23710 80TH CT W.PDF111111111111
7237
23710 80TH CT W
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR.
CRITICAL AREA�: ETERMINATION: E] Conditional Waiver
DISCRETIONARY PERMIT
DRAINAGE PLAN DA'
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DA
SEWER LED FEE
SHORT PLAT FILE:
SIDE SEWER AS BUILT DA
SIDE SEWER PERMIT(S)
SOILS REPORT DA
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:
OTHER:
LOT:
LID
BLOCK:
E] Study RequireXWaiver
LATEMP\DST1s\Fomis\Street File Checklist.doc
�IF70 W
PERMIT NO: 9927.
a=_ City of Edmonds
in Z"e
PERMIT EXPI. S
�14 C 9.9 C SIDE SEWER PERMIT
Address of ConstructiowkV/z2 ;��07 1�t el&o?,r 5
&) LUD #
Property Tax Account Parcel No.A?� OW1 �2",!W'
Attach'copi'es of all access and utility easements Verified and Approved b
Owner and/or Contractor:
Contractor License
Z;4ngi6 Family
0 multi -Family (No. of Units
El Commercial (No. of Units
E] Public
39,76� Building Permit
Invasio,n into City *Right -of Way: El Yes Ej<o
ARW Construction Permit.#
Cross other *.*.Private Property: El Yes f��No
*Attach legal description. and copy ofrecorded easement
Owner r contractor signWre and acknowledgement statement:
signin for this permit I certify that I have read- the City's public, handout entitled
g
Sw e
#iyde eo er Specifications, and shall comply with all'City requirements outlin &,therein.
/ 4� -e-0-
Date
W. CALL DIAL -A -DIG (1-800-42r,+75555) BEFORE ANY EXCAVATION W
R FOR INSPECTION CALL 425-771-0220 extensionW62
24 HOUR NOTICE REOUTRED FOR ALL INSPECTION'REOUESTS
NOTE: ' IF JOB SITE IS NOT READY FOR INSPECTION WHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION FEE WILL BE CHARGED.
Job Site Ready YES NO —Date:.Initial:
Partial Inspection: Date: Initial:
Date: Initial:
Partial Inspection:
FINAL INSPECTION APPROVED: Date: 'jniti�'I At-156ilfto Street File: -0
t, K.R.MIT MUSTBE POSTE0 ON. JOBSITE
White Copy: File' Gree , nCbpy: Inspdcto.r l3uffCopy:`A,plica*nt;
L;temp;bldg;forms;ssper�.iitjlg4/00
a
23710
SOTH COURT
LOT #15
2 E
45*
7)
F-I
Ld
CD
ry
(D
F-I F] F-I
2.5'
6 " C. 0.
5' DEEP
4 " C. 0.
2.5" DEEP Uj
r
.,5, 1 COLUMN
TO 14" C.O.
CITY OF EDMONDS SIDE SEWER AS -BUILT
ADDRESS: 23710 80TH COURT PERMIT
I NO: 9927
CONTRACTOR:
VIKING PROPERTIES
DATE
DRAWN: 6/7/05
HOMEOWNER:
CAJUN
DRAWN
BY: 1. ABILA
SCALE: NTS
0
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
The 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 the application to the City.
The purpose of the Checklist is to enable City staff to
determine whether any 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).
P117
L�3
Date Received:_',51 f
CityReceipt#:_ I
Critical Areas File #: _-0 003--W2_0
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant: 41-1/-03
A property owner, or his/her authorized representative,
must fill out the checklist, sign and date it, and submit it
to the City. The 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.
Please submit a vicinity map, along with the signed copy
of this form to assist City staff in finding and locating the
specific piece of property described on this form. in
addition, the applicant shall include other pertinent
information (e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant staff
in completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indeirmify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information fumished by the applicant, his/her/its agents or employees.
By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file plication qu*e behal e owner as listed below.
