19800264.pdffl
BUILDING DIVISION A p p I i Adt �': ill I t I
PERMIT APPLICATION inside Heavy Lines
NAME JOR NAME OF BUSINESS)
Jabil Developmemt Corp
MAILING ADDRESS
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3: P.O. Box 1582
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Lynnwood WA
NAME
John Sanford
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W ADDRESS
P.O. Box 1582
U
M CITY
4C Lynnwood
!NAME
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0 ADDRESS
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CITY
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778-4511
ELEPHONE NUMBER
778-4511
ws PERMIT
3.0 4 C N U M 13E It F3 0 0 2 6 1
.1013
A D 1) R I ',S 1115 4th Avenue
South
LEGAL DESCRIPTION
SUBDIVISION
1 S-35-63
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING 60'
6 0
PROPOSED
DEFICIENCY OF RIGHT OF WAY_.
PUBLIC IMPROVEMENTS REQUIRED
DRAINAGE IMPROVEMENTS REQUIRED
DRAINAGE PLAN REQUIRED
UNDERGROUND WIRING REQUIRED
CONNECTION TO SANITARY SEWER
El
SEPTIC TANK PERMIT REO'D 11 NO.
ELEVATION OF PROPERTY CORNERS
& FOOTINGS REO'D
LEPHONE NUMBER I SEE ENGINEERING MEMO DATED 6:i12=:Z-9--
rY LICENSE NUM13ER -MCHECKE0 BY
Rober ts
METER SIZE
1 -X2
BUILDING SU�PLY 571ZE
1 1 �2-Min
Legal Description of Property
W 1501 Lot
(Show t3elow or Attach Four Copies)
6 Block 1
REMARKS
Z
0 South Park
Addition to
IREMARKS
Pressure regulator Req'd
SIGN AREA
ALLOWED PROPOSED
ENV. REVIEW
COMPLETE EXEMPT
AOB NO.
U Edmonds
In
SHORELINE
III
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See 780343
ell
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VARIANCE OR CU
1PLANNING REVIEW 13Y
I DATE
YARDS
NEW
RESIDENTIAL
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GAS
LINE
FRONT
FIRE ZONE
NTIAL
NON -RESIDE_]
SIGN
2
F
ADD
DEMOLISH
RETAINING
SPECIAL INSPECTOR
REQUIRED
EALTER
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EXCAVATE
OR FILL
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WALL
FENCE
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ED YES NO
PLAN CHECKED By
REPAIR
PRE -MOVE
INSP.
swim
POOL
REMARKS
Z NUMBER OF STORIES
NUMBER OF
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3
DWELLING
1
12
UNITS
- NATURE OF WORK TO BE DONE
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Renewal
790269
In
of
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PLAN CHECK FEE
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BUILDING
PLUMBING
MECHANICAL
FENCE
SIGN
In "Applicant, on behalf of his or her spouse, heirs, assigns and
0
III
successors in interest, agrees to indemnify, defend and hold harmless
-I
2 the City of Edmonds, Washington, its officials, employees, and
RETAINING WALL
0: agents from any and all claims for damages of whatever nature,
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I arising directly or indirectly from the issuance of this permit. Issu-
SWIMMING POOL
a ance of this permit shall not be deemed to modify, waive or reduce
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0 ol any requirement of any city ordinance nor limit in any way the
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7: City's ability to enforce any ordinance provision."
7: C y
I hereby acknowledge that I have read this application; that the in-
I It e e
TOTAL AMOUNT DUE
formation given is correct; and that I am the owner, or the duly author-
r 0 r in a t i 0 n
ized agent of the owner. I agree to comply with city and state laws regu-
e d a g e It
ATTENTION
lating construction; and in doing the work authorized thereby, no person
a� ng c 0 I
will be employed in violation of the Labor Code of the State of Washington
III be e m
THIS PERMIT
relating to Workmen's Compensation Insurance.
rela I in g tc
AUTHORIZES
N OLT E: Permit Limit One Year(Except DEMOLITIONS and FILL
0
ONLY THE
PERMITS without conditional use permit, which shall be completed in 90
WORK NOTED
days; MOVED -IN BUILDINGS shall be completed in six months.)
SIGNATURE (OWN" OR AGENT)
I
DATE SIGNED
INSPECTION
DEPARTMENT
Vrf-�
CITY OF
EDMONDS
This psimit-6ovors work to be done on private property ONLY.
775-2525
Any construction on the public domain (curbs, sidewalks, driveways,
marquess, etc.) will require separate permission.
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. U13C 304,306.
1 02-78
LOT COVERAGE
SIDE REARI
C-ONSTRUCTION C65E E . I - G - HT
-Ihr 1976 3s
OCCUPANCY OCCUPANT
GROUP
1EA ; LOAD
THIS SITE is LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
VALUATION I FEE
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APPLICATION APPROVAL
This application is not a permit
until signed by the Building Official or
his Deputy; and fees are paid, and
receipt is acknowledged in space pro-
vided.
DIRECTOR'S SIGNATURE
I
J1
DATE
66
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
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RECORD OF INSPECTIONS
Co
Date Passed
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House
Porches, piers
Retaining walls
Garage, carport
PLUMBING
Undergrround
Rough -in
Water service
HEATING SYSTEM
0 MPLETE
-oA4
FRAMING
WALLBOARD.
FINAL
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