20000989.pdfl'-N
—EAEClA`ECj'q/
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PERMIT EXPIRES
USE PERMIT
CITY OF EDMONDS ZONE NUMBER
JOB Su TFJAPTA
CONSTRUCTION PERMIT APPLICATION ADDRESS
OWNER _NAM�AME OPSUSINSS
PI -AT NAME/SUBDIVISION NO. LOT NO� LID No.
ij tawf- LID FEE $
MAILING ADDRESS
W P. � A _p
PUBLIC RJG�tT OF WAY PER OFIICI��
EXISTING A_.P A-1-ITIL'T
CITY ZIP TELEPHONE V.-I.—
REQUIRED DEDICATION FT — .."'S ..".
17 JT'�T& -"g; ..........
Isl !S� 114, 37—
SIZE NO- OF FIXTURES PIV REQUIRED
METER SIZE I LINE
AVE YES 13 No 0
�g4,,
REMARKS
ADDRESS IOR RESPONSIBLE FOR EROSION CONTROUDRAINA—
a 40 612
CITY ZA *,rZ�Ns AM262�
T
-7
NAM DIDAT5
& ')IJO -S ENGINEERING REVIEWE
ADDRESS
72- 'd-FIRE REVIEWED By DATE
CITY ZIP TE PH
1 1 7 ?
'Wo2t
z
VARIANCE OR CU SHORELINE OR ADSS INSPECT ION BOND
A POLED
STATE LICENSE NUMB A OYE NO
—/6 -7kk_ (!--S o Z"7 REVIEW SIGN APSA EIGHT
SEPA
COMPLETE EXEMPT ALLO ED PROPOSED ALLOWED PROPOSED
'lp RTYTAX ACCOU A
�L 0 2s, 1 2,51
A 0 1 12z: 07:�, 00
EXP
C
LOT COVERAGE REQUIRED SETBACKS IFT.) PROPOSED SETBACKS (FT.)
FRONT SIDE REAR FRONT
SIDENTIAL 2"PLU..N. I ME�. ALLOWED ROPOSEO UASIDE IIEAA
lir 15 t;'al'
og
M
0
0 COMMERCIAL COMPLIANCE 08
ADDITION CHANGE OF USE LOTAREA LAN RET F
0
0 REMODEL APARTMENT SIGN AEO'D I PROVIDED
f-i — —
M
FENCE
0 REPAIR GRADIN' CYDS 0 X FT) REMAN— �
M z
-4
C�DiMOLISH 0 ANK
RETAIN RENEWAL
E ROCKB2 WALL
ErCAMRIAPO.AT ..0
co
O.n
-n
INESS OR ACTIVITY) EXPLAIN:
CHECKEDBY
OF
IF OCC PA
]TYPE
A.
GROUP 1:3
m m
NUMBER
OF
NUMBEROF
DWELLING
I'D
CRI TICA SIECIALINSPECTOR
AN
REQUIRED YES
JA� OCCURANIT 10
LOAe+e um
STO
t AT'
U 48 A 0
17 'L�
00 vj
0
C CA
90
DESCRIBE WORK TO BE DONE REMARKS
OGRESS INSPECTIONS PER USC 1081FINAL INSPE REOT
17-
M 0
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igc- 1-7 g& i
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CA
41 Ile U0
VALUATION
FEE
002kD_-�;C-C& LOT SLOPE 1.
GLAZING -1.
PLAN CHECK FEE
BUILDING
HEAT SOURCE
FA 6— 47 all,
DATE
PLUMBING
m
PLAN CHECM_
VESTED
MECHANICAL
EMIT COVERS WORK TO
WORK . T �T T" U LIC
THIS PERMIT AUTHORIZES ONLY THE _`Q'lED;�T"l.SUFEI,ON.N P B
PROPERTY ONLY. AN
GRADINGIFILL
BE DONE ON RAW ATE
SIDEWALKS, DRIVE S, MARQUEES, ETC.) WILL REQUIRE
DOMAIN (CURBS IRE
SEPARATE PERMISSION.
