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20050152A.pdfDATE RECEIVED PERMIT EXPIREE `%5✓ ZOE PERMIT CITY OF EDMONDS ZONE L' 5 - JZ NUMBER . _\ CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# II OWNADDRESS qER NAME/NAME OF BUSINESS "'"jI kt-tK ) Q N,4 LD m 112 Q a icrt PLAT NAME/SUBDIVISION NO. LOT N0. LID NO. Lbw MAILING ADDRESS LID FEE S O f, �,(� PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved p RW Permit Required O street Use Permit Roq'd (3 CITYZIP TELEPHONE EXISTING PROPOSED Inspection Required 13 ^ �y /�'% �j S�• 7 Sidewalk Required 13 underound 3 �T REQUIRED DEDICATION FT wiring required I � Wldnp raquirod Q NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED c7 YES ❑ NO ❑ z W w = ADDRESS REMARKS z O OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE Z g W CITY ZIP TFI FPHnNF AwaAorlq )/ `—L t R ENGINEERING REVIEWED BY DATE ADDRESS FIRE REVIEWED BY DATE W CITY ZIP TELEPHONE l NEEDV?44"Aic J STATF. LICENSE NUMBER EXPIRATION DATE CHECKED BY VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND REO'D POSTED ❑YES I KO s --- SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT P EL O % COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED Ion 1 EXP © ANC ❑ NEW RESIDENTIAL ❑ PLUMBING/MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REARCOMPLIANCE OR t, ❑ ADDITION ❑ COMMERCIAL ❑ CHANGE OF USE 3 �� 2 L 31 z / PARKING LOT AREA PLANNING REVIEWED BY DATE g REMODEL ❑ MULTIFAMILY ❑ SIGN REO'D PROVIDED ^' ❑ ❑ FENCE REPAIR ❑ GRADING CYDS M C`. 17� �' .� ( X Fn REMARKS Nnx ❑ DEMOLISH ❑ TANKOTH GARAGE RETAINING WALL ��cc�IIII FIRE SPRINKLER - 1Lx' 0 ❑ CARPORT ❑ ROCKERY ❑ FIRE ALARM (TYPE OF USE, BUSINESS OR CTN XPLAIN: NONE o scw avr^A1� A4tSI S .x. CHECKED BY TYPE OFONSTRUCTION CODE OCCUPANT ' GROUP NUMBER NUMBER OF CRITICAL OF DWELLING AREAS% SPECIAL INSPECTION AREA OCCUPANT STORIES UNITS NUMBER 1 REQUIRED r] YES LOAD DESCRIBE WORK TO BE DONE REMARKS _ V 'n �� PR KESS INSPECTIONS PER UBC 108/I6C109/IRC109 Fl INSPECTION REO'D 9 V m >r YI.P r /4e \/AI 1 IATIf1A1 I Z j p NMIm N = crn Ca ITIA011O OC _ M m Z D� Cn gm mn mm O N r r zr TIC $ Description FEE Description FEE } Z Plan Check State Surcharge < < 2 HEAT SOURCE GLAZING % LOT SLOPE % J Building Permit City Surcharge /d I Oz 11415 PLAN CHECK NO: VESTED DATE Plumbing Base Fee _'i . �O- I rp n m THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO Mechanical t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC iDOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC,) WILL REQUIRE Grading SEPARATE PERMISSION. Engr, Review w 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 (A •APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit n IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF 2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #lZ ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE ' S DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp, LReceipt# t. Due = NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Recording Fee I HEREBY ACKNOWLEDGE THAT 1 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 0jeVE LABOR CODE OF THE STATE OF WASHINGTON RELATING -TO FOR INSPECTION receipt is acknowledged In space provided. WORKMEN'S C.,qMPEjSATION INSURANCE AND RCW 1827. it FFI LS SIGNATU DATE S AT U(NE OR AGE r, ,� DATE SIGNED (425) 771-022 E ED BY DA E ATTENTION EXT 1333 IT IS UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTILA FINAL !' INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OFOCCU ORIGINAL •FILE YELLOW -INSPECT R PANCY HAS BEEN GRANTED, UBC109 / IBC110 / IRC110. PINK -OWNER GOLD -ASSESSOR 09/03 PRESS HARD =YOU ARE MAKING 4 COPIES