880484.pdf1\
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
�� �•l,fl j ti p
Y
USE PERMIT
ZONE NUMBER
JOB
ADDRESS D/yj'plr,
I FGAL DESCRIPTION CHECKI SUBDIVISION NO.
J7PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING REQUIRED DEDICATION
PROPOSED
ADDRESS
CITY TELEPHONE NUMBER
i
NAME
ADDRESS
CITY TELEPHONE NUMBER
STATE LICENSE NUMBER
Legal Description of Property • include all easements
(show below or attach four copies)
NEW E10J RESIDENTIAL IJ PLUMBING
ADDIALTER COMMERCIAL �n MECHANICAL
REPAIR CJ RETAINING WALL El SIGN
EXCAVA� 'EMOLISH OR FILL TE IENCE
x _FT)
aPRE -MOVE INSP.1 ❑ SWIM
REMODEL COMPLIANCE INSP. POOL
WOOD I NSERTSTOVEI F APT. BLDG RENEWAL
NUMBER OF STORIES NUMBER OF
f DWELLING
/ UNITS
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED, .
STREET USE PERMIT REQUIRED ;
SEE ENGINEERING MEMO DATED
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."
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 pbrson will be employed in violation of the Labor
Code of the State of Washington relating to Workmen's Compensa-
NATURE (OWNER OR AGENT) DATE SIGN[
KS
) Vic
TESCP
APPROVED BY
G
METER SIZE BUILDING SUPPLY SIZE (FIXTURE UNITS
REMARKS
SIGN AREA ENV. REVIEW
ALLOWED I PROPOSED COMPLETE I EXEMPT
VARIANCE OR CU
YARDS
FRONT SIDE
REVIEW BY
r HEIGH
i -7
REAR Lis 4
LOT
3HEE'CC�KKEEDD BY TYPE OF CON ST/R�U�CTION CODE
SPECIAL INSPECTOR AREA OCCUPANCY-�
REQUIRED GROUP R
❑YES .NO Z¢a-
REMARKS
PROGRESS INSPECTIONS PER UBC 305
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
GRADINGIFILL
STATE SURCHARGE
ENERGY CODE
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
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.
102.87
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
771-320a
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VALUATION
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OCCUPANT
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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
DATE
TE
BY: i7'
J2 7 /F/Yd
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor.-"
Mil
R E c a I
JUN 7 1988
PERMIT COUNTER
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890 199-
CITY Y OF EDMON S LARRY S. NAUGHTEN
MAYOR
250 - 5th AVE N. • EDMONDS, WA 98020 • 206) 771-3202
COMMUNITY SERVICES: PETER E. HAHN
Public Works • Planning Parks and Recreation • Engineering DiRecroR
June 6, 1989
Rob & Eileen Pierides
9001 Olympic View Drive
Edmonds, WA 98020
RE: Addition
Permit #880484
According to building division rec rds the subject permit is due to
expire on July 18, 1989. If your ork is complete or will be complete
by the expiration date please cont ct the building division for the
required final inspection.
If the work is not complete and yoj feel that you need more time beyond
the expiration date to complete th work please renew the permit by
contacting the City prior to the a piration date. A new application
will have to be completed and a re ewal fee charged.
Please contact the building division at 771-3202 with regard to your.
intentions.
Thank you,
Diane M. Cunningham
Permit Coordinator
• Incorporated At gust 11, 1890 • z t
Sister Cities International — Hekinan, Japans
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