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22307 93RD PL W
ZAVALES DESIGN ASSOCIATES
-HEIGHT G& LC_ S.
1243 N.E. 152nd Street
Suite B j J. 21
Seattle, WA 98155 j
362-2992 1A
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WATER SERVICE INSPECTI01
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1243 N.E. 152nd Street
Suite B
Seattle, WA 98155
362-2992
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SDR 35 (ASTM D3034)
Cdtical Areas'Checkfist
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Site Information (Soils/topography/hydrology/ etati n)
RFCF,1V,ED
1. Site Addressft-ocatio 07
n: F
2. Property Tax Account Number: _',!57q4(S o coo 0 10005'
3. Approximate Site. Size (acres or squmare f PERMIT WATER
4. Is this. site currently developeffl —=_yes; no.
If yes; howils site developed? 00> 5+t /+/Z t1,4 qnoia_�_
5. Describe e general site topqgraphy_� Check all that apply.
g
�"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
horizontal distance of 66-feet)-
Hilly: slopes present on site of more dian 15% and less than 30% a vertical rise
of 10-feet over a horizontal distance of 33 to 66-feet).
Steep: grades of greater dian 30% present on site (a vertical rise of 10-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-mund-standing water. Approx. Depth:
7. Site conitains areas of seasonal standing water. Approx. Depth:
What season(s) of the year?
8. Site is in the floodway floodplain of a water course.
9. Site. contains a creek or an area where water flows across the grounds surface? Flowsareyear-
round? Flows are seasonal? (What time of year?
10. Site is primarily: forested eadow sh 'rubs
mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
For City Staff Use Only
1. site is Zoned?. ks - 1Y
2. SCS rnapped soil type(s)?
3. Wetland inventory or C-A.* rnap indicates vvedand present on site? A10
4;.,. -,Critical Arm inventory or C.A. nup indicates Critical Area on site? AILI
5;, within designated earth subsidence landslide hazard area?
6.. Site designated on the Environmentally Sensitive Areas Mapl
DETERMINATION
"STUDY REQUIRED
V WAIVER...
Revie we d by:
Planner
CONDMONAL WAIVER
6--- Z - 7 C
Date
A
o fu L� i n %(-J4*
-At
az
A,
'4&
90-19
"A" iy.� Iful
City of Edmonds
Critical.Areas- .4
ne Critical Areas Checklist contained on ':and M&mk it t6the City. The City wiff.._
this form is to be filled out by.any person �rcview the Checidist, malm a precursory site
preparing a Development permit visit, -and make a dftenninat��n'of the
Application for the City of Edmonds prior submquent-stePs necessary to complete a
to his/her submittal of a development devekpnent permit application_�!,.-,
permit to the City.
With a Apted copy of this form - the
The purpose of the Checidist is to enable applicant should also submit a vicinity- map --
City staff to determine whether any or plot plan for ii�vidual lots of the parcel.
potential Critical Areas are or may be with mough &tail that City. staff '6n find
present on the subject property. The ;, I
information needed to complete . the and,iden* the sWject parcel(s) In
the applicsint. shall indude,
Checklist should be easily available from - other Pertinent information (e�g. dte
observations of the site or data available at plan; topography . map,.. etc -)'or sttidrsis i; 11�
City Hall (Critical Areas invcntones, maps, coldunction vath this checkrist -to asgm.l -
or soid surveys). staff in completing thew preliminary
assessment of thesite.
An applicant, or his/her representative,
must fill out the checklist, sign and date it,
I have completed thc. attached Critical Area Checklist and atte I st that the answers provided are I
factual, to the best of my knowledge (fill out the appropriate column below)..
Owner I Applicant: Applicant Representative: V
041P
Hl 14,40_,�
Name Name
Street Address
Street Address
3
City, State, ZIP h
P P,or
one City; state,- ZI
Y ne
f7
Signature Date' :Sri Date,
Critical Areas Checklist 01
Site Information (Sbials/topography/hydrol etation)
ogy.
