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ADDRESS
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MAILING ADDRESS
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PUBLIC RIGHT OF OFFICIAL STREET MAP.+. ■
Elgin TELEPHONE NUMBER
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TELEPHONEtill
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ENGINEERING MEMO DATED REVIEW BY
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AREA SEPIA REVIEW
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ALLOWED PROPOSED COMPLETE
Legal Description of Property
include all easements
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® LOT COVERAGE
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INSERT ROCKERY RENEWAL REMARKS
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:NUMBER OF STORIES NUMBER OF
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�Y+G DESCRIBE WORKTO BE • •PLOT PLAN)
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PLAN CHECK FEE
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{ i Plan Check No.This Permit U#
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WNAny construction on the public domain (curbs, sidewpiks,
driveways, marquees, etc,) will require separate permission. iV STATESURCHARGE
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successors in
interest,"Applicant, on behalf of his or her spouse, heirs, assigns and --OiIENG. INSPECTION FEE
harmless the City of • • •s, Washington, its officials,
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employees,and agents fromand all claims fordamages
• of this permit, Issuance of this permit shall not be deemed to
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whatever nature, arising directly or Indirectly from the Issuance
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TOTAL AMOUNT DUE
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il•herebyacknowledgethat I have readthis application;information given is correct; and that I am the owner, or the dulyI
.t ;i • APPLICATION
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Ga. authorized agent of owner. I agreeto comply with city and 11.
,Iq state laws regulating const!,L�ion; and in doing the work authoriz- This application is not a permit ntil
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�i;i ed thereby, no personwKbe,brinployed in violation of t Deputy; and fees are paid, and receipt is
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GENERAL CONTRACTOR
931 12TH A VENUE NORTH `
EDMONDS, WA 98020 s
778-4824
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CITY OF EDMONDS LARRY S. NAUGHTEN -
250 . 5TH AVE. N. • EDMONDS, WA 98020 • (206) 771.3202 MAYOR
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COMMUNITY SERVICES: PETER E. HAHN ";;.,
1 Public Works • Planning • Parks and Recreation • Engineering DIRECTOR ;
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LETTER OF TRANSMITTAL
Date: 5_ Po—
To: ylr.1E akarhAs
Project, Plan review number:
Address: a Oi yrnp; �, \11 ew DrNE
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Transmitting. Plans & Calcs Soils Report Other
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For your information: %� Comments:
PUEASf� t
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As requested by your office: e'e-4 'Mr►1 i S �E u Q.-�J�iY-�,
For structural plan review, t
101, YI Olr — X'VIA O V, is
For non-structural plan review, �2. A\ w11 _0a�4 eX�, 33
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For Washington State Energy Code review: �`° 5���-d u�� (-Ov A; ,J i�Y\S�z
TX wrlVl Y +JJOV t S Af
For Northwest Energy Code review: �' 1
�GIA �mllfi'Y�h2w �o� /ay�.0 '
For Fire Code review: ��E Ascz. �y - �i •e Y v},Gl_Q� -
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Note attached comments, `
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For Corrections and resubmittal: Building Division
Respond to letter in writing:
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Resubmit 2 revised plans: City Official s
Send directly to City Building Division, a4"c
• Incorporated August 11, 1890 •
Sister Cities international — Hekinan, Japan
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RECORD OF INSPECTIONS
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