18720 81ST AVE W.PDF11111111 lill
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18720 81 ST AVE W
9
TAX ACCOLTNT/PARCEL NUMBER: 23 2 /:z 06 3 ool 0 F
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS: !?,L-qq DETERMINATION: F1 Conditional Waiver E] Study Required V<aiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DA
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER): Z,4,1
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:— I,,`
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED: 31 ZD I La SIDE SEWER PERMIT(S) #d90 5
SOILS REPORT DA
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
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A-M. 171 N
OWNER/CONTRACTOR IS: RESPONSIBLE FOR
EROSION CONTROL AND DRAINAGE
(Z3 '2 7L.) .3 7)
LOT
I o" �� 9 0 S7,
S L
3117c0:3oc-'1,::,008,
RECEIVED
JUN 14 2002
BUILDING DEPT.
pt-GF P�L.rl-%,�-ll
(IZISF)
0 1 MEET FILE
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P/57 ro
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ROVED AS NOTED
Y ENGINEERWO
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Pate: 7-Z-02-"")
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RECEIVED,
J U N 2 4 2602
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
1)1-1-01x� Pr + loo
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OTHER
HEIGHT.
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let
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NORTH
20
0 PLANNING DATA 0
NAME:—/ -0-D- 0 M. j !3
SITE ADDRESS: IS7Zo Ik A W V' DATE:
ZONING: -z PLAN CHK#: �7- 06
PROJECT DESCRIPTION: 13&P1k06- A�R��
-
CORNER LOT Ye5 (Yes/No)
SETBACKS:
Required Setbacks:
Left Side: W'4�0 Rear:
Front: Aide: I;r
Actual Setbacks:
Front: 44a� LeftSide:-7,�/ RightSlde: 3q Rear: (R
street map checked for additional setback required?_ f-5 PL
,----(YesJNo)
LEGAL NONCONFORMING LANDUSE DETERMINATION ISSUED WN)
LOT COVERAGE:
Maximum Allowed: —Actual:—
BUILDING HEIGHT: 16 X
Maximum Allowed: Actual Height:
Datum Point: Datum Elevation: --
A.D.U. CREATED?: Alo
W &/
c
SUBDIVISION:
CRITICAL AREAS#:. 5-7-91 �,14MD .
SEPA DETERMINATION:
E' A.
LOT AR - - P
OTHER:
Plan Review By:— 3� so�j oovret-L-�
CAfi1cs\permit\Ap1�daLdoc
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A
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PERMIT COW.W.I.,
s*" 0-ft oft —
1 f'LE FILE
1 11) $;
,ASPUAUL,T
DRIVF,WAY
G
NORTH
Pl-CT PLAN
20
VV/ �W/ Z. j U Aj A. L — E I'LLI I.Lj 1 (4,43) DbZ-467 P. 002
No.
CA FRX
Ar4"
C,*'. MiSt 0
— — — — — — — --- — — — -- - — — — — — — — — — — -
Site Information (soils/topography/hydrology/veg�eMtion).
I.. site Address/L,&,mtiow /,00& UeA,,,41'i&LJJA#- �Wogg
Z :Pmp#Ay-'TaxAamntN=*ar-.
ApproAmAte Sit.e Siu (aaesrqpa. f,,t)-.
Is this site currently &-V4elloped? ::fylW;
Vyes;.howissitedevelopad?
Desd*e SW gweral site "ogeaphy. OWk alldw 4ply
w5s �Ct.devafion donge ev,;erertft sue.
_R0,RkW-'"4QPes'Qn 5i#-'9R0QmUY-1es& than 15%,(A v�z� rise of-10-feet O%NW a
horizonQJisbwcii� of 664ect)
'Site
JEW sl� 1 , se]k on
iidles� than 30% (-�4 "'cai'"
'77 Of UWe thm 1.5%
-risa.of 14-fiaet oVera h0rizontgil distance of-33 to 6&.Eee§-.
St4eep, grades.,of gmter ffim 30% present0in'site (a Vatiml nse of I 0-feet over
a hori'mX161 di*a= d less than 334eet).
