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CITY OF EDMONDS
ZONE NUMtit: tt 8I036-'
i BUILDING PERMIT APPLICATION
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LEGAL UESCRIPTION SUBDIVISION SHOII't
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MAILIN ADDRESS
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PUBLIC RIGHT Or WAY PEI# OFFICIAL STIt L'CT MAP
CITY
Edmonds, WA 98020
TEL[PHONE NUMBER
206 775-5970
EXISTING
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ADDRESS
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CITY
TCLEPHONE NUMBER
REMARKS
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NAME
BRAND X MFG., INC.
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METER SIZE BUILDING SUPPLY SIZE FI%TURF UNITS
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ADDRESS
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12049 124th AVE. N.E.
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CITY
TELEPHONE NUMBER
REMARKS
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Kirkland, WA 98033
206 621-6442
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ST^J,2,=C.El1�E.N1161PER
CITY LICENSE NUMBER
SIGN AREA ENV. REVIEW
ADR NO
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ALLOWED PROPOSED COMPLETE E%EMPT
SH OR CLINC
Legal Doscrlption o Property (Show Below or Attach Four Copies)
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Tract 76 Edmonds Sea View Tracts 3-76
VARIANCE OR CU PLANNING REVIEW BY
DATE
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BLK 000 D-01 —
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less W 84ft & less E 120ft TOW ESM
YARDS .1 / A
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LOT COVERAGE
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FRONT SIDE REAR
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REMARKS
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❑ NEW
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� RESIDENTIAL
a PLUMBING
CHECKEDBY TV PE DF CONSTR UCTIDN IcCDE
HEIGHT
❑ NON-RESIDENTIAL
❑MECH ANIGAL
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111971
ADD
❑ DEMOLISH ❑SIGN
SPECIAL INSPECTOR AREA
REQUIRED
OCCUPANCY
GROUP (7 !Z
OCCUPANT
LOAD
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ALTER EXCAVATE FENCE
[:]....VAT.
OR FILL ❑ I_ %_FTI
❑ YES ❑ NO
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REMARKS
REPAIR ❑ PR E•MOVE INSP./ OSWIM
INSP. POOL
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Ia1 / AU. ASb 1' �i�2- M 15 '5 : 2
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COMPLIANCE
IS
O NUMBER OF STORIES
NUMBER OF
DWELLING
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F
UNITS
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Install in main house, within existing
N
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m inside wall, an air —tight fireplace
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PLAN CHECK FEE
VALUATION
FEE
stove using outside air for combustion
and pressurized heating. See attached
BUILDING
PLUMBING
plan and descriptive brochure.
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MECHANICAL
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
FENCE•
marquees, etc.) will require separate permission.
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SIGN
Permit Application: 180 Days
Permit Limit:I Year •Provided Work is Started Within 120 Days
RETAINING WALL
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N ":\pphe':I ill. in behalf of his or her sp111Ke, heirs, assip I, and
SWIMMING POOL
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w n:cc ,or, in inrere,t, ❑Free, to indeinnil'y, defend and hold harniless
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Y the City "I Edmond.. W-hingtol, it, officials, employees, and
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EA agents from any and all vlauns for d:nn'aees of whatever nature.
2 :rising directly ur indirrrtly from the issuance of this permit. Issu-
o alive of (his permit sII,II not be deemed tit nuldif}', naive or reduve
TOTAL AMOUNT DUE
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U .IIl1' r,quiremoit of ally t'Ity' -dinaiwe Ills limit In ally n':ly' file=
abihly to a•nlllre•c any nrdinanee I I'Msiun."
ATTENTION
APPLICATION APPROVAL
I hereby aekn—ledge that I hacc read this application; that the in•
THIS PERMIT
This application is lint 'I letillll
application l
I tp rill at urn gi Va'n I, eotrect; and that I alit Illy owner, lit file' dilly author•
fled Ilea• I agree to e'ouwlp ' uith city and Stale laws tegll-
AUTHORIZES
tllllll sl�i',eti fly Illy lilllldlll� Oilli l:ll lit
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agent of "%%'net.
Idling and tit doing lilt' a rk authorved therehy, fit, petson
ONLY THE
Ill\ :Illy fees are I)ald, Mill
con%trlletKm;
will he elil(lkly'ed In Yullatlon (il the Labor Code it the S131C tlf Wa,Illilgtrll
WORK NOTED
lecelpt I% acknowledged Ill yace I'll)•
relating to W!VMklllen't QMr1pkr1s3II0n In,tltancC.
filled.
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SIG ATVRE (OWNER A ENT I
DATE SIGNED
INSPECTION
DEPARTMENT
DIRECTOR'S SIGNATURE
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9-2-81
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CITY OFyr-
EDMONDS
DATE
THIS SITE IS LOCATED
IN THE CITY
775-2525
q • �'i
OF EDMONDS. LOCAL SALES TAX
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SHOULD BE CODED 31.04,
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ATTENTION
ORIGINAL - Fd,' YELLOW ll,w M,
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE PINK - Ownl'1 GOLD - Assns,ot
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC 304, 306,
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FOUNDATION
House
Porches, pi,;'rs
Retainin-
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PLtJi'%C5j1'!G
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Urldr --;:-nd
Roo7h ill
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HEATING ':;`i S 1
%._,4.FRAMING
WALLBOARD
FINAL
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