810492.pdf■
•.-
r
11i�'�.. USE PERM,,
CITY OF EDMONDS ZDNr S 12 NUMBERR
BUILDING
PERMIT APPLICATION
De
NAM[ IOR NAME OF BUSINESS) nITUHE SS 19303 3D3
.
LEGAL DESCHIPPTION 51JUDIVI(al/O/N SHOHT SUU NO.
-
1
W
MAILING ADDRESS f
2
0
-; 1 �) • �, �/� ti 1, �1 .t �ji.. PUBLIC NIGHT OF WAY PEN OFFICIAL STRL-ET MAP
-
ITV [LEPHONE NUMBER -
o
EXISTING
tl 1...� `, L�—''
2 1
It I
rR OPOSED
A E
W I
DC*'ICILNCY Ot HIGIIT DV WAY
W
Z
U
h_
CHL c"', I"W ADDRE55
5[E ENGINEERING MEMO DATED --
Z
W
I
U
[
REMARKS
CITY TELEPHONE NUM BCR
a
NAME
E
METER 512E pUILDING SUPPLY SIZE FI%TU RE UNITS
0
ADDRESS
It
fIt
[
CITY TELEPHONE NUMBER REMARKS
a
;
h
2
0
U
STATE LICENSE NUMBER CITY LICENSE NUMBER SIGN AREA ENV. II.VIEW ADB NO.
ALLOWED PROPOSED COMPLETE EXEMPT
SHORELINE
I
Legal Description of Property (Show Below or Attach Four Copies)
���
- J1 f J i')"I •.J I�CZ v +C/ i_i<T11VARIANCE OR CU PLANNING REVIEW BY GATE
Z
0
h
�
nrin(?mil, 7- '1 CI - "I,L YARDS LOT COVERAGE
O
Z
s
FRONT SIDE REAR
Z
_
u) o � %, � CJ REMARKS
1
l
IUa
J
O
i
J
l
0
W
J
❑ NEW RESIDENTIAL D PLUMBING CHECKED By TYPE OF CONSTRUCTION CODE HEIGHT
1
�` 1
��'j ❑ NON-RESIDENTIAL ❑MEGH ANICAL - (E %- i�
t�[ r ADD
SECTOR AREA GH-UPANCV OLOCCAUDPANT
SPECIAL Iry DEMOLISH ❑SIGN
I
QUIRED
REQUIRED
❑ ❑ NO Z_A..- I^��3
❑ ALTER ❑EXCAVATE ❑FENCE YES
OR FILL (_ %_FTI REMARKS
13
2
PRE -MOVE INSP./ SWIM 1 j t-j(� ,1 ^ C
REPAIR �i'�IC '�-•L `� I N - r E-�� IU,•I S ("�L \ \./
O
J
COMPLIANCE INSP. D POOL
D
Z
NUMBER OF STORIES NUMBER OF
m
0
DWELLING
f
UNITS
L
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
C
r i�
W
O
BO
IST I A)(, T`) -C PLAN CHECK FEE VALUATION FEE
i
+
BUILDING
PLUMBING
i
MECHANICAL
I i
This Permit coven work to be done on private property ONLY.
Any construe It on the public domain (curbs, sidewalks, driveways, FENCE
I
marquees, ate.) will require separate permission.
j
SIGN
�1
Permit Application: 180 Days
l
l
Permit Limit: 1 Year - Provided Work Is Started Within 120 Days RETAINING WALL
i
yWj "Applicant. I'll behalf of III, or her sprin,%•, licir.s, assigns and SWIMMING POOL
W srrccessors in intere,t, agrees lU indemniq', defend and hold harmless
J
i
2 the City u( lid anon I,. O;Ishingtun, it, officials. employees. and
a agents Inlm any and all claims I'— danwge, of whatever naurc,
a
rc ul Ibis permit. Is,•
x arising directly or indira•tiy Irom the issu;mu
Off
all e deemed lu 1111AVy, %%;live or reduce TOTAL AMOUNT DUE
D once of till% 11ernlll shnut bm
. ' \� i 1
;alp city ordin:uc not limn in may lay the
J any rcyuirenrcm of ;atc
x (-ity's ability to enforce any ordinance provision.- ATTENTION
APPLICATION APPROVAL
I hereby' acknowledge that I have read this application; that the in-
THIs PERMIT
This a I licaUUll is riot a erilllt '
F I P
Yonnation given IS L'%IIr%•L'I; and Illal i :II11 the o%%ner, or the duly author.
fled agent of the owner. I agree to comilly with city and ,hale laws mgll• AUTHORIZES
until signed by lilt• Building Official or
lating construction; and in doing the work mllhoriied thereby, no person ONLY THE
Ill% I)L•ptily; alld fees are paid, and �
willbe employed in vil lotion of the Labor Codc of the State of Washington WORK NOTED
re%'elpt 1, acknowledged Ill space pro•
relating to Workmen's Compensation Insurance,
. vided
INSPECTION
SIGN,^,(TU E tOWNER OR AGENT) PATE SIGNED DEPARTMENT
'
DIRE TOR'. SIGNATURE
CITY OF
0. ,<'ii '�I•LL,'•'v
EDMON OS
DATE
THIS SITE IS LOCATED IN THE CITY 775-2525
OF EDMONDS. LOCAL SALES TAX
r
SHOULD BE CODED 31.04.
ATTENTION
ORIGINAL - Fdo YELLOW - Ins peel ar i
-'-`
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
PINK - Owncl GOLD - Assessor
DE AND APPROVAL OR
A CERTIFICATE CATE OFSOCCU OCCUPANCY HAS BEEN PECTION HAS BEEN AGRAN ED. UBC 04, 306. OCT
8 RECD
IOb18
1
Ln �,
V
�v
ti V
c�
NO
rj
w�
w
i
Ld
< --- h
/$' I:x15-r1NG
�` Srrtucrul2E t
O i
1110 �
a
v' • J ,a� I V1 !
CITY OF MOW
BLDG. DEPT. ZONE _ �, W I
CONDITIONAL PERMIT. SEs: .� I
RN
ADDRESS• /903o�
0
-_
APPROVED DATE. I L r 0
B Y
NElGHT
BLDG. Oi'Fl:;lAL
I KEEP THESE STAMPED
PLAN;; ON ,10')SITE FOR
ALL INPE,710NS '
PERMIT iVO, I bHEET
i q'?
8104 2 f
OF —
OLWAVic. Vt6w DR►vF—
,1
I
I
i
f•
�
RECORD OF INSPECTIONS
(,./
Date Passed
FOUNDATION
r
I
House ----------
!(
'
`
i
Porches, piers
�
Retaining wills
f
Garane, carport
PLUMIBING
Under -round
t
Water s�:rvic^
i
HEATING SYSTEM
FRAMING —"—
WALLBOARD--
'
FINAL _
I
,