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715 HANNA PARK RD.PDF715 HANNA PARK RD Sc4►-E I �= Sa �o N , Z01E �P FRO SIDE & REAR ° OTHER_ "' HEIGHT v N A,IAt %i � EKISZ. ;�LeS��Ei�cE ao, ! "L 'V . I ILIr- 05 � z Z CL RECOVEry- MAY 2 1 2001 BUILDING DEPT. L �h • DECLARATIONS OF APPLICANT Please answer all questions 1. What are the physical characteristics, (i.e. topography, shape of lot, etc.) which create a hardship for you in regard to development of your property? A portion of the existing structures is non-conforming-ccordinq to today's si'de yard setback requirements. 2. How does your property differ from other property in the same vicinity? When we applied for a permit to remodel, we were not aware that the structure was non -conforming. !✓� �,/�,, T, 3. Will this variance be detrimental to the public or damaging to other property or improvements in the vicinity? No 4. What hardships will result to you if the variance is not granted? Will these hardships have been caused by your own action? We have a flat roof that is 1 akina In order to permanantly correct this situation. we need to r bvf'1r1 the rnnf nn tha non -conforming structure. S. Can you make reasonable use of your property without the variance? ` lJ City of Edmonds Critical Areas Determination Applicant: Darren. Mock of Seattle Determination #: CA-01-64 Custom Deck for owner, Wendy Chaffle Project Name: Permit Number: Site Location: 715 Hanna Park Road Property Tax Acct #: 2427 032 094 00 Project Description: Non -Project Specific Determination: Study Required: During review and inspection of the subject site, it was found that the site appears to contain a critical area consisting of a Steep Slope Hazard Area pursuant to Chapter 20.15B of the Edmonds Community Development Code (ECDC). Based on these findings, prior to submission of any development permit, you will be required satisfy the requirements of ECDC 20.15B by completing a Critical Areas Study consisting of the following: Steep Slope Hazard Area Delineation Requirements: To determine if a Steep Slope Hazard Area does exist, a topographic survey prepared by a Licensed Land Surveyor delineating Steep Slope Hazard Areas must be completed. Any slope of 40% or more with at least 20 feet of rise will be classified as a Steep Slope Hazard Area. A 50- foot buffer is required from both the top and toe of the slope. A 15-foot building setback is required from the 50-foot buffer. For development of any kind which is proposed within the critical area, 50-foot buffer or 15-foot buffer setback, it must be shown that the development will not adversely impact the Critical Area or its buffer, by doing one or possibly both of the following depending on the outcome of the study: 1. For development proposals which will occur within the 50-foot buffer, but no closer than 10 feet from the top or toe of the slope, the 50-foot buffer requirement may be reduced to 10 feet if a study is completed by a licensed geologist or geotechnical engineer which clearly demonstrates that the proposed buffer alteration will have no adverse impact upon the site, the public or any private party. 2. If development must occur within the critical area, buffer, and/or buffer setback, and is not identified as an exception per ECDC Chapter 20.1513, a Reasonable Use Exception and Variance must be obtained pursuant to ECDC 20.15B.170A and 20.1513.040C. If the property owner wishes to apply for a specific development permit which they feel would not impact the Critical Areas located on the site, they may submit their proposal to the Planning Department for review. If the Planning Department finds that the proposed development permit will not adversely impact a Critical Areas or its buffers, a conditional waiver may be issued on a project by project basis. Please call me at 771-0220 if you have any questions. �c Star Campbell _ ,: Az_v� ply s � May 16, 2001 Name Signature Date Cited sections of the Edmonds Community Development Code (ECDC) can be found on the City of Edmonds website at www.ci.edmonds.wa.us. 2 City of Edmonds Critical Areas Determination Applicant: Darren