) z 0 m I FOUNDATION: Footlng . . ..................... Walltl ......................... Pler/Porch ................. etalhing.Wall' ........... Stab Insu ati on ......... PLUMBING:, nderground; .,U ............. o g_ -in R u' .................... '161 Final Conimerc ...... HEATING: Gag T6st' .1 ................... Gas: Piping ................ Equipment, ............... commercial Final EXTERIOR SHEATHING NAILING.......................... FRAMING', ........................ DATE RECEIVED / CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEftWE OF BUSINESS ros�-kl -T-P-A. ST16-noo MAILING ADDRESS CITY (--- b rA 0 t- M. ADDRESS CITY NAME ouset� [Eg ADDRESS -41 lo .5 tri CITY JWK 1W STATE LICENSE NUMBER qq,!5uj% I Z TELEPHONE ZIP ITELEPHONE CBL W ,5urm 105- ZIP TELEPHONE )01 1 T.;;5­ esi6— I .EXPIRATION DATE I CHNi PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB ADDRESS MAI qq SUnUAPT# PLAT NAME/SUBDIVISION NO. NO. -/00 LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TE3ZWAaP=qd RW Susm Use Pernk RWd EXISTING — PROPOSED InspseWnRequired SkIwalk ftquired REQUIRED DEDICATION— Fr Undergmund Wking roqt*W 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE :1 8AX2CC UNT PARCEL N PROPERTY T 7 NEW ADDITION P& REMODEL .[3 REPAIR DE LISH [3 MO GARAGE CARPORT [3 RESIDENTIAL PLUMBING MECH COMMERCIAL COMPLIANCE OR CHANGE OF USE TIFAMILY SIGN 13 MUL [3 GRADING 13 FENCE CYDS X FI) TANK [3 OTHER RETAININGWALL FIRE SPRI E 0 ROCKERY (TYPE OF USE. BUSINESS OR ACTIVITY]i EXPLAIN: NUMBER OF STORIES NUMBER OF ess,,!$�Lj DWELLING UNITS CRITICAL -A AREAS -NUMBER DESCRIBE WORK TO BE DONE HEAT SOURCE GLA23NG % LOT SLOPE % PLAN CHECK NO- VESTED DATE THIS PERMIT AUTHORMES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC 2 3 DOUNN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE t: SEPARATE PERMISSION. PERMrTAPPLICATION: 1160DAYS PERMIT UMM. I YEAR - PROVIDED WORK 19 STAFrMD 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 FROM ANY AND - ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY ORjNDWCffiy_ FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERM9,SflALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUI NJ4 IS160' NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDI HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPUCATION: 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'60NSTRUC- TION; AND IN DOING THE WO QRZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LA§l;KDE'OF THE STATE OF WASHINGTON RELATING TO 11 U WORMENS COMPIENSATfiN I SU CE AND RCW 18.27. DATE SIGNED 1 'Z - I I - -0 1) DATE FIRE REVIEWED BY DATE cc VARIANCE OR CU SHORELINE OR AD" INSMECTION BOND REO'D I POSTED is DYES ONO SEPA REVIEW SIGN AREA HEIGHT COMPLETE_, EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED __XP , , LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LJRSIDE REAR PARKING I LOT AREA I PLANNING REVIEWED BY DATE REO'D I PROVIDED CHECKED BY ITYPE SPECIAL INSPECTION JAREA REQUIRED [3YE GROUP OCCUPANT. LOAD " REMARKS 21 PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REaD Description — Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review FEE Descirlption FEE State Surcharge if I C-7 City Surcharge 15-0. Plan Chk. Dep Receipt # Total Amt. Du Receipt # ! ; APPLICATION APPROVAL CALL R INSPECTION This application Is not a Permit until signed by ther- Building Olficlal or hisftr Depuly: and Fees we paid, and receipt Is acknowledged In space provided. OFIVCIALS SLONATURE DATE �aA /0 3 i tvA. _9 5) Y 771-0220 -#RELE 0 / DAT �"j ATTENTION e. hAl 1 3 1,4 1 j IT IS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL fVVY I k�e A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE - YFI I OW - IN4PEC'(OR CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109 PINK -OWNER - GOLD -ASSESSOR 04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING .... ... .. ..