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820142.pdfIS USE PERMIT CITY OF EDMONDS ZONE NUMeEN CONSTRUCTION PERMIT APPLICATION oa • NAME (OR NAME OF BUSINESSI AOUNES5 LEGAL. OESCIiIPI�?jNECK IiVBOIVI.iIUN MAILING ADD S5 CI Y/ TELEPHONENUM9EP PUBLIC FIGHT OF WAY PER OFFICIAL STIIEEt MAP /� /� 'lr '�� ' EXISTING REOUIREO DEDICATION PROPOSED ,ME )DRESS In./ TELEPHONE NUMBER 7-1 TATE LICENSE NUMBER CITY LICENSE NUMBER nnnl n<cn-fin unn Df Fonertv. include all easements 820142 RIGHT OF WAY CONSTRUCTION PERMIT REOUI D STREET USEPERMIT REQUIRED SEE ENGINEERING MEMO OA tEO_. _.._------------ SEE PIW DEPT REVIEW CHECK LIST._ATEU SIGN AREA ENV. REVIEW nv nu- ALLO ALLOWED PROPOSED/ COMPLETE EXEMPT -�I Z ,(��/V���„+( SHORELINEN _Z VARIANCE OR CU PL NO EVIE D�A/T 7 Z m YARDS LOT COVERAGE z z canNi 510E —, REAR g v - I NEW RESIDENTIAL PLUMBING ElADDIALTER NON-RESIDENTIAL MECHANICAL RETAINING WALL "'SIGNEXCA REPAIR CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT ❑ FENCE i ElDEMOLISH OR FIILLTE K—FT) INSPJ SWIM SPECIAL INSPECTOR EA OCCUPANCY OCCUPANT I` ❑PRE•MOVE COMPLIANCE INSP. O POOL REQUIRED GROUP LOAD SIDE SEWER WATER LINE El YES NO REMARKS l7 z O m VUMBER OF STORIES NUMBER OF DWELLING UNITS NATURE OF WORK TO BE DONE/(ATTACH PLOT — . /- 11 VALUATION Ftt / PLAN CHECK FEE (BUILDING ell PLUMBING MECHANICAL This Permit covers work to be done on private property ONLY. GRADINGIFILL Any construction on the public domain (curbs, sidewalks, ` driveways, marquees, etc.) will require separate permission. S 00 OO Permit Application: 180 Days Permit Limit: 1 Year- Provided Work Is Started Within 180 Days llIpplicant, on behalf of his or her spouse, heirs, assigns and a successors In Interest, agrees to Indemnify, defend and hold W harmless the City of Edmonds, Washington, Its officials, i employees, and agents from any and all claims for damages of whatever nature, arising directly or indirectly from the Issuance m of this permit. Issuance of this permit shall not be deemed to modify, waive or reduce any requirement of any city ordinance = nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE provision." I hereby acknowledge that I have read this application; that the ATTENTION Information given Is correct; and that I am the owner, or the duly authorized agent of the owner. I agree to comply with city and THIS PERMIT slate laws regulating construction; and In doing the work authoriz• AUTHORIZES ed thereby, no person will be employed In violation of the Labor WORKNOTETHEDNOTED of tha St to of Washington relating to Workmen's Compensa• APPLICATION APPROVAL This application Is not a permit until signed by the Building Official or his Deputy; end fees are paid, and receipt Is acknowledged In space provided. nsur INSPECTION LSIGNATU 1 N DAT N D� DEPARTMENT 1� CITY OF OFF L'S SIGNATURE / _ _ YT THIS SITE IS LOCATED IN THE CITY EDMONDS k O aa/ DA 20 OF EDMONDS. LOCAL SALES TAX 775-2525 ATTENTION SHOULD BE CODED 31,04. 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 ORIGINAL — File YELLOW — 111spoclor PINK — Owner GOLD — Assessor 1 I I / I. 1 i 1 I I I , I I I �1 CHAPTER 102 16 Retaining walls I \L Garage, carport Of I PMBING yUnderground Rough -In Water service HEATING SYSTEM — FRAMING WALLBOARD FINALi�- t ,, i