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BUILDING DIVISION
Applicant Fill
USE PERMIT
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PERMIT APPLICATION
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PUBLIC IMPROVEMENTS REQUIRED
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DRAINAGE PLAN REQUIRED
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UNDERGROUND WINING RCQUIHEO
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CONNECTION TO SANITARY SEWER
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SEPTIC TANH PERMIT REO'D ❑ NO.
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ELEVATION OF PROPERTY CORNERS
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S FOOTINGS R[O'O
T[LrPPHON[ NUMBER
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SEE ENGINEERING MEMO DATED
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CITY LIGlNS NUMBER
CHECKED BY C7� AIZAM
Date IN w13uL
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1 ..1 Dw.rrintinn Of ProoertV (Show Below
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METER SIZE I BUILDING I.— SIYE
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SIGN AREA ENV. REVIEW ADB NO.
A 11AW ED PROPOSED COMPLETEI E P -IT
SHORELINE
J REMARKS
13
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J VARIANCE OR CU PLANNING REVIEW BY DATI
VARDS t LOT COVERAGE
5 'FRONT 1O SIDE REAR Or
❑ NEW ❑ NO N•R!S DCNTIAL ❑SIGN FIR[ ZON TYPE OF CONSTRUCTION COD! HEIGH
�-N 117, 30ri
❑ ADD ❑ DEMOLISH
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EiFMOVE
NUMBER OF STORIES
NUMBER OF
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DWELLING
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BUILDING
PLUMBING
MECHANICAL
FENCE
SIGN
'Applicant, on behalf of his or her spouse, heirs, assign> and
H
W successors in interest, agrees to indemnify, defend and hold harmless
WALL
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i the City of Edmonds, Washington, its officials, employees, and
RETAINING
¢ agents from any and all claims for damages of whatever nature,
POOL
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x arising directly or indirectly from the issuance of this permit. Issu-
NIMMING
D once of this permit shall not be deemed to modify, waive or reduce
any requirement of any city ordinance not limit in any way the
x City's ability to enforce any ordinance provision."
I hereby acknowledge that I have read this application; that the in-
TOTAL AMOUNT DUE
formation given is correct; and that I am the owner, or the duly author-
ized agent of the owner. 1 alit to comply with city and state laws regu-
ATTENTION
lating construction; and In doing the work authorized thereby, no person
witlbe employed in violation of the Labor Code of the State of Washington
THIS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
Permit lienit Ono Yeafl[scept DEMOLITIONS and I ILL
ONLY THE
NOTE:
PERMITS w"out conditional ujr permit, which shall be conlplcted in 90
woRK NOTED
days, M shall be conspleted In sip mnnihs.)
INSPECTION
�1.1',LDING
110NAT�OR ENT) DATE IGNSD
DEPARTMENT
tEDMONDS
CITY OF
ThM mlt oovfn work tB be dons on prlvEr[ pproPsrtV ONLY.
775.2525
Any eoneirueslon on the Public domain (curbs, sid►welke, drlvwvsys,
m[rGus[s, fte.) will require operate parmlwlon.
ATTENTION
TO USE OR OCCUPY A BUILDING OR STRUCTURE
IT IS UNLAWFUL
UNTVAOR
FINAL SPECTION HAS BEEN AND 0304`306.
AGRANTED.
A CERTIFICATE CATE OFOCCUPANCY HAS BEEN UBCDE
10a-Te
OCCUPANCY O[GUP
GROUP (J _'3 LOAD
OF EDM
SHOULD
VALUATION FEE
/
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APPLICATION APPROVAL
This application is not a permit
until signed by the Building Official or
his Deputy; and fees are paid, and
receipt is acknowledged in space pro-
/-2�9-S!b
ORIGINAL — Flle YELLOW — InsPecror
PINK — Owner GOLD — Assessor
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!t Avenue, vacated Northwesterly 12
its 11, 12, 13 and 14, Block 40, �;.,"•.,
i, vacated alley through said Block
and 10, Block 40, Original Plat of
'olume 2 of Plats, page 75, records i
,unty, Washington, which is described , I
ection of a line parallel to and 10 I
er line of Newport Avenue and a line ►,..•.,.. - �•
•esterly of the center line of
'34' We
195 leet; thence North
orth 38 34' East 50 feats thence I�w� i •'!
line parallel to and 13 feet South- i i
line of Lot 14; thence North 38 34' /
24'10" West 65.30 feet; thence South
int of beginning. All in the Southwest
or of Section 13, Township 27, Range
ep
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