637 ELM PL.PDF11111111111111
11163
637 ELM PL
0
0
ADDRESS:
TAX ACCOUNT/PARCEL #: 00-7'3&400(0624660
BUILDING PERMIT (NEW STRUCTURE) #:
COVENANTS (RECORDED) FOR:
CRITICAL AREAS el-1-61)cll DETERMINATION: Conditional Waiver El Study Required XWaiver
CRITICAL AREAS DETERMINATION: Conditional Waiver 0 Study Required Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORD FOR:
PERMITS (OTHER - list permit #'s):
PLANNING DATA CHECKLIST DATED: CPO-7/q-�-
SCALED PLOT PLAN DATED:
SEWERLID FEE $:
LID
SHORT PLAT FILE:
LOT:
BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #: qqq I
GEOTECH REPORT DATED:
STREET USE/ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DATED:
OTHER:
L:\TEMPkDST's\Forms\Jana's Street File Checklist 5-14-08.doc
CITY OF EDMOND&
CONSTRUCTION PERMIT APPLICATION
NER NAME/NAME OF BUSINESS
WJFJFA 47sim FgMt Mai Ir
0 �Ww IN, IN I N I M1 W_ N
ADDRESS
CITY ZIP
ITELEPHONE NUMBER
STATE LICENSE NUMBER V9 EXPIRATION DATE
�)K 2?
LP PmnPrtv - ine-hirip 511 'ni...-coRt.
Tax Account
—XVz
Pa.[ N.
(^Vy)i
NEW
RESIDENTIAL
PLUMBINGrMFCH
;?A.DITION
COMPLIANCEOR
COMMERCIAL
CHANGEOF,USE
REMODEL
APT. BLDG.
SIGN
GRA13IN13
FENCE
REPAIR
CVDS.
f X —FT)
DEMOLISH
WOODS , TOVE
I SERT
SWIM POOL
HOT TUB/SPA
GARAGE
RETAINING.WALL/
CARPORT
ROCKERY:
RENEWAL
T.YPE OF U S USINE!�;R AGT,1VITY).EX . PLAIN:
NUM13ER
0 OF
?
I�UMBFR OF
DWELL NO
I
CRITICAL
AREAS
STORIE S:
UN
NUMBE R0
DESCRIBE WORK TO BE DONEIT(AST I A� PLOT PLAN)
USE
ZONE PERMITf
NUMBER 9-7061,9
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. -
TESCP App,0"d
EXISTING REOUIRFD DEDICATION
RW Per mil Required
Street Un Permit Req'd 0
PROPOSED
Inspection Required E3
Sid".1k Required
METER SIZE
LINE SIZE
NO, OF: FIXTURES
PRV RE 'RED
YES D NO 0
1EMARKS
MEMO DATED
VARIANCE OR CU
ADS
SHORELINES
SEPAREVIEW
SIGN AREA
HEMPT"
COMPLETE
EXEMPT
ALLOWED
ALLOWED ED
PFIOPO�l
I
IPROPOSED
7-3 (,,4
1
E)(P
2
LOT COVERAGE
REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS (FT.)
ALLOWED
PR BED
FRONT SIDE REAR
FRONT URSIDE REAR
�7
C,
LET AREA
2.190 S r:�
,ZT=041
:St'
DATE
� / I f I ri -7
40 1 V — /V I - /-Ir 1 r _5
SPECIAL INSPECTOR OCCU NT
REQUIRED 1 LOAD PA
13 YES do" :.-- I I
PROGRESS INSPECTIONS PER LIBC 108 OR
I A
FINAL INSPECTION REOUIRE
VALUATI1
P�AN CH!CK FIEG
BUILDING
HEAT SOURCE:
111IG
PLUMBING
Plan Check N 0. 7 5-
MECHANICAL
This Permit covers- work to be done on pilvate property ONL
GRADINGIFILL
Any construction on the public domain (curts, sidewpiks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 11111ID Days
Pontiff Limit: I Year - Provided Work Is Started Within . 180 Days
STORM DRAINAGE FEE
"Applicant o . behalf of his or.her spouse, iheij,3j agAigns and
'Successors I� I terest, agrees t� Indemnify, def nd)and hold
harmless the Ity of Edmonds,. Washington, its officials,
ENO. INSPECTION FEE
x employees, a , agents from any and all claims for damages of
Whatever nature arising directly or Indirectly from the Issuanc
a 0
of this permit. 1; uance of this permit $hall not be deemed to
PLAN CHECK DEPOSIT
LV
`!�
modify, waive or reduce any requirement of an city ordinance
XO nor limit In any way the City's ability to on force any ordinance
TOTAL AMOUNT DUE
provision."
