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Critical Areas Checklist
--------------------------------------------------------------
Site Information (soils/topograp'hyAlydrol.ogy/Vegetation)
1. Site Address/Location:
2.
3.
4.
5.
Property Tax Account Number: 5 n n n -
,�pproximate Site Size (acres or
Is this site currently developed? t
If yes; how is site developed? f--,
4. 4M
�j
"Describe the general site topography. Check all that aDDIV.
,4-.e a )
Flat: less than 5-feet elevation change over entire'site. c- ox- po rAr
Rolling: slopes on site generally less than 15% (a vertical rise of I 0-feet over a
horizontal distance of 66-feet).
IS Mct ( Hillyi slopes present on site of more than 15% and less than 30% ( a vertical rise of CLiJ0'L
I 0-feet over a horizontal distance of 3 3 to 66-feet). 4Ngog4w (30 f- �- 0 e,
Steep: grades of greater than 3 0% present on site,(a vertical rise of I 0-feet over a
horizontal distance of less than 33-feet).
-_ . Other (please describe):
6. Site contains areas of year-round standing water: k) 0 Approx. Depth:
7. Site contains areas of seasonal standing water: ri fl) Approx. Depth:
What season(s) of the year?
8. Site is in the floodway E3 n 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 are seasonal? �j -7) (�s ltvf YOX �Y—)
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10. Site is primarily: forested meadow A s mixed
urban landscaped (lawn,shrubs etc) _X
11. Obvious wetland is present on site: o
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CA FILE NO
Critical Areas Checklist
--------------------------------------------------------------
Site Information (soil s/topography/hydrology/vegetation)
I Site Address/Location: a
2. Property Tax Account Number: 5 11 L - OC)n - O(O!R - nffl�
3. Approximate Site Size (acres or Csquare feeg�
4. Is this site currently developed? A�yes; no.
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
�Ys. - Flat: less than 5-feet elevation changeover entire site. ca_c-eor�
Rolling: slopes on site generally less than 15 % (a vertical rise of I 0-feet over a
horizontal distance of 66-feet).
�S Mt,,tA( Hillp slopes present on site of more than 15% and less than 30% ( a vertical rise of ca'I'C-6%
10-feet over a horizontal distance of 33 to 66-feet). d _'A-r P0 r
('k!' s.
Steep: grades of greater than 3 0% present on site (a vertical rise of I 0-feet over a C'-c Pr0PQX'k-'
horizontal distance of less than 33-feet),
Other (please describe):
6. Site contains areas of year-round standing water: k) 0 Approx. Depth:
7. Site contains areas of seasonal standing water: (1 6 Approx. Depth:
What season(s) of the year?
8. Site is in the floodwav n n floodplain h C) of a water course,
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? 6a '0 Flows are seasonal? 11 o (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site: 0
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DETERMINATION
-ca_chk.doc; Rev 10/03/97
RECEIVEP
MAR 2 3 1998
City of Edmonds COMMUNITY SERVICES
lkw 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 pdar-jo 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 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 assist staff in completing their preliminary
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:
L a'(- U *
Name Ili
r-a H ("', -�'C� - -� 9 t-�) � � , W ,
Street Address
L8 ron Y-�
city State Zip
H,�5 - D -� � — � a-7
Telephone
on-7�c�j -a
Signature
3—X—Qc;�
Date
c:reception\jana\cac1.doc
Applicant Representative:
Name
Street Address
C ity State Zip
Telephone
Signature
Date
(over)
-'.n C. 1 S913
March 26, 1998
Gary & Bonnie Nord
24025 79th Place West
Edmonds, WA 98026
CITY OF EDMONDS BARBARA FAHEY
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221 MAYOR
COMMUNITY SERVICES DEPARTMENT
Public Works e Planning/Building - Parks and Recreation * Engineering e Wastewater Treatment Plant
Subject: Determination regarding Critical Areas Checklist # 98-83
Dear Applicant:
Enclosed please find a copy of the Critical Areas Checklist you submitted. The "DETERMINATION" reached by the City
is located on the reverse side of the form (bottom of page).
It is very important for you to retain a copy of this Critical Areas Checklist "DETERMINATION" for your records.
............... ............. . .......... - .........
.... ... . . . ..... .........................
.......... ................ ............................
........ ...
.............. -'��IMPORTANTIN .0 . .... I . .. .....
. ...... .........
N
...........
. ... I ......... MA 7 Q�BE
..................
........................
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTAL CHECKLIS OR CRITICAL AREAS STUDY.
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
010. You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL .4111111111
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
Building Permits
Conditional Use Perrnits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Enc: Critical Areas Determination
* Architectural Design Board
C:Reception�Jana\CRLTR.doc
Thank you.
