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990080.pdf00 A4 aUSE Z m I n. N cm mp O� mz O i DZ r� i` V, I f. mm O y I N. Im Z 1 Z N' Z Q n. m I: ATT NTION IT I NLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL FILE YELL.— INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK , OWNER COLD ASSESSOR IPB PERMIT EXPIRES CITY ryp < /�Q zONENUMBIER 9 9008© CONSTRUCTIAPPLICATIONdoBsulTE/APTeAODRESS'Qtr`�OWNER 1��/LEGAL 7EDMONDS NAMEIME OF BUSINE DESCRIPTION CHECKSUBDIVISIONNO. LID NO. MAILINGAR'cSS p PUBLIC RIGHT OF WAY PER OFFICIAL STRE[T MAP EXISTING REQUIRED DEDICATION —n PROPOSED TREIYSPe mPPrea,bea ❑ oe ❑ snow O CITY T `L,E�P [ HE �Y ^ �{Et� ry`p`MC \ METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED D u q^* �ue ^L,, YES NO ❑ Q r ADDRESS REMARKS e CITY ZIP LEPH NE �o� �6-aa�w ITN' N E �" �0��� �1 ENGINEERING MEMO DATED REVIEWED BY ADDRESS �\� C� FIRE MEMO DATED REVIEWED BY — O CITY TUiL,EFH�E VARIANCE OR CU AOBb SHORELINE p FIN DATE EC Y ° SY-�l��l��so�\ ) ) EXPII v SERA REVIEW COMPLETE I EXEMPT ALLOWED EXP SIGN AREA PROPOSED HEIGHT ALLOWED PROPOSED O F _ LEGAL DESCRIPTION OF PROPERTY INCLUDE ALL EASEMENTS LOT COVERAGE REQUIRED ALLOWED PROPOSED SETBACKS (FT.) PROPOSED FRONT SIDE REAP SETBACKS IFT.) FRONT UPSIDE REAP VPROPERTY g TAX ACCOUNT PARCEL NO. LOT'AREq ,P.�LANNING REVIEW BY GATE JA'SD1s� Io�ra� `1 ❑ NEW � RESIDENTIAL ❑ PLUMBING IMECH gEMARKS ❑ ADDITION ❑ COMMERCIAL ❑ CHANGE OF USE REMODEL ❑ APARTMENT ❑ SIGN GRADING FENCE ❑ REPAIR ❑ CVOS ❑ ( X FT) CHECKED BY TYP. UCTION C PY' ❑ DEMOLISH � TANK ❑ OTHER GARAGE RETAINING WALL ❑ RENEWAL Cl CARPORT ❑ ROOKERY SPECIAL INSPECTOR AREA gEOUIRED YES �GCACDUPANT F (TYPE OF USE, BUSINESS OR ACTIVITY) E%PLAIN: REMARKS i - PROGRESS INSPECTIONS PER U6C 106 w � NUMBER NUMBER OF OF DWELLING , CRITICAL gREAS O STORIES UNITS NUMBER D CRIBE WORK LO\B� DONEMb� � C D � FINAL INSPECTION REQUIRED VALUATION FEE PLAN CHECK FEE 1 ' 1� HEAT BOURCE GLAZING % T SLOPE % BUILDING PLUMBING PLAN CHECK NO: TE FV-E.TE, MECHANICAL — THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BEGONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS,SIDEWALKS, DRIVEWAYS, MAgOUEES,ETC.) WILL REQUIRE SEPARATE PERMISSION. GRADING/FILL STATE SURCHARGE G EPMIT APPLICATIN: 1B0DAYS T OMIT. 1 YEAR- PPOVIDED WOflK IS STAflTEO WITHIN 1B0 DAYS STORM DRAINAGE FEES T. ON BEHALF OF HIS OR HER SPOVSE, HEIgS. ASSIGNS AND SULCEBORSENG. T, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FgOM ANY AND FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY ISSUANCE OF THIS PERMIT.ISSUANCE OF TIi15 PERMIT SHALL NOT BE O MODIFV, WAIVE OR REDVCE ANY REQUIREMENT OF ANY CITY ORDINANCE IN ANY WAY THE LITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' imJ INSPECTION FEE plgN CHECK DEPOSIT TOTAL AMOUNT DUE '2_7 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT I I It. INFORMATION GIVEN IS CORRECT; ANO THATI AM THE OWNER. OR THE DULY AUTH�Ih/.ED AGENT OF THE OWNER, I AGREE TO COMPLY WITH CITYAND STATE LAWS REGULATING CONSTRUC� TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASMINGTON RELATING TO WO KMEN'S COMPENSATION INSURANCE AND RCW I6.27. CALL FOR INSPECTION (425) �9 ! 71'022o APPLICATION APPROVAL This TPPricauan is not n pormit until signnE By Ihp BuilEing OIIicIal br hislhpr Oapuly: ana Foos:rm Puitl, nnJ rocoi0l is ncknowlatlpotl in spnco prontlntl OFF I SIG E F / SIG YIO R RAGENT) DAT SI NED (T�� V � REL � ATE I iUSE O �_ 0 m. —I 91 cm m� 0 OC mZ 2-111 A Cz T mm 0 C N f' mN �� A rn Z O n 0 m ' -: ATT NTI N /I IT I NLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORCERTIFI- OgPINK-OWNER • GOLD FILE YELLOWINSPE ASSESSe ,A CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PERMIT EXPIRES - CITY OF EDMONDS .^/ C ONE