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800175.pdf
Appl,Cant i-III h PERMIT AI�PlICATI®N Inside Heavy Lines JOB - NAME (OR NAME OF BUSINESS) ADDRESS tWn ` e0In , r LEGAL DESCRIPTION SUBDIV SION SHORT SUB NO. W MAILING ADDRESS I dd C 0 V PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP .EyL.EP-NIIlilfi-d9L#4Y5-fi_.. EXISTING ` NA _..__..__.-w PROPOSED F �r DEFICIENCY OF RIGHT OF WAY L..+ u W f lll��� ADDRESS, PUBLIC IMPROVEMENTS REQUIRED❑ UDRAINAGE IMPROVEMENTS REQUIRED �1 E Q CITY TELEPHONE NUMBER DRAINAGE PLAN REQUIRED Cl UNDERGROUND WIRING REQUIRED ❑ NAME CONNECTION TO SANITARY SEWER ❑ E SEPTIC TANK PERMIT REQ'D ❑ Q F ADDRESS \ ELEVATION OF PROPERTY CORNERS ❑ FOOTINGS REQ'D `TELEPHONE CITY NUMBER 0 �C �JI.� O`ffC5 &� SEE ENGINEERING MEMO DATED 'J U - C BER- CHECKED By oc '- e1 1re Legal D erl tion Of r perty (Show Below Or Attach Four (copies) METER SIZE I BUILDING SUPPLY SIZE D REMARKS Q F 0. Ll SIGN AREA ENV. REVIEW ADB NO. 'U.. /_ ALOWOPOSED COMPLET EXEMPT /� LEDPR W W SHORELINE J )-o-t Q REMARKS D ' W J 7 VARIANCE OR CU I. -INNING REVIEW BY DATE 7y1 ore YARDS 1 R LOT COVERAGE 1v REA NEW LGjJ gESIDEN TIAL ❑GAS FRONT SIDE ZS LINE FIRE ZONE TYPE OF CONSTRUCTION ICODE:��ff FHEIGHTNON-RESIDENTIAL❑SIGNAADD A/RETAINING SPECIAL INSPECTOR AREA OCCUPANCY WALL REQUIRED GROUP DEMOLISH ALTER EXCAVATE FE E ❑ YES ❑ NO OR FILL ®( XFT) PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY OF EDMONDS. LOCAL SALES TAX INSP, POOL REPAIR ❑ PRE -MOVE � POOL SHOULD BE CODED 31.04. REMARKS Z NUMBER OF STORIES NUMBER OF Q DWELLING �i(� /� ((�� UNITS I UCAZE' s ` "Pe IL S T�, F LL NATURE OF WORK TO BE DONE E U W LL)d,C_ D m Q FEE Q PLAN CHECK VALUATION FEE --- PLOT PLAN -- /// BUILDING c7`34 PLUMBING I MECHANICAL FENCE In 'Applicant, on behalf of his or her spouse, heirs, assigns and SIGN W successors in interest, agrees to indemnify, defend and hold harmless -_ i the City of Edmonds, Washington, its officials, employees, and RETAINING WALL tz agents from any and all claims for damages of ahatever nature, x arising directly or indirectly from the issuance of this permit. Issu. SWIMMING Pool Q ance of this permit shall not be deemed to modify, waive or reduce J any requirement of any city ordinance nor limit in any way the Q — x City's ability to enforce any ordinance provision." 1 hereby acknowledge that I have read this application; that the in- TOTAL AMOUNT DUE i ZpCl formation given is correct; and that I am the owner, or the duly author- APPLICATION APPROVAL ized agent of the owner, 1 agree to comply with city and state laws regu- ATTENTION lating construction; and in doing the work authorized thereby, no person will be employed in violation of the Labor Code of the State of Washington THIS PERMIT This application is riot a permit relating to Workmen's Compensation Insurance, AUTHORIZES unlit signed by the Building Official or t NOTE: P®rmit {, mit One Yo®P(Excepi DF'.1OLITIONS and FILL ONLY THE his Deputy; and fees are paid, and PERMITS without conditional use permit, which shall be completed in 90 WORK NOTED reccipi is acknowledged in space pro - days; MOVED -IN BUILDINGS shall be completed in six months.) vided E SIGNATUR(OWNER OR AGENT) DATE SIG EO INSPECTION DEPARTMENT DIRECTOR'S SIGNATURE .,s C .' CITY OF _ ,.._ EDMONDS DATE �''_' This Po It eovcrs work to be do 0 on privato p partONLY, y 775 2525 t o r on 2ho ublic doma;c !curs aidasYalk+ d�ivowo r R W Q F Z W f f E Q W W 0 H Z f S J W W Q F Z 3 f f Q u E 1, 1 - VSL PERMIT BUILDING DIVISION Applicant Fill ZONE NUM RF It `�� I �� PERMIT APPLICATION Inside Heavy Lines '(9 sou NAM[ (OR NAM[ OF BUSINESS) 10" RI Ss1 1- / )I, �%I.