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20040121 (2).pdfi RECEIVED PIRES 9.49 CITY OF EDMONDS USE PERMIT ZONE NUMBER CONSTRUCTION PERMIT APPLICATION JOB suffqwo ADDRESS U NY qq WIN R NAME/NAME OFAq8INESS &PLAT a\f\l NAME/SUBDIVISION NO. ] LOT NO. LID NO. .55� MAI7LNG —ADDRESS LID FEE S A;�711P I ESCP Appmed PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Pefrad Required ZIP TELEPHONE Strool Uso Peffnit Req'd EXISTING — PROPOSED- lnspKton P"uked 909do I I Skiewalk Asquirod REQUIRED DEDICATION— FT undorwourld WMg required NAME METER SIZE LINE SIZE 1��RES PRV REQUIRED I YEsI3 NO 1:1 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIORAINAGE CITY ZIP TELEPHONE NAME N ENGINEERING REVIEWED BY DATE DRESS 00 A _� -0 CITY ZIP TELEPHONE FIRE REVIEWED BY DATE us IEL STATE LICENSE NUMBER EXPIRATION DATE) CHECNED BY qARlANdE OFft SHORELINE OR ADB# �T INSPECTION BOND REO'D POSTED Is 7-7W67b%X DVP I., LO�05 10AV 10YEs 13NO SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX CCO PARCEL Nq. COMPLETE EXEMPT ALLOWED PROPOSED, ALLOWED PROPOSED 70 I EXP rPLUMBING/MECH NEW MRIESIDENTIAL LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR o COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE KREMODEL MULTIFAMILY SIGN PARKING LOT AREA PLANNING REVIEWED BY DATE ROVIDED GRADING FENCE REPAIR CYDS X FT) REMARKS DEMOLISH TANK oGARAGE [3 FIETAININGWALL FIRE SPRINKLEh CARPORT ROCKERY FIRE ALARM (TjfE OF USE, BUSINESS LAIN: 1 0- Lxfff CHECKED BY TYPE CONSTRUCTION OCCUPANT C H � 0 GROUP lim NUMBER NUMBER OF rrICAL An OF DINELLING CREAS AREA SPECIAL INSPECTION OCCUPANT S P UNITS NUMBER I STORIES Y-00, REQUIRED LOAD F I E YE DESCRIBE WORK To BE NE REMARKS R E PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD PR Qj�zkm in 01anniWIAdl K*d VALUATION VA Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % L Building Permit City Surcharge W5 PLAN CHECK NO: VEST ED DATE Plumbing IL Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPIEffff ONLY. AM CONSTRUCTION ON THE PUBLIC Grading DOMAIN (CUPAS, SIDEWALKS, DRIMMAYS. MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPUCATION: 180DAYS PERMIT LIUM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 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 9=1 r) 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 100 Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMR. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE cays ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # I HERE13Y 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 0111cial or his/her Deputy: and Fees are pald, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged In space provided. WORKMENS COMPENSATION INSURANCE AND RCW 18.27. OFFICIALS SIGNATURE DATE SIGIAATURE (OWNMO GE GNE9 I DATIE Sl ��).SJC3(�t4C J._/ 0 -OL[, 771-0220 6WEASED BY D TE ATTENTIO M 1333 0&dw� IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CEFjjIFI- Low. 14SPICT R -PI11"INER CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 / /71dju, - GOLD -ASSESSOR ltl�tkw 04/02 PRESS HARD -YO-0 ARE MAkNIG 5 COPIES GREEN - ACCOUNTING z 0 i 0 m =i 9i m Ma 0 -10 OC -1 C X rn c 0 -n n m M a 0 0 M C C4 c (1) M 0 M z z 0 1 ?s m I t wan, . .Fietaining DATE RECEIVED.P_L V PERMIT UPIRES USE PERMIT ZONE - CITY OF EDMONDS NUMBER o�94' JOB SU"VAPT# CONSTRUCTION PERMIT APPLICATION ADDRESS kvy R ME