1012 VISTA WAY.PDF11111111111111
13608
1012 VISTA WAY
Applicant shall repair/replace all damage to
i utilities or frontage improvements in City
right-of-way per Csty standards that is caused
or occurs during the permitted project. �y
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APPR BY PLANNING
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STREET FILE
DEC 0 9 2014
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
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PLANNING DATA s
SINGLE FAMILY RESIDENTIAL "
Name: �j �s -�-Z
Date: 1 Z /(y.
Site Address: b ('� V ���
Tax Parcel• d d 4,4c-f 4406oc,o 406
Project Description:
Plan Check #:
Reduced Site Plan Provided: IEY NO)
Zoning:
Map Page:
Corner Lot: ES NO)
Flag Lot: (YES /
Critical Areas Determination #: C K ZcSI t71(..
El 'Study Required
Waiver
SEPA Determination:
Exempt
❑ Needed (for over 500 cubic yards of grading)
❑ Fee ❑ Checklist ❑ APO List with notarized form
o- Re uired Setbacks
Street: ^�
Side:_ !.
Side: i v
Rear: t
Actual Setbacks
Street: 3�
Side: 2 Z
Side: ;
Rear:
�J
❑ Detached Structures:
❑ Rockeries:
❑ Fences/Trellises:
❑ Bay Windows/Projecting Modulation:
® Stairs/Deck: &
uildin Kei ht
Datum Point:
Datum Elevation:
Maximum Height Allowed:
Actual Height: j2
Other
Parking Required: r-11A
Parking Provided:
Lot Area: 1 Z jC{
Maximum Lot Coverage: 35% Proposed:., G/
Lot Coverage Calculations: ord s 13-7 Z s •� s -�� s , ��- �<-�. Z
ADU Created: (YES /( _ C i ��f3 s •• (mil �
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_
Subdivision: G-n 0
Legal Nonconforming Land Use Determination Issued: (YES /to
Comments
Plan Review By: cJ'���'I, Planning Data Form 07-14-09
PUBLIC WORKS DEPARTOT CHECKLIST
BUILDING PERMIT REVIEW.
]VOL, 1 ��--VA W, A
(address)
320
Street Right -of -Way Existing,'��
REQD As
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Access Easements ExistingREQDlot
H
Utility Easement Existing
I?Wlel+j REQD
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Lot Per Subdivision Plat k Assessor Map 400
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Site Plan .Checked for Accuracy
.�-� 1 Ell
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Underground Wiring Reqd.Noma
H
Check Accuracy of Legal Description
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Review by..
Date
w
Existing Water Main Size
Wa Main Required
Service e Required
Hydrant Size ti ng
ine.
Hydrant Reqd Per Fde
Size
w
Detector Check Meter Req .
Cross Connection Inspection
H
Fire Department Comnen
3
Water Met ge Regd.
Re ' Y.
Date
eptic Tank Design Approved
Date
Sept Tank Permit Reqd.
Permit No.
Sanitary r Availability
Pro'
Drawing No.
File No
Side Sewer Availabi
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Sanitary Sewer Connection e Regd.
3
Review by
Date
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Open Ditch Existing
Reqd.
Z
Culvert Reqd.
'ze
P4
Catch Basin Req
Indicat on Site Plan
Shoulder ge maintain collection on
swale open runo
H
e reqd.
Indicate on Site P1
Soil Conditions and Ground Water Field Checked
Review by
Date
Revised: 1v10-1977
Page 2
Stre g Regd.
H
Curb and Gutter
w Sidewalk Reqd.
w Curb Cut -for Driveway Regd.
w Right -of -Way Construction P qd.-
H Bond Reqd. for Pub l' rovements
Street Nai gn Reqd.
0 Signing Regd.
A:.. Pr't Site Inspection madeOn
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PA
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F-1
ENGINEERING
Special Requirements listed in mem to Comnmity Development Department,
Building Division
BY V VUl'UV1 Date —
o All items filled in on Building Permit Application
04 BY 1_ , Date
a' Drawings Stamped and Notations Made
w BY Date
Approved by Public Works Department
Revised: lv 10-1977
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CITY OF EDMONDS -
r PUBLIC W KS DEPARTMENT, ENGINEERII* DIVISION
APPLICATION FOR RIGHT -OF -MAY CONSTRUCTION PERMIT
THIS PERMIT MUST BE AVAILABLE AT THE JOB SITE FOR INSPECTION PURPOSES
Applicant to Complete Parts A and B
A, Permit to be issued to:
For Work a t : (address or vicinity)(
STN"EL"T .FILE
to Y \ �.:. i % r �� ► IC�1
Owner.
