21808 87TH PL W.PDF111111111111
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21808 87TH PL W
`7
CITY OF EDMONDS
18 9 1 9 c�z
-Z 1 C60 -7
C, C)
Address of Construction: 0 0
SIDE SEWER PERMIT
PERMIT
EDMONIDS
IMENT PLANT
Property Legal Description (Include all easements): 1:7 60tv ov-,(12 f
i7- (76.. z7 0 4- Z 1 1; L) o
Owner and/or Contractor: Z tj LL_ f-7 -1 i7\-, Al
State License No. - 7L) LP-4,e -FI-6 4!,,(X4A - Building Permit No. -t)) 0 7
�ilsingle Family
D Multi -Family (No. of Units—)
1:1 Commercial
0 Public
Invasion into City Rlght-of-Way:,4�,No 11 Yes
RW Construction Permit No. —
Cross other Private Property25-No El Yes
Attach legal description and copy of recorded easement
I certify that av—eread and sh�_Ilcomply with all city requirements
as indicated � the back of the Permit Card.
1 3 U
_2
D nt
ate
* CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION *
OFMCE USE ONLY
FOR INSPECTION CALL PUBLIC WORKS DEPT.
Permit Fee: Issued By
Trunk Charge:_-,�S. Date Issued: Of hl�p
Assessment Fee: Receipt No.:
Lid No.:
Partial Inspection: Comments Date —Initial —
Reason Rejected: Date —Initial —
Final Inspection Approved: Date Initial C.
I ---- J
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Green Copy: Inspector Buff Copy: Applicant
Rev,sed 3 90
Tk,m r; ^9 r.Afto%..A Side Sewer Drawing lk
EASEMENT NO. . . ....... . ................. .
NEW CONSTRUCTION 10 REPAIRS M LID NO . .................. ASMT. NO. — ...............
OWNER................................................................................................. CONTRACTOR .................................................................................... PERMIT NO. 8-?,88 .....
JOB ADDRESS ... C�213.Pl ............. Z.1 ... L .. .... W. .. LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ....................................
NAME OF ADDITION
4
� tv
r- --- ----
EDMONDS
TREA f IAN
Approved:
I PWW-0001 -11/75 (REV. 11178)
DATE... qA ....................... By ...... ...................
0
NOTICE:
No--Wa*r-rant-y ... OT -au�-, Y.
The -information *shown on the attached
map(s) was compiled for use by the City Of
Edmonds/ its Employees and Consultants.
Th.e City of �Edm.onds does not . warrant the
accuracy of anything set for.th on t - hese
Map(�_)- Any person or entity -requesting a
copy should conduct an independent
'ation shown on
Inquiry regarding the inform
including, but not limited to,
-t-Fe -map(s)/ ub shown. Such
th'e lociation of any sew-er st
sewer stubs may or may- not exist and may
or may not exist at the location shown.
Neither the city of Edmonds nor its
ernp*1,o'yee*s o'r office-rs -sh-a-11.1 be lIa-b-11--e for -41-he
information given on this map(s), nor for
any one representation provided based
upon said map(s).
. P I
CA F 1: NO.—
ok .4
Oritical Areas Checklist*
Site Information (Soi]S/to Poo ra phy/hy d rology/vegetatio n),.
1. Site Address /Location:
2. Property Tax Account Number: 2. 7 02-9 0 0 L-)
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? yes; no -
If yes; how is site developed?
.5- Describe the general site topography- Check all that appl
_y.
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
Ino
horizontal distance of 66-feet).
Hilly: slopesp.resent on site of more than 15% and less than 30% ( a vertical rise
Of I 0-fee-t over a horizontal -distance of 33 to 66-feet).
Steep: -grades of.greater than 30%,o present on site (a vertical rise of I 0-feat over a
horizontal distance of less than 33-feety.
:Other (please describe):
6. Site contains -areas of year-round standing water: P c5) _;Approx. Depth:
7. Site contains areas of seasonal standing water: <0 Approx. Depth:
What season(s) of the year?
8. Site is in the floodway ---� floodplain of -a water course.
9. Site contains 2 creek or an area where water flows across the grounds surface? Flows are year-
round? . Flows are seasonal? — (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
---For City Staff Use Only
1. SiteisZoned?
2. kS mapped soil type(s)? (-j,� -2
3. Wetland inventory or C.A. map indicates wetland present on site?
4.:-. :-...Critical Areas inventory or C.A. map indicates Critical Area oti site?
