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910867.pdfj CITY OF EDMONDS ZONE _Zq NUMBER 0JZ)6'6^ CONSTRUCTION PERMIT APPLICATION JOB t/L M SUITE/APT lI OWNER NAME/NAMyE. OF BUSINESS ADDRESS / / -7,7 1 p .`f 1 �L.(r� P �A'� (J LEGAL DESCRIPTION CHECK SUBDIVISION NO, LID NO. i jJ zMAILING ADDRESS `/'jf `/y`(A6/ L./'/ O � L-7 2 Tw -°' PUBLIC RIGH OF WAY PER OFFICIAL STREET.MAP. TESOF CITY ZIP TELEPHONEN NUMBER tN"t �{�• APPROVED BY . 67, 11 6_7EXISTING REQUIRED DEDICATION NAME'{��j (� (� `{�(t,' j •JC PROPOSED _ f I- V" 4 "' +".�-"`4 RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED w w ADDRESS % Lam' {, ��; �� j ,� y�y�.r� ( �'} STREET USE PERMIT REQUIRED ❑ 1114 U l o J \. et'� t t'"1 _ V V (l ( `� 2_c I SEE EN GINEERIN/GJ MEMO DAfTEjq/� BV z 1 < CITY p ZIP TELEPHONNEp NUMBER j CJJ J _ite f1/1)1J f )-L� t..�7�i ��r��"�� ,� % -'I.Ci L- REEMARKS NAMEitTC L,.- �E'Sh.S�.yv '�:OW�✓+LJZ- CkZ LLZI^GS" I/CS.�iL')-;hJ+2�G.l�l7lti Li G!' 1 I UNITS iI CITY �. ZIP ITELEPHONE NUMBER �� SIGN AREA ENV. REVIEW AGE NO. Legal Description of Property - include all easements ALLOWED I PROPOSED COMPLETE I EXEMPT (show below or attach two copies) SHORELINEp VARIANCEORCUCLk 1-170 P ANNc}1:5 wEW BY SETBACKS FEET r / HEIGHT LOT�COVEII& FRONT 6 SIDE ` REAR Tax Account Parcel No.571 �3 0 —000_0 2 d t UJ 7 REMARKS �j iD L. �Y ® NEW t,(y RESIDENTIAL 177 ��r1' PLUMBING j ADDIALTER REPAIR DEMOLISH REMODEL COMMERCIAL APT. BLDG. OR GRADE FILL CARPORT _EJE MECHANICALEl LJ SIGN ❑ FENCE K-� PQ�L 1511-1- CH�EC-ISED QY TYPE OyF-CONSTRUCTION CODE { HEIGHT SPECIAL INSPECTOR UIflED YES L'. NO AREA OCCUPANCY GROUP Q� n OCCUPANT LOAD ❑ WOOD STOVE/ INSERT ❑ RETAINING WALL/ ROCKERY ❑ RENEWAL RKS !- ,,, ,q.cFrrp,aE,p,s�frcew®in�^s PROGRESS INSPECTIONS PER UBC 305 (T PEOFUSE.BUSINESSORACTIVITY)EXPLAIN: Utt _It51I.DErt.C. p/11017741 UrGC ,cu// &W R 10 LJG,� ^� lZ*y, �% I` NUMBER OF STORIES NUMBER OF UNITSLING ' NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN) tV t !vC" "- bvc - FINAL INSPECTION REQUIRED Pt "", VALUATION FEE ,5vy/_,t �L.21 17C Z Ay ;r ' _"QL. PLAN CHECK FEE T BUILDING y' 6- ''}'y J /� / 7� A ��`p/ ' �t9s /-.l-lv1^167 /.V.54 � PLUMBING�E3Plan Check No./�MECHANICAL�yS This Permit covers work to be done on private property ONLY. GRADINGIFILG7`DSDL, rJ�TI fir 7 construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE (} Permit Application: 180 Days 4ALaf}py/ffjL-&o til so — Permit Limit: 1 Year -Provided Work Is Started Within 180 Days "Applicant, on behalf of his or her spouse, heirs, assigns and u, successors in interest, agrees to indemnify, defend and hold w harmless the City of Edmonds, Washington, its officials, m from ,lLjLWe(170VIfe O/ old }��i✓,LG' �'4i ��, f /© employees, and agents any and all claims for damages of iwhatever nature, arising directly or indirectly from the issuance // }}'� pcdJJ., J L of this permit. Issuance of this permit shall not be deemed to modify, waive or reduce any requirement of any city ordinance PLAN CHECK DEPOSIT %/// ,03 ! x nor limit in any way the City's ability to enforce any ordinance provision." - TOTAL AMOUNT DUE 9 �� I hereby acknowledge that I have read this application; that the information given is correct; and that I am the owner, or the duly ATTENTION APPLICATION APPROVAL authorized agent of the owner. I agree to comply with city and state laws regulating construction; and in doing the work authoriz- THIS PERMIT AUTHORIZES This application is not a permit until ed thereby, no person will be employed In violation of the Labor ONLY THE signed by the Building Official or his Code of the State of Washington relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is tion Insurance. INSPECTION acknowledged in space pr,Gvida N TUBE N ENTI DATE IGNE 3� �I DEPARTMENT CITY OFp C i ' URE DATE ✓ t.4lB�✓"J EDMONDS ATTENTION CALL FOR LEA D DAT INSPECTION a ` IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE%y-�i2O2 UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW'— In pest, A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. CHAPTER 3. UBC PINK — Owner GOLD — Assessor 10287