Mock of Seattle Determination #: CA-01-64 Custom Deck for owner, Wendy C6affle Project Name: Permit Number: Site Location: F715 H211112 Park Rd. Property Tax Acot #: 2427 032 094 00 Project Description: 6' X 16' Deck at SW corner of house Waiver Criteria (all criteria must be found to apply): X There will be no alteration of the Critical Area or its required buffers; X The development proposal will not impact the Critical Area in a manner contrary to the goals, purposes, objectives and requirements of the Critical Areas ordinance; X The development proposal meets the minimum standards of the Critical Areas ordinance; X The above findings are based on the following conditions of approval: Waiver Is only for proposed deck shown shown and described on atteebed documents. Based on the above findings and conditions, the requirement for a Critical Areas Study associated with this development permit is hereby Waived, as authorized by Chapter 20.1 SB.040 (A)(1) of the Edmonds Community Development Code. Stim rxabell �1e„i,,l,,.,, 1�2001 Name Signature Date b020'd . ZZZOT641wd SQNOWU X AiIO 2T:5t ZOOZ-Bt-&W Critical Areas Checklist CA File No: CA— 0M Site Information (soils/topography/hydrology/vegetation) 1. Site Address/ Location: -%/57 �&V lvA Ptse L t 2. Property Tax Account Number: 014 Zn C73 D C't q e9 y 3. Approximate Site Size (acres or square feet): 24&c7,6 17 4. Is this site currently developed? —4yes; no. If yes; how is site developed? �Q wt ( 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: _�1�� ; Approx. Depth: 7. Site contains areas of seasonal standing water: NCB ; Approx. Depth: What season(s) of the year? 8. Site is in the floodway T-0 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? (What time of year? ). 0. Site is primarily: forested ; meadow ;shrubs ; mixed urban landscaped (lawn,shrubs etc) 11. Obvious wetland is present on site: Critical Areas Checklist.dod3.19.2001 � �p ED,yro ti City of Edmonds Development Services Department �.. Planning Division Phone: 425.771.0220 -/nC I g90 Fax: 425.771.0221 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 the application 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). Date Received: b ­t,O City Receipt #: Critical Areas File #: GA — J — Critical Areas Checklist Fee: $45.00 Date Mailed to Applicant: A property owner, or his/her authorized 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 assistant staff in completing their preliminary assessment of the site. The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or incomplete information furnished by the applicant, his/her/its agents or employees. By my signature, I certify that the inf ation and exhibits herewith submitted are true and correct to the best of my knowledge and that I am authorized tgt- applic io on the behalf of the owner as listed below. SIGNATURE OF APPLICANT/AGENT DATE Property Owner's Authorization By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application, and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the purposes of inspection and posting attendant to this application. SIGNATURE OF OWNER (ivy `' %y ' A F� DATE PLEASE PRINT CLEARLY Owner/Applicant: Name Street Address City State Zip Telephone: Email address (optional): Applicant Representat' e: Tame < 59.0,� PL �nl Street Address City State Zip Telephone: LUQ5) 1O-7,:7-�— �o3Co Email Address (optional): Critical Areas Checklist.doc/3.19.2001 CA File No: cA_ Critical Areas Checklist Site Information (soils/topography/hydrology/vegetation) 1. Site Address/Location: ­7157 �&VNA 0A2 t2� 2. Property Tax Account Number: QZL 2'7 673 Q C�Kl �{ 3. Approximate Site Size (acres or square feet): Dcy 4. Is this site currently developed? -yes; no. If yes, how is site developed? �QIM 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: VC ; Approx. Depth: What season(s) of the year? 8. Site is in the floodway V-0 floodplain of a water course. 9. Site contains a creek or an area where water flows across,the grounds surface? Flows are year-round? �4 L62 Flows are seasonal? ' (What time of year? ). 