Name
{
Mailing Address
City State Zip
Contractor:
Name
4a67- E. y'i A "Y A
Mailing Address
4��AA?c, (G c�A,c.l0, L. 3 ?Clqqe�
City State Zip
Telephone Number
State License Number
[v,lq 7,-�441
Telephone Number
B. INDEMNITY: Applicant understands and by his signature to this application, agrees
to hold the City of Edmonds harmless from any injuries, damages, or claims of any
kind or description whatsoever, foreseen or unforeseen, that may be made against
the applicant. or 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.
Upon issuance of this permit, the contractor is responsible for workmanship and
materials for a period of one year following the final inspection and acceptance
of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until
the.final street patch is completed, at which time a debit or credit will be
processed for issuance to the applicant.
Work is subject to inspection and restoration in accordance with City Code. A
24-hour notice is required for inspection by Engineering. Call 775-2525, ext. 220.
I understand that this permit st be available t the job site for inspection
purposes at all times.
Signature 0 4. Date Q 17 D
wn r or Ag nt
TO BE COMPLETED BY ISSUING AGENCY:
Date Issued: Permit No.Fee:
Security Bond • N----�
Time Authorized:
APPROVED BY
10-771v (Revised)
Date :I
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SSE REQ NTS ARE TO BE UTILIZED --IN CO CTIOtVWITH nE M.U.T.C.D. MANt1AL PUBLISHED
,4Y THE DEPAR�NT OF TRANSPORTATION; WASHINGTON, D.C..
CITY. OF EDMON.D
- PUBLIC WORKS DEPARTMENT -
Construction Traffic Control Requirements
This notice is to.set forth basic safety principles and standards to be observed by
all those who perform work in a public street, to provide safe and effective work
areas and to warn, control, protect, and expedite vehicular and pedestrian traffic.
General Requirements for Traffic Control Devices. Two-way traffic must be maintained
during work performance whenever safe conditions are possible. Maintain all necessary
traffic control devices in proper condition and locations on an around -the -clock
basis until final work is completed and approved by the City of Edmands. Provide
"Construction Ahead" warning signs in advance of the work area in accordance with the
following speed conditions:. Under 25 m.p.h. - 500 lineal feet; over'25 m.p.h. -
1,000 lineal feet. Use of high-level warning signs is recommended on -all streets,
especially in restricted sight distance areas.
Street Closure Requirements (Refer to Figure 6-4). "Street Closed" signs and properly
worded barricades, indicating street closed, in accordance with Manual on Uniform
Traffic Control Devices and City Traffic Code shall be provided at the nearest inter-
sections to the work area which will allow an adequate traffic detour.routing.
Directional "Detour Route" signing shall be provided at all turns throughout the
detour route on streets of heavy congestion, high volume, or unusual directional
routing. Local access shall be provided whenever conditions allow safe passage.
Advance "Detour Ahead" signs shall be provided 500 feet in advance of the detour
route intersection of work involved.
The..Police, Fire, and Public Works Departments shall be notified of the actual street
closure location and period, both at the beginning and end. Streets shall be reopened
immediately upon completion of the actual work requiring the street closure.
It shall be the contractors responsibility to notify all abutting property owners
prior to commencing any construction which may impede traffic flow or cause the
temporary suspension of utility service. Notice should be provided 24-hours in advance,
if construction when possible.
Channelization of Traffic Lanes for Tkm-Way Traffic Without Provision of a Fla
Refer to Figure 6-7 Provide advance warning signs 1,000 lineal feet in advance
of traffic lane channelization markings or as stated for traffic speed conditions.
"Detour" or "Lane Change" warning signs shall be provided 500 lineal feet in advance
of traffic lane markings.
Cones or barricades shall be placed at a 15 to 30 foot spacing, in a tapered line,
at the lane change section for a distance of 100 to 250 lineal feet. For traffic lane
channelization, barricades are required to separate the actual work area from the
traffic thoroughfare routing.
One Lane Channelization for Two Directions of Travel With Provision of Fla (Refer
to Figure 6-5 an-6). Advance warning and lane change tour signs placed at
1,000 and 500 lineal feet, respectively, in advance of traffic lane markings.
Barricades are required to separate the actual work area from the traffic thoroughfare
routing.` One flagman is required at work section areas of short distances.