WAY
STATE SURCHARGE
PERMIT APPLICATI 0 N: ISO DAYS
PERMIT LIMIT. I YEAR � PROVIDED WO K IS STARTED WITHIN 180 DAYS
REVIEW FEES
_0
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
CITY OF
ENG. INSPECTION FEE
T
;APPLICANT.
N INT REST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLES.S.THE
GEN S OM ANY AND
AND A T�;
-6AAIDS�
WGP�66;18WFEE
NOS, WASHINGTON. ITS OFFICIALS, EMPLOYEES,
EDMO' C
I NATUFE.IAlElNGUIRECTLYORINDiRE
AEC I I
ALLCLAS=A�AWAGESOlYiHATEVER
THIS PERMIT. ISSUANCE OF THIS
FROM THE 0 PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
0 T MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
EEMED 0 PROVISION.-
A EIEL
0 NOR LIMIT IN ANYWAY THE CITWS ABILITY TO ENFORCE ANYORDINANCE
TOTAL AMOUNT DUE
7
ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. THAT THE INFORMATION
APPLICATION A PROVAL
I HEREBY
GIVEN IS CORRECT, AND THAT I AM THE OWAEA, OR THE DULY AUTHORIZED AGENT OF
ThA,ppl W, porm,J.1111 III— by III
THE OWNER. I FEE TO COMPLY WITH CITY AND STAT1.10AVVS REGULATING CONSTRUC
BE ' "Y"
CALL
8 -E 3111�1,li ., hi�bll DGpuVy7..d F .1. P.I�'
TION! AND IN DAOGING THE WORK AUTHORIZED THEREBY. PERSON WILL
OF WASHINGTON RELAMTPING TO
�d plAv,A.d,
FOR INSPECTION
IN VIOLAT10N OF THE LABOR CODE OF THE STATE
WORKMEN'S COMPSNSATION INSURANCE AND HOW 1827.
OF CALE SIGNATURE GAT
ATE S;N
(425)
::,N.ATg'10ANN��T)
'7E er
771-0220
Rll�ASEDB
EXT1333
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORtGINAL-FILE - YELLOW�INSPECTO
PINK � OWNER - GOLD - ASSESSOR
CATE OF OCCUPANCY HAS BEEN GRANTED, LEG SECTION 109
FAX
5198
CCWTACT
PHONE
ZONING
SR`E AREA
SF
BUILDING WJGKr CALCMATtON
OWNER A EL
CORNER a M- 107,�.o
CORNER C IL /W-
CORNER 0 EL m, -, -
TOTAL 1106-e . 4 . 1* IL 1,91�6
ALLOWABLE MOM MONT
MAX"MAUMM"BULDontimm M/Z(,-
PROPOW MAXIM WALDW WAVAMM al: -,dle
UD Z LF
PROPOSED SETBACKS F Af' S1veSNw8zAv =PMAZA"GEWDETENTION ",am REOMEO
BUILDNO MONT. (TRADE TO RIDGE fse Wcz
'FIRSTROOR AREA 1*90 cw
SECOND ROM AREA 17 4'7, AV I
CFXN EXCAVATION
IV
low, L
TOM GROGN AREA
5/ZZ VF
TOTAL GAZING AREA
TOM MITED AREA
lizz Vp
GLAZING TO FLOW AREA 1"
1,/.0%
excm Saw= By
WATER SERV= BY
%
SANTARY SEWER DSTFXT
IVUEPHOW Sam BY
�A
V
PROPOSED
DUPLEX
ENT
us
x
uj ul
A
CO)
11.0
="2
Lu cy 0
2. Cli LLI
STANDARD DRAINAGE DETENTION -SYSTEM
WORKSHEET
OVVNM Z U111 9&69 CALC RY:
ADDRESS -12,/ 22* 4`< 1" pRONE: 1/2_f-77g-?--
190-2-4 OQ
DATE:
'""DESIGN DATA **-
IMPERVIOUS AREA PIPE DIA PIPE LG ORIFICE
DOTENTION PIPE LENGTH LOCKING LID
FINISt! ATYPICAL)
T�G
MINI
MINI
NIL E VCAI' URE�Ej%plfcp Or
CONC BOX OR RISER
0 OUTLET
OUTLET CONTROL
MI N,
UPPER CATCH BASIN
CONTROL CATCH BA . SIN RECEIVED
SYSTEM CROSS SECTION OCT 18 2000
�N
.11. 1. 11. SLOPE
'rMITNL'
DEVELOPMENT SERVICES CM
CITY OF EDMONDS
E'X2*X6' DEEP, 4-6' SPALLS OR EQUAL
FROM CONTROL ED 2'X e'X 3- DEEP,` 3/'4' CRUSHED ROCK XISTING GRADE
FROM CONTROL OUTLET VASHED ROCK
'fRENC
POE P P R� MIN 10' LdNG.
