890674.pdfCITY OF EDMON DS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINFSR
I7� 1N\ r.,l(S kip,I 7TELEPHONE1Z
ADDRESS
NUMBER
AME
ADDRESS
CITY TELEPHONE NUMBER
STATE LICENSE
3escription of Property - include all easements
below or attach two copies)
LM NEW I LJE3�, RESIDENTIAL
ADD/ALTER COMMERCIAL
REPAIR APT. BLDG.
EXCAVATE
DEMOLISH OR FILL
CARPORT
REMODEL GARAGE
WOOD STOVE/ RETAINING WALL/
INSERT ROCKERY
NUMBER OF STORIES
NATURE OF WORK TO BE
(OAJ5
NUMBER OF
DWELLING
UNITS
E (ATTACH PPLOOI
/ ` An
J
[ADDRESS
PERMIT 89060
E NUMBER
�
AL DESCRIPTION CHECK SUBDIVISION NO. LID NO
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP
APPROVED BY
' EXISTING.----- REQUIRED DEDICATION __..
1PROPOSED______
PLUMBING
n� MECHANICAL
L J SIGN
(yCE x �aV FT)
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED
STREET USE PERMIT REQUIRED
SEE ENGINEERING MEMO DATED
'r Ce l✓vt*41�k P t f
SIZE
REMARKS
BUILDING SUPPLY SIZE
SIGN AREA
ALLOWED I PROPOSED
VARIANCE OR CU
SETBACKS - FEET
FRONT SIDE
OF
COMPLETE I EXEMPT
U=
UNITS
Inol
NING REVIEW BY I DATE
44
HEIGHT I LOT COVERAGE
wcc 1 /9Sgloo
❑SWIM SPECIAL INSRECTO= AREA OCCUPANCY
POOL REQUIRED GROUP
1-1 YES ':NO
RENEWAL REMARKS
PROGRESS INSPECTIONS PER UBC 305
S
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY,
GRADINGWILL
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
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
i whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
modify, waive or reduce any requirement of any city ordinance
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
1 hereby acknowledge that I have read this application; that the
information given is correct; and that I am the owner, or the duly
ATTENTION
authorized agent of the owner, I agree to comply with city and
state laws regulating construction; and in doing the work authoriz-
THIS PERMIT
AUTHORIZES
ed thereby, no person will be employed in violation of the Labor
ONLY THE
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
tion Insurance.
INSPECTION
SIGN TURE (OW OR GENT)
DATE SIGNED
DEPARTMENT
CITY OF
l( (J Q EDMONDS
ATT NTION 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
HEIGHT /
CO
OCCUPANT
LOAD
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,
FICIALSSIGNAiURE j / DATE
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EL ASE Y: ' BATE
ORIGINAL — File YELLOW — Inspector /
PINK — Owner GOLD — Assessor ✓
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The East loot of Tract 83 and the S 141 of N 42 of �! 20Q
according to Plat thereof recorded in volume .3 of Pla"s, Page ?6+
g� Yiow Tracts, •
records of Snohomish Count✓, across,
TOGETI�H �RTH an easement for ingroos and egress, and for utilities over,
nn+i under the following desoribed tract: 1 + hest of
' allol to E lino, 28t; thenco W para,llol to
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n point on the North line of said 'tract 81F which is 10
L•lto NL•' corner thereof; thence •� P
t • thence Northeasterly to point of be( nning• actits
N line, 15 � ingress and ogress, and for utilitieo over, ,
TOGETHERWITH an Baser/ientdQ cribed traot: + �'1 of the I'TE
end under the following +• thence
Beginning at a point on the N lino of
thence B parallel to E line, 42
thereof; thence w along the N 1
to point of beginAing• and utilities over, across, and dedo�•
northeasterly instrumei1ts recorded
SUBJECT TO,eaaements for ingress and egress, anted by
the S 14' of Z1 421 cf @ls20 k of slid10886979Trt8and'11124640e
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RECORD OF INSPECTIONS
Date Passed
EOUNDAT101%
House
Porches, piers
Retaining walls
Garage, carport
PLUMBING
Underground
Rough•ih
Water service
HEATING SYSTEM
FRAMING
WALLBOARD
FINAL
M