Sharla Graham
Acting Planning Secretary
0 Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
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SURVEY FOR
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This ts to certify that this is a true and accurate survey of
ji. HAJV C Lots 6,7 and 8, Mathay's Addition Ho.2. Recorded
40 VIA$ In Volume IS of Plats. Page 48, records of Snohomish
County, Washington.
Notej Bearings and Distances = Plat
M - Measured
P - Plat
At L)"W5 and that stakes nave been placed as indicated hereon. 0 - Re -Bar
CONT114ENTAL ENGINEERJNG CO. - monu-iont
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CITY OF EDMONDS
250 - 5TH AVE. N. * EDMONDS. WA 98020 - (206) 771-3202
COMMUNITY SERVICES:
Public Works * Planning e Parks and Recreation * Engineering
September 11, 1990
Mrs. Gary Nord
24025 - 79th Pl. W.
Edmonds, WA. 98020
Dear Mrs. Nord:
LARRY S. NALIGHTEN
MAYOR
PETER E. HAHN
DIRECTOR
��,j � /, /f 0
I appreciated your letter of August 29, 1990. Contrary to your
assumption, neighborhood traffic safety is high on my list of
priorities and I am always interested in having citizens share their
concerns with me.
As you may know, the City of Edmonds is meeting with residents in the
area between 236th St. S.W. and 240th St. S.W., from 76th Ave. W. to
Highway 99, in an attempt to solve some of the problems in the area.
These problems include truck traffic, vehicle speeds, and pedestrian
safety.
Your proposal for gravel walkways has merit from strictly economic
perspective. However, gravel walkways are not cost effective to
maintain. They also become used as parking strips by residents, which
defeats the original purpose -- to keep pedestrians from walking in the
roadway. The City of Edmonds typically constructs walkways on streets
by building a 611 extruded concrete curb, backfilling with 411 of gravel
and then placing 2" of asphalt to create a raised asphalt "sidewalk"
that provides an all-weather surface for pedestrians and a physical
barrier to separate them from motorists.
I do recommend that you watch your neighborhood for notices of meetings
and certainly do not hesitate to contact me with your individual
concerns. Together, City staff and citizens should be able to solve
problems to obtain mutual satisfaction.
Thank you for sharing your concerns with me.
Very truly yours,
G RDON C. HYD4EE'
Engineering Coordinator
GCH/sdt
GARYNORD/TXTST530
Albert:t'
9 Incorporated August 11, 1890 a
Sister Cities International — Hekinan, Japan
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ARA S
T T T rt E APPR BY /P�ANNING
PLANNING DATA
NAME:
SITE ADDRESS: DATE:
ZONING PLAN CHK#:
CORNER LOT_/� (Yes/No) FLAG LOT & (Yes/No)
SETBACKS:
.Required Setbacks:
Front: �� LeftSide: & RightSide: 7 �4' Rear:
Actual Setbacks:
Front: %9 Left Side: /6 Right Side:_-�� Rear:
Street map checked for additional setback required? (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED (Y/N)
LOT COVERAGE:
Maximum Allowed: A
ctual:
BUILDING HEIGHT:
Maximum Allowed: 1zW Actual Helght:_
Datum Point: Datum Elevation-
A.D.U. CREATED?:
SUBDIVISION:
CRITICAL AREAS #:
SEPA DETERMINATION: W
LOT AREA: q'50
Plan Review By:
c.Ta1es\perTnitkAp1andALdoc
APPLICATION
for
I bw Nw- SIDE SEWER PERMIT
The City of Edmonds', 1
OUTSIDE �F, INSIDE 0 REPAIRS [I I- / 12 /OF
?00
OWNER..... .......... /j ................ Az�-� ........
HOUSE No. . . .....
.. ..................................
CARDNo . ............... ..... . .. ...... ...
EASEMENT No . ........................ ...... ............
CONTRACTOR ..... ............ ......... cc-) .................... ............... PERMIT No.
STREET I
AVENUE LOT No . ......... 7 .......................................................... .. BLOCK No . ............... ............. .
NAME ADD ... ...... xlalelA� 2, Qf
.................. ............. . .......... .......................... ... ...... I ................. ...... ........ i
,f fi;-/
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7Z
7 1?
Date 7� Approved:
BACKFILL WORK ORDER ISSUED ............................................ DEPOSIT, $ ....... ........ ;r ......... ...........
SEWER WORK ORDER ISSUED ................................................ DAT ..... .. BY
NOTICE:
No warranty of accuracy.