I hereby acknowledge that I have read this application; that the
Information � given 18 Correct; and that I am the owner, or I" duly
ATTENTION
APPLICATION APPROVAL
agent of the owner. I agree to comply with city and
:uthorlzed
late laws regulating construction; and In doing the work authorlz-
THIS PERMIT
AUTHORIZES
This application is not a permit until
ad 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
Ion Insurance aria RCW 18.27.
INSPECTION
acknowledged In space provided.
SIGNATURE (OWNER OR AGENT) DATE SIGNED
0 EPA"T11N1
CITY OF
OFFICIA GNA jbATE
EDIVION DS
CALLFOR
INSPECT16N
frELEK i9l. Y; OfTE
7////19 Z
IT S UNLAWFUL TO USE OR OCCUPY A BUILDING OR, STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220
ORIGINAL — elle. YELLOW —'Inspector
.A CERTIFICATE OF OCCUPANCY -HAS- BEEN GRANTED. UBC
SECTION 109
lam
PINK — Owner GOLD — Assessor
6
k7-->o4,T-it-4c-- Oow=�w-
;ZF-
Jeffrey C. McNaughton
BUILDING DESIGNER
22000 64th Ave W., Suite 2F
Mountlake Terrace, WA 98043
PLOT
PLAN
(206) 775-6171
JUN 3 1997
"PERMIT COMITF-Re!
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APPI
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�9-
411
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PLANNING
;q7:
t
4-
4-41c=HT- A43p-i- P9�-J-
FILE NO
kritical Areas Checkli#
-- -----------------------------------------------------
Site Information (soils/ topography/ hydrology/ vegetation)
1. Site Address/ Location:
67 zc
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet)-
4. Is this site currently developed? L'yes; no.
If yes.- how is site developed?
5. Describe, the general site topography. Check all that apply.
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 than 15% 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 10-feet over
a horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: Approx. Depth:
7. Site contains areas of seasonal standing water:
L; Approx. Depth:
What season(s) of the year?
8. Site is in the floodway A-) floodplain--L—C)of a watercourse.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are
year-round? A �/L Flowsare seasonal? L-) L�' (What time of year?
10. Site is primarily: forested meadow shrubs mixed
4 urban landscaped (lawn,shrubs etc)
11. Obvious wetland. is present on site: K-) 1'�,
------ ------ ------- --- -------------- For City Staff Use Only ------ — --
1. Site is Zoned? ell �D —
2.:: .:::::.:S Smappedsoiltype(s?..:
Aca�chk.doq Rev 02/11/97
0 0
City of Edmonds
TW CRI TICAL 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,
m aps, 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:
I rJ"
Name
Street Address
-'V
city State Zip
Telephone
Signature
Date
Applicant Representative:
r)
Name
z I-
2
Street Address
City State Zip
Telephone
Signature
Z..
Date
(over)
c:rcception\jana\cac1.doc
0
City of Edmonds
N�WF 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 deten-nination 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:
Name
Street Address
OA� (-J�
Crt� State Zip
Telephone
Signature
Date
Applicant Representative:
L
. )r 0
Al �J-
Name
-2 (oq
Street Address
city State Zip
Telephone
Sigg"J.-
-�7
Date
(over)
cxeception\janakaddoc
FILE NO.
*Critical Areas. Check'l'iVst
----------------------------------------
Site Information (soils/ topography/ hydrology/ vegetation)
1. Site Address/ Location:
`7 1 1 1 Y��
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet): 2_ C
4. Is this site currently developed? L'yes; no.
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
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).
HHy: slopes present on site of more than 15% 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 10-feet over
a horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
\ C',
8. Site is in the floodway--L.) _62 floodplain L of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are
year-round? A Flows are seasonal? L.) L" (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
'Pnri—i QFnffTT
1.7 `777 -------------------- 77 ----------
1. Site is Zonedl
:2. SCS mapped soil type(s)? &VAVWW'e 1AP-41MY 4441-4 O.—Ir V.-
3. Wetlan.d.inven.tory or C.A.Map indicates wetland present on site?
.4. Crkical Are" M`ve'nt6r'y or C.A.. map indicates Critical Area . on s ite?
5. Site wid-tin designated earth sub
sidence landslide.hazard area?
