20918 80TH AVE W.PDF111111111111
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20918 80TH AVE W
NOTICE:
No warranty of accuracy.
The -information'shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of 'Edm ' onds does not warrant the
accuracy of anything set for.th on these
map(�-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
�h-e -map(s), Including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may* not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
emp-1-o-yees or offi-cer-s-) -Shall be HalDle for the
information given on this map(s), nor for
any one representation provided based
upon sa-id map(s).
APPLICATION
for
Thl City of Edmonds SIDE SEWER PERBUT
OMER H`LE NEW CONSTRUCTION 0 REPAIRS 0
OWNER ..... ------- ...............................
......... 1- Z.
ADDRESS -------- C4�-t ...
Sbra
16
0
0
0
PLANT EIASEMENT No . ..........................................
.....................................
CONTRACTOR ......................... .......... ........................ PERMIT No. k
LEGAL DESCRIPTION: LOT No . ............................................. BLOCK No . ........... ................ . ......
-7
6t
NAME OF ADDITION .......... ...... !�a�
...........
APPROVED
APR 2 0 1967
Approved:
4 7 ..............
DATE �.l .......................... ... By j ...... /fin.,/ . ..................
9IN17 NIVYI
Olswdovd
s IYA ViOV— 00
I �
ml,
CITY OF EDMONDS
ER — WATER -SEWER DEPARTMENT
Call I'Rospect 6-1107 when work
is ready for Inspection. (No.Inspec- ILTO
tions.Saturday, Sunday or holidays.) IN . 2078
1L)t CVVLK rtKMI
300 - 21st Avenue South
ADDRESS...........................................................................................................................
-OWNER ............. M.r.s.....Xa3.th!4,e --- R ...... Burle.y ............. CONTRACTOR ....................... omner ..........................................
ranted .... April_al .................. ig ... �7, for ........................ days to REPAIR or CONNE
Permission is g
CT a side sewer
with City Sewers In accordance with application on file and governing 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.
PICTE -No. 2—Obtain full Information regaxdlng Ordinance 11.16.030 and Regulations governing side sewers when you get permjt.
TE No. 3—To, 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 % will be permitted.
E No. 4—Trenches in street must be water settled aad 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. 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 appur-
tenances except to insert the pipe Into the wye.
i"I"PaRt I
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 * Engineering
8 9 0 . I C) 11
October 12, 1993 -
Marvin Wuest
20918 80th Avenue West
Edmonds, WA 98026,
RE: Construction of deck within setback area at 20918 80th Avenue W.
Code Enforcement Case #ZE-93-31
Dear Mr. VVuest:
LAURA M. HALL
MAYOR
00�- .13
49.9a
W
On May 15, 1992 a permit was issued to you for construction of a deck. On July 29, 1992
the Building Inspector inspected the deck and found that it is located within the side yard
setback. You will either need to remove the portion of the deck located within the setback
area, or apply for a variance to allow the encroachment.
The building -permit for the deck has since expired, therefore, a new application must be
submitted and new fees paid before any further work may be done. Should you decide to
apply for a variance, it is recommended that you do so prior to reapplying for the building
permit. Enclosed is a handout regarding variance applications.
You must take action by October 27, 1993 to either apply for -a variance, or submit a new
application for a permit to complete the deck and bring it in compliance with the code. No
such action by the aforementioned date will force this office to take the necessary legal
action to obtain compliance, including fines of $100.00 per day until compliance is obtained.
Your cooperation and attention to this matter is'appreciated. If you have any*questions,
please do not hesitate to contact this office.
Sincerely,
15 Z JXA-
Ann Bullis
Code Enforcement
cc: Building Department
ZE-93-31
Incorporated August 11, 1890 0
Siste:Cities International — Hekinan, Japan
CITY OF EDMONDSVIP Y"' "
CONSTRUCTION PERMIT APPLICATION
OWNER NAME NAVE OF BUSINESS
A11AAYJA1 W WlArW' fl?
