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322 MAIN ST.PDF11111111111111 14158 322 MAIN ST C E I V E D' S E P 8 — 1998 STREET USE PERMIT APPLICATION a SEP 0 ENGINEERING NAME OF APPLICANT: MWPI67TA I- BAOCK VAJI<kr PUBLIC WORK NAME OF BUSINESS: LMAIOM.) &MK6 =C, MAILING ADDRESS:8,3q 1Z LK JR WO TAWWft: c ?6qos- CONTACT PERSON AND PHONE ADDRESS OF PUBLIC USE: Describe the public place or portion of public space to be utilized: Specify the type of use desired: Specify the length of time for use: —MIZIDOL60 3-'-/ -H9S --C9XTt LL 3--q WA29 NOTE: The issuance of this permit is understood by the applicant to be Ofa temporary nature and that no vested right is granted INDEMMYT.- The applicant understands and by hislher signature to this application, agrees to hold the City of Edmonds harmless from any injuries, damages or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the applicant or the City of Edmonds, or any of its departments or employees, including but not limited to the defense or any legal proceedings including defense costs, court costs, and attorneyfees by reason of granting this permit. In addition, the application understands that the City shall be provided a Certificate of Insurance to indemnity and hold harmless the City of Edmondsftom all claims andlorproperty damage, and naming the City ofEdmonds as an additional insured CODE APPLICATION: By signing the application below the applicant warrants that s1he has read or had the opportunity to read Chapter 18 of the Edmonds Community Development Code and s1he understands that all terms of the adopted ordinance are incorporated herein as ifsetforth lin full and this application andpermits therefore are subject to the terms of that Chapter. Struseho.doqj1g6/98 SIGNATURE OF APPROVAL FROM ABUTTING PROPERTY OWNERS When applicable, if the street use proposal directly impacts any adjacent business or private property owner 40 the applicant must obtain written approval from the affected parties. Note, this requirement is evaluated by City Staff and, w.Ln required, the applicant will be notified. Signature Address Signature Address Signature Address ign S ature Address DO NOT WRITE BELOW THIS LINE --FOR CITY. USE ONLY Planning Division Approved .-C—L Public Works Approved B Date Fire Department Approved B Date Police Department Approved B Date Certificate of Insurance Verified By Engineering Division Approved B_ V Bond Date 9 � 0, 9 ;f Remarks or Comments: STREET USE RELEASED B BUILDING PE Struseho.docj1g6/98 L4� c7e WALK LEEM t� o v,-F t4 rz-L E-;\t A-n oo \1 i F_ W Yo 11 � 1'- 6 0 MINIAft- M I I M M I FP-ON'T OF AWWstYA TO C-0 IZ6 04 Mo M BA_UX= -To Cufa -jail i—WISHINGTONTent & Awning Inc. r.. I 824-C M. L. King Jr. Way Tacoma, WA 98405 (253) 54 Title rLF_VA7T1(.)0/S1DF_ VIEW 7 COM VZ-se- 01 F- 11 1 5�-ALf : i � Z-0 f p to-lo 4&-C;, TO q14 C> MAIN =..