5.. �ite within' designated earth subsidence landslide hazard area?
6. 8'ite designated on the Environmentally Sensitive Areas Map? Al
DETERMINATION
..�STUDY REQUIRED
CONDITIONAL WAIVER
i,Z WAIVER
Reviewed by:
-�e
Flanher Dat-�,.
Attachment 7
RCV 0 1/04/94
': 00. , W
9 0 1 9
Ci�y of Edmon&
Critical Areas Checklist
Ile 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 whetherany
potential Critical Areas are or may be
present,on the subject property. The
information needed to complete the
Checklist should be easily available from
observations of the site or data available at
City Hall (Critical Areas inventories, maps,
or soil surveys).
An applicant, or his/her representative,
must fill out the checkJist, sign and date it,
and submit it to the City. 'ne 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.
Vvrith:a signed copy of this form, the
applicant should also submit a vicinity map
or plot plan for individual lots of the parcel
Vithenough detail that City staff can find
and identify the subject parcel.(s). in
addition, the applicant shall include
,otherperfinent information (e.g. site
plan, topography map, etc.) or studies in
conjunction with this Checklist to assist
staff in completing their preliminary
amessment 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
Street Address
City, state, zip
Phone
SiSnature 7
Daie
Applicant Representative:
Name
4
Street Address
City, State, ZIP Phone
Siinature Date
we,
STREET ME
218th ST. S.W.
FX157tW& DITCH
IL,21
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r
heiqht calculabon:
f2O--,F-0 F-Oe- K- F- F-Y 14-51. (109 t 413 65- + 441.4-9-
44 3.-7-7 111-14 - -�7 4 --4,41,2
11�61, 2-0
0 2a 30 '40 60
MR- lot coverage calculation
,Sr-Al-C 2-
(-'LcFr 51 ze)-
legal description.
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WA 991,55
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1 09-08-1998 FROM
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SEP. 14 1998
IWATTL& VA
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S#w(oiD Plezed 5ftoev;w
�r:j flILE
TOTAL P. rd3
PLANNING D
NAME:
SITEADDRESS: -DATE:
ZONING: PLAN CHK#:
PROJECT DESCRIPTION:— A1W
CORNERLOT--�,)Q - (Yes/No) FLAG LOT L�O (Yes/No)
SETBACKS:
Required Setbacks: ff
Front: Left Side: Right Side: Rear:
Actual Setbacks:
Front: -,;�K Left Slde:Zli� Right Side: Rear:
Street map checked for additional setback required? _(Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED (YIN)
LOT COVERAGE:
Maximum Allowed% �22 �0 �056zdltuai: �Z/ 7 1 e � 5,IV4
I
BUILDING HEIGHT: 45-5-5 .
Maximum Allowed: —Actual Height:
J-14Y e- /
Datum Point: .5,5. ih Datum Elevation: '5', S
A.D.U. CREATED?:
SUBDIVISION: q7
CRITICAL AREASM
SEPA DETERMINATION: - DA6 IX P - /�-15
LOTAREA: S-zny.4
OTHER:
I
6 5 ALO L
CAW
2'- C.&A
CIA-
41 -&o
44+5
site n
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dalum TOPOP �5SHl
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TO 60 AJ 777-0/ 4.-
ec-r
Lor
RECEivED
SEP - 8 1999
DEVELOPMENT �ERVICES CTR.
CITY OF EDMONDS
-2/ (" 10, ls� grayNc scale
qOr
;0
0 f 4'
10 he!-ght calc lot coverage'
1720 S
E-"Z 15F&, 64PAPE 0 PL I leq-al description
lot 6 COLLrZT
ALLONW) :- 4(,&. 5e�> 4(P,5.
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tal (2W) M2M fax QW) 64&TM
Jx0liec
Esperanc'e Court
09 -03 alq
PLANNING DATA
NAME.��///�
SITE ADDRESS: 1.-/ ()DATE -
ZONING: PLANCHK#:
PROJECT DESCRIPTION: A
CORNERLO (Yes/No)
FLAG LOT
(Yes/No)
SETBACKS:
Required Setbacks: 7'4
Front: �7, '1i"ide: :;��_fNqM Side: a :v
Actual Setbacks:
Front: 9,�. �Wlde: Side: /0 aw:
Street map checked for additional setback required?_ YeslNo)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED —(Y/N)
LOT COVERAGE:
Maximum Allowed: R13_Actual: �776LI6&)
BUILDING HEIGHT:
Maximum Allowed:- qLdi - go Actual Height:- � to( 6
' IeDatum Elevation:—'��&.