,'6. Site designated on th.6 EnViroinmentally Sensitive Argais'Map�,._
ACa_chk.dc.c Rev 02/11/97
PLANNING DATA
NAME:- AjancLl 5co-++
61
SITEADDRESS: (o-37- 1-:-Lk,) il- DATE: //0 7
ZONING: PLANCHK#: 9-7- I-7Y
PROJECT DESCRIPTION: A8a4flor% 40 uep!ge- lqow- -Ovee-
C ORNER LOT Yes/No)
SETBACKS: � 0_41 j�S ;-n P 7 0'
Required Se!bZa., _f,
J
Front . to Left Side: -Right Side: Rear: o
Actual Setbacks:
Front: IV / Left Side: 0 Right Side: 0 Rear:
Street map checked for additional setback required? 1Vode--(Yes1No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED ^6
/,q,/G + 11t7 I t;gg V. -11
LOT COVERAGE: Actual: 57
Maximum Allowed:
BUILDING HEIGHT:
Maximum Allowed: Actual Height:
Datum PointAz() Datum Elevation:
SUBDIVISION: ZE-ZM
CRITICAL AREAS #: q-7- �� /
SEPA DETERMINATION: Wiyr-D 4=�-
LOT AREA: .2-7 50 S6 - F+-1
OTHE
Plan Review By: ZJ ASo,,) 1009:TU-I-Lal
.:dl
00
CD
V)
a)
Ce
CITY of EDIONDS
For Inspection Call 771- 3202
Address of Construction:
&I D E SEWER, PERMIT
STREET F � 7- PERMIT N 0. 076N
IA EOMONDS WAY
a:-T FV TRUNK LINE I
Property Legal Description (Include all easements):
0� 1EA lr_� _-VARug, -
Owner and/or Builder: nC) M (� 1C,\r-C 701N\��
Contractor & License No:
d
Single Family Residence
Multi -Family
V/
(No. of Units
Commercial (No. of fixture Units
Invasion into City Right- of -Way: No Yes (If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No Yes (If Yes, easement required,
attach legal description and county easement number.)
PLEASE EA E I LISTED ON THE BACK
(�rr t i;Fy have read -and shall comply D/te/
with the items listed on the back.
Permit Fee:
Trunk Charge:
Assessment Fee:
Partial Inspection:
Issued By: J,
Date Issued:
Receipt No.:
Comments
Final Inspection Approved: (;�- -5 - A
,Date Initial
Rejected:
Reason
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy - File Green Copy - Inspector
ffa—te Initial
Date Initial
Buff Copy - Applicant
The City of Edmonds Side Sewer Drawing EASEMENT NO . ..................... ------------- ........
NEW CONSTRUCTION [X REPAIRS 0 LID NO . .................. ASMT. NO - ------------------
OWNER A0.PASLJA-,ha0 ..... A-C.PAF-5 .... ................................ CONTRACTOR .... L.U-7-rZ.. ...... -H.Csie�.
- - ---------------- PERMIT NO.74-)--'l ---
JOB ADDRESS .... &3-7 -------- - ----- Pl.-ACE -- -------- LEGAL DESCRIPTION: LOT NO. —20� ....................... BLOCK NO. .-I -VIA-EDMON.M.MAY
TRUNK LINE
------------------------------------------------------------------------------------------------------ ......................... .................................
NAME OF ADDITION -- P.LN7 ....... OF ------- EA�t--\ ------ -- --------------------------------
62) 7
�ez la� r3'
4.5*DP
wo
PWW-0001-11/75 (REV.11/78)
I
LiD' 12
C-LtA ?LNcE
6
f
Approved:
DATE)uML.5
.... .......
0
11
f
Approved:
DATE)uML.5
.... .......
0
11
PRa= REVI34 C7
PpoykT NAMEt, PROJBCT AD RESS: 46—YEAC
APPLICATION RECEIPT DATE:
Reviewed by: Uni
ial/date)
Commam
PLANNING
WTR/SWR I STRE=1
ENGNRNG
FIRE
BUILDING
11T111F111
.�,n=s rAmILy/KjLTn-jLE/Ca4AM1AL - (Circle One)
jETBACKS CH== - Planning
7777777T
7111117111
VARIANCE/SETBACK ADJ.
