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20000561.pdfDATE RECEIVED ( 1�V L PER MIT EXPIRES 4yF ISEPERMIT CITY OF EDMONDS ZONE A S- NUMBER ` CONSTRUCTION PERMIT APPLICATION SUITE/APT PooREss o -')5 1 w- R NAMEINAME OF BUSIN�� /PLAT NAME/BUBOIVIBION N0. LOT NO. LID NO.V UD FEEG ADDRESSO� %/ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP ❑ EXISTING PROPOSED ZIP TELEPHONE � .��REQUIRED am. DEDICATION FT p p�'��'(//� SIZE LINE SIZE NO. OFF�yIURES PRV REQUIREDC� �+,! /�/J /� /Tice✓ LI i�1 "M�C({✓�YEB METER ❑ NO REMAPKSS ESS d � ��/ OWNERICONTRACTORRESPONSIBLEFOREROSIONCONTPOVDRAINAGE F ZIP� /./�- r//+f /' /�n�sm-Zm I!�^ENGINEERING OK/�% REVIEWE ATE ESSI?'�( ��FIRE REVIEWED B'I DATE ZIPTELEPHONE��Q� �A�) ygpIANCE OR CU SVIORELINE OR ADBM INSPECTION BOND HEO'D POSTED E LICENSE N.{UMB,EER /- �/EXPIRATION L/L !Js i�' O�i2 /'/^ O� a OO v �— AYES ENO SET PI SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO� EXEMPT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED yn,E/'� „ ,!�'I w / /V10 EXP I 25• 77st.s' J LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ❑ NEW RESIDENTIAL PLUMBING I MECH ALLOWED PROPPO.VSEDD FRONT SIDE REAR 7�S FRONT UR SIDE REAR 34� 33 COMPIIANCEOq ❑ 35� ,V-y IS Z�j 47 S �AUOITION ❑ COMMERCIAL CHANGE OFUSE PARKING LOT AREA PLANNING REVIEWED BY DATE ❑ REMODEL ❑ APARTMENT ❑ SIGN RE PPOy ED 9�4 Allt 2 FENCE ❑ REPAIR ❑ GRADING CVOS ❑ ( �- X ,_ FT) REMARKS m;} N "e L wLll � �' il ❑ DEMOLISH ❑ TANK ❑ OTHER {y( LA w.I VGa1 GARAGE ❑ gETAINING WALL ❑ RENEWAL CARPORT (TYPE OF USE. BUSINESS O CTIVITY) EXPLAIN: CHEC DBY TYPE OF CONSTRUCTION C OCCUPAIW - S _ A GROUP(\_ NUMBER NUMBER OF CPITICAL SPECIAL INSPECTOR AREA OCCUPANT OF STORIES DWELLING UNITS AREAS NUMBER REOUI RED ❑ VEB LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS•INSPECTIONS PER UBC 108(FINAL INSPECTION O Od Ik`eJS c"y ewe VALUATION FEE J / s•` //� �'nr•I!��—�O /NI PLAN CHECK FEE /�1I H ATSOURCE I LOT�L PE'. BUILDING V CDA PLAN C ECK NO: - VESTED E PLUMBING MECHANICAL ( " THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO ON THE PUBLIC - K' "`'� J J BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MAROUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. STATE SURCHARGE Sv PERMIT APPLICATION: 180 GAYS PERMIT LIMIT. I Y EAR -PROVIDED WORK IS STARTED WITHIN 1B9 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION INSPECTION FEE 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUGCc50R5 ENG, n IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING £ EDMONDS. WASHINGTON. ITSOFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND ALLCUIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY ORINOIRECTLY NOT BE INSPECTION FEE RECEIPT FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL ANY CITY ORDINANCE PLAN CHECK DEPOSIT DEEMED TO MODIFY, WAIVE OR REDUCE ANY REOUIREMENT OF LIMIT IN ANY WAY THE CITY ABILITY TO ENFORCE ANYORDINANCE PROVISION" _ NOR TOTAL AMOUNT DUE (� THEREBYACKNOWLEDGE 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 THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC CALL Tlms nppllcalipn rs not a pprmil unlit sr9natl CY — Bu11-9 011il P' pis/nor Dp `1 antl Foos a+p I,md d cre TICE, AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL. BE EMPLOYED RELATING TO FOR INSPECTION r Pepl is aekn".PI)0 in soap. pewid IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASI/INGTON WORKMEN'S COMPENSATION INSURANCE AND RCW 18,21 OFFI I LS SIGNATURE Df IL —SIG DATESIGNF.D (425) NAT 1077ICER R�AAG`ENT) �` 771-0220 RE SEDBY DATE ATTENTION EXT� 333 a TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 `l IT IS UNLAWFUL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORINA LINK A FINAL CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX P NK - GOLD ASSESSOROR 5/BB O _I m cm ma m0 Oc mm A_ DZ r= n mm_ O09 C 0) D z I x Z 0 III/ n m m .1-or 16( L-:-: 7-k) 42g RECEIVED I.UUU DEVELOPMENT SERVICES CTR. QTY OF EDMo,. P, 41 :D ) CT R. 70; ,v,., .,,. �... ..... ...... ... _ ... ... . . � ... � !� (1 � � ..�..(` , .J •,Opl'EHECEIVED (I I L ��) y PERMITEX�'::11 PERMIT USE y� ZONE CITY OF EDMONDS u NUMBER CONSTRUCTION PERMIT APPLICATION 'DBDRE6 ADS� �v f `� J�.., SUITE/APT. OWNER NAME/NAME OF BUSINESS ,L�/'''T /'` �/ Q0L 011 c PLAT NAME/SUBDIVISION NO. LOT NO. LIO NO. ' /-!(. / C' 1-'.; _;.. LID FEES a MAILTNGADDRESS Lr �/ PUBLIC RIGHTOFWAYPEROFFICIALSTREETMAP pyj S.p"u�pa+raAeege Q CITY Z'IJP TELEPHONE / // /— /'��—S7 y,J `"�// EXISTING —PROPOSED REQUIRED DEDICATION FT skewelx equpa O w'egiquwee eePRV ✓d 01j/ d G(7 V METER SIZE LINE SIZE NO. OF F,UjTURES REQUIRED O F fJ NAME ` I'� �Y �I C.?�DC� G6l. O/✓/116 'I % 1 oo ' 1 .I.•�J YES ❑ NO ADDRESS REMARKS OWNEAICONTRACTOR RESPONSIBLE FOR EROSION CONTROVDRAINpGE � a 4S2 / c AC lNi� i,gti• fry/ ��[. CITY ZIP TELEPHONE l CCU liS 1-1 e'fLl Iti— ��, C =' •G I (OG � TLC W� O/'36 ;?Cc- JLL 2.-1 2 "e1weeled iu V{1/S�lil }Trl(f (rile ur i .(17 d, rrpm �u [ C � Cll �j G{'O I[% S W - L�•Yi. .Wl ^ 0 U� r�C �! o N ENGINEERING R VIEWE All r /� �•� a -: U ADDRESS 2 J �/ �-� �c.P • w/ �- FIRE REVIEWED BY DATE . .. •, C CITY ZIP TELEPHONE .,v.m URI 4gi-7-? /99S o26 VARIANCE NE RrA k I PECTION BONU STATE/LICENSE NUMBER /7 ' EXPIRATION All j�CHECKED BY ��t I / REO'D POSTED ES ffNO r o//Oj/00 (f IGNA AREA EG SEPA REVIEW SIGN AREA HEIGHT EXEMPT ALLOWED PROPOSED ALL ED PROPOSED < w PROPERTY TAX ACCOUNT PARCEL NOG pP n �n -/� COMPLETE / d LI �V 00.L--V O d 00 EXP LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ❑ NEW RESIDENTIAL PLUMBING I ME CH