Odier (please desa*e).
16. Site- Contaiware" Of yearqowloi
Stawling.wabim: Approx. Dep&
7. ..Srite-Contakisarm of Seasotial 9&n4fmS water, Arpr,,�V
epth,
of ft year?.
---Sfte is in 4he floodwaj 0 -,jjoed-p wakrcourse,
Ali
at -ffieSrMm&=dace? Flowsare'
91. Sileconbdma pk*orana.rea:where'water."acrom
yeat-wimd? __ A R,6um iom seasorml? - A& IWI-W thm of year?
10. S.iteis rimadly- forested nwmlow mixed
. p shrubs.
imban W%dsmped (Jawnsl�rubs etcj'
11. Obvious. welland is present on giti: A4u-4
16
777A
ton —
map
MY io
_21
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06/16/97 07:48 MULTI —FAMILY
(425)562-4679 P. 00-1.
C* of Edmon'ds
ity
Critical Areas Checklist
'. L 0 1
The Critical Areas Checklist contained
an this form is to be filled out by any
person preparing a Development Permit
Application for the City of Edmonds
prior to his/ her submittal of a
development permit 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
information 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 CAty
will review the checklist, n%*_e a
precursory site visit, and nu&e a
detenytination of the subsequent steps
necessary to complete a developmcnt
p *t application.
err.-u
With a signed copy of this form, the
applicant should also submit a vicinity
map or plot plan for individual lots. of
the parcel with enough detail that City
staff can find and identify the subject
parcel(s). 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 p;elindnary
assessment of the site.
I have completed the attached Critical Area Checklist and attest that the answers
provided are factual, to the best of my knowledge (fill out the appropriate column
below).
Owner/ Applicane.
/'qz�v
Street Address
Applicant Repre�entative;
Name
.. Street Address
AJX VAZ4C -7Ve1.V,;C
city, state, ZIP Phorke
.00 Air
tare te
City, State, Zll> Phone
sigrahire Date
06/,,1.6 /97
07:49 MULTI —FAMILY (425)562-4679 P. 004
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Extended Page
06/16/97 07:47 MULTI -FAMILY (425)562-4679 P. 001
"THL RANKLYN FAMILY
':-KLTRRAY--,F
14410 ]Bd-Red Road, Suite 200
BCIIOUC� WA$hington .98007
Phone (.206) 644-2�Z'3. Fix (206) 643-3475
DATE
FAX TO:
COWANY: I T( OF AACNDE
FAX NO.-
9 OF PAGES: (ILL 1�mer)
FAXFROM-.
COWANY:
A 4 aA
1 :�4 9
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U R R A A N K L'( j
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1441D Sol-Rtd A094
SENDER'S MT(ALS bellay0g, Washington 12007
Todd Jacob
(206) 644.21z�
Project manogef fax (106) 643-3479
h(tP!Iiwww.rnurraYfranklyn..corn
C.* —*" cf&* Am F.W1. r—wr-w— . .,O-k "ow.
PM
iA7
APPLICATION
for
of Ed onds
m SIDE SEWER PERMIT
NEW CONSTRUCTION'Q�,-- REPAIRS
OWNER. ........ . ................ ................
..........
,ADDRESS .... L '3. ........ "..-q ........... ...............
I.Y.W.' PLANT
EASEMENT No . ................................... .......
PERM
CONTRACTOR IT No.
.. . ..........
LOT
LEGAL, DESCRIPTION: No � .......................... ........ BLOCK'No. .............................
6,�
CITY OF EDMONDS
CIVIC CEWMR — WATER-SEVVER DEPARTMENT Can PROsPeCt &1107 when Woft
is ready f- Inspection. (No inspec-
tions Saturday, Sunday or holidays.)
SIDE SEWER PERMIT N2 1808
ADDRESS .......... ............... 18720 - 81st
. ................ ................. A.venue ----- WeAt
OWNER .............. Fra k Ajq.
........ ... Wo.0d
................................................. CONTRACTOR ........
Permission is granted ...............................
