800208.pdfBUILDING DIVISION Applicant Fill ZONE NUMBIER 80 208
PERMIT APPLICATION Inside Heavy Lines ,oB
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Legal Description of Property (Show Below or Attach Four Copies)
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NEW
R[SID[NTIAL
❑-AS
LINE
ENTIAL
SIGN
❑ ADD
❑ D[MO L151/O
RETAINING
WALL
❑ ALTER
rrjt OR 'I
1�/�'❑Il
❑ FENCE -
❑ REPAIR
❑
INSP.
POOL
Z NUMBER OF STORIES
NUMBER OF
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-�
DWELLING
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H
UNITS
6 NATURE OF WORK
TO SE DONE
i I .Sir
71Y 1 _ /; - - _ _
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LEGwL DESCRIPTION
SU BOIVISION
SHORT SUB NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EAisTING Ai /A _
PR oPosE
DEFICIENCY OF HIG T OF WAY e
S
PUBLIC IMPROVEMENTS REQUIRE. ❑ e
DRAINAGE IMPROVEMENTS REQUIRED ❑ j
DRAINAGE PLAN REQUIRED ❑ t
UNDERGROUND WIRING REQUIRE. ❑ G
❑ r
CONNECTION TO SANITARY SEWER
SEPTIC TANK PERMIT REQ'D ❑ NO.
ELEVATION OF PROPERTY CORNERS ❑
Q FOOTINGS REQ'O I
SEE ENGINEERING MEMO DATED
CHECKED BY
METER SIZE
BUILDING SI �Y SIZE
REMARKS
SIGN AREA
ENV. REVIEW
A.B NO.
ALLOWED PROPOSED
COMPLET E.EMPT
SHORELINE
REMARKS
VARIANCE OR CU
PLANNING REVIEW BV
DATE
YARDS
EAT COVERAGE
FRONT SIDE REA
FIRE ZONE TYPE OF CONSTRUCTION
CODE
HEIGHT
SPECIAL INSPECTOR
AREA OCCV►ANCY
OCCUPANT
REQUIRED
GROUP
LOAD
❑ YEs ClNO
1 PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
REMARKS
CALL— S — o
m0 Lei Gi 1 - 1 �Ql PLAN CHECK FEE VALUATION FEE -
PLOT
BUILDING --
" PLUMBING
MECHANICAL
FCNcE
N (�-"-A➢plimnt, on behalf Of his or her spouse, heirs, assigns and SIGN =
u 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.
x arising directly or indirectly from the issuance of this permit. Issu-
SWIMMING FOOL
0 ante of this permit shall not be deemed to modify, waive or reduce
any requirement of any city ordinance nor limit in any way the ,FI L—k.— U _ -tWE
b-
I City's ability to enforce any ordinance provision."
fJ�y
I hereby acknowledge that I have read this application; that the in -
TOTAL AMOUNT DUE
formation given is correct: and that t am the owner, or the duly author-
ized agent of the owner. I agree to comply with city and state laws regu. ATTENTION APPLICATION APPROVAL
lating construction; and in doing the work authorized thereby, no person
wilibe employed In violation of the Labor Code of the State of Washington THIS PERMIT This application is not a permit
relating to Workmen's Compensation Insurance. AUTHORIZES until signed by the Building Official or
NOTE: Permit Mills One YBaP(Except DEMOLITIONS and FILL ONLY THE his Deputy; and fees are paid, and
PERMITS without conditional use permit, which shall be completed in 90 WonK NOTED receipt is acknowledged in space pro -
days; MOVED -IN BUILDINGS shall be completed in six months.) INSPECTION
vided.
•ION ATU OWN¢Ja OR AGENT) DATC SIGN [ /7�� D[FARTM NT DIRECTOR'S SIGNATURE
^/�,(�v CITY Or \. G u�i4/a---
s-! ED MLINDS DATE
wis
me
This Permit Cowlrs work to Id don[ n private pproperty ONLY. 775.2525
Any conatruetloe on the public do nlaih )curbs, aidawalks, driveways,
marquees, will require aaparets permlialon.
ORIGINAL — File YELLOW —Inspector
ATTENTION
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,
1 of-t■
HEATING SYS'iEM
FRAMING
WALLBOARD
FINAL