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US PERMIT
CITY OF EDMONDS 'ON' NUMBER
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CONSTRUCTION PERMIT APPLICATION ADDRESS 4L/
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE .. E ON P R.IVATE PROPERTY ONLY. ANY CO NSTRUCTION ON THE PUBLIC GRADINGIFILL
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EWALKS DRIVEWAYS, MARQUEES, ETC,) WILL REQUIRE
...N .UP. B'. BE.... PERMISSION. t 15—
SURCHARGE
7MIT APPLICATION: 160 DAIS
AR. PROVIDED WORK IS STARTED WITHIN 160 DAYS ENG �111 a&
PERMIT LIMIT. I YE , REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORM ION ENO. INSPECT ON FEE
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;A PLICANT.ONBEHAL OF HIS OR HER SPOUSE. HEIRS. ASRIRNS AND SUCCESORS
NINTEREST. AGREES TO �NDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF LAlqosv""`G
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2 EDMONDS, WASHINGTON TS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
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ALLCLAiMSFORDAMA EiOFW ATEVER,.ATURE. ARISING DIRECTLYORINDMECTLY
x FROM THE ISSUANCE OF THIS PERMIT. SSUANCE OF THIS PERMIT SHALL NOT BE
REDUCEANY REQUIREMENT OF ANY CITY ORDINANCE
DEEMED TO MODIFY, WAIVE OR
0 NOR LIMIT IN ANY WAY TH E CITY'S ABILITY TO E N FORCE ANY ORDI NANCE PROVISION.- RECEIPT
TOTAL AMOUNT DUE
I H EREBY ACKNOWLEOG E THAT I HAVE READ THIS APPLICATION, THAT THE IN FORMATION APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF ` A - A 1-1 A p,,.,t I.til S1,10 �y th,
THE OWNER I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC CALL 'u"T "10' 11 �
TION.AND IN DOING THE WOA� AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED dilg Off"i-I 11 "�lhll D,p,ly: Ild Poll 11, PlId, A,d
_��Ol TH A CODE 0 THE STATE OF WASHINGTON RELATING TO FOR INSPECTION ,ipl I. Ilk,mildged m 11 PI-1,10d,
01013NSATION INSURANCE AND RCVV 18.27, OFFI ALSS TURE GAT
E AGEN (425)
DA377— 7��,l 771-0220 LEASE DATE
N P�CUPY A BUILDING OR STRUCTURE UNTIL
IT IS UNLAWFUL T.0 771-0221 'INAL R
A FINAL 11 SPECTION 4ASIBEEN MADE AND APPROVAL OR A CERTIFI- ORII - FILE YELLOW INSIECTJ
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK -OWNER GOLD -ASSESSOR
1`98
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ENCkOACHMENT PERmfr #,"CL—L—
kECOkDING #
TOTAL FEE A50'— R-ECEIPT #
Property Owner Name 61-Ak
Property Owner Mailing Address
Business Name
Address of Encroachment Altu't 6' CAIV�v fV 1 471-1�(11/"y V.Na- �V�7 U
'�B.ildi.g Permit Number (ifapplicable)
TaxAcctParcel# /-';270S-2D��
Describe Type of Encroachment and Frequency of Encroach ment (i.e. Marquee for life of building, Flower cart
during summer months, etc.) 7:,eir�,c-e—
CRITERIA OF APPROVAL — As outlined per approved building permit or as follows if not
associated with a building permit. Criteria is per City Codes and Regulations and failure to comply will result
in a Civil Violation, Chapter 20.110.
> Must provide safe pedestrian travel, maintaining a minimum or 48 inches in "clear zone".
> Exterior light fixtures, banners and flags must be a minimum of 8 feet above City right of way.
> Must maintain clear landings on the exterior side of all required exit doors of 44 inches or no less than
width of door, measured toward the street.
> No projection into alley or City right of way less than 20 feet in width, except when projection exceeds
15 feet above pavement surface.
> Cannot block illumination from City light fixtures or hang objects from poles.
> Architectural projections must be approved by ADB and conform to UBC standards with approved
building permit.
> Must maintain 3 feet of clearance around hydrants, standpipes, manholes, water meters, blowoffs,
cleanouts & valves.
