18115 76TH AVE W.PDF111111111111
6234
18115 76TH AVE W
Side Sewer Drawing
,The City of Edmonds
EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION REPAIRS F-1 LID NO - ------------------ IASMT. NO - ------------------
OWNER------------------------------------------------------------------------------------------------ CONTRACTOR M ------------------------------------------------------- PERMIT NO.
JOB ADDRESS -------- ----------- LEGAL DESCRIPTION: LOT NO - ------ !4 --------------------------- BLOCK NO - ------------------------------------
KOM tA
NAME
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ID Slt4l)�l
E LWAONDS
i MAI MENT PLANT
. - I
Approved:
PWW-0001-1 1/75 (REV.1 1178) DATE .... ........ [�. ..... ------ q-0 ........... B y ....... ..........
STORM DRAINAGE DETENTION SYS7M.
V. V li date approved
address address A
\A
C6 cf3
Z4
Sukes
4Z'
approved by
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ITY,� Q-F EDMONDS Permit No.
COMMUNITY SERVICES
R16H I T-OF-WAY CONST979WIR T Issue Date'
A. 0 Owner: 'C� B. 9 Contractor: jo (3L�_
Nagi me -71
3. so
Mailing Address ailing A.1dress
Z 7-
P_ p mo O-S UJ A qw.zn WA.
City State Zip City State Zip
�-L C_ C_ I'
State License Number Telephone Number
C. 9 Address 6r Vicinity of Construction:
Type of Work to be Done: C_ C:�4_
L
D. 0 Work in Connection With-, Sub or Plat El Single Family 0 City Projects
��E] Commercial 0 Multifamily yutility
E. 0 Pavement Clit: El Y P"N F. 0 Size of Cut: — X
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of,TEdmonds
harmless from any injuries, damages, or claims of any kind or description whatsoever, forseen or unforse6n, that may
be made against the City of Edmonds, or any of its departments or employees, including or not * limit�d 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.
Estimated restoration fees will be held 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. I
• A 24 hour notice is required for inspection; Please call Engineering: 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.
I understand the above and that this P
,,ermit must be a ailable at the job site for inspection purposes at all times.
Signature- Date:
Owney or Contractor
J Permit Must be Posted at the Job Site For Inspection Purposes
his Permi,
Call DIAL -A -DIG Prior to Beginning Work
APPROVED BY:
Time Authorized: Void after I Ve days.
Special Conditions: N 'A! ,
RELEASED BY�
PERMIT FEE4��1_50_
Restoration Fee:
Receipt No.:
Fund 111 Fee:
Street Cut Dimensions:
Date . f—dl— 9/ INSPECTED BY
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
x
Date
t:ng. uiv, marcn m5y
FIELD INSPECTION NOTES (Fund 1. 11 Route copy to Street -'gept.
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. July 1985
16[it & !81 t 5- 76 -r H AN F-
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STORM DRAINAGE DE7ENTION SYS7EM qq
developer-121-� �vru�. dateapproved 90 K)C�090
address address
approved by ALoc
ORT
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CITY OF EDMONDS
E2 /NEW
ADDITION
RETIREMENT
STREET f ILE ASSET INFORMATION SHEET
ASSET NO.
ADDITION TO ASSET NO.
5 z 00(oo?,l 9-30-70
DESCRIPTION SQ-r \j k cQ— N ?,
SERIAL NO.
LOCATION r? Oil- pr \j -e-Nu-e- w DEPT. NO.
PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
PROJECT NUMBER o -j s (:),Rz
PROJECT COMPLETION DATE ?o
COST ? 21
B.A.R.S. ACCOUNT NO. 1(, 0 (20 3 L/S', OU, 6 3
ESTIMATED LIFE -
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
VDEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
G.L. ENTRY
REFERENCE DATE
ktnp INITIAL
DEPARTMENT FILE
VERIFIED BY
PROCESSED
BATCH NO. -
DETENTION WORKSHEET
STANDARD DRAINAGE .'PLAN.*
U PPF_P1
r-AXCH evrBE ILE
BASkN ET F -
ETENTIONW C0Kr1k0%- CATCH
(vr.t4T) - * SkSIN
r-- 14 MIN, 2' MAX COVE& --1 1 :7
% SLOPF---b-
9
SYSTEM CROSS SECTION
q00 Ll tl q
OLrrLrLT
Cot4TStOL�
.t�%:A
_11r 4. *
70 OLFrL-E-r
(si P RAP OR
P'UNOFF
SPREXDER)
2' 2' &"DOMP, At-&" SP^LA-S (mzvu^,-)
:2r 2' 3" IDEEP, V4*- C1ZUS%ArzD POCK
FIRVA
0 t-rr L ET
CON-I-ROL
WA3HIED
FROM
0 Lrrl_ ET
CONTPOL
RIPRAP OUTLET
OUTFLOW TRENCIA, IAlti 10' LONG, I .
'rOP 4 A" PE-PLF PIPIE -M SE L-V-V�L
I
.. ?F-RF P%PE: WITH C&P.S
RUNOFF SPREADER OUTLET
DETENTION SYSTEM
S11D
for L 7— f`
location7V it 3 - 771) 7;vAvr-�
.1 -r
plan by gr-7 L -
phone V 7 e fdl/
date
DESIGN DATA
System Imperm Pipe Pipe Orifice
Number Area Diam Length Diameter
I NOTES
1. Call Engineering Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the resvonsibility
of the property owner(s). Material
accumulated in the storage pipe must
be flushed out and removed from catch
basins to allow proper operation. The
outlet control orifice must be kept
open at all times.
no
W 111 F, ff"A 0 &WAS &1A Z'
t I
FOOTING DRAINS SHALL NOT BE
Page 9 of 9 CONNECTED TO THE DRAINAGE SYSTEM
CITY OF EDMONDS
E �ITr E�N T 10 N W 0 R K S fiLE
ST
L) FPF-F-
N p,pLr L.LrHGT%4 C.ArC%4
OrrEINITIO
MIN
=1_1101 MAX CONFER 72
I' MIN,
r—
OVTLXT
COWTRoe
4
A 11 1 r * '
-To 0LjrrL.S-r
(Pj p;tAv OR
RUNOFF
SVIREkDEIL) --I
SYSTEM CROSS SECTION
2' . 2! &;. oe=?' 4�.'6* f-p".LL.'
I: x 2' 3r DEEP, 1W_
0LrrLET
CON-rAOL
RIPRAP OUTLET
t tA I % I C), LO t-4 G .
w^smED CrVj04VLj f 01y"l-OW 'TRENC" p, pE
A' PE'IkF
FROM
oi,rr'ET
CC)N-rROL IpFRF p%pS WIT" 06,95
RUNOFF SPREADER OUTLET
DETENTION SYSTEM
Lo
Ccr V AZT
for
location
plan by
phone
DESIGN . DATA
system ImpFerm Pipe Pipe Orifice
Number Area Diam .. Length I Diameter
NOTES
1. Call Engineering Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage Systems On
private property is the resoonsibilitY
of the property owner(s). Material
accumulated in the storage pipe must
be flushed out and removed from catch
basins to allow proper operation. The
outlet control orifice must be kept
open at all times -
Is
FOOTING DRAINS SHALL NOT BE
r-ntom%=r.TFr) TO THE DRAINAGE SYSTEM
CITY OF FE3MONDS
SHEET
W'bRK,
to",
I - 1; i C RHO I
STREETF
14 MIN , 2' MAX COVEK
% 5LOPE-
COWrROL CATC"
--OLrrLCT
CONTROL�
91 - - -1-4-
SYSTEM CROSS SECTION
L700
- 0-2111 1
2' x 2' a 06mr, At- 16' SP^LLS (m rou^s-)
1V 2* 3r DEEP, CVUS"EV ;*cK
FROM
0 nL
LrrLE-r
CON-rROL
RIPRAP OUTLET I
'TO 0LJrrLJET
(FJ PRAP OR
RUNOFF
.SP11ZF-XDE:R)
WA3HZD &RUNYCL� fOLITFLOW TIKENC-44, 11AM 10' LOW,, . .
