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20031006.pdfI r N, I DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS tc, lr_ and )Wellr\ 00 \JS+C q MAILING ADDRESS a3S2kS 90' P1, \A/ CITY ZIP TELEPHONE *E�clmorl a � M o a(D I L4 ks - -7 1 Ll - 59 NAME WA ADDRESS CITY ZIP ITELEPHONE PERMIT EXP.IRES USE PERMIT ZONE ,3 — / NUMBER JOB SUITE/APT# ADDRESSGt3gC-),(g qo+t, PI, LAJ V"u" 9,EQ� PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. vlll�(4er 91K H LID FEE S PU13LIC R—IGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Pstrnfl Required EXISTING - PROPOSED Suset Use Peffnit Req'd Inspection Required Sidewelk Required REQUIRED DEDICATION- FT underground Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES I PRV REQUIRED I YES13 NO 13 NAME CBLN Nor -A'. it, Servi ADDRESS flGis H,,A\jcx1P- A\)e CITY ZIP TELEPHONE 5P_Q4(e 9 AD'- -53\,c� -99-70 STATE LICENSE NUMBER EXPIRATION DATE I CHECKE BY WORDT-511%ogjA PROPERTY TAX ACCOUNT PARCEL NO. 00113 000 00 Ll 00 0 NEW RESIDENTIAL PLUMBING / MECH COMPLIANCE OR ADDITION COMMERCIAL 0 CHANGE OF USE 0 REMODEL MULTIFAMILY SIGN 19 REPAIR GRADING FENCE CYDS ( X FT) DEMOLISH [3 TANK OTHER 0 GARAGE [:3 RETAININGWALL 0 F RE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS OR ACTWM EXPLAIN: '51 NUMBEW-5,1 NUM OF CRITICAL OF DWENING AREAS STORIES L NUMBER DESCRIBE WORK TO BE DONE Tree hsn.-a CePtilli (5- — 27,c, 1D n coru PW. r4l, 11 q HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: VESTED DATE REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING REVIEWED FIRE REVIEWED BY DATE DATE z VARIANCE OR_CLI SHORELINE OR ADB# INSPECTION BOND REO'D 113YEs POSTED ONO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSE D ALLOWED PROPOSED EXP , I I LOT COVERAGE REQUIRED SETBACKS (Fr) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR z PARKING I LOT AREA PLANNING REVIEWED BY DATE REO'D I PROVIDED REMARKS CHECKED, BY ITYPE OF CON*TRUCTION CODE OCCUPANT 1 11 GROUP I; —:- SPECIAL INSPECTION JAREA OCCUPANT REQUIRED [3 YE LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D A Amn Description ..FEE Description FEE Plan Check State Surcharge 5V I& Building P erm it <�7a I City Surcharge 0:1 Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 1 3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE - SEPARATE PERMISSION. Engr. Review PERMITAPPLICATION: ISODAYS PERMIT ILIMM I YEAR - PROVIDED WORK 18 STARTED WITHIN 1130 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPUCANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit I IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF I EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE. ARISING DIRECTLY OR INDIRECTLY Fire Inspection Receipt # 1 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 Landscapelnsp. Total Amt Due I NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording F Receipt # 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION .2= APPLICATION APPR 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 penrill until signed by the Bul Ing Ortficiall or his/her Deputy: and Fees are paid, and 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 TO R INSPECTION receipt Is acknowledged in space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. OFFI IAL NATUFJ9 /DATE SIG NEJ� DAT SI D 1A105) 4 SIL11f V3M&__1 771-0220 ED A717TENTION We 133 /M IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UN A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW. IN'SPEcTd CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 U PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING L z 0 4 0 M :q:—" ca � M M -48 0 C 5! z A 0 _n M M M X 0. z 3� 55 Z. 0 4 0 M n�, �TE RECEIVED I CITY OF EDMONDS i I CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS Daily- ArA Kwen �Joqs+rt4p MAILING ADDRESS a3'3 