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910320.pdf3 V CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER_jygME1E/NAM `F� � S�� BUSINESS � �E�Uj� MAILING ADDRESS CIT ZIP T LEPHONE NUMBER ADDRESS CITY NAME ADDRESS CITY STATE LICENSE NUM rAF: Legal D�sscription of Property - EPHONE NUMBER TELEPHONE NUMBER ude all easements c e1 w Tax Account Parcel No. j��? ��l _,Z_�©Y_dL►� �• NEW ,� RESIDENTIAL L� PLUMBING ADD/ALTER El COMMERCIAL Il MECHANICAL REPAIR APT. BLDG. El SIGN DEMOLISH GRADING El FENCE CYDS. ( x_FT) CARPORT SWIM REMODEL GARAGE POOL WOO INSERT G WALL/ ❑ ROCKERY RENEWAL z (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: w NUMBER OF STORIES NUMBER OF o DWELLING m UNITS D DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) ZONE PERMIT g5 j NUMBERj� JOB e �� SUITE/APT N ADDRESS Il/�Y _EGAL DESCRIPTION CNrurki SUBDIVISION NO. 11Gin Nn PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. I TESCP Approved ❑ EXISTING REQUIRED DEDICATION RW Permit Required ❑ Street Use Permit Req'd ❑ PROPOSED Inspection Required ❑ Sidewalk Required ❑ REMARKS z it w w Z ENGINEERING MEMO DATED REVIEW BY METER SIZE (BUILDING SUPPLY SIZE NO. OF FIXTURES REMARKS FM SIGN AREA ALLOWED I PROPOSED VARIANCE OR CU SEPA REVIEW COMPLETE EXEMPT EXP I P?kANNING REVIEW BY SETBACKS -,r FEET HEIGH FRONT'S 7 SIDE l`� REAR 2S ��+ SHORELINE q Yz --s/ `/ LOT COVERAG �A CHECKED BY TYPE OF CONSTRU;;t HEIGHT N>SPECIALINSPECTOR AREAOCCUPANT REQUIRED ❑YES LOAD PROGRESS INSPECTIONS PER UBC 305 PLAN CHECK FEE BUILDING PLUMBING Plan Check No. JMECHANICAL ?f • -• • Wages- •• • •.: • iuI•• } 1 � ry 7 Y STORMPemrilt Application: 180 Days DRAINAGE FEE Permit Limit: I Year - ail Provided Work IsStarted Within r Days ,SIB_ r- it t Ifs � - • • •• • • p ,;; PLAN CHECK DEPO a.e • •. • •- • •• •- -• • •• • • -• • • • �'. TOTAL AMOUNT fit? • • • z L hereby• : • • : that I have read this application;information given is correct; and that I am the Ipt h.k authorized agent of the ownI agree to comply with city an 11�� _r. iottzi; z11 state• ws regulating construction; and In doing the work auth rIz- 0 ,••thereby,no person will be employed in violationof ,•• f• Code of the State of Washington relating to Workmen's i7 f Compensa- tion SIGN (OWNER OR AGENT) DATE SIGNED �'� u u tt r 'I" itu. ei t r i pp}C qqt<yy �yy t i y�{qq 4 Rye ni 4 +ih t t y hr {,tp dh.`M1�t�ft�:Y, N i�ts4���t�d't�f?.i�.,uiti�.h.i� tr„I.r�.r�15i-�i!>•�.!nj4d, .1 v- • •. • •• • •' FEE APPLICATION APPROVAL This application is not a permit until signed by the Building Official or his/her Deputy; and fees are paid, and receipt is acknowledged in space provided. 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Cam'- i ........ ...... ... �.. , ... _._._ . �-•7"1'm'__'� , tR.- .. - , p"FR*'i'?`.,{'.-,°., $�"!'AS'n f � m' h .gyp l V1vMi A �`1 �, �•f i 1 �t FI y IV RECORD OF INSPECTIONS INSPECTOR DATE A PROV a• SETBACKS00 FOUNDATION: t I I I I 144 Footing Wall.... �. Pier/Porch Retaining Wall.......... g PLUMBING: Underground ....... . Rough -In ........ :... CF...........:........ , Ito It Sri HEATING: Gas Test..11 ..... . Gas Piping ............. l Equipment ............. :'. CF.................... FRAMING INSULATION ............�; SHEETROCK NAILING .. .LL t SPECIAL INSPECTION ... 4 FINAL APPROVAL �` a FOR OCCUPANCY s= I , .c a r• ILI I