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215 2ND AVE N.PDFIIIIIIIIIIII 4784 215 2ND AVE N CA FILE NO. CA -OD -(p-T Critical. Areas Checklist ----------------------------------------------------- ---------- Site Information (soi.Is/topography/hydrology/veg.etation) 1. Site Address/Location: Z I �;- T-AW 4VE- . JIQ 2. Property Tax Account Number: — 4(30&1 0// 003 666/ 3. Approximate Site Size (acres or square feet): -7s-6.0 5,P F7- 4. Is this site currently developed? V� —yes;_ no. If yes; how is site developed? :5r1ov6-t,6 r-Pt.&Ui&,7 12eF-S-eV&-A1CF 5. 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 I 0-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 1.0-feet over a horizontal distance of 33 to 66-feet). Steep: grades of greater than 30% present on site (a vertical rise of I 0-feetover a horizontal distance of less than 33-feet). Other (please describe): 6. Site contains areas of year-round standing water: A10— Approx. Depth: 7. Site contains areas of seasonal standing water: A /0— Approx. Depth: What season(s) of the year? 8. Site is in the floodway floodplain of a water course.— A10 — 9. Site contains a creek.or an area where water flows across the grounds surface? Flows are year. —1vo — round? Flows are seasonal? (What time of year? 10. Site ILprimarily: forested meadow ;shrubs mixed je-'u'rban fand—sca—p—ec-Ulawn,shrubs etc) 11. Obvious wetland is present on site: A10 MET-MMINAT109 AG�_ChLdoq Rev IUMM City of Edmonds Development Services Department Planning Division Phone: 425.771.0220 Fax: 425.771.0221 Critical Areas File #: '�� -- 00,( Critical Areas Checklist Fee: $45.00 Date Received by Dev. Serv. Dept: CityReceiptN6: 19,7_7(c Date Mailed to Applicant: d CRITICAL AREAS CHECKLIST The Critical Areas Checklist contained on this form is An applicant, or his/her. representative, mu fill out st .to be filled out by any: person preparing a the checklist, sign and date it, and submit it to the' Development Permit Application for the City of City. The City will review the checklist, m . ake a Edmonds Prior to his/her sub I mittal of . a development precursory site visit, and. make a determination of the . permit to the City. subsequent steps necessary to com lete a devel P o ment permit. application. p Please submit a vicinity map, along with the signed The purpose of the Checklist is to enable City staff to copy of this form to assist City'staff in finding and determine whether any potential Critical Areas are, or locating the specific piece of property described on may be,. present on the subject - property. The this form. In addition . , 'the applicant shall include information needed to complete the Checklist should -other pertinent information (e.g. site plan,. topography be easily available. from observations of the site or map, etc.) or studies in conjunction with this Checklist data available at City Hall (Critical areas inventories, to assist staff 'in completing -their preliminary maps, or soil surveys). assessment of the site. I have completed the attached Critical Areas Checklist and attest that the answers provided are factual, to the best of my knowledge (fill out the appropriate column below). Owner/Applicant: Applicant Representative: Name Name Street Address Street Address '7,F6 2-6 city State. zip Chy State zip. -t-f 2- S- -7 -7 Telephone' Telephone Signature ------------- Signature "o 00 Date Date' d:rweptiortlanatCACLHandoLit.doc Reviw viwm 9"IMMEMIC "M M "110 E B-ting Top ofmanbole cover at ft imsss=tion of FM MMRANT M and e A� Nordi Located at the comer 34 of2ld6andBell �,4 GENERAL NOTES R, LN. V Py. Edmonds, WA 98029 1-206-226-2315 Contact- As above Ind Descrintion: Los #3 Block 11 Plat of' Edmunds Tim ED: � .4344-011-003-OMI Zonizw. I RS-6 Lot " FIL 7,5W Pad Ares. 1,477 Lot Cov'rg 28% ExErea Floor 052 New Floor 132 Beat TM on CAsuffloor 25% DedgwLoad Roof ISM 25 LL Floor IODL 40 LL Wind Exposure B 80mph Selsok Zone 3 Son Co.