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20040113.pdfI DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS 'I t;-> I M MAILING ADDRESS 10 1 CITY NAME ADDRESS CITY r=— I Vv'- - 12 nj NAME ADDRESS &—s& Z! CITY 5_1%aw STATE LICENSE NUMBER ZIP ITELEPHONE ZIP TELEPHONE iias 7 s If C I LaL IV" USE ZONE JOB ADDRESS/ I PERMIT EXPIRES C4 PERMIT NUMBER SUITE/APT# PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE S I ESCP APPf0v0d PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Requited Street Use Permit Req'd EXISTING — PROPOSED inspection Required 93 Sidewalk Required REQUIRED DEDICATION— FT Underground Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED N YES 0 13 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE ENGINEERING REVIEWED BY DATE BY DATE FIRE REVIEWED zip TELEPHONE 7AS *79*0 P1^11-7 VARIANCE OR CU SHORELINE OR ADS# INSPECTION BOND EXPIRATION DATE CHE ED BY 7 --- I ;' /)1_1w kim REQ'D ME5kfNO POSTED I $ �ROPERTY TAX ACCOUNT PARCEL NO. '3L OW — 0 NEW 1:1 RESIDENTIAL ADDITION ;R<COMMERCIAL 0 REMODEL 0 MULTIFAMILY REPAIR I — 0 GRADING CYDS DEMOLISH TANK GARAGE CARPORT RETAININGWALL ROCKERY (TYPE OF USE, USINESS OR ACINITY11 :/ �P' 4fEb NUMBER _.'00y NUMBER OF OF DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE A % 11- 1 -% r 0.%. 11'0 -e- BEIRA REVIEW COMPLETE EXEMPT SIGN AREA - ALLOWED PROPOSED EIGHT �'ALLOWED PRPPOSED EXP PLUMBING / mECH LOT COVERAGE REQUIRED SETBACKS (FT1' FRONT SIDE REAR PROPOSED SETBACKS fftf FRON T L/R SIDE REAR OR ALLOWED PROPOSED ' El COMPLIANCE USE CHANGE OF PARKIN LOT AREA PLANNING REVIEWED*k kATE SIGN REOD P VIDED A4 111LI -7 FENCE - t ( X_ FT) REMARKS OTHER FIRE SPRINKLER FIRE ALARM CHECKED 13Y IT.KP it . I J� IF CONSTRUCTION CRITICAL T AREAS 157 SPECVUL_INSPECTION JAREA .NUMBE REQUIRED [:]Yes 12-0-s REMARKS I PROGRESS INSPECTIONS PER UBC T s A r Description FEE Description FEE 00 ;Q 9E Plan Check State Surcharge IG % LOT SLOPE % City Surcharge -Building Permh PLAN C VESTED DATE Plumbing Base Fee ZL 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 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 160DAYS PERMIT LIMM 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION APPLICAK ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit N INTEREST, AGREES TO INDEMNIFX DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt N ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECnY OR INDIRECTLY NOT BE FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Recording Fee Receipt # if 572 1 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 CRY AND STATE LAWS REGULATING CONSTR UC_ CALL This application Is not a permit until signed by the Building Official 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 FOR INSPECTION receipt Is acknowledged in space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. OF lcsl�;PIGN DATE SIGNATURE (OWNER, OF �ENT)) DATE SIGWD 1A9 iff 771-0220 EXT 1333 RELEASEDSY DATE ", A/M 260, 1 Id h Ll wewm-nnm IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGI QAL- ILE YELLC& - PISPECTC CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK. NER GOLD -ASSESSOR 09/03 PRESS HARD -YOU ARE MAKING 4 COPIES L � RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing...................... Wall., .......................... Pier/Porch ................. Retaining Wall ............ M! -.?,��Slab,,Jrisulation ....... PLUMBING: Underground ............. mi, -inRough ................... M Commercial Final ...... JHEATING: A 10 GasTest .................... G Piping ................. as Equipment................. . Commercial Final..... M EXTERIOR SHEATHING NAILING ........ .................. FRAMING... .... ........... ........ 0i FIRST FLOOR 'FRAMING... )DATE RECEIVED =MIT EXPIRES USE PERMIT CITY OF EDMONDS ZONE NUMBER JOB SUITFIAPTO CONSTRUCTION PERMIT APPLICATION ADDRESS/ C, o? OWNER NAME/NAME OF BUSINESS (IZ . � , I PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. L .4 OKA 11 #$A4 MAILING ADDRESS r 1'.71a 44it- &.,,- ADDRESS 6 CITY t— 'A NAME ADDRESS CITY STATE LICENSE NUMBER ZIP ITELEPHONE ZIP I TELEPHONE i rma d 44 azz CBL # ZIP TELEPHONE '71- LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TE.CP A,.=. RW Per" Street UND Peffnit Req-d EXISTING — PROPOSED— Inspection Required Sidewalk Required REQUIRED DEDICATION- Fr underground Wiringreq,dred 13 METER SIZE LIN�� OF FIXTURES PRV REQUIRED YES E3 NO [3 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE VARIANCE OR CU INEORADB# I INSPECTION BOND EXPIRATIONDATE I CHEWED13Y I.An REO'D POSTED . I I hhffC�__;;rPIf1 I PROPERTY TAX ACCOUNT PARCEL NO. oa, - as(4- oQ 0 NEW 0 RESIDENTIAL AADDITION fiic�COMMERCtAl_ 0 REMODEL 0 MULTIFAMILY 0 REPAIR 0 GRADING CYDS 0 DEMOLISH 0 TANK oGARAGE -1 RETAINING WALL CARPORT 0 ROCKERY (TYPE OF USE, BUSINESS OR A EXPLAIN: 'a", /Zle NUMBER NUMBER OF OF DWELLING U STORIES UNITS DESCRIBE WORK TO BE DONE A 1-1- V W $ SEPA REV EW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PRIPPOSED JOR EXP �O� 1 , /Vo 1 e4om 'M PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS 0*1 ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR COMPLIANCE CHANGE OF USE SIGN PARKING REQ`D. L03T AREA LANNING REVIEWED BY A5ATE ,PVIDED I fR /V#,/A.4 FENCE ( _x FT) REMARKS OTHER oFIRE SPRINKLER F RE ALARM CRITICAL L CHECKED BY I TXE& F CONSTRUCTION I CODE OCCUEA :J� / 44 Sp P OR bANT_/ *4 ` SPECIAL INSPECTION JAREA/.,.,,. OCCU, REQUIRED 157, LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D tu 01 If ?A;P $ Description r FEE Description FEE Plan Check StateSurcharge HEAT SOURCE GLAZING % LOT SLOPE % AIM,Ac,- qUilding Permit City Surcharge PUkN C�� VESTED DATE Plumbing Base Fee Mechanical THIS PERurr AUTHORIZES OkLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC X Grading 3 DONIAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. I= . P Q - PFRUFTAPPILICATION-y1abDA'�11itt Review PERMIT LIMIR I YEAR - PROVIDED WORK 19 STARTED WITHIN 160 DAYS Engr. Inspection SEE 13ACKOF 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 a EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND Fire Inspection Receipt # -1-74 /17- 7 ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE 91 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due tt) 15 2 NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- -z--3P-5 Recording Fee I Receipt # 2j.1- 1 HEREBY ACKNOWLEDGE THAT I HAVE READ TH S APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORREM AND THAT AM THE OWNEZ 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 unfit signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED' Building Official or hi0or Deputy: and Fees are paid. and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION. r000lptla acitnowledged lnspaoo provided. WORKMENS COMPENSATION INSURANCE AND RCW 18.27. OFY.]C!&"IGN DATE SIGNATURE (OWNER D IIAO 425) A 771-0220 RELEASED Y r uAlt: ATTENTION En 1333 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-YILE YE -IN§PECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PNK'OWNER GOLD -ASSESSOR 09/03 PRESS . HARD -YOU ARE MAKING 4 COPIES 0003 I' L z 0 4 0 M :; T, Vi � 0 M C M 10 0 r M M 0 _Tl M § Q) Fn- C 0) (A z 0 d 0 M