890082.pdfr,
i
SE
CITY OF EDMONDS ZONE
77!
RUCTION PERMIT APPLICATION joB
ADDRESS ��
AME OF BUSINESS)
_ n V \�. ... r LEGAL DESCRIPTION CHECKI S
yl
J:l
r
PERMIT NUMBER 990082P
DR-40
TELEPHONE NUMBER PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
S{'.• Z��j EXISTING —_ REQUIRED DEDICATION
v PROPOSEO -
(AIL 0cp
LID NO.
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED . .
STREET USE PERMIT REQUIRED
SEE ENGINEERING MEMO DATED
METER SIZE BUILDING SUPPLY
E�LEijHQNE NU�►AI4
r (� 7 '/ 4REMARKS
all easements
NEW in RESIDENTIAL U PLUMBING
ADDIALTER 0 COMMERCIAL 19 MECHANICAL
REPAIR CI RETAINING WALL LJ SIGN
EXCAVATEDEMOLISH OR FILL
PENCE
x _FT)
❑PRE -MOVE INSP.I SWIM -MOVE INSP.1 SWIM
REMODEL PREMODEL IAh2LINSP POOLPOO'
WOO INSERT APT. BLDG El RENEWAL
NUMBER OF 5TORIEs NUMUGn v
DWELLING
UNITS
NATURE OF WORK TO BE DONE (ATTACH PL(
SIGN AREA OOF ENV.
ALLOWED I PROPOSED C PLETE
VARIANCE OR CU
YARDS
FRONT IDE REAR
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."
1 hereby acknowledge that 1 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 pkson will be employed in violation of the Labor
Code of the State of Washington relating to Workmen's Compensa-
DA
TESCP
APPROVED BY
EXEMPT
REVIEW BY
DATE
HEIGHT I LOT COVERAGE
;HECKED BY TYPE OF���I lv"
ECIAL INSPECTOR M
SPAREA OCCUPAN�r,�i� OCCUPANT
REQUIRED GROUP // LOAD
❑ YES C NO (�
REMARKS
PROGRESS INSPECTIONS PER UBC 305
Fivied Itism pn yureek
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
GRADINGIFILL
STATE SURCHARGE
ENERGY CODE
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
ATTENTION
UNLAWFULIT IS BUILDING STRUCTURE
UNTIL AFINAL 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=3202
4,5• (D
CIIto
Z400 I w_
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.
OFfilelAL'S
RELEASED BY:
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
` 40 • Q f
�� 404" y
RECORD OF INSPECTION&
Date Passed
FOUNDATIOR,!" °"' -
House
Pordi-,s, piers
Rot-iitir,« vaills
G^r.: r :�,it) ort
PLi.'
'tltlt P-1d
021 v a s r
FR.=,t,�;i4�;G
WALLSO► RD
EINAL
8 goo 8 2�✓