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20050776.pdfDATE RECEIVED -' / )� PERMIT EXPIRES PERMIT ;� NUMBER(i,�� JOB SUITEIAPT# ADDRESS PLAT NAMEISUBDIVISION NO. LOT NO, LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCPApprovod O RW Permit Required 93 EXISTING PROPOSED Street tion Perms Required 13 Inspection Required 13 Sbawalk Roquued 1' REQUIRED DEDICATION FT Underground QWirino reauired METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED t7 YES O NO O z Lu Lu REMARKS w OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ? W CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF USINESS C /y 1 Ix MAILING ADDRESS 01 CITY ZIP TELEPHONE NAME `bol b 1 ! . DU�lti1 � • AZIP ELEPHONE UA �7� � it NAME CBL# 250 ADDRESS a*9 i '2 i -ii At C(11 CITY ZIP TELEPHONE utr t'tF c,.s� 4z� STATE LICENSE NUMBER71j/0 TON DATE C D BY >)AIIN1= 2_I�l<� `7 PROPERTY TAX ACCOUNT PARCEL NO ❑ NEW ❑ RESIDENTIAL ❑ PLUMBING I MECH COMMERCIAL COMPLIANCE OR ❑ ADDITION ❑ MIXED USE CHANGE OF USE ❑ REMODEL ❑ MULTIFAMILY ❑ SIGN ❑❑ GRADING ❑ FENCE X FT.) REPAIR CYDS ❑ DEMOLISH ❑ TANK ❑ OTHER ❑GARAGE RETAINING FIRE CARPORT ❑ ROCKERY WALL ❑ FIREA ARM SPRINKLER (TYPE OF USE, BUSINESS OR ACTTyITY) EXPLAIN: Cif/1AM1G Ae/,D/° NUMBER NUMBER OF Z DWELLING ST STORIES UNITS DESCRIBE WORK TO BE DONE ENGINEERING REVIEWED BY DATE T'rr/ ( % DATE w RIANCE CIA CU HORELINE OR ADB# INSPECTION SEPA ' REO'D COMPLETED EXEMPT 1E3YES ONO CA# ZONE SIGN AREA HEIGHT WAIVER13 ALLOWED PROPOSED ALLOWED PROPOSED STUDY O LOT COVERAGE • REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR O z z z PARKING LOT AREA PLANNING REVIEWED BY DATE g REQ'D r PROVIDED fl-rg- , rt) 1/ -- TYPE OF CnNRTBr rr TION VJ OCCUPANT GROUP SPECIAL INSPECTION CONSULTANT OCCUPANT REQUIRED ©YES LOAD [i iu �7 V . GEOTECH REPORT "PO)/ � I-II/ %y W&I— \041 � STRUCTURAL DESIGN BY: T— 4,2W "v T (� VALUATION $ n A Ly /�0.7Ti�C S Description FEE Description FEE r—/ ••'�6 7J. �j/f' Gy L/�4Z!/�- Plan Check State Surcharge HEAT SOURCE LOT SLOPE% VESTED DATE / Building Permit City Surcharge �S PLAN CHECK NO: Plumbing Base Fee f. THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO Mechanical BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC F DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading SEPARATE PERMISSION. s Engr. Review W PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5) a PERMIT LIMIT: SEE ECDC 19.00.005(A)(6) Engr. Inspection BACK OF PINK PERMIT FOR MORE INFORMATION in *APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire Review Plan Chk, Deposit IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF N 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 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due = NOR LIMIT IN ANY WAY THE CITY's ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Recording Fee Receipt # 1 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 he THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application is not a puttyperm: until signed by id, TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL 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. OFF/ S S TUBE DATE' SIGNATU (O NER GENT DATE 31 ED (425)ft v AJ 771-0220 Art SED By DA E ATTENTION EXT. 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL ii ` A A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- ORIGINAL -FILE YELLOW - INSP TOR FICATE OF OCCUPANCY HAS SEEN GRANTED, UBC1091 IBC110 1 IRC110. PINK -OWNER GOLD - ASSESSOR 10/64 PRESS HARD - YOU ARE MAKING 4 COPIES 0 z s J m Z 0 m ...I it cM Im 0 O0 M. Z . DZ r c 0 M m mm_ 0� nr M �N Z0. "'I D I. z 0) Z 0 m I FINAL PROJECT APPROVAL FORM ENUINEERING DIVISIUN DATE SIG PLEASL #N PLANNING DIVISION DATE p PtrME SIGN PROJECT C, �„A?�� `' /�f�� 2 m SITE ADDRESS w`'�}'' �V S Cn = vm C PERMIT # D.S' 077 ADB# DATE INSPECTED o pC DESCRIPTION OF WORK TO BE INSPECTED A CCC1'ri dif cp rTO/ = M M Z A field inspection Was conducted to determine. compliance ivith -approved. plans. Final approval D z denotes that there areno objections from the above signed Department to the release of r i PERFORI%IANCE BONDS and the granting of o"n M GRANT FINAL PROJECT APPROVAL gCn M rb� i Zin- GRANT PROJECT APPROVAL WITH CONDITIONS NOTED _ O Copy of CONDITIONS given to owner/contractor by inspector D 1 f. Cn -Zi Z FAILED FINAL INSPECTION - OUTSTANDING ISSUES O Copy of CORRECTION NOTICE given to owner/contractor by inpeclor m