ALLOWED PROPOSED FRONT SIDE REAR FRONT UPSIDE REAR u 34 COMPLIANCE OR 35•, %i4' ZS %S�ti IS •i% /7.S 33 a ❑ l AUDITION ❑ COMMERCIAL CHANGE OF USE PARKING 'LOT AREA PLANNING REVIEWED BY DATE g REMODEL ❑ APARTMENT ❑ SIGN REDO PROVIDED ! G Z 1944 FENCE REPAIR GRADING CYDS ❑ ( —E X REMARKS ❑ a;{, DEMOLISH ❑ TANK OTHER ❑ btGARAGE K CA nl A/aAc 'I. Z ❑ CARPORT ❑ RETRO[HIERY WALL ❑ RENEWAL ;. F (TYPE OF USE, BUSINESS CTIVITV)EXPLAIN: CHE_CIG�O OY TYPE OF CONSTRUCTION C OCCUPAIj(T) w NUMBER - NUMBER OF CRITICAL J SPECIAL INSPECTOR AREA OCCUPANT AREAS LOPD O OF DWELLING REQUIRED STORIES .3 UNITS NUMBER ❑ YES ncSCRIBE WORK TO BE DONE ......... - z b1aI ,I;Yv C HEAT URCE .� IN6P% l WT 6L PE% Cl PLAN CHECK FEE BUILDING VALUATION FEE %-fi -3 j� 1 09 (a f _� 777y r w PLAN CHECK NO: vesreD DA PLUMBING MECHANICAL •/�f //�) - m a THIS PERMITAUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BEGONE ON PPIVATE PROPERTY ONLY. ANYCONSTRUCTIONON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PEPMISSION'.'.;' DR�A(Htc: - STATE SURCHARGE S II a PERMIT APPLICATION: 180 DAYS PERMIT LIMIT:i YEAR- PROVIDED WORK IS STARTED WITHIN1g0 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATIONS "'; ENG. REVIEW FEES `s C%[J ENG. INSPECTION FEE 'APPLICANT ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AN05UCCESORS IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS T1iE CITY OF LANDSCAPING 2 EDMONDS. WASHINGTON. ITSOFFICIALS, EMPLOYEES, ANDAGENTSFROM ANYANO INSPECTION FEE ALLCIAIMSFORDAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PEPMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT 0 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OFANY CITYORDINANCE sNOR LIMIT IN qNV WAYTHE CITY'S ABILITY TO ENFORCE ANY ORDINANCEPROVISION' TOTAL AMOUNT DUE RECEIPT 4�W �.]}✓ t] REC ?? I HEREBY ACKNOWLEDGE THAT I HAVE READTHIS APPLICATION: THATTHE INFORMATION GIVEN IS CORRECT: AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC TION: AND IN GOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF'WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. SIGNAT gfi•IOWNER�RAGE1 OATE/nS�IGNEE,DD / �/.^%�Y �. LOC /1'� !�L ✓ J ATTENTION 'NLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 'NSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 'CCUPANCY HAS BEEN GRANTED. UBC SECTION 109 APPLICATION APPROVAL CALL This epplillt— Is not a pprmil unlit signad by Ihp Build,, Olf,6.1.1 hlslher Dppuly: xntl Foes era paid.. FOR INSPECTION rpcpipl is acMnpwlptlgpd In spscp P—ded. DA11T OFR I L6 SIGNATURE \ I (425) ' t •� 1 !71-0220 RE�E SEDSY DATE 1 EXT 333 '�. �.�./-�a •.u'nr'r,ti ��1 771-0221 1 FAX DPIGmAL. FILE vELLo'x INSPECTOR PINK OV/NER • -D A<BESSUD O 0 m 49 � —4 cm In On Cc: mm3 C Z n OMm 0 N C N -1 m .Zl ' z Z Z O m m