TOP 4 -4- PE-FLIF PIPE -M Se L.P-vWL
FROM
OLMLET
CON-rROL
. PERF PIPE WITH CAMS
RUNOFF SPREADER OUTLET
FOOTING DRAINS SHALL NOT BE
Page 9 of 9 CONNECTED TO THE DRAINAGE SYSTEM
STANDARD DRAINAGE-PUM
rl_trAvr-
DE I1%Mr%7r"L-
ILE
for Q— - Ile
location I It ZZY K A FEE tV"
plan by hk-7 K-,rI
phone -7i� 7 -7 ?�FAV7
date
it /I
DESIGN . DATA
System Imperm Pipe Pipe Orifice
Number Area Diam Length Diameter
NOTES
1. Call Engineering Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the resvonsibility
of the property owner(s). Material
accumulated in the storage pipe must
be flushed out and removed from catch
basins to allow proper operation. The
outlet control orifice must be kept
open at all times.
OVER on =VWTALW1
"IMM
ON
In W1, �Wjrf "'M 1.1 i
CITY OF EDMONDS
STREET FILE
CONDITIONS OF PERMIT APPROVAL
The City of Edmonds authorizes the issuance of Building Permit
# ZQQYI!�Z _subject to the following conditions-:
1. The Applicant acknowledges that he will comply with all
conditions that may be established by the Hearing Examiner for
obtaining a conditional use permit for the excess material
graded on the site, outside that which was originally
authorized under permit #870015 and #CU-37-86.
2. The City will not grant final approval or occupancy Until all
conditions have been met for remedying the excess grading that
has taken place on the property. The Applicant assumes all
risk associated with any damage that may occur to the proposed
residence as a result of such compliance work.
3. No other building permits will be issued on the site until the
excess grading has been brought into compliance.
We have read and acknowledge that we will comply with these conditions.
—1".- ei I // )& t. I
omas B 1 t / Da(te' Doris Belt Date
TENTION WORKISdEET.
uppap, V; it X,
CA-MH sim-5,
(BASIN DETENTION PIPC LENGTH CON-MOL C-ATCH
yr. wr BASIN
r— I' MIN, 2' MAX COVEP,
14 — OLITI-Vt
COWROC
SLOPE-- 77
4-
'TO OUTL-E-r
(RJ P RAP OR
KIJNOF�F
SPREADER)
SYSTEM CROSS SECTION
1-D 'P�F Ape
ft J&V.
J-.JSr"U, RZ(O 9—
rtPea-ov4L-
or
2' 2' 4t. G.
x 2' se 3r Deep, clwsmeD socr,
FROM
OLMLET
CON-1-11LOL
RIPRAP OUTLET
WA3HUD 12VRAVIFL� fOUTFLOW -fRENCIA, Mlh 10' LONG,
TOP PIFFLF POPE -M Be L.F-vWl_
FROM
0 Lrr. ET
CONTROL
4� ?I-RF PIPE WITH CARS
RUNOFF SPREADER OUTLET
FOOTING DRAINS SHALL NOT BE
STANDARD DRAINAGE PLAN
DETENTION SYSTEM
for
location ly-zhl
plan by
phone
date
t
DESIGN DATA
System Imperin Pipe Pipe Orifice
Number Area Diam Length Diameter
NOTES
1. Call Engineering Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the resDonsibility
of the property owner(s). Material
accumulated in the storage pipe must
be flushed out and removed from catch
basins to allow proper operation. ' fhe
outlet control orifice must be kept
open:at all times.
CITY OF EDMONDS
Page 9 of 9 CONNECTED TO THE DRAINAGE SYSTEM
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5/90
TO: Permit Coordinator, Building Division
FROM: Dan Smith, Engineering Inspector,
ADDRESS: DATE: /I (J96
OWNER:
PLAN CK#
After review of the subject building'.permit application, we have the
following comments:
1. Construction hours are: WEEKDAYS .......... 7:00 a.m. - 10:00 p.m.
(ECC 5.30.110) WEEKENDS/HOLIDAYS..10:00 a.m. - 6:00 p.m.