R F, CGE I V E D
L Site Address/Locadow-
.2.. Ptipperty Tax Acootint Number-. 6W41 -9 o 0 00 0 Iowa APR, - I
3. Approximate Site Size (acres or square
PERM.IT COUNTER
4. Is this site cuff ently developeR
—z._yes; no.
If. yes; how is site developed?_ L, 54f J+,(Z 9 [7 /1 0j,
5. Describe e generalsite topography- Check all that apply.
Flat less than 5'-feet elevation charige over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet overA
horizontal diista= of 6&.fed)-
Hilly., slopes present on ske of more than t5% and less than 30% ( a vertical rise
of 10-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-feet over a
horizontal disumm of less gm 33-feet)-
Other (please describe):
6. Site contains areas of year-round - standing water. Approx. Depth:
7. Site co�tains areas of seasonal stabdiqg: water. Approx. Depth:
What season(s) of the year?
8. Site is in the floodway —`7 floodplain of a water course.
9. Site. contains a creek or an area where water flows across the grounds surface? Flows are year-
round? Flows am seasonal? .,—' (What time of year?
10. Site is primarily: forested eadow _; shrubs mixed
urban landscaped Oawn,shrubs etc)
11. Obvious wedand is present on site:
For CKY Staff Use 0 F
1. Site is Zoned? Ll� -
2.. SCS inapped soil type(s)? .41
3. Wetland inventory or CIA. amp indicates vwetland present on site? A10
4;.>. -,Critical Arm inventory or C.A. inap indicates Critical Area on siw? Ale
5� within' designated eardi subsidence landslide haurd area? /Vu
6— Site designated on the Envimatneatally Sensitive Areas Map.
DETERMINATION
REQUIRED
WAIVER
Revic . we . d by.:
Plannner
acrOU0404
CONDMONAL WAIVER
Date
no -ti .I
.44
.1,9
90
%-ILY of Edmonds 'q "N"
J
Critical Areas Che
nc Qitical Areas Checklist contained an
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 Checidist is to enable
City staff to determine whether any
potential Critical Areas areor may be
present on the subject property. ne
information needed to complete the
Checklist should be easily available from
observations of the site or data available at
City EWI (Critical Areas inventories, maps,
or sdid surveys).
An applicant, or histher representative,
must fill out the checklist, sign and date it,
and submititto the City. -meaty will.
review the checklist, make a. precursory site
visit, and make a dcterminationof the
subsoquent steps necessary to complete a
&%VdbPMC11t. permit application-
Mr.th . fqPW copy of this form . the
applicant should also submit a vicinity inap"'
or plot plan for individual ko—ts of the parcel.
with enough ditail that City staff can find
and Wen"y the sWjcct parcel(s). . Ik
addition, the applicant shall include
othw pertinent infomation (eg. site
plan, topography nup, etc.) or studries in-
conjunctim With this Checklist to asdA - -
SW in completing their prelitninary
assessment of the�site.
I have completed the, attached Critical Area Checklist and attest that the answers provided am
factual, to the best of my knowledge (fill out the appropriate column below)..
Owner/ Applicant: Applicant Representative:
'Nam ?
S(red Address Address
City, State, ZIP ...4 -:.Phone'..' —7
city; state. ZIP Phone
j V,;f�0
— ---------------
-174 Z,
-,r Date
PLANNING DATA
NAME: Z
SITE ADDRESS:-7-Z$07 DATE: -7- q- V&/
-130
ZONING: —PLAN CHK#: 16 .
