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S � � � f .?.. _u .L. .,. •`t , I r } � � e t�.. ;R.p S �, i x ✓Lvr:�I'. �t t\46 CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS TJ _ SfEV H IN SOd ZMAILING ADDRESS p 1I^'4-03 !2n(f. A.VE. w. CITY ZIP TELEPHONE NUMBER EDMONDS 98026 672-6977 NAME TOM LEREN ADDRESS 191E 36th AVE. W * CITY ZIP TELEPHONE NUMBER LYNNWOOD 98037 771-0847 NAME K.A.STEVENSON CONSTRUCTION ADDRESS 18403 72nd AVE. W. CITY ZIP I TELEPHONE NUMBER LLLIVLV IJU .-iVVGV i �/�-VJ/ / STATE LICENSE NUMBER KASTEC126?7 Legal Description of Property- include all easements SEE ATTACHED �GL I.�✓ i4X A-CCT �i9�CeG �" r y IQ Tax Account Parcel No, LOT 2 SP#910$120231 NEW ® RESIDENTIAL © PLUMBING ADD/ALTER COMMERCIAL � MECHANICAL REPAIR 1:1APT. BLDG. LJ SIGN G D�� ❑ FENCE DEMOLISH CYDS. ( X_FT) swim REMODEL GARAGET POOL a WOO INSERT G WALL/ ❑ ROCKERY RENEWAL (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN USE ZONE PERMIT 9 200" NUMBER JOB SUITE/APT # ADDRESS .EGAL DESCRIPTION CHECK SUBDIVISION O LID NO o!c S=� (/� PUBLIC RIGH O� WAY PER OFFICIAL STREET MAP. TESCP A proved ❑ EXISTING � REQUIRED DEDICATION D / ®Required f51 ' Street UUUsi Permit Req'd ❑ PROPOSED �p Inspection Requirer� Sidewalk Required REM/A�In' bbl�RKS LOP- b O WliY4 /j r4,o. hair& PACs I�i® . � ENGINEERING MEMO DATED REVIEW BY S `n, Ater METE^S7E. I/ BUILDING SY9PLY SIZE NO. OF FIXTURES t SIGN AREA SEPA REVIEW AOB NO. ALLOWED PROPOSED COMPLETE EXEMPT owww '� SHORELINE # EXP VARIANCE OR CU PLANNING REVIEW BY ` DATE F/0a& `G� SETBACKS - FEET HEIGHT LOT COVERAGE �35 2 FRONT SIDE REAR r7 REMARKS Ct�me� I.P7— Qnr041m 9h r10702gr SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT REQUIRED YES GROUP LOAD REMARKS PROGRESS INSPECTIONS PER UBC 305 FINAL INSPECTION REQUIRED VALUATION :171SUILDING EE '�✓� c �S IfIlo PLUMBING Plan Check No. 6i:2 P MECHANICAL This Permit covers work to be done on private property ONLY. GRADING/FILL Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. STATESURCHARGE Permit Application: 180 Days Permit Limit: 1 Year - Provided Work Is Started Within 180 Days STORM DRAINAGE FEE "Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE in successors in interest, agrees to indemnify, defend and hold w harmless the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of cc whatever nature, arising directly or indirectly from the issuance of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT 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 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 ATTENTION authorized agent of the owner. I agree to comply with city and THIS PERMIT state laws regulating construction; and in doing the work authoriz• AUTHORIZES 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 tion Insurance. INSPECTION SIG AT E (OWNER OR AGENIL, DATE SIGNED DEPARTMENT r/ ZZ C)/ CITY OF / EDMONDS ATTENTION CALL FOR INSPECTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771'3202 A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC CHAPTER 3. 102.87 NUMBER OF STORIES NUMBER OF DWELLING 2 UNITS DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) /rew sloc- Af:!s1o&✓Le �- M 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. FFICIAL'S SIGNAVURE / 04TE V /105997- RELEASED B {DATE ORIGINAL —.File YELLOW — Inspector PINK — Owner GOLD — Assessor a Z w w z 0 Z w r, 0 Z z Z 5 16 , rE �. G:...: .C.y_.!' 1 �.. .._.... 1 d uu... ./I t.l. ..u.... J... _. r... .'w r...a_.. m.-«.wIQO .. r.. .. .. ( ea a i ..L•... r A.... ... 1.n .� A.... a_l.-w. C— -juls 16".0, C. DIwo r I j 'l II Ot $ t � C 7-y 4Q Zr cm) 1p I � eel � � � w ,n � -�•�—�' �� � o � I , i I 0 1 UJ CA s 1 , /, \ r rf ro >'OW r� AC <1 t R.