830491.pdfUSE PERMIT
- CITY OF EDMONDS ZONE ii �1 - (�i NUMBER 8����
CONSTRUCTION PERMIT APPLICATION Boa
' NA tOR NAME OF B ESS) ADDRESS � 9 'G
\\� � N ARC Rkc� LEGAL DESCRIPTION CHECK SUBDIVISION NO. D NO.
ZMAILING ADDRESS
O I ` L, LI C� // 7 �1 fir G V) CLC) �/Z'
CITY TELEPHONENUMBER PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
y �S�
�AMOn17J5 /�S^ % EXISTING_ REOUIREDDEDICATION_.-_._.._._
NAME �5„ �Oi1 PROPOSED ----
NAME OF WAY CONSTRUCTION PERMIT REQUIRED'
I- STREET USE PERMIT REQUIRED I'
w ADDRESS n
= SEE ENGINEERING MEMO DATED 1�--
rlTv TELEPHONE NUMBER SEE PIW DEPT. REVIEW CHECK LIST DATED -- ----
CITY LICENSE NUMBER i e7T k9(.1 ✓�RV1�'c"
SIGN AREA ENV. REVIEW
ALLOWED PROPOSED COMPLETE EXEMPT
all easements
µre
VARIANCE OR CU LANNM FAVIEW 0—
SIDE ZS�
NEW
fl .ESIDENTIAL
Li PLUMBING
�,11
,L'—ADDIALTER
❑ NON-RESIDENTIAL
❑ MECHANICAL
❑ REPAIR
❑ DEMOLISH
❑ RETAINING WALL
EXCAVATE
❑ OR FILL
❑ SIGN
FENCE
❑ 1—•--FT)`•
CHECKED BY TYPE OF CONST��RUSSCTION
N
CODE�nj Grp H/E�IG�F
I_I ( / !+-/
❑PRE•MOVE INSP.r
COMPLIANCE INSP.
❑ SIDE SEWER ❑ WATER LINE
NUMBER OF STORIES NUMBEROF
DWELLING
❑ SWIM
POOL
❑
El
SPECIAL INSPECTOR AREA OCCUPANCY OCCU
REOUIRED GROUP LOAD
I'YES NO
REMARKS
PLAN CHECK FEE
�� I
40
BUILDING
PLUMBING 5
to
MECHANICAL
This Permit covers work to be one on private property ONLY. GRADINGMILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit:l Year • Provided Work is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in Interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington. Its officials,
employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the Issuance
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
stale laws regulating construction; and in doing the work authoriz• AUTHORIZES
ad thereby, no person will be employed In violation of the Labor ONLY THE
Code of the State of Washington relating to Workmen's Compensa• WORK NOTED
tlon Insurance. INSPECTION
SIG= Tr ER OR GE T O IGNE DEPARTMENT
` Ct. y-�±-�� ` �- Pa3 CITY OF
EDMONDS
APPLICATION APPROVAL
This application Is not a permit until
signed by the Building Official or his
Deputy; and fees are paid, and receipt is
acknowledged in space provided.
OFFICIAL'S SIGNATURE
�OA.QR YVI - "�SlJZI.
THIS SITE IS LOCATED IN THE CITY
ATTENTION OF EDMONDS. LOCAL SALES TAX 775-2525 DATE 83
SHOULD BE CODED 31.04. q,&
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR�, e� �� 4u(;^I ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC u IJw PINK — Owner GOLD — Assessor
CHAPTER 3.
102.79 ..,...,,, ....,,.•,,; . e,...,.,,. we . nviw.
.+"� : u ...(t.c aas'�rr.: _..::�,_ ....;:.:,_ ._.... .-y:.,.„.,,«..:.+ �..,�:� a .x;.>�.-..r...a<ri.: -, .-.�,::n:•.x,......»r......—:•�smrr_.rms..rr`ti�.erad.. '
k xtrtda
� li'Un
f aa
� '�y«
It � � i }
-
;• rt
'^
4
�
G4
Rt -tA
P
p
�
r
"-cov�RETi
!
-
PAT o
pao s cr t
.._ 3U�J i2uUFQ
ef�.
I �m
� y
IL.na
V'p
1f}t7�o
-
MA-
114AT rog-ncN OF: c-? 0-sKNM ENT L'OT 5 � `.�GTIQN I � , T NN-:25 ! I P S"ll
N0FZ7H F,, a -t � DTI W! M , , M m e,;,= v H5 5:u-�aN�
UNc Off ►t7 l-c7j" 15 01.17 1,9 cf, Z= j' 20cl1c1 rL� i,
fl. ( 15 too R'T H i° 5z' Ye�;'�FtF'T r'F 'X-a 7 H C0 F;g'gEF— Cf-- SV-\ l L-:�
t-aT � • �(�-t�N ca �� To ;�ol N r � � >��cr►�µ INc��
i? FAG Sou TH I 5Z .ter 1OO �T To T 4e t toi TH W �4S ,a i'
To M I - .J , A.LLF-N ANV Ha-au-4 wi r �
Fa co xc--Va a 1.7 19 cu-, 3 U�4 C;'E.s FIB �4 0.
Io"11IW-7 ,` -e 5C)U-TH eb-33' �rvES ,mot-tDI-1 - THE. No�-rH '-4Ns pr-
�A.I 20 z. 3`jSTr� >4T!-� 37.- °T• 1: 9 8.� r ;
INNGwN ?� A ,iD DTI ON of t-oj'S 6:5' PN 17 "] fftGZ-K. 11 PNtv
Z 1 r-P.IJITt--,P�LZ ark THS To -rf4a
?` 1zEor- 1�-;H �lzuNlT I wool. Nc�lcN ,
,
u" .V
R C-G'RE) OF
";FDATIo1>[
Mouse -- -- ---
i�
Porches, piers --------------
ReQainin.-wa'iis —--------
-`
Garage. ciirperi----------�ii
i
Under round -----
- ---- -
Rou,nh-ict
Waiter service
HEATING S`(S i LM S
FRAMING -`--�
-"
WALLBOARD.27
FINAL -----
Y