PROJECT DESCRIPTION:
CORNERLOT A10 -(Yes/No)
SETBACKS:
Required Setbacks:
Front: 7- 3_ Left Side: 7 Right Side:774e_ Rear:
Actual Setbacks:
Front: 10 Left Side: '37 -2 Right Side: 10 Rear:
Street map checked for additional setback required? 0 Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED Al- (Y/N)
LOT COVERAGE:
Maximum Allowed: 3 F Actual:
BUILDING HEIGHT: I /
Maximum Allowed: 5- Actual Height:
Datum Point: SA'1-/ 'Fe,(e,e4,-e' Datum Elevation: 3 _71- 52
SUBDIVISION:
CRITICAL AREAS #: q6 H
SEPA DETERMINATION:
LOT AREA: U-11
OTHER:
Plan Review By:— .4;j �_ &
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ZAVALES DESIGN ASSOCIATES
1243 N.E. 152nd Street
Suite B
Seattle, WA 98155
362-2992
MILT ZAVALES,,MAME AWARD WINNER
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CITY OF EDMONDS
USE
ZONE PERMIT
NUMBER
CONSTRUCTION PERMIT APPLICATION
JOB SUITE/APT
ADDRESS
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LEGAL DESCRIPTION CHECKI
SUBDIVISION NO.
LID NO,
MAILING ADDRESS
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCP Approved 0
CITY ZIP
TELEPHONE NUMBER
EXISTING — REOUIRED DEDICATION
AW Permit Required 11
Street Use Permit Req'd 0
orell &'133.15W
.-,J,;L30
PROPOSED
Inspection Required 11
Sidewalk Required 0
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NAME
L)
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REOUIRED
YES 11 NO 0
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ADDRESS
REMARKS
CITY Z, P-7
PHONE NUMBER
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CITY ZIP
ELEPHONE NUMBER�
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STATE LICENSE NUMBER 'EXPIRfTION DATE
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PROPOSED
COMPLETE
Legal Description of Property - include all easement§
1EXEMPT
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DATE
SETBACKS —FEET
HEIGHT LOT
COVERAGE
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Property
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/Parcel No.
REMARKS
NEW RESIDENTIAL PLUMBING.
ADDITION' COM MERCiAL'- E] MECHANIC'ALI'�`
APT BLDG
1:1 REMODEL 0. SIGN
CHECKED By
TYPE.,OF. CONSTRUCTION ]CO
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OCCUPANT
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REPAIR C). M FEN E,
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DEMOLISH WOODSTOVE, SWIM POOL .
F INS ERT-, . .. 11, HOT TUB/SPA
FGARAGE RETAININ'G WALL/
ICARPORT
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SPECIAL INSPECT OR
REOUIRED
0
AREA
OCCUPANT
LOAD
REMARKS
PROGRESS INSPECTIONS�PER;UBC`305,'
El ROCKERY RENEWAL
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(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
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NUMBER
NUMBER OF
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STORIES
DWELLING
UNITS
-AREAs-,`
INUMBER ;y(p
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
FINAL.INSPECTION REQUIRED
VALUATION
FEE
PLAN CHECK FEE
BUILDING
HEATSOURCE
7AZING
0/6
PLUMBING
Plan Check No.
96' 3P
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
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE F EE
.
ENG. INSPECTION FEE
'Applicant, on behalf of his or her spouse, heirs, assigns and
w
2
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
m
tr
<
7:
�j
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
modify, waive or reduce any requirement of an, city ordinance
nor limit in any way the City's ability to enforce any ordinance
provision."
PLAN CHECK DEPOSIT
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 T.his 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.
SI NATUR to /NER OR AGENT), ED DEPARTMENT
% CITY OF OFFICIAL'S SIGNATURE DATE
L
EDMONDS
RELEASED BY: DATE
CALL FOR
ATTENTION 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
102-V
21
777 '7-,
JUL 3 1996
ENGINEERING
3E PERMIT
ZONE
CITY OF EDMONDS /�, ��, - e NUMBER 9GO423
CONSTRUCTION PERMIT APPLICATION jos SUITE/APT #
E NAME/NAMEOFBUSINF& ADDRESS
0 _07 9, k W
VrN-1,4jZk1 (�00'S-4r) fC'-r)6)1 f* LEGAL DESCRIPTIONMCHIECK SUBDIVISION NO. LID NO.
