870416.pdfV.
CITY OF EDMOP
CONSTRUCTION PERMIT
NE(OR NAME OF t)kS.1/ .1 L 11 �_�11� �I
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APPLICATION
USE i PERMIT
ZONE S. / Z NUMBER
Jul'
ADDRESS
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ENUMBER PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
-720< EXISTING REQUIRED DEDICATION
PROPOSED
NUMBER
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED ❑
STREET USE PERMIT REQUIRED
SEE ENGINEERING MEMO DATED
K
O METER SIZE BUILDING SUPPLY SIZE FIXTURE UNITS
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�¢ CITY TELEPHONE NUMBER
Z REMARKS
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U STATE LICENSE NUMBER
SIGN AREA ENV. REVIEW ADB NO.
ALLOWED PROPOSED COMPLETE EXEMPT
Legal Description of Property - include all easements
(show below or attach four copies) SHORELINE M
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REMARKS
ElNEW RESIDENTIAL El PLUMBING
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ADDIALTER El COMMERCIAL � MECHANICAL c�
REPAIR RETAINING WALL SIGN
I EXCAVATE ❑ FENCE CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT
DEMOLISH CJ OR FILL ( x—�
PRE•MOVE INSP.I SWIM SPECIAL INSPECTOR AREA OCCUPANCY �� OCCUPANT
REMODEL COMPLIANCE INSP. POOL REQUIRED
LOAD
WOOD STOVE/ CI YES W, 40
1:1INSERT El APT.BLDG El RENEWAL REMARKS
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;UMBER OF STORIES I NUMBER DWELL NG F
UNITS
OF YVORK TO
PLOT PLAN)
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
w successors in interest, agrees to Indemnify, defend and hold
uNi 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
modify,. waive or reduce any requirement of any city ordinance
°x 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-
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PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
GRADING/FILL
STATE SURCHARGE
ENERGY CODE
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
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.
102.78
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.
OFFICIAL'S SIGN
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ORIGINAL — File YELLOW — Inspecto
PINK — Owner GOLD — Assessor
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FINAL At' "/AfAL GIVEN LY: Date Pissed :z.+
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1 `..�iUNDATION.
House ----- __..
hi► b� 1 _ Porches, piers
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Retainin walls
Garage carport --_,_ _ ___ .._.. - -IA
�......_..._.- .._.._.-. _.._. _ _ - .....�� LUMBING
Underground ----- _
Rough•in ;
='Ir��' v:'ia•'3 ' ` Water service
. •'ttw 110431•:�47 • HEATING SYSTEM
FRAMING ;
WALLBOARD
FINAL
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