20020972.pdf0
111,11 11CIFIED
PERMIT EXPIRES
,FEDMONDS
CITY OF EDMONDS
US F
'24 PERMIT
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CONSTRUCTION PERMIT APPLICATION
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NAME
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FIRE REVIEWED BY DATE
REQ1D I POSTED
M ONO S
PROPERTY TAX ACCOUNT PARCEL NO,
COMILET� EXEMPT
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DESCRIBE WORK TO BE DONF
REMARKS
PROGFIE SS Pr /FINAL INSPECTION REaD
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Description
FEE
D.EILIIPII�q
FEE
Plan Check
lot. SUm"
GLAZING % LOT SLOPE %
Building Permit
C! urcharge
I VESTED DATE
PLAN ONECK N?W_ f ( _47 D DATE
Plumbing
THIS PERMIT AUTHORIMS ONLY THE WORK NOTED. THIS PERM
t a DOME ON PRIVATE PROPERTY ONLY. AMY CONSTRUCTION ON E BLIC
F
Grading
2 BOLIN (CURDS. SIDEWALKS, DRIVSWAYS. MARQUEES, ETC.) WITT RPU
EQUINE
:3 SEPARATE PERMISSION.
t:
Engr. Ravi
x PE MITAPPLICATION: 180DAYS
PERMIT LIMIT i YEAR -PROVIDED WORK IS STARTED WITHIN 180DAYS
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
Engr. inspection
Fire Review
Plan Chkd Deposit
'APPLICANT, ON BEHAL - OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
HOLD HARMLESS THE CITY OF
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AMC
ITS OFFICIALS. EMPLOYEE%AND AGENTS FROM ANY AND
Fire Inspection
Receipt 0
2 EDMONDS, WASHINGTON.
ALL CLAIMS FOR DAMAGES OF'HATEVER NATURE. ARISING DIRECTLY 08 INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Landscapoinsp.
Total Amt. Due
DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF My CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITY$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION,'
Recording Fee
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS 4PPLICATJON� THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
ThI1IIPPJ.eII--IIA- enedunHeIgn.d4yhe
"P I
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
ftikdlh�'e CUP�'�j' U.'%I-11ar 0 eply: and Fe a a are Pai d.
TtON; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
OF THE STATE OF WAS14INGTON RELATING TO
FOR INSPECTION nVa. 0,11—pacowo.1dad,
IN VIOLATION OF THE
WORKMEN'S COMPENSA C� AND RCW 18.27.
OF IALS SIGNATURE D7E
—
(421)
7 e 2-
AMni
771-0220 11L DATE
By
7-3/0"'
ENTION
EXT 1333
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING 08 STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE YELLOVi-INSPECTO
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PRIK-OWNER GOLD-ASSESSOn
ACCOUNTING
04102 PRESS HARD -YOU ARE MAKING
5 COPIES GREEN
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STATEMENT ON ACCESSORY DWELLING UNITS
GRANTOR: GRANTEE:
Property Address:
Edmonds, Washington
Legal Description: R1
P-7 SW
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-40
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Assessor's Parcel Number:
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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 CE
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dwelling unit, including a second kitchen, as defined in ECDC Section 21.05.015 is
prohibited until an Accessory Dwelling Unit Permit is approved.
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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, mm
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including an affidavit of occupancy and a covenant to be filed with the Snohomish 0
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County regarding the regulations imposed o s w King Units. a (n �11
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Property owner Signature: :-4
Property Owner Name (printed):
Date: 1, -
STATE OF WASHINGTON z
COUNTY OF SNOHOMISH) m
I certify that I know or have satisfactory evidence that mlewAf4-
signed this instrument and acknowledge it to be his/her free and voluntary act for the uses and
mentioned in this instrument..
purposes
Notary' suie mst be smudged. Dated-
-AN Signature of
Notary Public:
t4o'VARY
F,Ueoc Residing at: AE U en-CT-T-
12-5�2003 My Appointment
Expires:
OF W
THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR.
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DATE APPROVED
SETBACKS ...............
FOUNDATION:
Footing ......................
Wall..........................
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Pier/Porch .................
Retaining Wall ...........
Slab Insulation
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PLUMBING:
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Underground .............
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Rough -in . ..................
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Commercial Final
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HEATING:
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GasTest .....................
Gas Piping ..........
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Equipment
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Commer�lal Final
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EXTERIOR SHEATHING
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NAILING ..........................
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FRAMING ........... ............
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FIRSTYLOOR FRAMING
INSULATION ...............
Floor Insulation
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Wall Insulation ...........
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Ceiling Insulation
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