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USE PERMIT 0 007
CITY OF EDMON DS 20N` NUMBER
CONSTRUCTION PERMIT APPLICATION "0„ �J [j 1/ p�q%
O\':NI'i: NAX'i: N\\'E l'r fiUtiINE SS ADORES' V^] //Z MPIL F" 164
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:Uv ZIP TELEPHONE NUMBER
�32Z-11 `t z
NAME
AnoREss
CITY ZIP TELEPHONE NUMBER
F_A)-I ot,; 0 S
STATE LICENSE NUMBER EXPIRATION DATE.
F; L_u -P i —1 Q V,i jI - 11 {e
Leoal Description of Property - include all easements
Proge
fa%Acrounl
+ 13-Zw3.,4.-0►8 -Coc:3
l Nny
Parceo.
ONEW
RESIDENTIAL
LJ PWMBINGWECH
AUDITION
COMMERCIAL
D COMPLIANCE OR
CHANGE OF USE
�I
�nFML1pEL
APT SLOG.
SIGN
REPAIR
GRADING
CrOS
FENCE
(_x_F
DEMOI.ISH
TOVE
WOODS�POOL
❑ INSERT
❑ HOTMTUBiSPA
GARAGE
r7 G WALL/[�
CARPORT
ROCKERY
RENEWAL
NUI.TDER NUMBER OF CRITICAL
OF L DWELLING 1 AREAS
STORIES UNITS NUMBER
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
LEGAL DESCRIPTION CHECK
SUBDIVISIOI. NO
L-0 NO
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
F v15 TND ..__._.__ __ REOURIEDDEDICAUDN ._ .-
PROPOSED ___.___ _...__.____.-__. ____..._.. _.
TESCP APP"',RR ❑
FEW 13
"PER Use PPIm,I RP(j'1 ❑
Infpncl�en RP'1"�IeA ❑
VIr, I
S�eewelY Rl• d ❑
METT:nsizc
UNESILI:
NO OF rIXIURES
PRV REQUIRED
YES ❑ NO ❑
RFMARKS
ENGINEERING MEMO DATED REVIEWED RY
FIRE MEMO GATED REVIEWED Ely
SIGN AREA
ALLOWED PROPOSED
SEPA REVIEW
COMPLETE JIXEMPI
E%P
ADS NO
SHORELINE
VARIANCE OR DUE
PLANNING REVIEW BY
DATE
SETBACKS —FEET HEIGHT
FRONT SIDE REAR
LOT COVERAGE
REMARKS
CHECKED BY I TYPE OF CONITIIUCTI.H COOF��
OCCUP T
GR01
SPECIAL INSPECTOR
REQUIRED YES
AREA
OCCUPANT
LOAD
EMARKS
PROGRESS INSPECTIONS PER UBC 108
51-AU(s E. • Wro v PE
FINAL INSPECTION REQUIRED
VALUATION
PLAN CHECK FEE
I
\�. i / l• � — ��� � C
HEAT SCIURCE
GLAZINGjj1
BUILDING
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7 C;oGI^7
PLUMBING
Plan Check No. 96 -,
ton
MECHANICAL
This Permit covers work to be done private property ONLY.
GRADING/FILL
Any construction on the public domain (curbs, sldewolks,
'j�l
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,
rtemployees, and agents from any and all claims for damages of
< whatever nature. arising directly or indirectly from the issuance
T of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSITjjNO
motlEfy. waive or reduce any requirement of any city ordinance
�.—,
°T nor limn in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
�.X'• D�
provision."
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
This application is not a permit until
slate laws regulating construction; and In doing the work authoriz-
ed thereby, no person will be employed in violation of the Labor
AUTHORIZES
THE
ONLY THE
signed by the Building Official or his/her
Code of the Slate of Washington relating to Workmen's Compensa.
wORK
Deputy; and fees are paid, and receipt is
T Insurance and RCW 18.27.
INSPECTION
acknowledged in space provided.
IGNA RE (OWNER OR AGENT( DATE SIGNED
DEPARTMENT
OFFICE SIG A E DA E
r'
CITY OF
EDMONDS
/O
CALL FOR
RELEAB Y ATE
AWE ION
INSPECTION
l0
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
��� _O��®
ORIGINAL — File YELLO — I Spector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
SECTION 109
IoaaT
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q ,
PINK —Owner GOLD —Assessor
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3,21 ,%, i} \ Y i.w
CITY COPY
Q
f�
N Site Plan
„ Olympic View ®rive
32 X I
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RECORD OF INSPECTIONS
i
INSPECTOR
�- DATE APPROVED
/sue 6
SETBACKS.....;.......,..... — - IZ• ��• `(.
FOUNDATION:
Footing�` �Z • 8 ` 4�
Wall .......................
Pier/Porch................
Retaining Wall............
Slab Insulation ............
PLUMBING:
Underground .............
Rough -In ..... I...........
Commerclal Final........
. HEATING: _
Gas Test_ ................
Gas Piping ................:
Equipment ................
Commercial Final..... �...
EXTERIOR SHEATHING
NAILING ..................... .
FRAMING ....................
INSULATION: -
Floor Insulation_ .........
Wall Insulation ...........
Ceiling Insulation......,,.t
rSf{���dCKtNAIWNG c,
',.
SPECIAL INSPECTION ......
RADON MONITOR AT SITES
. FINAL APPROVAL
FOR OCCUPANCY....._. ---��
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