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519 6TH AVE S.PDFlill lill lill 5430 519 6TH AVE S APPLICATION The City of Edmonds for EASEMENT NO . ............................................ SIDE SEWER PERMIT NEW CONSTRUCTION REPAIRS F� LID NO . ............... — AsmT. No - ------------------ OWNER--------------------------------------------------------- CONTRACTOR .................................................................................... PERMIT NO . ......... .......... , /� �'j e- JOB ADDRESS -------- 6 ..... --, n ..... - ------------------------- LEGAL DESCRIPTION: LOT NO - ------ ------------------------------- BLOCK NO . ........ --------------------------- 0 .................................................................................................................................................................. NAMEOF ADDITION .............................................................. ........................................................ Approved: DATE............................................ By ............................................................ REGARDING: 519 Sixth Avenue South (address) R E C 0 R D 0 F C 0 N T A C T S MAMP 'PPnNM Mn DATE J, ADDRESS of CALLER COMMENTS ACTION TAKEN INITIALS 5/l/74 Carl Motes Certified Letter No. 406159 sent Letter received. TE P. 0. Box 70 requiring hook-up within 60 days. 5/9/74 Edmonds D.:L.Q.S TE 6/5/74 Certified Letter No. 406461 sent Letter received. TE rescinding letter. 0 RECEIPT FOR CERTIFIED MAIL-30�1 (plus po age) STM 105-05.550 �-.T,(Olk D�A., MOTES9 CARL P 0 BOX 70 age) )A, f., EDMONDS, WASH. 98020 (ID, 7 A C CD OPTIONAL SERVICES FOR ADDITIONAL F -6 0 I Shows d da N to whor" arto a dressee only ............ 6501, 00 RE dte delivered ............ 150 CL With delivery R ETUE 'IPT 2� Shows to whom, date and where delivered 350 SERVICES With delivery to addressee only .. . 850 DELIVER TO ADDRESSEE ONLY Bod C=L SPECIAL DELIVERY (extra fee requi red) Z PS Form NO INSURANCE COVERAGE PROVIDED— (Seo other side) Apr. 1971 3800 NOT FOR INTERNATIONAL MAIL QP0; 1970 0-397-490 ruc tons ;!nE-ASE,`,,FURNISH �SERV�ICE(,S),:,INDICATED�';B�Yi',,CHECI(ED,-�OLOCK( Y ',0 itionql�hcrg" o'w' �5�ddr','e` eredeli Vd*red' 04adreEi6&e� t -RECEIPT. 'q.1EGISTEREP�'NO` fill d 1 �SIGNATURE'4111;NA F2AuURL55i-.E--'(Mci�t,�ilwgiy�vbb.. e n .7. CERTIFIEDr NO. -ANY 7 3 ENT,: IF. -7 il)ATC41ELIVEREO 'Z T, t,i4'z �I�T, t j, SENDER:'-:Bi,,Jure. f o folio -111,EAS Y"': E, "FURNISH,! SERV' -c 0 dd -Show,'a ress t kl�tEIPT umbered c, 4.9 0c.rib'doltUe. 9V/.. IGN �T UREIOR�NAME,,OF,7AI)DRESSEE-,(M�, iIEGISTEREWINO'­��-,,T-'- Z RT ex)," :'A SI N URE W�.'ADDRIESSEE:S i di._ 1NSURED,M'.'j- �q "'HERE DELIVERE D A -SHOIV� AYHERE 7 Lf F C3 LLA LA_ W IL W 0 z 0 L W I 1 CL nm­ lomw M Lj z M E� 1'r C3 B cz 0 CD x z > 00 M 0 U. od cc W 0 T9V900 M T REET FILE JL DATF: Octohey" 22., 1976 ME110 TO: I la r rY I 'hi tcUtt Buildino.')fficial FROM:. Ri chird P. Allen As s is ta n t ritv rnni neer SUBJECT: BUILDING PERMIT ARP L I CATJ ON FOR PASTIA11 AT.,53,1�-196th Avenue S. After revie' 0 P p o v, f the 1,W),inct hui Id i hn nerm.i t armlication, ie hay.. th, f 1-. owi n q comments 1) Coordination of location of'bu-ilding with utilities is the respohsi.bilitv'of this contractor,. 