PIPE TO I LEVEL
P E W/ END CAPS
11, HTNIPtI.
,Rjj
D �CEE ?6F 'WATPHD`�%ARMN ROCK
MEh
WIMP OUTLEF
RUNOFF SPREADER. TRENCH
-0 DET ST
FOOTING DRAINS SHAU NOT BE CONNECTED 7 ENTION SY EM
NOTES.
1. Call Engineering Division (771-0220) for a tightline and detention system inspection
before backfilling and for find inspections. APPROVED BY
2, Responsibility for operation and maintenance of drainage systems on private property is the
*bility of thel property owner. J&terid accumulated in the storage pipe ust be flushed
respons In
fice, DATE
out and removed from the catch basins to allow proper operation. The outlet control ori
must be kept open at all times.
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Table 1 Detention Pipe Sizes
tmpqrmeable,
PIgb\Diameter
Required 15" 18" 24 1 - 301.
Vol Cu Ft—
2000
2500
3000
3500
000
4500
1 5000
50 40 28 16 io,
62 50 35 20 13
76 60 42 24 15 Required pipe
28 18 length in feet
87 70 32 21
'00 80 _(SD56L
36 '23
1'26, 100 '70' 40 25
Note: Allowable Pipe Materials: Reinforced Concrete
Aluminized Steel
Aluminum
CMP Asphalt Coated
N — 12 ADS (Not permitted on roads)
Table 2 — Outlet Orifice Sizes
Impermeable
Area Sg.. Ft,
Outlet Orifice Diameter (lnche�).-
2000.
2500
3000.,
5/8
5/8
3/4
314
4
4500
7/8
5000
7/8
----f—Requirements
Detention
Max� size Catch Basin
pipe diameter
knockout Ty2e
< 18'
181 to 24"
24" to 36"
36' to 42"
20- <1 a I 4CB 15
26: YN ;�:>
36 pe 1 9 (48' Basin)
42" Typell,CB19 19(54"Basin)
*Source: Assoc.
Sand & Gravel Co. Standards
5
Revised 3/16/95
t
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I
CONTACT PHONE
PrALM ADDRESS
-jz/ 41,* A-
",no,.Wj, 4.4 11020
Ira
BMW HEKINT, GRADE TO RIDGE S& 7MIA
'FWWROOR AREA 19147 OF,
SECOND FLOOR AREA 6
(v I, ul
STTIE AMA orrvs so,
AUOWABLE WTE COVERAGE Yjr-A I %WQlF
PoopolpsucovENAM zi-for
BUMMG HEIGHT CALCULATION
CORNER A EL /0/ �6
CORNER 6 EL /07,'-0
CORNER C v- /ozl-o�
,...D ia
TOTAL /0 6. lol�b
ALLOWABLE BUILDING HOONT --M—
MAX&MALLAWAKKASULD"O"Baft a./Zo-,
PROPOSEDMAXPAIMMUMUDIMORLEMM M�—,,oj
MIZ36SEFSAOM F/r' 9 /0' $10' Slr�
PROPOSMSEMACKS Flo"
TOTAL QLAZNG AREA
TOTAL HEATED AREA
QLAM- 'C"'OD'AREARMID
ELECTRIC Sswa By
WATER SBRRM BY
SANRARY SEWER DISTRICT
TELEPHONE SERVICE BY
Y
PROPOSED
DUPLEX
Iry
RES
`7
N
NOTF--
45 CY FOR CRAWLSFACE MAMMON N
UIT /'N
lq7
RECEIVED
0
CT 18 2000
z
cc to) Im
IL Rc
D
13
I- Z
T.0
M-2
Lu N 0
N Lu
I
FIRE RESISTIVE FLOOR-(EILIMG OR ROOF -CEILING ASSEMBLIES
Refef to Mailed specification available from Louisiana-Pacific before installing these assemblies
.......... t .