— M5 PMSI A 29 days RA.f. Steel Grade 40 Bars Lumber Grade ShA&Momfitcofstnuctura FWW-d Soms Indes Roof-24/0 Floor & All$.— M6 ft table 23-11-13-1 Pefar to shoot WS R2:cz,VZM JUL 2 U, 2090 DEVELOpMENT S OF E EF?VIC CITY DMON ES CTR. DS Building Wback Line B foot side Existing 121 aq SAME= ding Pad 529 sq, ft. K AL A. 13025 SldeWRl Eyisling 0 ESEDENCE 949sq. ft. BuilcUng Pad 0 Endu SidewAlk Existiall MY 1,500 sq fk —OMWI Buildinu Setback TA-- 01 .6"XA5&r "0144UTMgs ra evv. AS NOTED fy �4, 4L, I ,sk away exissing I story sectinnofiseiistin bodroom.DemolitimWill b.fromasisfin floorsbeathi, UP. ' . To am an extended now bedroom and laundry wom in ft same wm Sa.e MU46 '- 'o; Zia WELDING DLSCRWnON Occupancy goup; R-3 T�pe ofcoustmenon; VN B (80 MM FILE N TABLE OF CONTENTS IM Site Plan 218 Founded= Plan 2w— 1&—f Floor Plan 418 Upper Flow Plan SM RoofFraming Plan &S Building Section0etails 7/8 Ele-vations I WS I General Specificatim PLANNING DATA NAME: SITE ADDRESS: -Z15 gpdAVAI DATE: ZONING:— PLAN CHK#: PROJECT DESCRIPTION: Ao�00io7t, . CORNER LOT_--4[jO—(Yes/No) FLAG LOT M (Yes/No) SETBACKS: Required Setbacks: J* . , Front*-20" LeftSide: RightSide: 45 Rear: PS7 doei; via-f- Actual Setbacks: Front: Left Side: Right Side:. Rear: btpmi. s e4b k-s Street checked for additional setback required? (Yes/No) LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED (Y/N P-e5 14-2 jq*7,7 LOT COVERAGE: PftA 17-1 Maximum Allowed: b4 Actual: BUILDING HEIGHT: Maximum Allowed: Actual Helaht: Datum Point: k71A-r7h01e,,1 6" Datum Eleiiation: 4-100 A.D.U. CREATED9.- A10 , SUBDIVISION: CRITICAL AREAS SEPA DETERMINATION: LOT AREA: OTHER: Plan Review By: cAfi1es\perrnit%Ap1and8Ldoc CITY OF EDMONDS 250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771-3202 COMMUNITY SERVICES: Public Works * Planning * Parks and Recreation o Engineering 8 9 0 . 199 - April 4, 1991 E.G. Sant 215 - 2nd Ave. N. Edmonds, WA 908020 CERTIFIED MAIL ST13EET FILE RE: Problems with venting of your plumbing fixtures Dear Resident: LARRY S. NALIGHTEN MAYOR PETER E. HAHN DIRECTOR The City's sewer cleaning records show that the home at this address is experiencing problems with the venting of some of your plumbing fixtures when the City crew is conducting cleaning operations of the City sewer line in front of this address. The City's cleaning operation is essential for both you and your neighbors. It cleans debris in lines to prevent plugs, prevents corrosion and potential future collapse, and achieves a better flow characteristic in the public sewer lines. We need to do this often -- perhaps even 3 times a year -- in some critical areas. The City's cleaning operation typically involves the utilization of a high pressure water jet. The problem which occurs at the home is the result of a high pressure surge through your internal plumbing system. A properly constructed plumbing system is designed to easily vent this additional pressure