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6901 163RD PL SW.PDFiiiiiiiiii 870 6901 163RD PL SW CA FILE NO. �'ZOO Critical Areas Checklist -- ----------------------------------------------------------- Site Information (soils/ topography/ hydrology/ vegetation) 1. Site Address/ Location: 2. Property Tax Account N 3. Approximate Site Size (acres or square feet): IN ti (?my" 4. Is this site currently developed? / I yes; no. If yes; how is site developed? Zo 0 5. Describe the general site topography. Check 11 at 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 70 horizontal distance of 66-feet). 9:4�9 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). Ll Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a horizontal distance of less than 33-feet). L/ Other (please describe):/�e, Lek . I's A W 0", R_ coaz M; ,rja06 rl 1-4heA a - r;15r"1ArU ba a 6. Site coniaigs��6-<;/Prea -(FLO's'finding water: Approx. Depth:, Approx. Depth: 7. Site contains areas of seasonal standing water: What season(s) of the year? 1 8. Site is in the floodway—Na— floodplain of a water course. 9. Site contains a crPek or an area where water flqVs across the grounds surface? Flows are year-round? Flows are seasonal? IM J'_ — -_ (What time of year? 10. Site is primarily: forested meadow _; shrubs mixed urban landscaped (lawn,shrubs etc)- 11. Obvious wetland is present on site: � A Alk I d 01 City of Edmonds Critical Areas Checklist '4C. 199v 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 complete a development permit application. With a signed copy of this form,, the applicant should also submit a vicinity map or plot plan for individual lots of the parcel with enough detail that City staff can find and identify the subject parcel(s). 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 Area Checklist and attest that the answers provided are factual, to the best of my knowledge (fill out the appropriate column below). Owner/ Applicant: Name � (-ce, 0 1 / 6 3 Street Address 442 Applicant Representative: Name YXI-9 Street Address I cdmo-"'k ��/A City, State, ZIP Phone City, State, ZIP L, —4o a L- z 7-- � 7 Sign�ture NZO Date Signature -,lot . Z' (o 3 -3 D Phone Date 1p- C . 1 S 9 lz� February 23, 1999 Paula Church 6901 163d Place S.W. Edmonds, WA 98026 BARBARA FAHEY MAYOR CITY OF EDMONDS 121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221 DEVELOPMENT SERVICES DEPARTMENT Planning - Building - Engineering Subject: Determination regarding Critical Areas Checklist # 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. IMPORTANT INFORMATION TO BE NOTED: 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. nip, You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED. Permit applications include the following: Enc: Critical Areas Determination * Architectural Design Board C:ReceptlonQana\CRLTR.doc Building Permits Conditional Use Permits Subdivisions Variances Applications to the ADB* Land Use Applications Any,other development permit applications. Thank you. Sharla Graham Planning Secretary Incorporated August 11, 1890 Sister City - Hekinan, Japan 477. 60 -R-ar- ................ '51 IZ IS 0-6* 1 7- 7T.'