1.0. Site is primarily: for ; meadow ;shrubs ; mixed urban landscaped (lawn,shrubs etc) (� 11. Obvious wetland is present on site: tiV Critical Areas Checklist.doc/3.19.2001 OV.ED,y� •,;iwi; . ty of is n. t"Ai!•-- .,,. }... a. - Development Services Department Planning Division Phone: 425.771.0220 ; ago Fax: 425.771.0221 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 the application 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). � Date>Received: 5- . City Receipt #: Critical Areas File #: GA -O — Critical Areas Checklist Fee: $45.00 ,'Date Mailed_to Applicant: A property N 'owner, or'his/her authorized representative, mu_ st,filFout 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 assistant staff in completing their preliminary assessment of the site. The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or incomplete information furnished by the applicant, his/her/its agents or employees. By my signature, I certify that the inf ation and exhibits herewith submitted are true and correct to the best of my knowledge and that I am authorized to 1 this applic ion on the behalf of the owner as listed below. SIGNATURE OF APPLICANT/AGENT DATE Property Owner's Authorization By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application, and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the purposes of inspection and posting attendant to this application. SIGNATURE OF OWNER (JW4�� ds""�F� DATE . ' j'd PLEASE PRINT CLEARLY Owner/Applicant: Name'" Street Address City State Zip Telephone: Email address (optional): "P, W Street Address City State Zip Telephone: (qQ5) L9-7,:7�- �-n 3(p Email Address (optional): Critical Areas Checklist.doc/3.19.2001 City of Edmonds Critical Areas Determination Applicant: Darren Mock of Seattle Determination #: CA-01-64 Custom Deck for owner, Wendy Chaffle Project Name:I -] Permit Number: Site Location: 715 Hanna Park Road Property Tax Acct #: 2427 032 094 00 Project Description: Non -Project Specific Determination: Study Required: During review and inspection of the subject site, it was found that the site appears to contain a critical area consisting of a Steep Slope Hazard Area pursuant to Chapter 20.15B of the Edmonds Community Development Code (ECDC). Based on these findings, prior to submission of any development permit, you will be required satisfy the requirements of ECDC 20.15B by completing a Critical Areas Study consisting of the following: Steep Slope Hazard Area Delineation Requirements: To determine if a Steep Slope Hazard Area does exist, a topographic survey prepared by a Licensed Land Surveyor delineating Steep Slope Hazard Areas must be completed. Any slope of 40% or more with at least 20 feet of rise will be classified as a Steep Slope Hazard Area. A 50- foot buffer is required from both the top and toe of the slope. A 15-foot building setback is required from the 50-foot buffer. For development of any kind which is proposed within the critical area, 50-foot buffer or 15-foot buffer setback, it must be shown that the development will not adversely impact the Critical Area or its buffer, by doing one or possibly both of the following depending on the outcome of the study: 1. For development proposals which will occur within the 50-foot buffer, but no closer than 10 feet from the top or toe of the slope, the 50-foot buffer requirement may be reduced to 10 feet if a study is completed by a licensed geologist or geotechnical engineer which clearly demonstrates that the proposed buffer alteration will have no adverse impact upon the site, the public or any private party. 2. If development must occur within the critical area, buffer, and/or buffer setback, and is not identified as an exception per ECDC Chapter 20.1513, a Reasonable Use Exception and Variance must be obtained pursuant to ECDC 20.15B.I70A and 20.1513.040C. If the property owner wishes to apply for a specific development permit which they feel would not impact the Critical Areas located on the site, they may submit their proposal to the Planning Department for review. If the Planning Department finds that the proposed development permit will not adversely impact a Critical Areas or its buffers, a conditional waiver may be issued on a project by project basis. Please call me at 771-0220 if you have any questions. Star Campbell A �� May 16 2001 Name Signature Date • Cited sections of the Edmonds Community Development Code (ECDC) can be found on the City of Edmonds website at www.ci.edmonds.wa.us. 2 il APPLICATION for The City of Edmonds SIDE SEWER PERMIT NEW CONSTRUCTION 0 REPAIRS 0 EASEMENT No . .......................................... 