840492.pdfUSE PERMIT `7� q��
CITY OF EDMONDS ZONE NUMBER' 64,04-92
^T / Tom(
CONSTRUCTION PERMIT APPLICATION JOB
j -
NAME (OR NAME OF BUSINESS) ADDRESS •� O I e- v `' uj 1
J LEGAL DESCRIPTION CHECK SUBDIVISIOW NO LID tJO.
tJ
MAILING ADDRESS
CITY TELEPHONE NUMBER PUBLIC RIGHT OF yJAY PER OFFICIAL STREET MAAPPP-
) ; '.�
�:71117 ,7 %; •.TI; ':--"Cr EXISTING "REQUIRED DEDICATION _/ /
-
NAME PROPOSED..
Z
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED' w
2
w
F
ADDRESS STREET USE PERMIT REQUIRED: T
,.
O
- SEE ENGINEERING MEMO DATED
CITY TELEPHONE NUMBER SEE PI DEPT. REVIEW CHECK LIST DAT D__._
- REM K J
NAME i
K- fE t/��SS
ADDRESS �� Zn'W% gY DC_,
( 1
Q
n
�f �I1N�1,' , METER SIZE BUILDING SUPPLY SIZE FIXTURE UNITS
I
U
O
CIT`Y/yJ TELEPHONE NUMBER
REMARKS 3
i )
i
O
STATE LICENSE NUMBERCITY LICENSE NUMBER
KFe I/X cZr( P IA/ SIGN AREA ENV.gEViEWFA=DS_jN0&.___ALLOWED
�.
PROPOSED COMPLETE EXEMPT Legal Description of Property- Include all easementsZ(show
0
be low or attach four copies) ORELINE#
F
h
Zvi- ati �'�!' t !^ . '}}'[' r1 r'F , \ �+� ?'--. VARIANCE OR CU PLANNING REVIEWyq/Y.},,y DATF I
'
w
YARDS LOT COVERA E
r ,:, r /70 • 5 -a�"� 3 ! t,,:.nrdcd GlreJr T ZS /� z =
. FRONT SIDE REAR r 5
I
^ � ,C JJ
or
3lo Zn 1D ar7 C.�^Y1)l..)i'I�:� bl-!�. f 3// �EMARKS •L/
NEW LSJ RESIDENTIAL I�
ILJ PLUMBING
I
ADDIALTER NON-RESIDENTIAL D MECHANICAL
D
I
REPAIR RETAINING WALL SIGN
CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT
DEMOLISH OR FILLTE ❑FENCE X __FT)
s"
SPECTOR AREAY OCCACUUPANT
PRE-MOCOMPLIANPOOL
rSy"
OCCUPJOCCUPANCY
CESNSNPJ P. EOUTALI
REQUIRED"
, YES O
SIDE SEWER ® REMARKS
_
WATER LINE
o 0 0 ,1,zss ' e k
U
w
p
NUMBER OF STORIES NUMREq OF
DWELLING '
'.
o
unn�
NATURE OF WORK TO BE DONE (ATTACH PLO PLAN)
477-1 Sl n r e
i
VALUATION FEE
PLAN CHECK FEE _
-
BUILDIIG '2 +J
✓
PLUMBING lit
lJ
MECHANICAL
This Permit covers work to be done on private property ONLY. GRADUJGIFILL
Any Construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
-
_{
Permit Limit: 1 Year • Provided Work is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
Wsuccessors
in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
+
z
employees, and agents from any and all claims for damages of
a
0
whatever nature, arising directly or Indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to CO
modify, waive or reduce any requirement of any city ordinance
'
i
nor limit in any way the City's ability to enforce any ordinance provision." TOTAL AMOUNT DUE
1 hereby acknowledge that I have read this application; that the
information given Is correct; and that I am the owner, or the duly ATTENTION APPLICATION APPROVAL
1
authorized agent of the owner. I agree to comply with city and THIS PERMIT
state laws regulating construction; and in doing the work authoriz. AUTHORIZES This application is not a permit until
)
ed thereby, no person will be employed In violation of the Labor ONLY THE signed by the Building Official or his
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.
SIGNATURE [OWNER OR AGENT) IGr D DEPARTMENT
JGATE
{$ OFFICIAL'S SIGNATURE
r✓/ [ /- CITY OF
EDMONDS/
ATTENTION
771.3202=E�
IT
IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
�'
I
(
UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW — Inspector
OF OCCUPANCY HAS BEEN GRANTED. UBC AUG 1 41984
CHAPTERIF3CATE
PINK —Owner GOLD —Assessor
10248
CATCH BASIN:
AL13 0153o(OIL TRGNCN L&rNGTH
WU■,L
t a
S � i
9
TPCPtCH Cavaia
4 -na uNl€ LtVBL TRSNCH
4�PERF vlvs �AP
TEE W/ 4'LONG LEGS
SYSTEM CROSS-SECTION
MlP_AFI 50ox
OK "I,,/ E LEL'"r
TO L/11(E1:;? if
'TRs1C44 COVER
3/4■ — 11/2' WASHED
GRAVEI
4■01AM PERF P
0■
TRENCH CROSS-SECTION
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE I OF 2
for c/�� G1_C 4l CC�/1° lMQ%7,hPWS
location
�'c( �,✓f9 9F0.,2d
inn .t .
plan by
phone
date
DESIGN DATA
Trench Perc LF per Imperm Trench
Number Rate 1000 sq.ft, Area Req.
NOTES
1. Call Engineering Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the responsibility
of the property owner(s). Preventive
maintenance consists of preventing
soil and other materials from entering
trench during construction as well as
after construction. Catch basins should
be cleaned of floating material and
sediment at regular intervals ( t least
twice per year). /
CITY OF EDIVIDNDS
0
1
I
AUG 141984
y
ql
f r
Y
Pa Y
ca
,� 4 � � i q •n. �
UI