The URL can be used to link to this page

970914.pdfE CITY OF EDMONDS us E PERMIT /:fi'1 :°"E NUMBER {r/%,�k� CONSTRUCTION PERMIT APPLICATION doa SUITE APT k r IL ADDRESS } pe O /'� re o D M NE" NAME NAME/O0F BUSINESS Q k / -1 L LEGAL DESCRIPTION CHlEECK SUBDIVI'ION NO UP NO MAILING AOnRE es w ;O i V V 1 e CJ P14. PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTG_-- nEOUIREO DEDICATION PROPOSEC TESCP APPlevad ❑ RW Permll Repu,red ElIN Stleel Use Pe— Re Is ❑ Inspection Renu,red ❑ Sidewalk Requ,red ❑ LIT, IJ 1 prZP TELEPH°NENUMBE.RI �y7 4V p- Od D L�}�Y7�� Y{gJV NAME METE" SIZE LINE SIZE NO OF FIXTURES PRV REQUIRED w YES ❑ NO ❑ ADDRESS REMARKS Z u¢ i - LI - CITY ZIP TELEPHONE NUMBER z Z NAME O ADDRESS 7) C `Js�'/ - r . / ,{• 'r iY YaT/ELEPHONE ENGINEERING MEMO DATED REVIEWED BY CITY ZIP Y / e Y NUMBER _ 2' i D FIRE MEMO DATEp REVIEWED BY - ° STATE LICENSE ^ �� 1'K E-PIRA'-ION DATE / 1U` S 4• {l " 9 [aY/ SIGN AREA AM LLOWED PROPOBED BEPA REVIEW COMPLETE E%E ADS N0. PT sHOREUNEs Legal Description of Property - include all easements 4 EXP VARIANCE OR CU PLANNING REVIEW BY DATE - u SETBACKS -FEET HEIGHT LOT COVERAGE i w FRONT SIDE REAR I Praparty TaX Account �/ S-6 - UO ,., - O / 3' ©0 `� -7 Parcel NP. k�I�II REMARKS ❑ NEw 1L1,1 RESIDENTIAL II'�1 PLUMBINGIMECH COMPLIANCE OR ADDITION COMMERCIAL CHANGE OF USE REMODEL APT BLDG. El SIGN GRACING FENCE REPAIR CYDS (_K_Fij SWIM POOL DEMOLISH INSERTTOVE HOT TUB SPA GARAGE RETAINING WALL/ CARPORT ROCKERY RENEWAL CHECKED BY TYPE OF CONSTRUCTION CODE �G' / 4 OCCUV T GPO SPECIAL SPECTOfl AREA REQUIRED YES DOCAUUPANT REMARKS O IS PROGRESS INSPECTIONS PER UBC 108 (TYPE OF USE. SUSINESSO ACTIVITY) EXPLAIN: % ^A /lY�vk�/(� {;I"l r, /1 O m0 NUMBER OF STORIES / NUMBER OF DWELLING UNITS CRITICAL AIL NUMBER -' BE GONE PLOT PLAN) ��^T _ VC OESC IBE WORK TO tATTACH ,, 1' (rag Ct+++ FINAL INSPECTION REQUIRED Jim, 40D J i� 7—d TUT VALUATION FEE PLAN CHECK FEE BUILDING HEATS URGyE. / �+ A.Is. CY'O- J GLAZING P/P PLUMBING 3 Plan Check NO. MECHANICAL �^ This Permit covers work to be done on private property ONLY. GRADINGIFILL Any construction on the public domain (curbs, sidewelks, STATE SURCHARGE driveways, marquees, etc.) Will require Separate permission. Permll Application: 180 Days Permit Limit: 1 Year - Provided Work Is Started Within 180 Days STORM DRAINAGE FEE w w f "Applicant. on behalf of his or her spouse, heirs, assigns and 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 whatever nature, arising directly or indirectly from the issuance of this permit. Issuance of this permit shall not be deemed tG ENG. INSPECTION FEE PLAN CHECK DEPOSIT omodify, r 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 ��+'f �7 provision." Y I hereby acknowledge that I have read this application; that the ATTENTION information given is correct; and that I am the owner, or the duly authorized agent of the owner. 1 agree to comply with city and THIS PERMIT state laws regulating construction; and in doing the work authoriz• AUTHORIZES ed thereby, nD person will be employed in violation of the Labor ONLY THE Code of the State of Washington relating to Workmen's Compensa. WORK NOTED lion Insurance and RCW 18.27. INSPECTION APPLICATION APPROVAL 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. SIGNAjU1�E IOwNER OR A E I DATE SIGNED DEPARTMENT (//J/�1-(' p� 6 CITY OF �a EDMONDS OFFICIA S SIGNATURE DATE ie•ALL FOR ATTENTION INSPECTIION RELEASED BI DATE IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771 -0220 L.00CN roe MTCn Ilan ORIGINAL - File YELLOW - Inspector SECTION log 10287 o s PINK - Owner GOLD - Assessor 0 h1, I�z 32XIC