850469.pdf■
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
CITY
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ADDRESS
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STATE LICENSE NUMBER
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Legal Description of Pr(
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ENE NUMBER
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USE PERMIT
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LEGAL DESCRIPTION CHECKI SUBDIVISION NO, I LID NO. 17
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING REQUIRED DEDICATION
PROPOSED
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED ❑
STREET USE PERMIT REQUIRED ❑
SEE ENGINEERING MEMO DATED
SEE PIW DEPT, REVIEW CHECK LIST DATED
t
METER SIZE BUILDING SUPPLY SIZE FIXTURE UNITS
TELEPHONE NUMBEE/ / 5 --44 REMARKS
CITY LICENSE NUM
SIGN AREA ENV. REVIEW ADB NO.
party Include all easements ALLOWED PROPOSED COMPLETE EXEMPT
ur copies) SHORELINE
VARIANCE OR CU PLANNING REVIEW BY P DATE
2G eef l
YARDS I LOT CJOVVER G
Zs FRONT /0 SIDE � REAR 3�/D
El NEW RESIDENTIAL PLUMBING
L� ADDIALTER NONRESIDENTIAL MECHANICAL
REPAIR El RETAINING WALL SIGN
EXCAVADEMOLISH OR FILLTE (ENCE x—FTl
1-1 PRE -MOVE INSP.I n SWIM
ElSIDE SEWER 0 WATER LINE
El
NUMBER OF STORIES NUMBEROF
J DWELLINU I
UNIIS
NATURE OF WORK TO BE DONE (ATTACH PLOTPLAN) 1
I71
REQUIRED
0 YES
TYPE OF CO
77
;TOR ARE
❑ NO
000
WSPACC
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
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. 6/
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
w 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
xx nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DU
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 of Washington relating to Workmen's Compensa• WORK NOTED
tion Insurance. INSPECTION
SIGNATURE (OWNERORAGENT) DATE SIGNED
�y DEPARTMENT
e5 z / ` EDIMONO S
ATTENTION / 771.3202
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTUfi$UG 2 71985
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED, UBC
CHAPTER 3. �1el������ ;7l
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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,
OFFICIAL'S SIGNATUBJ,
e 94
ORIGINAL —/File YELLOW — Inspector U
PINK — Owner GOLD — Assessor
Kmlyon Pmhng . F.UmonU6. WA 0 71. '. 19
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CITY OF EDMONDS
250 5th AVE. N. EDMONDS, WASHINGTON 96020 • (206) 771.3202
COMMUNITY SERVICES
October 3, 1986
Tom Powell
18427 Olympic View Dr.
Edmonds, WA 98020
LARRY S. NAUGHTEN
MAYOR
PERMIT: 850469
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*
iteannine L. Ural` -
Permit Coordinato
PETER E. HAHN
DIRECTOR
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PUBLIC WORKS PLANNING PARKS AND RECREATION ENGINEERING c(}w,Kftir,<1 i t
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RECORD OF INSPECTIONS4.
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FOUNDATION''
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- Porches, piers t
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Retaining walls
Garage. car�)ort.. ._ .
PLUMBING --
Underpmind _-
Rough-in
Water service
ti , HEATING SYSTEM
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FRAMING
WALLBOARGf t�
FINAL
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