950327.pdfUSE
CITY OF EDMONDS ZONE PERMIT �3`�� �
CONSTRUCTION PERMIT APPLICATION NUMBER 3
JOB ^ sUIIL APT n
f1lNNEn NAME NAME OF BUSINESS ADDRESS `/' /j ..) •+ /� , - _ - _ I I . n
CI I\
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCI' APPr°vea
❑
21P
C%s,6ZU
TELEPHONE NUMBER
EXISTING REQUIRED DEDICATION.
nW Permrl 11 11111eA
❑
I iv J�5
_.._..-
PROPOSED
S11-1 Use Pernnl nrvl U
Inspection nr!glrirerl
❑
❑
CI
P.
NAME
METEn 512E
LINE SIZE
NO Of FIX TURFS
I'IIV IILIJUIIII:U
YES ❑ NO ❑
-
0
ADDRESS
REMARKS
iy
CITY ZIP
TELEPHONE NUMBER
NAME
MEMO
o JtH 1 1 L,r- `1 )U• H /'
o
--- - -� HLVIEWLD HY
STATE I ICFN17 NUMRFR EXPIRATION DATE
-
F I L C 0 Li 10 10 -9 S
SIGN AREA
ALLOWED PROPOSED
BEPA REVIEW
COMPLETE EXEMPT
ADB 1111
Legal Description of Property - include all easel
O_
I
SHORELINEM
EXP
VARIANCE OR CU
PLANNING REVIEW BY
DATE
of
w
SETBACKS - FEET HEIGHT
LOT
COVERAGE Z
FRONT SIDE REAR
Property
i'32-703-+-0Zh•-cif: 09
REMARKS
Parcel
Parcel No,
No.
IILI'• 1'-`..' RESIDENTIAL PLUMBING
ADHI IION COMMERCIAL MECHANICAL
nFMOOEL APT BLDG. El SIGN
n0
`J REPAIR GRADING CYDS FENCE X-FT)
DEMOLISH WDODSTOVE SWIM POOL
INSERT HOT POOL
GARAGE RETAINING WALL/
Z CARPORT I I ROCKERY RENEWAL
CHECKED BY
TYPOF CONSTRUCTION
/LL
CODE
OcOCUPANT
SPECIAL INSPECTOR
REQUIRED
0 YES
AREA
O CUPANT
LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC 3OS
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
5'iNC-LC FRti11E y
w NUMBER
o OF
m0 STORIES
NUMBER OF
DWELLING
UNITS
CRITICAL
AREAS
NUMBER
m
2 ` ff
•�j�r �/ L�
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
PUMP UI ,t CLE/-N OUVILIN JSE-D
FINAL INSPECTION REQUIRED
OIL TANK, •• FILL WITH CEMF,:N SL1VRR.
VALUATION
FEE
PLAN CHECK FEE
HEAT SOURCE-
GLAZING
BUILDING
0/0
PLUMBING
Plan Check No.
MECHANICAL
•
This Permit covers work to be done on private properly ONLY.
Any construction on the public domain (curbs, sidewalks,
GRADINGIFILL
STATE SURCHARGE
driveways, marquees, etc.) will require separate permission.
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
,A Successors in interest, agrees to indemnify, defend and hold
w harmless the City of Edmonds, Washington, its officials,
aemployees, and agents from any and all claims for damages of
whatever nature, arising directly or Indirectly from the issuance
0 of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
o modify, waive or reduce any requirement of any city ordinance
x nor limit in any way the City's ability to enforce any ordinance
provision."
TOTAL AMOUNT DUE
vY
j
I hereby acknowledge that I have read this appllcation; 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
lion Insurance and RCW 18.27. INSPECTION acknowledged in space provided.
SIGNATURE tOWNER OR AGENT) DATE SIGNED DEPARTMENT
// UZOFF C 'S SIGNATURE DA E
1YW-17/ 1.�% LMt-M'1.6- - 9 CITY OF
EDMONDS
ATTENTION CALL FOR LEASED Y DATE
INSPECTION
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 YELLOW - Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
!,
o28 CHAPTER 3. PINK - OAner GOLD - Assessor
,,. M
vy
TO: Permit Coordinator, Building Division
FROM:FIRE DEPARTMENT
ENGINEERING DIVISION
PLANNING DIVISION
OWNER a P ADDRESS
PERMIT# % ADB# INSPECTED ONE �S
A field inspection was conducted to determine compliance with approved plans.
Final approval denotes there are no objections to the granting of:
Occupancy for the building Performance Bonds may be released
Maintenance Bonds may be released -Landscaping is approved , I_
V Other inspected L� S .T (i��d �� uc� (- ���°� UJ� A4'C 4-0'
PASSED FIRST INSPECTION - CONDITIONS NOTED
1.
2.
FAILED INSPECTION - OUTSTANDING REQUIREMENTS - RECALL FOR INSPECTION
1.
2.
3.
4.
p� OCCUPANCY APPROVAL DATE-7 BY C9�
FAILED FIRST INSPECTION DATE BY
RE -INSPECTED - APPROVED DATE BY
RE -INSPECTED - FAILED DATE BY
RE -INSPECTED APPROVED DATE
FEES RECEIPT#
OCCAPRVL/TXTRECEP/October 13, 1993