SIGNATURE OF APPMANTIAG DATE AZ /0
r
Property Owner's Author . ati
By my signature, I cerfi*� I e authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for e public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
SIGNATURE OF OWNER —DATE
Owner/AppUcant:
41220L�/ 1J
Name
2 1; C3 Z F -:5c�
Street Address
e;�DWOW5
city State zip
/ ' 1
Telephone: C,
Email address (optional):
AppUcant Representative:
t
Name
1 -77, / Hcio,;t IT- All;; -
Street Address
. Z--,-4&r crr—
city State zip
Telephone: 7-,572-
Email Address (optional): ohry okp-bt --,sall, cz>x�
Ciftical Areas Checklist.docG.19.2001
0
LI
City of Edmonds
Development Services Department
Planning Division
Phone: '425'771.0220
Fax: 425.771.0221
The 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 subn-dttal of the application to the City.
The purpose of the Checklist is to enable City staff to
determine whether any 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).
Date Received: 1072
City Receipt#:_ (ty `1� c)
Critical Areas File #: -700--:5 -002-i
Critical Areas Checklist Fee: $ 5.00
Date Mailed to Applicant: !6L�3 -
A property owner, or his/her authorized representative,
must fill out the checklist, sign and date it, and submit it
to the City. The 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.
Please submit a vicinity map, along with the.signed copy
of this form to assist City staff in finding and locating the
specific piece of property described on. this form. In
addition, the applicant shall include other pertinent
information (e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant staff
in completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information fumished by the'applicant, his/her/its agents or employees.
By my signature, I cer* that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file plication "e behajf,"e owner as listed below.
SIGNAnTRE OF APPLicANT/AG DATE z Zo
Property Owner's Author* ati
1,01;x
By my signature, I cer* I C authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for e public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
SIGNATURE OF OWNER
Owner/AppUcant:
42W J)/
Name
25c3z
Street Address
16�-6"JV95
city State zip
/ 7 7
Telephone: 410!;- L"( 'r
Email address (optional): ,
DATE
Applicant Representadve:
Name
-77, / Alc;4dl -rr- 4a-;;- 0/
Street Address
qT
city State zip
Telephone: 7-572- - ZeZ
Email Address (optional): )oht-,V okp-bs
Critical Areas Checklist.doc/3.192001
0
0-
City of Edmonds
Development Services Department
Planning Division
Phone: '425'771.0220
Fax: 425.771.0221
The Critical Areas Checklist contained on this forni is to
be filled out by any person preparing a Development
Permit Application for the City of Edmonds prior to
his/her submittal of the application to the City.
The purpose of the Checklist is to enable City staff to
determine whether any 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).
Date Received: V 10-72
7-7 V:.�p
City Receipt#: I
Critical Areas File#: 00z-2- I
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant-- -1/-eU
A property owner, or his/her authorized representative,
must fill out the checklist, sign and date it� and submit it
to the City. The 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.
Please submit a vicinity map, along with the signed copy
of this form to assist City staff in finding and locating the
specific piece of property described on this form. In
addition, the applicant shall include other pertinent
information (e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant staff
in completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indernnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information famished by the applicant, his/her/its agents or employees.
By my signature, I cer* that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file owner as listed below.
SIGNATURE oF ApnicANT/AG DATE
Property Owner's Authod ad
17001
By my signature, I cer* I nave authorized the above Applicant/Agent to apply for the subject land use application,
I
and grant my permission for Ve-upublic officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
SIGNATURE OF OWNER
PLEASE PRINT CLEARLY
Owner/AppHcant:
"OLJ1 'J)/
14ame I
F -
Street Address
4;6w0A4?5
city State zip
Telephone:
Email address (optional):
DATE
Applicant Representative:
11I)C41k) /
Name
177,1
Street Address
city State zip
Telephone: 1Y 7-572- -,?eZ
Email Address (optional): joht-,yj 4P-bt--�W/1,CDW,
V W
CriticW Arms Checklist.doc/3.19.2001
ILEIVO.
Critical Areas Checklist
-
--------------------------------------------- -----------
Site Information (soil s/topography/hydrology/vegetation
I .
Site Address/Location: 800-6'- 234214 S2
2.
_01:
Property Tax Account Number:
3.
Approximate Site Size (ac res or square feet):
4.
Is this site currently developed? _,��Yes; no.
If yes; how is site developed? 5,,71 6AI -Sd5- AXT7btl J/= JO,��
5.
Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Allk Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a
horizontal distance of 66-feet).
PI'A Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of
I 0-feet over a horizontal distance of 3 3 to 66-feet).
Steep: grades of greater than 3 0% present on site vertical rise of I 0-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6.
Site contains a.reas of year-round standing water: AIJA1,A' Approx. Depth:
7.
Site contains areas of seasonal standing water: Ajjt'�-_ Approx. Depth:
�J.
What season(s) of the year?
8.
Site is in the floodway Ale floodplain of a water course.
9.
Site contains a creek or an area where water flows across the grounds surface? Flows are. year-
round? NdM5� — Flows are seasonal? (What time of year?
10.
Site is primarily: forested meadow ;shrubs ;mixed
urban landscaped (lawn,shrubs etc) tQ7W t�- -7V
11. Obvious wetland is present on site:
------------ -------- ---------- City Staff Use Only�T�� -------- ------ — — --
site is ZO* ned!
.... . .... .. ...
.2 $CSmapped soil ty e(
p .... sr.
ZAT51"
... . ... . ...
3. Wetland inventory or C.A. map indicates wetland present on site1
.... .......... .
4. Critical Areas inventory or C.A. map indicates Critical Area on site�
5. Site within designated earth subsidence. landslide hazardarea?.
6.' Site on the Environmen t*ally Sensitive Areas Map?. Ma.
:bM9MKk . T . I 1 0 . N
....... &TUDYREQUIR8D:*:::::
yt ga,,z,
PlanneKT I - 151te
CONDITIONAL WAIVER
^ca_chk.doc; Rev 10/0',
G
RECE IVED
City of Edmonds JAN 0 6 ing
COMMuNiTy ssVICLS
1W. CRITICAL AREAS.CHECKLIST
The 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 whether any 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 checklist, sign and date it, and submit it to the
City. The City will review the checklist, make a
precursory site visit, and make a determination of the
subsequent steps necessary to complet6-.a,development
permit application.
Please submit a vicinity map along with the signed
copy of this form to assist City staff,in finding and
locating the specific piece of property described on
this form. In addition, the applicant shall include
other pertinent information (e.g., site plan, topography
map, etc.) or studies in conjunction with this Checklist
to assist staff in completing their preliminary
assessment of the site
I have completed the attached Critical Areas Checklist and attest that the a . nswers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
O,v's,ner/Applicant- Applicant Representative:
/ OA.IQ Vi
Name Name
Street Address
Street Address
-i)A/
1V qsal:z
&AZ
city State Zip city State Zip
Telephone Telephone
r
16141 "�
Si na
9 *e Signature
,47T
e Date
(over)
c:reception\jana\cac1.doc
OWNER/CONTPA0'fof-,j IS IjESPONSIBLE
FOR EROSION CON-T,9PI- AND DAMA E
FAMILY
IDENCE
ALL EXPOSED SURAI
BE COVERED WITHIN
MAINTAIN PLAT INSTALL&
(qq
g
A ve�-Q 7.,
aL
N
OWNER/CON TRACTOR 40�
VIKING PROPERTIES, INC. E
P.O. BOX 1034
LYNNWOOD, WASHINGTON 98046
SING&
R�SIC
23704 80Y
J
36.'!
B - -
2!
SINGLE
RESIC
23711 80th
,36.5, '
!M
TIGHTLINE
N
MATERIAL
SDR 35 p
SCH 40 C
N - 12 R
F810 HANINBLE - 1-=20-
0' 10' 20' 0.
R g: 6 Z. 1. ".V-
A W� I
PHONE : 425-670-2711 PLOT PLAN -W 2 0 2o04
BENCH MARK FOR DEVELOPMENT
THE PROJECT BENCH MARK IS THE CONCRETE
MONUMENT IN CASE LOCATED AT ME LOT 15, VIKING HOUPD, Ags cTR-
CENTERLINE OF 238TH STREET S.W. AT
APPROXIMATELY THE MIDPOINT OF THE IN SE1/4, SECTION 31, T.27N., R.4E., W.M.
