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1025 9TH AVE N (3).PDF
111111111111 9830 1025 9TH AVE N CITY OF EDMON CONSTRUCTION PERMIT A OWNER NAME NAME OF BUSINESS MAILING ADDRESS GITY �ZIP . `,� TELEvh STATE LICENSE NUMBER PERMIT NUMBER 93a6gC3 JOB ADDRESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 7ESCP Approved ❑ R EXPIRATION DATE easements CO Parcel o. Z r/Z 7 03_-Parcel ElNEW RESIDENTIAL PLUMBING ElADDITION COMMERCIAL MECHANICAL REMODEL El APT. SLOG. ' SIGN REPAIR O GRAOIND CYOS. O FENCE I x_FT) DEMOLISH ❑ INSERTTOVE a HOT 7POOL GARAGE CARPORT G WALL/ 0 U8 SPA ROCKERY O RENEWAL W NUMBER NUMBER OF CRITICAL o OF DWELLING AREAg STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE (ATTACH PLOT PLANT EXISTING REQUIRED DEDICATION SW Permll Requred D $Treat Use Perm,I Red ❑ PROPOSED mspeCllon Required D Sidewalk Required ❑ METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES ❑ NO ❑ 3 SIGN AREA SEPA REVIEW ADS NO, ALLOWED PROPOSED COMPLETE EXEMPT SHORELINE EXP VARIANCE OR CU PLANNING REVIEW BY �. DATE SETBACKS —FEET HEIGHT LOT COVERAGE FRONT SIDE RF.o OHECKED BY TYPE OF CONSTRUCTION CODE OCCUP, GROUP SPECIAL INSPECTOR AREA OCCUPe REQUIRED ❑ YES LOAD R MARKS PROGRESS INSPECTIONS PER USC 305 FINAL INSPECTION REQUIRED PLAN CHECK FEE HEAT SOURCE: GLAZING BUILDING r `� IN) PLUMBING Plan CheENO. MECHANICAL This Permit covers work to be done on private property ONLY. GRADING/FILL Any construction on the public domain (Curbs, sidewalks, driveways, marquees, etc.) will require separate permission. Permit Application: 180 Days STATE SURCHARGE Permit Limit: 1 Year - Provided Work IS Started Within 180 Days STORM DRAINAGE FEE "Applicant, on behalf of his or her spouse, heirs, assigns and w successors in interest, agrees to indemnify, defend and hold ENG. INSPECTION FEE harmless the City of Edmonds, Washington, its officials, employees, and agents from any and all Claims for damages of i 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 PLAN CHECK DEPOSIT requirement of any city ordinance z nor limit in any way. the City's ability to enforce any ordinance provision." TOTAL AMOUNT DUE I hereby acknowledge that I have read this application; that the Information given Is correct; and that I am the owner, or the duly authorized agent of the owner. I agree to Comply ATTENTION APPLICATION APPROVAL with city and state laws regulating construction; and In doing the work authoriz• ed thereby, no person will be employed in violation AUTHTHIS PERMIT O This application is not a permit until of the Labor Code of the State of Washington relating to Workmen's Compensa• ES ONLY THE signed by the Building Official or his/her tion Insurance and RCW 18.27. WORK NOTED Deputy; and fees are paid, and receipt is SIGNATURE IOyrNER OR' NT / DATE SIGNED INSPECTION DEPARTMENT acknowledged in space provided. �c��, CITY OF f EDMONDS t OFvI 1 S SIG TORE DATE 1 .TTENTION CALL FOR RELEAgEO By DATE IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE INSPECTION 1Til A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED, UBC IAPTER J. 77'f O��O ORIGINAL — File YELLOW —Inspector 'd7 PINK — Owe, GOLD — Assessor h ' i f.. 't,yha•.-.— � v .✓y;:j:•%vcV t ..JTv ..f� �✓-r .r•:..:� � • r,s"�.�;.y .. _� f• a7r' y {, u;aJ R'r�vvr';v-.��'i�'9•k.,l�•r•�• [ .,< {t:n;P:�,, pro• �w�.-,s a auv�;=. z Q U a a a Q as A w a O U W no O E_ 04 O w A F U C4 O w CITY OF EDMONDS V COMMUNITr C6S D JAMT / RIGHT -OF- C MIT C A. • Owner: Washinaton Natural Gas Nam, 5--,15 6 AVNE Mailing Address Reb1aliale� TATn 98007 City State Zip 72-�i-8Asue ermit No.z Date B. • Contractor: Same Name Mailing Address City State Zip 447-0700 State License Number Telephone Number • Address or Vicinity of Construction: 1025 - 9 AV Type of Work to be Done: New gas service inst tion Work in Connection With: ~ .0 Sub or Plat' `❑ :Single Fafiily' ❑CI Projects ❑ Commercial' ❑ Multifamily Utility Pavement Cut: ❑ Y ❑ N APPLICANT TO READ AND SIGN INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City ofEdmonds harmless from any injuries, damages, or claims of any kind or description whatsoever, forseen or unforseen, that may be made, against the City of Edmonds, or any of its departments or employees, including or not limited to the defense of any legal proceedings including defense costs, court;costs, and attorney fees by reason of granting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. Funds held from the Security Deposit (estimated restoration fee) will be he until the final street patch is completed by City forces, at which time a debit or credit will be processed for issuance to the applicant. • A 24 hour notice is required for inspection; Please call Public Works: 771-3202 • Work is to be inspected during progress and at completion. • Restoration to be in accordance with City Code. • Street to be kept clean at all times. • Traffic Control to be in accordance with City regulations. • All street -cut ditches must be patched with asphalt or City approved material prior to end of working day; no exceptions. 3. Y. I understand the abov ndthat this per Dustb be available at the job site for inspection -purposes at all times. Signature: Date: 12 - 2 8 - 8 8 Owner or Contractor This Permit .Must Be Posted at the Job Site For Inspection Purposes Call DIAL -DIG Prior To Beginning Work ISSUED BY: • r f,. Time Authorized: Void after' days Special Conditions: Amendments: PERMIT FEE:"y 22 --'(i(T /-12 /2 4 6 P�1 Security Deposit: Receipt No.: Fund 111 Fee: Street Cut Dimensions: X = NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. July 1985 FIELD INSPECTION -NOTES (Fund I I I Route copy to Street Dept.) Comments: I Diagram: CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO Partial Work Inspection by P. W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: Eng. Div. Jul, 44I� 162.66 J' rP 2STW IP IBC Mow• �IwL (C P) 'j'L MOw. \., w< IC Pi �K .� 104� J•9193 f / `\9oad•e zs•E 1%s . 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ZLLIauf..-..l .......................................................................... CONTRACTOR .................................................................................................. PERMIT No... -----......._..... ADDRESS ....... ........................................................... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No. ............................. .............. NAMEOF ADDITION ......................................................................................................................................... 9 0 APPTFw,JESTED ON SEWER, 1972 DATE................................................ By ......................................................................