11W1171
111i11171
USE PERMIT
////////
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////////
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,TREEV FILE
8
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/////////
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////////
9
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/////////
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10
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A�13DEW - PML1C/PRTVAn
/////////
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AWK.NVE SWM COMWPION IF W) LTDO
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/////////
////////
13
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14
17TW-17-11-71-17-771171111
777T7777----
0m) RE)Qf) mR PuBlac Impmvfimm
//////
/////////
/////////
////////
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7 ZRI --//7/ -
7 T1 7
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//////
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/////////
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/J
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IIIIITTIT17TI77
771-777111
IDEWALK RK.UTRO)
//////
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T/ 7 7 T1 7 T7
7 T7 / 7 7 7 7 7
JRB CUP MR DRIVEWAY ROM
1-0
1111111IT777TI777T
�.%EET NAME SIGN RE M_
21
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/////////
22
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//////
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//////// -
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////////
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26
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'MRWr REQUIRM
/////////
////////
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__1T7T7T9_RTF1T1777
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.MRANT SIZE MISTING
/////////
////////
28
7TIT77
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%OSS MhTNECTION INSPWrlal REM
29
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/////////
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32
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//////
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35
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SIZE
//////
/////////
36
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�,TCH BASIN REQD
//////
/////////
37
[T7TF_flT11_1111__/fl111111
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Ilk
38
MULDER DMINAGE MAINTAIN
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39
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EVIEWED BY: PLANNING MGR. D�GINEERMG MGR. PUBLIC WORKS �ra.
X7
CITY OF EDWNDS
CONSTRUCTION PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
Homeland HOnes Inc.
MAILING ADDRESS
221 James St.
EITY --T7E__L_EPHONE NUMBER
Edmonds 775-2033
NAME
Design Consultants
903 10th.
CITY
TELEPHONE NUMBER
Mukilteo
745-6569
NAME
Homeland Homes Inc.
ADDRESS
221 James St.
CITY —TTFELLPHOINE
NUMBER
Edmonds
775-2033_
STATE LICENSE NUMBER
HO-ME-LHI*174KE
Legal Description of Property - Include all easements
(show below or attach four copies)
Lot 20, Plat of Elm Place
NEW
1xj RESIDENTIAL
L PLUMBING
ADDIALTER
COMMERCIAL
El MECHANICAL
REPAIR
RETAINING WALL
SIGN
EXCAVATE
FENCE
DEMOLISH
OR FILL
( X_ FT)
PRE -MOVE INSPJ
El
swim
REMODEL
COMPLIANCE INSP.
POOL
WOOD STOVE/
[I
INSERT
APT. BLDG
RENEWAL
5 NUMBER OF STORIES NUMBER OF
one
two DWELLING
[UNITS
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
construct single family home
I USE PERMIT
ZONE NUMBER
Rs-6/PRD
rJOB
q�
ADDRESS 637 Elm Place
LEGAL DESCRIPTION CHECK
SUBDIVISION NO.
1
LID NO.
/0 1
t -go
I /I Lf3_
�7 /9
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING REQUIRED DEDICATION
PROPOSED 0
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED 0 W
Uj
STREET USE PERMIT REQUIRED 0 Z
0
Z
SEE ENGINEERING MEMO DATED tu
REMARK
METER SIZE
BUILDING SUPPLY SIZE
FIXTURE UNITS
cc
REMARKS 3:
SIGN A REA
ENV. REVIEWiMPT
ADS 14-6.
ALLOWED PROPOSED
I COMPLETE EXE
I
i
I SHORELINE#
VARIANCE OR CU PLANNING REVIEW BY D
YARDS &P HEIGHT I LOT COVERAGE/
FRON'r - AE EAR I ;��v
CHECKED BY ITYPE OF CONSTRUCTION
SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT
R EQUIR
0 YES EC GROUP LOAD
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Perm ' it covers work to be done on private property ONLY. GRADING/FILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission. STATESURCHARGE
Permit Application: 180 Days
ENERGY CODE
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
"Appllcant, on behalf of his or her spouse, heirs, assigns andi
successors in Interest, agrees to Indemnify, defend and hold
J harmless the City of Edmonds, Washington, Its officials,
J
E employees, and agents from any and all claims for damages of
r
whatever nature, arising directly or Indirectly from the issuance
of this permit. Issuance of. this permit shall not be deemed to PLAN CHECK DEPOSIT
modify,.walve 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
I hereby acknowledge that I have read this application; that the
VALUATION
FEE
_b10-00
I/
1 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 This application Is not a permit until
or
ed thereby, no person will be employed in violation of the Lab I ONLY THE signed by the Building Official or his
Code of the State of Washinyn relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is
t1Qjn.tasu,pnc9. 1 INSPECTION acknowledged in space provided.
SIGN TU (OWN OR AGEN DATE SIGNED DEPARTMENT
3/27/86 CITY OF OFFICIAL'S SIGNATURE DATE
;GW-W EDMONDS
1! y1plogigiii III
I i:! 1; 771-3202 RELEASED BY: DATE
ATTENTIOtT
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE /tr- _?1S1196
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3. PINK — Owner GOLD — Assessor
102-78
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