900083.pdfS ,
USE PERMIT
CITY OF EDMONDS ZONE 3N NUMBER �pp3
CONSTRUCTION PERMIT APPLICATION joa
OW NAME/NAME OF BUSINESS ADDRESS /")/ t/�1��1 / lleIV, /'
t� COO
LEGAL DESCRIPTION CHECK SUBDIVISION NO. /L (/ LID NO.
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ZMAILINfG1ADDRESS �%' 1,
Z Z �f3 Q L PJ C v W� I _1 `� PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP
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TELEPHONE NUMBER APPROVED BY
�/ ►l ` ��� EXISTING __ REQUIRED DEDICATION __---
!�/J/ PROPOSED
NAME
ADD ESS
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CITY
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STATE LICENSE NUMBER
LEPHONE NUMBER
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TELEPHONE NUMBER
�7 71, �S93S
)ascription of Property - include all easements
below or attach two copies)
J:jx ACCA- A 4 D$3-000-ooi -000(o
NEW RESIDENTIAL PLUMBING
ADDIALTER � COMMERCIAL El MECHANICAL
REPAIR APT. BLDG, SIGN
EXCAVATE
DEMOLISH OR FILL ❑ (ENCE
x _FT)
CARPORT SWIM
REMODEL GARAGE POOL
FI
WOOD STOVEI ❑ RETAINING WALL/
I INSERT ROCKERY RENEWAL
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
T NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
I_ L
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED. .
STREET USE PERMIT REQUIRED.
SEE ENGINEERING MEMO DATED
REMARKS
SIZE IBUILDIN
REMARKS
SIGN AREA
ALLOWED PROPOSED
VARIANCE OR CU
SETBACKS — FEET
FRONT SIDE
Y SIZE IFIXTURE UNITS
COMPLETE I EXEMPT
PLANNING REVIEW BY DATE/O
1' -2/
HEIGHT LOT COVERAGE
REAR 114, t -
IN
P14j rl /i►'h T15&e77A'100r �lC
;HECKED BY TYPE OF CONSTRUCTION CODE
SPECIAL INSPECTOR AREA OCCUPANCY
REQUIRED GROUP
❑ YES f : NO
REMARKS
PROGRESS INSPECTIONS PER UBC 305
SWIG Flec�-P�RMiT � �3y3/ I
.SIGN --
PLAN CHECK FEE
/ — 3y D BUILDING C/6 r.(
PLUMBING V
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
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 PLAN CHECK DEPOSIT
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 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
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
lion Insurance. INSPECTION
SIGNATURE �OWNEA OR AG NTI. DATE SIGNED DEPARTMENT
f
ATTENTION
0
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
CITY OF
EDMONDS
771-3202
FEE
OCCUPANT
LOAD
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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.
QFF
RELEASED
ORIGINAL — File YELLOW — Inspector U
PINK — Owner GOLD — Assessor
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SENT TO PLANNING—;?,2-'�P6)
PLANNING FINAL APPROVAL FORM
DATE:
PROJECT:
ADDRESS: 3�7 r C0 U 0
ADB #: �'7 PERMIT #
PERMIT APPROVED FOR FINAL
PERMIT NOT APPROVED REQUIREMENTS:
14
Associate City Planner
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SAGE �o.
F C B 21990 `:
PION
?ebruary 1. 1990
Ms. Lei 911
Francis
City of Edmonds
ning
Dept. of plan
98020 ,
Edmonds, tiQA
Dear Ms. Francis: put in the
acknowledge that We will P our north
Council along
This letter is aired by the City feted on or before
planters as required
will be comp
property line.
Apil 1, 1990.
Sincerely►
Patricia Page
EDMONDS, WA 98020 •
—1233 OLYMPIC VIEW DR.
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RECORD OF INSPIECTIONS
Date Passed
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