.ae ------------------- for ---------------------- P or C E Sde w
with CitY Sewers 'in 'mordance with aPPlication on file and governing Ord
(Ujy,8,,t,0 RE AIR ONN CT a I se r
e'.
ATTENTION IS CALLED 'TO THE FOLIAMING:
NOTE No. I —The owners of the -Property may obtain & Permit to construct sewer Inside property line. A licensed Side Sewer Contractor must
be employed to CODstruct side sewer in street area. Do not cover any portion of
NO. 2--bbtain full information regarding Ordinance sewer before it has been Inspected.
NO- 3—TOP Of side sewer mus 11-16-030 and Regulations governing side sewers when you get permit.
t have at least 30 inches coverage at Property line and 12 inches inside property line; Minimum grade of 2%.
No bends in grade sharper than % will be permitted.
NOTE No. 5—It Is unlawful to alter or do any other work than Is provided for in the permit, or to do any work on the Main sewer or its ap-
No. 4—Trenches In street must he water settled and surface of street restored to Original condition. Contractors shall be responsible for
failure due to improper work which may develop within one year of completion.
Purtenances except to insert the pipe into the wye.
8 9 0 . 19 C� -
0 STREET FILE
CITY OF EDMONDS
250 - 5TH AVE. N. - EDMONDS. WA 98020 - (206) 771-0220 - FAX (206) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works e Planning * Parks and Recreation e Engineering
LAURA M. HALL
MAYOR
December 15, 1992
Michael Lambert
18720 - 81st Ave. W.
Edmonds, WA 98026
Dear Mr. "Lamb-Li-rit:
I have reviewed your account and will allow a credit to your account
according to our City policy: the average consumption for the same
period during the previous year charged at normal customer rates, plus
the excess usage charged at the City's cost, plus a surcharge of 15%
applied to the excess only. Only one leak credit will be granted in
any three year period.
Should you have any additional questions after you receive your new
billing, please contact Ilene Larson, Utility Billing Clerk.
Sincerely,
Kon HoA5rnd
Water/Sewer Supervisor
RH/l k
cc: Ilene Larson
Utility Billing Clerk
BILLAJUS/TXTWATER
9 Incorporated August 11, 1890 9
Sister Cities International — Hekinan, Japan
7 4'
WA !8020 9 771
so _�qjj Stfq�t , Edly!o �q -0241
0 m b 'U y 0
-on d s '
Cit M EdMohds Co'M ned,,,Utilit —.1
,f E dm
C t 0
.71
'* E;02
,W T L "T
SANITARY SEWAGE IS Tfl TED AT THE EDmONEiS TREAT
A A E S T
r It4r
L _. 0]
MOTOR OlLt PAIar
.n .d
..M I - -A I GE S N Tj USED t
I .,A _T 0 - I R N r
PLA4T; STORM DRAINAGEL—IS NO . SSLY
TLr 'LY
4T ` ..e H 13E
-N WASTES TJ4OUGHTi_E
.0
.,L
.T M
THINNE-Rt PE'T EXCREMENT & QTHErZl
_XL AM c
S NL
A - -N 60 STRAIGHT TO OUR STREAMS
3
_M A I
DR
DuMpED INTO STORM DRAINS
D I 'To Tj 4E
-i THE
U r �T A NT
KFEP PETS AWAY FROM STREAMS ANT
I P
c,
r j D .E
Message PUGEJ �,oi_JND.