(1-f7- z e-51S 7 -1A � N asmo INN* 4j tu PRWBCTNAME: -511,C-Ch6mo-I PRWECT ADDRESS: APPLICATION RFECEIPT DATE: 11-16 - fl Reviewed by: (initial/date) COMENTS MANNING WrRISWR STRM imvrm FIRE 13UILDING SINGM FAMILY/KMTIP`LE/CCMERCIAL - (Circle One) SETBACXS CIMCKED - Plwining nt-gl/T VARIANCE-/SF.MAACK ADJ. W/ 7R111 '-7 71-1-1-1-171- -7 7T7 7 -77 7 TF1 7 7 -77 7 7 7 - CONDITIONAL USE PEMUT ///////// //////// .2 7= 77-7777777 ADB REQUIRDOM CHECKED 1, 777777 - OTHER ZONING REQUIRE!vgUM 4 77777-7 ENVIRONMENTAL FEATURES 11117777T 777777 t L ACCESS SMPP & VFIiICTr ACCESS beh 6 IN V DRAINAGE PLAN (On Site) 777777-77 MT kEET FITE jal 777777 777T/777T 777T 77777 7777-777 r-FAGAL DESCRIPTION VPRTFICATION 9 7T777777777777-77777777 77777-7/7 -)UIT CIAIM/DFDTCATIONS 10 //////7777777777777/-/-/7/- RAMAENT - PUB1,IC/PRT\rATC I)fAl 1 11 T U 711111111777/77777777777- 21MMATE SIN�M CON14BC NO LID# ///////// //////// 12 -7 77777777 -M 7 7 7 7 7 PLAT/SUBDIVISION REQUIRMEIM ///////// //////// - 13 7777 7TR7TI7 777TR77 71---ti-YY kTG1fT--0E-WAY CONSTRUCIPION PERMTT RFJ_D ////// ///////// ///////// 14 777Tff 77/--/7777T77/////// 30M REQD FOR PUBLIC IMPROVEMEMS ////// ///////// ///////// 15 30IIS CONDITIONS & GROUND 777Tff 777777/77 77777777 77777TfT MPER FIETD CIfECKED 16 �'MdMT PAVING REQUTRED 17 fl-771-7 111111711 -1-17777Tff AJRR AND MPPER REQ0TRED ////// ///////// ///////// 18 7/7777 171117111 7TF177777' -;-fDEWALX RD-.)UIRED ////// ///////// ///////// 19 TIT/7 7 -77T77 T1 7 7 7TI 7 7 Tff TITFIT177-1' URH CUP MR DRIVE -WAY REM 20 777777777 777TI7717' --fTZEE`P NAME STGN RFJ.-jD 21 7777/7 IfFIfTF17777717711 /7777F/T/7' MfER STCNING RECO 22 'TDE SEWER AVAIIABILITY 77771 777777R7 777777T/7 77 7 7 7 7 7 7 23 Tff/ff 7177R71 777777777 OCISTING t�WVER MATN SIZE 24 7-777/7 71-f7l-717T- 77T/-//-/7-// - ZATER M.M.'ER SIZE 25 77777 T/7/7777 /,, 7777/777 7F 1777TIW - 'F 2VICE LrNE SIZE �Ijl 26 fYDRANII REQUIRED 7777Tff ///////// 111777777 - 27 7FI-U7 fl-Ff77Tff -7771-777TR - IYDRANT SIZE EXISTING ////// ///////// 28 fl77ff -71TMIIII 7 7 7 7 7 7 7 7 -1771-777TF ' 'ROSS CONNWHON INSPWPION REQD ////// ///////// 29 - f77717 -77-7777/777 NATER NOIER CHARGE REQD 7-, 5, 30 FIRE LINE CHARGE REY-)D - SPRINKLER 31 3TREET CUT 32 )PEN DITCH EXISTING 33 7= RE)QO 34 77T/7 'ULVF .RT REr-)D 35 7/77-77T/T SIZE ///////// 30 2ATC11 BASIN REQD 777Tff ////// 7E77777777 77/77/777 17TM -IITIT177-1- .37 INDICATED ON SITE PLAN ////// ///////// 38 SHOULDER DPAINAGE MAINTAIN TT ffT ////TT RT_ FT11T /7:� SHALE OPIN RUNOFF 39 11TF17Tff KISC: 40 REVIEWED BY: PLANNrNG MGR. ENGINEERING MGR. PUBLICCMRKS MGR. L; L I V ED 17.198 IC WORKS CITY OF EDMONDS GONS-TRUCTION PERMIT APPLICATION NAME (OR NAMEPF BUSINESS MAILING ADDRESS USE ZONE PERMIT NUMBER UVO ' , ADDRESS lb-5xD /�� _5hl.. LEGAL DESCRIPTION CHECKI SUBDIVISION NO. LID NO. / - _L_ / "L, o_ Li -,Ina I �? b 0 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP APPROVED BY CITY TELEPHONE NUMBER EXISTING -30 - REQUIRED DEDICATION NAME PROPOSED :30 RIGHT OF WAY CONSTRUCT ON PERMIT REQUIRED V1 I( STREET USE PERMIT REQUIRED: ADDRE$Z R=VIE SEE ENGINEERING MEMO DATED CITY TEiEPHONE NUMBER REMARKS NAME ADOR METER SIZE/,, IBUILDING SUPPLY SIZE IFIXTURE UNITS CITY Trtj,O�E 2NN MBER A/ /Z'1/1 REIAAAK� STATE LICENSE NUMBER V SIGN AREA COMPENV. REVIEW Legal Description of Property - include all easements ALLOWED PROPOSED LETE I EXEMPT (show below or attach four copies) I W1 P,J NEW RESIDENTIAL El PLUMBING 1:1 ADDIALTER COMMERCIAL 1:1 MECHANICAL DREPAIR El RETAINING WALL E] SIGN EXCAVATE 1:1 FENCE E] DEMOLISH 08 FILL I— x _FT) PRE -MOVE INSPJ ET swim E] REMODEL COMPLIANCE INSP. POOL WOOD STOVE/ F-1 INSERT APT.BLDG RENEWAL I NUMBER OF STO IES NUMBER OF DWELLING UNITS NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN) This Permit covers work to be done on private property ONLY. Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission, Permit Application: 180 Days Permit Limit: 1 Year - Provided Work is Started Within 180 Days "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 X of this permit. Issuance of. this permit shall not be deemed to 0 modify, waive or reduce any requirement of any city ordinance 0 nor limit in any way the City's ability to enforce any ordinance provision." I hereby 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 the owner. I agree to comply with city and state laws regulating construction; and in doing the work authoriz- ed thereby, no p�rson will.be employ d in violation of the Labor Code of t e St 1411, tion Insur 7gton relating to Workmen's Compensa- SIGNAT �"5AGENT) IDATE SIGNED VARIANCE OR CU PLAIN YARDS FRONT SIDE REAR BY TYPE OF CONSTRUCTION W BYZ Z 1W a: ADB NO, IORELINE N REVIEW BY I DATE -F—HEiGHT I LOT COVERAGE ' CODE HEIGHT /17f_s- 2�-,/ SPECIAL INSPECTOR AREA OCCUPANC�- OCCUPANT REQUIRED GROUP LOAD El YES I.- NO REMARKS PROGRESS INSPECTIONS PER LIBC 305 VALUATION PLAN CHECK FEE BUILDING PLUMBING MECHANICAL GRADING/FILL STATE SURCHARGE ENERGY CODE IPLAN CHECK DEPOSIT 1 1—/ o 0 1 C/-5-6 q I TOTAL AMOUNT DUE ATTENTION APPLICATION APPROVAL THIS PERMIT AUTHORIZES This application is not a permit until ONLY THE signed by the Building Official or his WORK NOTED Deputy; and fees are paid, and receipt is INSPECTION acknowledged in space provided. DEPARTMENT CITY OF OFFICIAL'S SIGNATURE DATE EDMONDS ATTENTION Z7� 771-3202 RELEASED BY: DATE It IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE 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 102-87 a Z Z Z CL CITY OF EDMONDS SIF(Ef ..T FILE 2NEW ADDITION RETIREMENT ASSET INFORMATION SHEET ASSET NO. ADDITION TO ASSET NO. DESCRIPTION SERIAL NO. LOCATION D FT. N (I./ PURCHASE ORDER NO. PURCHASE ORDER DATE COST B.A.R.S. ACCOUNT NO. Z, ESTIMATED LIFE INITIATED BY DATE PROJECT NUMBER PROJECT COMPLETION DATE COST APPROVED BY "SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST *SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT ACCOUNTING ONLY U-/DEPRECIATE MONTHLY DEPRECIATION AMOUNT ANNUAL DEPRECIATION AMOUNT G.L. ENTRY REFERENCE brp) INITIAL VERIFIED BY PROCESSED BATCH NO. DATE DEPARTMENT FILE 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 forth 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 employees or officers shall be liable for the information given on map(s), nor for any one representation provided based upon said map(s). .:dl 00 CD CITY of EDMONDS STREET IDE FILE s SEWER PERIAH. For Inspection Call 771-8�02 PERMIT NO. 07900 Aririrp-,cz nf rr)nrtrijrtinn- /') �0 / /63d P� - � &-.) Property Legal Description (Include all easements): Lo+ 14 Muvociwc(A(E Owner and/or Builder: .