MAILING ADDRESS
CITY Zir TELEPHONE NUMBER
NAME
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ADDRESS
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CITY — ZIP I TELEPHONE NUMBER
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- include all easements
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ZONE R5' NUMBER
JOB
ADDRESS 5"//
�EGAL DESCRIPTION CHECKI SUBDIVISION NO I LID NO
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCP Approved
RW P.I.i. Required
0
EXISTING — REOUIRED DEDICATION
Sl.,eol.Uge Permir Req'd
0
", '. ,i." .,u ad
0
PROPOSED
I
Sidewalk Required
13
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REOUIRED
I
YES 0 NO 0
TaX Account
Parcel
(0 0 0
NEW
LM RESIDENTIAL
PLUMBING
ADDITION
F� COMMERCIAL
MECHANICAL
REMODEL
El APT. BLDG.
SIGN
REPAIR
GRADING
E] . CYDS.
FENCE
I x _FT)
DEMOLISH
WOODSTOVE
INSERT
SWIM POOL
HOT TUB/SPA
GARAGE
CARPORT
RETAINING WALL/
ROCKERY
RENEWAL
(TYPE OF USE. BUSINESS OR ACTIY4,TY) EXPLAIN:
,,, 4, E X -),
NUMB7ER
NUMBER OF
CRITICA<�_f
OF
STORIES
DWELLING
UNITS , iL
AREAS
NUMBER
DESCBJBE WORK TO BE DONE (ATTACH PLOT PLhN)
REMARKS
MEMO DATED
SIGN AREA
ALLOWED PROPOSED
1A
VARIANCE OR CU
SETBACKS —' FEET
FRONT 1�7,4 SIDE?),
SEPA REVIEW
COMPLETE 1EXEMPT
EXP x
REAR
INGOSEVIEW BY
HEIGHT I LOT
CHECKED BY TYPE OF CONSTRUCTION CODE
x), 191
SPECIAL INSPECTOR —] AREA
REOUIRED
13 YES
REMARKS
PROGRESS INSPECTIONS PER. LIBC 305
FINAL INSPECTION REOUIRED
PLAN CHECK FEE
BUILDING
HEAT SOURCE:
GLAZING 0/0
.
PLUMBING
Plan Check No.
MECHANICAL
GRADINGIFILL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewpiks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
successors in interest, agrees to indemnity, defend and hold
ow
harmless the City of Edmonds, Washington, its officials,
m
employees, and agents from any and all claims for damages of
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
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nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
REVIEWED BY
REVIEWED BY W
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OCCUPANT
OCCUPANT
LOAD
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provision."
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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 thje duly
authorized agent of the owner.'I agree to comply with city and
THIS PERMIT
This application is not a permit until
state laws regulating construction; and In doing the work authoriz-
AUTHORIZES
signed by the Building Official or his/her
ed thereby, no person will be employed in violation of the Labor
Code of the State of Washington relating to Workmen's Compensa-
ONLY THE
WORK NOTED
Deputy; and fees are paid, and receipt is
tion Insurance and RCW 18.27.
INSPECTION
acknowledged in space provided.
SIGNATURE (OWNER.OR AGENT) DATE SIGNED
DEPARTMENT
OFF] *SGN URE DATE
CITY OF
EDMONDS
ATTENTION
CALL FOR
INSPECTION
ELEASED dy: DATE
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-0220
ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
PINK — Owner GOLD — Assessor
_j
102-87
STREET FILE
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
USE
ZONE PERMIT
NUMBER 9 90:336
JOB
ADDRESS ITE/APT
20qla 0 4 L,"e 14Y
#
cr
UJ
Z
3
0
OWNER NAME/NAME Ol� BUSINESS
LEGAL DESCRIPTIO
"7
EIDIVISION NO. LID
NO.
Cc
uj
Z
Z
U)
MAILING ADDRESS
2 t'_
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING REQUIRED DEDICATION
PROPOSED
'Sidewalk
TESCP Approved 0
RW Permit Required 0
Street Use Permit Req'd 0
Inspection Required C3
Required 0
CITY ZIP
f_D
4�1 0,6z4?6? �,gk
TELEPHONE NUMBER
7A1.4A—a7
WO
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NAME
REMARKS
ADDRESS
CITY ZIP
TELEPHONE NUMBER
NAME
ENGINEERING MEMO DATED REVIEW BY
ADDRESS
cc
0
CC
10-
Z
8
METER SIZE
.
ILDING SUPPLY SIZE
7
NO. OF FIXTURES
CITY ZIF___7ONE
NUMBER
EMARKS
STATE LICENSE NUMBER EXPIRATION DATE
SIGN AREA
ALLOWED PROPOSED
SEPA REVIEW
COMPLETE EXEMPT
ADS NO .