' f. , _ T IN
.0 _LU, �4 TL DOWN THE TOILET OR BURY'IT
t,OUND) FLUSH WASTE
0 r, & THINNERS OR 'TAKE TO A
T 0 A
U LL P - NTs
F,r SE A A,
YOUR YArui. USE ALL P Al NTS
Y )U r NOW
V I I Z FTtOU W COMPOST BINS 6RE
E
HAZARDOUS WASTE ROUND-UP#
THE WHOLESALE�
You EACH (HALF
AVAILABLE- THE COST IS�$26 CA LL
HOUSEHOLI. -
COST) WITH. A LIMIT OF ONE VIN PER
(RECYCLING) TO _put<CHASE,-
�771 -.-0220j,' EXT. :317-
METER READJf4GS/DATF TION AMOUNT
P.N.Sul"OPFFET CODE
PREWOUS PRESENT,
�,CbOUNT NUMBER:
Z, 9 2
, �46/,
-7
-AV
'.SjRVIC� w
X
�DDRESP
2
-4
F:... mum
I A
KEEP THIS
LAMBERT MICHAEL
PORTION
FORYOUR .19720 SIST. -AV W
REPOROS EDMONDS WAl.. 98026--582.1
TY: W.�-,TER, WA$,TEkATER�,—,..-���STORM�WATER.-.-I,�ORAINAGE..
,.CQMB1NED,UT,1Lf
0
I
0
167EO 61st. Ave. W.
Edmonds. Wa. 98026
December 11. 1932
Ron Holand
501 Bell Sit,
Edmonds. Wa. 98020
Dear Mr. lic-lanr":
When I race ived th -is b i 11 for ilia ter i n t1he amount OF
$1!-:Ii 14-5 . I !-. new Some 'L h 41 no was Ii-I 7-ona . I checked and Found
that I had a leak in the water, 11"na between the meter and mu
'10LISS. I duo UO this line. all 60 Feet OF it and reolaced
it. I do not have mu receiot For the new line and
Cmnnectinq narits. w"hich were our -chased at Thuriman Flumbing
on Highwau 99. but anuone drivi-no bu can see that MU Uard L--JaS
duo uo. I am reauestino a leak credit. as I renaired the
leak as soon as it came to mu attention,
Ueru trulu pours,
Michael L.. a Ljert
An
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS
-TDL)D M
MAILIP ADDRESS Of,
1 7 W
ZIP 11ii-EPHONENUM.E.1
90W-4 71-Z - 1-93(l
ADDRESS
1ADDRESS t,_
C
LICENSE NUMBER EXPIRATION DATE
Descriotion Of PrODertv - include all easements
,-F..y
Tax Account
7) 7 W3 OM 0 08
Pamel Nag
NEW
RESIDENTIAL
19( �Lumslx EPH
[KIDITION
El COMPLIANCE OR
COMMERCIAL:
CHANGE OF USE
1:1
D APT. BLDG.
REMODEL
SIGN
REPAIR
[:] GRADING CY FENCE
09
DEMOLISH
L_ X
WOODSTOVE IM POOL
El SW
INSERT HOT TLIB/SPA
FGARAGE
]CARPORT
r7 RETAINING WALL/
L—J ROCKERY T:.EWAL
TYPE OFPP
IrUSTIN
,,,VCTIVIT�E _ C—p—
jo ;r i�
NUMBER NUMBER OF
OF DWELLING*
STORIES UNITS
DESCRIBE WORK TO BE DONE (ATTACH PLOT
USE
ZONE PERMIT 13 71 0
NUMBER
ADDRESS cr—
.EGAL DESCH IPTION CHECKI
SUBDIVISION NO..
LID NO,
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCP Apprmed E3
.EXISTING 13EQUIRED DEDICATION _
RW Permit l4qui,'"" 0
Sir" U" Permit RW- 0
impeclion Requi. a
Sid"alk ReiTufred 0
PROPOSED
METER SIZE.
I LINE 911
NO..25XTURES
PRY REOISIRED —
YES 0 NO 13
DATED
VARIANCE OR CU
SHUR LINE It
SERA REVIEW
COMPLETE
EXEMPT'
SIGN AREA
ALLOWED
HEIGHT
ALLOWED
EXP
V
I
]PROPOSED
IPROPOSEE
2-4� 1 G
LOT COVERAGE
AULO!ED
P-21,SED
REQUIRED SETBACKS IFT)
FRONT SIDE REAR
PROPOS D SETBACKS (F
FRONTEURSIDE REAJ
'ITS,
LOT AR11;
If 1_
P AN I"r
�R
'11.71
1AT __7
1 1_ 1,7
IREQUIRFp . OYES LOAD
IREMARKS
PROGRESS INSPECTIONS PER LIBC 108
fl%L; " I I IV tv qZJ Ir- I %:.j U I -a lq- rjw
INSPECTION REOUIRED
N
VALUATION
CK FEE
HEAT SOURCE:
GLAZING
PLUMBING
PlanCheckwo. q-7-
_9 0
MECHANICAL
This Permit covers work to be done on private property ONLY..
