18032 69TH PL W.PDF111111111111
5344
18032 69TH PL W
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-2
HEIGHT CALCULATIONS
Original
Proposed
A
348.00
352.00
B
356.00
352.00
C
355.00
352.00
D
351.00,
352.00
Average Grade
352.50
352.00
Datum = MH #9
347.53
cut / fill
0.00
Height of Structu
25.00
25.00
Maximum Allowe
377.50
377.001
-4 07
1Z- E.Sln MAR 2 2 20o2
Z a'
46 -71 MOM DEVELF
�iMEN
-Y T SERVICE
-S CTR.
OF EDMOND.
- Z�-
FEB 15
47o'21 Qo lz�
DEVELOPMENT SERVICE CTR.
CITY OF EDMONDS
FOOTING DRAINS NOT
TO BE TiEb INTO
DETENTION SYSTEM., ACCEPTABILF -11UHTLINE
MATERIAL
SDR 35
Lejal: Lot 6 Olympic View Crest SCH 40,
N-12
Address: /q3 wxx, (f,-r-rGkF1f-W
F010 HANCOR
Assessoes Tax Parcel *b
A 11
Co. Inc Seale: 1"=26PA QVED AS NOTED
owner: Westar Development ENGINEERING
16927 W Ave. NE
APPROVED BY PLANNING
lConmore WA 98028 CRTY COPY
42.1.487-2757 10-�'
Date
*ritical Areas Checki
------------------------------- -------------------7-----------
Site Information (soils/topography/hydrolog,y/vegetation)
I Site Address(Location: U/ � ?f ;7
2. Property Tax Account Number- f _72-'704'2 -
3. Approximate Site Size;(i tres or square feet): 4, -7
4. Is this site currently developed? 4.-1 yes; no. -
-If yes; liowis site developed? ZZ
5. Describe, the -general site topography. Check all that -Apply.
4--�- Me less than 5-feet elevation change over entire site.
feet,over a
Rolling! slopes on site generally less than 15% (a vertical rise of 10-
horizontal distance,of 664eet).
Hi Il y: slope's present on iite:of more than. 15% and less than 30% ( a vertical rise of
I 0-feet over a horizontal distance of 3 3 to 664eet).
Steep grade's of greateir than 30% present on site (a vertical rise of 10-feet over a
1�0`horizontal distanc'e'df less than 33-feet).
Other (please describe):
6. Site contains Areas of year-round standing water: Approx. Depth:
7. Site contains areas of seasonal standing water: 00 Approx. Depth:
What season(s) of the ydar?
8. 'Site is in the floodway floodplain of a water course.
9. Site contains a creek or an area where water flows agross the grounds surface?/Filows are year-
round? Aj! (What time of year? #4
Flows are -seasonal? �d
10. Site is primarily: forested meadow shrubs mixed
urban 'lands.caped(lawn,shrubs etc)
11. Obvious wetland is present on si te:
5it
414-4-
t In
.W
d0le
;,.B000
tidt d hiiiird...afte
_0100.0
D ERMNAT10K :
to,p
NW' 4w,.,
4eei 6f41-,A a4�r-e4-4 5;in^ -f �11 s'oe-y S i-W r con SAW
jam3m
ATTACHMENT 12
RECEIVED
M I.-Ti
City Off Edmondas
DEvELOPMENT smptvn
CRIIRC� L AWFAS CIT"F1,CKITST
be Critical Areas Checklist co-Anained on this form, iq
I
be fill%ed out by any person
prepafmg a
)evelopment Permit Application for the City of
4 '�Vn' _"W1'-'tLzU n-.
ermit to the Citv.
'he purpose of the Checklist is to enable City staff to
A L3-4441L "44.1 JW L
"ex-"4 4-1-C w`MU " POTUIU4_1�_%.Z"Llcal Are=-- are. ur
t"i -
my be, present on the subject property. The
1-fol-Matio-In, needed to complete the Checld.;_ct �rjnmilfi
e easily available from observations of the site or
ata available at City Hall (Critical Areas inventories,
lapps, Or 3011 s- eys'.
