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20050915.pdfDATE RECEIVED " (z i' a [PERMIT EXPIRES _ ERMIT CITY OF EDMONDS NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUITEIAPTN, ADDRESS 00 _� OWNER NAMEINAME OF BUSINESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO MAILING ADDRESS LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TE5CPAptKovod O RW Pormit Required 13 Street Use Permit Required 13 CITY ZIP TELEPHONE EXISTING PROPOSED Inspection Required D Sidewalk ReQueed 0 ( f G' 7 y erground ( t'r/Y�(+}V,•�J�'j Lfj�.��.(!• t'I� a >;?G? •� L% i• REQUIRED DEDICATION_ FT _ UndUnit ro uued 0 NAME METER SIZE LINE SIZE. NO. OF FIXTURES PRV REQUIRED L7 YES O NO13 z Lu Lu ADDRESS REMARKS w OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROIJDRAINAG z m z 1 ^ / \ w CITY 71P TPI. FPHONF / • C JA -i'• T/ r 1 fV f 1 " 1 / /ll 1 . Li�1 11/ � I"A� ! I CBL# ZIP I TELEPHONE NEERING REVIEWED f REVIEWED BY DATE STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY VARIANCE OR CU SHORELINE OR ADEN INSPECTION SEPA REO',1 COMPLETED EXEMPT O YES LLT NO PROPERTY TAX ACCOUNT PARCEL NO. CAN &K- ' 2SIGN AREA HEIGHT I ZONE . WAIVER13 ALLOWED PROPOSED ALLOWED PROPOSED .Sfj _ f'3Uf� �'S s STUDY C� # 1`J^els 14A f i 5t ❑ NEW RESIDENTIAL❑ pL!JMBING / MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE REAR El CHANGE COMPLIANCE ORfor ❑ ADDITION ❑ CHANGE OF USE ,` ❑ REMODEL MIXED USE ❑❑ .PARKING LOT AREA PLANNING REVIEWED BY DATE MULTIFAMILY ❑ SIGN REO'D PROVIDED J O ❑REPAIR CYDS ( ❑ GRADING © FENCE ^ jA .� X 1�c, FT.) REMARKS L OTHER 5i 'Ao W'41+ + !K�•r�x. ❑ DEMOLISH ❑ TANK GARAGE RETAINING WALL FIRE SPRINKLER �' � bZ3 b,, u.&.96� perEcOC ❑ CARPORT ❑ ROCKEIRY ❑ FIRE ALARM 23 404 4224 0 (TYPE OF USE, B INES O ACTIVITY) EXPLAIN: ' 1 TYPE OF CONSTRUCTION C OE OCCUP _ i GROU ' NUMBER NUMBER OF�+ c OF DWELLING SPECIAL INSPECTION CONSULTANT OCCUPANT w m w C STORIES / /� UNITS LOAD REQUIRED 1 YES DESCRI E ORK OBE DONE REMARKS i itg ( •os . r 4- V viol voij S % to -t4- GEOTECH REPORT BY: m rtsv�L..-46t_ STRUCTURAL DESIGN L� 114P` Fit VALUATION $ 0 &Lu Description FEE Description FEE Plan Check Stale Surcharge HEAT SOURCE LOT SLOPE% VESTED DATE Building Permit City Surcharge PLAN CHECK NO: J / Plumbing Base Fee THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO Mechanical t BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBIC DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC,) WILL REQUIRE Grading SEPARATE PERMISSION. Engf. IRCVI2W 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 N '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 # a ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY = FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE G DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due s 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 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 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. FI S SIGNAT R DATE �A1T`UR `� R_ AGENT): DATE SIGNED (425 2 425)20SIG ✓ i C' 5' D BY7�1 02 1h 7Y— 0000�i r ATE ATTENTION EXT. 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- ORIGINAL - FILE YELL W • I PECTOR FICATE OF OCCUPANCY HAS BEEN GRANTED, UBC109It IBC110 1 IRC1104 PINK -OWNER • GOLD - ASSESSOR 10104 PRESS HARD - YOU ARE MAKING 4 COPIES Z O 400001SUNNIn m W _ C m� —� O n 0C. =m M Q —I C Z r_= 0 an ion mm O� nr M Zr -01 m = I: D t Z Z W Z O 0 M J i 70 00 ... r► H c i t 40 As �.. 1 0 -� -m 41 i A . tip trk m j� �7 Cl) a x vm trb V4 MO r� o . .� on v `4 1 mZ 0 10 i �1 IL M 4; o M j� y x k s e z.' r* M m 16 dr 0 LAP 0 Fn } h: c (j) OP ; Z f O olgaFence must be located on privaQe property. Z WO Oki Z y M n Property owner responsible for determimng h Z. . U1 U� j till property lines.. Z Fence shall not enclose or prevent access to an Cit maintained utilities. Z G, -4 a , y y j x o m (� I j OI I 9l ' tol dT 10 Oj Z 'r a "*1 J 1/ `v O O I Ul_ p Vi l O f A p A v " '^ n z c1 :.n e fin m a� T