�f AJC iA(�Z 4 bc— U Contractor & License No: L C L / k C 1A 4 "1 59, Single Family Residence 0 Mu I t i - Fam i 1 y (No. of Units LYNNWOOD LINE] Commercial (No. of fixture Units Invasion into City Right -of -Way: No /-k 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 \,J Yes (If Yes, easement required, attach legal description and county easement number.) PLEASE READ THE ITEMS LISTED ON THE BACK RL(;L1 VLU MAY Z- 1989 1 certify that I have read and shall comply PUBLIC, INORKIS Date with the items listed on the back. Permit Fee: '30— Issued By: Trunk Charge: �Date Issued: 7- Assessment Fee: Receipt No.: a -3 66 Partial Inspection: Comments Date Initial Final Inspection Approved: DSte Initial Rejected: Reason Date Initial ** PERMIT MUST BE POSTED ON JOB SITE ** Wh.ite Copy - File Green Copy - Inspector Buff Copy - Applicant A 1' The City of Edmonds Side Sewer Drawing EASEMENTNO - -------------------------------------------- I NEW CONSTRUCTION [Y" REPAIRS F-1 LID NO . .................. . ASMT. NO - ----------- ------ OWNER ---------------------------------------------- ........ ---------------------------------------- CONTRACTOR e!lPASZ ...................... PERMIT NO. 0-71-qll JOB ADDRESS ----------- LEGAL DESCRIPTION: LOT NO - ------ tq ........................ BLOCK NO - ------------------------------------ .......................... . ....... tA An � et \k k lkI t-,, 11'r -eve ...... --- ;3 -------- - --------------------------------------------------------- G) 0 *-V -,� - I " 0 F PWW-0001-1 1/75 (REV.1 1/78) NAMEOF ADDITION ----------------------------------------------------------------------------------------------------------------------- 2' DC912. V - c, 49 1 t Deep. ELY=NN\WfVOOD LINE�j L L F-1 Approved: 4- DATEL> .................... . ............... Byc ..... ------ ------ �uu ECEIVED STREET FILE NOV 0 6 2001 ERVIT COUNTER - I:c 161. 0-5- 1�c —4 Z-i A \1 Z 0� PE wbe ui dl cc ui ss CIO-, GUTTERS/DoWNSPOUTS, CT TO EXIST. SYST- CO Ilk C)i T (oto SDR --aw 60 r-3 N -A2 Cl RA� Per 41A APPROVED AS NOTED 4-r- PL 0 T PLAN BY ENPINEERING 0 /0 20 30 Date: CCAZE /" : / 1 -0 // PLANNING DATA NAME: C�ucyc* SITE ABDRESS: PROJECT DESC REDUCED SITE PLAN PROVIDED?: Q / No MAP PAGE: 45-7 CORNER LOT: (Yes FLAG LOT: (Yes ZONING: CRAMAL AREAS DETERMINATION #: Ckq Study Required: Waiver U Conditional Waiver CH SEPA DETERMINATION: Ll Fee Ll Checklist L3APO list w/ notarized form U (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger) Exempt SETBACKS: &> (91611�21 Required SetbaAcJs_:'1_&�. I Street: If�' Left Side: 10' Right Side: 10 Rear: Actual Setbacks: Street: @1W Left Side: Right Side: Rear: — Street map chocked for additional setback required? (Yes No gNN-) U DETACHED STRUCTURES: LJ ROCKERIES: LJ FENCES/TRELLISES: L) BAY WINDOWS / PROJECTING MODULATION: USTAIRS I DECKS: PARKING: Required: a Actual:2— LOT AREA: I:g 5L4 LU I UUVLKAW i�>'�>911, I Calculations: LCYT- 1 -12 14, BUILDING HEIGHT: Datum PointeAMB f5A%1M —Datum Elevation: Maximum Allowed: f Actual Height: _� A.D.U. CREATED?: (No / Yes) SUBDIVISION: 3��C> i - bLA LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: (Yes / No OTHER:- 1-b DA-r0t._& fb I tZrr f ��f= 1,A p, 1.0 Plan Review By: !2)4t'_ NewBPP1anningDataForm.D0C D �DATE RECEIVIO PERMIT EXPI RES CITY OF EDMONDS USE PERMIT ZONE 2, 0 NUMBER JOB ITE/APT# ADDRESS &q ()/ I ( PL CONSTRUCTION PERMIT APPLICATION I a OWNER NAME/NAME OF INESS . . PLAT NAME/SUBDIVISION NO. L�D NO. fie 1? 