112-07950 OWNER. .......... Dauglas-.S....Egan ------------------------------------------------------------ CONTRACTOR ....................................................... .......................................... PERMIT No.......-_.._........... ADDRESS ...... ................................................. LEGAL DESCRIPTION: LOT No - ---------------------------------------------- BLOCK No . ............................................ NAME OF ADDITION .................................. ...................... Dye Tested On Sewer 1972 Approved: DATE! ------------- - ................................ • 13Y ---- ...... ........................ ................ ................ PLANNING DATA NAME:S-AAktEg c_ SITE ADDRESS:3 1 o mrgk CLU,Rn . DATE: O1 ZONING: 'k I- . PLAN CHK#: D-� ► PROJECT DESCRIPTION:j n,-L� CORNER LOT Vescop FLAG LOT (Yes/Ro SETBACKS: Required Setbacks: Front: Left Side: Right Side: Rear: l�lp� Actual Setbacks: Front: Left Side: Right Side:,Rear: Street map checked.for additional setback required? (Yes o LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED (/N LOT COVERAGE: Maximum Allowed: Actual: BUILDING HEIGHT: / Maximum Allowf+d: Actual Height: Datum Point: Datum Elevation: A.D.U. CREATED?: jjr) SUBDIVISI CRITICAL AREAS #: eA- 01 - (o%4 — ('jowo. �Z(k\VQa SEPA DETERMINATION LOT AREA Plan Review By: c:V"des\permit\^plandat.doc City of Edmonds Critical Areas Determination Applicant: Darren Mock of Seatfie Determination #: CA-01-64 Custom Deck for owner, Wendy dame Project Name: Permit Number: F- I Site Location: 715 Hanna Park Rd. PropertyTax Acot #: 2427 032 094 00 Project Description: 6' X 16' Deck at SW corner of house Waiver Criteria (all criteria must be found to apply): X There will be no alteration of the Critical Area or its required bufFers; X The development proposal will not impact the Critical Area in a mariner contrary to the goals, purposes, objectives and requirements of the Critical Areas ordinance; x The development proposal meets the minimum standards of the Critical Areas ordinance; X The above findings are based on the following conditions of approval: Waiver is only for proposed deck shown shown and described on attached documents. Based on the above findings and conditions, the requirement for a Critical Aroas Study associated with this development permit is hereby Waived, as authorized by Chapter 20.15B4O44 (A)(1) of the Edmonds Community Development Code. Star CAUZ&ll 5118,O1 Name Signature Date tb©2o I d T ZZO %I6^ZFb KNOWO �O h1 I O Z T : St TOW-81-41 iw FILE #'T. STREET FILE DATE CITY OF EDMONDS FEE BOARD OF ADJUSTMENT ' `'7 RECT ���� APPLICATION FOR APO' S HEARING DATE: J APPLICANT TER;e l S'C i ADDRESS 7/ S //,g w.4 CITY & ZIP Fc�.,,o.,�c 9�oa� PHONE 77L— INDICATE TYPE OR DEGREE OF INTEREST IN PROPERTY LOCATION OR ADDRESS OF PROPERTY 7/S .y P.-,P< LEGAL DESCRIPTION OF PROPERTY Lot 3 of Plat, the South 342 feet of Government Lot 1, Section 24, T27NR3E, less East 660' thereof VARIANCE REQUESTED: Re -construct roof of recreation room ^!� '�+-�—+'� p C c' �/� .�cr ...�� i S /✓O i.-.?��� - /�� t ..-,. . vti , C_ r f S c'__ 7 FOR OFFICE USE ONLY USE ZONE : �S ( �. ZONING ORDINANCE REQUIREMENT: j b •�'y�z,..