2)' ..Conn-ection to sanitary sewer requixed. 3) Lot drainage to'. be contained on site. 4) 14here wi I I off-st�eet parkinq be provided? WIJ 11 RHA: Rij r P[7 P11T ADIMFS�5_9 (�Mi 41Y/Ilf Date I ol 17C,- LEGAI. 1) E S' C P. I __11 14H I OrILITa;- r 3 BUILDING, PLRHIT P -_VI EW - EN�,MtEPI NG DEPARTMENT CHECK LIST F Instruction: Check Accuracy of I.e(jal Pescription Check Anainst Assessor's Man for Lenal Subdivision Does it conform to city An proved Subdivision? Revie0or's Initials 1. This lot included in , ",uhdivi s"ion/Plat No. 2. Site Inspectfon made -on: An, - 3. What are oround water and soil conditions? 4. Site nraiwe Check(,d? .5. Storm Sewer Availal )i I i ty: __Yro ect �.54 __MCj_kM sht. ot rIvin. Mo., Roadside. Ditch 6. Gradinq ?4,Fi nal Contours 7. Septic Tank System Pes i pil Approved.: .,8. Sanitary Spwer Pvailahilitv Sht. 1-7. of r�.ia. No Projec`tLjn -7 Side se,wor availabilitv: az 4�- 9. Sanitary Sew.er Connection Fees?' 10. Uater Mains A Tire 11),drants (Indicate Size" t1ain)f1w t\j O"H?D; K7 ri t4 7. Check Fire Dept..'s Conini�nts I ll.. Sidewalks.: (,Site inspection s hows conditions of sidevialks as f-ollo,,4s) 12. Curh CUts/nriveways� (Check driveoays for safety, location, grade' and width): AISTIM 7Z) 1j. Underqt7ound -Ili ri nn: Street Liqhts: .14. Street P"i (111 t-of -wa.y A RT(1q. setbad"s:_r;/w SO#T--,ht of nfficial Street Ma P. 15. Exi sti nq Uti 1 i ty - Easements? 16. Access Easements- Kit S N. P-M, 7. S-ite Plan checked for, aft0racy? 18. Special Requi.r(,ments listed in Memo to. Bldg., Dept. Twis 19. Commercial F, Apt. Rnriui rements form comple'ted? — 20. Drawings staripe& notations, r*iadO 1 0. — 21. All Items filled. il n �)n Bldg. Permit Application? 2/1 22. Bonds posted for Ote work? 23. Riqllt-of-wly Invasion Pej�mit required? COMMENTS: FILE 1', 90 -1 gq- City 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 devel ment ' to the City. OP pCMUt 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. 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. With a signed copy of this forn:,, the ' , applicant should also subinilt a vicinity map of the parcel with enough detail that City staff can find and identify the subject parcel(s). In addition, the applicant is encouraged to include any other pertinent information or studies in conjunction With this Checklist to assist staff in completing their preliminary assessment of the site. I have completed the attached Critical Area Checklist and attest that I the answers provided are factual, to the best of my knowledge (fill out the app ropriate column below). Owner / Applicant: 1:21 4,4""", Name . 0"All e, Title - StireetAddress City, State, ZIP Phone C 5� 24 A il;;tu�e Date Applicant Representative: Name Title Street Address City, State, ZIP Signature Phone Date Critical Areas Checklist Site Information Project Name.