2. A separate Right -of -Way Construction Permit is required for any work on
City property. (ECDC 18.60)
3. Connection to City water system required. Separate water meter charge
required. (ECDC 7.30)
4. Connection to City sanitary sewer system required; obtain separate permit.
LID # '-� . Fees paid: Yes — No — Charge $ (ECDC 18.10)
i-�NAAOtvtl t1^JC-
5. Water and sewer lines should be separated by 10 feet minimum. (ECDC 18.10)..
6. Driveways must be paved a minimum of 20 feet back from City right-of-way;
separate permit required. (ECDC 18.80.060C)
7. Driveway slope not to exceed 14%. Waiver granted to
(ECDC 18.80.060D)
8. Back water valve'required if downstairs plumbing is below elevation of
upstream manhole. (ECC 7.20)
9. Builder/Owner responsible for containing all temporary runoff and erosion
control on site. (ECDC 18.30.030D)
10. No burning of construction refuse without permit from Fire Department.
11. Street to be kept clean of debris, dirt, mud, and construction material.s.
Contractor responsible for dust control. (ECDC 18.30)
12. Inspection required on drainage system, catch basin installation, driveways,
and sidewalks. A final engineering inspection is required prior to the
building division granting occupancy. (ECDC 18.30, 18.80)
13. Repair or replace all defective existing curb, gutter, and sidewalk. If
intersection is involved, installation of wheelchair access may be required.
(ECDC 18.90)
14. Underground wiring required on all new construction. Also, if the proposed
addition, alteration or repairs exceeds 50% of the total assessed valuation
of the existing structure. (ECDC 18.05.010)
15. (418wOM100
61\)S(Te lau'pvvl� �Vyllojroz)01 (p,prre-d''
S.TfEiE-f FILE
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97-3-
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5/90
TO: Per terwIteding Division
FROM: Da$tSmit WEn neering Inspector
ADDRESS: 110716 DATE:
13.
26
�7_
OWNER: - PLAN CK#
After review of the subject building permit application, we have the
following comments:
1. Construction hours are: WEEKDAYS .......... 7:00 a.m.— 10:00 p.m.
(ECC 5.30.110) WEEKENDS/HOLIDAYS..10:00 a.m. - 6:00 p.m.
2. A separate Right -of -Way Construction Permit is required for any.work on
City property. (ECDC 18.60)
3. Connection to City water system required. Separate water meter charge
required. (ECDC 7.30)
4. Connection to City sanitary sewer system required; obtain separate permit.
LID # Fees paid: Yes — No — Charge $ (ECDC 18.10)
i_yr44Jo'?V'0
5. -Water and sewer lines should be separated by 10 feet minimum. (ECDC 18.10)
6. Driveways must be paved a minimum of 20 feet back from City right-of-way;
separate permit required. (ECDC 18.80.060C)
7. Driveway slope not to exceed 14%. Waiver granted to
(ECDC 18.80.060D)
8. Back water valve required if downstairs plumbing is below elevation of
upstream manhole. (ECC 7.20)
9. Builder/Owner responsible for containing all temporary runoff and erosion
control on site. (ECDC 18.30.030D)
10. No burning of construction refuse without permit from Fire Department.
11. Street to be kept clean of debris, dirt, mud, and construction materials.
Contractor responsible for dust control. (ECDC 18.30)
12. Inspection required on drainage system, catch basin installation, driveways,
and sidewalks' A final engineering inspection is required prior to the
building division granting occupancy. (ECDC 18.30, 18.80)
13. Repair or replace all defective existing curb, gutter, and sidewalk. If
intersection is involved, installation of wheelchair access may be required.