without any visible impact at your residence. An undersized venting pipe (or not having enough vents) cannot handle the pressure surge, and the only release that's available is then through your toilet (or another fixture). The Uniform Plumbing Code typically requires a 211 vent, and further requires a separate vent for each plumbing fixture which is connected to the sewer (a toilet, a sink, a shower). Your home clearly does not have an adequate venting system (you either have a 1-1/411 vent, or not enough of them), and you therefore may continue to experience the pressure surges. The City does not have a choice as far as discharging its responsibility in cleaning the public sewer line. It is therefore up to you to take corrective measures as to how to properly vent your own plumbing system. The City has come up with two options that will remedy your problem: Option 1: Upgrade stack vents for toilets and other fixtures which are experiencing problems to required sizes. * Incorporated August 11, 1890 0 Sister Cities International — Helkinan, Japan M Page 2 Option 2: Install a clean -out outside of house per attached specifications. Enclose box so it can vent properly when excess pressure is put on house lines. This option would be the cheapest and simplest way of correcting this problem. At the same time, it would allow access to sanitary sewer lines if stoppage should occur. This vent clean -out would allow a place for backup in lines to go before entering your house and causing costly damage. The City would appreciate your expeditious cooperation in this matter. The City must continue proper maintenance of its sewer lines, but we obviously do not,wish to see continued problems occurring on your property because of poorly designed vents. It is your responsibility to correct these deficiencies. We cannot keep notifying you each time we come out to clean the line. It's up to you to have a plumbing system that conforms to code. Option 2 is a relatively simple one to construct. Should you have any questions on these options, please call Everett Akau, Scott Highland or myself at 771-3202, extension 317 or 318. Sincerely, �L GA "Q Ron Holland Water/Sewer Supervisor Enclosure SEWERVEN/TXTSEWER t Siole S-f-e-3 M A+,e.--Nt ( S '- x -Pv C- r; �k AsVe") F, v Pi bj C.41,p P k -%YvC -J�, C---JC- Ll Ll " pvc +, C4 "C', C At OR�r cc if Li "C�� 3/te/ql ;K rN 4- C, aw t� 0 C-1 V%i %7tj -76 Ar� '5-RT V, rs �( 5,3 ?V,L ?\Q� le-Ap o-% a 40 D,;Il 1/,j-'14v1,--S fo Vemt- rXe_575 Atr 4 The City of Edmonds Water Service Drawing EASEMENT NO. ..... .......................... NEW CONSTRUCTION 0 REPAIRS Z LID NO . .................. . ASMT- NO . .................. OWNER MARA. 14. Pl-tj ... . .............................................. CONTRACTOR JOB ADDRESS ........... PERMIT N0960,A.5 A NO ... .... .... i LEGAL DESCRIPTION: LOT NO'.-'.* ......................................... BLOCK NO . ............... ..................... rl-13 z a PWW-0001 -11/75 "1' %', 1 1/7b) NAME OF ADDITION ..: ......................... 2.1514 lmo Av. No. 3afr 3/V cop & 34,44"VA, Vc- 2mo Av. No 11.5 SS �S — - - - - - I 3/4 v P FE . F,xls,t .3/4" VAL-Vt IGO P.S.I. PF-. ul 3WICappelz IR& j A 0 0 A.poi�,ved: PhsvrlAl. 46-14-9(o F I t4AL. DATE ........ G..-Tr7 - 9 G ........................ E, ........... Z :1� U 0 U Z CITY OF EDMONDS PUBLIC WORKS DEPARTMENT RIGHT - OF - WAY CONSTRUCTION PERMIT A. *Address or vicinity oCConstruction Owner: Name Mail , ing,Address 6 City, State, Zip Code I - e Contractor:— Z , If d: 1 k -0 A n. e N C rl O'A Name /kl 7-AV" Ma�ling Address L,,e4 City, State, Zip Code Permit NO. — 'R I - 1..8 Issue Date 7 0 Permit Issued To: Type of Work to be Done: r6p Al Pc X & o rk' i' Connect"oopn /1�& n I W, El Sub or Plat JFQ' Single Family El Comml. /Ind. 0 Apt. Condo. Pavement Cut: D Yes F-l' N o / o - 4 " -A,) & - ­r V 6;,� r-S S&Ze Licen"se Number -? ? 11- a 4;�,q 7 Telephone Number * * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * * B. APPLICANT TO READ AND SIGN INDEMITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of it's departments or employees, including or not limited to the defense of any legal proceedings including defense, costs, court costs, and attorney fees by reason of granting this permit. Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year following the final inspection and acceptance of the restoration by the Engineering Division. Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at which time a debit or credit will be processed for issuance to the applicant. Work is to be -inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call 775-2525, extension 220. 1 understand that this permit must be available at the job site for inspection purposes at all times. Signature: li Z - /-/ Owner or Agent N te THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES CALL DIAL - DIG PRIOR TO BEGINNING WORK C. Issued By: Time Authorized: Vold after —days Spec.ial Conditions: Ammendments: Permit Fee: -4 o , Security Deposit: Receipt No.: Fund III Fee: Street Cut Dimensions X NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. December 1978 FIELD INSPECTION NOTES Mind 111 - Rotite conv to Street Dept.) Comments: F� am C E I V ED AU G 6 1981. rr:% m Dii. ui Public Works Diagram: M Contractor called for inspection . Yes . NO Work Disapproved Bv: Date: Bv: Date: Work Approved By: <Z: D a Inspector: EnQ. Div. December 1978 I CITY OF E0M10N!1",t"'­' ' 200 DAYTON ST. - EDMONDS. WASHINGTON 98020 - (206) 1 DEPARTMENT OF PUBLIC WORKS iMarch .16, 1981 HARVE 11. HARMSON M. AY 0 i i P14 Dear Resident: On February 17, 1981, the Edmonds City Council passed' Resolution 488 for construction, reconstruction and repair of deteriorated sidewalks. A puhlic hearing will he held in'the Council Chambers at the"Civic C:ent(--,r on April 21,1981 at 7:30:P.m. You are invited to.attend hearing.for h is discussing ions of det I e io bd r rat si'dewalk abutting ou �,p operty.—T e—im'p'rovement o "C3—w- lks in y h f si e need of repair at the expense of the abutting propertv owner is provided by City Ordinance, Chapter 7.20 and Revised Code of Washington, Chaptor 3.5.68. The areas needing repair have heen marked in paint on the sidewalk adjoining your prOT)erty. Reconstruction and repair of these sidewalks must he (_r)[11plot-ed on or before September 1, 1981. In the event linnt-nvements are not completed within the above specifir�d the City will perform and complete the improvci,,ient..!:,, (-it, i_-he cxpen!Z!,0. of the abutting property owner. This action is in response to many citizen requests and pedestrian falling accidents which havo been increasing in recent years as a result of sidewalk deterioration and increased pedestrian traffic. S I incerely, P R F: 1) T,-' . If ERZ BE: RG Director of Public Works APPLICATION for The City of Edmonds SIODE SEWER PERNUT EASEMENT No . .......................................... NEW CONSTRUCTION 0 REPAIRS 0 113-02100 OWNER........... E ...... G ..... S-an.t ------------------------------------------------------------------------- CONTRACTOR -------------------------------------------------------------------------------------------------- PERMIT No . ...................... ADDRESS ------ 215..2ad..Ave...