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PERMIT EXPIRES U2-21(21
CITY OF EDMONDS
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SEPARATE P ERMISSION
STATE SURCHARGE
PERMIT APPLICATION� 180 DAYS
PERMIT LIMIT. I YEAR. PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG 1IFYIE. I EC�
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FINAY, PROJF.CT APPROVALTM
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MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: 111-'4 (--- I DEPARTMENT DATE-Q---(L-""r
ENGINEERING DIVISION DATE--
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PLANNING DIVISION DATE—
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SITE ADDRESS
PERMIT# ao.)��Oq ADB#_______DATE INSPECT
DESCRIPTION OF WORK TO BE INSPECTED-��C-P'-L-
A field inspection was conducted to determine compliance with approved plans, Final approval denotes that
there are no objections from the above signed Department to the granting of:
___�—Final approval of the described work
Bonds associated with the project may be released
�LGRANT FINAL PROJECT APPROVAL
__GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
___------FAILED FINAL INSPECTION - OUTSTANDING ISSUES DEC 0 1 2000
1 . EDMON S A E 0F.
2.
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________.RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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SAMPLE PLOT PLAN
IMPERVIOUS SURFACE 7CALCS Scale: V=20' Ile 109
Existing Building Pad: 2000 sf. (constructed In 1962) +105
Existing Covered Porch: 75 Of. (const-ructed in 1962) 0-1
ract�q..
Existing Driveway: 610 sf. (constructed in 198]7)
eted. 8s)
Existing Patio: 200 sf. (constructed In 1985)
's .
Proposed Addition: 440 sf. +100
Proposed Garage: 500 sf.
Proposed ..I: go sf.
BEIGIFIT CALCS
A = +991
B = +107' .0.0
C = +100' *99 o
D - +1041
AVE GRADE - 102.5' B
51 10
V !+ 7
ACTUAL - 123' +99,
MAXIMUM 127.5-
Existing
25'-0" um�b Residence
LOT COVERAGE: C—t.
3515 SQJFr. (26%) 2000 sq.ft.
LOT AREA,
13,527 SQ-Fr.
Tax Account Parcel #:
3476-001-003-3049
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LOT SLOPE: 11%
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Existing
Asphalt
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A,
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MAIN STREET
DATUM FT. +100' Center of Right-Of-WaY
Top of SS Manhole Cover
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PE M ITAPPLICATION; ISODAYS
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PIC
;APPLICANT. ON BEHALPOOFHI OPHER SPOUSE. HEIRS� ASSIGNS AND SUCCESORS
INDEMNIFY. DEFEND AND HOLD HARMLESS — -1 1 -1
AGREES T I
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LAN SCAP
N NTEREST.
EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
INSPECTION FEE
ALLCLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY ORINDIRECTLY
SHALL NOT
PERMIT ISSU NCE OF THIS PERMIT BE
RECEIPT
PLAN CHECK DEPOSIT
F ROM THE ISSUANCE OF THIS
DEEMEOTOMODtFY. WA"EORREDU E ANY REQUIREMENT OF ANY CITY ORDINANCE
PROVISION."
RECfj� If
NOR LIMIT IN ANYWAY THE CiTY�S ABICLITY TO ENFORCE ANY ORDINANCE
I i I IC) I
I
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN I ARECT, AND THAT I AM THE OWNER. OR THE DU�Ly�AUTHOTI'INI.ED AGENT OF
S Co LAW EGLI, CON,,RUC
STAT
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THE OWNER, I AGREE TO COMPLY WITH CITY AND
TION. AND'" DOING THE WORK AUTHORIZED THEREBY. No PERSON WILL BE EMPLOYED
RELATING TO
-9011,-1, hll puty:lldFlllll0plld—d
B"I t�j
TION — ,,,,p, I, ,,,,wl,l,ld I 1p'll P'—d1d,
IN VIOLATION 0 ' THE LABOR CODE 0 THE STATE OF WASHINGTON
WORKMEN'S COMPEN SATION INSURANCE AND POW 18.27.
I — ' DATE
OF SIGNATUR
DATE7NED,
(425) 2
2
771 -0220 RE EASED BY
EXT 333
Afr�NTION
IT IS-IONLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTWI-
ORIGINAL FILE YELLOW INSPECTOR
ASSESSOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBG SECTION 109
FAX PINK - OWNER GOLD -
----------