The URL can be used to link to this page

20051055.pdf,DATE RECEIVJ�Dp�, CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS rAl 7 F J, _ Mph? Y MAILING ADDRESS a L CITY ZIP I TIfLEPHONE NAME W� 36e 1 v► VV0 _ = ADDRESS CITY . ZIP ITELIPHONE NAME CBLN at ADDRESS R. CITY NUMBER PROPERTY ❑ NUMBER OF STORIES PERMIT EXPIRESPERM�J BI NUER JOB SUITEIAPJtJ ADDRESSL�q 1 PLAT NAME/SUBDIVISION NO. LOT NO, LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved ❑ RW Permit Rngwrml E3Street Use Permit Rrqulred. ❑ EXISTING _ PROPOSED Inspecuon Required ❑ Sidewalk Required ❑ REQUIRED DEDICATION FT Untlergrdund ❑ — Winnit re wmd ❑ METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 0 NO i3 z REMARKS W W OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE _ u W ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE W ZIP TELEPHONE n r ^ U, EXPIRATION DATE CHECKED BY VARIANCE OR CU SHORELINE OR ADEN INSPECTION SEPA REQ'D COMPLETED I EXEMPT 0 YES 0 NO .� PARCEL NO. CAN J�� ZONE SIGN AREA HEIGHT WAIVER ED PROPOSED ALLOWED PROPOSED STUDY O c ALLOW ❑ RESIDENTIAL ❑ PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (FT). PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR t, COMMERCIAL COMPLIANC z ❑ MIXED USE T� z PARKING LOT AREA PLANNING REVIEWED BY DATE g ❑ MULTIFAMILY ❑ SIGN REQ'D PROVIDED ❑GRADINGFENCE (a CYDS ❑ ( X FT.) REMARKS 1:1TANK ❑ OTHER ❑RETAINING WALL FIRE SPRINKLER ROCKERY ❑ FIREALARM OR ACTIVITY) EXPLAIN: � e ex C6� TYP O CONSTRUCTION CODE GROUP NUMBER OF ~ n DWELLING}� SPECIAL INSPECTION CONSULTANT OCCUPANT UNITS -• ■ I I LOAD I �� TO BE DONE REQUIRED Li YES D r REPARKS r ell GEOTECH REPORT BY: F� _ /I �`7JV� M�(� STRUCTURAL DESIGN BY: VALUATION 220 Description FEE Description FEE Plan Check L' State Surcharge HEAT SOURCE LOT SLOPE% VESTED DATE J Building Permit City Surcharge PLAN CHECK NO: Plumbing Base Fee r THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Mechanical BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBIC Grading DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE g SEPARATE PERMISSION, Engf. RBVIeW 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 Fire Review Plan Chk. Deposit 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #402 ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY LGE M THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE ED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due 1. IMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,' Recording Fee Receipt # ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF This application Is not a permit until signed by the ER, •1 AGREE TO COMPLY WITH C17Y AND STATE LAWS REGULATING CONSTRUC• CALL Budding Official or hislhor Deputy: and Fees are paid. and D IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED TION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged m space provided. N'S COMPENSATION INSURANCE AND RCW 18:27, OFFICIALS SIGNATURE DATE RE (OWNER O GENT' DATE SIGNED r Q �2 / 1425, , I1 // —�� It 771-0220 RE EMSED BY DATE ATTENT N EXT. 1333/5 , / IT IS UN LA UL TO USE OR OCCUPY A BUILDING STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND AP ROVAL OR A CERTI- ORIGINAL - FILE YELLOW - INSPEC OR FICATE OF OCCUPANCY HAS BEEN GRANTED, UBC109 / IBC110 I IRC110, PINK -OWNER • GOLD - ASSESSOR 10104 PRESS HARD - YOU ARE MAKING 4 COPIES I NEW ❑ ADDITION ❑ REMODEL ❑ REPAIR ❑ DEMOLISH ❑GARAGE CARPORT NUMBER OF STORIES PERMIT EXPIRESPERM�J BI NUER JOB SUITEIAPJtJ ADDRESSL�q 1 PLAT NAME/SUBDIVISION NO. LOT NO, LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved ❑ RW Permit Rngwrml E3Street Use Permit Rrqulred. ❑ EXISTING _ PROPOSED Inspecuon Required ❑ Sidewalk Required ❑ REQUIRED DEDICATION FT Untlergrdund ❑ — Winnit re wmd ❑ METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 0 NO i3 z REMARKS W W OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE _ u W ENGINEERING REVIEWED BY DATE FIRE REVIEWED BY DATE W ZIP TELEPHONE n r ^ U, EXPIRATION DATE CHECKED BY VARIANCE OR CU SHORELINE OR ADEN INSPECTION SEPA REQ'D COMPLETED I EXEMPT 0 YES 0 NO .� PARCEL NO. CAN J�� ZONE SIGN AREA HEIGHT WAIVER ED PROPOSED ALLOWED PROPOSED STUDY O c ALLOW ❑ RESIDENTIAL ❑ PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (FT). PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR t, COMMERCIAL COMPLIANC z ❑ MIXED USE T� z PARKING LOT AREA PLANNING REVIEWED BY DATE g ❑ MULTIFAMILY ❑ SIGN REQ'D PROVIDED ❑GRADINGFENCE (a CYDS ❑ ( X FT.) REMARKS 1:1TANK ❑ OTHER ❑RETAINING WALL FIRE SPRINKLER ROCKERY ❑ FIREALARM OR ACTIVITY) EXPLAIN: � e ex C6� TYP O CONSTRUCTION CODE GROUP NUMBER OF ~ n DWELLING}� SPECIAL INSPECTION CONSULTANT OCCUPANT UNITS -• ■ I I LOAD I �� TO BE DONE REQUIRED Li YES D r REPARKS r ell GEOTECH REPORT BY: F� _ /I �`7JV� M�(� STRUCTURAL DESIGN BY: VALUATION 220 Description FEE Description FEE Plan Check L' State Surcharge HEAT SOURCE LOT SLOPE% VESTED DATE J Building Permit City Surcharge PLAN CHECK NO: Plumbing Base Fee r THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Mechanical BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBIC Grading DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE g SEPARATE PERMISSION, Engf. RBVIeW 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 Fire Review Plan Chk. Deposit 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #402 ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY LGE M THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE ED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due 1. IMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,' Recording Fee Receipt # ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF This application Is not a permit until signed by the ER, •1 AGREE TO COMPLY WITH C17Y AND STATE LAWS REGULATING CONSTRUC• CALL Budding Official or hislhor Deputy: and Fees are paid. and D IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED TION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged m space provided. N'S COMPENSATION INSURANCE AND RCW 18:27, OFFICIALS SIGNATURE DATE RE (OWNER O GENT' DATE SIGNED r Q �2 / 1425, , I1 // —�� It 771-0220 RE EMSED BY DATE ATTENT N EXT. 1333/5 , / IT IS UN LA UL TO USE OR OCCUPY A BUILDING STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND AP ROVAL OR A CERTI- ORIGINAL - FILE YELLOW - INSPEC OR FICATE OF OCCUPANCY HAS BEEN GRANTED, UBC109 / IBC110 I IRC110, PINK -OWNER • GOLD - ASSESSOR 10104 PRESS HARD - YOU ARE MAKING 4 COPIES I