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870896.pdff Cr Z 0 U w x Q a tr 0 Z Z O U Z _o s U w 0 J 4 w J CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION NAME (OR NAME OF BNSINESS) U I (VL bA y 14 Cl ADDR SS o. C90 %k C NUMBER TELEPHONE NUMBER �7 7(,--3 7( , VE NUMBER I_C 1. 'I [ of Property • Include all easements ach four CODies) l=J NEW RESIDENTIAL PLUMBING ADD/ALTER COMMERCIAL MECHANICAL REPAIR RETAINING WALL SIGN EXCADEMOLISH OR FI LTE ❑ `ENCE x_F) ❑❑ PRE -MOVE INSP.1 ❑ SWIM REMODEL COMPLIANCE INSP. POOL ❑ WOO INSERT F1 APT. BLDG RENEWAL NUMBER OF STORIES NUMBER OF DWELLING UNITS NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN) ILY ) 5 /1)EV64�E 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 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." USE PERMIT ZONE NUMBER g770Sm% 6 SOB ADDRESS 3 /D LEGAL D yE �SC jRIPTION CHECK SUBDIVISION NQO./ LID NO. %J to PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. EXISTING RE DEDICATION PROPOSED lf� r RIGHT OV WAY CONSTRUCTION PERMIT REQUIRED 0 STREET USE PERMIT REQUIRED C SEE ENGINEERING MEMO DATED /•,iA/ f7 L .. AV �D O iTEZBUILDING 11 UPPLY SIZE (FIXTURE UNITS Y) �1\ y ,ecp.D SIGN AREA ENV. REVIEW ADB NO. ALLOWED I PROPOSED COMPLETE I EXEMPT 1a VARIANCE OR CU PLANNING RE REVIEWY DATE 1 c�7 YARDS a HEIGHT LOT COVERAGE FRONT�� SIDE � REAR AR p�, tv CHECKED BY WA /_TIMT REQUIRED ❑ YES ❑ NO 17L Zk5i el"Z U Z R w w Z a Z w s w I CODE HEIGHT 148s .Zs OCCUPANOCCUPANT P,3 GROUP LOAD l796 o is kr a6i 3oS TION PLAN CHECK FEE ' 2co BUILDING O 2�S 4103 PLUMBING J 33 MECHANICAL GRADINGIFILL STATE SURCHARGE ENERGY CODE ! �5 PLAN CHECK DEPOSIT TOTAL AMOUNT DUE I hereby acknowledge that I have read this application; that the [a'uthorized formation given is correct; and that I am the owner, or the duly ATTENTION agent of the owner. I agree to comply with city and THIS PERMIT tate laws regulating construction; and In doing the work authoriz• AUTHORIZES d thereby, no person will be employed in violation of the Labor ONLY THE ode of the State of Washington relating to Workmen's Compensa- WORK NOTED on Insurance. INSPECTION G ATURE (OWIN'EiR OR �AGNT)( DATE SIGNED DEPARTMENT �W 1) ✓ I ` �� J� CITY OF EDMONDS '`"771.3202 (` ATTENTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE DEC - 4 1987 UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED, UBC CHAPTER 3, Ir"Ehh'i1T C!`!1"'TE! 102.78 --/00,0o 1 4�0&9S 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 SIGNATURE DATE 12.2$•$7 ELEASED BY: UAI J2[� 3/ 8 ORIGINAL — File YELLOW — Inspector U PINK — Owner GOLD — Assessor REAR OTHER RECrI, VED f. HEIGHT _ 251MOW CITY CO DEC - 41987 PERMIT COUNTER PLANS ON jOCSITE FOR %J b ALL INSPE• TIONS ri n PERMIT NO. SHEET ; OF o z 3 u F„ z Q p d a o o t b 0 h J A e A O r . (n 4 2 0 • s � eft l'tP � d J �I � rl 0 w N r o4 ..ftd .:n.t.:w {s�+;•T's.I�_...,4, Y',• /f .tf1s i,�+. j ` :�tTjn .<: i' •r•' '' ^'A'� t F ��1'. I Lj +spaK/� R m 4 Alf r e o `t)K*Fbt - Qw 9 y • f1M.XWAWJ Intl ' M/u ��.. •� . '.. II1'N10 OL i 1NdINP1'IJ /, 1f 1f1n (• fCD99V \ a -t_, o;os re .+n.e•r mew � \ i O'Opf rj.n a I t, 4+j G- + TL �•az = CAP-h6� ld�V� �c(x ' 3 �•1�'r+vim ^r'T1( r li it ti q l� Kx ' s.kit, 1 nay �c`�wF Ff y�" Js-Ir��ra�,tit �t.6: J * - - COMMUNITY SERVICES ENGINEERING/BUILDING FINAL FORM MEMO TO: Building Division FROM: Engineering Division SUBJECT ADDRESS: 1'/ �ew I. [ePERMIT APPROVED FOR FINAL PERMIT NOT APPROVED FOR FINAL Requirements: 1. . 2. 3. 4. 7 Zo�g �4 I 1.1 r y _ I I , r. RECORD OF INSPECTIONS Dates d • FINAL APPROVAL GIVEN BY: / .. .. I FOUNDATION Date • ' ' �'•,, }louse Building 3' _._._........,. porches, piers fDew ;. _.._....:. ire �.I Retaining walls - Lngineeri!-.-_•......o... I Garage, carport rk PLUmE Underground t • ;, Rouah4n Water }{EATING SYSTEM z —ST--?'s1� +s. FRAMING yVALLBOAW1 . ZD• �� ` jT 6 FINAL cry