810314.pdfUSE
CITY OF EDMONDS ZONE
BUILDINGPERMIT APPLICATION ,DB
NAM[ (OR NAME OF BUSINESS/I) ADDRESS
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PERMI",
NUMBER 810314
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PUBLIC RIGHT OF WAY PER OFFICIAL
STREET MAP
NUMBER
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EXISTING
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7' I )\i1 I (EC S.
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PH OPOSEO
Dir. Of Public Works
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DEFICIENCY OF RIGHT OF WAY
ESS
CHECKED UV
SEE ENGINEERING MEMO
DATED_
TELEPHONE NUMBER
REMARKS
LCT Dr-AItiAL-c PEO-
03-0 1110, r
AplpI2.vV60Pt-AO
METER SIZE IBUILDING SUPPLY SIZE
IFIXTURE UNITS
I
CITY LICENSE NUMBER
SIGN AREA
ENV. REVIEW
A
ALLOWED PROPOSED
COMPLETE
,'``
SHORELINE
tV (Show Below or Attach Four Copies)
VARIANCE OR
CU
PLANNING
REVIEW BY
DATE
3 ' oo t'T- OF
1y EI
/'�
LOT COVERAGE
FRONT
SIOE REAR
!/
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MRE.ARKS
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❑ NEW
RESIDENTIAL
PLUMBING
CHECKED BY7��A&LUrA
NSTRUCTION
CODE
HEIGHT
❑
NON-RESIDENTIAL
❑MECHANICAL
��
�,�
I&A
❑ ADO
❑
DEMOLISH ❑ SIGN
SPECIAL INSPECA
REQUIREDGROUP
OCCUPANCY
OCCUPANT
LOAD
❑ ALTER
®
EXCAVATE I FENCE
OR FILL IXI I_ X_FT)
❑ YES ❑
❑
COMPLOIANCE INSP. POOLWIM
O
REMARKS�1E 1
_ - C"'� `�`�-�'REPAIRIN
44
UMBER OF STORIES
DER OWELLINGFA�
DF.`
UNITS
PE(L C:Uf-rt'�rel> VL
ATURE OF WORK TO BE
DONEIATTACH PLOT PLAN)
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AE'
PLNHECKVALUATION FEE _
BUILDING
PLUMBING
MECHANICAL
This Permit coven work to be done on private property ONLY.
Any construction on the public domain icurbs, sidewalks, driveways.
FENCE
marquess, etc.) will require separate permission.
Permit Application: 180 Days
SIGN
Permit Limit:( Year- Provided Work is Started Within 120 Days
RETAINING WALL
"Applicant, on behalf of his or her spouse, heirs, assigns ;slid
SWIMMING POOL
m successors in interest, agrees to indemnify defend and hold harmless
J
i he City of Edmonds. Washington. its officials, employees.:md
Q agents It any :old all claims for damages of whatever nature,
s
x arising directly or indirectly front the issuance of this permit. Issu-
0 ance of this permit shall nor be deemed to urudily. waive or reduce
TOTAL AMOUNT DUE
pany requirement of any cip' ordinance nor limit in :my way the
I City's ability to enforce any ordinance provision."
ATTENTION
hereby acknowledge that I have read this application; that the III -
formation given is correct; and that I all( the owner, or the dilly author.
THIS PERMIT
ized 'agent of tire owner. I agree to con,111)N'ith city and Ste IL' laws Ie•gu-
AUTHORIZES
lacing construction; and in doing the work aullionted thereby, no person
ONLY THE
will be employed in violation of the Labor Code of the State of Washington
WORK NOTED
relating to Workmen's Compensation Insurance.
SIGN U E (OWNER OR ENTI
DATE SIGNED
INSPECTION
DEPARTMENT
"7`•'"-
J.,
r- may' .1 tl
CITY OF
EDMONDS
THIS SITE IS LOCATED
IN THE CITY
775.2525
OF EDMON DS. LOCAL SALES TAX
SHOULD BE CODED 31,04•
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC 304, 3-j
UN
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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
leceipt is acknowledged in space pro-
vided.
IRECTOR'S SIGNATURE
1,c�nL�
'ATE
ORIGINAL - Fdc YELLOW lospe
PINK - OWne, GOLD - A--.,
SS
RETAINING WALL DET'
WAYNE S. W.�1t.L,drCE 19303 OLYMPIC V1EW
CONTeAC'me : 1=aA.VK LE FEe
s
(
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t ,
I
RECEIVED
JUL 311981
Dir. of Public Works
I �
• s 'rd. BARS a 12" Or_ MAX.
(�erfircp/ Bars.
MIN. DEPTH CLASS `
GRAVEL BEHIND WAIL
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Z"CLZ
f
• hd<es �3 BARS@1BOC MAX. Norl -Z. B,qr-
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H'r o 0 0
SPgt 9 1491(µfMlWfMpy
v
e� ili 4n1�i.// fl�+l�� o a° dl
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c 4- AD 4 a b 4a BARE er 18 "OC. MAX.
a•
} � 3, , ®� 9� Rlser Bars Gohtly,
sail a �a�ast o�
7'oe or po�cr d
at9,V140 irrsr�
So �
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SURVEYORS• DEVELOPMENT. CONSULTANTS -PLANNERS
40108 = 100t6 W. EDMONDS, WA 98020 775-A94
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