21807 96TH AVE W.PDFiiiiiiii lill
9430
21807 96TH AVE W
PR9JECT HECKLIST
PR6JECT NAME PLAN CHECK #:
I Le t
PROJECT ADDRESS: ua of Lf, /j RECEIPT DATE:
JREVIEWF
ti...
a[/Da
te
1.,..FIRE,,,I.,BLD,G"...I,S,EWER
PLAN ,j��.R(jni
COMMENTS ....... - ....... ...
'--
is TR==T
Cme-
Setbacks/Variance/Setback Adjustment
..........
I.X
Conditional Use Permit
AD13 Requirements
3
Other Zoning Requirements
-4
Underground Wiring Required
............
5
Lot Slope 15%
6
SEPA Environmental Checklist/Hydraulics Permit
Ims Im
T-�
Tree Cutting Plan
Plat/Subdivision Requirements 5ee 96- 1014
: ...........
"
9
Legal Description Verification G'196- to(-t
Quit Claim/Street Dedications
Easements - Public/Private
..... . . . . . . . . . .
. ...............
j
Engineering Storm Drain Review Fee
. . . . . . . . . . . . . . .
13
Engineering 2.2 Inspection Fee
41
Drainage Plan (on -Site) 96- G)Q
. . . . . . . .
\j
Setback - Top of Bank, Stream, Water Courses
. . . . . . . . . . . . . . . . .
Setback - Storm Drain Line
Open Ditch - Existing
. . . . . . . .
Culvert Required
Culvert Size
......................
Shoulder Drainage/Shale Open Runoff
. . . . . . . . . . . . . .
. . . . . . ......... _ .........
Catch Basin Required
Driveway Slope & Vehicle Access
IMMUNE'
Sidewalk Required
Curb & Gutter Required
----------- --------- ---------
Curb Cut For Driveway Required
. . . . . . . . . . . . . . . . . . . . . . . . ..............
Street Paving Required
Right -Of -Way Construction Permit Required
Street Name Sign Required
Other Signing Required
1� 1 -3* 0.
Bond Required For Public Improvements
FEMA Ma Check/Water Table
Side Sewer Availability
Calculate Sewer Connection Fee If No LID #
Create Street File
...........
Existing Water Main Size
36'.
Water Meter Size
--------------------- -
Service Line Size
3//4 A
.
Water Meter Charge Required
. . . . . . . . . . . . . . . . . . . .
Hydrant Required
Hydrant Size Existing
. . . . . . . . . . .
Fire Line Charge Required - Sprinkler
WW" AP
Street Cut
43
Miscellaneous
Reviewed By:
FIRE
PLANNING
ENGINEERING
APR 0 3 1997
pUBLIG WORKS DEPI
.4
R E C 0 R D OF C 0 N T A C T S
1
21
2
22
3
23
4
24
5
25
6
26
7
27
8
28
RW PERMIT # DATE ISSUED RECEIPT #
9
29
10
30
31
12
32
13
PAID $ RECEIPT # DATE
33
SS PERMIT # DATE ISSUED ��2�E7RECEIPT
14-
PAID $ RECEIPT # DATE
34
15
35
16
36
17
37
METER SIZEY/,I/ PAID'$ <� DATEa/,Rq/;--):Z RECEIPT #
18
38
19
39
20
I
51TE PL'A-,N
LOT 3 OF
CITY OF E10MOND5 OR - 3 1997
�5xlo wo m I ISH CO. I WX..
'� -2- COUNTER
-SITE lNDj> ize- SS 12, 0 &vc ,$(--PERMIT
at>v-1 0 V,,.o tr�,,s
FO f�L,'- TOM �44 tx) C�,
HEMHT. CALC 5
-H .912-35'
-MS7AXI
c Il COPY
1 0 0
HA,%.
APPROVED BY PLANNING
84.0 AN
4-1-? 7
y?2
--m . A.Tto,-- .
