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20040044A.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS 17T '-Qc%4'o� Qc-,,,+ Z T MAILING ADDRESS I 'd -_;� �) u A%Acocc, Ptve Q CITY ZIP ELEPHONE NAME ADDRESS CITY NAME ADDRESS ZIP ITELEPHONE CBL # CITY ZIP TELEPHONE hu_6.A,-rN wA 1,953- ' 5(.16/ STATE LICENSE NUMBER EXPIRATION L -SE: W F f, ID 9/30 0 CH 'ROPERTY TAX ACCOUNT PARCEL NO. 000e see NEW RESIDENTIAL IADDITION,' 3 COMMERCIAL mummmit:y REMODEL 0 REPAIR GRADING CYOS DEMOLISH 0 TANK GARAGE I RETAINING WALL CARPORT 1:1 ROCKERY WVEAF USE, BUSINESS OR ACTIVITY)l EXPLAIN: K�QS4Ck%.Arar\+ . NUMBER ONWUMBM OF ELLI� OF ING STORIES UNITS DESCRIBE WORK TO BE DONE j [PERMIT EXPIRES Z, L� USE PERMIT ZONE NUMBER JOB .c SUITE/APT# :123,511 HWI 59 110 PLAT NAMEISUBDIVISION NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TE AW"1Pr.APP1'=1r. EXISTING - PROPOSED Street Use permit Raq`d Inspection Required Sidewalk Required REQUIRED DEDICATION- FT Undeforound "'"u" ad 13 METER SIZE LINE SIZE NO. OF FIXTURES V R:EQUIRED P R�13 I ]7YE:S NO 13 z REMARKS I OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE is ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE VARIANCE OR Cu SHORELINE OR AD I diT INSPECTION BOND 'D REO POSTED 13Y'Es 13NOis BEIRA REVIEW SIGN AREA,' .1. HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED 4`ALLOWED PROPOSED EXP PLUMBING/MECH LOT COVERAGE REQUIRED SETBACKS (FT)", % PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE . REAR FRONT. L/R SIDE REAR oCOMPLIANCE OR CHANCE OF USE PARKING LOT AREA [7NING REVII SIGN REO'D PROVIDED FENCE I I ( - X FT) REMARKS OTHER FIRE R FIREOPLE CHECKED BY ITYPE OF CONSTRUCTION JCO CRITICAL im SnrinL-Wr 1 9 AREAS SPECIAL INSPEC71ON JAREA NUMBER REQUIRED REMARKS PROGRESS INSPEC I 1011,11S PER LIEW 101 c dS' +Qnr M cove tv� evt DATE OCCUPANT GROUP OCCUPANT LOAD INSPECTION RE(WD VALUATION, $ 00. Denrlpflon EE Doscriptlan FEE ... Plan Check State Surcharge HEAT SOURCE GLAZING % ...... LOT'SLOPE % . BuildingOermft'� City Surcharge PLAN CHECK NO: VES TED DATE N-oo Plumbing Base Fee THIS PERMIT AUTHORCMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Mechanical t: ?I :E DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC OMAIN SIDEWALKS, Grading (CURBS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. x Engr. Review PERMIT APPLICATION: 180DAYS PER&irr umm I YEAR - PROVIDED WORK IS STARITED WITHIN 1130 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 to Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE, ARISING DIRECTLY OR INDIRECTLY 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 Landscape Insp. Total Amt. Due 13a�:Sc 0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' E---- , Recording Fee Receipt I HERE13Y 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 APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED CALL This application Is not a permit until signed by the Building 0111cial or his/her Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. FOR INSPECTION receipt Is acknowledged In space provided. SIGNATURE (0)NNER A ENTI DATE SIGNED 1425) G T RE D7A led ac&� 771-0220 or RELEASED -BY PATE I AWENTION M 1333 'T �Wx L IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL V71 1 / /t/j� A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 OR;GIN ' FILE)� YELLOW INSPE&TOR P 09/03 NK - NEA - GOLD - ASSESSOR PRESS HARD -YOU ARE MAKING 4 COPIES j i L z 0 1 0 m 749 6-4 a m c Ma 0 --40 0 C 3� m m m 10 A 0 -n n � E2 r. mm a V5 0 o Fn C ch c CA M 0 Z I ;u z cn z 9 0 m ISSUES GRANT FINAL PROJECT APPROVAL RE -INSPECTED OUTSTANDING Si 0 caprvl.doc.l:wxnp-bldg:fonnsIO/OI 9 n .,.Gas Pipi I 10Y d 4 'Equipment. I. t t 4 d L L k I I d I I d 4 t , , L . . ' , , , I ' r I L I I L r v Inall *$bigot -Commercial F 0 1 1 L r d r I P L� P 'L k4 ;L'p P EXTERIOR SHEATHING.,. I P 1 1. 