20050187 (2).pdf516
DATE RECEIVED
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CITY. OF EDMONDS
�)1 PERMIT EXPIRES
USE PERMIT
ZONE NUMBER
CONSTRUCTION PERMIT APPLICATION JOB t SUITE/APT#
OWNER NAME/NAME OF BUSINESS ADDRESS 2256. Highway 99
Fran ];1 i n Edmonds LLC/Big Foot Java PIAT NAME/SUBDIVISION NO. LOT NO. LID NO:
i
MAILING ADDRESS LID FEE S p
15 015 Main St. It 203 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TES
y Perrmitit Requioveired Q
O
Street Use Permit Req'd
CITY EXISTING PROPOSED Inspection Required p
ZIP TELEPHONE Sidewalk Requited 13
Bellevue 98007 REQUIRED DEDICATION FT underground
Wiring required 0
NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
YES ❑ NO ❑ Z
i ual
ADDRESS REMARKS z
j - OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY ZIP TELEPHONE
NAME CBL oo�
Plumb Signs Inc. ENGINEERING REVIEWED BY DATE
ADDRESS
c; 909 S."28th St.
I FIRE REVIEWED BY DATE w
CITY ZIP TELEPHONE
3 Tacoma 98409 253-473-3323 cMc
STATE LICENSE NUMBER EXPIRATION DATE Y VARIANCE OR CU SHORELINE OR:ADBT#INSPECTION BOND
REQ'D POSTED
PLUMBSI077QS 11/10/05 S 60No s
SEPA REVIEW v IGN AREA HEIGHT
y
PROP ��298C UNT EAFICVNO. COMPLETE EXEMPT ALLOV ED PROPS D ALLOWED PROPOSED
U30740 EXP � '� 1 tc7,W
NEW ❑ RESIDENTIAL ❑ PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR
COMPLIANCE OR Z
❑ADDITION ~COMMERCIAL Z
lam\ ❑ CHANGE OF USE z
PARKING LOT AREA PLANNING REVIEWED BY DATE 5
❑ REMODEL ❑ MULTIFAMILY SIGN" REO'D PROVIDED CL/
ro
1:1 REPAIR
REPAIR ❑ GRADING CYDS ❑
( X FT)REMARKS "
❑ DEMOLISH ❑ TANK ❑ OTHER
" ❑ GARAGE CARPORT ❑ ROCKERY NING WALL ❑ FIRE ALARM FIRE LER
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
Coffee sales l e s CHECKED BY TYPE F C "N RU TION C OCCUPANT
�s GROUP
uS NUMBER NUMBER OF " CRITICAL
OF DWELLING AREAS 1� f SPECIAL INSPECTION JAREA OCCUPANT
DSTORIES UNITS NUMBER ��, VVV REQUIRED ❑YES LOAD
DESCRIBE WORI TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D '9
Install building signoe for m
Big FootA Java VALUATION
$
Description FEE Description FEE
Plan Check State Surcharge
HEAT SOURCE GLAZING % LOT SLOPE %
.Building Permit t, City Surcharge
PLAN CHECK NO: VESTED DATE Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
Ic BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC.
7 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading
SEPARATE PERMISSION.
Engr, Review
5 PERMIT APPLICATION: 180 DAYS
a PERMIT LIMIT. / 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
Q EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND 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 Landsca a 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- CALLThis 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 Foes 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 10.27.
C OF IALS NATURE TE
SIGN TURF NER O T) DATE SIGNED. (425) • �%
10/6/04 AA
771-0220 ELEASED Y DAfrE
ATTE TION EXT 13332&§d
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
4 M
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-oRlOwL • F E YELLOW -INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109 PINK- NER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN -ACCOUNTING
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