7-(- L
Alto. SOL o. 1-3
I MIA
A
IV v- '417 1
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-9-
CITY OF EDMONDS
8 9 0 9
Address of Construction: FO 7-
Property Legal Descript.ion (Include all basements):
Owner and/or Contractor: -
State License No
Single Family
Multi -Family (No. of Units
El Commercial
El Public
Al
SIDE SEWER PERMIT
.?,C— ctj .
PERMIT lr%2 8884
EDMo4-DS
TREATMENT Di
()Rys U t F I
Building Permit No' 4? 7
Invasion into City Right-of-fty:y No 0 Yes
RW Construction Permit No.
Cross other Private Property No 13 Yes
)Y
Attach legal description and copy of recorded easement
I certify that I have read and shall comply with all city requirements
as indicated on the back of the Permit Card.
�7
Date(
CALL DIAL -,A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
OFFICE USE`bNLY.
FOR INSPECTION CALL*74-�, PUBLIC WORKS DEPT.
Permit Fee: 650 00 Issued By.
00 19�
Trunk Charge.— Date Issued: 7
Assessment Fee: Receipt No.:
Lid No.:—/,q,:�
Partial Inspection: Date Initial
Comments
Reason Rejected: Date —Initial
Final.Inspection Approved- Date-U—X InitialeL
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Green Copy: Inspector Buff Copy: Applicant Revised 3!90
NOTICE. -
a n ty... Ut a UCU
-N'O*"W,a
The -information shc)wn on the attached
Hed for use by the OtY 01
map(s) was com ' pi
Edmonds/ its Empl-oyees and Consultants.
Th,e City ofEdm.onds does. not I warrant the
0
accuracy of anything set forth n t ' hese
M a P (s"). A n . V person or entity -requesting a
copy should conduct an independent
Orm'ation shown-c
Inquiry regarding the inf*
-m a p including, but not Jimited to,
the lotation of any sewer stub shown. Su(
ay- not exist and ma\
sewer stubs may or m
or may not exist at the location shown
Neitheir the City of Edmonld SJ nor its
empto-yee-s o-r off icers -shal-1 be 1--Ja-b-1--e forth
information given' on tNs map(5), nor for
any one representation provided based
upon said map(S'.
The City of Edmonds Side Sewer Drawing EASEMENT NO . ............................................
NEW CONSTRUCTION ff- REPAIRS F-1 . LID NO . .................. ASMT. NO . ..................
OWNER........................................................................................... .... CONTRACTOR .................................................................................... PERMIT NO. Bes At
...............
JOB ADDRESS ...... . ........... r . ....... W .........
AV
... . .. --------- LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK ---------------------
EDMO,�DS
_r
_Mf
T
... PL
...................................................................................................................... rT R:E- :A __-ANT------'
NAMEOF ADDITION .......................................................................................................................
--7
7'
7- G'
7'
Heck
/30'
POLY P=Pls
Few- e
Approved: r
8- �-Ce ................ By
PWW-0001 -11/75 (REV. 11/78) DATE ........................ ... ............
--- —, T-, -------------------
.. lso(3
city 'of Edmonds.
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Num ber.-96—
Lssue Date: I / 2 -7 / 0
A. Address or Vicinity of Construction: C?eq 'I A-VE v./
B. Type of Work (be sPmiflc): b P-4 V P wjs v 0 1V
f
z., Contractor-1-6 t�j Contact:
Phone: �74,17 Z6
Mailing Address: P 4
S t 'L
'ic ns it.
\ta e e e . J!Ibrl jz t tj 7- rf I Liability Insurance: Bond: $
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. E] Commercial J] Subdivision n City Project E] Utility (PUD, GTE, WNG, CABLE, WATER)
0 Multi -Family n Single Family n Other
INSPECTOR: \'A,4M';4 — INSPECTOR:
F. Pavement or Concrete Cut : D Yes [:]No G. Size of Cut: x
I APPLICANT TO READ AND SIGN .
