18226 SUNSET WAY11111111111111
14500
18226 SUNSET WAY
--p F ': ` -, ,
IF
a
210
Plot
SCALE. P . W-W
Plan
LEGAL DESCRIPTION
LOT COVERAGE CALCULATION
Lar Zc;�� —ea—
LOT A'WA 32W 6a FT.
LaT C47,WRAGE PERCENTAGE 3218%
HEIGHT CALCULATION
N &5*44'41r w
POW W
262.50
PONT V
215.Sv
F40W v
214-110
POW ID'
284BV
PONT Z'
265M
---------------------------
TOTAL
1364AW DIVIDED BY 5 212AP AVEMAdiff CARACE
AVERAW C.9ADE (21ZAV) DM WT. (25'-V)
MW MAXMUM BUILIONG WEbSWT ACTUAL F0000 251AW
121-1 AMPLO
A �J' Z' '_ '_' - )
DEVELOPMENT sERVICES CTR.
CITY OF EDMONU3
--- — — — — — — — — — — — — — — —
>. # . y / / — — — —,I — — —
6
I �L.
200
J_ W-dr MVATE
DRAINAGE
EASEMENT
265
M10.
CCINCRE T13
DRIVSUAY
CATC.14 BASP
ON
TRACT *A
ACCeSS -0
SUNSET QW,
I
APPROVED BY PLAN
,�7 9
1"�np4eAr_,_.A, C. L,�S
N
0 of
Flandafl J. Munson
BUJILDING DESIGNER
12423
1 4t1h A-9 S.W
S..tU.
W..hf�q ..
98146
V.I..
(206) 241-7420
F..
(206) 241-0288
0
125
0 §680raq
z-
h
BL
�51� : K
DRAWN RJM
ISSUE DATE 4/6/00
LATEST REV.
b
cs
401c)
I AINAI' b4m w
- - - - - - - - - -
AG
cot, C4 $WP4 of pu
DRAINAGE
EASEMENT
PONT
)4 262m, 213W'
- - - - - - - - - - - - - - --------- --------
POINT'C'
X
J/
ri
260- DECK 2w
15116"
W!
y
ED
---.----,Prop68ed
10'-0" PRIVATE
DRAINAGE
Rbsidibn
qe C RE TE EASEMENT
61 FWAIAK
MAIN PILR /I
261.2sy 285
/ I I
/XCTU /R[DdE
,p
T
ELEV, TION 2SIA14' a
IASI
CONCRETE
SIA -WER
PER
41TAR SE DRIVEWAY
E *mEt ID
265 Ar, NO. &4M,
CATCH 54-S
X
L ON w)—=—,
GARAGE- TOP OF CATCH
FFL - 28100' BASIN TRACT 'A'
I'lY
ACCESS TO
SUNSET WAY
— — - — — — — — — — — — — — -
/,t/�PIIIIT T V
284
N M'44'40" W
210
NORTH
T P.
2-
Plot Plan �,rxl Aa� (AA
SCALE: I- . 20'-C"
LEGAL DESCRIPTION
LOT 3,
EDMONDS, WASHINGTON
LOT COVERAGE CALCULATION
--------------------
LOT COVERAGE 4,211 SQ. FT.
LOT AREA 13,2SO 80. FT.
---------------------
LOT COVERAGE PERCENTAGE 32J8 X
HEIGHT CALCULATION
PO:NT:A' 262W'
PONT IS' 213 .50
PO:NT:C. 214DO'
PO NT D 284W'
POINT 'E' 26%='
--------------------------- APPROV
.2'- . .
, �- Al NOTED
TOTAL 136400'DIVIDEID BY r, - 212W'AVERAGr GRADE 00,
AVERAGE GRADE (212,009 - MAXIMUM BUILDIWG WT. (25'-0")
2SIW'MAXIMUM BUILDING HEIGHT - ACTUAL RIDGE 2-JI*4'
15,7rp55T- F, LIE
CA FILE NO.
Critical Areas Checklist
7 --------------------------------------------------------
Site Information (soils/topography/hydro ogy/vegetation) -14*
I . Site Address/Location: 1 2 /,� W jc/ n se- 14 a V C 1�1/91 V PUAj� - /NOV
2.
Property Tax Account Number: 7 bq2- 04,9
-1.
