21117 77TH PL W.PDFIIIIIIIIIIII
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21117 77TH PL W
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VIA BALL
INGER
LWT STATION
CITY OF EDMO SIDE
ND
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Address of Construction: CZ -
Property Legal Description (Include all easements):
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jUN 0- 7 1994
p, IgLIG- WORKS DEP7
SEWER
P E R M'I.T`--"...
PERMIT. '1\41
3 5 9 4
Owner and/or Contractor:
re e-
e
State License No. reela=
11QbL,&
Building Permit No.
93n
El Single Family
I!Kmulti-Family (No. of Units
C3 Commercial
C3 Public
Invasion into City Right-of-Way:Me"No 11 Yes
RW Construction Permit No.
Cross other Private Property: 11 No
-Attach legal description and copy of recorded easement
I certify that I have read and shj�omply with all city requirements
as indicated on the back of the e rmit Card.
Date
* CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION * "
OFFICE USE ONLY
FOR INSPECTION CAL� PUBLIC ORKS DEPT.
771-0220
Permit Fee: 3,0 Issued By
Trunk Charge: C2? 0 C) Date Issued: 7
Assessment Fee: /1) Receipt No..:
Lid No.: —
Partial Inspection: Date —Initial —
Comments
Reason Rejected: Date —Initial
Final Inspection Approved: DatRvl&—( Initial" -
PERMIT MUST BE POSTED ON JOB SITE
White Copy: File Grmn Copy; Inspector Buff Copy: Applicant
Revised 3!90
The City of Edmonds
t
Side Sewer Drawing
EASEMENT NO - ---------------------------- ---------------
NEW CONSTRUCTION REPAIRS F-1 LID NO - ------------------ ASMT. NO - ------------------
OWNER ------------------------------------------------------------------------------------------------ CONTRACTOR -.S-UPA00V-)-W ---- C- 0. N- -S.T ---------------------------------- PERMIT NO. ..........
JOB ADDRESS 2 1117 7 7 PL. W.
....... ................... --------------------------------------------------- LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
51D P
S"C-0,4c. MAIN —
PWW-0001-11/75 (REV.11/78)
8,,�'LlNiGER
VIA - - ION
Utl S-fAT'ON
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to
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Approved: PART tALS
G-7-94 R 0 —
C.-5-94 J.W
DATE.��2-7-1�� ................... By ... Z� ------- A� ----- ---------
The City of Edmonds Water Service Drawing EASEMENT NO . ............................................
NEW CONSTRUCTION REPAIRS F� LID NO . .................. . ASMT. NO . ..................
OWNER............................................
................................................. CONTRACTOR .................................................................................... PERMIT NO . ....................
JOB ADDRESS ..... Z.1 --- I .... 1-77 .......... �k
..... . .... PL...W . ............
......... I .................. LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ....................................
PWW-0001 -11/75 (REV. 11/78)
�QlAtftc
Approved:
DATE....... tQ ...... 5) 4 ................ B y jil ................................
0 STREET FLE ("'l,
M 7 2
CITY OF EDMONDS
USE
ZONE& PERMIT
m 2"Li NUMBER
CONSTRUCTION PERMIT APPLICATION
JOB SUITE/APT
ADDRESS
2
is
.OWNER NAME/NAME OF BUSINESS
LEGAL DESCRIPTION
ION NO.
7
LID NO.
W
Z
MAILING ADDRESS
0
Ac� 4+
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCP Approved 0
CITY ZIP
,6 c)7-��e, z. 990/ Z
TELEPHONE NUMBER
f P/ - AM 6
EXISTING — REOUIRED DEDICATION
RW Permit Required
Street Use. Permit Req'd NE�3
",a,
NA,�6p
A
PROPOSED
Inspectio Required
Sidewalk Required C3
'0
a:
REMARKS
ADDRESS
CP(;5_9,? ;7
W
W
Z
Z
Uj
CITY I zip
TELEPHONE NUMBER
NAME
---AJ 61 1),5— e) r)
ENGINEERING MEMO DATED REVIEW BY
00:
ADDRESS
"""1
METER SIZE
BUILDING SUPPLY
OF FIXTURES
jCITY ZIP
TELEPHONE NUMBER
/
77
W
Z
8.,
; �_�
I -t/
4L Cg(, I
7 V,5 '7 el
REMARKS
MBER EXPIRATION DATE
-7H A9g5,e,,_- 0 D U
SIGN AREA
SEPA REVIEW
ADS N
Z
Legal Description of Property - include all easements
,vo,ir IF.
061, 6—
ALLOWED
I
PROPOSED
COMPLETE
EXEMPT
SHORELINE N
2
I'_
CL
C00 V 064 S
EXP
VARIANCE OR CU
PLANNING REVIEW BY
DATE
06
Lu
C4
SETBACK).7,,FEET
/0 1�
HEIGjd
LOT COVERAGE
le,
Z
Z
j
Propetly
FRONT SIDE REAR)l
Tax Account
No. 61f 3 -00o- 0/j- 000so-
REMARKS
Parcel
(,C) L)
r7lol-
P'NEW
I?
RESIDENTIAL
PLUMBING
ADDITION
COMMERCIAL
E10"APT. BLDG.
MECHANICAL
P/Ml F_)E
REMODEL
SIGN
GRADING FENCE
REPAIR CYOS.
CHE
me;/
TYPE OF CONSTRUCTION C DE
I 1
HEIGHT
—., /
:�1-130
I— X _FT)
WOODSTOVE SWIM POOL
I C^n
9/
/
DEMOLISH INSERT 0 HOT TUB/SPA
SPECIAL INSPECTOR
REOUIRED
AREA
OCCUPANCY
GRPP/
OCCUPANT
r7 GARAGE RETAINING WALL/
CARPORT RENEWAL
0 YES
I
REMARKS
LOAD,�g
ROCKERY
PROGRESS INSPECTIONS PER UBC 305
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
'-f IN/ 6XI
Lu
NUMBER OF STORIES
UM BER OF
U '
lrvjn e9oFl
DWELLING
W
FN
0
UNI S
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
d,
SPECTION REQUIRED'
VALUATION
FEE
FEE
BUILDING
HEAT SOURCE:
GLAZING
/X,
PLUMBING
A61enj-r
Plan Check No. 6?-�
MECHANICAL
_57,9/f%474_
17—
4-W / 7-
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewplks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
7A
Permit Application: 180 Days
-5-0
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
,n
successors in interest, agrees to indemnify, defend and hold
'Wn
harmless the City of Edmonds, Washington, its officials,
m
employees, and agents from any and all claims for damages of
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<
whatever nature, arising directly or indirectly from the issuance
X
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
a
0
X
I
modify, waive or reduce any requirement of any city ordinance
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 agent of the owner. I agree to comply with city and
THIS PERMIT
state laws regulating construction; and In doing the work authoriz-
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
tion Insuranc
INSPECTION
acknowledged in space provided.
GNATURE JOWNER OR A E T) DATE SIGNED
DEPARTMENT
OFFIIIAL'I UN�TURE DATE
CITY OF
EDMONDS
ATTENTION
CALL FOR "Rn:?AsF6
INSPECTION
By: DATE
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 YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
PINK Owner GOLD — Assessor
102-87