920514.pdf}
CITY OF E7A-
USE PERMIT
ZONE `g NUMBER
�} q
`��`""��
CONSTRUCTION
PERATION
JOB r
l/
OWNER NAMEINAME OF BUSINESSADDRESS
`
.�,�
LEGAL DESCRIPTION CHECK
SUBDIVISION NO.
LID NOMA
INGAD,D'RTESS"3
t
�
TESCP Approved ❑
V ,�7
PUBLIC RIGHT OF WAY PER OFFICIAL STREET
MAP.
Required ❑
RWet
CITY
/r.^�-, ,.q('�`'
ZIPBER
Lj-1
' i
ry L{`j
EXISTING REQUIRED DEDICATION
Use
Street Use Permit Req'd{,�•�
Inspection Required ❑
9,J1....j, v
NAMM�
CJ✓
PROPOSED
SltleWelk Required ❑
REMARKS
ADDRESS _<—.�.,
xt)0
i I (9'A �� C)1 , ,,,/ t..�'L-� METER "DING SUPPLY SIZE
CITY .I'll TELEPHONE NUMBER _
L y\'v1 L,iloo o !> Oat � " �� � � REMARKS
STATE LICENSE NUMBER EXPIRATION DATE
^ i 1 .yC- SIG71EIP
SEP!
JG f.J l.- ALLOWEDOMPLETE
Legal Description of Property - include all easements
PropertyTax �jf7 r�
P0(11
o.
T 002 �I
�i
jaaxrcjelccount
EDN
(1JC.J
L =! RESIDENTIAL
LJ PLUMBING
NEEW
[D"ADDITION
D COMMERCIAL
MECHANICAL
REMODEL
APT. BLDG-
(�I
(_� SIGN
REPAIR
❑GRADING
CYDS.
❑ FEDNCE —x—�
DEMOLISH
❑ NSERDT TOVE
El SWIM POOL
HOTTUe SPA
E] GARAGE
CARPORT
ROCKERYRETAININGWALL!
RENEWAL
(TYPE OF USE, BUSINESS OR A¢CTIVITY) EXPLAIN:
/�✓C�\li t2t t�IGC-ztMC1Ut J 5K-
NUMBER OF STORIES NUMBER OF
REVIEW BY
VARIANCE OR CU P(A NnVIEW BY .T D
SETBACKS —FEET I HEIGHT LOT COVERAGE
FRONT SIDE REAR
�r
9/
1 7-.5 '
SPECIALINSPECTOR
AREA
OCCUPANCY
OCCUPANT
REQUIRED
GROUP
LOAD
❑ YES
REMARKS
O
PROGRESS INSPECTIONS
PER UBC 305
s
V ) tl
FINAL INSPECTION
REOUIRED
,,,.� )—
of AJ
VALUATION
FEE
PLAN CHECK FEE.
.�
BUILDING
HEAT SOURC GLAZING
,
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY. GRADINGIFILL
Any construction on the public domain (curls, sidewalks,
`/
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
7,
Permit Application: 180 Days
STORM DRAINAGE FEE
Permit Limit: 1 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,
employees, and agents from any and all claims for damages of
i
whatever nature, arising directly or Indirectly from the issuance PLAN CHECK DEPOSIT
of this permit. Issuance of this permit shall not be deemed to
0
modify, waive or reduce any requirement of any city ordinance
Oxx
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
`
iJ 6
provision."
1 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
WORK NO
Deputy; and fees are paid, and receipt is
Code of the State of Washington relating to Workmen's Compensa.
acknowledged in space provided.
ti n Insurance.
SIGNATURE OWNER R GEN GATE SIGNED
INSPECTION
DEPARTMENT
CITY OF
OFFI I 'S SIGNATURE ! DATF�
EDMONDS
?/J
ENTION
CALL FOR
INSPECTION
AS � TE
�W Zr
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220
ORIGINAL — File YEL OW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED, UBC
PINK — Owner GOLD — Assessor
CHAPTER 3.
102.87
s, CIVIC CENTER`1�
° NW If4; NW I/4 .32-27-4 Rom WA WA 9e02Q
\ 3 `
y t•i 2 P•rc. at a min./In.
n
n JQOO �yN �• N89'OB'00"W 368.03
I • 5126 241.19
cancel. ri+• �, 131�
dna 1$ u
- 23ox3� off° Is,axp.an• ,
2 V N c^ I E,108 w it / 2J a
,; •�- - n1u 1m_ nth � -219.9E-- x -_•-7'02tI0
0
p, N 32199 389•58•10-E „
� o �, w "J Ti•Zi'2j'E ty
PIS 'p. ., manbol•�! ff01Y1 q, a3 '•..49in3 .i
', �L��L.wc� � ba•i.
.' •• it - / 6•• 3.n.Y to a 7. P. 30 f
?� W t9 Scale: 1° =771
APPROVED BY PLANNING
a
m
x
2.0 K T
•• _ 20 20
to
NOTE: Approval of this short
suu division is subject to the
conditions found in City of
e.ao"
Edmonds File 1#S-37-95.' x
t3.3rs3t
° •d-)?:;Z:°..-•--- Sa3•SJ'e>:E 2e6193 ro of , . P a73.22•SO••w •-••_.•�•-_..
Y OF ED'n1G:JDS AUTf?C^ [Z17
1 _?T. ENGR: BRING DIV. _
rcr.
Ja
........ ��P op wA&N�yO��
SURVEYOR'S CERTIFICATE
This map correctly represents a survey H =
made by me or under my direction in AtIs oeEDS����
conformance with the requirements ro
{ thp. Survey,AgCo� A�—
VOL 1946PISE2311
,
_.
s-
xy i ti'
,__—.._ _ . .._.:..�..
,�.w,,.,:�., .,,rig ,c„, ,� ,r ri z � �; � uY'�� „
€�.r. �xxza=,-,s1�k;�i�
�
..
_ ,�,
t . t . r. � '.. a-'
W:.
1
1
� • , �..
�}
, .
;S a .i
;}�
ti_ �'afai� ��
t
1
— r�t
�,
�.,,:
�.
..:,
,..
..
,,
� ..
y
{
f.