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CITY OF EDMONDS ZONE
CONSTRUCTION PERMIT APPLICATION JOB
ADDRESS
OWNER NAME/Nfp%rPF BUSINESS
PERMIT
NUMBER 90090
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CHECK SUBDIVISION NO. ILID NO.
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3 a PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP
APPROVED BY O
.,r TELEPHONE NUMBER
EXISTING _—___ REQUIRED DEDICATION
PROPOSED—..—.-.
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NAME
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED w
w
STREET USE PERMIT REQUIRED, z
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SEE ENGINEERING MEMO DATED
2 _._.. TELEPHONE NUMBER
SIZE
REMARKS
Legal Description of Property - include
(show below or attach two copies)
M
NEW Htb1Ur" 11^6
A00 ALTER COMMERCIAL
REPAIR APT. BLDG.
EXCAVATE
DEMOLISH OR FILL
CARPORT
REMODEL GARAGE
F WOOD STOVE ❑ RETAINING WALL/
INSERT ROCKERY
1�
easements
U PLUMBING
XMFGHANICAL
LJ SIGN
FENCE
( x _FT)
r'-1 SWIM
RENEWAL
NUMBER OF STORIES NUMBER OF �---/
� DWELLING
o UNITS
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
le SS /00/ 00
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."
I hereby acknowledge that I 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 person will be employed in violation of the Labor
Code of the State of Washington relating to Workmen's Compensa-
tion Insurance. -
S
r,
SIGN AREA
ALLOWED I PROPOSED
VARIANCE OR CU
SETBACKS — FEET
FRONT SIDE
CHECKED
E OF
ENV. REVIEW
COMPLETE I EXEMPT
PLANNING REVIEW BY
REAR
UNITS
w
a
3
ADS NO.
SHORELINE N
DATE
HEIGHT I LOT COVERAGE
SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT
REQUIRED GROUP LOAD
YES L: NO
REMARKS
PROGRESS INSPECTIONS PER UBC 305
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
GRADINGIFILL
STATE SURCHARGE
ENERGY CODE
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
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
CHAPTER 3.
102•87
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
771-3202
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 SIGNATURE DATE
/Xhy/ 0
5IfLEASW'JPrDATE I
ORIGINAL — File YELLOW — Insp0tor
PINK — Owner GOLD — Assessor 4
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CITY OF EDMONDS LARRYS. NAUGHTEN 9
250 - 5TH AVE. N. • EDMONDS, WA 98020 • (206) 771-3202 MAYOR
COMMUNITY SERVICES, PETER E. HAHN
Public Works • Planning • Parks and Recreation • Engineering nimmnQ I.
890 194
December 27, 1991
Valley Natural Gas r
2605 McDougall Ave.
Everett, WA 98201
Re: MECHANICAL PERMITS) NEEDING INSPECTIONS/FINALS
The attached copies show permit(s) issued to your company in 19909
that, according to our records, have not received the proper j..'
inspections or final inspection.
Please arrange for the proper inspections by calling 771-3202 and
requesting a mechanical inspection within the next 30 days from the
date of this letter.
If you have any questions, you may call me at 771-3202.
Thank you,
Sharon Nolan
Permit Coordinator
cc: Building Official
MECH91/TXTDOS62
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RgCQRD OF INSPECTIONS
ass d
FOUNDATIOty
House
Porches, piers ,.
Retaining walls -------
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Garage, carport
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PLUMBING
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Water service
HEATING sY5TEM
a FRAMING ----
WALLBOARD
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