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910302.pdf
x USE PERMIT tA?tlit;�t7}h ��.irliS,t�b-+ c.rr2,x. .�. _ 0 - ,�,. %� PSPITE/APT $I 'j"�] CONSTRUCTION PERMIT APPLICATION joeADDRESSJ/ c•/�_`-C s/ OWNER NAME/NAME OF BUSINESS JA LID NO. LEGAL DESCRIPTION CH SUBDIVISION NO. w MAIL/ G ADDRESS TESCP - - o �i �^ ^i 27 �'iv L� PUBLIC RIGHT O�FiWAY PER OFFICIAL STREET MAP. APPROVED BY 1 D L+ l c• C/�yZIP TELEPHONENUMBER EXISTING _S� REQUIRED DEDICATION'S ;m CITY n L�6 �2� � � `23 6G ` � 69Il CADS PROPOSED _ �� L' Z w NAME {7 '� 1 �Lf� w III �� V� Fovc� J 1 µGA 11 RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED ❑ Z l STREET USE PER REQUIRED Cl Z w ADDRESS ` ' , �� A, `✓ REV/ BY w ��Od3d 1.�_ vyQ�tly�1U(� j1 SEE ENGINEERING ME�MQ/3A�TED U �f l Vrt Zlp TELEPHONE NUMBER c Cl Q REMARKS14 : `b l(J AL ��rd Oi I�P�LS' rGflli� i lee y�� 5le) �Gsc� NAME FIXTURE UNITS ¢ ADDRESS - C� l2>�r �, METER SIZE BUILDING SUPPLY SIZE Q t J �. a U^ I TELEPHONE NUMBER CITY REMARKS �j z�l ( YL'� / iq6 I'� L��%/J C� 4►'%i"I✓l"V�� 0 S O STATE LICENSE NUMBER ENV. R -VIEW ADB NO. SIGN AREA -,�+=`- G ALLOWED PROPOSED COMPLETE EXEMPT (show belowpolr attach two cei opies) all easements SHORELINE N ZQ PLANNING REVIEW BY DATE a �� 7UDDI A!IOH �1�L_VARIANCEO CU EE �/1> D /- D ,mow M► 4' C, U w ) �7 SETBACKS —FEET HEIGHT LOT COVERAGE Z '� I I�U� '^ FRONT SIDE REAR g a rIN� C.OKD�TIorcAL w �0F65 REMAR J Tax Account Parcel No. t r 6 UO�-U�Z_O (02•-Oob� ��t /�M/,N� I CON' DNS (.�.f_ © RESIDENTIAL CI PLUMBING ��� /�.�1/ ® NEW !!! LLL ❑ COMMERCIAL MECHANICAL El ADDIALTER I �J APT. BLDG. SIGN CODE HEIGHT REPAIR w CHECKED BY TYPE OF CONSTRUCTION ® EXCAVATE, FILL El FENCE � x_FT) �n n C'7RgnFNh EJ DEMOLISH OR GRADE ( SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT REMODEL CARAGEPORT POOL swim REQU RED GROUP /�� LOAD El YES I-; NO WOOD STOVE/ RETAINING WALL/ ❑ RENEWAL REMARKS O INSERT ROCKERY PROGRESS INSPECTIONS PER UBC 305 0 Z20 (TYPE OF USE, SINESS OR ITY) EXPLAIN: BU AC (.,C7i�l`t 2� 12�Stflt-.�y fry. Le�� �L V i� ER w NUMBER OF STORIES pyVELLINGF� UNITS NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN) C LG� l KS i qL.L �REN�-? p2r�t�l FINAL INSPECTION REQUIRED D�'j per/ !, ��� •�- At VALUATION FEE - �,� rat PLAN CHECK FEE � F�I�TAC0c i 7 BUILDING 1 oUj [ WP 1:5ILIJ11 PLUMBING I1 t MECHANICAL Plan Check No. i2r�r�f4/6- 27,W q .. 35 / This Permit covers work to be on on private property ONLY. GRADING/FILL Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE Permit Application: 180 Days Permit Limit: 1 Year - Provided Wor15 is Started Within 180 Days Wit/ �fW y "Applicant, on behalf of his or her spouse, heirs, assigns and and j,�$/��c�/dn �t� Fr successors in interest, agrees to indemnify defend W old harmless the City of Edmonds, Washington, its officials, G 2 employees, and agents from any and all claims for damages of iwhatever 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 rce any ordinance TOTAL AMOUNT DUE ° nor limit In any way the City's ability to enfo provision." I hereby acknowledge that I have read this application; that the ATTENTION APPLICATION APPROVAL information given is correct; and that I am the owner, or the duly THIS PERMIT This application is not a permit unti authorized agent of the owner. I agree to comply with city and signed by the Building Official or state laws regulating construction; and in doing the work authoriz gON`Y T�HEs Deputy' and fe are paid, and recei is ed thereby, no person will be employed In violation of the Labor WORK NOTED edg n s p ed. Code of the State of Washington relating to Workmen's Compensa- INSPECTION tlonInsurance. PATE IGNED DEPARTMENT i ATE R NT) IC SI TURE WN „7 CITY OF EDMONDS D TE I �w77 CALL FOR RELEASED B INSPECTION ATTENTION 771-3202 ORIGINAL — File YELLO — InsZ or UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE A FINAL INSPECTION HAS BEEN MADEAND GRANTED. ER� /Ziz PINK — Owner GOLD — Ass e IF OF ER 3.