->T. EDMONADS, WA �pj Er4-T1ZAf4(-L U:� F .119 ID To C-L)R15 LAMP F05T -me*. A FPO" AWtAlrA" 'RU-04E.4Z: LtX-A-TIDO X SHINGTONTent & Awning Inc. Title PLOT PLAti F:ti>- 10- Compan 824-C M.L.KingJr.Way Tocoma,WA98405 (253)57 a, 2&37 lzo5e e>uc;� VRAvild L/ ye, L4� CM WALK LINF-L -- A— I I (e;;rfZ9e:-r') GlZOur40 (,�F-L I 1 .1 1 <— Y � Nl- W ? Ll'- I C) I F;ZO NT 0 F AW W I -ro C-0 IZ15 To 1�0<CrO F-Le-VA-noo viF—W ye,"= i 1-6f W SHINGTONTent & Awning Inc. 824-C M. L. King Jr. Way Tacoma, WA 98405 (253) 54 I f% 0 -gol 14 4 Title C;LEVA-MDO/S I De \1 16W COM iN 7 Me, F-.>L)C> , TO cuas MAIN 1�7r. W A 1p PF2,opf _TZ-f;� L-I NE. 3 1-9 LAKAP P05T k 16 To C-ulze, 11 LOWE Ir =47 VF71 WYPRAW7 A FROM AWOINL. lft-/--o4E.4Z� LOLA-TIDO Title -T FtAt-4 ASHINGTONTent & Awning Inc. PLO Compan WAO 824-C M. L. King Jr. Way Tacoma, WA 98405 (253) 57M37 1Z05e e>UC> v I is —9-f --2! NEW Lj� Pe WALK LvIF-L J4-IDYZ F V-0 t-tT 0 F A W ro CA.> IZ6 MO M 15.1-VG To e-tif a t� 0 <j 14 E-L EV A--n 00 V I C- W *) " = It- 6' A TI M AA I I - 710, 3, 14- 4 MM no. Title PA-M% HINGTONTent & Awning t,�LF-VA-TI(D(,J/SIDE VIEW Z)-It-qb COM EN: S 824-C M. L. King Jr. Way Tacoma, WA 98405 (253) 5*37 rzrL E5L) C> lw� K�E-5 lop, 5c,ALf—: C � Z4C5 140'—C;' ADMESS: TO f_uszs MAIN '�Fr. Nlo C> 1p PFOPF—TZW L-1 WE. 0 i Uj- .rReE LAMP 170ST 3 k' IC5 ro C-Ulze' L*Aj '9 .5 (OF -WALK At N '-:�'$T IIJ ek," FP 0 AM-AINL, 'REo(—(:)qE.4Z: LtX—A—T100 ISHINGTONTent & Awning Inc T'lle MC;rr FLAr, e>- to- 824-C M. L. King Jr. Way Tacoma, WA 98405 (253) 57M37 Compan lza� PRLA%"r4 0-4; & RANd ONLY AND CONFERS NO RICHTS UPON THE CERTIFICATE 21EDGWICK OF WASH] N G T 0 N HOLDER. THIS CEF* 'IFICA7E DOES 10'r AMEND, UTENO Oit ^,, 441 5900 A S a f e c 0 our^vve oo °f Amer/"n —___—�--__-------_- COMPANY r 11 -... a ....'^. ...^. L � -- Oj rshberg COMPANY 13200 S.W. Glenn Court Q ,~.°°,""" vr x/oou CM011APANY 47 I'll L T1115 IS TO CERTIFY Thu THE POLICIES OF INSURANCE LISTEIJ kl-6W HAVE *BEEN iS�Ub TO 'F'OR'THE "PER T11 lk�URED NAMED AGOVi" PfiftY I OD INDICATED, NOTWMSIAnDIN6 ANY ffIQUIREMENT, TERM OR CONDIT103 DF ANY CONTRACT OR OTH[R DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. 114E INSURANCE AFFORDED BY THE POLICIES D[f: RIBED 14EREIN IS SUBJECT TO ALL TfIE TERMS, 1-f1PE OFwSUmNW | mOUICv Ntmem WITS QP4OUO�2S -_z-���. ' �/2//y8EACH occump-Ncc *5 Goo AUTO ONLY - EA ACCIDENT 2 Tg,YjJ&Vp, ER I UwVEu5r000 AwO AGHEc0 TUAT TxE ClTv nF [DH0NO3 15 M8�ED A A ADDITIONAL INSURED AS RESPECTS FOP. PERMIT NEEDED TO \EcOvcx AWNING ON BUILDING ON MAIN SAFECO INSURANCE COMPANY OF AMERICA Home Office: 4333 Brooklyn Ave. N.E., Seattle, Washington 98185 SAFECOG (A stock insurance company) POLICY NUMBER: SP4000325 SAFEPLAN STATEMENT OF COVERAGE TRANSACTION: POLICY CHANGE EFFECTIVE: July 29, 1998 NAMED INSURED: TRUST OF HENRIETTA BLOCK 15040 SW TRILLIUM LANE C/O JOAN HIRSHBERG BEAVERTON OR 97007 ENTITY: AN