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Fire Review
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ALL CLAIMS FOR DAMAGES OFWMTEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
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EXT 1333
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771-0221
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A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL � FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
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PERMITUMMIYFAR-PROIRD WORK IS STARTED WITHIN IM DAYS
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SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICAN1. ON IIINAUF OF HIS Or' HER SPOUSE, 1115111. AIIIIINI AND 1UCC.A1HIs
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREES To INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
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ALL CLAIMS FOR DAMAGES OFWHATEVER NATURE, ARIS No DIRECTLY OR INDIRECTLY
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1 HEREBY ACKNOWLE BE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNE . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
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ATTENTION
EXT 1333
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.
ORIGINAL -FILE - YELLOW -INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK -OWNER - GOLD -ASSESSOR
10101
FINAL PROJECT APPROVAL FORM
TO:_
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE —
ENGINEERING DIVISION DATE 02-
PLANNING DIVISION DATE
PROJEC
SITE ADDRESS (Q0 C1 AA
PERMIT#_aqj2-700-'f-'- ADB# —DATEINSPECTED
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A field inspection was conducted to determine final compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
��GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
1. MICROFILM
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE —
ENGINEERING DIVISION DATE.
PLANNING DIVISION DATE-
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from the above signed Department to the release of
denotes that there are no objections
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Date— Sign_
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CITY CLERK CONFORMED COPY
CITY OF EDMONDS
121 STH AVENUE NO. 200204150810
EDMONDS, WA 98020 04/15/2002 03:18 PM Snohomish
P.0002 RECORDED County
STATEMENT ON ACCESSORY DWELLING UNITS.
Property Address: 9al� Ayr=-- �Jo,
Edmonds, Washington el 2,Z0
Legal Descrip
tion:
-7 IV 9 4E-
Assessor's Parcel Number: -703 cO
I have read the requirements for accessory dwelling units contained in Chapter 20.21 of
the Edmonds Community Development Code (ECDC) and understand that an accessory
dwelling unit as defined in ECDC Section 21-05.015 is prohibited until an Accessory
Dwelling Unit Permit is approved.
I also understand that an Accessory Dwelling Unit Permit cannot be approved unless all
the criteria in Chapter 20.21 are met, and all the necessary items are submitted,
including an affidavit of occupancy and a covenant to be riled with the Snohomish
County regarding the regulations imposed on Accessop�,Dwelliug U
Property Owner Signature: _ 4*�ol
Property Owner Name (printed):,
Date:
STATE OF WASHINGTON)
COUNTY OF SNOHONHSH)
I certify that I know or have satisfactory evidence that
signed this instrument and acknowledge it to be his/her free and voluntary act for the uses and
purposes mentioned in this instrument.
Notary's pressure seals must be smudged. Dated: lt'44,14
Signature of
X ......... Notary
Y Residing at: C,14
My Appointment
RIWG
Expires: . ......... e:�' r,& 47,
TIUS CU NT UST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR.
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AGGREGATE LEGAL DESCRIPTION
LOT I. AND TRACT
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UNDER AUDITOR'S FILE NO. 199907155002. RECORDS OF SNON Oi S-98-34, AS RECORDED
oMjsj4 COUNTy,
WASHINGTON.
ALSO,
LOT Z CITY OF EDMONDS BOUNDARY LINE AOXSTMENT NO. LL�2000-37, AS RECORDED
UNDER AUDITOR'S FILE NO. 200004245001, RECORDS OF SNOHOMISH COUNTY, WASHINGTON,
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(ALL BEING A PORIJON OF GOVERNMENT LOTS 3 AND 4 IN SEC71ON 13, TOWNSHIP 27 NORTH.
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ENGINEERING DIVISION DATE--f��-(I�
PLANNING DIVISION DATE
PROJECT OarUSO
SITE ADDRESS 15 65'
PERMIT # NZ-6043 ADBk-DATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED
A field inspection was conducted to determine flual compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PEBEORNL4,NCE BONDS and the granting of:
ZGRANT FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractor by inspector
1. MICROFILM
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Sip,
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EXTERIOR SHEATHING
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FRAMING ..............
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation
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SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
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