Cc
LU MAILING ADDRESS 411A
Z
/4. 7— PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
3: TESCP Approved 0
0 d 0
ZIP ELEPHONE NUMBER RW Permit Required 0
EXISTING REQUIRED DEOICATION Street Use Permit Req'd 0
d -dd 3�) inspection Required
6. PROPOSED Sidewalk Required 0
NA
XTURES PRV
METEjR S]fE LINE SI NO. OF FI REQUIRED
"Al, , /11 1
i 1� YESVNO 0
ADDRESS I / 1 (9
REMA RKS Z
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w ZIP 17 E NUMBER V "KI
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ENGINEERING MEMO DATED REVIEWED BY
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ZIP TELEPHONE NUMBER
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L) STATE LICENSE NUMBER EXPIRATI TE
SIGN AREA SEPA REVIEW ADB NO.
ALLOWED PROPOSED COMPLETE EXEMPT
Legil —Description of Property - include all easements SHORELINE#
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EXP
VARIANCE OR CU PLANNING REVIEW BY DATE
LU
C3 SETBACKS — FEET HEIGHT jL6T COVERAGE Le
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FRONT SIDE REAR Z
Property 5
j REMARKS Q.
Tax Account �7, 44
Parcel No.
FVI KA
NEW RESIDENTIAL LC!� PLUMBING
ADDITION COMMERCIAL LICI MECHANICAL
ElREMODEL APT. BLDG. El SIGN CHECKED BY ITYPE OF CONSTRUCTION CODE OCCUPANT
[—] FENCE 9,(/ GR07:7
-RAM CYDS. x _FT)
El REPAIR r
WOODSTOVE SWIM POOL SPECIAL INSPECTOR AREA OCCUPANT
DEMOLISH INSERT El HOT TUB/SPA REQUIRED LOAD
ARAGE RETAINING WALL/
KCA El ROCKERY El RENEWAL REMARKS
Z
0 1 EXPLAIN: PROGRESS INSPECTIONS PER.UBC 309 0
(TYPE OF USE, BUSINESS OR ACTIVITY _j
Ix
N MBER OF CRITICAL
NUMBER
93 OF DWELLING AREAS
co STORIES -2- 1 Uu,TS NUMBER
DONE (ATTACH PLOT PLAN) W
0
DESCRIBE WORK TO BE
F -74,
n) t-.,q FINAL INSPECTION REQUIRED
VALUATION FEE
PLAN CHECK FEE
BUILDING Aj 6) -3 0 -7&;g
H5,AT SOURCE: GLAZING
% PLUMBING
MECHANICAL
Plan Check No.
This Permit covers work to be done on private property ONLY. GRADINGIFILL
Any construction on the public domain (curLs, sidewpiks,
driveways, marquees, etc.) will require separate permission. STATE SURCHARGE
Permit Application: 180 Days
STORM DRAINAGE FEE
F rmit Limit: I Year - Provided Work Is Started Within 180 Days
e
ENG. INSPECTION FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
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
a: 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
" 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."
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 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.
tion Insurance and RCW 18.27. INSPECTION
A (0
I TU'�7 NER ENT) DATE GNED DEPARTMENT OFF!�I DATE
CITY OF 4 '.
j
EDMONDS. I - 711�1
RELEASED%Y- DATE
CALL FOR C.- -
ATTENTION INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPRQVAL OR ORIGiN'AL — File YELLOW — Inspector
771-0220 U
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC -
CHAPTER 3. PINK — Owner GOLD — Assessor
USE PERMIT
CITY OF EDMONDS ZONE NUMBER 9r.0423
CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT #
E NAM
0 E/NAME OF BUSI ADDRESS
0/ ff e C7?(7 j".1 LEGAL DESCRIPTION CHECKI SUBDIVISION NO. LID NO.
