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20040079.pdfA DATE RECEIVED /_ CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMENAME OF BUSINESS Coppe-12STONZ P)IdA,, CITY NAME ADDRESi CITY NAME G bAkO#JDS ADDRESS . P 0. CITY STATE LICENSE NUMBER V ITELEPHONE ZIP ITELEPHONE ZIP ft PERMIT EXPIREVIIN"A USE PERMI ZONE T NUMBER JOB � U V0 ADDRESS PLAT NAME/SUBDIVISION NO. T NO. LID NO. r LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Requkod Street Use Permit Roq'd I EXISTING — PROPOSED inspection Roqt1kod Sidewalk Recitived REQUIRED DEDICATION- FT Underground Witingrequired METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED I YESI3 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE LO: ENG NEERING REVIEWED BY DATE FIRE REVIEWED BY DATE I TELEPHONE 2 (o I A25 4:4.4 0 Z44 EXPIRATION DATE CH 3 FY i4yd 6-zl-o,�-Jm NEW RESIDENTIAL PLUMBING I MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL 9, MULTIFAMILY SIGN REPAIR GRADING 0 CYDS FENCE x Fr) DEMOLISH 1:1 TANK OTHER oGARAGE CARPORT [3 RETAINING WALL ROCKERY Fa ME SPRINKLER — -IRE ALARM (TYPE OF USE. BlUSINESS OR ACTINTMEXPLAIN: M NUMBER NUMBER OF — CRITICAL a OF WELLING A EAS qj STORIES UNITS NuMBER DESCRIBE WORK TO BE DONE GV VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND REQ'D POSTED Is 1[3y ES 13NO SEPA REVIEW SIGN AREA I HEIGHT COMPLETE EXEMPT ALLOWE13 PROPOSED,:� ALLOWED PROPOSED EXP , , , LOT COVERAGE REQUIRED SETBACKS (Frf �PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT.. LIRSIDE REAR PARKING LOT AREA PLANNING REVIEWED'dY DATE REQ'D I PROVIDED REMARKS CHECKED BY SPECIAL INSPECTION JA"EA REQUIRED [3 YES REMARKS PROGRESS INSPECTIONS PER UBC 1 GROUPKIIPI I OCCUPANT LOAD i I INSPECTION REG'D 9 I pa VALUATION Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit city Surcharge PLAN CHECK WO-0 VESTED DATE Plumbing Base Fee Mechanical THIS PERMIT AUTHORDIS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC 2 Grading 3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: ISO DAYS CL PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN ISO 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 X' Plan Chk. Deposit Iz/6 IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF 2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANYAND Inspection Receipt # IFire 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 MY CITY ORDINANCE Landscapelnsp. Total Amt. Due 0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Recording Fee Receipt # I HERE13Y ACKNOWLEDGE THAT I 14AVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL IS CORRECT, AND THAT I AM 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, VWUKK EN'S COMPENSATI��NCE AND RCW 16.27. URE JDATE DATE SIGNED (425) Z -7-10 5 7- I - 771-0220 �q A R EA DAT ATTEE'""11r1_dW_ EXT 133 Z[M& PhA 117�114 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 YELIOW - IN4ECTOR y CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 09/03 PRESS HARD -YOU ARE MAKING 4 COPIES z 0 q FINAt-, PROJECT APPROVAL k ORM DATE: z 0 m =i m c m 0 80 c M m 10 Z c � 0 _n n m M 0 0 0 M C cl) 9 co) rn 0 z 3! co z 9 0 m 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Signature I:tcmp:bldg:fonns:ocaprvl 3/25/04 71; .k! . !b M DATE'RECEIVED. CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS d MAILING ADDRESS U I � � -q* CITY �Mmw& ELEPHONE NAME ADDRESS CITY ZIP ITELEPHONE 14 ,-c)q J�a* _LPERMIT EXPIREV�� USE PERMIT - ' ZONE NUMBER JOB Sul ADDRESS 411A PLAT NAMEISUBDIVISION NO. LOT NO, LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCIR AWDvfd RW Permit Required at Use Peffnit Raq'd EXISTING - PROPOSED- Inspecftn Ractuffed Sidewalk Re"Ired REQUIRED DEDICATION- FT - Underground Wking required 13 METER SIZE LINE SIZE 0. OF FIXTURES PRV REQUIRED I f YES13 NO C3 REMARKS WNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE NAME CBLN C- b RO " DS SE"112 I-N Al CDM M I AX - ENGINEERING REVIEWED BY DATE I 0 ADDRESS P0. (00 FIRE REVIEWED BY DATE 1 CITY ZIP TELEPHONE 0 Ir6 I-)) AA () NOS %02 A25 -1-74 QZ4 VARIANCE�OR CU SHORELINE OR ADBN INSPECTIO SO STATE LICENSE NUMBER EXPIRATION DATE CHEMED BY REO'D POSVD/ 10YES ENID$ IEC0(d1A/ChN0k)5(_0i4),d 15-Z1_C6 ((V SEPA REVIEW SIGN AREA HEIGHT PROPERTY CO 'PABCEL No. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROP08ED 2 .2T;Vn#0-f'7190 EXP , t: , , NEW RESIDENTIAL PLUMBING / MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) FRONT SIDE REAR FRONT LIRSIDE REAR ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE 0 REMODEL MULTIFAMILY 0 SIGN PARKING LOT AREA PLANNINWREVIEWED BY DATE REOD I PROVIDED REPAIR [3 GRADING FENCE CYDS X FT) REMARKS OTHER 0 DEMOLISH TANK oGARAGE o RETAININGWALL F RE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPEOF USE, BaESS OR A EXPLAIN: R 11 CHECKEDjTYP?fj CONqTRUCTION jCjfj 93 NUMBER OF CRITICAL . �OFO DWELLING AREAS INSPE OCCUPANT SPECIAL CTION 1 STORIES UNITS NUMBER ST JAREA REQUIRED [] YES LOAD DESCRIBE WORK TO BE DONE I W ST IS Q Q C-) E LOU-3 VOK_T%kt-_.E REMARKS — , 1. PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REaD FIRE: AtAr-M 45NS11M. VALUATION $ Description FEE Description FEE )tIO Plan Check e State Surcharge rg] HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Base Fee Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC X (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.)."LL REQUIRE DOMAIN Grading SEPARATE PERMISSION. Engr. Review PERMIT APPLICATIbIt 111110DAYS. 9L PERMIT ILIMM I YEAR - PROVIDED WORK IS SFARTED WITHIN IGO DAYS Engr. Inspection SEE 13ACK OF PINK PERMIT FOR PADRE INFORMATION "APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review PlanChk.Deposft 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 MATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Total Amt. Duo DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE Crr1rS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Recording Fee Receipt 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 MPILY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a perat untill signed by the TION; AND IN DOING THE OAK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or hielzir Deputy: and Fees are paid, and IN VIOLATION OF THE BOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt to acknowledged In space provided. WORKMEN'S COMPEN 10 ,NdASU§ANCE AND RCW 18.27. OFFICIALS SIGNATURE /DATE A E DATE SIGNED IQ 1,425) 771-0220 r42\EASi?DW DAT Antr4bdW EXT 133 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- OR�GINAL-FILE YE40N.INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PNK-OWNER GOLD -ASSESSOR 09/03 PRESS HARD -YOU ARE MAKING 4 COPIES z 0 M