INDIVIDUAL NATURE OF BUSINESS: PROPERTY OWNER POLICY PERIOD FROM 08/27/98 TO 08/27/99 12:01AM STANDARD TIME AT YOUR MAILING ADDRESS -PREMISES LOCATION'OF LOCATION ADDRESS 1 322-324-326 MAIN ST. EDMONDS SNOHOMISH WA 98020 LOCATION COVERAGES PART COVERAGE LOC BLD LIMIT OF INSURANCE ONE SPECIAL COVERAGE PART ONE DEDUCTIBLE $250 LOSS OF INCOME ALL ACTUAL LOSS SUSTAINED, NOT EXCEEDING 12 CONSECUTIVE MONTHS BUILDING(S) 1 001 $ 334,300 BUILDING ORDINANCE COVERAGE 1 SAME AS PART 1, BUILDING LIMITS TWO LIABILITY & MEDICAL EXPENSES ALL $2,000,000 PER OCCURRENCE TENANTS LEGAL LIABILITY ALL $2,000,000 PER OCCURRENCE MEDICAL EXPENSES ALL $ 5,000 PER PERSON FORMS:.INCLUDED IN THIS -'POLICY:. SAFEPLAN PACKAGE BOOKLET SP-0001 02 - 97 WASHINGTON-AMENDATORY ENDORSEMENT SP-0131 10-92 WASHINGTON-EXCLUDED CAUSES OF LOSS SP-0152 06-93 BUILDING ORDINANCE ENDORSEMENT SP-0433 10-94 ADDITIONAL INSURED (LANDLORD) SP-0403 10-92 SEDGWICK OF WASHINGTON, INC. 2101 FOURTH AVENUE STE 1700 SEATTLE WA 98121-2317 AGENT TELEPHONE: (206) 441-5900 MORTGAGEE/INTEREST COPY Sp 16 11 EP 1192 DATE PREPARED: OCT 14, 1998 G2 4 6 E SAFECO INSURANCE COMPANY OF AMERICA Home Office: 4333 Brooklyn Ave. N.E., Seattle, Washington 98185 SAFECOG (A stock insurance company) POLICY NUMBER: SP4000325 SAFEPLAN SCHEDULE OTHER INTEREST SCHEDULE JADDITIONAL INSURED - PREMISES CITY OF EDMONDS BUILDING DIVISION 121 5TH AVE NORTH EDMONDS WA 98020 APPLIES TO LOCATION 1 BUILDING 001 MORTGAGEE/INTEREST COPY DATE PREPARED: OCT 14, 1998 SP 16 13 EP 1/92 G1 Z U 0 U 0 H >4 04 Z 0 U 04 0 �4 CITY OF EDMONDS y COMMUNITY SERVICES DEPARTMENT RIGHT - OF - WAY CONSTRUCTION PERMIT A. * Owner: 20-615441- CLI�&M Aome5 Name 3 2-2— rh .4, w aq Mailing Address — IP70 r.4 CA IM t'i —KotZ City State Zip 9 Address or Vicinity of Construction: Type of Work to be Done: Lit( SA,u 4 &,.o,,oP, Work in Connection With: El Sub or Plat El Commercial Pavement Cut: El Y " _3 -3 ;7- Permit No. — Issue Date B. 0 Contractor: (5 r(,,-- 111i lk C' P, -c tk Name ' Mailing Add ess P(Q ('= �_J_ 91 ?0 2Z City State Zip State License Number Telephone Number C) 0 Single Family El City Projects 910Multifarnily El utility APPLICANT TO READ AND SIGN INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from any injuries, damages, or claims of any kind or description whatsoever, forseen or unforseen, that may 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, court costs, and attorney fees by reason of granting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed by City forces, at which time a debit or credit will be processed for issuance to the applicant. • A 24 hour notice is required for inspection; Please call Public Works: 771-3202 • Work is to be inspected during progress and at completion. • Restoration to be in accordance with City Code. • Street to be kept clean at all times. • Traffic Control to be in accordance