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850252.pdfCITY OF EDMONDSONE mom111U.BERSEE SE PERMIT HUMBEH ®C/AE 71o� _FTY j CONSTRUCTION PERMIT APPLOB AME OF BUSINESS) DDRESS L� •) f• I DESCRIPTION CHECK SUDDIVISION tJO. LID NO. ` DRESS ,,. iEGAL TELEPHONE PUDLIC RIGHT OF WAY PER OFFICIAL STREET MAP. i0 2- EXISTING ,..._.. .. REQUIRED DEDICATION . PROPOSEDRIGHT PERMIT REQUIRED OF WAY CONSTRUCTIO14 STREET USE PERMIT REQUIRED SEE ENGINEERING MEMU DATED TELEPHONE PIW DEPT. REVIEW CHECK LIST DATED ... ....-....._ .--- vl;n� M1-•, ex, Gl�l•I:':TF , NUMBER Z lC 'Y LICENSE NUMBER E.)(IS ( WV -7r--f •VIc.E SIGN AREA ENV. REVIEW ALLOWED I PROPOSED COMPLETE I EXEMPT easements slow or attacn tour copies) t1 I) "i VARIANCE OR -s� R�7"tip 1 �.C.t 1 :t'i;'11:=,� �t•;-i YARDS r, ,!. • ... !-, .•, I G'.j �, 0)+,I FRONT ❑ UAEIE RESIDENTIAL ❑NEW ADDIALTER ❑ NON-RESIDENTIAL ❑ ❑ ❑ ❑ REPAIR RETAINING WALL ❑ EXCAVATE © CKED BY ❑ DEMOLISH OR FILL ❑SWIM SPECIAL SIYES ❑ COMPPRE-MLIANCESINSP. UIRED ❑ ARKSWATER SIDE SEWER LINEALNUMBER OF STORIES NUMBEROF UWELLI NU UNtIb PLOTPLAN)TV Vc y�NATURE OF WORK TO BE DONE (ATTACH REVIEW 6Y j2 �Fbo 136L 7fl AREA OCGUPANCV OCCU GROUP p1� 1 LOAD NO I ` coyAAl=c`T)oA coyMLOL PSIL E55 1 N�(�cTlariS rLE.fl� PLAN CHECK FEE I BUILDING PLUMBING MECHANICAL I 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. 9OOL Z50 O 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 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 Ilmit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE t� provision." I 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 In doing the work authoriz• AUTHORIZES signed by the Building Official or his ed thereby, no person will be employed in violation of the Labor Workmen's Compensa• WORK NOTED Deputy; and lees are paid, and receipt Is Code of the State of 1hington relating to acknowledged In space provided. if. Insurance. INSPECTION R R G)<NTI SIGNED DEPARTMENT OFFICIAL'S SIGNATURE L-TUREWN LIG -- h ,j,jj 7(}' JPATE _ 5 .�.2 �7 CITY OF EDMONDS �a-09-`'- ATTENTION N n,-szoz DA,—e IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUC UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAT�U,fj€.V HAS BEEN GRANTED, UBC l C yn,9 IJ r ORIGINAL - File YELLOW - Inspector A CERTIFICATE OF OCCUPANCY CHAPTER 3./mod s�Zy 5-•' T•� /PINK -Owner GOLD - Assessor _ 102-78 r V L- tb f99rof , i I .1. 1 e . 9 1•� q0.O .Z v I GW& @o Di�0�D6 j 0 -#A—TER-ttEPARTMENT ro CONNECTION CONTROL I hazards, inst211aLon j is n conditic) t}: following water systa provided: r Ie: ' O F2ESSURE Api c ti�sc.f� �„• DER' -A LL- FIRS HO 00 �.• ,U o,� 5J o IJ,G DeET — — - (ID -- w47 SST �U.X-� L �S o 12 0 . i�I 1 ,► crrr • �- �5 12000 ECT: I I INTER -OFFICE COMMUNICATIONS ?5-0 7— 5- z. k/ OLr?P/C VIEW POO T-- L0 W 14�V I C_F_ 1 M S 7-A4-LFb ya BUILDING APR 7 - 1986 XT kze 411Y -3/z/ X-20 7- 1,95— RECORD OF INSPECTIONS_ Date Passe FOUNDATION House Porches, piers Retaining walls Garage, carport PLUMBING Underground Rough -in Water service HEATING SYSTEM FRAMING WALLBOARD FINAL 1,44,0,4,0000"