Ann -applicant- or hisfk-r renr sent-it;vp 4:;11
thO, checklist, sign and d it,
I ate an submit it to the
City. -Ibe City will re -view the checklist, make a
1511� art��in a deie -nation of the
-,subsequent steps nec�ssary to com�lete a development
Please submit a vicinity map along with the signed
N
Copy 0 - I tws 10rm to asslst CIL, staft -in finding ana
locating the specific piece of property described on
other pertinent inf�,rination (e..g.. sit - e plan, topography
map, etc.) or studies in cbnjuniction�"With this. Checklist
to ass.st SWU iiii comPieting
tileur prehminai�y
assessment of the site
have completed the attached Critical Areas Checklist and attest. that the answers provided are fnn
- t"aL to, the.
est of my knowledge (fill., out the appropriate column beloNy).
hvner/ArnIzennt:
I
6 q 2 C
treet Address
A nnlirnnt Renresents-bi've!
f*4 arne 'I-
A: f
Street Address
ity State Zip City State Zip
Z-Y
!Ierhone
oUq SURFACE CAEFULAYMNS
JF Z'rLzyr*-f 4 pad 1,360 -SF
115�� Lu 4S Pfqxmw Stdiding
:�5 1 t-:, Proposed GeraP 644
*.,rpm 120 SF
V proposed peso & docks
is SF
Proposed Wahm-ays
1200 SF
Pmposed Dd"
Z" IMPWW, SUfj. 3340 SF
% 8031 SF
LAt Size
1LOtca"rage 25% 2004 SF
'I. APPROVED AS NOTED
BY ENGINEERING
-film TUr
DA- A 02-
34 -8 vow—
Ir
Wff CALCUUMONS
WOO orwnal Promw
fj
A 348.00 352.0
B 356.00 352.0
C 355.00 352.0
352A
D 351-00
AveragaGra" 352.50 3mc
... El -E D,s
R
NG CALCULATIONS Wi so 347.63
adiOR 0A
MAR 1 8 2002 H*M of SVuM 26.00 "A
Cu'r 148 CY Mwdffmm Anum 3".W' 317A
DEVELOPMENT SERVICES CTR- FILL 48 CY
EDMONDS
CITY 0 -b
BALANCE 0 CY
xA� (�q
[�F z' & - -, f 0;,
G "T Q � W-
;7L.,: tV
TOTAL
1 0
Akddrew /Z x x?< 6�9,ULFL-W I LOT SLOPE 10 %
Tax Parcel IN:
"�o�'��OOROYOCOL-'Ni'-%S��UCTION 40 ALL EVOSE[rSURFACES To
TEMPORA BE COVERED WITHIN 2 DAYS
ENTRANCE REQUIRED I t1E ET
Ofter. Wcoftr Devokpagat Co. Ine Scale: 1"4010"
1W7$0Av*.XZ
Kamom WA 98M 00 74E��S Att4 Piro 5xmosz�o le.
425487-2757 OWNEMCONTRACTOR IS RESPONSIBLE FOR U...�/ -C/i 2.4- .14 rc S.,
EROSION CONTROL AND DRAINAGE 7.) P09VXJS -M 15E,
TO CW-S,177C�
PLANNING DATA'
NAME: (4/?-3 ft;'- Pp-y' t-0 . DATE: 314 t I-z-
SITE ADDRESS: 19032- .- (,q7.- P�' Q, PLAN CHK#: 0 1 -
PROJECT DESCRIPTION: Notj - 45-ij, OV-041-
REDUCED SITE PLAN PROVIDED?: (YR No
MAP PAGE: 35 CORNER LOT: (Yes FLAG LOT:
ZONING: PS -9 CRITICAL AREAS DETERMINATION #: 962 - 144 (o�- 010, 1/,"' 60'," 5w6Avj
Ef Study Reciulred��WiiL - - f4Le� ri.�i a., r'i-e
13 Waiver
UConditional Waiver
SEPA DETERMINATION:
U Fee STR
UCheckllst F ow
--ZF
Ll APO list wl notarized form
5 El Needed for 500 cubic yards of grading, Shoreline Area. site within 200 ft. of Puget Sound or Lake Ballinger)
-Exempt
SETBACKS:
Required Setbacks:
Street: 7. 15 ' Left Side: -2, 57' Right Side . : -7,5' Rear: -7.5
Actual Setbacks:
Street: Zi., Left Side: Right Side: It Rear: )4'
Street map chocked for additional setback required? (Yes ltwo)l
Q'DETACHED STRUCTURES: 0--,
El ROCKERIES: /-'� ' ,
UI'FENCEsrrRELLISES:
la'BAY WINDOWS / PROJECTING MODULATIO . N: 9— fta.-)
Ef STAIRS / DECKS:
PARKING: Required: 2- Actual: 3
LOT AREA: t I () I I "
LOT COVERAGE I s6o,- IA4
Calculations: 0.07)
BUILDING HEIGHT:
Datum Point: AU041elr) -0, Datum Elevation:— 2) 4 7. 3.