(ECDC 18.90)
14. Underground wiring required on all new construction. Also, if the proposed
addition, alteration or repairs exceeds 50% of the total assessed valuation
of the existing structure. (ECDC 18.05.010)
15. j'P& �/j
Pr6JET REVIEW CHMMIST
k�
-7
PROJECT NAME: 15 pPT
F tvl� RAWIRESS: M11-5 6
APPLICATION RECEIPr DATE: 3 & WC
FIRE
SIN= FAMnY/MULTM2/CMMC3:AL - (Circle One)
SMACKS CHECKED - Planiiing
VARIANCE/SMACK AW.
PLANNING
BUILDING
Reviewed by: (initial7Ete)
WrR/SWR STREET ENGNRNG
I'T
CONDITIONAL USE PERMIT
7TF1 TF17T
/////////
71TIT177
////////
7T/-/-/ -77-777-
ADB REWIRDOM CfflXMM
777177
/////////
/////."7
7111111111
3
OTHER ZONING REQUIREMENTS
_7F17TM1
4
ENVIRONMENTAL FEATURES
/77/77
IT171TI 77
/////////
7///////
////////
5
Aamss sLoPE & VEHICLE ACCESS
T17111111
77777774
6
DRAINAGE PLAN (On Site)
11TR1
//////
777"7777
7
STREET FILE
/7P//
8
LEGAL DESCRIPTION VFRIFICATION
9
QUIT CLAIM/DEDICATIONS
777777
10
EASEMM - PUBLIC/PRIVATE
777777777
77777777
I
CALCULATE SEWER CONNECTION IF NO LID#
=7
12
PLAT/SUBDIVISION MQUIRMENTS
7777777
RIGHT-OF-WAY CONSTRUCTION PERMIT REQD
111177
7T17TR11
?113lfO
14
BOND REQD FOR PUBLIC T�TROVEMENTM
15
SOILS CONDITIONS & GRO UND
WATER FIETD CHECKED
777777771
111111111.1111111.4*1
TIT=
1
16
STREET PAVING REQUIRED
771777
1111ITT"
17
CURB AND GUTTER REQUIRED
11117T
00-
18
SIDEWAIX REQUIRED.
7TMI
1/////
/V
19
CURB CUT FOR DRIVEWAY REQD
111711
ITTT71TI7
///////1/
20
STREET NAME SIGN REQD
1111111.11'77T7
=-—
1411111111
1411111111
21
OTHER.SIGNING REQD
111117777
11111117
22
SIDE SEM AVAILABILITY
23
EXISTINGMATER MAIN SIZE
777777
//////
777777777
*"5 F
777/=
T
—
24
WATER MMM SIZE
1"777777T=
1504 fr
7/777=
—
25
SERVICE.LINE SIZE
"71111111
7777T/7777
—
26
HYDRANT REQUIRED
7TI=
7TT17=
17 7 7 7 7 7 7
7TTrl=
—
27
HYDRAWL SIZE EXISTING
9
28
CROSS CONNECTION INSPECTION REQD
7=
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/////////
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////////
29
VATER MMM CHARGE REOD
T=
7 =
TfT1 77=
—
30
FIRE*LINE CHARGE REQD -.SPRINKLER
77777777
//////
IIIITIT177
31
STREET CUT
32
OPEN DITCH EXISTING
ITTTR
33
11111T
777777777
34
CULVERr P=
7777777777
7 7
35
SIZE
TTR
36
CATCH BASIN REQ . D
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37
INDICATED ON SITE PLAN
TTTR T
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38
SHOULDER DRAINAGE - MAINTAIN
SHALE OPO4 RUNOFF-
39
MISC:
717777M
40
-C El V D
WaRKS
REVIEWED BY:
PLANNING MGR. ENGINEERING MGR. -PUBLIC
S MGR.
Fit F
USE PERMIT
CITY OF EDMOOS ZONE
CONSTRUCTION PERMIT APPLICATION joa NUMBER OCIA 4�D
OWNER NAME/NAME OF BUSINESS ADDRESS A/y, SUITE/APT
a: /'7" LEGAL DESCRIPTION CHECK SUBDIVISION NO, LID t4o.