Two flagmen are required at a work section area of long distances or when end of one
lane section is not visible from one end to the other. One flagmen, only, is to be
designated to control traffic direction changes.
Flagman must possess a card certifying completion of the State of Washington,
Department of Labor and Industries Flagman Course.
State Highway Roadway Locations (Refer to Fig. 6-5 and 6-7). Advance warning and one-
lane/detour traffic signs placed at 1,000 and 1,500 lineal feet, respectively, in
advance of channelization markers. Distances may vary as to existing speed conditions.
LaFi change channelization taper markers placed at 30 lineal feet spacing for 300 lineal
feet in advance of work area. Other requirements as described for two-way or one -lane
conditions shall apply.
(V1n%r; 11orl i / 7S2 1 _1% _ (111T: A _
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ar- Flag-
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Truck a bv—d. with
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NOTICE, NO WARRANTY OfACCU
RACY The Information shown on the
4.1 --,attached map was comPil0for use by the City of Edmonds, its comp,cyces
and -cons. "!- *—The-Cify of Edmonds does not warrant the of
Ex t;r.
P-v*oj anything set fdrth on the map. Any person or entity requx:an espy
shcu Id conduct an independent Inquiry regarding
the Informatica s:l!, 011
the map, including, but not limited to, the location of any swvjc
shou 'rn, Such sfirier stubs may or may not e)dst and may or m zy not C;'j C-i L
thp--10ckon sho-Vin- Nelther.the -City.-cf-Edmonds-ncr- its employ -j c,
'S officL� shall be liable for the information given on this map, nor for any orcl
lkat. P representation provided based upon said map
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14 -13-7- L�
CITY OF EDMONDS
` • ENGINEERING DEPARTMEO
APPLICATION FOR RIGHT-OF-1,4'%Y CONSTRUCTION PERMIT
lAoclica':t to Cc. oZcte A & _ cr:d Subrmt in ✓ pZicate)
A. Permit to be issued to:.,l�Gr t /� /%��� �/j S — %��' " % '
For work at: (address or vicinity)
Type of work to be done:
(Attach Drawing ?.'hen Applicable)
4 �uf4= LeAQ
Time Required -- Start: ,/ / Finish:
Owner:
Name r
l
7•,(
Mailing Address '
City State
Contractor: -/ f,�'. ✓f - �Vi �:'��i�/-'.�/�= �J
Name
Mailing Address
City
State
;/ 1
Telephone Number
State License ;lumber
C,, .7 i
TelephoneNumber
B. INDE`NITY: Applicant understands and by his signature to this application, agrees
to hold the City of Edmonds harmless from any injuries, damages or claims of any
kind or description whatsoever, foreseen or unforeseen, that may be made against
the applicant or the City of Edmonds, or any of its departments or e-mployees,
including but not limited to the defense of any legal proceedings including defense
costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and
materials for a period of one year following the final inspection and acceptance
of the restoration by the Engineering Department.
'Work subject to inspection and restoration in accordance.with City Code. A
24-hour notice is required for inspection by the Engineering Department.
Call 775,Z" 5. ,
Signatu� � ` 9 ,- • � l`- / O �',� ��'' 3�
Owner _or Argent Date Signed
C. DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
Permit Issued (Date)mh@MS01277 Permit Number
Fee: { 2 . ✓ � Bond:
Time Authorized:
Subject to inspection and restoration. All work to be in accord
with - - i
For inspection call 775-252S,
ext. 220.
GINEER' S Y OVAL DATE
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c� .,, . �,...;,_....._.. _.. LOT-5.- .1WATERVIEW. MMOR J10i3 r.:0...7G1 IO_..-_.....
_. F_D.MOF-fC7. .�.WASNl.t�1CTO.N .... .
of - VI5T'A WAY
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CITY of EDMONDS --- PUBLIC WORKS. DEPARTMENT.
Routing of Building Permit Applications
�'(�
Proposed Property Address of Application: 1012 Vista -,ate--
NOTES.
BUILDING�1�Q�
DEPARTMENT COMMENTS
IF
USE PERMIT
Applicant.Fill
90 LD ING DEPARTME ZONE NUMBER.1
PERMIT APPLICATIO? Inside -Heavy Lines JOB
ADDRESS
NAME (OR NAME OF BUSINESS)
Id
ARIANCE OR COND. USE NO.
VARIANCE
ADB NO..
14 Wt- r
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W
MAILING ADDRESS
0,
PROPOSED YARDS
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[ALLOWED
LOT COVERAGE
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CITY
TELEPHONE NUMBER
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FRONT SID 4,,,REAR.