- Permit Number: Site Location: .rl, .9 el 1�34&,e 1-- XIFW-m-4-Rroperty Tax Account Number: 2-1`Z,70 3 - Z- -.OZ,9 Approximate Site Size (acres or square feet): Woo r:z 7"�t -6�0 X J Have you filled out a Critical Areas Checklist for a project on this site before? Ale General Site Conditions 1. Has the site been cleared or logged? Date of most recent action: Soils / Topography 2. In the Snohomish County Soil Survey, what is the mapped soil type(s)? 3. Describe the general site topography. Check all that apply. Xflat: less than 5 feet elevation change over entire site. lling: slopes on site generally less than 15% (a vertical rise of 10 feet over a horiz�ntal distance of 66 feet.) Hilly. slopes resent on site of more than 15% and less than 30% ( a v p ertical rise of 10 feet of horizontal distance.) Steep: grades of greAter than 30% present on site. Comments 14- hle,4Are hlar 9,e-.e­-*7 CA-7 AO"10-J'-7�V -r�e,9CC 1140 HydrologyNegetation 4. Site contains areas of year-round standing water: A/O 5. Site contains areas of seasonal standing water: 44 --Approx. Depth: 6. Site is in the floodway floodplain of a water course. 7. Site contains a creek or an area where water flows across the'grounds surface? /.V. flows are year-round? Flows are seasonal? 8. Site is primarily: forested meadow ;,shrubs 9. Obvious wetland is presenton site: 10. Wetland inventory or map indicates wetland present on site: 11. Critical Areas inventory or map indicates any Critical. Area on site: For: City.Use 0 My Rey 3/27/92 .A � - aft 61 r, EET PALE a:,(V\ (" t 0 P'D'D F�b 31? 4 elo OEM= Z- 0 to Z. 0 1 Z-4. O/a 1 N Nn 32 1157 -�o 1. IV V Z.O.00 6-7 0 7b" P, x o -;s -0 Z,7 — 000 o .0 XA A L" -1) STREET FILE STATEMENT ON ACCESSORY DWELLING UNITS Property Address: 4/ 9 Ae- W. Z�,,wl,, k),9 Feeic, Legal Description -�—&c 7 S- xll�-- I —lay ,e- -r. . / I- -) -?o F:1— J- -y- 7W -e- /,(-0 /-7-7— r-# -r 61' cf /— 7— /t) IIE:::7— 7-,Pl /� 610 "J 7e�r X I, b -,(',? 7 e/.( z 0 , 9 - 0 o," c, I have read the requirements for accessory dwelling units contained in Chapter 20.21 of the Edmonds Community Development Code and understand that an accessory dwelling unit, Including a second kitchen, Is prohibited for two years after occupancy by the current owner is granted and until after a conditional use permit has been approved by the City of Edmonds Hearing Examiner. I also understand that approval of a conditional use permit is subject to a public hearing, and neither this statement nor the issuance of a building permit shall act to limit the discretion of the City review In the review of any application for a conditional use permit Property Owner Name Vawl "A Joy e— On iej� ev '# -ld'e" R, V C� Date C- 00 STATE OF WASHINGTON T. 0 00 COUNTY OF SNOHOMISH rsk I certify that I know or have satisfactory evidence that signed this instrument and acknowledge it to be his/her free and voluntary act for the uses and purposes mentioned in this Instrument. It, Dated s+" 1" Signature of OF Notary Public go 0 4.- 01 0' :.A L! I Y - 00 Title of �p - - . s, 12 - 9 My appointment WASW Expires: THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR ACDUSTM.DOC Un' a I$.