890344.pdfY
Z
0
-..1 � ..e-. ... ;._ ._ ....�-.�3a .r iQ�..... �.i.�.........�_ _7fw....� .. �.. _ _ _ .. _. .. .-� .. � .. _ J ._.�.lti. ... Iit wN +1.. .t� � _,.�.cA�.t�"l'.•Y` A 1r {�i%-,n ..rr?+,�..�. t
R 9 asps .
BUILDING DIVISION
PERMIT APPLICATION
EMEEM
AME IOR NAM[ nR mualwtaal.
2
Applicant Fill
Inside Heavy Lines
dJkWVA
NE NUMBER sso34 -
JOB
ADDRESS
LEGAL DESCRIPTION I SUBDIVISION ISHORT SUI
vlo vyle \2 01 Im
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
,1 [LEPHON[ NUMBER
EXISTING
`d PROPOSED
DEFICIENCY OF RIGHT OF WAY
�R[!f PUBLIC IMPROVEMENTS REQUIRED ❑
DRAINAGE IMPROVEMENTS REQUIRED ❑
Y [L r NE NUMBER DRAINAGE PLAN REQUIRED ❑
UNDERGROUND WIRING REQUIRED ❑
NE ONNECTION TO SANITARY SEWER ❑
Q t EPTIC TANK PERMIT REQ•D ❑ NO,
DREff ELEVATION OF PROPERTY CORNERS ❑
lo3 �� a FOOTING! REQ•D
Y [LEPHO NUMBER
N<Az► -�-t�Lo ISEE ENGINEERING MEMO DATED
VV V CITY LICENSENUMBER 7CHECKED BY
tie "G q nC ay3Y-,
or Attach Four
SIGN AREA
ALLOWED I PROPOSED
REMARKS
VARIANCE OR CU
YARDS
FRONT
NEW RESIDENTIAL GAS
LINE FIR ZONE 7NON-RESIDENTIAL SIGN
® AOD EMMMME13 DEMOLISH
RETAINING SPECIAL INSPECTOR
WALL REQUIRED
❑ ALTER a ORCF LLT[ � PENCE x—� ❑ YES ❑ NO
PLAN CHECKED BY
ElREPAIR PRENs MOVE IDE Pswim
OOL
Z NUMBER OF STORIES NUMBER OF REMARKS
O DWELLING
1: UNITS
NATURE OF WORK TO BE DONE
W
o &AdWO
1 M. ..� �. �..
� I 000
ZA- G50
N "Applicant, on behalf of his or her spouse, heirs, assigns and
W
J successors in interest, agrees to indemnify, defend and hold harmless
i the City of Edmonds, Washington, its officials, employees, and
agents from any and all claims for damages of whatever nature,
x arising directly or indirectly from the issuance of this permit. Issu-
j ance of this permit shall not be deemed to modify, waive or reduce
O any requirement of any city ordinance nor limit in any way the
X City's ability to enforce any ordinance provision."
I hereby acknowledge that 1 have read this application; that the in-
formation given is correct; and that I am the owner, or the duly author-
ized agent of the owner. I agree to comply with city and state laws regu-
lating construction; and in doing the work authorized thereby, no person
will be employed in violation of the Labor Code of the State of Washington
relating to Workmen's Compensation Insurance,
NOTE: PWRO Li" OM YllW(Except DEMOLITIONS and FILL
PERMITS without conditional use permit, which shall be completed in 90
days; MOVED -IN BUILDINGS shall be completed in six months,)
This Permit covers work to be done on private property ONLY.
Any construction on the puMle domain (verbs, sidewalks, driveways,
marquees, etc.) will require Separate permhSlon,
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 3ti4, 3W,
1 02-7a
BUILDING
PLUMBING
MECHANICAL
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
M
rOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZE!
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
775-2525
ENV. REVIEW I ADB
E MPLTEI EXEMPT
PLANNING REVIEW BY IDATE
COVERAGE
SIDE RE
BE CODED 31.04.
VALUATION I FEE
a/r-
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 pro -
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
H
Z
W
E
6
w
0
F
Z
W
L
O
J
W
Y
O
F
Z
E
O
U
_tea •.1 a.n..
i
I
7/89 G� Turf o.E
^0090j /lw 6'
z. stt� � fop 040/mot%
f.
RECORD OF INSPECTIONS
Dar---e= ed
FOUNDATION
House
Porches, piers
Retaining walls
Garage, carport
PLUMBING
Underground
Rough -in
Water service
HEATING SYSTEM
FRAMING
WALLBOARD
FINAL
n
♦