20020141.pdf11-�sk DATE RECEIVE
CITY
USE
Z.IIE RS2C)...
PERM T
yj
OF EDMONDS
NUIMEIER��W)/-)
CONSTRUCTION PERMIT APPLICATION
JOB ESE
ADDR
But EIAITI
SU�I�ESS
'T
Y�F 'la 0
PLAT NAMEISUBDIVISION NO.
LOT 110,
LI 110,
MAILING ADDRESS
RA
I
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
. LID FEE It
r-1 —
tol- ... P-1. Paso 13
CITY ZIP TELEPHONE
EXISTING — PROPOSED
REQUIRED DEDICATION—
FT —
Requese
foa—mm.ald
WU 11ZId
rr. us. 0
-Lim-i,L
NAME
MIFTEN SIZE LINE SIZE
OF FIXTURES
PAV REQUIRED
I
YES 13 NO 13
ADDRESS
REMARKS se
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/0--
CITY ZIP ITELEIHONE
NAME — I I I
I - 1)
a
I — 11 - FIRE REVIEWED By
ZIP NE
TEL11110
'AR,A,r
...... ... "a OR CU
DATE
BOND
POSTED
;I
MPT ALLOWED
PRUPERTWY TAXX ACCOUNWT CEL NO. COMPLETE EXEMP P.Urro—
0 M P L E T E
at
94-lor,007�1 (Y) Exp
X P f�
LOT ffl�&TE%RAQ I SETIACK (1)
V
IQ GgrEO
NEW ... WE IAL D(PLUNISIN.1 l@EC ALLOWEDC VPAO 0 ED U. BE EAR
P
us
ADDITION COMMERCIAL COMPLIANCE OR 9q 1 0 On fuel-burninje. Options--
El
CHANGE OF USE - —DATT'
P A
PARJ��WTSPW
E Ir
REMODEL APARTMENT SIGN REOD L
[j REPAIR [3 GRADING CYOS 0 FENCE
RE M A -K S
( — X Fn REMARKS
0 DEMOLISH 0 TANK OTHER
[3 GGA"AGE R OCKEING WALL 0 RENEWAL
ARPORT 0 RET"Fly
UWE OF USE. BUSINESS OR AD
CHECKED BY O�COUFAN/T
or
�C Up
RITIC L
NUM11111 P.CIALE1.11.1ECTOR JAREA OCCU NT
It CAREAS IV14
UNITS NUMBER REQUIRED [3 YES LOAD
E.U,.
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER USC 110811PINAL INSPECTION REOD
OIA41,Af— 411 A #I
9
Description
' no
FEE
Description
FEE
Plan
HEAT SOURCE OL42ING % LOT SLOPE %
LCheck
Building
PLM CHECK NO: VESTED DATE
Plumbing
7
Mo. an,..,
Mechanical
THIS PERUITAUTHORIZES NLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
8 DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON
Grading
Recording Fee
WTHEPUBUC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETCj UALREQUIRE
SEPARATEPERMISSION.
Engr. Review
City Surcharge
PER"TAPP"CAR N: INDAYS
'DEDWOR ISSTARTBOMTHIN INDAYS
PERMIT IJMrp I YEAR - PROVI K
Engr. Inspection
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHAL HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESONS
Traffic Mitigation
Plan Chit Deposit
IN INTER ST, AGREES TO INDEMNIFY, DEFEND A140 HOLD HARML SS THE CITY OF
FROM
Receipt III
EDMONDES, WASHINGTON, IT$ OFFICIALS. EMPLOYEES, AND AGENTS AM AND
ALL CLAIMS FOR DAMAGES OFWHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
1.1LL NOT BE
Fire Review
FROM THE ISIUA OE OF T1111 "'.IT ISSUANCE OF THIS PERMIT
ANY OF ANY CITY ORDINANCE
Fire Inspection
Total Amount Due
DEEMED TO MODIFY, WAIVE OR REDUCE REQUIREMENT
NOR LIMIT IN ANY WAY THE C17YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,'
—
Landscape lnsp�
Receip t#
1 HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPI ICATI
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
Tris applieraw. 1—t. parrnitrudit argred by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WAS14INGTON RELATING TO
FOR INSPECTION
"'Houe o"Ical or Melba, Deputy: sod Foos am pold. 4
WORK4EN'S COMPENS 11 NCE AND ROW is 7,
OFFICIALS SIGNAT DATE
0 DATE S LINES
(425)
C1
711-1111--
FILE ABED BY DATF/
ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING 08 STRUCTURE UNTI
771-0221
1
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFIL
ORIGINAL - FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
FAX
PINK -OWNER . GOLD- ASSESSOR
10/01
z
0
0 rn
C
0
80
C
In
In Z
CA
0 -n
ITIM
0—
O"n
0 rn
C (j)
C w I
M 0
z
z
z
hn
ma
0
80
c
M
on
3:
m M
a
0
0
c M
C/i
m (A , ,
M 0
;u
z
9