with City regulations. • All street -cut ditches must be patched with asphalt or City approved material prior to end of working day; no exceptions. I understand the above and that this permit must be available at the job site for inspection purposes at all times. Signature: -------- Date: Owner or Contractor This Permit Must Be Posted at the Job Site For Inspection Purposes Call DIAL -DIG Prior To Beginning Work ISSUED BY: Time Authorized: Void after 36) —days. Special Conditions: Amendments: PERMIT FEE: -7f je�) Security Deposit:_. _ZJZ3 Receipt No.: — Fund I I I Fee: Street Cut Dimensions: X NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. July 1985 FILE CITY OF EDMONDS LARRY S. NAUGHTEN 250 51h AVE. N. EDMONDS. WASHINGTON 98020 - (206) 771-3202 MAYOR COMMUNITY SERVICES PETER E. HAHN DIRECTOR June.-,19, 1987 Bjorn Thuesen 322 Main St. Edmonds, WA 98020 Dear Mr. Thuesen, We have received a complaint about property you own at 21814 93rd Pl. W. in Edmonds. The complaint is that the property is a hazard, as yard waste dumped on the property has built up to a point where two excavated holes on the property have become dangerously deep. A fence around the lot has been allowed to deteriorate in recent years to the extent that it is falling down and is accessibl�, by neighborhood children. The lot is a nuisance, as noted in Section 7004 of the Uniform Building Code. Section 7004 is enclosed for your reference. As the owner of the property, you are responsible for its maintenance. A solution to the problem is for the fence to be rebuilt and for "No Dumping" signs to be posted. The City is willing to assist you in resolving this matter by taking responsibility for posting the "No Dumping" signs. The fence would need to be constructed within the standards of the Community Development Code, which are enclosed. One option you might consider is turning over ownership of the lot to the City. With this option, maintenance for the property would become the City's responsibility. If you are interested in this option, please call Duane Bowman of the Planning Division at 771-3202. In the meantime, this matter'needs to be resolved. The fence needs to be reconstructed so that the property is no longer accessible to children. Please respond to this matter no later than June 19, 1987. Your cooperation will be appreciated. I can be reached at 771-3202. Sincerely, Leig-h Francis Code Enforcement AA F7 c) YC(A ve-kp- PUBLIC WORKS P LA iN '111 N G PARKS AND RECREATION ENGINEERING v ;Tc� 7A (f - -e- 77-e,-r /2 Aft, -,c < 17 zc') 4 STREET RLE CITY OF EOMONOS 250 5th AVE. N. - EDMONDS, WASHINGTON 98020 - (206) 771-3202 COMMUNITY SERVICES Mr. Bjorn Thuesen Bjorn Thuesen, Inc. 322 Main Street Edmonds, WA .98020 Dear Bjorn: RECEI VED Ff-8 10 1987 LARRY S. NAUGHTEN EnG'NEERING MAYOR February 10, 1987 PETER E. HAHN DIRECTOR After meeting with you in