790287.pdfBUILDING DIVISION
PERMIT APPLICATION
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USE PERMIT
ZONE NUMBER 79028.7
JOB
ADDRESS / 75/ / / //0211
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LEGAL DESCRIPTION I SUBDIVIAAON I ewmnT C1I ue.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING
PROPOSED
DEFICIENCY OF RIGHT OF WAY
PUBLIC IMPROVEMENTS REQUIRED ❑
DRAINAGE IMPROVEMENTS REQUIRED ❑
DRAINAGE PLAN REQUIRED ❑
UNDERGROUND WIRING REQUIRED ❑
CONNECTION TO SANITARY SEWER ❑
SEPTIC TANK PERMIT REQ'D ❑ NO.
ELEVATION OF PROPERTY CORNERS ❑
& FOOTINGS REQ'D
SEE ENGINEERING MEMO DAT
CHECKED BY
BUILDING SUPPLY SIZE
SIGN AREA ENV. REVIEW
ALLOWED I PROPOSED COMPLETEI EXEMPT
REMARKS
OR CU IPLANNING REVIEW BY I DATE
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❑ NEW Y�I RESIDENTIAL LINE FIRE ZONERON TYPE OF CONSTRUCTION CODE
HEIGHT
❑El NON-REStDENTIAL SIGN ADD El DEMOLISH
WALL RETAINING SPECIAL REQUIRED OCCUPANT
AREA OCCUPANCY OCCUPANT
ALTER ❑ El EXCAVATE FENCE ❑ YES ❑ NO GROUP LOAD
OR FILL FT 1 PLAN CHECKED BY
THIS SIT I E IS
REPAIR PRE -MOVE swim, OFEDMONDS.OI IOCA1 ALES TAX
INSP, EIPOOL SHOULD BE CODED 31,04,
Z NUMBER OF STORIES NUMBER OF REMARKS
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"Applicant, on behalf of his or her spouse, heirs, assigns and SIGN
.Wi successors in interest, agrees to indemnify, defend and hold harmless
2 the City of Edmonds, Washington, its officials, employees, and RETAINING WALL
aagents from any and all claims for damages of whatever nature,
I arising directly or indirectly from the issuance of this permit. Issu- SWIMMING POOL
0 ance of this permit shall not be deemed to modify, waive or reduce O
p any requirement of any city ordinance nor limit in any way the `
= City's ability to enforce any ordinance provision."
I hereby acknowledge that I have read this application; that the in- TOTAL MOUNT VUE 0 0
formation given is correct; and that I am the owner, or the duly author-
ized agent of the owner. I agree to comply with city and state laws regu-
ng construction; and in doing the work authorized thereby, no person ATTENTION APPLICATION APPROVAL
will ,employ d in violation of the Labor Code of the State of Washington
relaTHIS PERMIT This application is not a permit
tin to Work ttten' Compensation Insurance, pp
1 AUTHORIZES until signed by the Building Official or
0 Permi Limit One Year(Except DEMOLITIONS and FILL ONLY THE his Deputy; and fees are paid, and
ERM T ' hou nditional use permit, which shall be completed in 90 WORK NOTED receipt is acknowledged in space pro-
ays; E -I LDINGS shall be completed in six months.) vided. IGNA E (O NE OR AGENT) T SIGNL INSPECTION
CDEPARTMENT DIRECTOR'S SIGNATURE
CITY OF ` am
Is Per o s wor be done on private property ONLY. EDMONDS DATE
A y constructio on the publi omaln (curbs, sidewalks, driveways, 775-2525 _� _
marque s, etc.) will re ire separate permission.
ATTE N ORIGINAL — File YELLOW — Inspector
IT IS UNLAWFUL TO USE OR OCCU Y A BUILDING OR STRUCTURE PINK — Owner GOLD — Assessor
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UnC 304. 30r,
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