- "EET FILE U5r ZONE PERMIT .,.C(TY OF EDMONDS NUMBER 940635 CONSTRUCTION PERMIT APPLICATION Joa SUITE/APT ADD ... S OWN NANIE/NAME OF BUSI �7-/ C� - (jo P A L) L P--k 2 LEGAL DESCRIPTION CHECK SUBDIVISION NO. LID NO. ujl MAILING ADDRESS Z PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved 0 0 Z fil I CITY ZIP I 1CLEPHONENUMBER EXISTING REQUIRED DEDICATION RW Permit Required El N ME CITY Al -"NIJ W C? STATE LICENSE NUMBER &C--) 7 ) /U Street Use Permit Req d U Inspection Required C3 PROPOSED Sidewalk Required 13 a u METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED I YES 13 NOE) REMARKS e,-511 vwsPro 7� NUMBER dTELEPHONE NUMI All includda-11 easements MEMO DATED REV[ _EDBY IT/aAw Ac 4 DATE SIGN AREA SEPA REVIEW ADB ALLOWED 4,PROPOSED COMPLETE 1EXEMPT SHVEXP VARIANCVP CU )Pt N1111 tg 7fEVIEW BY a - I-) - I-T Z Z 5 SETBAC9S - FEET F ONTM SIDE REAR HEIGHT 1-5 L6T 66VEgAGE ' 55�5,12> Property Ta Account -2,1� P.Xrcel No. " � - 2 - 61Z) - REMARKS NEW Ro*'RESIDENTIAL PLUMBING ADDITION COMMERCIAL El MECHANICAL REMODEL REPAIR El APT. BLDG. GRADING CYDS. El El SIGN FENCE I- x -FT) CHECKED BY TYPE OF CONSTRUCTION CODE OCCUPANT G7�� DEMOLISH GARAGE CARPORT WOODSTOVE INSERT RETAINING WALL/ ROCKERY D El SWIM POOL HOT TUB/SPA RENEWAL Z 0 5 SPECIAL INSPECTOR REQUIRED C3 YES AREA OCCUPANT LOAD IREMARKS PROGRESS INSPECTIONS PER UBC 305 (TYPI159F USE. BUSINESS OR APTIVITY) EXPLAIN: NUMBER OF STORIES NUMBER OF".,.,,�-OCRITICAL DWELLING LINITS _ AREAS NUMBER 4:73 DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) Ayo �FIN�AL �INSPECTION REOUIRED J A A- - IV., VALUATION FEE -7- PLAN CHECK FEE cz) n UA) 7-" BUILDING HEAT SOURCE: GLAZING % PLUMBING Plan Check No. h? MECHANICAL This Permit covers work to be done on private property ONLY. GRADINGIFILL Any construction on the public domain (curbs, sidewpiks, drivewaysi marquees,.etc.) will require separate permission. STATESURCHARGE 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 successo . rs in interest, agrees to indemnify, defend and hold 'Unj harmless the City of Edmonds, Washington, its officials, m employees, and agents from any and all claims for damages of cc ly or Indirectly from the issuance < whatever nature, arising direct DEPOSIT of this permit. Issuance of this permit shall not be deemed to PLAN CHECK modify, waive or reduce any requirement of any city ordinance (1,5C 0 1 nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE Iff4 provision." I hereby acknowledge that I have read this application; that the ATTENTION APPLICATION APPROVAL information given is.correct; and that I am the owner, or th i e duly authorized. agent of ihe'owner. I agree to comply yoth city and� THIS PERMIT This application is not a permit until state laws regulating construction; and In doing thtWofk aulbpriz. AUTHORIZES ONLY THE signed by the Building Official or his/her ed thereby, no person will be emplo 0 In violatl6h bf;the%t:rabor Code oft he State 2j,�/ashl ngton rel ng to Workmen's Compens WORK NOTED 0�21NSPECTION Deputy; and fees are paid, and receipt is acknowledged in space provided. tion Insurance ayffl FjCW 18.27. 