OF,��INESS FLAT NAMEISUBDIVISION NO. LOT NO. LJD NO. MAICING ADDRESS LID FEE S TESCP Appmv*d PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Iftmo RoquWal q9 8"M Use PaffM Rold CITY ELEPHONE EXISTING — PROPOSED— hupecdon Roquired - Sidewla floWited REQUIRED DEDICATION— FT UndwWound 661 Pod Zip r WkIngrequWW 13 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES13 NO E3 ADDRESS MA ROEWNERRKICS4% MT'MjEr0ELbjCjROL/DRAINAGE a III a 1110 it .3-7- & a — a vm�� CITY ZIP TELEPHONE NAME C7 #-W- ENGINEERING REVIEWED BY DATE ADDRESS FIRE REVIEWED BY DATE C!Ly TELEPHONE 2 zip _/0--vt VARIANCEO U SHORELINEORADB# IN§PECTION 1$ BOND STATE LICENSE NUMBER EXPIRATION DATE REO'D POSTED 1010-5 SEPA REVIEW SIGN AREA DYES E3NO HEIGHT ITY TAX- CCO PARCEL N9. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPERTY TAX A g? 70 YZ OO.Q 6621900 EXPz�: PROPOSED ul OX [3 NEW WRESIDENTIAL 0 PLUMBING/MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REAR COMPLIANCE OR ADDITION COMMERCIAL 11 CHANGE OF USE —PLANNING PARKING LOT AREA REVIEWED BY DATE REMODEL MULnFAMILY [:1 SIGN RE(YD I PROVIDED 06 REPAIR GRADING FENCE X FT) REMARKS CYDS 1:1 [3 DEMOLISH TANK §rO'rERr c3GARAGE o RETAININGWALL [3 FIRE SPRINKLEiR CARPORT ROCKERY FIRE ALARM (WE OF USE, BUSINESS 0A TFVFM EXPLAIN: o rrif CHECKED BY nE TRUCTION WDE OCCUPANT GROUP NUMBER N 'ER OF -_01 CRITICAL UMI G AREAS SPECIAL INSPECTION AREA OCCUPANT OF DWELLIN LOAD STORIES U NUMBER REQUIRED [] YES DESCRIBE WORK TO BE NE -1gr REMARKS PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION RECtD nrki mo�. i-1- t'l-i Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing Mechanical t: zi k: a- 15 CL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVIEVAYS, MARQUEES, FTC.) WILL REQUIRE Glading WARATEPE"IVION�, Engr. Review PERUITAPPILICATION: 180DAYS PERUff ILIDAM I YEAR - PROVIDED WORK 18 STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, . ONAEHALF OF HIS OR HER SPOUSE. HEIRS,- ASSIGNS AND SUCCESORS Fire Review Fire I 50 PlanChk.DepOSft IN INTEREST. AGREES TO -INDEMNIFY, DEFEND AND -HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFIFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection re DO Receipt # Y ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIREOTLY E NOT BE FROM THE ISSUANCE OF THIS PERMM ISSUANCE OF THIS PERMIT $HALL E DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapainsp. Land' Total Amt. Due NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Recording Fee RM tF 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 APPLICAIION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a permit until signed by the 2 TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED r IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building Official or his/her Deputy: and Fees are paid, and receipt is acknovdedged in space provided. WORKMERS COMPENSATION INSURANCE AND RCW 16.27. OFFICIALS SIGNATURE DATE SiGLIA TURE (OWNER 094GEgry", I DATE SIGNE9 1A0 1,425) t4 ��el 771-0220 AW),EASED BY OFE ATTENTION EXT 1333 i(�kj IT IS UWLAW�OL TO USE OR OCCUPY A BUILDING Oft STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND A.PPROVAL OR A CEftjlrl- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 1091 LLAAj iv ORIGINAL-FIL-E - YELLOW- 14SPECTOIR PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKI 5 COPIES GREEN - ACCOUNTING TIL_