person I have further reviewed your claim for extending certain sewer stubs to your Townhouse Green project. Your position is that the City was responsible for making a "mistake" by not designing the system appropriately. The position that I would take is that the LID was done for the benefit of the property owners, and that it was their responsibility to review.the proposed improvements and either accept or reject the assessments made at the time. To my knowledge no such protests were made for the property you now own. I do not believe that it would be reasonable to go back 20 years and undo the Final Assessment Roll for this LID. This would be both illegal and totally impractical. Sincerely, Peter Hahn cc Bob Alberts PUBLIC WORKS PLANNING 0 PARKS AND RECREATION ENGINEERING 011—f"ki CITY OF EDMONDS USE ZONE PERMIT rp- NUMBER 80 G9S CONSTRUCTION PERMIT APPLICATION JOB ADDRESS Ub 17117SP. ITE/APT # OWNER NAME /NAME OF BUSINESS i*1)R1F_, VA&)Ife VU&I LEGAL DESCRIPTION CHECKI SUBDIVISION NO. LID NO. cc W 'MAILING ADDRESS Z L of 01 SE 3 9D 0 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. EXISTING —REQUIRED DEDICATION TESCP Approved 0 RW Permit Required 0 Street Use Permit Req'd 0 CITY ZIP Woo 41 TELEPHONE NUMBER LJ2 S . -3 It* ;��, 7 BEIG PROPOSED Inspection Required 11 Sidewalk Required 0 cr NAME METER SIZE —LINE SIZE NO. OF FIXTURES W PRV REQUIRED O_ < YES 0 NOD 0 LO ADDRESS u t: REMARKS Z cc w w cc CITY ZIP TELEPHONE NUMBER < Z 69 S` - I / /, P. NAME ADDRESS ENGINEERING MEMO DATED CITY ZIP I TELEPHONE NUMBER STATE LICENSE NUMBER EXPIRATION DAT�,, LVA59114:12.2 htir jig 9,-r VARIANCE OR CU ADB # SHORELINEr Legal Des , cription of Property - include all.easen�ents I eqymaj�j 4�0j) 4s 3.22-2fo Ww ST (Wz I SEPA REVIEW COMPLETE I EXEMPT SIGN AREA ALLOWED PROPOSE&- HEIGHT ALL:: 71"P OSE I LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS I FRONT UR SIDE RE oF 704AW 0F.j0j"V_( Properly, 122,0,410 5'1-lq 03'7- 003 0008 Tax Acco nT - Parcel No- 33(p #1041IJ lq34/41 011(c 005 LOT AREA LANNING REVIEW BY DAT 15 E] NEW RESIDENTIAL PLUMBING(MECH COMPLIANCE OR EIADDITION COMMERCIAL 0 CHANGE OF USE REMODEL APT.BLDG. ASIQN GRADING FEN/E�! REPAIR — CYDS. I— x _FT) WOODSTOVE SWIM POOL DEMOLISH INSERT HOT TUB/SPA FGARAGE 177 RETAINING WALL/ ]CARPORT ROCKERY RENEWAL (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: 4t[213 I — ' REMARKS 1HECKED BY TYPE OF CONSTRUCTION ljjijj� kvn CODE OCCUPANT GROM SPECIAL INSPECTOR ]AREA REQUIRED 13 YES OCCUPAINT LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108 NUMBER OF STORIES NUMBER OF DWELLING UNITS CRITICAL CRT TAREAS NUMBER 'U. DESCRIBE WORK TO BE DONE (ATTACH PL T PLAN) I" I 909.&A, /,.u- Zkoili 5txj�lw FINAL INSPECTION REQUIRED AWSIDli AJ16 VALUATION FEE PLAN CHECK FEE BUILDING HEAT SOURCE: TL ING % PLUMBING Plan Check No. 1W, MECHANICAL GRADINGIFILL 1.