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CITY OF EDMONDS ZONE PERMIT
NUMBER 9089
CONSTRUCTION PERMIT APPLICATION JOB SUITE/APTq
OWNER NAME NAME OF BUSINESS ADDRESS q)e) / c.
cc om'� �,� .; .P`�r' OFL, LEGAL DESCRIPTION CHECK SUBDIVISION NO. LID NO
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O 0 9 • �` Plc " lao P Q � • PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved ❑
CITY ZIP TELEPHONE NUMBER RW Permit Required ❑
r_ ^m 0 A;1>5 � F , EXISTING REQUIRED DEDICATION Street Use Permit Req'd El(�11/7 IIY/ff✓✓✓ PROPOSED Inspection Required ❑
NAME Sidewalk Required ❑ U
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CITY ZIP TELEPHONE NUMBER
NAME //�� x� 6�If kc, MCC4 ENGINEERING MEMO DATED REVIEW BY
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ST TE LICE SE NUMBER /X,,IRAT7DATE
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AREEROPOSED COMPLETE AREVIEW ADB NO.
Legal Description o wiyt ' cl'u1de all ease ents
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ADDITION El COMMERCIAL LLB MECHANICAL
REMODEL 1:1APT. BLDG. El SIGN
GRADING a FENCE CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT
JLNJ REPAIR CYOS. ( X_FT) E�'f
DEMOLISHWOODSNSERTTOVE El SWIM POOL HOT TUB SPA SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT
REQUIRED YES GROUP LOAD
GARAGE CARPORT ROCKERY G WALL/ ❑ RENEWAL REMARKS
(TYPE OF USE, BUSINESS OR ACTIVIT )EXPLAIN: PROGRESS INSPECTIONS PER UBC .905 0
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FINAL INSPECTION REQUIRED
PbO L exTex r� 4 &�A 1 S /I-,L, 6 VALUATION FEE
PLAN CHECK FEE
HEAT SOURCE: GLAZING BUILDING b%
% PLUMBING
Plan Check No. 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. 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
N successors in interest, agrees to indemnify, defend and hold
W harmless the City of Edmonds, Washington, its officials,
5 employees, and agents from any and all claims for damages of L)`U
iwhatever nature, arising directly or indirectly from the Issuance PLAN CHECK DEPOSIT
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 TOTAL AMOUNT DUE
provision." PC
I 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
state laws regulating construction; and in doing the work authoriz• 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/her
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 provided.
SIGNATU (OWNER OR AGENT) DATE SI NED DEPARTMENT
q CITY OF OFF( 'S I T RE DAT
�cL C�lLy� / EDMONDS �tJ
7.
CALL FOR EL AS BY:
ATTE ftION INSPECTION 93
IT IS UN}.AWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL !Y FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771=0220 ORIGINAL — File YELLOW — In70r
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A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED, UBC
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