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USE _AMIT
CITY OF EDMONDS ZONE NUMBER
CONSTRUCTION PERMIT APPLICATION joB
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BER OF
NATURE OF WORK TO BE
NUMBER OF
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IRED LOAD
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OGRESS INSPECTIONS PER UBC 305
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BUILDING
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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
v, Successors in interest, agrees to indemnify, defend and hold
W harmless the City of Edmonds, Washington, its officials,
21 employees, and agents from any and all claims for damages of
swhatever nature, arising directly or indirectly from the Issuance PLAN CHECK DEPOSIT
0 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
Code of the State of Washington relating to Workmen's Compensa• WORK
NOTED
CTION
tion In ante. DATE SIGNED DEPARTMENT
SIGN UR (OWNER OR AGENTI
CITY OF
EDMONDS
771-320901
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL CERTIFICATE INSPECTION OCCUPANCY HAS EN ADE N L
BEENGRANTEDA
OR
AFE UBC
CHAPTER 3.
102.87
OCCUP,
GROUP
ATION
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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 SIGNATU DATE
RELE ED B DATE
ORIGINAL — File YELLOW — Inspect
PINK — Owner GOLD — Assessor
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CITY OF ED`AAONDS
WORK PEMMM JOB CARD
(POST AT JOB SITE)
Porinit No2w2a. _
TYPE OF JOB +�
CON.STRUCTION:k� 0 ._, � ADDAESS(9 . a r • (�,V✓ _ _ ,_, _
OWNER l.ti•I� 7 PERMIT EXPIRES_
ISSUED F3Y DATE. ISSUED &3?,
INSPECTIONS ARE MANDATORY. A 24•HOUR NOTICE IS REQUIRED, HAVE CITY APPROVED PLANS ON JOB
FOR ALL INSPECTIONS, POST THIS CARD FOR INSPECTOR'S NOTATION FOR CITY INSPECTIONS CALL
771.3202 AND ASK FOR APPROPRIATE DEPARTMENT, ALL ELECTRICAL INSPECTIONS ARE THROUGH THE
DEPARTMENT OF I..ABOR AND INnUSTRIES,
DEPT. INSPECTION ITEM APPROVED BY DATE COMMENTS
Foundation,
_
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Site Improvements (if required)
FINAL APPROVAL
f., Hydrants (if required)
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FINAL APPROVAL r ~�
NOTE; OCCUPANCY without approval is a violation of Section 305 of the UNIFORM BUII,DING CODE,
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Date Sent To Engineering
ENGINEERING APPROVAL FOR OCCUPANCY
MEMO TO: Permit Coordinator
Building Division
FROM: Lyle Chrisman
Engineering Inspector
DATE INSPECTED: I16013'f 76
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SUBJECT ADDRESS: �Z31 OLy�?l�lG vlP(/y �4
PERMIT HOLDER: 13U, C17 PERMIT # 2000 7
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PERMIT APPROVED FOR FINAL
is PERMIT NOT APPROVED FOR FINAL, SEE REQUIREMENTS
Requirements: //-
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Page 4, January 2 - 50 1990
DATE DATE *** END ****
DOC TYPE CH* LEAD AGENCY ** PROPOSAL ISSUED MAILED REVIEW
DNS 19 U.S. Fish and (NEPA Draft EA) Franz Lake National Wildlife Refuge, acquire 594 12/21/89 01/31/90
Wildlife Service acres to preserve diverse and rare floodplain wetland and
riparian habitat on the N shore of the Columbia River, in the
Arthur & Franz Lake areas, Skamania County
99 WA State Dept. Aerial application of herbicides via helicopter to control 01/03/90 01/18/90
of Natural emerging vegetation in a conifer plantation, 2.5 miles NW of
Resources PeEll in Lewis County, and 4 miles SW of Littlerock, Thurston
County
1 City of Construct repairs and modifications.to a dock, bulkhead, float 12/21/89 12/29/89 01/05/90
Bellingham and boat lift, at Fairhaven Area 1, immediately E of Padden
Creek on Bellingham Bay (Tollycraft Yachts)
1 WA State Dept. Clear cut harvest timber from a 7 acre parcel and convert the 01/04/90 01/19/90
of Natural land to pasture, 2 miles SW of Ferndale, Whatcom County (Wade
Resources Martin)
1 Whatcom County Install four 60,000 gallon liquid petroleum gas tanks with pumps 12/28/89 01/12/90
and piping at an existing LPG facility, 4100 Unick Road,
Ferndale (Texaco USA)
2 WA State Parks Construct a 12x70 ft concrete boat launch ramp for, use by a 01/04/90 01/22/90
& Recreation garbage scow, at the W end of Fossil Bay at Sucia Island State
Commission Park, San Juan County
3 City of Burlington Heated Storage and Mini -Storage, construct a 28,000 12/27/89 01/11/90
Burlington sq ft warehouse and four 12,400 sq ft mini•storage bldgs on 1.4
acres, at the SW corner of the intersection of Fairhaven and
Norris Streets (Lowell & Milton Pauli)
3 City of Adopt the City of Burlington Landscaping Ordinance 12/27/90 01/11/90
Burlington
3 City of Adopt revisions to the City of Burlington Sign Ordinance 12/27/90 01/11/90
Burlington
3 Skagit County Big Lake Store & Lock, construct three 100x20 ft mini storage 12/29/89 01/16/90
bldgs on 3/4 acre, fill 940 cu yds, at the N end of Big Lake
adjacent to Nookachamps Creek and the Big Lake Grocery Store
(Tim & Linda Woiwood)
4 Island County Construct a 180 ft tall antenna tower and a 336.sq ft equipment 01/02/90 01/16/90
bldg,for cellular telephone communications, 615 N Wind Sun Way
on Camano Island (Interstate Mobilephone Company)
5 Kitsap County Kingston Kitsap Bank, rezone 88,000 sq ft and develop 2 bldgs 12/28/89 01/11/90
totaling 12,200 sq ft, in Kingston at the SW corner of SR-104
and Lindvog Road (Helen Smith)
6.`. ,Cityof.Edmonds Construct a single family residence, 9231 Olympic View Drive 01/02/90 01/17/90
(Charles Burnett)
6 City of Edmonds Construct a single family residence, 8509 Fredrick Place (Ted 01/04/90
Ferry)
6 City of Everett Subdivide 4.4 acres into 2 lots, possible wetlands are on -site, 12/26/89
2505 W Casino Road (Putnam Architects)
6 City of Everett Biringer Business Park, fill and grade 100,000 cu yds on 5.5 12/29/89 01/16/90
acres containing a pond and wetlands, future filling and
business park development will occur, W of I.S, S of Steamboat
Slough, E of SR-529 (Karl Biringer)
6 City of Lake Demolish and replace the 20th Street and.the 124th Street 01/02/90 01/17/90
Stevens Bridges, install box culverts and construct intersection and
roadway improvements, at Catherine Creek near the HE shore of
Lake Stevens
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RECORD 01: INSPECTIONS
Date PassedIt 4
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FOUNDATIOR ,
House
�piers
�• Porchest p ,r.
t<
5 E ��� Retaining
walls
• Garage, carport
i_ PLUMId
BING
Underground 3
Rough•in
water service
HEATING, SYSTEM �C5 ti
FRAMING' , .
_ .. WALLBOARD
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FINAL
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