The information shown on the attached
map(s) was compiled for use by the City of
Edmonds,, its Employees and Consultants.
The City of 'Edmonds does not warrant the
accuracy of anything set for ' th on these
map(s). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
the -map(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may'not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
emp-l-o-yee-s o-r officers sh-a-111 be [ia-bl-e for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
CITY OF EDMONbs
CONSTRUCTION PERMIT APPLICATION
USE
ZONE PERMIT
NUMBER 4t
joe SUITE/APT #
ADDRESS 0
-N4-4,, P]
OWNER NAME/NAIVIE OF BUSINESS
rA a iz, N� C-A
LEGAL DESCRIPTION CHECK
7, lk__
SUBDIVISION NO.
7
LID NO.
u)
Z
MAILING ADORE
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING REQUIRED DEDICATION All
PROPOSED
TESCP Approved Aj 1.4 0—
RwPermilRequiredA/, 0
Street Use Permit Req'dlVO
Inspection Required/V 11
Sidealk Required �J;,' 0 Cc:
CIT ZIP
e-1, 9961026
TELEPHONE NUMBER
77q-1,11
NAME
-a e-
METER SIZE
LINE SIZE
NO. OF FIXTURE�T
W
PRV REQUIRED
)0
0
Q
ADDRESS
REMARKS Z
cr
CITY ZIP
TELEPHONE NUMBER
NAME
cc
ADDRESS
ENGIN7ERING METO DATED
REVIEWED BY
0
ITY ZIP
C CT,
TELEPHONE NUMBER
STATE LICENSE NUMBER EXPIRATION DATE
Legal Description of Property - include all easements
VAREOR
T - 24yu I,
ADB
__.
SHORELINE
SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWEO� PROPOSED
I
L2 I
'04AX,
EX
LOT COVERAGE
REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS (F5
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT UR SIDE REAR
�
,ser �11 It
tpl./ � /11!�,
y
17
I
Propetty
Tax Account
Parcel No.
0
LOYREA
L
�9_
ING REVIE y
!Z
_4
REMARK
REMARKS
S
F NEW RESIDENTIAL PLUMBINGfMECH
COMPLIANCE OR
FIADDITION COMMERCIAL CHANGE OF USE
-7
191
APT. BLDG.
igREMODEL El SIGN
HECKED BY
TYPE OF CO, J;AUCTI N
COD
GRADING FENCE
E] REPAIR CYDS. x —FT)
DEMOLISH WOODSTOVE SWIM POOL
INSERT HOT TLIB/SPA
RETAINING WALL/
El
S C,
SPECIAL INSPEC OR
REQUIRED
U
13
-AREA
REMARKS
IRC 0 ROCKERY RENEWAL
ZI
P
PROGRESS INSPECTIONS PER UBC 108
(TYPE OF USE. BUSINESSOR�AQTIVITY)-EXPLAIN:
NUMBER NUMBER OF CRITICAL
OF DWELLING AREAS
STORIES UNITS I I NUMBER
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) . I
FINAL I
PLAN CHECK FEE
BUILDING
HEAT SOURCE:
GLAZING
%
PLUMBING
Plan Check No.
MECHANICAL
/0,
This Permit covers work t6 bd-done on privatd property ONLY.
GRADING/FILL
Any construction on the public domain (curbs, sidewolks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Pennit 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
,n successors in interest, agrees to indemnify, defend and hold
'Wn harmless the City of Edmonds, Washington, its officials,
m employees, and agents from any and all claims for damages of
cc
whatever nature, arising direbtly 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
:r nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
I hereby acknowl;dge that I have read this application; that th e
*
information given is correct; and that I am the own ' er, or the duly
ATTENTION
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
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
tion Insurance aria RCW 18.27.
INSPECTION
DEPARTMENT
SIGNATURE JOWNER OR AGENT) DATE SIGNED
CITY OF
EDMONDS
I -Al I FOR
REQUIRED
MMT=
LOAD
7
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his/her
Deputy; and fees are paid, and receipt is
acknowledged in space provided.
9�LjyffbNAT,61%E17
VATE j
LEA
1 111
ATTENTION INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVALj'OR ORIGINAL File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTEP! 771-02-20
BC r
SECTION 109 /0 1*4� PINK — Owner GOLD — Assessor
a
Z
a
_j
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
CAA-1 -f &IVA) It 11J D P— '0
MAILING ADDRESS
2 401S 7a P t L'
CITY zip TELEPHONE
E:P/yl olv'o 5 CIL
NAME
ADDRESS
CITY
NAME
5 r-- L F
ADDRESS
CITY
STATE LICENSE NUMBER
ZIP I TELEPHONE
C (f
ZIP I TELEPHONE
-C- (_
CHECKED BY
PROPERTY TAX ACCOUNT PARCEL NO.