91-F LIFE (OWN R 0 AUtN 11) 4N(Ud DEPARTMENT OF I AL-S.SIGNAfURE DAJTE CITY OF Ar EDMONDS CALL FOR Vri rn v DATE T E N 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. USC CHAPTER 3. .7 PINK - Owner GOLD - Assessor T:ET F1LE`­',,., USE ZONE PERMIT .CITY OF EDMONDS NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT m 0 ?y NAME/NAME OF BUSINESS ADDRESS P, 7�1 7Z/ �e_ LEGAL DESCRIPTION CHECKI SUBDIVISION NO. LID NO. MAILING ADDRESS -9 TESCIP Approved 13 0 -e-1 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. CITY IP TELEPHONE NUMBER ' RW Permit Required 0 _72 EXISTING — REOUIRED DEDICATION Street Use Permit Req*d 0 PROPOSED Inspection Required C3 NAME Sidewalk Required 0 a Z REMARKS Fx Lu W w ADDRESS Z Z w CITY ZIP TELEPHONE NUMBER NAME e--,' ENGINEERING MEMO DATED REVIEW BY cc ADDRESS 0 METER SIZE 8 LDING SUPPLY SIZE NO. OF FIXTURES CITY zi P TELEPHONE NUMBER 7 Z REMARKS STATE LICENSE NUMBER EXPIRATION DATE SIGN AREA SEPA REVIEW ADB NO. ALLOWED PROPOSED Legal Description of Property - include all easements COMPLETE EXEMPT SHOREHNEP Itl EXP F_ VARIANCE OR C �U P�A &NP REMIfiuu-A---- DATE �J,4 lev Z-0 w .j SETBACKS — F*T, HEIGHT LOT COVERAGE/ IT L SO ;EAR,L� -7- Z FRONT 'j Pro T=ertcyouril REMARKS Parcel No. 1:1 NEW RESIDENTIAL PLUMBING K71 q3- 2 2— )!fN ADDITION COMMERCIAL MECHANICAL 619 T. BLDG. P] REMODEL 0 AP El SIGN 1-7 GRADING FENCE CHECKED BY TYPE_OF CONSTRUCTJON CODE HEIGHT REPAIR 1:1 — CYDS. I— x _FT) I -T--//V I '�/ 25-' DEMOLISH r 10081888"W& SWIM POOL SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT 1 -1 INSERT HOT TUB/SPA REOUIRED GROUP LOAD GARAGE RETAINING WALL/ 0 YES ( 1:1 ROCKERY RENEWAL WEMARKS Z 0 (TY;PEF USE, BUSINESS OR ACTIV TY) E I XPTN: PROGRESS INSPECTIONS PER UBC 305 Z _j ir NUMBER OF STORIES UMBER OF 0 WELLING 4//T UNITS 0 _ DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) FINAL INSPECTION REQUIRED VALUATION FEE 4,z,,�A,-wve,7_M 6tis rteA7 PLAN CHECK FEE H Et:�"A- BUILDING 5 13 _5� &6 GLAZING IAJ, 70 0/ * 0 6e -CC 7— CVor PLUMBING Plan Check No. MECHANICAL This Permit covers work to be done on private property ONLY. GRADINGIFILL Any construction on the public domain (curbs, sidewolks, 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 FEE "Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE w 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 whatever nature, arising directly or indirectly from the Issuance of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT —/oo modify, waive or reduce any requirement of any city ordinance 0 I 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 th.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 relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is tion Insurance. I INSPECTION acknowledged in space provided. LSjIGNVURE 9,WNER OKR�EN�p rO;ATE WSIGNEO —1 DEPARTMENT OFFIf.IAL-S SIGNAjAjRE DATE V CITY OF EC ;,z )MONDS CALL FOR '('�AELEASED-8y:L DATE ATTENTION INSPECTIO'W C IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 7711-0220� ORIGI'�AL — File YELLOW — Inspector A CERTIFICATE OF; OCCUPANCY HAS BEEN GRANTED. USC ; , , 1i