H. Chargq�_$
INDEMNITY: Applicant understands and by his signature to this application to hold the City of Edmonds harmlessfrom injuries, damages, or claims ofany
kind or description whatsoever, foreseen or unforeseen, that inay be made against the City of Edmonds, or any of its departments or
employees, including or not limited to the defense of any legal proceedings including defense costs and atiorneyfees by reason of granting this permit.
THE CONTRA CTOR IS RESPONSIBLE FOR WORKMA NSHIP A ND MA TERIA LS I -OR A PERIOD OF ONE YEAR FOLLO WING THE FINA L INSPEC-
TION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREETPATCHIS COMPLETED
BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT
Two sets of construction drawings of proposed work required with permit application.
A 24 hour notice is required for inspection. Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut trench work shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and understand the permit requirements and the pink copy of the permit will be
available on site at all times for inspection purposes.
Signature: oc�m a 1fz'.' - 0 17— Date..
Ontractor or Ag_e_n-7)_____T . t
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY�. )e_�z RIGHT OF WAY FEE:
TIME AUTHORIZED: VOID AFTER Ngr4 61 DAYS DISRUPTION FEEIFUND III:
SPECIAL CONDITIONS: RESTORATION FEE:
T.O.TA.L.FEE:
r;
_J I
RECEIPT NO.: 02
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div 1997
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.)
I Comments:
:.CONTRACTOR CALLED FOR INSPECTION El YES E-1 NO
Partial Work Inspection by P.W.:
.Work Disapproved By: Date:
YINAL APPROVAL BY: Date:
7,4 0,3- - % ` - P,(1— P&-"4
CRITICAL AREAS #: C-A -% - o-77 - W,(4�kCr
SEPA DETERMINATION:
LOT AREA: IX (06
OTHER:
PLANNING DATA
NAME:
SITE ADDRESS:- 2-18-0 7 - V- 4L,,- V—DATE: -f
ZONING: P-5 4 PLAN CHK#:
PROJECT DESCRIPTION: A4,,w
CORNER.LOT NO - (Yes/No)
SETBACKS:
Required Setbacks:
Front: ZS' Left Side: � �i Right Side: Rear: / 5'
Actual Setbacks:
Front: 7-5- Left Side: -7 Right Side: Rear: 1-7'
Street map checked for additional setback required? fl(I - p�w� (-,A (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED AJ (Y/N)
LOT COVERAGE: (-? 175- 4- G 7& 2-71-1
Maximum Allowed: 36-S _Actual: !D11t, 3017.
BUILDING HEIGHT:
K"*4- j, VA - Maximum Allowed: Actual Height: 2-3��-'
Datum Point: C41a, b-s,,, Datum Elevation:
A.D.U. CREATED9.: A- A-0m Atlwr� r9y.KoVU fnaurr (t.- . Af
A,,b- ck4- .3
ALN
V
RHRnlVlql Kim 412-1r� 0) oA- /V /--I, I 1� 1 22 1n7Q0 At
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lfl� 0 "L
Plan Review By:
PERMIT APPLICATIONREQUIREMENTS
X Applicant
Jamal Mahmoud, Engineering Inspector
wncr. rr,,,1 plan M7t No: 9 10-5
8 1 ff
ddress: 4, ""FET FILE
�,Jq= 9i�) If
fter review of the subject permit application, the following requirements must be met
Construction hours are: WEEKDAYS — 7:00 A.IVL-10:00 P.M.;WEEKENDS/HOLIDAYS — 10:00 A—IVL-6:00 P.IVL
A separate RIGHT-OF-WAY CONSTRUCTION PERMIT is required for all work on public property. (ECDC 18.60)
Truck haul route plan must be submitted and approved prior tcLpermit issuance.
Builder/owner is responsible for containing all temporary runoff and erosion control on site (ECDC 18.30.030d).