> Bistro Dining tables and chairs must be in accordance with City Ordinance #3293.
> Merchandise racks, carts (espresso, flower), benches must not be located within "clear zone".
> Ramps require a separate building permit and must conform to UBC standards.
I *Clear Zone refers to an area 8feet in height and 48 inches in width providing a leve4 safe waWng surface
i (Le. measuring 48 inchesfrom edge of street tree grates or newspaper stands towardsplace of business and
from the ground up to a height of 8feet).
IT IS THE RESPONSIBILITY OF THE PROPERTY OWNER TO INFORM ALL
PRESENT AND FUTURE TENANTS OF THESE REQUIREMENTS
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Owner agrees to incorporate this agreement by reference in any subsequent deeds to the
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property, but any failure to do so does not invalidate Us provision.
8. CaRacity. Each party represents that the person(s) executing this Agreement on
behalf of such party has the authority to execute this Agreement and by such signature(s) thereby
bind such party.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement on this
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day of CL� J, 20j��.
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CITY OF EDMONDS
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By:
James C. Walker, PE
City Engineer
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STATE OF WASHINGTON
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COLTNTY OF SNOHOMISH
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This day, personally appeared before me, P, 9 to me
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known to be the person who executed the within and f6regoing document a& that' signed
the same as Ile free and voluntary act and deed for the uses and purposes therein
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mentioned.
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FINAL PRWECT APPROVAL FO
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: DEPARTMENT DATE-
-ENGINEERING DIVISION DATE 'S-17rl'v
________PLANNING DIVISION DATE—
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PROJECT
SITE ADDRESS
PERMIT # ADB#____------PATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED -F:& n (--e
con— to determine compliance with approved t
fielA=pecofi_or��as ' ducted" p an.: Final approval denotes that
there are no objections from the above signed Department to the granting of:
inal approval of the described work
Performance Bonds associated with the project may be released
GRANT FINAL PROJECT APPROVAL
-GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
AILED FINAL INSPECTION - OUTSTANDING ISSUES
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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I.: BE DONE ON PRIVATE PRRAOLP R EW ANYCoNaSTERUCTION ONTHE PUBLIC
WILL nEQUIRE
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IGN.
SE�ARATE PERMISS
WSURCHARGE
PE MIT APPLICATION: 18D DAYS
PERMIT LIMIT'. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 18D DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
FEE
Ap .. T�."AGFEES T F S OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESOR$
'APPLICANI N BEHALF HI
;N NOEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
ENG. INSPECTION
LA"V�"
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IPLTIERE!3 ST
% OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
INSB"�GM4EE
SoFWHATEVER NATURE,ARISING RECTLY OR INDIRECTLY
T PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
F ANY CITY ORDINANCE
RDINANCE PROVISION,'
RECEIPT
TOTAL AMOUNT DUE
-1 THAT I HAVE READ THIS APPLICATION, THAT THE INIORMAI
APPLICATION APPROVAL
HEREBY ACKNOWLEDGE
GIVE AND THAT AM ED-NER OFATHE IULY�A-TH-FIZEO A ENT OF
N 'NS LAWS EGU LATI NG CONST RUC-
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T ,p p I �.,ld by 1$0
CALL F - P-lb �ld
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AUTHDRIZED THE REBY NO PERSON WILL BE
o,"_, h," D.P�Iy' .�d
.-IlIldgl- p p-lded,
LEMPLOI
TION. AND IN DOING THE WORK
OF THE E TN..E��TAT�.OF WASHINGTON RE -ING To
FOR INSPECTION
;.Vg'�o.L�E�omp�psL7�l.-o�','N.I....AN�FE A ;W 27,
OFlIC LS RE ATE
SIG A 0 AGENT
(425)
771-0220 DATE
LEASE
EXT 333
A
ATTENTION
)U UNTIL
0 IA
ITISLINLAWFULTO�U1 0 A BUILDING OR STRUCTURE
771-0221
FILE YELLOW - INSPECTOR
A FINAL INSPECTION HA;%QECC MPADE AND APPROVAL OR A CERTIFI-
ORIGINAL -
GOLD - ASSESSOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX PINK - OWNER
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