20050344.pdfDATE RECEIVED
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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEMAME OF BUSINESS
Starbucks Coffee
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MAILING ADDRESS
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22828 — 100th Avenue West
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CITY ZIP
TELEPHONE
Edmonds 98020
(425)775-9292
NAME
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ADDRESS
CITY
TELEPHONE
NAME
Plumb Signs Inc. NR 0 OrBL
425
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ADDRESS
8
909 S.'28th St.
CITY ZIP
TELEPHONE
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Tacoma- 98409
(2!
(253)473-3323
STATE LICENSE NUMBER EXPIRATION DATE
CHEC D BY
PLUMBS1077QS 11/10/ O&t
PROPERTY.TAX ACCOUNT PARCEL NO.
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.00610600300201
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NEW RESIDENTIAL PLUMBING I MECH
ADDITION Xn COMMERCIAL COMPLIANCE OR
CHANGE OF USE
REMODEL MULTIFAMILY %OYISIGN
REPAIR GRADING CYCIS FENCE
( X FT)
DEMOLISH 1:1 TANK o OTHER
Ei GARAGE RETAINING WALL FIRE SPRINKLER
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CARPORT ROCKERY FIRE ALARM
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(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
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NUMBER NUMBER OF CRITICAL
OF DWELLING AREAS
STORIES R4�4011 UNIT NUMBER
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DESCRIBE 'f (IRK TO BE DONE
channel letter wall sign
reading Starbucks Coffee., %0--
7�A 4— C. IV 15� VV
HEAT SOURCE
GLAZING %
LOT SLOPE %
PLAN CHECK NO:
VESTED DATE
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
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PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT I YEAR - PROVIDED WORK 15 STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CI`TY OF
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EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIREC MY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SIIALL NOT HE
DEEMED TO MODIFY� WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
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NOR LIMIT IN ANY WAY TXE CI1YS ABILRY to ENFOHCE ANY ORDINANCE PROVISION.
I HEREBY ACKNOWLEDGE THAT I HAVE READ Tills APPLICATION TI11AT THE INFORMAf ION
GIVEN IS CORRECT. AND TIIAT I AM THE OWNER, OR TIIE DUL� AUTHORIZED �OtNT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC,
TION; AND IN DOING TIIE WORK AUTHORIZED THEREBY, NO PERSON WIl L 94 EMPLOYED
IN VIOLATION OF TIIE LABOR CODE OF THE STATE OF WASIIINGTOfrELATING TO
WORKMEN'S COMPENSATIOI�)NSUFIANCF AND RCW 11127,
SIGNATUR-JPW
DATE SIGN D
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PERMITEXPIRES _L.42,
SE PERMIT
ONE
NUMBER i5--el)
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DDRESS
22828 100th Ave. West
PLAT NAME/SUBDIVISION NO. LOT NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING - PROPOSED
REQUIRED DEDICATION FT
METER SIZE LINE SIZE NO. OF FIXTURES
LID NO.
LID FEE $
TESCIR Approved
RW Permit Required
street use permit Roq'd
Inspection Required
Sidewalk Required
Underground
Meng requited
PRV REQUIRED
YES 13 NO 13
REMARKS
DWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE
:NGINEERING REVIEWED BY
:IRE REVIEWED BY
VARIANCE OR CU
SEPA REVIEW
COMPLETE , EXEMPT
XP x
LOT COVERAGE
NILLOWED PROPOSED
� PARKING
REQ'D I PROVIDED
REMARKS
'HECKED BY
DATE
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DATE W
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SHORELINE OR ADB# I INSPECTION I BOND
REQo,. POSTED
OYES AND $
SIGN AREA HEIGHT
ALLOWED PROPOSEDIC ALLOWED PROPOSED
G co tv 1 '62-, tci ---4—
REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.)
FRONT SIDE REAR FRONT URSIDE REAR
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OT AREA I PLANNING REVIEWED BY DATE
SPECIAL INSPECTION JAREA
REQUIRED [I YES
OCCUPANT
GROUP
OCCUPANT
LOAD
IEMARKS
3ROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQT1
VALUATION
Description
FEE
Description
FEE
Plan Check
State Surcharge
Building Permit
City Surcharge
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Plan Chk. Deposit
144e�_
Fire Inspection
Receipt #
Landscape-irLsp.
Total Amt. Due
Recording Fee
Receipt#
CALL
FOR INSPECTION
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APPLIC,A )RoVA,
This application is not a permit until signed by the
Huilding Official or hisiher Deputy: and Foes are paid, and
roculpt Is acknowledged Ili space provided.
. F] IS SIGNATI))IF
DAJE
(425)
771-0220
ATT ENT16N e"Y' Off 1333//
IT IS UNLAWFUL TO USEonOCCUPY A BUILDING Oil STR TURE UNTIL
A FINAL INSPECTION HAS BEEN MAC )VAL OR CERTIFI-
Li
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES
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PINK OWNE111 GOLD ASSIESS011
(IIIIIEN ACCOUNIINO
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