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3: � ��, ? d PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved 13
0 .. ZIP TELEPHONENUMBER RW Permit Required 0
9T1Y 771 EXISTING 60 REQUIRED DEDICATION Street Use Permit Req'd 13
I rev Inspection Required 430
PROPOSED
N4MJ Sidewalk Required 0 cc
PRV REQUIRED
Z
14
METER S1,7-,E LINE SI)I)
0 YESXNO 0
u, ADDRESS
43 AJE REMARKS
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cc TELEPHONE NUMBER vw!�c-111.x, d w
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NAME
cc ADDRESS ENGINEERING MEMO D�ATED REVIEWED BY
0
cc CITY_ ZIP TELEPHONE NUMBER
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Zcc
0 . 5 U-
STATE LICENSE NUMBER EXPIRATI N DATE
-1k 0 716 6- 7? SIGN AREA SEPA REVIEW ADB NO.
-------- PROPOSED COMPLETE EXEMPT
Legal Description o.f -Property - include all easements SHORELINE 0
Z EXP
0. VARIANCE OR CU PLANNING REVIEW BY DATE
(r
W
SETBACKS — FEET HEIGHT LOT �OVERAGE Z
Z
REAR
FRONT SIDE
u. Property REMARKS a.
y Ta Account
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NEW PLUMBING
RESIDENTIAL svi
ADDITION COMMERCIAL LL'i MECHANICAL
REMODEL APT. BLDG. El SIGN Is
CHECKED BY TYPE OF CONSTRUCTION CODE OCCUPANT
F-� GROff FENCE 9,(/ GROUIr,
El REPAIR CYDI. El x _Fn
WOODSTOVE SWIM POOL SPECIAL INSPECTOR A EA OCCUPANT
FIDEMOLISH INSERT HOT TUB/SPA LOAD
REQUIRED
0 YES
WARAGE RETAINING WALL/
CA ROCKERY RENEWAL REMARKS
Z SS INSPECTIONS PER UBC 305
0 EXPLAIN: PROGRE
(TYPE OF USE, BUSINESS OR ACTIVITY _j
al
NUMBER NUMBER OF
Lu 'WEL No CRITICAL
0 OF LI AREAS cj
00 STORIES -2 t ; INUMRER / " �. d
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
fr-1) C-1- SA I y- I -A I i_,� FINAL INSPECTION REQUIRED
VALUATION FEE
PLAN CHECK FEE
BUILDING
H9AT SOURCE: _F5G_L�AZINIG % PLUMBING Auk
Plan Check No. MECHANICAL
This Permit covers work to be done on private property ONLY. GRADINGIFILL
Any construction on the public domain (curbs, sidewelks,
driveways, marquees, etc.) will require separate permission. STATE SURCHARGE '5 0
Permit Application: 180 Days
STORM DRAINAGE FEE
13 rmit Limit: I Year - Provided Work Is Started Within 180 Days
e
"Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE
cn Successors in interest, agrees to indemnify, defend and hold
ow 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
< PLAN CHECK DEPOSIT
X of this permit. issuance of this permit shall not be deemed to
0 1 any city ordinance
modify, waive or reduce any requirement o
0 nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE
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 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 T . his application is not a permit until
signed by the Building Official or his/her
ed 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 Deputy; and fees are paid, and receipt is
acknowledged in space provided.
I n
La
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s' a
ed
Co
tion Insurance and RCW 18.27. INSPECTION
I DEPARTMENT
S ZUREJOWNER OR AGENT) DATE/
I OFFIC "SIO&WWE DATE
CITY OF
EDMONDS.
CALL FOR I rASrn BY:,,, DATE
ATTENTION INSPECTIO'N
NLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
IT IS U
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPRQVAL OR ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC 771-0220 _j
CHAPTER 3. Ai� PINK — Owner GOLD — Assessor
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