I 1 (0
()00 0 C) 43 00
NEW
V"R)SIDENTIAL
PLUMBING MECH
ADDITION
/Ei—C OMMERCIAL
o
COMPLIANCE OR
CHANGE OF USE
4 MODEL
0 APARTMENT
SIGN
REPAIR
[3 GRADING
CYDS
0
FENCE X FT)
I
DEMOLISH
TANK
OeToHEjR)0 i F� T
[3GARAGE
CARPORT
E:] RETAINING WALL
OCKERY
&NhS1AA4 AV#"
WAL
(ME OF USE, BUSINESS OR ACTPATY) EXPLAIN:
1% L4 I— -T I
�3 (4 A /00 S 6--
NUMBER
NUMBER OF
CRITICAL
OF
DWELLING
AREAS
STORIES
UNITS
NUMBER
DESCRIBE WORK
TO BE DONE
F 1AJ) f, H
vA / 5 7j1V( , 0 e) --n
PERMIT EXPIRES
USE PERM'T
ZONE V=14�2 NUMBER
JOB —11 SU #
ADDRES82 Q C) Z :�j
L
PLAT bimmugbivislObl NO.
LOT NO.
LID NO.
LID FEE S
TESCP Approved
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
RW Pwft Required
Sftd U" Pwmk RWd
EXISTING - PROPOSED
inspection ReqLdred
Sidewalk Requhred
REQUIRED DEDICATION- Fr -
underiltmond
WIMU required
METER SIZE
LINE SIZE
I
NO.'LOF FIXTURES
I
P& REQUIRED
YES [3 NO C3
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
ENGINEERING
FIRE REVIEWED BY
REVIEWED/DATE
DATE
a
z
I
z
z
I
rL
VARIANCE OR CU
v-qg .0
SHORELINE OR ADB#
INSPECTION
REO'D
E3 YES (3 NO
I PBOND
OSTED
SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWED PROPOSED
EXP ,
I
,
LOT COVERAGE
REQUIRED SETBACKS (FT)
PROPOSED SETBACKS (Fr)
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT LIRSIDE REAR
PARKING
RE0`D I PROVIDED LOT
I
A PLANNING REVIEWED BY DATE
ARE I
o
CHECKED BY I TYPE OF
SPECIAL INSPECTOR JAREA
REQUIRED [] YES I
OCCUPANT
GROUP 0
OCCUPANT
LOAD
REMARKS I
PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION RECID
VALUATION $1
in
r
Descriptio
FEE
De4riptlon
FEE
PI an Check
HEAT SO GLAZING`�'% LOT SLOPE %
x I s r iu`RtCEd F q .1
Building
PLAN CHECK NO: VESTED DATE
Plu
THIS PERMIT AUTHORIZES OM Y THE WORK NOTED. THIS PERMIT COVERS WORK TO
t BE DOME ON PRIVATE PROPERTY ONLX MY CONSTRUCTION ON THE PUBLIC
Grading 001m
Recording Fee
23 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MMQUEES, ETC.) WILL REQUIRE
t SEPARATE PERMISSION.
Engr. Review
City Surcharge
PERMITAPPLICATION: 180DAYS
CL Plifjjq�UIIAM I YEAR - PROVIDED WORK is'STARTED WITHIN 180 DAYS
Engkinspectloo..
State StrchargiP 4,,,s 0 -
SFAE BfCK OF PINK PERMIT FOR MORE INFOR11115TIbb!
-
Teaffi6 Mitigat on
Plan Chk Deposit
- T. ON HALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
'APPLICAN_
IN INTEREST AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
a EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
Receipt #
I-�%-ALL..CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALI. NOT BE
Fire Inspection
A
Total Amount Due
Fill
-.-:
V
9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CrTTS ABILITY TO ENFORCE ANY ORDINANCE PROVISIOINL�
Landscape Insp.
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORREC`11 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 --CALL
Ibis application Is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
Building Official or his/fier'Deputy: and Fees are paid, and
FOR INSPECTION receipt Is acknovAedged In space provided.
WORKMEN'S AND RCW 18.27.
,P"SATION INSURANCE
0 IG E DATE
SIGNATURI (OW G NT) DA IED/
7 slab
QA
142
1-5)
771-0220
DAfE
.
ATTEN1'ION
EXT 1333
IT IS UN LAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
7/t�
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI.
11'_—'�RIGINAr F14-1' YELLOW !INSPE6TOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER - GOLD - ASSESSOR
V/
10/01