850261.pdf0
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< �.: PERMIT
CITY OF EDMONDS NUMBER Q?6'7RUCTION PERMIT APPLICATION fME OF BUSINESS) / /i/C t/( jCr°,ii^/ N CHECK SUBDIVISION NO. LID NO.
[N7AMOR
MAILING ADDRESS
AS9/o Ot.YM/0/C V� /VE
CITY TELEPHONENUMBER PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
Z0 10���S '776 —00 cg 8 EXISTING REQUIRED DEDICATION
PROPOSED
NAME
V EU.) 4100Z A /'7" X F A � RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED ❑
ADDRESS STREET USE PERMIT REQUIRED ❑
4 / / c � lGL O co Ale / ^ `/O SEE ENGINEERING MEMO DATED _
CITYo TELEPHONE NUMBER SEE PIW DEPT. REVIEW CHECK LIST DATED/
v �f17iL E �8 -�6 REMARKS
//KS ,�,/ C
NAME. ////'u/1'11, llj✓AAI ;C'
ADDRESS
CITY
STATE LICENSE
z//T L_OA/0577
TELEPHONE NUMBER
CITY LICENSE NUMBER
Brty • Include all easements
r CODles)
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(35 of l) /80 dp of eL V e3 ao
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SUPPLY
REMARKS ,
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SIGN AREA' I ENV. REVIEW
ALLOWED I PROPOSED COMPLETE I EXEMPT
OR CU
YARDS/
5 FRONT
NEW RESIDENTIAL PLUMBING
�ADDIALTER 1:1NON-RESIDENTIAL MECHANICAL
REPAIR RETAINING WALL SIGN
EXCAVATE FENCE CHECKED BY
DEMOLISH OR FILL ( x—FT)
PLANNING REVIEW BY
SIDE
TYPE TYPE OF CONSTRUCTION
PRE -MOVE INSP.I SWIM SPECIAL INSPECTOR
COMPLIANCE INSP L.J POOL REQUIRED
❑ ❑ YES ❑ NO
❑ SIDE SEWER F WATER LINE REMARKS�j
NUMBER OF STORIES NUMBEgOF
UWI-LLING
UrvIts
NATURE OF WORK TO BE DONE (ATTACH PLOT BAN)
Xi4�J�lir'/irr
5!
PLAi4 CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY. GRADING/FILL
Any construction on the public domain (curbs, sidewalks, rz
driveways, marquees, etc.) will require separate permission. %, r ails/ /
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
N successors in interest, agrees to Indemnify, defend and hold
J 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
o modify,.waive or reduce any requirement of any city ordinance
°z 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
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 of Washington relating to Workmen's Compensa• WORK NOTED
tion Insurance. INSPECTION
SIGNATURE (OWNER OR AGENT) DATE sirNED DEPARTMENT
CITY OF
EDMONDS
ATTENTION 7713202
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 J=�
CHAPTER 3. -
102-78
1T
H:1911h
VALUATION��
UNITS
ADB NO.
SHORELINE
DATE
LOT COVERAGE
�Q
FEE
OCCUPANT
LOAD
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.
OFFICI L'S SIGNATURE
DATE
F
3
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ORIGINAL — File YELLOW — Inspector
I
PINK — Owner GOLD — Assessor
Kmqun Vnnling . Enmunu> WA . 7759494 ` ,I
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CITY OF EDMONDS
250 5Ih AVE. N, EDMONDS, WASHINGTON 98020 • (206) 771.3202
COMMUNITY SERVICES
October 3, 1986
R. Kean
18910 Olympic View Dr.
Edmonds, WA 98020
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LARRY S, NAUGHTEN
MAYOR
PETER E. HAHN
DIRECTORrr it
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PERMIT: 850261
Within the last year you'have obtained a permit from the
City of Edmonds Building Division. Our records show that
your permit has expired and not received a final evaluation
and approval from our offices. As part of the City
Ordinance and Building Code, all permits issued must be
inspected for final approval by the Building Division.
If your work was contracted, you may not have been aware of
your responsibility to schedule a final.inspection• Please
call 771-3202 extension 257 to schedule a final inspection
if your work is complete.
If your work is not yet completed') please call the Building
Division to update the status of, your permit.
Thank you for your assistance.'
K'eannine L. Gra
Permit Coordina
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