23/37' tp p. k4iq Tw
LF1 Jmt,iwd 74'
1.1,4*lyi.Sgyp,��.Ilb.,d��..,�174'�,, fakdbyo:
3' W�� 1- lk ba imi. SM9F, Typ G �Iwwl 6' 1- TYPI S
b.1 I.. k W" W
................... ................
73"32" wq. p.0 $bftq
117,18' : d.pe,) zz�'__
MIMI, W04'
WP dp 1. wwl awnh 1� TbA, 24' 48' 1 20u=1.W,
1 A pe vz 6.ml,
�Rh 1, bbg �h� 9 KI d.�i�
lyp S Qb"d 8* 'L"
23/32' tonge 8 98 shuaftg
74' W, W o�,
w-61* bo, 5/8* Tp
iit,
;.'. �
!emd
' e
f��Olil
wilboW ...I w 6flq d
wd 1� 60W, Qh V 1
Qh �p� S Wbad
I?
J� lim A 15,
Typ 5 .11bod ,
hS,
15/8' lyp S -.1 W 8'
.116nd
�,.
SOUND AND IMPACT RATINGS
ST(
ST!!!!!!!!!
��H,e�1,10/oqewd 51
72
withm'.&W 'W'dV# so
50
Wjtha1wT,h.,d/mpetwdPd 51
77
50 73
so
73
Wilh,dial d.-VaYl
50 41
50
Wilh ,0, 1�,t od Pnd 50
73
46 68
46
68
Wiffi,olol 6., W, A#
0 '40
46
40
9
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F-7-7,
Height Calculation Worksheet
Address: :51,�;!,!,
Date: -7 t)
I-Spect-ro): '4114-0
Point:
1. Datum
0'
2. Datum Point Elevation:
g,
3. Average Grade:
4. maximum Elevation Allowed: average grade) + 25'
5. Referenc e Point Elevation Shot to House:
C)�
0 1��
-120 (datum elevation) WOAerade to transit lOV2Lliu&4hQt494"ydft)
—AO
M
6. Measurements from line shot onto house to roofridge:
L&L
vy,
Total
er
Z,
0
In
7. Actual Elevation: (reference point el evation) + asurements
from #6) 6-,
conclusp
iter ss allowed); therefore the house is/
eu rement per ECDC 16.20.30 requirements
L-\TEWWILDlNGWsc\Height calculation Worksheet.doc
102046
CITY OF EDMONDS
INTER -OFFICE RECEIPTS
DATE:
DEPARTMENT!-
REcEiVED:--
41n±
ch,s, 4 cash $
Lessehold PF#POM TAX
-----------
its
Aid Got 011113111111
Cemetery Fees
War _T",
W.
M,
01
m
Sal* Of A18111115001(s
Sian Tax
photoststing
to
Business License Fee
Business Ucards Faulty
it
in, psn,�
we Pofmtt
0,
tm m
Fgwarkt -PerMit
Ftow"prialing
�Afllfml control Charges
*as FOSS
Rentals
gibe
F 642v� C,
0
V
W
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Clerk:
8
CITY OF EDMONDS 18771
Ski
DEVELOPMENT SERVICES
DATE:
Received of:
Z,
01,
4;
AAddress: one:
Project Location:
R
-4 -n;
Check No. Zgf(�g � Catth Total R.iv
�$�
Water Meter Size:
Amount
Water Connection Fee
Street CUI/Restoration Fe (620 Fund)
Sewer Permit/Repair
Trunk Charge
SeWer Connection/1-ID Fee
D F a a
R)W Conauction Permit Pee
"M it F
Street Disruption Fee (Ill Fund)
a if 1 1 Fund)
.Engineering Inspection Fee
on F a
Plan. Fee
,,Engineering Specs & Plans Fee
Storm Drainage Fee
Street Use Permit
Building Permit Fee -ITy2pe
Plan Check Fee #
State Surcharge (622 Fund)
-Zon1qQ Application Fee - T a
Landsca , rta
pe inspection Fee
bnoroline Permit Fee
SEPA Review Fee
Recording Fee ----------- 11�
Maps/Books
hotoc —
�Poples
.Traffic Mitigation Fee
Sidewalk Contribution
0
M,
M
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0
C;4
nn�
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4
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Project Review Checklist
Plan Che #:
ProjectName: ck
Date:
Proi ect Address: Receipt /
Underground Wiring Required
Hydraulics Permit
Plat/Subdivision Requirements
Street Dedications
Easenients—Public/Private
Engineering Storm Drain Review Feel
OCT 92000
Engineering 2.2 Inspection Fee
Drainage Plan (On -site)
P"'11C WORKS 0,1pi
Setback - Storm Drain Line
Open Ditch - Existing