�Q-c STATE OF WASHINGTON) ss. COUNTY OF SNOHOMISH) ignature of Applicant, Owner, or Representative On this date, before me, the undersigned, a Notary Public in and for the State of Washington, duly commissioned and sworn, personally appeared t � „ <13/" , who, being duly sworn, on his/her oath deposes and says that (s)he ha4 prepared 'and read the attached statements and has acknowledged to me that the recititations contained therein are true, and has signed this instrument as his/her free and voluntary act and deed for the purposes therein mentioned. Subscribed and sworn to before me this�_�day of , 19�. Notary Publ��,�d� fo �b State of Washington, residing g r. w ov� --- ----- ----- i i -- � a�ri�urs��s:tea? �\�;�, i /��,: �. oc rl J RI (D o Y ,DATE RECEIVED a' u f FrRMIT EXPIRES CITY OF EDMONDS USE PERMIT ZONE NUMBER:: CONSTRUCTION PERMIT APPLICATION JOB SUITE/APTa ADDRESS pV �.. ! IJA �t r' ? r y 1 •� NAME/NAME OF BUSINESS ttOWNER yy l_::•- f vF j r(.11 A../a�'.f 1, t Cyi- -.• i 1, I is PLAT NAME/SUBDIVISION NO. LOT NO. '? LID NO. MAILING ADDRESS W Z 3 _• ! �••• LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved 0 O tt't h..i fr.,� N-�lk�,, i-F# R.,✓ EXISTING PROPOSED RW Permit Required ❑ Street Use Permit Req tl Inspection Required 0 CITY ZIP TELEPHONE r .' • ` �% , , 1 } .r `.;y�.j, J d7-,. ,.,, d., L-! REQUIRED DEDICATION FT Sidewalk Required 0 Underground F .. Wiring required 0 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED ~ YES ❑ NO ❑ C7 Z W r ADDRESS REMARKS Z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE z a z W CITY ZIP TELEPHONE NAME { ENGINEERING REVIEWED/DATE Cr ADDRESS FIRE REVIEWED BY DATE z CITY ZIP TELEPHONE cc } t c�a STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY VARIANCE OR CU SHORELINE OR ADBa INSPECTION BOND REQ'D ❑ YES POSTED J , a PROPERTY TAX ACCOUNT PARCEL NO. SEPA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED EXP ❑ NEW 0 RESIDENTIAL PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED `FRONT •'X'SIDE REAR FRONT'" t1R°SIDE REAR AUDITION COMMERCIAL COMPLIANCE OR ... ,. - ",,, s%i..v- z CHANGE OF USE -- ::; PARKING Q REMODEL O APARTMENT SIGN .•LOT AREA PLANNING REVIEWED BY DATE REO'Dye, PROVIDED ti•y` a GRADING CYDS FENCE ❑ REPAIR El jj t / •.,r ( X FT) REMARKS DEMOLISH TANK,. OTHER,)„.,,,., q•.. GARAGE ❑ CARPORT RROCKERNG WALL RENEWAL z O a (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: /' r::. "= r %'. i ` l CHECKED BY TYPE OF-CONSTRU Y TION CODE .. OCCUPANT „ -i. , . j J` /' GROUP oNUMBER NUMBEROF CRITICAL m OF ` S STORIES DWELLING + AREAS rf SPECIAL INSPECTOR AREA OCCUPANT O 9 UNITS I NUMBER ,�,f s REQUIRED Q YES DESCRIBE WORK TO BE DONE ` REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D c7 o J / ��• VALUATION FEE PLAN CHECK FEE HEAT SOURCE GLAZING % LOT SLOPE % .'�;�,., ^Fa.� '�1i.•.J.... BUILDING PLAN CHECK NO: VESTED DATE •'� ! /�••� -•• PLUMBING THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO MECHANICAL t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC 2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE J GRADING/FILL r SEPARATE PERMISSION. w PERMIT APPLICATION: 180 DAYS STATE SURCHARGE a PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ' SEE BACK OF PINK PERMIT FOR MORE INFORMATION ENG. REVIEW FEES n "APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS ENG. INSPECTION FEE W IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF 2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND LANDSCAPING cc ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY INSPECTION FEE = FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE PLAN CHECK DEPOSIT- RECEIPT r �'/•• O NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' x TOTAL AMOUNT DUE RECEIPT - ••, -• � d' ' •���: t ' -�> [;,.� 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 APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL This application is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid, and VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is W WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. acknowledged in space provided. p SIGNATURE (IOWNER OR.AGENT) �.j`y'•!f f DATE SIGNED 425-', OFFICIALS, SIGNATURE .• DATE �, rj f, ?✓�/Yrh ,'�,.Y�,,? F . �� -- E..�.'.i ; 771 -U220 'f ATTENTION EXTt333 RELEASED BY DATE IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL ' ' r.' `''''1 l t ;r.•• A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-771 ,...; ,,, �• CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX ORIGINAL - FILE YELLOW - INSPECTOR PINK OWNER 5/9B - GOLD - ASSESSOR J "