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840326.pdfF + IER ZONE NUMDUSE CITY OF EDMONDS S - .t94(p_?' j r p1N�� CONSTRUCTION PERMIT APPLICATION JOB ADDRESS �j• 1 NAME (OR NAME OF BUSINESS) f4 LEGAL DESCR IONN]CHECK SU N IVISIDI O. LID NO. MAILING ADDRESS 0 D 9 is l ' CITY TELEPHONE NUMBER PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. ' C� OA .J V 6O 7 ,s/ It,EXISTING__._ REQUIRED DEDICATION PROPOSED - NAME LLV Z RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED I I ¢ I-' STREET USEPERMIT REQUIRED (_ 0 ADDRESS r Z u SEE ENGINEERING MEMO DATED... _ C CITY TEI. EPHONE NUMBER SEE PIW DEPT. REVIEW CHECK LIST DATED REMARKS 1„ i NAME 4 t: 2 ADDRESS METER SIZE BUILDING SUPPLY SIZE FIXTURE UNITS CITY TELEPHONE NUMBER I¢u REMARKS a 0 3 D STATE LICENSE NUMBER CITY LICENSE NUMBER SIGN AREA ENV. REVIEW ADB NO. Legal Description of Property. Include all easements ALLOWED PROPOSED COMPLETE EXEMPT Z (show belowor attach four copies) LI/� SHORELINEp I 0 • VARIANCE OR CU PLANNING REVIEWBY DAT v u O ` YARDS I LOT COVER GE 'f Z J ! Z w FRONT SI REAR "JJ O REMARKS a 1 ❑ NEW © RESIDENTIAL ❑ PLUMBING 2, �� vx, ® ❑ ❑ ADD/ALTER NONRESIDENTIAL MECHANICAL ❑ ❑ WALL ❑ SIGN REPAIR RETAINING H7EIGHT DEMOLISH ❑ OR FILL ❑ (X-FT) � Iqi 1 U )M,` EXCAVATE FENCE CHECKED BY TYPE OF CONSTRUCTION CODE Q ❑ �5 ❑PREMOVE INSP.1 ❑ SWIM SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT ' COMPLIANCE INSP. POOL REQUIRED GROUP r7 �?, LOAD ':-YES NO r4^ ❑ S1DE SEWER ❑ WATER LINE ❑ REMARKS O N CODo ❑ El El'f e&MRL )NSuL_ peo- 19 eo .5i .-.. ;' w NUMBER OF STORIES NUMRFROF p GWtLLING m UNIIb NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN) VALUATION FEE PLAN CHECK FEE f: �QI� BUILDING V QZ� 7 C v�J PLUMBING MECHANICAL / This Permit covers work to be done on private property ONLY. GRAowGIFlu / Any construction on the public domain (curbs, sidewalks,'_ driveways, marquees, etc.) will require separate permission. Permit Application: 180 Days Permit Limit: I Year • Provided Work is Started Within 180 Days - - I "Applicant, on behalf of his or her spouse, heirs, assigns and successors in interest, agrees to Indemnify, defend and hold w he the City of Edmonds, Washington, its officials, I m 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., 0 modify, waive or reduce any requirement of any city ordinance i nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUET $j provision." 1 hereby acknowledge that I have read this application; that the ATTENTION APPLICATION APPROVAL 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 This application is not a permit until state laws regulating construction; and Indoing the work authoriz- AUTHORIZES signed by the Building Official or his ed 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 Deputy; and fees are paid, and receipt Is tion Insurance. INSPECTION acknowledged in space provided. - SI NAT fl LO VNER O AGEr TI < DATE SIGNED DEPARTMENT ,'�.`��.A..� •`�" OFFICIAL'S SIGNATURE . r, / �'L.C� 8y CITY ��-- EDMONOS I -L'� L-C'I D CUAO�eK.. 771.3202 DATE ATTENTION IZZl84 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE AN CERA FINAL TIFICATE NOFE OCOCU ANCYY HAS HAS BEEN ABEENDE N GRANTAPPEDA UBC JUN 5 �g84OVL OR 0RIGINAL —File YELLOW —Inspector CHAPTER 3. PINK — Owner GOLD — Assessor 102.78 iCm. 1A 1 � That portion of Section 12, Township 27 North, } ° t Range 3 E.W.M. described as follows: Beginning at point 20.28 feet north and 1.24 feet east of the southeast corner of said section; thence north 73010152" west 213.88 s feet; thence north 34°22108" cast 51.46 feet; • thence south 73°10"52" east 193.58 feet; ' thence south 5°43'08" west 36.25 feet; thence Yf south 26004140" west 13.67 feet to the point Of beginning being a portion of the unrecorded i S••; ' Plat of Maple Manor; i r -7!,• el . Per'- �v�T(NC� Fo2MS APPRIu.:_.Fb(2- CbNG- ... l i-- ` RECORD OF INSPECTIONS Date Passed FOUNDATION House' Porches, piers Retaining walls - Garage, carport PLUMBING ' Underground Rough-16 I Water service / HEATING SYSTEM FRAMING g " WALLBOARD ..... - FINAL