Legal Description of Property - include all easements
Z
L
_j
u _j
EXP
Z
SHORELINE 0
VARIANCE OR CU
PLANNING REVIEW BY
a/DATE
-Z_
SETBACKS — FEET
FRONT-25:;.— SIDE I /2—REAR
HEIGHT
LOT COVERA
Pro e",
P 'r
T1. A "nt
Parcel No. 13 7-_--1C;;I 03-0(o
MAR —
EINEW RESIDENTIAL PLUMBING
ry
ADDITION COMMERCIAL MECHANICAL
A
APT. BLDG.
REMODEL SIGN
Z
0
E
GRADING FENCE
REPAIR — CYOS. I— x _FT)
DEMOLISH WOODSTOVE SWIM POOL
INSERT
F HOT TUB/SPA
GARAGE RETAINING WALL/
CAR ROCKERY RENEWAL
CHECKED BY
TYPE OF CONSTRUCTION
Ic
ODE
ag2n
HEIGHT
Z
9
SPECIAL INSPECTOR JAREA.
REQUIRED
13 YES
OCCUPANCY
GROUP jjP
OCCUPANT
LOAD
REMARKS
PROGRESS INSPECTIONS PER USC 305
(TYPEOFUSE BUSINESSOR ACTIVITY) EXPLAIN:
41 AUII�-AIA 76 A44
05
NUMBER OF STORIES NUMBER OF
-7
to
to
0
E IN13
W LLI
D I
Ut
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
FINAL INSPECTION REQUIRED
VALUATION
FEE
PLAN CHECK FEE
BUILDING
Z2 7-0
HEAT SOURCE:
%
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks,
GRADINGIFILL
STATE SURCHARGE
driveways, marquees, etc.) wil I require separate permission.
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
u)
21
2
<
0
x
I
"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,
employees, and agents from any and all claims for damages of
whatever nature, arisinadirectly or Indirectly from the issuance
of this permit. ss 4* -, I
1 ur cl�`o . t Ormit )6hall not be deemed to
modify, waive or r Lice any reqdlieriterif of any city ordinance
nor limit in any way the City's ability to enforce any ordinance
provision."
ENG. INSPECTION FEE
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
he�r , n
3 g�, _Tv,ledge that I have read this application; that the
lnf�rma I ven s 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 authoriz- APYHORIZES T . his application is not a permit until
ed thereby, no person will be employed in violation of. L4 THE" signed by the Building Official or his/her
5 P9,r.3
0 . I WORK NOTED
0
I the StateloW"hington relatingito WorkMen a C pisirisa. Deputy; and fees are paid, and receipt is
74rance.'
ri
I NSPECTION acknowledged In space provided.
SIGNATURE jOWNER OR AGENT) DATE SIGN D DEPARTMENT
CITY OF OF I NATURE DATE
EDMONDS , 5113#�__
CALL FOR qFIELhr4yI3Y- DAT
ATTENTION INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE 771-0220
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YE I nVV iInSneetor
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED, UBC
CHAPTER 3. PINK — Owner GOLD — Assessor
102-87
-� af, EET
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OtBUSINESS
N pyl,,V AJ
RESS
/I J& /j Lla-
CITY
STATE LICENSE NUMBER EXPIRATION DATE
Legal Description of Property - include all easements.
t �: '. -.9
Frope.y
Tax Accouril 3:736-tw/-0O3-C&
Qel No,
ID
NEW
RESIDENTIAL
PLUMBING
ADDITION
COMMERCIAL
El
MECHANICAL
ElREMODEL
APT. SLOG.
SIGN
GRADING
FENCE
REPAIR
C'DS
I x —FT)
wo DSTOVE
SWIMPOOL
EMOYSH
El INVERT
HOT TUBISPA
E] GARAGE
CARPORT
RETAINING WALL/
L—J ROCKERY
RENEWAL
OF STORIES NUMBER OF
I DWELLING
UNITS
E WORK TO BE DONE (ATTACH PLOT PLAN)
USE PERMIT
ZONE
NUMBER
B YITE/Al
ADDRESS A
0 L./
LEGAL DESCRIPTION
7--,
SUBDIVISION NO.
