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18906 92ND AVE W
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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS ADDRESS
t"'�t4 C-- NA t 11 1;= rl-- EGAL DESCRIPTIC
V%Q) 161-1/`15
PAC - t-AuJ-f
ZIP I TELEPHONE NUMBER
pji!� �3-70 -42:,
1,)I---z,) 4k 4C
ZIP 9NE NUMBER
-7
ITELEPH
k-! —/
C-2 / (�,, —/ V
EXPIRATION DATE
ty - include all easements
TadiActimunt
Parcel No. 4-54(. - oco 03o(�
F—I-EW
RESIDENTIAL
PLUMBING
154 DDITION
COMMERCIAL
MECHANICAL
MREMODEL
F-1 APT.BLOG.
El SIGN
GRADING
FENCE
E]
ElREPAIR CYOS.
I x —FT)
DEMOLISH WOODSTOVE
INSERT
sw OOL
HOTIMTPUB/SPA
GARAGE RETAINING WALL/
CARPORT ROCKERY
RENEWAL
(TYPE OF USE. SS 01]1 ACTIVITY) EXPLAIN:
5F A" ldextt
NUMBER
NUMBER OF
CRITICAL
OF
DWELLING
AREAS
STORIES
UNITS O*eINU.,ER
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
PERMIT
NUMBER
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP,
TFSCP Appirmad 0
Rw Permit Required 0
EXISTING — REOUIRED DEDICATION _
street U" Permit Req'd 0
I rispection Required 0
PROPOSED
Sidewalk Required 0
REMARKS
REVIEW BY
METER SIZE BUILDING SUPPLY SIZE NO. OF FIXTURES
REMARKS
SIGN AREA SEPA FIE I
ALLOWED I PROPOSED COMPLETE 177
1EXP
VARIANCE OR CU 3AN5G REVIEW BY -7/, 7qA�>
I I
SETBACKS — FEET LOT COVERq
I FRONT SIDE 1A0 REAR -2f-1 11�1 -is
2157 / 11 �<, &,, -- 1 :5. -6
SICZ--- A*.77zr-f> 0".." A
CHECKED BY TYPE OF CONST N CODE HEIGHT
77 91 2--.Sj
PECIAL INSPECTOR JOCCUPANCY OCCUPANT
LOAD
REOUIRED YES GROUP
ARKS
PROGRESS INSPECTIONS PER LIBC 305
11.1 r--A-I- % Z-V-) --di-AZZI U
FINAL INSPECTION
REOUIRED
-Ruicir— c)t,-t 5A- I �5-r 1 t-J (7
VALUATION
FEE
PLAN CHECK FEE
BUILDING
HEAT SOURCE:
FP=r=;P-1
GLAZING
1 /1//+ %
PLUMBING
Plan Check No. 93 -zz
MECHANICAL
-
This Permit covers work to be done on �rlvate property ONLY.
Any construction on the public domain (curts, sldewplks,
driveways, marquees, etc.) will require separate permission.
GRADINGIFILL
STATE SURCHARGE
1 1. 1
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within ISO Days
STORM DRAINAGE FEE
"Applicant. on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to Indemnify, defend and hold
harmless the City of Edmonds, Washington, Its officials,
.7 employees, and agents from any and all claims for damages of
�< whatever nature, arising directly or indirectly from the issuance
x of this permit. Issuance of this permit shall not be deemed to
0
-, modify waive or reduce any requirement of any city ordinance
ENG. INSPECTION FEE
PLAN CHECK DEPOSIT
Ox nor lim I it In any way the City's ability to enforce any ordinance
provision."
TOTAL AMOUNT DUE
I
&? R -?-�
WA;M—
I hereby acknowledge that I have read this application; that the
ATTENTION
APPLICATION APPROVAL
Information given is correct; and that I am the owner, or the duly
:thorized agent of the owner. I agree to comply with city and
tuate laws regulating construction; and In doing the work auth 0 riz-
THIS PERMIT
AUTHOR IZES
This application is not a permit until
ad thereby, no person will be employed In violation of the Labor
ONLY THE
signed by the Building Official or his/her
Code of the State of Washington relating to Workmen's Compensa.
WORK NOTED
Deputy; and fees are paid. and receipt is
n ns r Co.
