21113 77TH PL W.PDFIIIIIIIIIIII
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21113 77TH PL W
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The City of Edmonds Water Service Drawing EASEMEN7 NO . ............................................
NEW CONSTRUCTION Er REPAIRS Ej- UD NO . ............... -.ASM7. NO . . .....
OWNER ..........................................
...................................................... CONTRACTOR ......................... -- ...................................................... .. PERMIT NO . ....................
JOB ADDRESS ........ ................ LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ....................................
7 7 T I-V 'PL.W.
PWW-0001-11175 (REV.11/78)
21, 1(00 P'5-1-
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lllmerep.
7
Approved:
DATE ...... 9.4 .................. By
J .... .. . .. .... jk ....
R -r 4-4
GERI
VIA BALLINGER
F S 0
CITY OF EDMOND LIFT STATION SIDE
9 0 1 9
4
y
SEWER
P 'MIT.
E.':R,.
PERMIT
Address of Construction: ,7 7
Property Legal Description (Include all easements): <-091 e,
fle-7 I!q 0/4�3
RECEIVED
JUN 0 7 1994
PUBLIC WORKS DEPT
Owner and/or Contractor: ox I 'd
9,7 o 7 3
State License No. -7-1112 E 1= F C_ I C> L A Building Permit No.
Single Family Invasion into City Right -of -Way: Er'N-o El Yes
Multi -Family (No. of Units RW Construction Permit No.
Commercial Cross other Private Property: 0 No V<es
El Public Attach legal description and copy of recorded easement
I certify that I have rea8 -and s
as indicated on the back,of th
V.
f comply with all city requirements
ermit Card.
&/',7-/,74
Date
CALL DIAL -A -DIG (1-800-424-5555),PEFORE ANY EXCAVATION
OFFICE USE ONLY
* FOR INSPECTION CALLIZ-71
Permit Fee: — 3 0
Trunk Charge:
Assessment Fee:
Lid No.: A) /A
Partial Inspection:
2 PUBLIC WORKS DEPT.-*
)220
Issued By
Date Issued: 7- 9
Receipt No.: z 2R
Date * Initial
Comments
Reason Rejected: Date —Initial
Initial
Final Inspection Approved: Datgz�&�
PERMIT MUST BE POSTED'ON JOB SITE
White Copy: File Green Copy: Inspector Buff Copy: Applicant
Fle�ised 3.190
t
The City of Edmonds
A
Side Sewer Drawing
EASEMENT NO - -------------------------------------------- 'k
NEW CONSTRUCTION [jj" REPAIRS Fj LID NO . .................. . AsmT. NO. — ---------------
OWNER ------------------------------------------------------------------------------------------------ CONTRACTOP - ------ S-ut4MW-kl .... C-0-1416T: ---------------------------------- PERMIT NO. 25'53 ..
LJOB ADDRESS -2-1.11 --- 3 --------- . ..... w, ------------------- LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
PWW-0001-11/75 (REV.11/78)
...............................................
FV�A BALLIN,'�'---r?
L,I:—
FN�ZMXAZ
59, --)0
8 "comc
14-31
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7 7 T P PL.
Approved: PAk-rlk LS,
(0 -7 4
.i?94
G 2
DATE.. ................... By ------------------------------------------------------------
0 IT"" W,
FILE
USE
ZONEpM PERMIT
CITY OF EDMONDS 2 Lj NUMBER
-CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
7;o�_ 7— -9-6 a T,7 �ellll 7-Nfx--r_
Z MAILING ADDRESS 701"
kled-Olf X07W,644- My
CITY ZIP TELEPHONE NUMBER
?07t4olr,-6,1� '?SV2_j
AODRESS
< CITY ZIP _TTELEPHONE NUMBER
I F4AoNbl ?V.-Ito 1 77h -70
NAME
Al 0
ZIP I TELEPHONE NUMBER
6� 1 2-A5 -\,7 9 q
LICENSE NUMBER EXPIRATION DATE
P)�E��C // 6 DLC
i of Property - include all
IP Of 7'&,e �
!VlAilowh &-A-4 16~01149
491A�' —
49Z.-
Or J�yoe�"Ijlv
06.
Property
1rax Account
bl#? -000- 014r-00ar
Parcel No.
El
NEW
LM RESIDENTIAL
PLUMBING
EIADDITION
0
COMMERCIAL
MECHANICAL
EIREMODEL
2"APT. BLDG.
11
SIGN
GRADING
CYDS.
FENCE
REPAIR
L_ X_ F7)
DEMOLISH
WOODSTOVE
INSERT
SWIM POOL
HOT TUB/SPA
GARAGE
RETAINING WALL/
E]
CARPORT
ROCKERY
RENEWAL
— CeMpt" //y/ IIA4
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
WORK TO BE DONE (ATTACH PLOT PLAN)
JOB
AUI)HtbS 76"Vt7 - 0?16Z
7z'�W e�_)
S TE/ #
S _F I's _rn
LID NO. —
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCP Approved 0
't�
EXISTING — REQUIRED DEDICATION —
RW Permit Required
Street Use Permit Req'd 0 '
'1�15S
PROPOSED
Inspection Required
Sidewalk Required 0
REMARKS
ENGINEERING MEMO DATED
METE�RIZE BUILDING SUPPLY SIZE
REMARKS
REVIEW BY
IFZ- 4 -6c,
NO. OF FIXTURES
SIGN AREA
SEPA REVIEW
ADS NO.
ALLOWED
PROPOSED
COMPLETE IEXEMPT
/M
A o
— �
E P I
SHORELINE
VARIANCE 7-C,
0 U
,eto, Mg
NING REVIEW BY
pp,41
I JA L-L Cj�,je
SETBACKf—
F§P7
HEIGHT
LOT COVERAGE
044
I
FRONT
j -5 . SIDE /f--,i
REAR :)
ls�.x
CHEC
TYPE OF CONSTRUCTION CODE I tLEIGHTI
-rr - , ) 1 01 ratc-rz^
SPECIAL INSPECTOR AREA OCCUPANCY -OCCUPANT
REQUIRED 0 1 1 GFIOU)?J�Aj ) I LOAD 'el 9
PROGRESS INSPECTIONS PER UBC 305
A
14swit n I 11r Lew.40*11"Ir -
FINAL INSPECTION REOUIRED
----q VALUATION
PLAN CHECK FEE
I BUILDING
HEAT SOURCE:
G
Ce.e,
%
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewelks,
STATE SURCHARGE
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: I 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
2 harmless the City of Edmonds, Washington, its officials,
m employees, and agents from any and all claims for damages of
4 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
TOTAL AMOUNT DUE
0
I nor limit In any way the City's ability to enforce any ordinance
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
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
dd thereby, no person will be employed in violation of the Labor
ONLY THE
Code of the State of Washington relating to Workmen's Compensa-
WORK . NOTED
I
ER OR GENT) DATE SIGNED
I NSPECTION
DEPARTMENT
7-
CITY OF
EDMONDS
CALL FOW-'
INSPECTION
771-0220
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC
CHAPTER 3.
102-67 .�
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.
7,
DATE
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
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