Maximum Allowed: Actual Height:
A.D.U. CREATED?: Qo) Yes)
SUBDIVISION: (Srelk . fa�-
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: es
QL—
OTHER:
Plan Review By:
NewBPPlanningData.Form.D0C
13 C.�
*INN HEIGHT CALCULATIONS
Original Proposed
....... . ......
ROM=
A 348.00 352.00
B 356.00 352.00
352.00
c 355.00
D . 6
351.00, 352.00
Average Grade 352.50 352.00
Datum = MH #9 347.53
C3 cut / fill
0.00
Height of Structu �5.00 25.001
Maximum Allowe 377.50 377.00
Ar
:� iLL twTum
7 IZ- ESIn MAR 2 2002
-MEMO 461.
DEVELdPMEIVT SER�ICLS
oil CITY OF EDUOjVDS CTR.
-47t2 RECE'VErD
FEB 15 2002
FOOTING DRAINS NOT DEVELOPMENT SERV ICES CTR.'
TO BE TIED INTO CITY OF EDMONDS
DETENTION sySTEM db
'ACCEPTABLE TIGHTLINE
S I -r 6.- FLA- KN MATERIAL
SDR 35
Legal: Lot 6 O"Ple View Crest
SCH 40
Address: / e cc�--tud-JI-W N-12
Assessoes Tax Parcel #-. HANCOR k
Scale: 1"�--2MROVED AS WOT�D-,,.
owner: Westar DCYCIOPMeD t CO. ID c BY ENGINEERING
1027 W Ave- N1 APPROVED BY PLANNING
A 98028 FIL
Kenmom W
425-487-2757 --7
V
CA FILE NO.
Critical Areas Checklist
-----------------------------------------------------------------
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Locati6n:
2. Property Tax Account Number: (90 -0001
3. Approximate Site Size (acres or square feet): 4, -7 a
4. Is this site currently developed? yes; — no. -
If yes; how is site developed? :S:�E (a
5. Describe the general site topography. Check all that apply.
Z,— Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of I 0-feet over a
horizontal distance of 66-feet).
-/---Hilly: slopes present on site of more than 15% and less than 30% a vertical rise of
I 0-feet over a horizontal distance of 3 3 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: )L) 0 Approx. Depth:
7. Site contains areas of seasonal standing water: /-)D Approx. Depth:
What season(s) of the year?
8. Site is in the floodway k2o floodplain of a water cour se. 0
9. Site contains a creek or an area where water flows agToss the grounds surface? lows a e year-
round? kllA —Flows are- seasonal? (What time of year?
10. Site is primarily: forested ;meadow shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
------- — For City S�aff- Use Only ------------- — - -----------------
Site, is Zoned?. . P—S
.. .. ... ...... I W bl lg,�A
:2 SCS.m ped so 1: type( ).?.. I�Atjk4wm'A 4P-,db leab
Ap
-5. Weiland iinventory.or C.A map -indicates wetland
present. on site? .
ap: cates.0 �J/fiy�jw"' - &O'k4.: AXJ,�.,,
:4, ;.critica-JAreas. inventory.or.C.A;.m' Andi ritical. Area on. sftel,,� Yet,, 61::$gi
gn - ited e*arth Mo
3. �Site 'itb:in;desi:': b dslide hazardaiea?
su, sidence ]an
4 1 S
Site d.e ignated onthe Enviromuentally Sensitive Areas. Map?
City of Edmonds
RECEIVED
MAY 2 0 1999
DEVELOPMENT SERVICES
CRITICAL AREAS CHECKLIST
The Critical Areas Checklist contained on this form is
to be. filled out by any person preparing a
.Development Permit Application for the C ity of
Edmonds prior to his/her submittal of a development
pen -nit to the City.
