860447.pdfi
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
MAILING ADDRESS
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CITY TELEPHONE NUMBER
7 77S, 1003
NAME
,,l T ��E2C eAC, .[ S TELEPHONE NUMBER
236-o334Y
¢ ADDRESS
0 �2y/7 1,elf
CITY r TELEPHONE NUMBER
O STATE LICENSE NUMBER
Legal Description of Property - Include all easements
(show below or attach four copies)
1E,;07V"j4e S% / L.OT OF �iLiC Ob /
Lois sd 6
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C� NEW RESIDENTIAL PLUMBING
® ADD/ALTER COMMERCIAL ❑ MECHANICAL
REPAIR El RETAINING WALL SIGN
DEMOLISH OR FILLTE FENCE
(_x_FT)
❑ PRE•MOVE INSPJ ❑ SWIM
REMODEL COMPLIANCE INSP. POOL
❑ WOO INSERT
❑ APT. BLDG RENEWAL
w NUMBER OF STORIES NUMBER OF
o DWELLING
m UNITS
0
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
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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 ands
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 1 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-
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USE . PERMIT
ZONENUMBER 860447
ADDRESS /QUOI 0/I1017 lie
1%/C,(ry
LEGAL DESCRIPTION CHECKI SUBDIVISION NO. ILID NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING REQUIRED DEDICATION
PROPOSED
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED 17
STREET USE PERMIT REQUIRED ❑
SEE ENGINEERING MEMO DATED
METER SIZE BUILDING SUPPLY SIZE FIXTURE UNITS
REMARKS
SIGN AREA ENV. REVIEW ADS NO.
ALLOWED PROPOSED COMPLETE EXEMPT
SHORELINE N
VARIANCE OR CU PLANNING REVIEW BY DATE
YARDS
/ / HEIGF T LOT COVERA E
FRONT' S16E R� 7,
REMARKS
CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT
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SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT
REQUIRED GROUP � LOAD
O YES O NO
i
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
GRADINGIFILL
STATE SURCHARGE
ENERGY CODE
PLAN CHECK DEPOSIT
FEE
0
TOTAL AMOUNT DUE I 14 ff 7)1 37y( f
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.
102.78
ATTENTION APPLICATION APPROVAL
THIS PERMIT This application Is not a ermit until
AUTHORIZES pp p
ONLY THE signed by the Building Official or his
WORK NOTED Deputy; and fees are paid, and receipt is
INSPECTION acknowledged in space provided.
DEPARTMENT
CITY OF OFFICIAL'S SIGNA RE DATE
EDMONDS �.
771.3202 d R ED BY: / DATE
ORIGINAL
— File
YELLOW
— Inspector
PINK —
Owner
GOLD —
Assessor
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CITY OF EDMONDS
250 5lh AVE. N. EDMONDS, WASHINGTON 98020 • (206) 771.3202
COMMUNITY SERVICES
March 5, 1987
Harry Poll
18401 Olympic View Drive
Edmonds, Washington 98020
Permit
Number.
860447
Date
Issued.
6/30/86
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.
1 01 1 11 "I t' it
If you are ready for fina protect approva p ease ca "spec ions
at 771-3202 to schedule an appointment.
Your cooperation in this matter is appreciated.
Last Inspection Date 9/11/86
Sincerely,
Jeannine I G...
Permit Coordinator
PUBLIC WORKS
• PLANNING PARKS AND RECREATION ENGINEERING
CITY OF EDMONDS
250 51h AVE, N. • EDMONDS, WASHINGTON 98020 (206) 771.3202
COMMUNITY SERVICES
October 26, 1987
Mr. Harry Poll
18401 Olympic View Drive
Edmonds, Washington 98020
RE: #860447
S. NAUGHTEN
MAYOR
E, HAHN
DIRECTOR
According to building division records the subject permit has expired.
Section 305 of the 1985 edition of the Uniform Building Code requires a
final inspection on all permits issued. Please contact the building
division within the next 10 working days regarding the status of your
permit.
If the work is complete please call 771-3202 to schedule for the
required final inspection.
Thank you,
Jeannnine L. Gra
Permit Coordinator
PUBLIC WORKS PLANNING PARKS AND RECREATION ENGINEERING
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RECORD OF INSPECTIONS
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