NO WORK SHALL BE DONE WITHIN 15 FEET OF STREAM OR 10 FEET FROM ANY CLOSED D9AJXAGE
FACILITY. BUILDER/OWNERIS RESPONSIBLE FOR IDENTIFYING CONDITIONS ON THE DRAVVIRG.
(ECDC 18.30.50G)
FILTER FABRIC FENCE SHALL BE INSTALLED AND INSPECTED PRIOR TO CLEARING AND CONSTRUCTION.
(ECDC 1830)
INSPECTIONS ARE REQUIRED ON STORM DRAINAGE SYSTEMS, TIGHTLINES AND CATCH BASIN
INSTALLATION. INSPECTIONS ARE REQUIRED PRIOR TO BACKFELLING. (ECDC 1830)
Repair or replace all defective existing curb, gutter and sidewalk adjacent to the property. If an intersection is involved, a handicap ramp
may be required. Contractor shall meet with the City Engineering staff to determine the extent of repair prior to issuance of the permit
(ECDC 1&90)
Driveway slope shall not exceed 14% without a waiver. Every attempt should be made to keep the slope below 14%. Waiver granted to
(ECDC 18.80.060D)
Driveways must be paved from' property line to City RIGHT-OF-WAY. A separate permit is required. (ECDC 18.80.060C)
INSPECTIONS ARE REQUIRED ON DRIVEWAYS AND SIDEWALKS PRIOR TO AND AFTER POURING. (ECDC 18.30)
No burning of construction refuse without a permit from the Fire Departinent
Connection to City water system is required. There is a separate charge.for the water meter (ECDC 7.20)..
A back water valve is required if downstaiis plumbing is below the elevation of upstream manhole. (ECDC 7.20)
Water and sewer main lines should be separated by 10 feet minimum. (ECDC 18.10)
Connection toAe City sanitary system is required. A separate permit is required.
LID# AlI Fees paid: Yes No Charge (ECDC 18.10)
Underground wiring is required on all new construction, and for additions, alterations, and repairs that exceed 50% of the total assessed
value of the structure. (ECDC 1&90)
i
A FINAL ENGINEERING INSPECTION IS REQUIRED PRIOR TO THE BUILDING DIVISION GRANTING OCCUPANCY
OF THE BUELDING OR STRUCTURE. (ECDC 18.90)
p JECT REV1EVV-jCHECKL1ST,'-,,;
PROJECT. F
PLAN CHE
* F_I
X R mi
PROJECT AD DRESS ECEIPT D'A7
EV IE
0 W2.
WATER
.. ... to UM NTS
F R
t) G
, S* E* W `E
S TR
Underground Wiring
Lot Slope Is%
SEPA Environmental
Tree Cuttina Plan
Permit
Flat/Subdivision Requirements $ee
......... ...
- - ------ --
Legal Description Verification to(-/ 10
Quit Claim/Street Dedications IMMIM U.N. III
1�. � I
Easements - Public/F
Engineering Storm D
Engineering 2.2 Insp,
Drainage Plan (On -Si
Setback - Top of Ban
Setback - Storm Draii
10pen Ditch - Existin
Fc—uivert Required
JC�Ivert Size
Review Fee 3 C>
in Fee 3 C;,
- �-� s__ 9 6 - I o�_
'ream, Water Courses
M. ML
LVM- Ma��
Sidewalk Required
Curb& Gutter Reguir d
M4 me Men
dred
Street PavinaBp-qu
--An VAR-MITIMM."MMUMna
UFM M
roll
124U 1,FT7*1FQ F-1
mwg
M F1 -11 ri IWO
top r-M oil' 8 re
'Create Street File
M
Existing water Main Size
Water Meter Size
X$.XK,
Service Line Size
H Grant He uired
Y
!sting
LTj
xp�
Street Cut
Miscel eous
Reviewed By:
FIRE
PLANNING ENGINEERING
AftlVrp
po 0 3 1997.