INSPECTION
acknowledged in space provided.
SIGNATURE 10!4LNER OR AG DATE SIGNED
DEPARTMENT
4 7-3
CITY OF
E
7 -711, 7�- 3
EDMONDS
z
ATTENTION
CALL FOR
INSPECTION
F�E. 7 DATE
IT S UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
771-0220
UJIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
ORIGINAL — File YELLOW — inspector
!,,F�,��IFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
0
0
z
NOTICE:
.. o r—amu-u- r-*-.aw - - -
formation'shown on the attached
The in
map(s) was com.piled for use by the City of
Edmonds/ its Empl.oyees and Consultants.
Th,..e City ofEcim.onds does. not. warrant the
n these
accuracy of anything set for,th o . *
Map(�-). Any person or entity -requesting a
hould conduct an independent
COPY S
inquiry regarding the information shown or
_t_FiE� -map(s), including, but not Jimited to,
-er stub shown. Suc
the lociation of any sew
sewer stubs may or may not exist and may
or may not exist at the location shown.
Neither the City of Edmo'nds nor its
tomp-1-o-yee-s o-r office-rs -shal-1 be 11a-b-'Fe for the
information given on this map(5), nor for
any one representation provided based
upon said map(S).
APPLICATION
MR HLE for
The City of Edm SIDE SEWER PERMT
EASEMENT No . ...................... .............
NEW CONSTRUCTION REPAIRS 0
WIES2
OWNER................................ ...... 7 ................................................ .................. CONTRACTOR .............. ................................................................................... PERMIT No ................
ADDRESS .. ........................................... ............................................... LEGAL DESCRIPTION: LOT No . .............................................. BLA)CK No. ....................................
L--
Mc"C*404s �sEbl-VMEW t -MNCr 4IE3t
NAMEOF ADDITION .......... ....................................................................................................
is
0
Approved:
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
Call 775-2525 for side sewer inspections BEFORE covering any portion of the constructl on'
Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday Inspections.)
ADDRESS LOCATION OF CONSTRUCTION ......................................
...................................................................................................................................
PROPERTY LEGAL DESCRIPTION ....................................................... I ............................
............................................................................ I ................................. ....................................... ............... .................................... ..................................................
................................................................ OMWERAND�OR BUILDER ...............................................................................
CONTRACTOR'S NAME & ADDRESS ................................ I
................. .................................................. ......................... ...................................................
Pennission Is granted . ...................... ....... : ............................. for repair and/or connection of a side sewer to the city sanitary sewer
m in accordance with City of Edmonds ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. I —The owners of the property may obtain a permit to construct sewer Inside property line. A licensed Side Sewer Contractor must be employed to construct
side sewer in street area. Do not cover any portion of sewer before it has been Inspected.
NOTE No. 2—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtain full Information regaxding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Top of side sewer must 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 'A will be permitted.
NOTE No. 5—Trenches In street must be 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.
NOTE No. r,—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 appurtenances except to in-
sert the pipe into the wye.
DISAPPROVED Date .............. .,,r ................ By ................ Date .....
...... ... BY .... .. Date ............... . ................... By ................
APPROVED Date .......
. ...... ........... If ...............
By ..... . ...........................................................
R,emarks:
..................................................................................................................................................................................................... ........................................................
BOTH VP,,,.e it Copies MUST Be Signed By Qmner of Firm Performing Construction PRIOR To Request For Inspection
tll� hereby certify that the side sewer installation constructed under this permit
I .......... ........... & �o---
1_� (Owner of Contra Firm Perf g rst� ti n)
uc o
in
was installed in accordance with all govecr�Z�ng.COdinaiices of the City of Edmonds.
Dated this.... ..."y Of .....
- . S, ......... ...... 19
V V Check BEFORE you dig for: Water Ej, Gas E], Telephone E], Power [j, Sewer [], Other [3 V I
19
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711
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neceivEl)
JUL -8 1993
P""W'T COUNTER
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........... ......
FILE
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-NIX T
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ZONING M-1 - I e--
SEPA 4MIA00,
—e-SEETBACKS A le- 6p-
LOT COVERAGE
BUILDING HEIGHT
SIDEWALKS
STR ET DE'D I CAT! -ON
suf"
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