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910627.pdfUSE CITY OF EDMONDS zDNE PERMIT F NUMBER `S"` CONSTRUCTION PERMIT APPLICATION JOBsulT ,Apra ADDRESS A OWN NAME/!NAME OF BUSINESS 6c) _ —� J [— /// j I L t LEGAL DESCRIPTION CH(ErCKKJSSU`B,�DIVISION NO. "D NOI—A iMAILING ADDRESS T i9 �.. ' O 1 © 22 t l=Y PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved ❑ ❑ CITY ZIP TELEPHONE NUMBER EXISTING REQUIRED DEDICATION RWPermll Required 983177 _' y� — j `' 7 Slrcal Use Permit Red ❑ 'YV+ lr (U (= / InSpeclion Required ❑ Lam.-•/�1^'� PROPOSED Sidewalk Required ❑ m NAM (� L+ I,JV �, REMARKS w ti ADDRESS Z U I LD N 1' q CITY � r ZIP TELEPHONE NUMBER L G i33 �FZ- l`= S ,, NAMEIF3f r,� �- /\U }�JL �r...�iL �^ G-06.OAL ��, I ENGINEERING MEMO DATED REVIEW BY „ 1 ✓✓✓ , d, ADDRESS 0 METER 512E BUILDING SUPPLY SIZE NO, OF FIXTURES s CITY ZIP TELEPHONE NUMBER w 0 REMARKS 3 0 STATE LICENSE NUMBER r I „� �/ �.— �j SIGN AREA SEPA REVIEW ADD NO. Legal Description of Property - include all easements ALLOWED PROPOSED COIN PLETEI4 E%EMPT SHORELINE, VARIANCE OR CU P �NINBV !.i �Oj o ' w SETBACKS —FEET �[''� �7 HEIGHT LOT COVERAGE x FRONT a t SIDE- 15 V REAR f if /S 713 710 g J Tax Account Parcel No. Js I � _ REMAHK5 - LJ NEW RESIDENTIAL PLUMBING [O CJ ADDIALTER COMMERCIAL MECHANICAL l�I ElREPAIR APT. BLDG. SIGN 11 GRADING FENCE CHECKED BY TYPE OF CONSTRUCTION CODE HEl EIGHT; DEMOLISH CJ CYDS. fx._FT) SPECT❑OYEs M swim SPECIAL INRAR OCCUPANCY LOADPANT REMODEL GARAGET POOL GROUPOCCU REOUIREO OO ❑ WOODINSERTVEI WALL! ❑ RENEWAL REMARKS z g � ROOKERY z PROGRESS INSPECTIONS PER UBC 305 m (TYPE OF USE. BUSINESS OR ACTIVITY) o 0 m - @ NUMBER OF STORIES NUMBER OF m { DWELLING m t UNITS DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) FINAL. INSPECTION REQUIRED VALUATION FEE PLAN CHECK FEE Q J . BUILDING / 2/ / ,5Z AR PLUMBING Plan Check No. 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 SQ Permit Application: 180 Days STORM DRAINAGE FEE Permit Limit: I Year - Provided Work Is Started Within 180 Days '---- "Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE N successors in interest, agrees to indemnify, defend and hold w harmless the City of Edmonds, Washington, its officials, r s employees, and agents from any and all claims for damages of a whatever nature, arising directly or indirectly from the issuance x of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT o 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 T 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 authorized agent of the owner. I agree to comply with city and THIS PERMIT This application is not a permit until state laws regulating construction; and In doing the work authoriz• AUTHORIZES signed by the Building Official or his/her 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 Deputy; and fees are paid, and receipt is acknowledged in space provided. tion In sU rants. INSPECTION SIGNATURE (OWNER O AGENT) DATE SI NED DEPARTMENT CITY OF OFFICIAL'S SIGNATURE EDMONDS ;7, ATTENTION LEAS �i- D E CALL FPR INSPECTION Y`yL} p 1 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE 771-3202 UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW — In pe,Ltcr A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC PIN({ GOLD — Asse sor CHAPTER 102.07 3. —Owner Y// d*