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20050022.pdfDATE RECEIVED CITY OF EDMONDS I I PERMIT EXPIRES — / .9 4444 UstPERMIT ZONE zoNE NUMBERr CONSTRUCTION PERMIT APPLICATION JOB ESS o��r- SUITE/APTM W, Vey,!�v OWNER NAME/NAME OF BUSINESS 0 1 r.V::.:;hin�on i•iuUL.al. PLAT NAME/SUBDIVISION NO. LOT NO. LID NO LID FEE $ Lu MAILING ADDRESS TESCP Approved �] P . 0 . B 0 7: 7 7 U nG PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Rw Permit Required Su O Streot Use Ponnit Roq'd CITY ZIP TELEPHONE EXISTING PROPOSED sidew tk ReqInsection uired O ound - -, - REQUIRED DEDICATION ,_ FT WiringUnderrequired u � n C h C /� wldn0 required p NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES ❑ NO ❑ _ ADDRESS REMARKS 2 ¢V OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE i CITY ZIP TELEPHONE NAME CBLN P l u fa b Signs Inc [ ENGINEERING REVIEWED BY DATE C ADDRESS Z 1 909 S. 28th St. 0 FIRE REVIEWED 8Y DATE tu¢ 4 CITY ZIP TELEPHONE 11: TacO::lcl 98409 253-Z.73-3323 m STATE LICENSE NUMBER EXPIRATION DATE C ECKED BY VARIANCE OR CU SHORELINE OR ADEN INSPECTION BOND REO'D POSTED _ PLUM,13S.1.07710S 11/10/05 � YES ❑NO 5. BEIRA REVIEW SIGN AREA HEIGHT (n -I UPROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PRO ?07ft ALLOWED PROPOSED v M 00C.9100001G0!_ EXP ,-/ 1100 5Q.I 0C,4-) Ma ❑ LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) O NEW ❑ RESIDENTIAL ❑ PLUMBING / MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR i 0 C COMPLIANCE OR ❑ ADDITION COMMERCIAL El �) C CY1� w� '� ',% t% L h� % z I CHANGE OF Z PARKING LOT AREA PLANNING REVIEWED BY DATE I i M Z ❑IL REMODEL ❑ MULTIFAMILY SIGN REO'0 SPR-OVIDED ❑ REPAIR ❑ GRADING CYDS ❑ FENCE X FT)�� KS_AC0� , mo FFGA.VfALL 4r=1& I . r —) �aB' 2 ❑ DEMOLISH ❑ TANK ❑ OTHER �( GARAGERETAINING WALL FIRE SPRINKLER /� E�t�,y71f�Co „ 0 ❑ wn CARPORT ❑ ROCKERY ❑ FIRE ALARM I Iowa r4!M"e_2n1n_ INA (TYPE OF USE, BUgINESS OR ACTIVITY) EXPLAIN: I I ITT M i L :: C Bank CHECKED BY TYPE OF CONSTRUCTION CO E OCCUPANT 0 NUMBER NUMBER OF CRITICAL � O l� OF DWELLING AREAS SPECIAL INSPECTION AREA OCCUPANT O STORIES UNITS NUMBER REQUIRED ❑YES LOAD C N . DESCRIBE WORK TO BE DONE IIIWIIM C": O V C? C :: i S t 111'9 a ri l K CO) REMARKS i i m 0 PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D ? ZZ r- insi_all nzl-u for iIa .hin ;ton islutual m �7P1 ., aL..ach,--NC't Sclo,rlY i —I D &00 r VALUATION Z $ i Description FEE Description FEE ZO Plan Check State Surcharge 0 0 HEAT SOURCE GLAZING % LOT SLOPE % IRI ,Building Permit �© r.- City Surcharge PLAN CHECK NO• . VESTED DATE Plumbing LiuMechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO C BE DONE ON PRIVATE PROPERTY ONLY.ANY CONSTRUCTION ON THE PUBLIC Grading 7 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION, Engr, Review 5 PERMIT APPLICATION: 180 DAYS IL PERMIT LIMIT. 1 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 Plan Chk, Deposit IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF Imm' s EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # I ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE a Landsca Ins Total Amt. Due - DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE p p' NOR LIMIT IN ANY WAY THE CITY'S 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 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. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. 1C!ALS SIGNAT RE DATE SIGNATU E (OW R O ,IGEN DATE SIGNED (425) 771 OLLO RE ED BY DTE ATTE IO EXT 1333 l 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 YELLOW. IN ECT CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109 .7�fr��%/ZE'r PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD =YOU AR MAKING 5 COPIES GREEN ACCOUNTING