LID NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCP Approved .0
AW Permit Required El
EXISTING — REQUIRED DEDICATION —
Street Use Permit Req'd 13
Inspection Required 0
PROPOSED
Sidewalk Required 0
REVIEW BY
SIGN AREA
SEPAREVIEW
ADB NO.
ALLOWED
PROPOSED
CO M PLETE
- -
JEXEMPT
SHORELINEII
EXP
VARIANCE OF CU
IONT'255�
PLANNING REVIEW BY
TE
SETBACKS — FEET
FR SIDE 77/2—REAR /4�'l
EIGHT
MZ
I LOT COVERAN
S's
I CA — 92.- 1 / n r-4,r- I
REOUIRED YES
REMARKS
PROGRESS INSPECTIONS PER UBC 305
FINAL INSPECTION REQUIRED
PLAN CHECK FEE
BUILDING
HEAT SOURCE:
GLAZING
0/0
PLUMBING
Plan Check No.
MECHANICAL
GRADINGIFILL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewelks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
ENO. INSPECTION 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,
employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirement of any city ordinance
nor limit In any way the City's ability to enforc6 any ordinance
P LAN CHECK DEPOSIT
.
TOTAL AMOUNT DUE
provision."
mommom�
I hereby acknowledge that I have read this application; that the ATTENTION
Information given is correct; and that I am the owner, or the duly
authorized agent of the owner. I agree to comply with city and THIS PERMIT
state laws regulating construction; and In doing the work authoriz AUTHORIZES
ed thereby, no person will be employed in violation of the Labor ONLY THE
Codg�of the State of Washington relating to Workmen's Compensa- WORK NOTED
ns INSPECTION
- RE OR AGtNIj E SIGNED EPARTMENT
A T. Ur%h
CITY OF
EDMONDS
CALL FOR
'ATTENTION INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY,A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-0220
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
W247
OCCUPANT
LOAD
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his/her
Deputy; and fees are paid, and receipt is
acknowledged in space provided.
ORIGINAL — File
YELLOW Inspector
PINK — Owner
GOLD — Assessor
4
.. RREET FILE
Critical Areas Checklist
Site Information
Project Name: L2t-- /?' /
Permit Number:
Site Location: !10;41;14 ME �/ Property Tax Account Number:
Approximate Site Size (acres or square fe et): 14 50
Have you filled out a Critical Areas Checklist for a project on this site before?
General Site Conditions
1. Has the site been cleared or logged? I'Ve Date of mostrecent action:
Soils / Topography
2. In the Snohomish County Soil Survey, what is the mapped soil type(s)?
3. Describe the general site topography. Check all that apply.
Flat: less than 5 feet elevation change over entire site.
—Rolling: slopes on site generally less than 15% (a vertical rise of 10 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 10 feet of horizontal distance.)
—Steep: grades of greater than 30% present on site.
Comments
Hydrology/Vegetation
4. Site contains areas of year-round standing water: AMAIE
5. Site contains areas of seasonal standing water: Approx. Depth: IVOIV2��
6. Site is in the floodway Mo floodplain Na of a water course.
7. Site contains a creek or an area where water flows Across the grounds surface? flows
are year-round? Flows are seasonal?
.shrubs mixed
8. Site is primarily: forested meadow
9. Obvious wetland is present on site: &) Z�
10. Wetlana inventory or map indicates wetland present on site: ly6AI
11. Critical Areas inventory or map indicates any Critical Area on site:
-For City Use Only --
STUDY REQUIRED: Critical areas study is required.
CONDITIONAL WAIVER: Critical areas study not required if specified conditions satisfied.
b'_�XAIAR/C13 r' -, I A . *. A
I ca at eas stu y 3 "%J- 1 '-4u 1
O'g—S
Determination Number.
Reviewer 6
Planner
Date.
Rey 3/27/92
& 9 0 . 19 q -
City of Edmonds
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 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 in ' formation needed to
complete the Checklist should be easily
available from observations of the site or
data available at City Hall (Critical Are"
inventories, maps, or soil surveys). f
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 determination of the subsequent
steps necessary to complete a development
permit application.