ENGINEE�rRING
ROUTE n dd? Total DaYs�_M ailed
RESUB fil'ON To Back -Add? Total DaysL Mail
FILIF
RESUB #2 ON TO Pack Add? -Total DaysL_Mailed
1. Site/Drainage Plan &.Calcs_w/o(a-J oK — Corrections Required- Received
I f
2. Grading Plan/Calcs/CYG__L 2-Ce, sEPA?A�&ol( 1.
n C�?
3.-Driveway Slope Vo_Z, /0 Profile _OK 2.
4. Truck Route Plan OK 3.
5. Street Dedication? FEET 4.
6. Easement I Type _OK 5.
OTHER COMMENTS:
100
t Back� FIRE REVIEW Date Sent Back
PW REVEEW Date Sen
PLANNING REVIEW TIME TOTAL DAYS' ENG REVIEW TIME TOTAL DAYS
FIRE DEPT REVIEW TIME
TOTAL DAYS * * * PW REVIEW.
BUILDING DEPT REVIEW TIME: In -House Outside
ORDINANCE COMPLETION DATE COMPLETION DATE
PERMIT #
TOTAL DAYS
TOTAL DAYS
TOTAL REVIEW TIME DAYS
ISSUE D TE
*CONTACT PERSON STATEMENT*
BY SIGNING TEIIS FORM I UNDERSTAND THAT I AM THE ACKNOWLEDGED CONTACT PERSON FOR
THIS PROJECT. IT IS My RESPONSIBILITY TO COORDINATE ALL SUBMITTALS WrM THE CITY
AND ONLY I CANMAKE INQUIRIES ON THE STATUS OF TEOE PERMIT. I UNDER . STAND THAT IT IS
My, RESPONSIBILITY TO DETERMINE IN ADVANCE OF PERMIT SUBMITTAL ANY DISCRETIONARY
PERMM THAT MAY BE APPLICABLE TO THIS PROJECT. I ACKNOWLEDGE THAT TO TEIE BEST OF
My ABILITY I HAVE SUBMITTED ALL NECESSARY DOCUMENTATION IN ORDER TO MAKE A
COMPLETE APPLICATI
Al
�� L/
Signed Date Mailing Address
Q)
ON
Contact Person (Piint Clearly)--
7 7"? fv 0 c'
Phone Number '-MekguSber
ROUTEDOCAITemp/Bldg/Fonns-5/96 K C ov v�e_.C� j �A_-�
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51TE FLA-,N
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CITY OF EIDMOND5 AN 3 1,cl,97
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APR - 3 11997
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The City of Edmonds Water Service Drawing EASEMENT NO . ............................................
NEW CONSTRUCTION JK REPAIRS El LID NO . .................. . ASMT. NO . ..................
OWNER . . ........... ... ...................................... CONTRACTOR .................................................................................... PERMIT NO. 174WI.
........................ ... . ............
JOB ADDRESS ......
jFjrr,0 S 08
ON
er 0
Gr
SL
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SL
it ra
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LEGAL DESCRIPTION: LOT.NO . ...................................... BLOCK NO . ....................................
NAMEOF ADDITION ..: ....................................................................................................................
I
I '�O #� 7-o / "c- 0-
2 jr
Approved:
PWW.0001-11/75 (REV. 11/78)
DATE ... ?.- .-Y-7 .................. By I ... . . .....
_r
ZSE T
ONE PERIM
--�':x'CITY..-OF EDMONDS
NUMBER
CONSTFtUCTION PERMIT APPLICATION
jos
ADDRESS
AUITE/APT 11
, q,� . (I
PWNEA NAN.I.EtNAME Of- BUSINESS
LEGAL DESCRIPTION CHECK
SUBDIVISION NO..
LID NO.