6_�'g 9 P I CITY ZIP TELEPHONE iEclmo!ja� "N'-waW L4�s--7-7L/-�2 NAME NJA CITY ZIP ITELEPHONE P PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB SUITE/APT# ADDRESS 3C6 oNg c104L, pl, W tArk1j5' 9-F PLAT NAME/SUBDIVISION No LOT NO. LID NO. Til�ck5er BIK L4 LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP I TESCF Approved RW Pormit Required EXISTING PROPOSED Street Use Perrnh Raq'd Inspection Required 13 sidewalk Required 13 REQUIRED DEDICATION— FT Undewound VVIMG required 11 METER SIZE LINE SIZETNO* OF FIXTURES PRV REQUIRED YES[3 NO [3 z REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE NAME CBL N Norcklc, Serv;reS,TnL, ADDRESS WAvede A\je W. 161<9 CITY ZIP TELEPHONE 103 1 aciio- -9!S;-1b STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY NORDX�!VjOaA I- I- tope PROPERTY TAX ACCOUNT PARCEL NO. 00-11.3 0D000 9 00 0 NEW RESIDENTIAL PLUMBING I MECH ADDITION COMMERCIAL COMPLIANCE OR 0 CHANGE OF USE 0 REMODEL MULTIFAMILY SIGN REPAIR GRADING FENCE CYDS x FT) 0 DEMOLISH 0 TANK OTHER E:iGARAGE 0 RETAINING WALL 0 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM UWE Or- USE, BUSINESS DR ACTIVITY) EXPLAIN: ' 151 No, 10— rzw"" f -i NUiADER NUMftA OF CRITICAL OF DWELLING AREAS RlEs bP_,,jr_1 UNITS NUMBER DESCRIBE WORK TO BE DONE Ani ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE VARIANCE OR CU SHORELINE OR ADBI INSPECTION BOND REO'D I POSTED I DYES 13NO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED EXP , I I LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR BY DATE PARKING LOT AREA PLANNING REVIEWED IL PROVI In! r I am I IIIIIIIII CHECKED BY JTYPE OF CONSTRUCTION TCODE OCCUPANT GROUP SPECIAL INSPECTION JAREA OCCUPANT REQUIRED rj YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D VALUA"ON $ Description FEE I DescriptIon FEE Plan Check —1 & State Surcharge If. SV HEAT SOURCE GLAZING % LOT SLOPE % 11:�C(d Building Permit City Surcharge k-C-0ed, - PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AUTHORMEB ONLY THE WORK NOTED. THIS PERMIT COVERS WI(TK TO, C� BE DONE ON PRIVATE PROPE ION CONSTRUCTIQN0HTiIWPUB CS%=,A LIT I R' WALKQ. A fijRQY"�M.) VAL REtIUIRE DOUNN (CILT. 3 SEPARATE PERMISSION. Engr. Review PERMITAPPILI�ATIION: 180 DAYS PERMrr UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMrr FOR MORE INFORMATION 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review PlaMChk. Deposit - IN NTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS'THE CITY OF EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire',Inspecflon Receipt III, CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECMTLY IALL FRONI THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT B9' Landscliliei InSp. Total Arnt. Due 9 DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE I NOR LIMIT IN ANY WAY THE CrrY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. I Recording al;� Receipt # - . 121 I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMAI ION APPLICATION APPROVAL GIVEN IS CORRECT, AND THAT I AMITHE 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 urffll signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Bul ng Official or his/her Deputy: and Fees are paid, and I� IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO AOR WiPECTION receipt Is acknowledged In space provided. WORKMENS COMPENSATION INSURANCE AND RCW 18.27. SIGN4TPRE DAT SIG ED OFFI41A'Sr"?;R'�' DATE 0' (OWNE C3 771-0220 EASED BY D TIE ATTENTION M1333"'.." 'UN IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE. 4� A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI OR�GINAL - FILE YELLOW - INSPECTO� CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PNK-OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING k � z 9 0 m am C MS 40 0 C:: �z m S Z Ca 0 'n '�" 9 M m a Vi 0 6 Fn 0 ;a CO) z 0 4 0 m