With a signed copy of this form, the
applicant should also -submit a vicinity map
of the parcel with enough detail that City.
staff can find and identify the subject
parcel(s). In addition, the applicant is
encouraged to include any other pertinent
information or studies in conjunction with
this Checklist to assist staff in completing
their preliminary 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 / Applicant:
Name
Title
Street Address
City, State, ZIP Phone
Applicant Representative:
Narne
Title
Street Address
City, State , ZIP Phone
Signature Date Signature Date
City of Edmonds
Critical Areas Determination
Applicant:. e S'7� Determination M
Project Name: Permit Number:
Site Location: �q 094 * Fdtll 40� J Property Tax Account Number:
Project Description:
Waiver Criteria (all criteria must be found to apply):
Z-�There will be no alteration of the Critical Area or its required buffers;
The development proposal will not impact the Critical Area in a manner contrary to
the goals, purposes, objectives and requirements of the Critical Areas ordinance;
The development proposal meets the minimum standards of the Critical Areas
ordinance;
The above findings are based on the following conditions of approval:
2.
ki
4.
Based on the above findings and conditions, the requirement for a Critical Areas Study -
associated with this development permit is hereby Waived, as authorized by Chapter 20.15B. 150
(B) of the Edmonds Community Development Code.
Name Signature
q-,f - U-)- . .
STREETTILE
USE PERMIT
CITY- OF EDMONDS ZONE NUMBER
CONSTRUCTION PERMIT APPLICATION JOB
I OWNER NAME /NAN1f OF BUSINESS 77.71 AODRESS
NAME
ADDRESS
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCP Approved
RW Permit Required
0
13
ZIP
TELEPHONE NUMBER
77
EXISTING — REQUIRED DEDICATION
Street Use Permit Req-d
0
PROPOSED
Inspection Required
Sidewalk Required
0
0
Z
REMARKS
Z
ZIP [TELEPHONE NUMBER
METER SIZE
TELEPHON
REVIEW BY
NUMBER
SIGN AREA SEPA REVIEW ADB NO.
ition of Property - include all easements ALLOWED PROPOSED COMPLETE 1EXEMPT SHORELINE
EXP
VARIANCE OR CU PLANNING REVIEW BY DATE
I
SETBACKS — FEET
FRONT SIDE
REAR
HEIGHT
i-1 W—AGE
Tax Account Parcel
No.
REMARKS
ElNEW
11 AIDDIALTER;
ElREPAIR
GRADING.
E] DEMOLISH CYOS.
r--j CARPORT
REMODEL GARAGE
WOOD STOVE/ RETAINING WALL/
INSERT ROCKERY
PLUMBING
MECHANICAL
SIGN
FENCE
I
swim x —FT)
POOL
RENEWAL
CHECKED BY
TYPE OF CONSTR
I V TTION
CODE
I Rg
7
SPECIAL INSPECTOR 7—AREA OCCUPANCY
REOUIRED OYES 1769 -9� 1 GROU77)
I OFCU—PA
ILOAD
MARKS
PROGRESS INSPECTIONS PER
UBC 305
TYPE OF USE, B�INESS
an)_5XPLAIN
OR ACTIVITY)
ifrk) I? L9 12
4UMBER OF STORIES
INUMBEROF
DWELLING
UNITS
DESCRIBE WORK TO BE DONE (ATTACH
PLOT PLAN)
t��
FINAL INSPECTION
REQUIRED
VALUATION
PLAN CHECK FEE
BUILDING
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
GRAOINGIFILL
STATE SURCHARGE
Permit Application: 160 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
x.
01
XO
"Aoplicant, on behalf of his or her spouse, heirs, assigns and
Successors in interest, agrees to Indemnity, defend and hold
harmless the City of Edmonds, Washington, Its officials,
employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance
of this.permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirement of any pity ordinance
nor limit in any way the City's ability to enforce any ordinance
ENG. INSPECTION FEE
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
provision.
I
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
Is tate laws regulating construction; and In doing the work author' z*
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/her
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
Deputy; and fees are paid, and receipt is
t,Q-n,nsur,,n cis.
INSPECTION
acknowledged in space provided.
SIGNATURE (OWNER OR AGENT) DATE IGNED
DEPARTMENT
CITY OF
S SIGNATURE DATE
EDMONDS
ATTENTION
CALL FOR
RELEASED BY: DATE
INSPECTION
IT S UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
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UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
ORIGINAL — File YELLOW — inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
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PINK — Owner GOLD — Assessor
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