PROPERTY. WATER & SEWER CITY OF EDMONDS
ELEVATION : 200.00. INSPECTIONS REQ'DSNOHOMISH COUNTY, WASHINGTON
DATUM : ASSUMED CALL 425-771
APPROVED AS NOTED
=tUBY ENrINEER51N
0 ... - I
ly -/
'jj�
Date: 4—
Lovell - Sauerland & Associates, Inc.
En&eers/Surveyors/Pla=ers/Development Consultants
e—mail: info@lsaen&ftring.com - web: Isaengineering.com
I%W 33rd Avenue T, Suite 200 Lyanwood, TA 98036 - (425)775-1591 - (425)672-7998 fax
DRAWN == DAM
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I HIGAOBURKHOLDER
ASSOCIATES, LLC
LAND USE PLANNING I CIVIL E"GINEBRING
1721 ttwMtt Avenue a suite 401 111 Everett. WA 98201
phc,rie (425)252-2826 fox (425)252-9551
LIIJ & ASSOCIATES 4862746 P.01
CA- SW
UAILY FIELD REPORT
ric'u mep. Kage Fzbl5&-T1,3
LIU & ASSOCIATES, INC. 4AO85 J. LiLl 1 of 1 6
GQOIV��)I)IiCA! Ungincering. f:f`i%,iqU:1zFiV_L (;C0106 & J:uth Sciaice VITO _S TIMOZ11 ItO 03te
26 1 1:50A 2!18/2005 F, r
1920 Kerilake Place NE I ravel Tlirr-S (Hrs) ri m—eW� I t �4 V%�fe 7at i Z 7�
Kenmore, Vfaih;ncton 98028
z 1 12.:30P
11hone:025)483-9134 Fax:(425)486-27 7C��l
ehicle Rrs on Sites Ts 12 gO ViS;t,)(S
i - - E 1.5 - -_ ___
Job Locabon Gi fit
Lots 14 through 19 - Sunrise Ridq V
80xx - 238th Stree! Sw, Gdrricinds Vlk��12M.ties
eral Ccwwaci6ir— Gler, e ra I C ontraf__-(_or_§u—peh n tanae ft -- R42CQ I vc-d Un C h;_C�—OC-15
Vikiric Pr
Ted Coleman
P _-Ri"dy
6rthwork Conlraeor E.cirthivork Contractor 9v t,— ewoived eTk,
Caw Excavating I
At the reouest by Ted Coleman with Viking Properties, I come on site to verify the footing bearing soilr, for the
houses to be built on the subject lots. At the time of my sitle visit the footing trenches on Wese lo's 1ave all been
excavated out down to the footing level.
,rt,L footing trenches over about the eastern halves of the building footprints are. cut. intc light -gray, gfave(ly, silty fine
sand, whiie the footingIs over about the eastern halves of the buildirg footprints are cut into brown silty fine sand'.
A steel T-bar manually pushed into the footing Dearing sails car. penetrate no more then a coup!e of inches into tile
p, ray grave:)v silty send, but --an penetrate up to about 8 to 10 inches into the brown silty sand
I inforrn Bob, the foreman with Viking Properties. that the loose disturbed soils pushed into the footing trenches
stiould be removed, and tne surficial brown silty fine sand in the footing trenches over about the eas�ern nvves ol ti1c,
building footprints shOU'd bre; compacted to a non -yielding state with a vibratory mechanical compactor. If the above
are done. it is my opinion that the footing bearing soils will be able to render an allowable bearing capacity of a, least
3.000 psf.
RF-CEWFED
FEB 212005
DEVELOPMENT SERVICES CTR.
WY OF EDMONDS
1) Ted Ccleman/Viking Properties
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62
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OWNER/CONTRACToR IS RESPONSIBLE
FOR EROSION CONTROL ANDIDIMA(�gj('
FAMILY b
CC) C�:
IDENCE
th COURT
ALL EXPOSED SURFACEt, TO
BE COVERED WIT_
21'37" W
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OWN ER/CON TRACTOR SCH 40 W E
MKING PROPERTIES, INC. N - 12
P.O. BOX 1034 F81 HANCOR 0' 10, 20'
LYNNWOOD, WASHINGTON 9804% RE& IVED
PHONE : 425-670-2711 S; WATER & SEWER cr-It-
INSPECTIONS REQ'D.PLOT PLAN SU 2 0 2004
BENCH MARK rX-L 425-771-0220 M 1326 FOR DEVELOPMENT SERVICES CTR.