Culvert Required
Culvert Size
Shou I Ider Drainage/Shale Open Runoff
Catch Basin Required
Driveway Slope & Vehicle Access
Sidewalk Required *,-.s Xa*w
Curb & Gutter Required A*, W Araw
Curb Cut for Driveway Required
Street Paving Required
Right -of -Way Construction Permit Required
Bond Required for Public haprovements
FEMA Map ChecklWater Table
Side Sewer Availabi lity
Calculate Sewer Fee if No LID#
&Q"17 A
Water Meter Size
Water Meter Charge Required lwrIA6-mv
LAM-�l I;.
Hydrant Required WA V&
Street Cut
Miscellaneous
# Date Issued
Receipt# /,,/Z!��z
RW Permit
SS Permit # Date Issued 0
Receipt #
Paid $ Dat
/ e
Receipt #
Meter Size
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NOTICE: IF 714E DOCUMENT IN THIS FRAME is LESS CLEAR THAN THIS NOTICE
IT IS DUE TO THE QUALITY OF THE DOCUMENT.
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE—
T- ENGINEERING DIVISION DATE-!�LLZ '01
PLANNING DIVISION DATE—
PROJECT—L2L
SITE ADDRESS- 4k OWL
PERMIT # 00 C1 ADB#__________pATE INSPECT
DESCRIPTION OF WORK TO BE INSPECTED --
A field inspection was conducted to determine compliance with approved plans. Final approval denot I es that
there are no objections from the above signed Department to the granting of:
Final approval of the described work
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
2.
3.
RE -INSPECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
ocaprvl.doc.l:temp:bldg:fonns6/98
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
3' -a
Footing ......................
7?,�,7--t I
Wall..........................
Pier/Porch .................
Retainirig Wall ...........
-4
stab insulation ..........
PLUMBING:
q _n
w
Underground . .............
14-0
DOS
Rough -in ..............
M
Commercial Final
HEATING:
Gas Test ....................
1,z
Gas Piping ................
Equipment
Commercial Final
x
MIT
EXTERIOR SHEATHING
NAILING........................
—7
vo
FRAMING .......................
—01
r_
co
C � ; , ,
M 0
FIRST FLOOR FRAMING...
INSULATIOR ...................
Floor insulation
wait Insulation
Z,
Ceiling Insulation
z
SHEETROCK NAILING
SPECIAL INSPECTION
up �gl
ITl
MISCELLA..OA
------
FINAL APPROVAL FOR
OCCUPANCY ..................
A
U\
outpWd$ _Rewlpt#./.�
waftrMeterSin
Ao=tPdd, R Ipt 41
Ddepurc"Insed 14144 -
D Expires,
DATE RECEIVED OdRMIT;(EXPIRES I z-- I
PERMIT
CITY OF EDMONDS ZONE NUMBER
JOB SUITEIAPTN
CONSTRUCTION PERMIT APPLICATION ADDRESS
OWNER NAMEINAME OF BUSINESS
PLAT NAMEISUBDIVISION NO, LOT NO,, LIO NO,
1_11) FEE S
- FMAILING ADEDRESS U
o
— rlE. A�_,,
PUBLIC RIGHT OF WAY PEI, OFFICIAL S EETMAI R. I.— n7Z.,
�11 — P.— ..AP
EXISTING P OPO D N
CITY ZIP T L WE ,a u C,
z qZ3z-
5 /L
REQUIRED DEDICATION FT
Q OF FIXTURES PRV REQUIRED
IT" lee
METERS
YES 0 No 0
IKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY ZIP ITELEPHONE
AP Aeelipq!�ll
NAM
��_O -7Vl A(JlJef0_
NGINEERIWG, R,V,EW'DIDATE
E END"
ZMF ;z & ,,, Al
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ADDRESS
)w j Mij
DATE
REVIEWED By
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VARIANCE OR CU
SHORELINE ADBI
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STA:!=SE NUMBER
16 7ZL(_ (2�3 0Z,? 1<4 Ll I
SERA REVIEW
COMPLETE I EXEMPT
SIGN A EA
ALLOWED PROPOSED
ALLOWED PROPOSED
PRO PITY TAX, ACCOU PARCE9.
