1130 7TH AVE Siiiiiiiiii lill
14757
1130 7TH AVE S
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
USE
ONE �✓ �/ PERMIT 9r_n' 92
(O NUMBER c+v v
J B .30 H3 Z
ADDRESS_BUSINESS
P4�
OWNER NAMEfJJAME OF
:: ! �" I .� •j
.,
/'' ' '/ el ! A t t!f v'
LEGAL DESCRIPTION HECK
SUBDIVISION NO.
'
LID NO.
MAILING ADDRESS I
F , /
'ITY f�
? r
:' i
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING REQUIRED DEDICATION
TEBCP Apprasd O
RW Pwmit Required O
Sttat Use Permit Req'd O
In6tlonR Wood O
- ZIP
.4- O/,,. :! c ,. L S
HONE
TELEPUMBER
�l , ; - F. % % (
PROPOSED p0O so
Sidewalk Required O
METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED
YES ❑ NO 0
REMARKS
'ELEPHONE NUMBER - -A a 40 T .4 L L r..t/r /i / MJ e l A17- C)/'c' • L(/�'
,rcE JrSE lr,�,� : •�,� - F,�o /'F/�> ,r, vi,'r`.C: ,E'Fsi'r,
�� [ cJlf1 Tip'„/ � %'k ✓/f'�'� L'U,m�'� � s
ENGINEERING MEMO DATED REVIEWEDBY
E LI 8E NUMBER
Legal Descriptionln of
Property = Include all easements
a p
Pael o�No.
v
lX�-a9
ED NEW
10RESIDENTIAL
PLUMBING
OADDITION
1:1COMMERCIAL
MECHANICAL
El REMODEL
D APT. SLOG.
SIGN
,❑
GRADING®
PE�
REPAIR
❑ CYOS.
nNCE
y'.iln�_M
DEMOLISH
WOODSTOVE
INSERT
SWIM POOL
NOT TUMPA
CARPGE
ORT
RETAININ
ROCKERYG WALL/
❑ RENEWAL
NUMBER NUMBER OF
OF DWELLING
STORIES UNITS
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
SION AREA SEPA REVIEW
ALLOWED I PROPOSED COMPLETE EXEMPT
EXP
VARIANCE OR OU IEW BY A
SETBACKS — FEET HEIGHT LOT +J
FRONT SIDE REAR
ARK
❑ YES I
wwu
MA KS
PROGRESS INSPECTIONS PER UBC 305
FINAL INSPECTION
REQUIRED
,.+
(� (' �•'�-C•n _,,,�'(, ��C,{�
VALUATION
FEE
PLAN CHECK FEE
HEAT SOURCE
•
GLAZINGBUILDING
%
PLUMBING
Plan Check No.
MECHANICAL
This Permit Covers work to be done on private property ONLY,
GRADINGIFILL
Any construction on the public domain (curbs, sldewelks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application:180 Days
Permit Limit: I Year - Provided Work Is'Started Win 180 Days
STORM DRAINAGE PER
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENG.INSPECTION FEE
successors In Interest, agrees to Indemnify, defend and hold
harmless the City of Edmonds, Washington, Its officials
a 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 to
PLAN CHECK DEPOSIT
9 modify, Waive or reduce any,requlrement of any city ordinance
i nor limit In any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
1 hereby acknowledge that I have read this application; that the
Information given Is correct; and that I am the owner, or thf3 duly
ATTENTION
APPLICATION APPROVAL
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 and RCW 18.27.
INSPECTION
acknowledged in apace provided.
1 N'TURE (OWNER OR AGENT) GATE STONED
DEPARTMENT
/ .' / r
�-. - �•<', . �.9 ; [ • ' . ti ' ; r
CITY OF
EDMONDS
OFFICI S NA RE DATE
L C
ATT>=NTT ON
CALL FOR
RELEASED BY: DATE
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
��� v�Lo
File YELLOW
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
,.
ORIGINAL - — Inspector
CHAPTER 9.
A04 ?w 24
PINK — ,Owner GOLD — Assessor