CHAPTER'3. PINK — Owner GOLD — Assessor 102-87 -1 CITY OF EDMON.DS USE PERMIT ZONE —9 NUMBER CONSTRUCTION PERMIT APPLICATION 4 OB SUITE*APT ADDRESS X OWNER NAME NAME OF BUSINESS paw/ - LEGAL DESCRIPTION CHECKI SUBDIVISION NO LID NO MAILING ADDRESS Z TESCP Approved 13 0 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. EXISTING — REQUIRED DEDICATION RW Permit Required 11 Street Use Permit Req'd 0 0 I Y ­WM BER PROPOSED Inspection Required Sidewalk Required a: Li NAME 14- METER SIZE LINE SIZE NO. OF FIXTURES PRV REOUIRED YES 11 NO 0 0 ADDRESS REMARKS Z a: W W Z CITY IER a Z Lu NAME If,_01re­ ADDRESS 0 ENGINEERING MEMO DATED REVIEWED BY 0 CITY ZIP TELEPHONE NUMBER cc FIRE MEMO DATED REVIEWED BY Z 1 Lu Lr STATE LICENSE NUMBER EXPIRATION DATE SIGN AREA ALLOWED PROPOSED SEPA REVIEW COMPLETE EXEMPT ADB NO. odj. include Legal Description of Pro erty - all easements e � I I SHORE LINE N 1.7 / EXP 4/14 VARIANCE OR CU PLAN/4.ING BY A�T E AJML3 ®R IV! /yr SETBACK9 — FEET T41GHT LOT CdVERA'G FRONT SIDE REAR ,:,ZE Z Z 4 u.' Property Tax Account Z 49 O'� Z 049 60 REMARKS Parcel No. 'r _ 0 NEW RESIDENTIAL PLUMBING ADDITION COMMERCIAL MECHANICAL APT. BLDG. SIGN REMODEL GRADING FENCE El CHECKED BY TYPE OF CONSTRUCTION I CODE I OCCUPANT GROUP REPAIR CYOS. L_ x _FT) WOODSTOVE SWIM POOL DEMOLISH INSERT El HOT TLEI/SPA SPECIAL INSPECTOR7AREA REQUIRED OCCUPANT LOAD 13 YES FGARAGE RETAINING WALL/ � CARPORT ROCKERY Ej RENEWAL REMARKS Z PROGRESS INSPECTIONS PER UBC 305 (TYPEOF SE. BUSINESS OR ACTIVITY) EXPLAIN: 0 _7NUMBER L) U ) w NUMBER /_ I NUMBER OF Fit CRITICAL AREAS 0 OF Z"T J.DWELLING -UNITS to STORIES 04,*f A i U, 0 DESCRIBE W601k T4E DONE (ATTACH PLOT PLAN) FINAL INSPECTION REQUIRED A41 gkzmk�lrl` tffa el VALUATION FEE PLAN CHECK FEE BUILDING HEAT SOURCE: crix GLAZING 1 2 % _r PLUMBING Ian Check No.. MECHANICAL GRADINGIFILL _�p This Permit covers work to be done on privatdproperty ONLY. Any construction on the public domain (curbs, sidewelks, driveways, marquees, etc.) will req!Aire 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 CHECK DEPOSIT < whatever nature, arising directly or Indirectly from the Issuance of this permit. Issuance of this permit shall not be deemed to PLAN 0 modify, waive or reduce any requirement of any city ordinance 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 ATTENTION APPLICATION APPROVAL information given is correct; and that I am the owner, or th.e duly 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. ce and RCW 18.27. INSPECTION WNER 08 AG NT) DAT7ESI N L) DEPARTMENT OFFICIAL S SIGNATURE DATE CITY OF A EDMONDS #147 CALL FOR ATTENTION INSPECTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE -ORIGINAL — File YELLOW — Inspector HAS BEEN MADE AND APPROVAL OR 771-0220 L UNTIL A FINAL INSPECTION A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC CHAPTER 3. PINK — 0,Ar-er GOLD — Assessor - - .1. : .. � ..... . . ,. . - .. . - '* I . .. . 1. . . . '. . ' . . I . � : �. -!"--".'�' , :'."' �' , - m . . . .. ... I I . . .. . . I . . I . . .- -.. .'' . . . . . . 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