MAILING ADDRESS
Z
0 7
PUBLIC RIGHT OF �AY PER OFFII�AL EE4A�. TESCP
CITY ZIP TELEPHONE NUMBER EXISTING REQUIRED DEDICATION APPROVED BY
NAME PROPOSED
Z
CC
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED
u0ji ADDRESS STREET USE PERMIT REOUIRED 0 Z
0
0 77, SEE ENGINEERING MEMO DATED REVIEW BY�1,.:rl z
Uj
P
=1T Y z I TELEPHONE NUMBER
REMARKS
NAME
ADDRESS
a:
0 _7RE UNITS
METER SZE BUILDING
L) SUPPLY SIZE
cc CITY ZIP TELEPHONE NUMBER cc
I W
Z __ / —
0 REMAR S
0 STATE LICENSE NUMBER 7)k V Ize 4), 0,
SIGN AREA ENV. REVIEW ADB NO.
Legal Description of Property - include all easements ALLOWED PROPOSED COMPLETE EXEMPT
Z (show below or attach two copies) �HPRELIN�!
2
CL
cr VARIANCE OR CU PLANNING REVIEW BY
DATE
U
SETBACKS —FEET HEIGHT -RAGE
LOT COVE
W FRONT SIDE REAR 4 Z
Tax Account Parcel No. REMARKS
-122 f17_12AC_L-."_LD
ET'NEW D/RESIDENTIAL PLUMBING I
El ADDIALTER COMMERCIAL MECHANICAL Ojoku) I —ri o/j t5
EIREPAIR L APT. BLDG. I SIGN
EXCAVATE. FILL f7 CHECKED BY TYPE OF CONSTRUCTION ICODE
'I FENCE HEIGHT
DEMOLISH OR GRADE I— x _FT) _/J/ 2,5 1
CARPORT swim 00
REMODEL GARAGE El POOL SPECIAL INSPECTOR EA OCCUPANCY OCCUPANT
REQUIRED GROUP LOAD
WOOD STOVE/ F7 RETAINING WALL/ E)YES NO
INSERT ROCKERY El RENEWAL REMARKS
Z
01
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: PROGRESS INSPECTIONS PER UBC 305
C L)
r D
UO NUMBER OF STORIES UMBER OF
0 DWELLING _r/W1_ AeA 119(g Wj11?rYA6y alOe
co UNITS
0 �ATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
`�01L_S AeD"V /JCW(7 lkrOC, FINAL INSPECTION REQUIRED
k_ -VALUATION FEE
PLAN CHECK FEE
BUILDING 120 123 602-
PLUMBING 2-5-
Plan Check No. -cr-rl-3 MECHANICAL
This Permit covers work to be done on private property ONLY GRADINGIFILL
Any construction on the public domain (curbs, sidewelks,
driveways, marquees, etc.) will require separate permission. STATE SURCHARGE
[Perm it Application: 180 Days
P
Permit Limit: 1 Year - Provided Work is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
'Wn harmless the City of Edmonds, Washington, its officials,
x. employees, and agents from any and all claims for damages of
a:
< whatever nature, arising directly or Indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT
modify, waive or reduce any requirement of any city ordinance
0
:r nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE
provision."
I hereby acknowledge that I have read this application; that the
information given is correct; and that I am the owner, or the duly ATTENTION APPLICATION APPROVAL
authorized agent of the owner. I agree to comply with city and THIS PERMIT
state laws regulating construction; and In doing the work authorlz- AUTHORIZES This application is not a permit until
ed thereby, no person will be employed in violation of the Labor ONLY THE signed by the Building Official or his
Code of the State of Washington relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is
tion Insurance. I NSPECTION acknowledged in space provided.
SIGNATURE (OWNER OR AGENT) DATE SIGNED DEPARTMENT
CITY OF OFF! IA S GNATURE DATE/
EDMONDS 77" �71
L
CALL FOR AIE CE A I W BY:' DATE
ATTENTION INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-3202 ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC Ll
CHAPTER 3. PINK — Owner GOLD — Assessor
102-87
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