o_7:�, 00
E.P
c:
0
-'RESIDENTIAL 5VII.SiNGIMECH
LOT COVERAGE
ALLOWED ROPOSED
REQUIRED SETBACKS (IT.)
FRONT SIDE REAR
rlTEACK
PRIGPI�)�ID'
S E AR
GE
�n T Rf
ON
W
no WT
C OMPLIANCE OR
Llr.7. l4t,-3
m
0
C] ADDITION n COMMERCIAL C3 CHANGE OF USE
0
PARK
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ROVID ED
A REA
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A SIGN
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ARA E
f9-`GARPGW 0 �AI�J.N,� WALL 0 RENEWAL
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ECKE DBY
TYPEOFCO RYTION
T,
GOD OCCOPANk
GROUP
NUMBER �UMBEROF CAiTICA
OF 2 NG ARE R
&`TLLI NUM
SP CIA�L INSPECTOR
REQUIRED YES
OCC PA T
LOA
Tr.
M m
STO ills,�
GE�CRJBE WORK TO BE DONE
5
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PROGRESS INSP�6TIONS
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V ILL
Bw
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FEE
. . . ....
PLAN CHECK FEE
G A LOT SLOPE I
BUILDING,
HEAT SOURCE
at � _
It A d-f -
PLAN cp ECK(re2_ VESTEDDATE
0
PLUMBING
MECHANICAL 12
m
THIS PERMIT AUTHORIZES ONLY THE VVORK OTED� THIS PERMIT COVERS WORI�,Td
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
ETC.) WILL REQUIRE
GRA INGIFILL
DOMAIN (CURBS, SIDEWALKS, DRIVEWAY MARQUEES,
S
SEPARATE PERMISSION,
STATE SURCHARGE
PERMITAPPLICATIO : 10�DAYS
PERMIT LIMIT. I YEAR . PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PrINK PERMIT FOR MORE INFORMATION
RE�IEW FEES
END, INSPE TION FEE
;,A,,,pL,�C�A.N.T�,OAN.BI.IALFOF'I On HER EIOUS�, HEIRS. ASSIGNS AND SUCCESORS
NT R ES To INDEMNIFY. DEPEND AND HOLD HARMLESS THE CITY OF
LANDSCAPING
';�,
a EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
ALLCIUMNISFORDAMAGES OF WHATEVER NATURE. ARISINC
OF THIS PERMIT SHALL NOT BE
RED T
CHECK DEP SIf' RED
ISSUANCE
FROM THE ISSUANCE OF THIS PERMIT. F
13REDUCEANYREOUIREMENTO ANYCITYORDINANCE
DEEMED To MODIFYWAIVEO ON.*
o Won LIMIT IN ANYWAYTHE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.*
PLAN
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FO RR �l N PECTION
IN VIOLATION OF THE LABOR CODE OF THE
WORKMEN'S COMPENSATi N INSURANCE AND RCW 18 27
03CIA�S SIGNATURE DATE
SIONAT DATE E
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(425) R
,
4/ 1771,4tv
771-0220 RE LEISED BY DAIE
ATTENTION
EXT 1333
'it[S UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
AND APPROVAL'OR A CERTIFI
771-0221 ILE < YELLOW -INSPECTOR'
ORIGINAL ' 4f
A FINAt INSPECTION HAS BEEN MADE
BEEN GRANTED. UBC SECTION 109
PINK � OWNER - GOLD - ASSESSOR
FAX
CATE 0 2CCLJ�ANCY HAS