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840580.pdf
CITY OF EDMONDS 1 CONSTRUCTION PERMIT APPLICATION I NAME (OR NAME OF BUSINESS) l Dean Dretske MAILING ADDRESS 17504 Olympic View Dr. TY I TELI Edmonds. Wa. V Seat iF ffq USE PERMIT ('� y ZONE U NUMBER 84 05 ©0 •n- , JOB v II J�OCJ t� ADDRESS 17504 Olympic View Drive IDNENUMBER t�U�'BEHIP.W IC RIGHT OF WAY PER OFFICIAL STREET MAP. -4519 ING.. _.. REQUIRED DEDICATION OSED..._...... - -... T OF WAY CONSTRUCTION PERMIT REQUIRED ET USE PERMIT REQUIRED. ENGINEERING MEMO DATED... ONE NUMBER DEP1. REVIEW CIIECK LIST DATED_._ INC. CITY LICENSE SIGN AREA ervv. HEVMVV nun rv0. ALLOWED I PROPOSED COMPLETE I EXEMPT / � SHORELINE p VARIANCE OR CU PLANNING REVIEW BY DATE l'J YARDS U I A I LOT COVERAGE ❑ NEW LiRESIDENTIAL L^J PLUMBING ElALTER❑ NON•RESIOENTIAL MECHANICAL ❑ ❑ REPAIR RETAINING WALL SIGN ❑ EXCAVATE I� FENCE CHECKED TYP DEMOLISH OR FILL L__x_.FT) SNSP. AL INSPECTOR COMPLOIANCEVF POOL REOUSPECIIRED ❑ WATER ❑ YES NO REMARKS SIDE SEWER LINE �(Lo C. 2E55 BY (UMBER OF STORIES NUMBEROF UWtLLINU and automatic gas water heater NCY AREA OCCUPANCY OCCUPANT GROUP i7 — LOAD This Permit covers work to be done on private property ONLY. Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. PLAIT CHECK FEE BUILDING PLUMBING MECHANICAL GRADINGIFILL 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 in Interest, agrees to indemnify, defend and hold wsuccessors harmless the City of Edmonds, Washington, its officials, 2 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 a 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 information given Is correct; and that I am the owner, or the duly ATTENTION 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 ed thereby, no person will be employed In violation of the Labor ONLY THE Code of the State f Washington relating to Workmen's Compensa- WORK NOTED tion Insurance. INSPECTION SIGNAT NER GENT) DATE//SIGNED DEPARTMENT ��•[� CITY OF _ I DMONDS AT 'ELATION 771-3202 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 CHAPTER 3. 10278 I; i 1. �II I II I I i 1 l i I t• i y i I. �I. I I 1 1 1TE to �y2 ORIGINAL — File YELLOW — Inspector -_ PINK — Owner GOLD — Assessor ,......., , mm,�,a, vu • ns..v, cam: NS 1�3G °= I304s 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. 0 FOUNDATIOR }louse Qorches, Piers Retaining vralls— i t � s +• ra a or ---- — pwmeimG underground Rougil•in Water service --=. SYSTEM HEATING FRAMING :. a WALLBOARD. FINAL + _ A