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... USE PERMIT �y
CITY OF EDMONDS ZONE NUMBER l.� g ()4
CONSTRUCTION PERMIT APPLICATION JOB
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NAME (OR NAME OF BUSINESS) ADDRESS
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O PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. APPROVED BY
CITY TELEPHONE NUMBER
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PROPOSED �y
NAME Z
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RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED, . w
�- STREET USE PERMIT REQUIRED Z
FADDRESS REVIEW BY Z
= SEE ENGINEERING MEMO DATED
a CITY TELEPHONE NUMBER
REMARKS
NAM 1 SQL /_ /t,�) 6e amw vyroled�z�s
ADDRESS l 1 ►l7 C -C� iL L
O METER SIZE BUILDING SUPPLY SIZE FIXTURE UNITS
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O STATE LICENSE NUMBER
L ��,) SIGN AREA ENV. REVIEW ADB NO.
ALLOWED I PROPOSED COMPLETE i
EXEMPT
Legal Description of Property - Include all easements
(show below or attach four copies) SHORELINE N
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ElNEW I PRESIDENTIAL PLUMBING
ADDIALTER COMMERCIAL El MECHANICAL
REPAIR El RETAINING WALL
EXCAVATE
�EMOLISH OR FILL
PRE -MOVE INSP.I
REMODEL COMPLIANCE INS
❑ WOOD STOVE/ ❑
INSERT APT. BLDG
NUMBER
OF WORK TO
NUMBER OF
DWELLING
UNITS
(ATTACH PLOT PLAN)
ElSIGN
FENCE
I. x _FT)
I —I SWIM
Cl)
RENEWAL
VARIANCE OR CU
YARDS
FRONT
SIDE REAR
NING REVIEW BY
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HEIGHT I LOT COVERAGE
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;HECKED BY PE OF CONSTRUCTION CODE
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SPECIALINSPECTOR AREA OCCUPANCY
REQUIRED GROUP Q
❑ YES C NO
REMARKS
PROGRESS ESS INSPECTIONS PER UBC 305
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PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY. GRADINGIFILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission. STATE SURCHARGE
Permit Application: 180 Days
ENERGY CODE
Permit Limit: 1 Year- Provided WorK is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
m 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
iwhatever nature, arising directly or indirectly from the issuance PLAN CHECK DEPOSIT
0 of this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirement of any city ordinance
Ox 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. I agree to comply with city and THIS PERMIT
state laws regulating construction; and in doing the work authoriz- AUTHORIZES
Ledtherebyt no pkson will be employed in violation of the Labor ONLY THE
he State of Washington relating to Workmen's Compensa- WORK NOTED
rance. INSPECTION
(OWNER OR AGENT) DATE SIGNED DEPARTMENT
/ CITY OF
G ! 30 EDMONDS
TT'ENTI ON 771-3202
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.
102.87
VALUATION I FEE
HEIGHT
OCCUPANT
LOAD
ZS OU
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.
OFFIQAL:S SLGNATUR. / DOTE
/7/30
LEASED BY:/ j DATE
ORIGINAL
— File
YELLOW
— Inspector
PINK —
Owner
GOLD —
Assessor
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PARCEL 2
All that portion of Government Lot 1, Section 18, Township 27
North Range 4 East, W.M., described as follows: Beginning at
the northwesterly corner of said Section 18, and proceeding i
thence along the west line of said Section 18, S 100113711 W
656958 feet to the southerly margin of the Edmonds -Beverly Park
Road; thence along said southerly margin on a curve to the
left, having an initial course of N 5400811311 E and a radius of
349.60 feet, a distance of 126.04 feet; thence N 33028150" E
58.79 feet to the intersection of the southeasterly margin of
the Edmonds -Beverly Park Road with the northerly margin of
Sunset ,Way as was conveyed to the City of Edmonds by Quit Claim
Deed recorded under Auditor's File No. 1794710, records of L
Snohomish County, Washington; thence continuing N 3302815011 E,
a distance of 101912 feet to the True Point of Beginning of
this description; thence continuing N 3302815011 E, along the
southeasterly margin of the Edmonds -Beverly Park Road, a
distance of 96.23 feet to the point of curve of a curve to the ---
right having a radius of 98.90 feet, thence northeasterly,
along the arc of said curve to the right and through a central;
angle of 6804013611 a distance of 118954 feet; thence
S 904915611••E, a distance of 130996 feet�T�•c, thence S 80°10'04" W,
a distance of 10. 00 feet to 'the ppointCi �dfCFc �N� a curve to I
P. W. DEP.T. ENGINEERING DIV.
EXAMINED
BY ��; DATEvI
REMARKS e I
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the left having a radius of 75.00 feet; thence westerly, along
the arc of said curve to the left and through a central angle i
of 57*5213411, a distance of 75.76 feet; thence N 6402413011 W, a
distance of 124.54 feet to the True Point of Beginning.
---
INTER-OFFICE COMMUNICATIONS
DATE, 19
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