GRADINGIFILL
Any Construction on the public domain (curLs, sidewplks,
STATE SURCHARGE
driveways, marquees, etc.) will require separate permission.
Penri-iflAppli4flon,'1180 Days 1, 1
.- ; ' /-1 -
Permit Limit: I Yiar - Provldedi4o� 1. Started VIffthf."1180,Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
S u cessors in interest, agrees to indemnify, ddfekd and.hold
hacrml.S, he City of Edmonds, Washington, Its off icials,
ENO. INSPECTION FEE
am ployeas, and agents from any and all claims for damages o
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
OX
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 .
ATTENTION
APPLICATION APPROVAL.
authorized agerIlgi the =r. I agree to comply with city and
state laws re IN ion: and in doing the work authoriz-
'g 80
THIS PERMIT
This application is not a. permit until
ad thereby, ri.�p o=l' . am
, bc ployed.in violation of the Labor
I
AUTHORIZES
ONLY THE
signed by the Building Official or his/her
Codeofthw9ta *ashin0to relating to Workmen's Compensa-
WORK NOTED
Deputy: and fees are paid. and receipt.is
tion Insu,4nqNrW,.RCW 182 ,
INSPECTION
acknowledged In space provided.
SIGNAT ER OR AGENT DAT;
7�ED DEPARTMENT OFFICkA1# SIG
IfI7 C
'ITY OF
EDMONDS
CALL FOR. �fA E Y:
TENTION INSPECTION.
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
.11 — .. I . V. — --OVAL OR I f I — IYI& U QB-Gl AL --m- File YELLOW — Inspector
A CERTIF;CATE OF OCCUPANCY HAS BEEN GRANTED. UBC
SECTION 109
Illec PINK — Ow net GOLD — Assessor
AQ.
AtE RECEIVED
RMIT EXPIRES
p
410- �Ro
t I/ USE PERMIT
CITYOF EDMONDS ZONE NUMBER,�)t)K13._(2_RJ
CONSTRUCTION PERMIT APPLICATION JOB ITEIAPT#
U
OWNER NAME/IJAME OF 6 MUS L
PLAT NAWSUBDIVISION NO. LOT NO. LID NO.
d-Z b
I NG ADDRESS LID FEE $
TESCIP Apimov
PUBLIC RIGHT�61` WAY PER OFFICIAL STREET MAP RW Pam* Rawkw
M'�f Street Use Perink Rwld
CIP ONEi EXISTING! PROPOSED hapection RaqLd-d
TELEPH Sidewalk Required
REQUIRED DEDICATION FT Underipround
vvmng req� 13
NAME METER SIZE LINE SIZE 0. =OF FIXTURES REQUIR&VD,,,
Z
YEPIVI N1
ADDRESS REMARKS z
z
bWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY ZIP TELEPHONE KEI'D 5VZON 02- Ooftv'
To OmTu IF IkMLA,106 0 A L,'
NAME
ENGINEERING REVIEWED/DATE
ADDRESS 0
0 D. L6FrT
ass
24 -412
FIRE REVIEWED BY DATE
CITY ZIP TELEPHONE
rE
STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY VARIANCE OR CU SHORELINE OR ADB# INSPECTION 66ND
REO'D P06TED
14_N6,1.t_dD1MA4 5,1 fe 1_ 13 YES [3 . NO
SEPA REVIEW SIGN AREA HEIGHT
PROPERTY TAX ACCOUNT PARCEL No
COMPLETE :XEMPT ;ALLOWED - PROPqIED ALLOWED PROP BED
-7/ -7- 10, -0 -f 0 �'o I 'X N/A I N .216 11 f 11
6P, /A Iss
LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SET13ACKS (Fr.)