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, 'or
may be, present on the subject property. � The
infor . mation needed to complete'the Checklist should
be easily available from observations of the 'Site or
data available at City Hall (Critical Areas inventories,
maps,.or soil surveys).
An applicant, or his/her representative, must fill out
the checklist, sign and date it, and submit it to the
City. The City will review the checklist, make a
precursory site visit, and make a detennination of the
subsequent steps necessary to complete a development
permit application.
Please submit a vicinity map along with the signed
copy of this form to assist City staff in finding and
locating the specific piece of property described on
this form. In addition, the applicant shall include
other pertinent information (e.g., site plan, topography
map, etc.) or studies in conjunction with this Checklist
to assist staff in , completing their preliminary
assessment of the site
I have completed the attached Critical Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/Applicant:
NLie
6, 72� / ��O --
Street Address
City State Zip
Applicant Representative:
/J
Name 94y
4 Is 71f-�? ?0 2-
Street Address
ALA 1262-o I
city State Zip
Date Date
(over)
creception\janakad.doc
r-1 a / k rj U U W I U . -4 J 14 4 J 64 0 1 Z J I U
1NML..-')U11-11UUVMM I I M
r, WIL
rl 87D 10 +-
101
NELSON-COUVRETTE &ASSOCIATES, INC.
CONSULTING GEOTECHNXAL ENGINEERS, GEOLOGISTS
ANo ENVIRONMENTAL SCIENTISTS
Facsimile Transmiffal R E C D
To: LYL#— MAR 10 2000
Company: Ch--� 01�, E.W-O�JD5 ENGINEERING
Phone:
Fax: (4,29) 7 0:1 z I
From:
Company: Nelson-Couvrette & Associates, Inc.
Phone 425486-1669
Fax: 425-481-2510 8 U I L D IN 6
Date: MAR 1 6 2000
Pages Including Cover Page:
NCA File #:
cc:
Comments:
u�)/ L Lit d-uuu 1U. 41J d- �) 4 O.L 4 �J.L U
NELSON- COUVRETTE & ASSOCIATES, INC. FIELD REPORT
CONSUL77NG GEo1'EC—,'C-1, ENCINEERS. GEOLOGISrs
vfnOwEAMAL SCIENTiSrS
17311-135th Avenue NE. A-500 Project: 0LqMLC' -VA� U&I-r File No. 2L4-199
Woodinville. WA 98072 a/ 9 00
(425) 486-1669 - (425) 337-1669 Owner: &)Udl Date: -S/9
Pax (425) 481-2510 e V �4r *'
Location.: Report No. 14
Weather: ( )Vf - Page: Of 1-4
Purpose cv'�� t'
of Visit.. - )('� �!)') Mo� IT Of-4'�& By: AP V,
qah*k--- '-nor'. M� 00f- C�IJE-OIYT -TO ErVALA-If- C-On WE- &I
Lbt 1VILL- CDM4,Cf,00.
AKM iki- Wf &Z tll-b ILL. LEEW? OE T f Cfl%%fA-fS4
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14;0'1� -GT- Sid MD WIE� fIfILL0 TO fA4EMhJ- f*,--a-')Pr1"%J -e.*IL- r-111 '
A-T'- -r y4- 55PLM 14X&, OF VL c5i'Ma -- J+Ap Affi3 CDVkkU;:, QIQ 0 -ro 12_ " of
VDlft A,111 C-Afff:0 O'EfE 4birr- 100*5 OF i-L-2546(i EpcK- 6d)(Z. f"OLS�-C.
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nf- �coii- f�jLi- F:or, f,'JAL04110,J , -rV&- i=iLL (-OJLD PgoMb I -r-,- 2" &J)I-H A
Y2 (' bf"tTU 5t(--C-J- i�OD J�Dk�L A'ftf,4Tt_ R4-f.6LXS-. lt�-?LgL Dukwr� 7U-rs WQ&TAWI,
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f- tLL- �JAD AM P1,Aiefl) Q� LOTS 10 Af�o 91,LL- 14T7L4= 114*T-
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ki" R.,V-F-b A lWo&W-f P040
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To 19' OF -91-EOCT04L. Ffil-L
MAR 1 6 ZUUU
Ld- f-VALI)ATE'D FiLl' co L-OT-s I( 'P If A�D Z0, TO
4 QL ?,6TJf0d,-c, 06AF-
V—X "LJN� TfAcKtoE -TH404a'O THf- Looc+,— wF,2r-- -Mfso )L- Ty Ufti-
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Lov )OWILL Inoi-45P,87-4- UE-1,SIAC, W-PwcL
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Attachments: Signed:
Distribution:
03/10/2000 10: 45 4254812510 NLL�:)UN-t.;UUVKL I I t r-MUr- KJJ
17311-135th Avenue NE, A-500
Woodinville. WA 98072
(425) 486-1669 - (425) 337-1669
Fax (425) 481-2510
NELSON- COUVRETTE & ASSOCIATES, INC.