THE PROJECT BENCH MARK IS THE CONCRETE
MONUMENT IN CASE LOCATED AT THE L 0 T 15.. VIKING HEMPTS's
CENTERLINE OF 238TH STREET S.W. AT
APPROXIMATELY THE MIDPOINT OF THE IN SE1/4, SECTION 31, T.27N., R.4E., W.M.
PROPERTY. CITY OF EDMONDS
ELEVATION : 200-00 SNOHOMISH COUNTY, WASHINGTON
DATUM : ASSUMED.
APPROVED AS NOTED
BY 81GINEERI IS
T t
D a t e; K
�ffm% Lovell — Sauerland & Associates, Inc.
Lla&eers/Surveyor3/Planners/Development Consultant3
L�E 0 e—mad: info@Liaengineering.com - web: Isaengineering.com
MOD 33rd Avenue 1. Suite 200 Lynnwood. TA 98036 - (425)775-1591 (425)672-7998 fax
DRAWN FIL
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I == I mm ] scmz 20' 1 FU No
DATE RECEIVED
F ER11IT EXPIRES
10 44�
CITY OF EDMONDS
OSE PERMIT
ZONE NUMBER Ar�A&_
CONSTRUCTION PERMIT APPLICATION
JOB SUITE/APT#
ADDRESS
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RW Permit Required
Street Use Permit Req'd
Inspectl n Required
Sidewalo Required -13W
Undergrowd
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CITY
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TELEPHONE
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SIZE
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OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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-715 1AS/0
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REMARK 1 1
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0
GARAGE RETAINING �WALL - FIRE SPRINKLER
CARPORT ROCKERY - FIRE ALARM
"E OF USE, BUSINESS ACTI XPLAIN.
CHECKED QY
I
TYPE CVf4TRUCTION
Q "DE
OCCUPANT
GROUP
U
NUMBER
OF
STORIES
I'NUMBER OF CRITICAL
DWELLING AREAS
UNITS NUMBER (:Aj\_j
o
a-C,
SPECIAL INSPE'ATION
REQUIRED
YE S
&
5KW
dqP
M
OCCUPANT
LOAD
DESCRIBE WORK TO BE DONE
(3 Cl
A
REMARKS
PROGRESS INSPECTIONS PER UBC 106/.IBC109`/IRC109 FIl`*LINSP9CTION REO'D
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N MIR U
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VALUATION
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0-escriptfon
Description
FEE
Do 044/4'
Plan'Che�k
State Surcharge
NEAT SOURCE N
jG.LAZI N�, i`LoT'6LOPE %
k- 9 -- ng�Pgrmit rg
h\ 11,hk1w A3 ,,Buildi City Surcherg:e
PLAN CHECK NO: ILf V— V T Base Fee
010 �Plumbing
Oq -?C
THIS PERMIT AUTHORIZES ONLY THE WORK Na C&--- WORKTO Mechanical 4,60-
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC 7,0%
X Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION. Engr. Review
PERMIT APPLICATION: 160DAYS
IL PERMIT LIMIr I YEAR ' PROVIDED WORK IS STARTED WITHIN 180DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFX DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
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 ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.*
Recording Fee Receipt #
I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application Is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL Building Otlicial or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknovviedged In space provided.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
1. _OFFICI&LS SIGNAT E E
SI Ej&�VbR AGENrf,/ -,.�ATf SIGNED 1A&3 7�T )
5W" . - 6. V/7nlu � A674
Lisss.p L 21
ZZE 15
771-0220 LEAffl) BY DATt
ATTENT16N M 1333
BUILDING OR STRUCTURE UNTILAFINAL
ITISUNLAWFULTOUSEORoccu4 vlm�ilvjml
_�/
INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU-
PANCY HAS BEEN GRANTED. UBC109/IBC110/IRC110. ORIGINAL -FILE YELION-INSPE R
09/03 nr%IIT-t%t% LJ A nr% %1^1 1 A IT11M 92 A WlLlf% A ^^n111=Eb PINK - OWNER GOLD - ASSESSOR