The URL can be used to link to this page

20050390.pdfDATE RECEIVED % PERMIT EXPIRES `` PERMIT CITY OF EDMONDS NUMBER, CONSTRUCTION PERMIT APPLICATION JOB UITE(APT# ADDRESS DwtR N ME/NAME OF BUSINESS jk A)l /)z PLAT NAMEISUBDIVISION NO LOT NO LID NO. m MAILING ADDRESS LID FEE S /� w f Z+y / PUBLIC RIGHT 0 AY PER OFFICIAL STREET MAP TESCPApprovel E3❑ ° T ��1)1 RW Permit Requited Street Use Permit Required 13 CITY ZIP TELEPHONE EXISTING PROPOSED inspection Requited ❑ • FkiANSPECT� (N RE�` UIRE unaen,9nu a01f"d o REQUIRED DEDICATION �_ Winne required ❑ NAME. r METER SIZE ki;k 1.O RENCLGEA VEE . DMPJSUIREO i YESC3 NOD 3 W ADDRESS REMARKS P{I F2 y w OWNEkICONTRACTOk12�5�t7N�l©L[ FORLR0510N CONTROL/DRAINAGE a ce a W CITY • WATER METER TO BE REMOVED OR iNbIALLM NAME I CBL# NIP SIrE ONLY 'ATE �1_T_�_� « <,� ENGINEERING REV D BY cc ADDRESS +� L(.rt,. _.". jj• 1OE CARD ° _ FOR I(�S1'i.� ijur; :nc-:• FIRE REVIEWED BY DATE Z CITY ZIP TELEPHONE it O LL U STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY VARIANCE OR CU SHORELINE OR ADB# INSPECTION SEPA REO'0 COMPLETED EXEMPT O YES 0 NO PROPERTY TAX ACCOUNT PARCEL NO. CAp _ ��' • ZONE SIGN AREA HEIGHT WAIVER 0 ALLOWED PROPOSED ALLOWED PROPOSED W . ._ STUDY O ❑ NEW � ESIDF.NTIAL ❑ PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR m 1:1 CHANGE ❑ ,COMMERCIAL COMPLIANCE OR ❑ CHANGE F USE z ❑ MIXED USE PARKING LOT AREA PLANNING REVIEWED BY DATE g ❑ REMODEL El MULTIFAMILY ❑ SIGN REO'D PROVIDED ❑ REPAIR ❑ GRADING ❑ FENCE CYDS X FT.) REMARKS ( ® DEMOLISH ❑TANK ❑ OTHER ❑GARAGE RETAINING WALL FIRE SPRINKLER CARPORT ❑ ROCKERY ❑ FIREALARM % (TYPE OF USE, BUSINES ACTIVITY) EXPLAIN: It jVd9L W✓ TYPE OF ONSTRUCTION CQ OCCUPANT rz J ( GROUP W NUMBER NUMBER OF -:-41 hj c OF DWELLING SPECIAL INSPECTION CONSULTANT O UPA T M STORIES �40 UNITS Q - L AD -, REQUIRED � YES DESCRIBE WORK TO Z DON REMARKS Z GEOTECH REPORT m BY: r STRUCTURAL DESIGN BY: VALUATION $ . Description FEE Description FEE Plan Check Stale Surcharge HEAT SOURCE LOT SLOPE% VESTED DATE Building Permit City Surcharge PLAN CHECK NO: Plumbing Base Fee THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO MOChanIC81 BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBIC Grading DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE g SEPARATE PERMISSION. � Engr. Review w PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5) 0. 1 PERMIT LIMIT: SEE ECDC 19.00.005(A)(6) Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION , uNi '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 W EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt q G 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 Anil, Due = NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.• Recording Fee Receipt N 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 app APPLLICIC is not a punnd until signed by L THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL Building Odiead or hislher Deputy and Fnus are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION = 1 rune pl is dcknowledgud m spaco provided WORKMEN' COMPENSATION INSURANCE AND RCW 18:27, C 1OFF/ CIAa.S,S(GI�ATUR[7 ATE DATE SIC EO (425) '�. f �, ii /, ,_ 1 SI4TURVEb A / e771 -0220 RELEA5[D BY D E AEXT. 1333IT IO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND Al"FROVAL. UK h %,nK t IF ORIGINAL FILE YELLOW • INSPECTOI FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 I IBC110 I IRC1104 PINK • OWNER GOLD ASSESSOR 10104 PRESS HARD - YOU ARE MAKING 4 COPIES