,-/-Nll CONSULTI,FVG UorECHAIICAL EIVOINEERS. CEOLOGISTS
/V0 ENVIRONMENTAL SVENTISTS
OL�YMf IC- V1 W, CtiV- .--
Project:
Owner:
Location:
Weather.
Purpose
of Visit:
FIELD REPORT
FileNo. 2-64-111. -
Date: 3/2100
14
Report No.
Page: 2- of
By: AD k,
G7- SW- COL&OAE- AP)D t-&r St-1- IAF-17 a
rg oF
o r -qW— P6T,41 P-1S:r,7 Afk1AdA, 24Y
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or-)jL oh#JioA lltf— UM L40t- &Ao I -Dr
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WE
Of-
4,11
;OIL=
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fool7t)c,5 Aff_
t\) ATED
fXQ
MAR 2000
.4
Attachments: Signed:
.41
Distribution:
vnrTE & Ass ociATES, INC. IN -PLACE MOISTURE AND DENSITY TESTS
'ov
Lo�
Cain" GmwomL Swam Gmo=
adulp, OWN mAm"
'PROJECT NAME: 0Lk?M?jC, Vlfv) CPfS-r �JOBNUMBER: 264199
LOCATION: EDMO14DS REPORT NO.: [PAGE OF
PROCTOR METHOD: — ASTM D - 698-91 1 -Z-ASTMD-1557-91 TESTS CONDUCTED BY: MP�,
- APPROX. APPROX.
TEST GENERAL FEETTO FILL % WET . DRY MAX % %
DATE NO, LOCATION GRADE DEPTH MOIST DENSITY DENSITY DENSITY COMP-1 SPEC COMMENTS
*110C C, 7 -�;a-Suf- fiAt� .2 (a JQ.7 1,34,7 121 Pbgke 1"
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RECEIVEP
W10
OkRMIT EXPIRES
CITY OF EDMONDS
us E
ZONE
A5— �
PERMIT
NUMBER
.-CONSTRUCTIONPERMIT APPLICATION
JOB
ADDREW
OWNER NAMEINAME OF BUSINESS
PLAT NAMEMU13DMSION NO.
LOT NO..
LID NO.
*.. . — ~. — 1— /' r — -T—.
MAILING ADDRESS
102-1
CITY ZIP
I V-VWh0q('- TbO2
ADDRESS
hi
I TELEPHONE
MooDOWI L.A
'99)771490
4Q4
NAME
U)r;4zT,A1rr2_
ADDRESS
5(4 p Z,
a 5
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PIT y
P.
TELEPHONE
ATATE LICENSE NUMBER
-EXPIRA71ON DATE
IRORPITY TAX ACCOUNT PARCEL NO. f
ro&7+ -0006-04b:�-.4
WNEW. RESIPENtZ"
ADDITION COMMERCIAL
[3 REMODEL [3 AI!ARTMENT
REPAIR C'YDS
[3 DEMOLISH 13 TANK
M0=E RETAINING.W1,"
p0(1RT IJ ROCKERY
ji7PE OF USE. 13UNNEW OR ACTMM ECRAW
I . 5 r t-j cv, LEp
NUMBER. NUMBER OF
OF DWELLING
STORIES UNITS
a BE WORK TO BE DONE
I :§ar
7Np
T!�Wlfti
LID FEE
TZOW APP�
PUBLIC RIGHT OF WAY PER OFFICIAL MEET MAP RW FWM11 Requbld
8"M U" Pwmk Recfd
EXISTING PROPOSED kupeadw Rowked
SMew4ft RNW&W
PUBLIC RIGHT
EXISTING
L-7 REQUIRED DEDICATI0N_-----A-. FT
Q ='-qum
SIZ 140. OF FDMRES P RjyV E. U
MEW SIZE LINE SUE 0 IIRED
D YE - NO E3
R M 6
d. jEMARKS
I Cc
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAJ
�110
PLUMBING I MECH
C
C�
0 SIGN
FENCE
_X_Fr)
E3 -OTHER
E3 RENEWAL
IGINEERING REVIE%YED/DAIE
Iq In I.