7777 L D FEE $ z M—AILING ADDRESS 1 .12 f PL (,qC)( PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Apprmed 0 RW Permit Required 0 0 Street Use Permit Req'd 0 EXISTING_ PROPOSED Inspection Required 0 Sidewalk Required CITY ZIP TELEPHONE REQUIRED DEDICATION— FT Underground Wiring required 0 NAME METER SIZE LINE NO. OF FIXTURES PRV REQUIRED YES 0 NO 0 3 W L 3 ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE z z L a (4 wi� r-u) ai ui bITY ZIP TELEPHONE N'A� G NAME 515, lt,�- "J (1)-P(1HTWJ0 It ANAL-- JAt!A�, c, ENGINEERING REVIEWED/DATJ ADDRESS cc R 1 .0 1� Ir FIRE REVIEWED BY DATE cc CITY ZIP IEVyiiot�vs I ?70 TELEPHONE A17 4 5-11-5 I'- z U VARIANCE OR CU SHORELINE OR ADB# INSPECTION REO'D I BOND POSTED t STATE LICENSE NUMBER EXPIRATInN nATr CHfiefty B 0 =1115 111LO31 [] YES Q NO I \ SEPA REVIEW SIGN AREA HEIGHT -JIPROPERTYTA x ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOW OPOSE'D W I -i EX p F1 NEW RESIDENTIAL PLUMBIN ECH LOT COVERAGE ALLOWED PRO POSED AEOUIRED SETBACKS (FT.) 'ON SIDE REAR �,F , �) 'r T I PROPOSED SETBACKS (FT.) FROIT URPIDE REAR ADDITION COMMERCIAL COMPLIANCE OR 7F, z z CHANGE OF USE f-1 REMODEL 0 APARTMENT SIGt PARKING REO'D PROVIDED LOT AZR..W,. PLANNING F14VItWED BY DATE I :L n REPAIR C3 GRADING FENCE CYDS X REMARKS I, — * �&k Qa (!J� 7r(; PA —A ll�j t M DEMOLISH 0 TANK OTHER 0 GARAGE RETAIN G ILL C] RENEWAW z CARPORT R.CKF: (TYPE N: OF USE, BUSINESS OR ACTIVITY) EXPLAI tj eziftmoci� CHECKED BY TYPE OF CONSTRUC.TION C006? -&f OCCUP OCCUP! cc J� N 5�-yq -RrK, . I., "N -7, GROUPP n a NUMBER OF NUMBEROF DWELLING CRITICAL 4. AREAS ..SPECIAL INSPECTOR JAREA 'REQUIRED P4VjjQ(,): ' ip k9(Y6 OCCUPANT OCCUP LOAD LO 0' STORIES UNITS NUMBER E]YES I 1.�T-PU 14(7 DESC91BE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D PWOM 'j, F) —lot/ VALUATION FEE PLAN CHECK FEE HEAT SOURCE LAZ6G LOT SLO BUILDING 10 31 DIN 2�; 10' 15 PLAN CHECK NO: ;7 VESTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO ggrl t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADING/FILL: DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. STATE SURCHARGE PERMIT APPLICATION: ISO DAYS uj 'I CL PERMIT LIMIT. YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION 00 *APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS ENG. INSPECTION FEE kv uj IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF i LANDSCAPING 9 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND INSPECTION FEE ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY REC PQ;U x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE, OF THIS PERMIT SHALL NOT BE CHECK DEPOSIT DEEMEDT 0 MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE ..PLAN 0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- x — TOTAL AMOUNT DUE RECEIPT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT. 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 This application is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building Official 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 acknowledged in space provided. WORKMEN'S OM RANCE AND RCW 18.27. '41CIALS SIGN (0" DATE SIGVED I (425) 0 RE DATE SIGNATU 41 ff�fAGE 771 022d 1 -W tt,A--S D, B T D9TE ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL(_Flj.� YELLOW' INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX-- PINK - OWNER GOLD - ASSESSOR 5/98