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20050899.pdfDATE RECEIVED C '� Lin yvrG 7 C PERMIT EXPIRES `. nc CITY OF EDMONDS Nu BIER `� �n O �� r CONSTRUCTION PERMIT APPLICATION ADDRESS D /� �/^� UIT APT# OWNER E� OF BUSINESSI*j % PLAT NAME/SUBDIVISION NO. LOT NO. ' C LID NO. MA19p ADDRESSLID FEE S 3 • ��x v PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCPApproved O 0 - RW Permit Required E3 Street use Permit Required 0 CITY Z TEL N EXISTING PROPOSED Inspection Required O C` 21210A y� ��y - r w m e �!Da VTRequued REQUIRED DEDICATION '+ "" "'`: %�T ,i.' ri tlQ s"d O md El NAME METER SIZE LINE �' �. N . G; i ' IRED mint �� NOS _ U.... . II 1 ADDRESS REMARKS vy U OWNER/CONTRACTOR RESPONSIBLE gtEll N' DRAINAGE Q ul CITY ZIP TELEPHONE NAW CBL ry ' .. ,..r......w J.�� Prmu GAn/�/'�' ENGINEERI i. r•• f DATE ADDRESS & Industries stAte'JcV � C6f FIRE REVIEW DBY •„-•” 'j �M ' DATE Lu z CIT P TELEPHONE I W 0 LL UM1 ST LICENSE NU ER EXPIRATION A E HECKE Y VARIANCE OR Cu SHORELINE OR ADB# INSPECTION SEPA �/C�N �� REQ'D COMPLETED EXEMPT O YES D NO -r PROPERTY T///��yyAAAtM,UNPAR L A# ZONESIGN AREA HEIGHT / Iry/� J�/' \ - WAIVERO - ALLOWED - PROPOSED ALLOWED -PROPOSED 66 vLJ /V/U� STUDY 0 rI LOT COVERAGE REQUIRED SETBACKS (FT.) ❑ NEW ❑ RESIDENTIAL UMBIN / ECH PROPOSED SETBACKS ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR t7 ❑ COMMERCIAL COMPLIANCE OR z ❑ ADDITION 1:1 CHANGE OF USE _ ❑ MIXED USE PARKING LOT AREA PLANNING REVIEWED BY DATE g ❑ REMODEL MULTIFAMILY ❑ SIGN REO'D PROVIDED CL ❑❑ GRADING ❑ FENCE REPAIR CYDS ( X FT.) REMARKS ❑ DEMOLISH ❑ TANK ❑ OTHER Z ❑ CARPORT 1:1 ROCKERY GE IG WALL IRE 13 FIRE ALARM LER (TYPE OF USE, BUSINESS OR AOTIVI EXP IN' TYPE OF C TRUCTI C(� OCCUPANT v / ) GROUP C JA NUMBER NUMBER OF lJ OFDWELLING SPECIAL INSPECTION CONSULTANT OCCUPANT O STORIES UNITS LOAD REQUIRED 13YES DESCRIBE WORK TO BE DONE REMARKS i 0 GEOTECH REPORT m r BY% STRUCTURAL DESIGN BY: VALUATION ( $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE LOT SLOPE%a VESTED DATE Building Permit City Surcharge PLAN CHECK NO: Plumbing Base Fee THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO Mechanical, , BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBIC Gradin DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE g SEPARATE PERMISSION. Engr. Review. W PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5) a PERMIT LIMIT: SEE ECDC 19.00.005(A)(6) SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engf. Inspection W•APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire Review Plan Chk. Deposit w 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 # Q 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 1 AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF This application is not a permit until signed by the THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC• CALL Building Official or his/her Deputy: and Fees are paid, and TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided. WORKMEN' SATION INSURANCE AND RCW 18:27, OF SI AT E UAT SIGNAT E N OR N DATE SIGNED •�(425) 1� 1. ©^ � —C 7 ! 1 A@0220 REL SED Y DAT , ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL . m• Aur. A MMM^\/A 1 AO A P•CDTI_ A FINAL IN,rcto i iu1Y nma Orrn mr+vL; M1,11W nrr r.v......+.. r...--•-• • ORIGINAL • FILE YELLOW - INSPEGiO FICATE OF OCCUPANCY HAS BEEN GRANTED, UBC1091 IBC1101 IRC110o PINK -OWNER GOLD ASSESSOR 1010+ PRESS HARD - YOU ARE MAKING 4 COPIES I