20020508.pdfit
PERMIT EXPIRES
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
Ubd PERMIT
ZONE Ul""
JOB SUITE/APT#
ADDRESS 4� ell 41211w-
19S
OWNER NAMENAME 01 SLIMNESS
LuA
PLAT NAMEISUBDIVISION NO, I LOT NO
5 - � - 8 1
LID NO.
LID FEE $
VIAILING ADDRESS
11 ';1, 1 6",-
PUBLIC RIGHT OF WAY PER OFFICIAL STREET AP
MSTING — PROPOSED
E.I.H.E. FT
!L
CITY ZIP
C'
ko 4-0
ITELEPHONE
I I
NAME
I
NEVER SIZE I
LINE SIZE
I NO. OF FD(TURES
PW� REQUIRED
0
8 !�ib s- 'K I P ( (J
FIRE REVIEWED By DATE
"RE. RV'EW'
I CITY
0
MNI
03-6 6
VARIANCEORCU
'A 'ANC. OR'
H02ELINEORADII
IN21.IE.C�TOdN
BOND
STATE LICENSE NUMBER DATE
CHECKED BY
CHECKED BY
G
POSTED
I
BE
""
a
SEPA REVIEW
C. PLE". XEMPT
-XP V"
f7
SIGN AREA
ALLOWED , 1110101E
0
HEII HT
ALLOWED PROPOSED
1z 5; 1 1 've -
PROPERTY TAX ACCOUNT F
0-7 030,5_ QQ;�) 0(0300
IMEC
C
NEW PR RESIDENTIAL rn-1 LOMBING H
C MPUANCEOR
E I'
ADDITION COMMERCIAL COANGEOFUSE
REMODEL MULTIFAMILY E:1 SIGN
FENCE
[71 REPAIR GRADING CYDS X—FT)
LOT COVERAG
ALLOWEIG PROPOSED
R """ED SETBACKS (FT.)
FRONT SIDE REAR
PROPOSED SETBACKS IFT.)
FRONT SIDE A
PARKING
IEOD PROVIDE 0 1 UOTA4AEA
D D PRO'
7 f46
IF
3
PLANNING REVIEWED BY DATE
'7/' /0 2-
?"41
_Rf -
A, 2-5
E] DEMOLISH n TANK 12 W�14(4. 44�
ri GAR E 111INGIL [3 Fj,RES?.R,1NKLrFtC6.,tf\
AG ROCKERY
CARPORT
4ta, 4-f .,� 6AM,
(TYPE OF USE, BUSINESS 0 "fT
-NECKED BY TYPE OF C!!�ffibl ICON GROUP
CCUPAN
SPECIALIN CTI N
LOOCAI.UPANT
REOLIII ED8PEYEO
a 43'�
_�U_MBER
an OF
_fba
STONIES�
NUMBER OF
DWELL No
U NITS
DESCRIBE WORK TO BE DONE
A, iE
REMA KS
PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REOT
ta-"zot
VALUATION
Description
FEE
DeSCrIptlon
FEE
Plan Check
State Surcharge
!2
G
PE %
Building Permit
City Surcharge
PLAN CHECK NO;,�,'X
VESTED DATE
JESTED DATE
-1. PEN.- AUDNOWZE. ..- IN. WORK .-a.- THIS PERMIT COVERS WORK TO
b: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONST UOTIONONTHEPUBLIC
D OMAIN (CURSS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
Grading
t: SEPARATE PERMISSION.
PERMITAPPUCATI " TRBDAYS
PERMIT LIMIR I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
;APFUC ON BEHALF 0 HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
AM'
N INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS T E CITY OF
2 EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
Plan Chk. Deposit
Fire Inspection
-
Receipt #
74'a-
ALL CMMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
,
11011 THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
Landscapeinsp.
Total Amt.. Due
11
DEEMED TO MODIFY, WA VE OR REDUCE ANY REQUIREMENT OF MY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
_4
Recording ��e
Receipt #
'�Q�
HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION
APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, 08 THE DULY UTHORIZED AGENT OF
CONSTRUC-
Thi-ppiwad-
1-1. parraft unfil algaW by a
THE OWNER ' AGREE TO COMPLY WITH CITY Me STATE LAWS REGU ING
WILL BE EMPLOYED
CALL
Ballai's Offid.1 .1 1,11/hal a' .1y: and Foos am paid. and
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTIO N
/I .�.lpll..�k�-l�dopdin.p.c�p,.id.d.
WORKMENe COMPENSATION INSURANCE AND RCW 18.27.
DATE
S N T RE (OWNER 0
NTI`
E SIGNED
10
(425)
(
ZL
�SIONAIU
IA" &Aal,( I
/
1;LCvy--v- "�2 771-0220 DATE
ATTENTION EXr 1333 '7 Y,
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- OFdGINAL.FIUE - YEUUOW�INSPECTO
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER - G UO-ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES 04EEN -ACCOUNTING
z
0
0
OM
C
MO
0
0
C:
ITI
ITI z
—4
—z
0
'n
ITI M
00)
0 r-
0 M
C: Cie
M 0
Z
z
co
z
0
q
0
M
4
c m
Ma
0
80
c
-4 m
x m
m
o -n
n Lo
mm
a
0
0 Fn
C
z
X
z
z
0
1
0
m