�c_cJ cl)is�11C �El[PNONE-Nuwwca_ ._ <I 9197 - 9172- Vu L_ /-4 o 9 A TELEPHON O DDR [SS e [ ITY TELEPHONE NUMB I. U C FILV i ICF.NiC . vc - r of 'ree Legal Desert tion of r party (Show Below or Attach Four Cc 2 D ! p •7Y1 O lkci < N t3lk _ _ W RU O 1 D W j T -M ere ❑ N[W R[bl D[N TIAL LINE ® ADO ❑ NO N•R CSIDl NTIAL ❑SIGN ❑ DEMOLISH ❑ WALLI NING ❑ ALTER ORDFILLTE REPAIR ❑ INEP S.O POOL Z NUMBER OF STORI[b NUMBER OF f UNITS C NATURE OF WORK TO BE DONE [ Uw l W D oa � PLOT PLAN LEGAL DESCRIPTION SU 021S.ON SHORT 5UB NO, PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING PROPOSED DEFICIENCY OF RIGHT OF WAY PUBLIC IMPROVEMENTS REQUIRED ❑ DRAINAGE IMPROVEMENTS REQUIRED :l--tt DRAINAGE PLAN REQUIRED ❑ UNDERGROUND WINING REQUIRED ❑ CONNECTION TO SANITARY SEWER ❑ SEPTIC TANK PERMIT RED ❑ NO. ELEVATION OF PROPERTY CORNERS ❑ & FOOTINGS REO'D SEE ENGINEERING MEMO DATED 1 CHECKED BY METER SIZE BUILDING SUPPLY SIZE REMARKS SIGN AREA ENV. REVIEW ADB NO. ALIAWED PROPOSED PLET EXEMPT — SHORELINE REMARKS VARIANCE OR CU PLANNING REVIEW By DATE VARDS1 LOT COVERAGE '' 11I 5 1 FRONT 1v SIDE ZS REA FIRE TYPE OF CONSTRUCTION CODgE1 HEIGHT ,ZO'N[ SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT REQUIRED GROUP -2 LOAD ❑ YES ❑ NO 7 PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY OF EDMONDS. LOCAL SALES TAX SHOULD BE CODED 31.04. REMARKS Pf'uv IZESs lu"PeCTIC4E. PLAN CHECK FEE VALUATION FEE '---- BUILDING PLUMBING MECHANICAL FENCE 2 =_ H "Applicant, on behalf of his or her spouse, heirs, assign% and SIGN j successors in interest, agrees to indemnify, defend and hold harmless I the City of Edmonds. Washington, its officials. employees. and RETAINING WALL [ agents from any and all claims for damages of whatever nature, z arising directly or indirectly from the issuance UI 1h15 permit, 1((ll• SWIMMING POOL O anee of this permit shalt not be deemed to nlodity, waive or reduce _ any requirement of any city ordinance nor limit in any way the — i City ability to enforce any ordinance provision.'• 1 hereby acknowledge that I have real this application; that the in- TOTAL AMOUNT DUE CU qI z-- formation given is correct; and that I am the owner, or the duly author• ized agent of the owner. 1 agree to comply with city and state laws regu• ATTENTION APPLICATION APPROVAL lating construction; and in doing the work authorized thereby, no person willbe employed in violation of the Labor Code of the State of Washington THI. PERMIT This application is not a permit relating to Workmen's Compensation Insurance. AUTHORIZES until signed by the Building Official or NOTE: Permit Limit One YeOrtEscept DEMOLITIONS and DILL ONLY THE his Deputy; and fees are paid, and PERMITS without conditional use permit, which shall he conmpleted in 90 WORK NOTED Iccelpt is acknowledged in spacC Pro - days; MOVED -IN BUILDINGS shall be completed in six wrilh,'1 INSPECTION cidrd. SIGNATURE IOWNLR OR AGENT) OAT[ SIG ED DEPARTMENT TOR'S SIGNATURE CITY OF DIRE \.. CLiL%l�%— EDMONDS DATE This P It coven work to be doe on private pi6porryrONLY. (curbs, driveways, 775.2525 • �'� �•(•' Any w ,on on the Public It'=I, sidewalks, marquess, etc.) will require "parole permission. ATTENTION ORIGINAL — Fde YELLOW — Inspector IT IS UNLAWFUL TO USE OR OCCUPY 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. UBC 304,306 IBZJ6 a lZ W i I 1 F Z � W j H W i D IF Z i. I A .a W W O F Z I I I I V i I I a .� e _._._�.�_..____r..____._...._._...��.__...._.___..........__......... __._.__....__.._ �. SO � -�' Retaining walls f� Garage, carport � PLUMBING �� Underground f Rough -in Water service HEATING sYsTEM FRAMING WALLBOARD _ �© FINAL �.