FIRE REVIEWED BY:;. DATE
Ir
VARIANCE OR CU
SHORELINE OR ADS*
INSPECTION
BOND
RE
POSTED
[3 YES
SEPIA REVIEW
SIGN AREA
HEIGHT
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWED PROP08ED
I
, 0
Zq
EXP
LOT COVERAGE
REQUIRED SETBACKS (Fr.)
PROPOSED sETsAcKs (Fr.)
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT UR SIDE
3 7.' Z59
5'
25 7.5 7,5
.9
Z. 1, . // I
PARKING.
Lot AREA
PLANNING REVIE . WED By DATE
REO'D PROVIDED
g
AREAS f101 10 1 SPECIAL IN8PECTO1
NUMBER REQUIRED E]:yES
REMARKS
PROGRESSINSI
OF SSJ�N C
CCU NTX Y
0 PA
GROUP
_JZZ�UA
OCCUPANT
LOAD
PER UBC 101111FINAL INSPECTION
FEE
FEE
Pith Check
Wf
WAT. SOURCE P. LOT SkWF,
Build Ing
b 0 116:36
PLAN CHECK NO: WEBrED DATE
Plumbing
Mechanical
Ties Pwmrr AvrNoRGZS OMY THE WORK NOTED. -THIB PERMIT COVERS WORK TO
e BE DONE,ON PRIVATE PROMITV OWX ANY CONSTRUCTION ON THS'PUBLIC
Grading
Recording Fee
DOMAIN (CURBS, SIDEWALK14 DRIVEWXM MARQUEES, ETC4 WILL REQUIRE
SEPARATE PERMI
x
Engr. Review
—7
7 City Surcharge
P ERMITAPPLICATION: ISODAVS
PERMIT LIMM I VEAR - PROVIDED WORK IS STARTED WITHIN, 180 BAVS . ...
lEngr. Irispecillon 2.00 State Sur charge
SEE BACK OF PINK, PERMIT FOR MORE INFORMATION
'APPUCANT, ON BEHALF OF HW.OR HER SPOUSE, HEM, ASSIGNS AND SUCCESO
Traffic MM ation
W
Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND-AND.HOLD HARMLESS THE CITY. F�,
EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM
I
�flre Review
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE, ARISING DIRECTLY OR INDI
. OT.
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OFTHIS PERMIT.
go lbspection
Total Amount Due
DEEMED TO MODIFY. WAIVE OR REDUCE ANYREQUIREMENT OFF ANY CAff[TY 0
NOR LIMIT IN Aw WAY THE cffn ABiLrryTo ENFORCE ANY ORDINANCE PROVISION.'.
=Receipt
Landscapelnsp.
#
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE. INFORMATION
'GIVEW 18 CORRECr AND THAT I AM THE OWNER. OR THE DULY AU . THORIZED AGENT OF
APPUCATIONAPPROVAL
THE OWNER. I AGREETO COMPLY WITH CITY AND STATE LAWS REGULATINO,60NMUC-
CALL
TM applic . allan Is M a pemift WVII slarl6d by OW
MR AND 01 DOING THE WORK AUTHOIIIZED: THEREfff. NO PERSON WILL BE'-EM04YED
&Mft OftW or Mslhw Deputy: and Fees we paid. w4
IN VIOLATIONOF THE LAVOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
m-lpt Is adwawlefted In opm prouldecL
WORX]MEff8,qWW"p INSURANCE AND RCW 1827.
SK1NA7f(OWN E DATE 8I*ED
OF IALS 810�IATURE
771-02 2.0
TFMs:n
By UATE
ftL ED By
R
A#ENT1601
off 1333.
IT IS UNLAWFUL To I CCUPY A BUILDING OR STRUCTURE UNTIL
I
77-1-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFIm
ORIGINAL FILE (_-_JELLOW IN4ECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK -.GWNEFr--- GOLD -. ASSESSOR