1 I r d off 8 4 1 r P L r . . . r e k I I I d L P -,-FRAMING 1 .1 4 r I I Fn FIRST FLOORFRAMING.4. If I r 1 11, ILL t P .4� . . . . . . INSULATION I P 1 4 1 P I d r r d 'L , r. . I I . L I d d 11. 1 1 . Floor Insulation I d I r I I d I N k d . t J-'j A r k Wall Insulation I . I . . I m E RECEIVE D-4 _71ZI441 Ne I PERMIT EX PIRES CITY OF EDMONDS USE PERMIT ZONE NUMBER CONSTRUCTION PERMIT APPLICATION- JOB sunTJAPT# ADDRESS 1A ) 10 OWNER NAMEINAME OF BUSINESS on,, TfT Seo,.Co4 Qes4 PLAT NAMEISUBDIVISION NO. LOT NO. UD NO. MAILING ADIJAESS LID FEE $ '-A C Cj PT ve 0 7F.SCP Appm"d PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW PenTA Roqukrad CITY ZIP TEL)EPHONE Street Uee P@fm% P.Wd EXISTING — PROPOSED kapection Wulred Sidewalk RowlrW W.A 2 c) REQUIRED DEDICATION— FT undwwmw wworsqum 13 NAME METER SIZE LINE SIZE PO. OF FIXTURES PRV REQUIRED I YESE3 NO 13 z ADDRESS REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE CITY ZIP TELEPHONE NAME �"Iriz ? ENGINEERING REVIEWED BY DATE RE r e, -e A st-A o ;Y _a+ FIRE REVIEWED DATE CITY ZIP TELEPHONE /—/ WA 5800 A-53-951---16/5 _Nu6Arr% VARIANCE OR Cu SHORELINE OR ADB# INSPECTION BOND STATE LICENSE NUMBER EXPIRATION DATEq REO'D POSTED I I I F? 9/30/o4 OyEs 13NO S E W ol-.)c SEPA REVIEW SIGN AREA HEIGHT PERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED U 03 Ou —7 EXP I , NEW RESIDENTIA L PLUMBINGIMECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED, FRONT SIDE REAR FRONT URSIDE REAR qa COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE REMODEL mummmv SIGN PARKING LOT AREA PLANNING REVIEWED BY DATE REQ`D PROVIDED GRADING FENCE deEPAIR CYDS X FT) I REMARKS OTHER DEMOLISH [:3 TANK GARACE o RETAININGWALL FIRE I KLER CARPORT ROCKERY FIREaOE> (TYPE OF USE BUSINESS OR ACTIVITY) EXPLAIN: CHECKED BY TYPE OF C CODE OCCUPANT - Ol!STRUCTION GROUP NUMBER NUMBER OF CRITICAL 40. DWELLING AREAS SPECIAL INSPECTION OCCUPANT 4Y_QRIES UNITS NUMBER JAREA REQUIRED [3 YES LOAD DEGORIBE WORK TO BE DONE r, "t REMARKS PROGRESS INSPECTIONS PER UBC 108/F11NAL INSPECTION REG'D Pke ty- a 4e C, dS �UC +QnCA P-11' ove rA e'Nt- VALUAnON $ �)Qool Description FEE Descirlption FEE Plan Check State Surcharge HEAT SOURCE LAZING % LOT SLOPE % i Building Permit )Q4 city surcharge - F�HECK NO: VESTED DATE Plumbing Base Fee U Mechanical THIS PEMff AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 1= BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC 3 Grading DOMAIN (CURBS, BIDEVALKS, DRIVEWAYS. MAIROUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. I') . .1 1� .1 1 Eritartfleview PERMI'TAPPLICATION. 160 DAYS IL PEAMIT LIUM I YEAR - PROVIDED WORK 19 STARTED WITHIN 180 DAYS Engr. Insp"n, SEE BACK OF PiNK PERMIT FOR MORE INFORMATION -APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND 86406�8'� Plan Chk. Deposit IN INTEREST. AGREES TO INDEMNIF% DEFEND AND HOLD HARMLESS THE'dgy OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND Fire Iri'spiction Receipt # ALL "MS FOR DAMAGES OF WHATEVER MATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PER14rr. ISSUANCE OF THIS PERMIT SHALL NOT BE LandscapoIns Total Arnt. Due 39L DEEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CRY ORDINANCE P. NOR LIMIT IN ANY WAY THE CnYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # Lukia I HEREBY ACKNOWLEDGE THAT I HAVE READ 7111S APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECn MID 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 mipplication is not a peffnit until signed by 1he TION: AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building Offlelal 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 acknovAedged in spaco provided. WORKMERS COMPENSATION INSURANCE AND RCW 18.27. OF ic SIGN T RE DA7f SIGNATURE (0 ER AC ENT) DATE SIGNED IA95) �mb) 17,00 771-0220 RELEASED Y OATF Al'TENTION M 133 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINW. ILE YELLM/ INSPEdTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - GOLD - ASSESSOR 09/03 PRESS HARD -YOU ARE MAKING 4 COPIES