- This Permit covers worW,to,be,done on- private. p rp party ONLY. Any construction on the public domain (curbs, sidewMks, 41-11 driveways, marquees, etc.) will requite separate permission. STATE SURCHARGE Permit Application: 180 Days Permit Limit: 1 Year - Provided Work Is Started Within 180 Days STORM DRAINAGE FEE 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 whatever nature, arising directly or indirectly from the issuance of this permit. Issu4ncig of this permit shall not be deemed to modify, waive or reduce any requirement of any city ordinance nor limit in any wAy ih� City's ability to enford�/19 r rty ordinance provision." PLAN CHECK DEPOSIT TOTAL AMOUNT DUE I A k 4 1 11 ­4 Ohl. . li—fi— #K.t f1h. I hereuy adnnow e ge a .1. . IWO` i information given is correct; and that I am the owner, or the duly it ATTENTION APPLICATION APPROVAL authorized agent of the owner. I agree to comply with city and THIS PERMIT T his application is not a permit until state laws regulating construction; and In doingthe work authoriz- s AUTHORIZES THE . signed by the Building Official or his/her ed thereby, no person will be employed in violation of the Labor ONLY Code of the State of Washington relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is t t ion Lnsurlilnce arid RCW 1EI.27. [a INSPECTION acknowledged in space provided. s IGNAT DATE N DEPARTMENT 7,E R�EOWN�" CITY OF o OFFICIA IGN OAT EDMONDS CALL FOR ELE E DATE VL AfTENITION INSPECTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MVE AND APPROVAL OR 771-0220 ORI' It e YE Inspector A OF OCCUPANCY HAS BEEff- GFIANTED��) UB,C. CERTIFICATE SECTION 109 PINK — Owner GOLD Assessor 102-eT 0 1� 0 7. PERMIT ZONE, . � : - . I NUMBER V CITY OF: E-MOND5 slellf, CONSTRUCTION PERMIT A�PLICATIQN JOB SUITE/APT # 1AOWNER NAME/N �EGALIDESCRIPTION CHECKI SUBDIVISION NO LID'NO ADDIRESSi AME*OF BUSINESS MAILING ADDPESS z 0 TESCP Approved 0 PUBLIC iD �\ S* - . . . AIGHT,OF WAY PER OFFICIAL STREET MAP ZIP_ CITY TELEPHONENUMBER RW Permit Required 0 is REQUIRED DEDICATION D TING Inspection Required 0 T-- Street Use Permit Req'd 0 Sidewalk Requi PROPOS D:� red NAME a: W ME7EIR SIZE SIZE. NO OF FIXTURES PRV REQUIRED YES 13 NO El A�RIESS Ll REMAX rs ww CITY PRONE NUMBER ce z A15DREST cr p 0 �E�MEM�O DATED" REVIEWED 13Y 1: <b (0 NE NUMBER ITELEPHO FIRE MEMO DATED REVIEWED BY UJI 0 EC EX�IWON q�TE--* LICENSE VARIAN E OR'CU SHORELINE I STATE Legal Description of Property- include all -easement SEPA REVIEW SIGN EA HEIIII HT' COMPLETE, EXEYPT ALLOWED, ROPOSED ALLOWED PROPi3S& EX LOT CO ERAGE REQUIRED. SETBACKS.(FT.) PROPOSED SETBACKS V -(FT.) �LLOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE REAR z z IT 0e7 LOT AREA IEW BY (L Prolm, Tax,A=unt.:* Par0iI.N.o. 1005 -REMARKS- T71'RisIDENTIAL EJ �LUMBINGIMECH C OMPLIANCE OR C, A ADDITION COMMERCIAL CHANGE OF USE ,I W-o AP'T'BCDG' REMODEL SIGN CHECKED BY* TYPE OF�CONSTRUCTIOW_ occu GRADING FENCE GRO&7!Z CYDS. x _FTY "00v [:].REPAIR I C?1Q WOODSTOVE swim POOU SPECIAL INSPECTOR AREA 17 —j =xVr"0* OCCUPANT DEMOLISO 'INSERT' El HOT TUB/SPA -REQUIRED if LOAD YES /CMX GA I R�.