-.N ------------------------------------------------------------- LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................ NAMEOF ADDITION ......................................................................................................................................... "It i Dye Tested On Sewer 1972 Approved: DATE................................................ By ...................................................................... 10 CITY OF EDMONDS S E USE U 0 NE ZONE Z PERMIT NUMBER 9 CONSTRUCTION PERMIT APPLICATION j 0 jOI3 B ADDRESS SUITE/APT # R E SS 5 0 NAME /NAME OF BUSINESS 0\ TADD LEGAL DESCRIPTION CHECK SUBDIVISION NO. LID NO� t ir uj M%ILING ADDRESS Z V PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. EXISTING REQUIRED DEDICATION TESCP Approved 11 AW Permit Required 0 Street Use Permit Req'd 0 0 C71 CITY ZIP 1� / 4, TELEPHONE NUMBER e4l P p OPOS ROPOSED inspection Required 0 Sidewalk Required 0 cc NAME METER SIZE LINE SIZE W PRV REQUIRED YES 0 NO 0 WO ADDRESS L) REMARKS ui Z cr CITY ZIP TELEPHONE NUMBER 3 Z W NAME v /V Cr ADD?qSS ENGINEERING MEMO DATED REVIEWED B�Y 0 L_� �_ 2- 0 CITY ZIP 7FIELEPHONE NUMBER I( I/- 7 001 -1 L: 7 41 FIRE MEMO DATED REVIEWED BY § _'L W !E STAYE LICENSE NUMBER EXPIRATION DATE SIGN ALLOWED AREA PROPOSED SEPA REVIEW COMPLETE ADB NO. Legal Description of Pwoerty -.include all easements Z 1EXEMPT EXP SHORELINE I VARIANCE OR CU PLANNING REVIEW BY DATE I ASETBACKS — FEET FRONT SIDE Property Tax Account Parcel No. el-;LUMBING EINEW RESIDENTIAL 1:1 1:1 Ej ADDITION COMMERCIAL MECHANICAL 1:1 E] APT. BLDG. El IREMODEL SIGN El GRADING FENCE REPAIR - CYDS. I x _FT) FIDEMOLISH WOODSTOVE SWIMPOOL INSERT HOT TUB/SPA RETAINING WALL/ EGARAGE ] C ROCKERY 0 RENEWAL �TYPE OF USE. BUSINESS OR AFTIVITY) EXPLAIN: Lc BY ITYPE OF REAR I _AZ_ - 11 \f SPECIAL INSPECTOR AREA REQUIRED OYES ' I - REMARKS AL PROGRESS INSPECT&N/S PER' NUMBER NUMBER OF CRITICAL U 47 1 DWELLING AREAS OF 0 STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) _. I I - " � ( C . - �_ 1"! )e.:t !,-( f FINAL INSPECTION REQUIRED tA Y, VALUATION HEIGHT I LOT COVERAGE V X_3 OCCUPANT LOAD 7-9 .4" I FEE ec PLAN CHECK FEE BUILDING HEAT SOURCE: GLAZING IN) 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: 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 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 PLAN CHECK DEPOSIT 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 1,,4 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 Insurance and RCW 18.27. INSPECTION acknowledged in space provided. SIGN . A -TYRE (OYVNER OR AGENT) IGNED DEPARTMENT JDATE CITY OF OFFICIAL'S SIGNATURE DATE EDMONDS _7 ATTENTION CALL FOR RELEARF() BY: DATE INSPECTION 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 a Z Z Z ATE R CEIVED tk� PERMIT EXMRES 2f/2 d/6 L CI-N. OF EDM6`ND!