NEW eRESIDENTIAL PLUMBING 0(o ALLOWED OOPOSED FRO SIDE REAR 9EM L/R SIDE
NT
AD >/4 _ 4
COMPLIANCE OR 4 -
DITION COMMERCIAL CHANGE OF USE 316 2-5 1 z
P F4ING ATE
'A LOT AREA P G R Y
REMODEL APARTMENT SIGN REOD PROVID, :0
7-9
REPAIR GRAf o FENCE
4 Q18G
13 Cyns X FT) RE
r 0R.WFM -6 A
0 DEMOLISH 0 TANK OTHER.
OARAG -AIZ
E I RETAINING WALL ' I . F* -
CARPORT AOCKERY RENEWAL
ITYPE OF USIS—MISINESS, OPR A N:
CTIV" EVLAI
'd j CHECKEP BY ITYPE ION OCCUPANT
01
v r I 4L,_ GROUP .
NUMBER ER OF RITICAL .12L
OF DWELLING A E SPECIAL INSPECTOR AREA OCCUPANT
STOR14S Uklms
N REQUIRE . D YES 1)4.jC�,W Mo LOAD
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER U13C 1108/FINAL INSPECTION REG'D
L/ 1411141jee-
LW a'r/ /S 0/41f
I f
I&W� &jVtL9 4- f!!ilC J<M� * ;10 1 a_
VALUATION
Tilikirlption FEE tm,-,w?Q9scrIptIon FEE
Plan'Check
GLAZING %. LOT SLOPE %
-T Building
PLAN CHECK NO -
VESTED 0 ATE i Plumbing
Mechanical
,THIS PERMIT AUTHORIZES ONLY THE WORK-N�1r6.'_,THii PEiM'IT,C ERSWORKTO
BE DOME ON PRIVATE PROPkRTi ONLY. ANY CONSTRUCTION HE PUBLIC
2 Grading
DOMAIN (CURBS, SIDEWALKS. DRIVIEWAY13 ' MARQUEES, ETC. WILL REQUIRE Recording Fee
SEPAMWE PERMISSION.
Engr. Review City Surch
arge
PERMIT APPLicAinom. i so DAYS �% -t ' j, - - . . .
IL PERMIT UMM I YEAR - PROVIDED wdRK'IS STARTED WITAN'480 DAYS Engr. In spe�ion 'Stat . e Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Traff
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE,L HEIRS, ASSIGNS AND SUCCESORS 1c Mitigation Plan Chk Deposit,
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLE) HARMLESS THE CITY OF
X EDMONDS, WASHINGTON, " OFFICIALS, EMPLOYEES. AND AGENTS L FROM ANY AND Fire Review Receipt iF
IALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
9 DEEMED TO MODIFYs WAIVE OR REDUCE ANY REQUIREMENT 0 L F ANY CITY ORDINANCE Fire Inspection Total Amount Due
21 NOR LIMIT IN ANY WAY THE CnYS ABILITY TO ENFORCE ANY ORDINANCE PROVISIOR.'
Landscapelnsp. Receipt#
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 APPLICATION APPROVAL
THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application IS notLa permit untfl signed by the
TION; AND'IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED CALL Bufld[Ag Official or hi&Mer Deputy: and Feas are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION —Ipt Is acknow4edged In space provided.
WOR"tft 9MRNSAn%kNSURANC 18.27L
E ANY RCW
OF CIALS SIGNATURE DATE
E 0 DATE SIGNED 1A63
%425)
771-0920 RELEAS
E BY
A"TI EXT 1333
IT IS VNLAW111 0 E OR OCCUPY A BUILDING OR STRU&URE UNTIL NI" I IV &0-3
2 1 4,
L To V/
A FINAL INSPE%CTN HAS BEEN MADE AND APPROVAL OR A CERTIFI- 771 m0221.
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION log ORIGINAL - Fl&,-" YELLOW - INSPECTOR
FM Id, PINK.- OWNER GOLD -ASSESSOR
10/01