4
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SIGN AREA
ALLOWED PROPOSED
ENVIRON MENTAL REVIEW
NAME
L-i COMPLETE XEM
REMARKS
ADDRESS
W
PLANNING PEPT. APPRPVAL DA)rE
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CITY
TELEPHONE NUMBER
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LEGAL LOT
E3 YES ]NO
LOT AREA
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SUBDIVISION
NAME
STREET R/W
EXISTING STREET R/W* Z, �oFlr. DEFIC�I/NYTHIS PROPERTY
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COMP, PLAN ST. R/W 'S FT. FT.
ADDRESS.
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REMARKS t t ') oxceed those
CITY
TELEPHONE NUMBER
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CHECKED BY
Tk
STATE LICENSE NUMBER
CITY LICENSE NUMBER
-egal Description of Property (Show Below or Attach Four Copies)
STREET AND/OR UTILITY
�WORKJR,
NO
R E Q'D. 0 YES �-O.
R/W Ph IT REQUIRED
El NO
UNDERGROUND.
WIRING REQ'D. MYES ❑0
s
TYPE CONNECTION
SANITARY SEWER
YES
❑NO
VERIFIED B Y
•
SEPTIC SYSTEM
APPVD BY CITY ENG.
=
0 YES
0
PERMIT NUMBER
REMARKS
METER SIZE
SERVICE SIZE
CLEARANCE
CHECKED BY
.......
REMARKS
� v 41
NEW EIRESIDENTIAL
NON-RESIDENTIAL
r-1DD A
❑ DEMOLISH
D
F❑ ALTER , ER.
F] EXCAVATE,
OR*FILL❑
GAS
FILINE
❑ SIGN
RETAINING
❑ WALL
FENCE
_F
FIRE Z !?,E-
TYPE OF.CONStRUCTION
CODfF
SPECIAL INSPECTOR
REQUIRED
YES NO
AREA
OCCUPANCY OCCUPANT
GROUP;" LOAD
PLAN-.C.HEC5ED 4Y THIS,SITE IS LOCATED IN THE CITY
F-1 REPAIR PRE -MOVE
INSP.
swim
OPOOL
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31,04,
R.EMARK t
A
ftUMe�gR OF STORIES
NUM qER OF
DWELLING
'UNIT'S
NATURE OF WO" TO BE DONE
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0
PLAN CHECK
NO.
VALUATION
FEE
PROPOSED USE
it
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PLOT PLAN (INDICATE BUILDING SETBACKS,
ABUTTING STREETS)
0
BUILDING
PLUMBING
HEAT & GAS LINE
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011 Wq-,"
FENCE
SIGN
RETAINING WALL
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SWIMMING POOL
THe' City of Edmonds
APPLICATION
for
SIDE SEWER PERMIT
EASEMENT NO. ---•--•--• .....................•--------••--
NEW CONSTRUCTION REPAIRS ❑ LID NO. ...... ASMT. NO_ __________________
OWNER ---- W OC -�1,VF �1----•-------••--------------------•--•------ •--••---- CONTRACTOR ' ' M---.EXGI�Tc�FSS S'7 1�L -
--------•--•..............••---•--•------------- PERMIT NO. ---------•-----•--..
JOB ADDRESS __�D�z_'VI�T�' WAY .....--•---•----------- ................... LEGAL DESCRIPTION: LOT NO. ---......_:_.._..-----•--------•-•---- BLOCK NO. ----•-••-------------- .............
NAME OF ADDITION ..:._ - ..._..
Approved:
DATE .. .. 2 226/ ................ BY t'
I 1 /75
r .Kt x yt ti. .• f..!'as",m+R3pr ", . 'T'g�� MST ✓ °3+(^- r _
F �..•t?ti (t F`'� �5i+:h .g rL�t it>G'd r,.tr� f I�.�;a
A CITY OE EDMOrNDS : SID�E�SEWER PERMIT , ��
WATEWSEWERFtiDEPARTMENT',
1 P,ERMGIT' 7Y4 � M
r ,
CalhG775 2626,tfor -e1deG aewer',Inspactionei RFFOR
- 4 al,�`, •. -,, �,\Inepectlon.wlll be provided witFiln. 24,.hours afters requst NO 8at:,uSun _i,or.holiday, •Inepectiona.� r � .-, r e»V�iY.3''''i- i •�
J.
