850591.pdfCITY OF EDMUNDS
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STRUCTION PERMIT APPLICATION
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TELEPHONE NUMBER
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STATE LICENSE NUMBER
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NEW RESIDENTIAL C� PLUMBING
OADDIALTER COMMERCIAL MECHANICAL
OREPAIR RETAINING WALL SIGN
ElEXCADEMOLISH OR FILLTE O (ENCE x -
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wNUMBER OF STORIES NUMBEROF
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O NATURE OF WORK 70 BE. DONE (ATTACH PLOT PLAN)
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PERMIT
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ADDRESS
LEGAL DESCRIPTION CHECKI SUBDIVISION NO.
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
REMARKS
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METER SIZE
REMARKS
SIGN A
ALLOWED
VARIANCE OR CU
YARDS
FRONT
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SPECIAL II
REQUIRED
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WILDING SUPPLY SIZE (FIXTURE UNITS
EA ENV. REVIEW ADB NO,
PROPOSED COMPLETE I EXEI.IPT
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BUILDING
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NING REVIEW BY IDATE
HEIGHT ILOT COVERAGE
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AREA OCCUPANCY OCCUPANT
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MECHANICAL
This Permit covers work to be done on private property ONLY. GRADING,FILL
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
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
a whatever nature, arising directly or indirectly from the issuance
= of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT
omodify, 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 ATTENTION
information given is correct; and that I am the owner, or the duly
authorized agent of the owner. 1 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
LSIGNATURE
rance. INSPECTION
;OWNER OR AGENTI DATE SIGNED ' DEPARTMENT
CITY OF
f EDMONDS
771 3202
ATTENTION
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.
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VALUATION I FEE
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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.
FIC AL'S SIGNATURE DATE
2 _ �r ,s i may'
ELEASED BY:
DATE
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ORIGINAL — File YELLOW — Inspector U
PINK — Owner GOLD — Assessor
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_ } CITY OF E D M O N D S LARRY S. NAUGHTEN , f
MAYOR
t 250 51h AVE. N. EDMONDS, WASHINGTON 98020 (206) 771.3202
PETER E. HAHN
� COMMUNITY SERVICES
DIRECTOR
January 6., 1987
Donald Hansen
16411 75th Pl W.
Edmonds, WA 98020
PERMIT NUMBER: 850591
Building Division records indicate that you have been repeatedly
notified of your building permit which has expired without final
inspection. Section 305 of the Uniform Building Code, as adopted by
the City, states, "it shall be the duty of the person doing the work
authorized by a permit to notify the Building Official that such work
is ready for inspection...there shall be a final inspection and
approval on all buildings and structures when completed and ready for
occupancy or use.
Please notify the Building Division within 15 days date of this letter
to schedule for a final inspection. If we do not receive a response
from you we will be forced to turn this matter over to the Office 'of
the City Attorney.
/eannine L. Graf
Permit Coordinator
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PUBLIC WORKS PLANNING PARKS AND RECREATION; ENGINEERING }
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