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20040290 (3).pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS t � % V16, r e v% lic-� CUMM1,11,j-'s MAILING ADDRESS %J Cj I S+. SW CITY ZIP TELEPHONE 1::.611 M 0,4" 1.4 W P A NAME ADDRESS - 1 -3 o o -74', 54% it 10 q ZIP c1tr'Liov, 01 go5s, -1 TELEPHONE �4e 'a71-7!M .3 NAME P 110 (fvw �BLN c ADDRESS -?14 CITY Se4t.g-U- V, eNz"I V` TELEPHONE r ,W6-qV)- INN STATE LICENSE NUMBER EXPIRATION DATE 1. CHECK& BY EaT-1,0 I0,1010MID 51-)10 PROPERTY TAX ACCOUNT PARCEL NO. 6.1*Vj, a'7 Q j 10-20 0 -3 0 110 DO IV061201-1000 13 NEW ff"RESIDENTIAL PLUM13ING / mECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL MULTIFAMILY SIGN 0"REPAIR GRADING A144—L CYDS FENCE ( _ X_FT) 0 DEMOLISH [3 TANK OTHER E(GARAGE CARPORT RETAINING WALL ROCKERY o F RE SPRINKLER FIRE ALARM CrYPE OF USE, BUSINE§&qBA;qIVrM WPDPWI A In.4 /1 1—A A:L - NUMBER NUMBER OF CRITICAL XVtM VEIr— OF DWELLING AF STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE A MR61111M.0", M'SPAME e PERMIT EXPIRES USE _,PERMIT 3 00U� ZONE NUMBER Ilutj ADDRESS Z4P PLAT NAME/SUBDIVISION NO. LOT NO. D NO. �D -78 1 FEE $ IESCP AP a', PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Dquirld RW Permit Required Street Use pormh R&q'd EXISTING — PROPOSED Inspection Required 13 Sidewalk Required 13 REQUIRED DEDICATION Fr Underground wiring required 0 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 13_ NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE grro, /ksp, EN6,k- Fr N AL . X I ENGINEERING REVIEWED BY DATE ktij 7 9ME REVIEWED BY* DATE -7�ARIANCE OR CU SHORELINE OR ADS# I INSPECTION 1$ BOND RE%D0 POSTED 13YES jkNO SEPA REVIEW SIGN AREA - HEIGHT COMPLETE I EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED .41 'XP x 0& 5 LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED IpR�.PO�ED FRONT SIDE REAR FRONT LJRFIDE ,R AR ,g a, 0 9 7.. "7 PARKING LOT AREA PLANNING REVIEWER B� 15ATE R CY I T!gD jqj REMARKS C_ _—_j N F X-1 --,. -s LHECKED BY TYPE nr—qNURUPTION OCCUPANT GROUP AV SPECIAL INSPECTION JAREA OCCUPANT LOAD REQUIRED [3YES I W cc rL 2 INSPECTIONS PER UBC IGO/FINAL INSPECTION REO'D . & .— - . i ), . P. ., A AC— �-- A 47—� JJ- �6162�j gj* VALUATION $ &v/;U7— I i Description FEE Description FEE OLJ- Plan Check State Surcharge _WT SPURCE GLAZING % LOT SLOPE % Building Permit City Surcharge N Ot%-'r,-- I - - I 0 PLAN CHECK NO: VESTED DATE Plumbing A Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO It BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading 3 DOMAIN (CURBS, SIDEMIALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPUCATION: ISODAYS PERMIT LIMM 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 IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 NOR LIMIT IN ANY WAY THE CnYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' MI Recording Fee I HEREBY 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 THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC. CALL TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION,0F THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION WORKMEN'S 310M^SATION INSURANCE AND RCW 18.27. C SIGNATUR ER DATE SI NED ot��P� (425) 1" 1 �S,2(110� 771-0220 "nd I ATTEN N Off 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 04/02 PRESS HARD -YOU ARE MAKING 5 COP Plan Chk. Deposit Receipt # Total Amt. Due Receipt # . L70 APPLICATION APPROVAL This applicallun is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid, and receipt Is acknowledged In space provided. FFICI SIGNAT WE. DATE 14-1 Iq 7rL �f I ff &Itt iLo�) ORIGINAL - FILE YELLOW -4NSPEdc PINK -OWNER GOLD -ASSESSOR GREEN - ACCOUNTING V N Z E ON SETBACKS* FRONT r 0 SIDE U AJ e L A J J h L) REAR OTHER HEIGH SJ-45108 EX. IRON PIN WITH CAP 147.94 NO'D 4561 N 23"36' W 0.07 )4 lid 0444 �q pa En 0 0) ul lij in-oc�4�i ui fD CD lopi %0, 04 APPm E D 0y PLANINVING NOV Vp, EX. IRON PIN WITH CAP )--7 NO'D 4561 S 81*51' E TRUE POINT 0.08 EX. IRON PIN WITH CAP OF BEGINNING NO'O 4561 N 55*12' W SET NAIL WITH b 0.07 WASHER NO'D 146.01 22969 w------------ N 89017'34" W b 184th AVENUE S.W. cq D E RSCE 1pv TY CUL a MAR 2 62004 OUNTE-P PERMIT C �%V� Vx; 0,0 FINAL PROJECT "PROVAL FORM TO: am c MO 0 80 MM M Z JO F- � V) 0 m M a V5 Fn C 0) c 0) M 0 z X z V) z m GasTest .................... hj!. Gas Piping ................. -n 'Equipment ... ............. Commercial Final ....... EXTERIOR SHEATHING NAILING ........................ C FRAMING ........................ ... , I . s MT are Milton The Initial Thompson, a temporary contract for the CitY. inspector 4 DATE' RECEIVED -r�lz I I PERMIT EXPIRES USE PERMIT /-) .14)"" CITY OF EDMONDS ZONE NUMBER,/,� 0011 t� J013 SUITE/IIPT# CONSTRUCTION PERMIT APPLICATION ADDRESS OWNER NAMEINAME OF BUSINESS korPA * 9%. � A PLATNAME/SUBDIVISIONNO. LOTNO. LID NO. MAILING ADDRESS 1j LID FEE S 7ESCP Approved Ll PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW PsU It Required C1 105 sw — Street "ne Permit Req'd CITY TELEPHONE EXISTING — PROPOSED inspection Required REQUIRED DEDICATION Fr underground ZIP WIM19 required 13 Sidwalk Required NAIJE METER SIZE LINE SIZE NO. OF FIXTURES RV REQUIRED YEB 13 NO 13 E ADDRESS REMARKS OWNERICONTRACTOR,RESPONSIBLE.FOR EROSION CONTROLIDRAINAGE 3 1) D S VJ '3+. :0 10 q CIL ZIP., TELEPHONE V NAME CBLN P110 Cov. Q# A U Tri C. ENGINEERING REVIEWED BY DATE cc ADDRESS 4 - -A z ILI 5 AfIE REVIEWED BY DATE CITY TELEPHONE Sp, 4 L, WA z'P, ob- 46-1 - 1?() 1 VARIANCE OR CU _�HORELINE OR ADBO INSPECTION BOND STATE LICENSE NUMBER EXPIRATION DATE CHECK BY REGAr POSTED 151 ES &N 5 I — E3Y 01 1: 1- 0 lei 010M10 -))0 SEPA REVIEW . SIGN AREA I HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE , EXEMPT ALLOWED , PROPOSED ALLO�D PROPOSED "76 0 M 00,30110 9310120 11000 EXP M LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr.) . r o NEW eFIESIDENTIAL PLUMBING / MECH ALLOWED PRPJ03 , D FRONT, SID� R�AR 9 FRONY IJUIDE /RVR 2f 10, 1 0,A51 Its 0C COMPLIANCE OR CHANGEOFUSE 3511/0 11 &7. 9.197.4 ADDITION COMMERCIAL fc�l 0 6ATE :0 z . . PARKING I LOT AREA PLAN41NG REVIEW A. M -MODEL MULTIFAMILY R TO I ?X0vl1rED liq q3 I / RE SIGN FENCE 4/0 it GRADING �eREPAIR CYDS' X Fr) REMARKS 9T7VCT*%(re OTHER 11 DEMOLISH 0 TANK A V 'to V dof VVA f, CO j —I/ V C71/t"? a E RETAINING WALL FIRE SPRINKLER 0 ROCKERY FIRE ALARM UYPE OF USE. BUSIN!p HECKED BY TYP�M7TION occu =ivnMr GROUPPANT OL MITI -IF X. C NUMBER NOMBER OF CRITICAL XVX4 VC AR OF DWELLING CREAS SPECIAL INSPECTION EA OCCUPANT LOAD C: ED rlvr 0 Fn STORIES UNITS d. NUMBER REQUIR DESCRIBE WORK TO BE DONE REMARKS M 0 PROGRESS INSPECTIONS PER UBC 1189/FINAL INSPECTION RECrD. ft AA42 6 Y.IF= MIVIM2E�= -4-4 :s;—:: VALUATION z s j�W 1_1/0,� e DescriptIon FEE Description FEE Y: z 0 _k Plan Check State Surcharge -4 WT VURCE GLAZING % LOT SLOPE % C 3 Building Permit ity Surcharge M NONIP- I - - PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PEWIT AUTHORRES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DOME ON PRIVATE PROPER1Y ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading X - DOMAIN (CURBS,.SIMWALKS, DRNMAYS, uARQuEEs, ETC.) WILL REQUIRE SEPARATE PERMISSION. t: Engr. Review It. DAYS PERMIT ILIMM 1114AWC VAR-W Engr. Inspection SEE BAqF!31!j amp F%ND SUCC Fire Review Plan Chk. Deposit 'APPLICANT, ON BEr �FIAI Wlapousfil IRS, A ESORS IN INTEREST, AGREES INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANYAND Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, 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 Landscapelnsp. Total Amt. Due 5:q .5 U NOR LIMIT IN ANY WAY THE C11TYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- --- I ' I I ' 2 -�,3q Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION API OROVAL 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- TNs application Is not a permit unfill signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED CALL Building Official or hisfher Deputy: and Fees ate paid, and IN VIOLATION F THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided. WORKMENS M^SATION INSURANCE AND RCW 18.27. (425) DATE�V !t DATE LNED (, I V � 771-0220 T-3 A EAVD BY, D ATTEN1`16N EXr 11333 C IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL Qkl A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- OR�GINAL - FILE YELLOW -/INSPE40R IV CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 P NK - OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPI� GREEN - ACCOUNTING