_ejADDRESS,LOCAMOM,OF CONSTRUOTION.:.. 1O Z Vj..3 a WaV' i
PROPERTY -LEGAL ;DESCRIP,1'ION :..: { LOB �F Wcl E'1` t7 L`W I'i3X10 _ 1 n
.. ....._ �.... .._
t ...
:_
OWNER AND/OR` BUILDER WOODHAVEN ( + r
CONTRAFCTOR'S;NAME &sADDRE$S OWI1eY ��z.
..........................................
` Fehruar 22, 77
Permission is,,granted :.................................:y , 18 ,for repair +and/or+,connection tof ,a sideY3sewe>r to`^ the 'city sanitary', sewers'
s,*erfu-ini.accordance with Ctty'of• Edmonds ordinancos z / ,
A'1,1'ENTIIN.--ISLCAaLED TO THE;FbLLOWING: r„
,NOTE No:,.l—The;,ownerevot the -property �may.obtaln; a, Perm awao'-•construct, sewer lnslder�propertyallne A licensedG 81detSewer::Contractor7muetibe-Gemployeditto':bonatruct��,., ;;
1s13e'faewer:.ln;,etreet; area. Do notcover.'an-,,portlon,of'sewer'.before.It has;Ueen,lnepeated:: 7
NO.T�E.No 2Zill,work+performed In;clty right-of=waye:requlres.an.'Invaelon:.6f Flight-of=Way'P,eimlt•obtelnable.fromlhe Clty Engineers3ottice w Jr J
NOTE,' 3'—Obtafn� fulLlnformation.fregarding �Ordlnance-11 18 030.`and ReBulations„governing; sfdej?sewerei whem`youGget,pe=it.• ; . .° �a y p'., 4
NOTE No:,c4,—Topuofifeldersewer, must.have at^least�30•;inches coverage;at,property'�linefand'.-12f5lhehe's.+insidetpropertyi,llneT;+miniinumtlBradei�off2p�, No{�ttende'in grade+e.. 1-
shaip'er'thaji, W %w111 ,be;Permltted . , o:. p-,f'.
NOTE No.,5'-Trenches in street,,,must',lie water settled!Tand-,surtabe,of,•street:restored^°to,original;icondilion- Contractors.ehall}be,reaponelble'for,fall`ure duertoilmprop.'-•`.
• work whlcfi;:may:develop within• 6ne+ Year `of completion =� - •. "
NOTEFNo.1B-It,'itsirunlawful=to °alter,orr:dotany other, work,thatr,is provided-for:fn, the�permlt,orto4do;any)work,'on^:thelmain'3sewer of ttetiappurteaenoes"except to in
sert•Ahe;I ij;E -into the:wye.-
DISPRQV�ED 'p Date a� By Date >� r By Date By
APPROVED jj Dateya......1:. :....: B
r i'
, Reuuhrks: ._
........................ ......... _....._ ............
t,•7:
—;-BQTHIFPerinit Copies MUST Be Siiliie'By Owriel of-'Fir.m` Performing -onstructlon; PRIOR .To"Request ;For,Inspection
> ♦ - 5 i i r
! T,..:...... hereby certify, that,Ithe)`side`tsewer�installation°constructed under this;,
(0 ner'of;;Contraeting Firm Per ming: Construction'),
lnstall'e ji 'accordance; with, all g ,erning_ordinances of .the; City W-. Edmonds
n ......Dated this .....a !! ..
. '
�f� Check,BEFURE you dig. for Water p,'L Gas' p, Telephoner+„�}-Power�p,• Sewer 0; Other. ' 1�r� s ,•
•
APPLICATION
The City of Edmonds for EASEMENT NO. _____......... ______________________________
SIDE SEWER PERMIT
V NEW CONSTRUCTION � REPAIRS ❑ LID NO. .-_L___....... _ASMT. NO. --------------
LlOWNER .......... _J�.'i l s�r�F: /-------------------------------------- CONTRACTOR .._-C'>` {Y+' `� T------------------ PERMIT NO. :�.�J_%`..-._..
JOB ADDRESS - t0,j a- Vj-S3-A--\A/P,Y---------------------------- LEGAL DESCRIPTION: LOT NO. ----- 4--------------------------- BLOCK NO. --•------------ --------------------
--------- _.t3- ►• _1(-_�_"'T a =....... VA � -----------------•---•--•---.._................._............----
NAMEOF ADDITION ................................. _........... �-----•------------------•---------•-•-----•---•-......---•---------
REM
FEB 2 2 1977
1,7rnrs t)ptj
Approved:
DATE-------------------------------------------- By............................................................