§� ISE P�PMIT ZONE NUMBE CO F-C NSTRUCfION. PERMIT APPLICATION- JOB SUITE/APT# ADDRESS )�k k) Yrl tAs� OWNER NAME/NAME OF BUSINESS PLAT NAMF_/tUBDIVI SION NO. LOT NO. LID NO. c, LID FEE $ w MAILING ADDRESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCIP Approwed RW Permit Required 0 w I 0 Street Use Pennit Req'd E)* EXISTING PROPOSED Impaction Required 0 Sidewalk Required 0 CITY ZI TELEPHONE 1-31 REQUIRED DEDICATION- FT Underground w NAME METERSIZE LINESIZE I NO. OF FIXTURES PRV REQUIRED a z YE S C1 NO x C CilkiO w I w A0111AESf" REMARKS z 9 OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE 0 z -56 Wew T7w--(, egsr, ik)o, _<i3A&q61Cu_1 CITY Z777 EPHONE w i 'NAME ENGINEERING- REVIEWED/bATE AD7DRESS FIRE REVIEWED BY DATE* w cc CITY 21P l`- z 0 L) r�� . VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND . STATE LICENSE NUMBER EXPIRATIONDATE1 CHECKEDBY REC%r POSTED 0 YES 0 SEPA REVIEW SIGN AREA HEIGHT Lu ES4�CCO C C P,4 COMPLETE EXEMPT ALLOWED PROPOSED ALLOWEQ4& PROPOSED ly 't q _j EXP -62R NEW ESIDENTIAL PLUMBING I MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SEYBACKS (FT.) R SIVEAR ALLOWED PROPOSED 'OF�RON DITION COMMERCIAL o COMPLIANCE OR 0 0 ;, Z z CHANGE OF USE P�ANINING F] REMODEL E] APARTM I ENT E] SIG N PARKING REO'D PROVIDED -7-0 LOT AREA REVI�WED'BY I e-l" I E]. GRADING FENCE C3 REPAIR CYDS 0 X FT) R MARKS OT15p [D DEMOLISH C3 TANK J�e )RENEWAL E3 GARAGE RETAINING WALL z CARPORT ROCKERY . (TyxF USE; BUSINESS OR ACIIVt TY).EXPLAIN:� a-11: 411,.,�..i, CL Fx CHECKED BY TYPE OF CONSTRU TION ICqE OCCUPANT GROUP u` w 0 ffi NUMBER OF NUMBER OF I v.1 DWELLING CRITICAL AREAS S ECIAL INSPECTOR RP AREA OCCUPANT f4 Rmie., 1CV LOAD 0 STORIE S UNITS NUMBER EQUIRED YES RIO" DESCRIBE WORK TO BE DONE REMARKS' z PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D 5 &iLlcn 7 1 Lwu TM ma/v AQ, Yx-) OL nc 07(� QS—fwt'� F.- rj C r AoD 2eeLAciP1 FLAT- VALUATION FEE T PLAN CHECK FEE HEAT SOURCF_� CAAZM.% OT&pk% BUILDING .14 1.0 1 `51-7 40 6a PLAN CHECK NO.: VESTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED.. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GR ADING/FILL DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE :3 SEPARATE PERMISSION. STATE SURCHARGE U cc PERMIT APPLICATION: 180 DAYS w PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION ENG. INSPECTION FEE 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS. w IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING _j 2 EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND INSPECTION FEE M 4 ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY . RECEIPT x THE ISSUANCE OF THIS PERMIT. ISSUANCE OFTHIS PERMIT SHALL NOT BE FROM PLAN CHECK DEPOSIT a DE CTO EMED TO MODIFY, WAIVE OR REDUCEANY REQUIREMENT OF ANY CITY ORDINANCE i 0 CITY'SABILITYTO ENFORCE ANYORDINANCE PROVISION.' I NOR LIMIT IN ANY WAYTHE IRECEIPT TOT I AL AMOUNT DUE 4-4// I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION 'APPLICATION APPROVAL GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application is not a permit until signed by the CALL TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or histher Deputy: and Fees are paid. and IN VIOLATION OF THE LABOR CODE OF THE TE'OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided. il"kU 18.27. EN'S COMPENsATidNi RANCE A;?RC 0 F NAT DATP. =1ALI A(YENT) AT 1 (425) �hD 771-0220 LEASED AT RE;,5E4 it J( E TION EXT1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 A FINAL INSPECTION, HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL FILE YELLOW - INSPECTOR CATE OF OCCUkNCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK -OWNER GOLD - ASSESSOR 5/98