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930197.pdfUSE CITY OF EDMONDS ZONE PERMIT CONSTRUCTION PERMIT APPLICATION NUMBER JOB OWNER NAME: NAME OF BUSINESS ADDRESS 7704 Ol rzlc 11 iJ-'un Park Res. LEGAL DESCRIPTION CHECKI SUBDIVISION NI 7704 Olympic Vi CITY ZIP Edmonds, WA 98026 NAME QICITY NAME 17 3019 ew Drive PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP ELEPHONENUMBER 74-0139 EXISTING REOUIREDDEDICATION PROPOSED REMARKS E NUMBER ADDRESS 14111 NE 24th Street CITY ZIP TELEPHONE NUMBER Bellevue, WA 98007 641-4222 STATE LICENSE NUMBER EXPIRATION DATE 223-02BELLEPH288NU 07-0.1-93 Legal Description of Property - include all easements Tax Account Parcel No., / l✓ NEW E2 RESIDENTIAL © PLUMBING ADDITION F COMMERCIAL 1:1MECHANICAL REMODEL APT. BLDG. SIGN REPAIR GRADING FENCE CYDS. ( x—FTI DEMOLISH ❑ NSERTTOVE SWIM POOL a HOTT B SPA GARAGE CARPORT 1:1ROCKERY WALL/ ❑ RENEWAL (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN NUMBER OF STORIES NUMBER OF DWELLING UNITS DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) HEAT SOURCE: GLAZING ENGINEERING MEMO DATED TESCP Approved ❑ RW Permit Required D Street Use Permit Req'd .❑ Inspection Required ❑ Sidewalk Required ❑ t7 Z REVIEW BY METER SIZE (BUILDING SUPPLY SIZE NO. OF FIXTURES REMARKS SIGN AREA SEPA REVIEW ADB NO. ALLOWED I PROPOSED COMPLETE (EXEMPT u EXP VARIANCE OR CU PLANNING REVIEW BY DATE SETBACKS — FEET I HEIGHT LOT COVERAGE FRONT SIDE REAR L BY TY OF CONSTRUCTION CODE HEIGHT INSPECTOR AREA OCCUPANCY OCCUPANT D GROUP 4! q ❑ YES J LOAD PROGRESS INSPECTIONS PER UBC 305 FINAL INSPECTION REQUIRED VALUATION PLAN CHECK FEE BUILDING PLUMBING Plan Check No. MECHANICAL This Permit covers work to be done on private property ONLY. GRADINGIFILL Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE 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 i 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 g whatever nature, arising directly or indirectly from the Issuance of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT 3 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 ATTENTION ki IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC CHAPTER 3, 102.07 INSPECTION DEPARTMENT CITY OF EDMONDS CALL FOR INSPECTION 771=0220 WT11 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. OFFICI NA RE DATE R LEASED BY: DATE ORIGINAL — File YELLOW — Inspec r PINK — Owner GOLD — Assessor j