860160.pdfl
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
NAME (O ME 0 BUSINESS)
n.
ADDRESS
CITY
STATE LICENSE NUMBER
l// 0
C" "
TELEPHON
- include all easements
ZONE
V5•-/ Z
PERMIT
NUMBER yR, -60
JOB
ADDRESS
LEGAL DESCRIPTION CHECK SUBDIVISION NO. LID 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
276,
METER SIZE
REMARKS
SIGN AREA
ALLOWED I PROPOSED
VARIANCE OR CU
YARDS ~
^`���� 1
FRONT L.PSIDE / D
SIZE IFIXTURE UNITS
ENV, REVIEW
COMPLETE I EXEMPT
PLANNING REVIEW BY
ADB NO.
DATE
.1 HEIGHT I LOT COVERAGE
3siD12)
1 NEW RESIDENTIAL Li PLUMBING
ADDIALTER COMMERCIAL F1 MECHANICAL
REPAIR RETAINING WALL SIGN
DEMOLISH � oRCF EXCAVATE ❑ FENCE X—� CHECKED BY TYPE OF CONSTRUCTION CODE
El
PRE•MOVE INSPJ ❑ SWIM SPECIAL INSPECTOR AREA OCCUPANCY �2
REMODEL COMPLIANCE INSP. L REQUIRED GROUP
❑ WOOD STOVE/ El
}� ❑ YES 0
INSERT APT, BLDG I XI RENEWAL REMARKS
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
C k 140240
J/� �•vG//1 ��� VALUATION FEE
PLAN CHECK FEE
BUILDING
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.
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
i 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 limit in any way the City's ability to enforce any ordinance
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
authorized agent of the owner. I agree to comply with city and
state laws regulating construction; and In doing the work authoriz-
ed thereby, no person will be employed In violation of the Labor
Code of the State of Washington relating to Workmen's Compensa-
ATTENTION
PLUMBING
MECHANICAL
GRADINGIFILL
STATE SURCHARGE
ENERGY CODE
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE I I � po
1
OCCUPANT
LOAD
ATTENTION APPLICATION APPROVAL
THIS PERMIT This application is not a permit until
AUTHORIZES signed b g
ONLY THE y the Building Official or his
WORK NOTED Deputy; and fees are paid, and receipt is
INSPECTION acknowledged in space provided.
DEPARTMENT
OFFICIAL' SIGNATURE DATE.
CITY OF
EDMONDS 0/0 iV/
771.3202 ASED BY: DATE
C?
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.
102.78
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
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CITY OF EOMOIVOS
250 51h AVE. N. EDMONDS, WASHINGTON 96020 • (206) 771.3202
COMMUNITY SERVICES
March 5, 1987
Robert Duvall
9318 Olympic View Drive
Edmonds, Washington 98020
Permit Number: 860160
Date Issued: 3/14/86
LARRY S^ NAUGHTEN
MAYOR
PETER E, HAHN
DIRECTOR
This letter is to advise you that Building Division records do not
indicate recent inspections for the subject building permit. If no
progress has been made on construction, please advise the Building
Division so appropriate notation can be made in your file.
The initial building permit is valid for one year. If your project has
not been completed within the year a renewal is required. Please call
the Building Division,for more information.
If you are ready for final project approval please call "Inspections"
at 771-3202 to schedule an appointment.
Your cooperation in this matter is appreciated.
Last Inspection Date 5/14/85
PUBLIC WORKS PLANNING
• PARKS AND RECREATION •
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