Datum Point: A
A.D.U. CREATED? -
SUBDIVISION:
- A
CRITICAL AREAS #: �� - 1115'�
SEPA DETERMINATION: /�Jwv
LOT AREA: a13
CITY OF EDMONDS
USE
ZONE Z,),f
—D �
PER111111hi
NUMBER
9 �9
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
QB SUITE/APT #
ADDRESS 0
t-A KC 11 601L� V If Z --, 'IN
LEGAL DESCRIPTION CHECK11
SUBDIVISION NO,
LID NO.
W
Z
;MAILING ADDRESS
- 01-1
`1 P - 3
�'Dev. 4� ;,-
u
PUBLIC RIGHT OF WAY PER
OFFICIAL STREET MAP.
TESCP Approved IT
I
CITY Z IF
n�_
TELEPHONE NUMBER
RW Permit Required /V/, 13
l< v
S k. A I I L, 1�_' 11 LIJ,
4�
11.
C_ - Z i -
(S
EXISTING _Y11___-%EOUIRED
DEDICATION
Street Use Permit Req'd, Vcp
NAME
PROPOSED
Inspection Required a
Sidewalk Required/V,' 13
P11
METER SIZE
LINE SI E
NO. OF FIXTU�ESJ.
PRV REQUIRED
cc
L)
ADDRESS
YES NO El
REMARKIS I
ev t
<
Y
E NUMBER
IV 7;d /j\/
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ADDRESS
L
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0
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ENG EE NG MEMO DATED
47
RIEYITE�D�y
1
m
CITY ZIP
TELEPHONE NUMBER
Z
FIRE MEMO DATED
REVIEWED BY
0
STATE LICENSE NUMBER EXI RATrN DAfE
r-I 1�__7
lu-
-) ? N I (_-A� � .44. A ! 1 4)
VARIANCE OR CU
ADB#
SHORELINE #
Legal Description of Property - include all easemehts
Z
c) Uj
SEPA REVIEW
COMPLET� XEMPT
SIGN AREA
ALLOW ROPOSED
HEIGHT
ALLOW�p I PROPOSED.
2
CL
7,
L)
L/
EXP
LOT COVERAGE
REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS (FT)
ALLOWED
PROPOSED
FRONT SIDE REAR
FRONT LIR SIDE REAR
0
Z
/,�
*�� 7�� /5
Z
Z
LU
_1
Property
�
Tax Account
Parcel No. C) 0
!9IMP
-W BY
CL
NEW
a-RIESIDENTIAL
PLUMBING(MECH
REMARKS
COMPLIANCE OR
ADDITION
COMMERCIAL
CHANGE OF USE
DREMODEL
El APT. BLDG.
El
SIGN
GRADING FENCE
zj:�c
CHECKED BY
TYPE OF CO
!NSTRUCTION
CODE
OCCUP N
GR 0
REPAIR CYDS. I x —FT)
9
r—.3
4
fl
DEMOLISH WOODSTOVE SWIM POOL
INSERT HOT TUB/SPA
SPECIAL INSPECTOR
REQUIRED
AREA -tV1,5
P�4_lAe4 V_ Al
jgPDU PA IN T
GARAGE RETAINING WALL/
CARPORT El RENEWAL
13 YES
1
REMARKS
/4f-
7�ImI4-7_n Iloer) 7<—
, �`
A
AD
ROCKERY
/ III
(TYPE OF USE. BUSINESS OR ACTIVIT PLAIN:
PROGRESS INSPECTIONS
PER UBC 1,66-,
D
LU
NUMBER
NUMBER OF
CRITICAL
50d'o,
0
cO
OF
STORIES
DWELLING
UNITS
AREAS
NUMBER
0
DESCRIBENVOISK�76 BE DONE (ATTACH PI'UrPLAN)
4�
&r ,J rzd IZ1411�_
FINAL I
REQUIRED
VALUATION
FEE
I
PLAN CHECK FEE
906
1161&-o ITO (1A 117 L) CL
A
BUILDING
HEAT SOURCE:
GLAZING
1:51 12 4-1
4U0
L�- A
PLUMBING
Plan Check No.
