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20050887 (2).pdfDATE RECEIVED � s PERMIT EXPIRES CITY OF EDMONDS PERMIT u BER —111 12 (X/ CONSTRUCTION PERMIT APPLICATION JOB SUI E/APT# OWNER NAMEINAME OF BUSINESS ADDRESS I "� ' �l U__ PLAT NAMEISUBDIVISION NO ►I if /LOT NO. LIDNO MAILING ADDRESS ( LID FEE S i ��r+ IESCP Approved to '11/ T/ L [3a, 7� /vi-k/_� PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW permit Required O Street Use Permit Requded C3 CITY ZIP TELEPHONE EXISTING �irROPOSEO mwection Required O Cll/''�i r` _ _ Sdowalk Requvea I3 J�/�•�� ♦ CG' 1 unaorground I7 REQUIRED DEDICATION FT___ Winn re wroa 17 ADDRESS 3 / c 416b1Q wt,4. &Air?% l evioe . CITY ZIP NAME c6_ Ly � U"zvvv cO ADDRESS UU Z CITY ZIP O U STATE LICENSE BER x Q PROPERTY TAX ACCOUNT PARCEL N et0� `� pocyo ❑ NEW RE ENTI 4V ADDITI ❑ IM RCIP METER SIZE LINE SIZE NO, OF FIXTURES I PRV REQUIRED YES [ NO O Z cc w REMARKS z OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE 3 w LGINEERING REVIEWED)43Y DATE /L hd� Ak ELEPH FIRE REVIEWED BY P DATE ui RA D CHECKED BY ,VARIANCE OR CU SHORELINE OR ADB# INSPECTION SEPA I- Ck� , wA Pr p � REQ'D COMPLETED EXEMPT j� ,1 W • ` DYES xN0 CA# OS' (Z -a ZONE SIGN AREA HEIGHT if N'G STUDY O / J�5 ^ .ALLOWED PROPOSED ALLOWED PROPOSE AN 1K 9W I- y 5' z�.5{ PL I 1 MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT �/RSIDE REARII CE OR 3 G �/� L�. i/� .L � ZB�I' 7Z' t 130 /b�%� 1 z ED USE E OF USE ✓ 1 5 11 o mi,n y-8 211 { / 10 z PARKING LOTAREAJ PLANNING REVIEWED BY DATE 5 ❑ REMODEL MULTIFAMILY IGN REQ'D PROVIDED °' FENCE. Z !�' Zloloaa Iola3�o5" ❑ REPAIR C' S ( X FT.) REMARKS , ❑ DEMOLISH ❑ TANK ❑ OTHER All U+ A A 7DL4 tW{ GARAGE RETAINING WALL FIRE SPRINKLER 1011 ' , `'m ' `' sly CARPORT ❑ ROCKERY ❑ FIRE ALARM V (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: n �� Lr ' Q TYPE OF CO RUCTION rnonE OCCUPANT GROUP NUMBER NUMBER OF OF 'Z _ DWELLING SPECIAL I_ SPECTION -CONSULTANT OCCUPANT STORIES UNITS DESCRIBEWORK TO BE DONE LOAD LWKI K Ant �1, L Lio � 1156CIO r G ! GEOTECH PO T (�iT. BY: ..,L( y�� �L• NS�Li D `J STRU RA DESIGN BY: i I E hF LiP C- * 1117 71 ' VALUATION J fGC - tvo� I t ll �l $ 3 5 , DOv �n� A 6VtV .corn I� �� I�GLt/ Description FEE Description FEE IT, �illpifflvmfar 55W Plan Check State Surcharge L � HEAT SOURCE LOT SLOPE% VESTED DATE Building Permit City Surcharge / PLAN CHECK NO: Plumbing 3 �a 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. s Engr. Review w PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5) o PERMIT LIMIT: SEE ECDC 19.00,005(A)(6) Engr. Inspection BACK OF PINK PERMIT FOR MORE INFORMATION 10 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire Review Plan Chk. Deposit Lu IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF N EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt If 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 Amt. Due _ . NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # ]am v7A) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT, AND THAT 1 AM THE OWNER; OR THE DULY AUTHORIZED AGENT OF THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy' and Foes are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged In space provided WORKMEN'S COMPENSA NCE AND RCW 18:27. FF LS SIGN jRE DAT SIGNATOR (OW O GENT n DATE SIGNED (425) ` 771-022 R SED B DAT AtTENTiON t EXT. 1333 rl IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL v 01 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- FICATE OF OCCUPANCY HAS BEEN GRANTED, UBC109 I IBC110 1 IRC1104 , oRl INAL • FILEOLD - • INSP CAR PI K •OWNER GOLD ASSESSOR 101" PRESS HARD - YOU ARE MAKING 4 COPIES ' i mm o le m i X D O m , Z O n M 0M Milo �O On M _ mZ a� C Z r �4 mm o le m i X D O m ,