11 /75
HEM TO Ilarry Phitciitt �TRr�,
Buildinn nfficial - FILE'
FROM: Richard H. Allen
Assistant.Cit.v Fnnineer WQI
SUBJECT: BUILDING .PERMIT APPLICATION .FOR DUANE 000DS AT 1012•VISTA WSE.
After review of the suh,j(,ct huildinn nermit anplication; we have the fol-
lowing comments:.
1) Coordination of location of,building with utilities is the
responsibility of this contractor.
2) Underground wiring required:
.3) Connection to -.sanitary sealer renuired.
4) Lot. drainage to be contained on site or directed to storm
sewer system,.
5) Right=of- •ray Invasion Permit requi red for. curb cut.
1JJH : RIiA: mj r
DATE'Ib I 1S _ PERMIT ADDRF I �� 1157
LEGAL DESCP.
6-4
BUILDING PERMIT REVIEW - ENGINEERING DEPARTMENT CHECK LIST
Instruction:
Check Accuracy of Legal Description
Check Against Assessor's Map for Legal Subdivision
Does it conform to City Approved Subdivision?
Reviewer's
Initialls(
VitV- 1.. This'lot included in Subdivision/Plat No.: J( '� -N'� ,_
I'd_ 2. Site Inspection made on: IOro Imo, El �
3. Idhat are around water and soil conditions?�'b�R.a
4. Site Drainage Checked?
5. Storm Sewer Availabilitv: `' Sht. -k of Dwg. No.fb t&Proj
Roads i de. Di tch
6. trading & Final Contours:
lz�rgc—=, ) -K�
7. Septic Tank System Design Approved:_ _
8. Sanitary Sever P.vailability_- Sht. 1 of n4/g. No11MrProject�
Side sewer availability:
9. Sanitary Sewer Connection Fees?
10. dater Mains & Fire Hydrants (Indicate Size Main)_
Check Fire Dept.'s Comments
11. Sidewalks: (Site inspection s ws conditions of sidewalks as follows)
�� 0 I
12. Curbs: Curb. Cur Cuts/Driveways (Cho driveways for safety, location,
grade and width): K b 'r A I �'� A
13. Underground Viring: Street Lights:
14. Street Right-of-way R Bldg. setbacks A&i '2j 1 \►tSht. of official Street Map. S,
'
15. Existing Utility Easements? ` ir-' w� ' ��� .
of
16. Access Easements:
17. Site Plan checked for accuracy? f53 fr7Cal
18. Special Requirements listed in Memo to Bldg, nept.
19. Commercial & Apt. Requirements form completed? �1
20. Drawings stamped & notations made? IA0 I 9 V71e
21. All Items filled in on Bldg. Permit Application? �� ➢�8 V(0
22. Bonds posted for site work?��°
d
23. Right-of-way Invasion Permit required?
COMMENTS:
Rev. 7/l/76
NOTICE
TO PERMITTEE AND/OR OWNER
❑ PARTIAL APPROVAL
❑ VIOLATION
[j-CORRECTIONS REQUIRED
PERMIT
NUMBER
JOB ADDRESS----
NO PERMIT - STOP WORK - REMOVE CONSTRUCTION OR OBTAIN
❑
PERMIT AND MAKE WORK COMPLY WITH BUILDING LAWS.
❑CONSTRUCTION IS NOT IN ACCORDANCE WITH APPROVED PLANS
AND PERMIT - STOP WORK. MAKE EXISTING WORK COMPLY WITH
APPROVED PLANS AND PERMIT OR REMOVE IT.
P4TOP WORK - UNTIL AUTHORIZED TO CONTINUE BY INSPECTOR.
❑CORRECTIONS LISTED BELOW MUST BE MADE BEFORE WORK CAN
BE APPROVED.
❑ WORK DESCRIBED BELOW HAS BEEN INSPECTED AND IS APPROVED.
❑CONTACT INSPECTOR AND ❑
ARRANGE FOR APPOINTMENT. RECALL FOR INSPECTION.
! � r
THE- ACTIONS OR CORRECTIONS INDICATED ABOVE
WITHIN .................... DAYS OR PENALTIES IMPOSED B
APPLIED. FOR INSPECTIONS CALL: 775-2525.
INSPECTOR
DATE
ARE REQUIRED
Y LAW MAY BE
BUILDING
DEPARTMENT
CITY OF
EDMONDS