9 9 - 'i. / 1,
MECHANICAL
This Permit covers work to be done on private pro perty ONLY.
GRADINGIFILL
140
Any construction on the public domain (curbs, Sidewalks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
.4
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
5-61
w
successors in interest, agrees to indemnify, defend and hold
20
harmless the City of Edmonds, Washington, its officials,
m
employees, and agents from any and all claims for damages of
cc
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
0
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
N 0 ij" 1,
I hereby acknowl;dge that I have read this application; that the
information given is correct; and that I am the owner, or th i e 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 relati�'g to Workmen's Co pensa-
WORK NOTED
Deputy; and fees are paid, and receipt is
tion Insurance aria 5eW1,6.27. I. r
INSPECTION
acknowledged in space provided.
siq�ATUIE
(OWNER OR�fT DATE GNET
S1
DEPARTMENT
11"
CITY OF
OFF C 'S SIG44ATURE DATE
EDMONDS
I
ATT E T 1 0 N
CALL FOR
AELE"ASED�BY iDATE
INSPECTION
P/
I IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCT
T URE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220
ORIqeNAL - Foe YELLOW - Inspe'
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
I
SECTION 109
PINK - Owner GOLD - Assessor
ing.A7
i-0 C. 1 B913
CITY OF EDMONDS
250 5TH AVENUE NORTH - EDMONDS, WA 98020 - (206) 771-0220 * FAX (206) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works Planning Parks and Recreation Engineering
Fge:::#:
LAND USE COMPLAINT FORM
The UDDer Dortion of this form is Dublic record and will be nhotnennied for thp
Zt!1305 e7V+--VL-
BARBARA FAHEY
MAYOR
DATE OF COMPLAINT:
FES 2 - 2000
SUBJECT OF COMPLAINT:
DEVELOPMENT SE14VICES CTR,
CITY OF EDMONDS
1-7
VIOLATION ADDRESS/ LOCATION:.
W
NAME: Lj' r V1
PHONE:
IS ALLEGED VIOLATOR THE 12"'OWNER
OR EITENANT OF THE ABOVE PROPERTY?
DETAILS OF COMPLAINT:
was O)V4kk
--r-
*0 kLA,%rvA\'-!j
.3
Or f 0 6 2-(,rtC Yf- �Q Ul-L
�e
V
yv'e- kv�j
V� lo-wer-e� it -A-
o-F vit!j
pr!�!ge-v*4 iv, v-y'afep-
+-0 C C' M 0 j 4L*e- -"-Q""J+'
-i-- ere V '* I-f,-
d\ r o� k n cx- ox- �o o -,e
0\.Qj re 5 5 o�,x
+-o m 4 j2 ro�o
-Tke,, A111 C0r,-ejrV-KA C" -+- ^-t -K'. A
cc 6 -'t C'
Under the 'provisions of the Public Disclosure Law, RCW 42.17.3 ro (I) (e), the complainant may indicate a
desire for disclosure or nondisclosure of their identity. If nondisclosure is chosen, the bottom portion of this
form will not be released to the public. Please note that if this case is filed in court, your name must be
U a�- va�- yvu dl�' IV �- a WItIlUbb III WE; Ildbu.
The City of Edmonds investigates possible violations on a complaint basis only, therefore, the name of the
person filing the complaint must be provided.
Name (please Print): 0 K *� t=-7 S A E-P-,-,- E-A, Phone: %2_5 -77-5-5yF-z-
Address: ��70 6 '2-1 F14 5v SW
P�Ie�e check one of the following boxes:
Yol
You may disclose my identity if requested. LJ You may not disclose my identity without my permission.
Signature:
Date: , 2-L-10 0
y
V%,
X
IL
q 05rr-l� Incorporated Au
gust 11, 1890
Sister Cities International — Hekinan, Japan
P
(4- -mv S.6 \ " , ;.R 1".