�G�',. RETAININGWALL/ RENEWAL'' - REMARKS ,p RrORT,;. ROCKERY ­ PR z Z` OGRESS INSPECTIONS PER:UBC 108 9:(�y USE�,BUSINESS OR ACTIVITY) EXPLAIN: 'o 444,11 hy rc S:2 &Ay 95a CRITICAL NUMBER MBM OF�. '00, 1.111%1ELbN'6.'-) - ":. . Wvlmay 1,-*1,ceAx1j646 AREAS r1rz 6 STORIES. 241 UNITS NI)MBER 104. AY 4"A0j314nY,1f DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) 1-.;`7ero-A& ZRIZZ-7, CbrA M 0 FINAL INSPECTION REQUIRED - VALUATION FEE wa,", PLAN -CHECK FEE 0 BUILDING. HEAT SOURCE: GLAZING IN) PLUMBING /yo W6 if Lk osi-Q, MECHANICAL �epk Nd.'�q, one on private property ONLY. GRADINGIFILL This Peirmit'covers vorkto bed Any,co I nstruction-on'the oublic-domain,(curLs;,sidewelks, dr v w ys, �m' i e 'arq9ees,.etC].): will require separate plifthission. STATE SURCHARGE Oermit, 11 tiort: 11W'Days STORM DRAINAGE FEE P t "it; , 1. Yeati, - P , r6vlded'Wo,� � Is Started Within 180 Days� erml Ll "Aplill cant; 6n'b6half of'his-or her-s . pouse, heirs, assig I ris'arid, ENG.'INSPECTION FEE a (n, successors in interest, -agrees 1**6 Indenihify, defend harmless the City of Edmonds Wi66iirglion,-, its,0061iii!, a W employees, and agen s,from any �knd.,pi,l�,claiens..f,or7damages,�ofj whatever nature, arisi i6'81rectly or-ihdirdctly;feom.thq�issuancO' PLA C4 IT W of this permit. Issuair ce of -this permiieshill not be,deemed*to, N. ECK DEPOS dify, waive or re -.61 0 dice a6y'retliArement'o :any �.�,�,8jdina ' nce- U 'hot )limit, in anyway I he:City'&: ability, to enforce 46y'jbrdinancw� C ��/AFA OUNT DUE provision." I he r6by'ac knowledge, that I have read thisioplicitloh��thatthe A''r,Or f" I T information glyen is boerec.t; 6ndihat I arii.*tfiB',6 he.,Pu y,� itNTION APPLICATION APPROVAL But '_ ze I of the owner,., -66J�.Wlih �Ity"and` hori,' &-aden' I agree to �om THIS PERMIT This application is not a permit until late laws regulating constructl6n,.and in doing the w6rk authoriz- AUTHORIZES ned by the Building Official or his/her S ONLY THE Sig thereby, no person;,will be employed in violation of the Labor NOTED Deputy: and,fees are paid; and -receipt is e ohWash1.9g!on.r "Code bflthe�State,- lating to.Workmen�s Compensa- 7ackhoWIi6d6ikI.:in space provided.: i6n.1 hsu rarfce- artd�� INSPECTION _R OF�AGENTJ���- DATE'SIGNE,D� DEPARTMENT E (OWNER DATE 0 RE FFICJAL'S�SIGN&TU —6 G CITY OF EDMONDS� lo . I I . , . 1. t DATE EL A a CALL FOW.. AT ENTIOIN'�4�'; INSPECTION.;., AWFUL.TO Y.A BUILDING,, -OR STRUCTURE� -IT. IS..UNL VSE OR-':OCCUP �HAS� BEEN MAC '� AND, AP,PROVAL OR 77 2­0 ORIGINA FiW YELLOW . Inspector U. -�-:UNTIL. A FINAL INSPE IE 'A CERTIFICATE OF'. QCCUPANCY HAS BEEN GRANTEM UBC' Owner GOLD — Assessor Irr.-rinm ina PINK