910898.pdfI
y
NIP
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
EDMOND Le BROWN
MAILING ADDRESS
18529 OLYMPIC VIEW DRIVE
CITY ZIP TELEPHONE NUMBER
EDMONDS 98020 774-5852
ADDRESS
CITY
HONE NUMBER
USE PERMIT
ZONE NUMBER-�8
JOB
ADDRESS 18529 OLYMPIC VIEW DRIVE
I rr;At_ nESCRIPTION CIAECKI SUBDIVISION NO. LID N0.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING REQUIRED DEDICATION
PROPOSED
REMARKS
t;
• , • • •
•
ZIP
•
CITY
LYNNWOOD • i • ••
F=
STATE LICENSE NUMBER
s
A•
Tax Account Parcel No.
NEW ER RESIDENTIAL CJ PLUMBING
® ADDIALTER El COMMERCIAL MECHANICAL
REPAIR El APT. BLDG. LJ SIGN
DEMOLISH GRADING FENCE
CYDS. Ll X—FT)
CARPORT swim
REMODEL GARAGE POOL
❑ WOOD STOVE/ ❑ RETAINING WALL/ D RENEWAL
INSERT ROCKERY
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
NUMBER OF STORIES I NUMBER OF
1 DWELLING
UNITS
' DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
CLOSET, 30 FT. PIPING. 75,000 BT
Plan Check No.
ENGINEERING MEMO DA
METER SIZE
REMARKS
TESCP Approved ❑
RW Permit Required ❑
Street Use Permit Req'd ❑
Inspection Required ❑
Sidewalk Required ❑
REVIEW BY
NO. OF FIXTURES
SIGN
AREA
SEPIA
REVIEW ADB NO.
ALLOWED
I PROPOSED
COMPLETE
IEXEMPT I
EXP
lIVIVIl
VARIANCE OR CU PLANNING REVIEW BY DATE
SETBACKS —FEET I HEIGHT ILOT COVERAGE
FRONT SIDE REAR
F
IYI't Ur VVIYJII VVllv.. R AREA OCCUPANCY OCCUPANT
GROUP 03YES
NSPECTIONS PER UBC 305
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work is Started Within 180 Days .
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, Its officials,
employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirement of any city ordinance
nor limit in any way the City's ability to enforce any ordinance
provision."
I hereby acknowledge that I have read this application; that the
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
state laws regulating construction; and in doing the work authoriz-
ed thereby, no person will be employed in violation of the Labor
Code of the State of Washington relating to Workmen's Compensa-
•
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL FURN -
GRADINGIFILL
STATE SURCHARGE
12.00
�_ STORM DRAINAGE FEE
—'
SIGNATUREjar,, ..
Y
i
.��f.'rlrx'lihi
f<.it•t I u it lnj:; I.d .ita�n e �1>, if .) �'"H ..
A_ •
IT IS UNLAWFUL TO USE OR OCCU PY A BUILDINGOR
INSPECTION STRUCTURE
UNTIL A FINAL APPROVAL•-
A CERTIFICATE • •CHAPTER 31
IPING-1
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
CALL FOR
INSPECTION
77111
3900
30.00
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.
OFFICIAL'S SIGNATURE D)TE
BY:
DATE
M
w
Q
i?
ORIGINAL
— File
YELLOW
— Inspector
PINK —
Owner
GOLD —
Assessor
911
f\
1, .. - r' tom.. mar . i �••^ 4M ,4 i
77
t� F
i
NOTICE r I 'I
TO PERMITTEE AND/OR OWNER
❑ PARTIAL APPROVAL
❑ VIOLATION
C? CORRECTIONS REQUIRED
PERMIT
NUMBER a
l0B ADDRESS oolooll
S
NO PERMIT -STOP WORK - REMOVE CONSTRUCTION OR OBTAIN
❑ PERMIT AND MAKE WORK COMPLY WITH BUILDING LAWS.
CONSTRUCTION IS NOT IN ACCORDANCE WITH APPROVED PLANS
El AAND PERMT - STOP WO. MAKE PPROV DIPLANS AND PERM T OR REMOVEGWORK COMPLY WITH
IT.
ElSTOP WORK - UNTIL AUTH
STOP TO CONTINUE BY INSPECTOR.`,
CORRECTIONS LISTED BELOW MUST BE MADE BEFORE WORK CAN
to BE APPROVED. .;
❑ WORK DESCRIBED BELOW HAS BEEN INSPECTED AN APPROVED.
4
CONTACT I149�ECTOR AND toRECALL FOR INSPECTION.
❑ ARRANGE FOR APPOINTMENT.
• If;
j 4 .'I:
Vote
GG al•�� E.!
o •,� S o � ,
t
Y rV
,
i &ems 2b F
u Al
T•p s�Pn lam•
REQUIRED WITHIN
THE ACTIONS OR CORRECTIONS INDICATED ABOVE ARE
Q_ DAYS OR PENALTIES IMPOSED BY LAW MAY BE APPLIED. `
FOR INSPECTIONS CALL: 771-3202. BUILDING DIV.
r
❑ PUBLIC WORKS
INSPECTOR El FIRE DEPT.
CITY OF D E
EDMONDS
CF....................
FRAMING ...............
- INSULATION ............
SHEETROCK NAILING ...
SPECIAL INSPECTION .. .
r.
c
FINAL APPROVAL
FOR OCCUPANCY ...... .