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS
I M 'r— 0 R Pj ff- r7 T> 0 IF 6? � 1- r,'(
W MAILING ADDRESS
Z
3:
0 t 06 1 -2 1 C-11-4 191 r-- fV r=,
!9z-
NAME
A
NUMBE
, -?-I
CITY ZIP TELEPHONE NUMBER
-) L rz Pj V fL ". Wn f3 g
t,\-/ 0 0
NAME
I'll,
TITY
ZIP I TELEPHON
STATE LICENSE NUMBER EXPIRATION DATE
T L),,2 ^1 K R`Z ,-) a-4 ��A 2 - 0
Legal Description of Property - include all easements
/_ c) IF 7 < -1 IG - / e�_ 5d
Property
Tax Account
7N
Parcel No.
L-_/'�JRESIDENTIAL PLUMBINGIMECH
,M_NEW
COMPLIANCE OR
ADDITION
COMMERCIAL CHANGE OF USE
El APT. BLDG.
REMODEL
SIGN
GF14Wn FENCE
REPAIR
CYDS. I x —FT)
DEMOLISH
WOODSTOVE SWIM POOL
F
INSERT HOT TLIB/SPA
GARAGE
RETAINING WALL/
RENEWAL
CARPORT
ROCKERY
(TYPE OF USE. BUSINESS 0 ACTIVITY) EXPLAIN:
.7
r.
r— a. r,, S ) i rc C 1--it_
NUMBER
NUMBER OF
CRITICAL
OF
DWELLING
I
AREAS e // <-
I '?(ee
STORIES
UNITS
NUMBER
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
F', L) 0 (_
) :) L'i -54-- -:, lr��
— I,,- / IN
USE
ZONE
PERMIT
NUMBER 93-07814
JOB
ADDRESS
5f771
441pga
SUITE/APT It
We$
7EGAL DESCRIPTION CHECKI
SUBDIVISION NO.
LID NO
&_,
51
IM C rE
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP,
TESCP Approved �04.A"f 0-
EXISTING —'---REQUIRED
DEDICATION (.2
RW Permit Required Q_
Street Use Permit Req-dAP
PROPOSED
Inspection Required Y45 0-
Sidewalk Requiredpj, 0
MEIER SIZE
"21
LINE IZE
NO, OF FIXTURES
w
PRV REQUIRED F-
Y ES NO 0
IEVAR14S
Z
Zis 4 0
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DATED REVIEWED BY
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VARIANCE OR CU
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SHORELINE III
SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWED PROPOSED
I
I
LOT COVERAGE
REOUI RED SETBACKS (FT.)
PROPOSED SETEIACKS (FT.
ALLOWED
PROPOSED
FRONT SIDE -BEAF.6
FRONT URSIDE BEAR,
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LOT-ARFA
REVIEW BY/-
I IDATE
SPECIAL INSPECTOR OCC&P-ANT
REQUIRED 13 YES LOAD
REMARKS
_1111RIC 108
ROGRESS INSPECTION S_ PE u
FINAL INSPECTION CREOU.IRED
0
VALUATION
e
<-%
PLAN CHECK FEE
"gla4e
BUILDING
4PI
SOURCE:
GLAZING
HEAT
):r
PLUMBING
If
Plan Check No.
MECHANICAL
ell
62 7
GRADING/FILL
213
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (cufts, sidewolks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
I
Permit Application: 180 Days
STORM DRAINAGE FEE
3'
Permit Limit: I Year - Provided Work Is Started Within 180 Days
ENG. INSPECTION FEE
30-
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
LWO harmless* the City of Edmonds, Washington, its officials,
m employees, and agents from any and all claims for damages of
PLAN CHECK DEPOSIT
cc whatever nature, arising directly.or indirectly from the' issuance
of this permit. Issuance of this. permit shall not be deemed to
waive or reduce any requirement of any city ordinance
modify,
0 nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
1 1, h acknowlecirle that I have read this application; that the
. y
'y
information given is correct; and that I am the owner, or the duly
ATTENTION
APPLIUA I IUN AVIJHUVAL
d
authorized agent of the owner. I agree to comply with city and
lal
THIS PERMIT
This application is not a permit until
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state laws regulating construction; and In doing the work authoriz-
AUTHORIZES
'r
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
ti on Insurance aria
INSPECTION
acknowledged in space provided.
TURE (OWN R OFrAGENTV DATE
DEPARTMENT
CITY OF
O"ICIA IGNA7VR1 D VE
I
4P
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A ?
EDMONDS
CALL FOR
REL
SE DA7
ATT TION
INSPECTION
IT IS UYLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-022 0
0 IIIGIr, YEL W — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
SECTION 109
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