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20060452.pdf/ 7 DATE RECEIVED C13Y OF EDIVIONDS CONSTRUCTION PERMIT APPLICATION rMMAILING NER NAME/NAME OF BUSINESS P. r (i _ AD RESS ZIP K rA�) NAME c /V'11t r TCXF� NAME Sz���lt ADDRESS Pa CITY 14)STATE LICENSE NUMBER ❑ NEW ❑ ADDITION ❑ REMODEL ❑ REPAIR ❑ DEMOLISH n ❑GARAGE CARPORT (TYPE OF USE, BU INE St/' NUMBER OF STORIES f TELEPHONE TELEPHONE yzs 'j3, X664 1160 4HOlb ZIP TELEPHONE EXPIRATION DATE CHIN PARCEL NO. ❑ RESIDENTIAL ❑ PLUMBING / MECH COMMERCIAL COMPLIANCE OR MIXED USE ❑ CHANGE OF USE ❑ MULTIFAMILY ❑ SIGN ❑ GRADING ❑ FENCE CYDS ( X ❑ TANK OTHER ❑RETAINING WALL n( FIRE SPRINKLER ROCKERY SMF OR ACTIVITY) EXPLAIN: r4 r NUMBER OF DWELLING UNITS 01� -1 Jt S Lift PERMIT EXPIRES. PERMIT NUMBERJOB ADDRESS / tr SUITE/A T�� G PLAT NAME/SUBDIVISION NO 1.0"Ir NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Perm.t Reou,red EXISTING _.._.. Street Use Permit Regoued PROPOSED _.._. _----. ._.-_--___--- -- emspeu.on Requued Sidewalk Required REQUIRED DEDICATION FTUnderground —" '— W,nn. re ,area METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YESE3 NO13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE I7sr= BY FIRE REVIEWED BY DATE W IM VARIANCE OR CU SHORELINE OR ADBq INSPECTION SEPA REO'D COMPLETED EXEMPT O YES ONO CA# ZONE SIGN AREA HEIGHT ❑ WAIVER ALLOWED PROPOSED ALLOWED PROPOSED ❑ STUDY LOT COVERAGE REQUIRED SETBACKS (FT.) ' PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR L$ z z z FT.) PARKING LOT AREA PLANNING REVIEWED BY DATE a REO'D I PROVIDED I _ E OF REQUIRED OYES REMARKS GEOTECH REPORT BY, STRUCTURAL DESIGN BY, CONSULTANT OCCUPANT GROUP OCCUPANT LOAD Description FEE Description FEE HEAT SOURCE LOT SLOPE96 VESTED DATE Plan Check State Surcharge 6V PLAN CHECK NO: Building Permit City Surcharge >— . ' Plumbing Base Fee ' .. THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO MBChanICBI t BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC i DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE I SEPARATE PERMISSION. Grading i PERMIT APPLICATION: SEE ECDC 19,00.005(A)(5) ERgf. Review Recording Fee a PERMIT LIMIT: SEE ECDC 19.00.005(A)(6) SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection Plan Chk. Deposit .� In •APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS W IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF Fire Review — Receipt # i EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND t ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY If A� = FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT SE Fire Inspection Total Amt. Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE = NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.• Landscape Insp. 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 CALL This application is not a permit until signed by the THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC. Building Otticial or his/her Deputy: and Fees are paid. and TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED FOR INSPECTION receipt is ac nowledged in space provided IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.( A 2C) ALS SIG E 07E SI RE W R AGENT) DATE SIGNED 771 �UL(' 'f6Jv�Lr�U ,r C C 7 ( C✓ R ED BY DATIE ` J EXT. 1333 ATTENTION 91 1 kt�l IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- FICATE OF OCCUPANCY HAS BEEN GRANTED, UB0109 / IBC110 / IRC110. ORIGINAL - FILE YELLOW - INSPECTOR PINK - OWNER GOLD - ASSESSOR 6105 PRESS HARD = YOU ARE MAKING 4 COPIES a z 0 J M oe r w —i N amnn mm ON nr C co r m n ,-Z-I r . X D z -.I C Q z O I � n ( m I c M My 0 .0c M _ mz z p � �z r w —i N amnn mm ON nr C co r m n ,-Z-I r . X D z -.I C Q DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: FIRE DEPARTMENT DATE PLEASE SIGN .. - ENGINEERING DIVISION. DATE PLFASESIGN O PLANNING DIVISION DATE rn PLEASE SIGN PROJECTS/L`��6''� Cn vrn SITE ADDRESS m 0 n PERMIT #�vvr �7 _ADB# DATE INSPECTED rn rn DESCRIPTION OF WORK TO BE INSPECTED y z • r= A field. inspection was conducted to deter compliance with approved plans. Final approval 65 denotes that there are no objections from the above signed Department to the release of omn PERFORMANCE BONDS and the granting of mrn - 0C/) r GRANT FINAL PROJECT APPROVAL C Q Z ern • 2 GRANT PROJECT APPROVAL WITH CONDITIONS NOTED z ❑ Copy of CONDITIONS given to owner/contractor by inspector 1. z o FAILED FINAL INSPECTION - OUTSTANDING ISSUES M rn ❑ Copy of CORRECTION NOTICE given to owner/contractor by inpector.