19790269.pdf9
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BUILDING DIVISION Applicant Fill ZONE NUMBER 790269
PERMIT APPLICATION Inside Heavy Lines J 0 El
ADDRESS
NAME JOR NAME OF BUSINESS) / / / 5 -- 6� — 4
) 3 LEGAL DESCRIPTION SULWIVISION 't�CHORT SUB NO.
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CITY ELEPHONE NUMBER
EXISTING
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NAMFJ
f- ey,- JIL r-(,( DEFICIENCY OF RIGHT OF WAY
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A EJ CWEr-S PU13LIC IMPROVEMENTS REQUIRED
Y, DRAINAGE IMPROVEMENTS REQUIRED
U REQUIRED
0: CITY DRAINAGE PLAN
LA-4 UNDERGROUND WIRING REQUIRED
]TELEPHONE NUMBER
NAME' CONNECTION TO SANITARY SEWER
SEPTIC TANK PERMIT REQ'D El NO..
0 ADDRESS ELEVATION OF PROPERTY CORNERS
FOOTINGS REQ'D
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TELEPHONE NUMBER
SEE ENGINEERING MEMO I
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METER SIZE BUILDING SPPPLY SIZE
Legal Description of Property (Show Below or Attach Four Copies) /Ai
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0 ADB No.
SIGN AREA ENV. REVIEW
COMPLETE EXEMPT 7
ALLOWED PROPOSED 9
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J VARIANCE OR CU IPLANNING REVIEW BY FDATE
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NEW RESIDENTIAL LINE FIRE ZONE ITYPE OF CONSTRUCTION CODE HEIG
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NON-RESIDENJTIAL SIGN
F-1 ADD
SPECIAL IN ECTOR AREA OCCUPANCY OCCU
RETAINING
Li DEMOLISH Li WALL REQUIRED El N 0 L9 GR(
EXCAVATE FENCE El YES
ALTER OR FILL X—FT) PLAN CHECKED 183Y I HIS zil I E 11
OF EDMONI
F� REPAIR F7PRE-MOVE swim SHOULD BE
INSP. L_j POOL R ARKS
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3 UNITS
IL N]RURE OF WORK TO BE DONE
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PLAN CHECK FEE
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�JPLOT PLAN
Ale 34.3
BUILDING
PLUMBING
MECHANICAL
FENCE
In I "Applicant, oil behalf of his or her spouse, lleirs, assigns and SIGN
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W successors in interest, agrees to indellilliry, derend and hold harniless
-1 RETAINING WALL
2 tile city or Edmonds, Washington, its officials, employees, and /0
X agents from -,my and all claims for damages of whatever nature,
< SWIMMING POOL
I arising directly or indirectly froll, tile issuance of this permit. Issu-
a ance of this permit shall not be deemed to modify, waive or reduce
any requirement of any city ordinance nor limit in any way tile
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X City's ability to enforce any ordinance provision."
J1 ----
I hereby acknowledge that I have read this application; that the in- TOTAL AMOUNT DUE
formation given is correct; and that I am tile owner, or the duly author-
ized agent of tile owner. I agree to comply with city and state laws regu- ATTENTION
lating construction; and in doing the work authorized thereby, no person
will be employed in violation of the Labor Code of tile state of Washington THIS PERMIT
relating to Workmen's Compensation Insurance. AUTHORIZES
NOTE: Permit Limit One Year(Except DEN1101-FriONSand 1-1 ONLY THE
PERMITS without conditional use Permit, Which shall be Completed in 90 WORK NOTED
days; NICIVED-IN BUILDINGS shall be completed in six nionths'.)_ INSPECTION
SIGNATURE (OWNER OR AGENT) DATE SIGNED DEPARTMENT
-,�;Ir, L. CITY OF
W', ig 2 - - 0 �— /� 1- 11 EDMONDS
This Perrrnt--c-ohrs work to be done on private property ONLY. 775-2525
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTW6J&,---1
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL1%qP.J11
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC 304,Wi.1
102-78
LOAD
-OCATED IN THE Cl-
LOCAL SALES T�
,ODE D -31.04.
4,
VALUATION FEE
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APPLICATION APPROVAL
This application is not a pernlit
until signed by tile Building official or
Ilis Deputy; and fees are paid, and
receipt is acknowledged in space pro-
vided.
DIRECTOR)f-.WGI`jATQR-E/
DATE f 14
-43 - 7C /
ORIGINAL -- File YELCOW — Inspector
T� PINK — Owner GOLD — Assessor
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