1v 1A
cc
W -MAILING
ADDRESS
Z
0
0
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCP Approved b
ZIP TELEPHONE
NUMBER
EXISTING -REQUIRED DEDICATION
RW Permit Required 0
Street Use Permit Req'd 0
-77
14 - I-/ Z_ 0
Inspection Required
PROPOSED
Sidewalk Required
I�AME
cc
W
0 tv S V 1-,t. A T\JT&
M�T713sl fl
SIjj
NO.OFF!)(TURES
F PRV REQUIRED
W()
ADDRESS
YES NO
A
t:
c) 6
REMAFIKS
M
CITY ip TELEPHO
NE NUMBER
py, tl V,
Z
t1ell V V, L_77:� 7
45* 9
VIA (.,A IMM010O.S =1f600&tj
0
NAME
A, )L tF_ Q- 1-4 G
C,
ir
0
ADDRESS
x :114-
ENGINEERING MEMO DATED REVIEWED BY
/,r 2-9,1
cc
CITY fir
NUMBER
Z
0
iir
EA r"I L) 77
FIRE MEMO DATED REVIEWED BY
STATE LICENSE NUMBER EXPIRATION DAT
�;_j
To Q_ I vio 2- 1
SIGN AREA
SEPA REVIEW
ADB.NO.
I '=
r."I
Legal Description offroperty - include all easerAents (,ki—
ALLOWED
PROPOSED
COMPLETE
EXEIA0T
SHORELINE11
OZ
0 Iva )/L4 otp _St;�. T.
EXP
CL
VARIANCE OR CU
PLANNING REVIEW BY
DATE
QXr. ov
+,-A) 7
Lu
V N T- I,/ \A1 !I
SETBACKS —FEET
V ,
FRONT 2. 5 S] REAR 15
H
;EIGHT
2-5
ff
LOT COVERAGE
3 5"'A
Z
Z
Z
'uj
Property
Tax Account
00 7 22S) 6 y-
REMARKS
Parcel No.
RESIDENTIAL
PLUMBINGIMECH
1:1
COMPLIANCE OR
ADDITION
COMMERCIAL
CHANGE OF USE
1-1 APT. BLDG.
SIGN
REMODEL
13:71 FENCE
CHECKED BY
";MCTION
C
1^1 d,04—
EIREPAIR CYDS. x __6—FT)
WOODSTOVE SWIM POOL
FIDEMOLISH D INSERT HOT TUB/SPA
SPECIAL INSPECTOR
REQUIRED
LOAD
GARAGE RETAINING WALL/
CARPORT ROCKERY RENEWAL
REMARKS tj
2
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
PROGRESS INSPECTIONS PER USC 108
IL
W
ui
NUMBER NUMBER OF
DWELLING
I
CRITICAL
AR EAS
�NUMBER
T
0
00
OF
STORI UNITS I
1149
9
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
)(PWAl'by 1&9mu I XtO2 �:w Z2211
I
I
f
FINAL INSPECTION
REQUIRED
C,
VALUATION
FEE
PLAN CHECK FEE
51 ol�� 15_�
BUILDING
_EA_
H T�S06RCE:
GLAZING
%
PLUMBING
Plan Check No. oc-
D
MECHANICAL
.
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
Permit Application: 180 Days
STORM DRAINAGE FEE
0
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns an
ENG. INSPECTION FEE
,n
successors I n 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
cr
whatever nature, arising directly or Indirectly I rom 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
0
T nor limit in any way the City's ability,to enforce any ordinance
TOTAL AMOUNT DUE
11612
provision."
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
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
ONLY THE
WORK NOTED
Deputy; and fees are paid, and receipt is
Code of the State of Washington relating to Workmen's Compensa.
acknowledged in space provided.
ance and RCW 18.27.
INSPECTION
(OWNER 0 AUt:NI) D
DEPARTMENT
OFFICIt4t_f"S't GNAN /DAT�
CITY OF
EDMONDS
CALL FOR
RELEASED'BY:
ATTENTION
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
BEEN MADE AND APPROVAL OR 771-0220
ORIGINAL — File' YELLOW — Inspect 7U
UNTIL A FINAL INSPECTION HAS
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC
SECTION 109
PINK — Owner GOLD — Assessor