Approximate Site Size (acres or square feet):
4.
Is this site currently developed? v"- yes; _ no.
If yes; how is site developed?
5.
Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of I 0-feet over a
horizontal distance of 66-feet).
Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of
10-feet over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of I 0-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6.
7.
Site contains areas of year-round standing water: 221) Approx. Depth:
Site contains areas
of seasonal standing water: Approx. Depth:
What season(s) of the year?
8.
Site is in the floodway floodplain-_ ofawatercourse.
9.
Site conta k or an area where water flows across the grounds surface? Flows are year-
i;U/T
round? Flows are seasonal? _ (What time of year?
10.
Site is primarily: forested meadow ;shrubs mixed
urban landscaped (lawn,shrubs etc)
11.
Obvious wetland is present on site:
e/,_ ......
mapped soil type(s)'?,
I present�66�sitei
3. W tj inventor A
..... emnd.i ybr:f.
mapAndica. esvet and.
:QiUal: Arelas 'inverif A.- j`
ffi4p.,n. icatesCriticaf: xqa�:on:, site
...........
esignate �tart stibsideince an s i &hazard' V
I d I �d
area
Site:d th 't
.0sighAted n, e r: rne tall :8ens e .4ea
P.V1 on
s a
p
ItDy.-
^ca_chk.doc; Rey 10/03/97
Oy, ED-At
City of Edmonds
Critical Are'as' -Checklist
4C.
The Critical Areas Checklist contained on
this form is to be filled out by any person
preparing a Development Permit
Application for the City of Edmonds prior to
his/her submittal of a development permit to
the City.
The purpose of the Checklist is to enable
City staff to determine whether any potential
Critical Areas are or may be present on the
subject property. The information needed to
complete the Checklist should be easily
available from observations of the site or
data available at City Hall (Critical Areas
inventories, maps, or soil surveys).
An applicant, or his/her representative, must
fill out the checklist, sign and date it, and
submit it to the City. The City will review
the checklist, make a precursory'§ite visit,
and make a determination of the subsequent
steps necessary to complete a development
permit application.
With a signed copy of this form, the
applicant should.also submit a vicinity map
orplotplan for individual lots, of the parcel
with enough detail that City staff can find
and identify the subject parcel(s). In
addition, the applicant shall,include other
pertinent information (e.g. site plan,
topography map, etc.) or studies in
conjunction with this Checklist to assist
staff in completing their preliminary
assessment of the site.
I have completed the attached Critical Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner� �Iica -
' '--V / . .
__00 17
Name
4>�3 F,� ? 1w 'Je;l'�zj
Street Address
Y,
City, State, ZIP Phone
Signature Date
Applicant Representative:
Name
Street Address
City, State, ZIP Phone
Signature
Date
is
0
T;��07
4-C 9 tj
-PERMIT NO: 92-57.
City of. Edmonds
PERMIT EXPIRES
SIDE SEWER PERMIT
Address of Construction: Surisex. WO—Y MID #' 14VkNaVAI
Property Tax Account, Parcel No. T)4 C. (:),-+1 000
Attach copies ofall'access and utility easem
ed And Approved by
Owner and/or Contractor: �J=bkAAJS
p
Contractor L I icense#: i)N1=Af=-F5VA OCIC) V,"Z, -Building. Permit#: QCCACO
XSingle Family
Multi-Fam ily (No. of.Units
Commercial (No. of Units
. . F] Public
Invasion I into'City *Right -of Way: El Yes. gNo
*RW Construction Permit
Cross. other.* *Private Property: E]Yes No
"Attach legal description and copy'of recorded easement.
Owner or contract -or signature and acknowl—e&gement statement Datd
By signing for th is permit I certify that I have read the City's public handout entitled
Side Sewer Specifications, and shall comply with all City requirements outlined therein. [TR0 'MANT
92.
CALL DIAL -A -DIG (1-800-425-5555) BEFORE ANYTXCA
2 FOR INSPECTION CALL 425-771-0220'extensio67.3,2z!-�9���-�M
VATION 9
24 HOUR NOTICE REOUIRED FOR ALL INSPECTION REQUESTS
NOTE: IF JOB SITE IS NOT READY FOR INSPECTION. WHEN
INSPECTOR ARRIVES A'$45 RE 1NSPEPTION FEE -WILL BE CHARGED.
Job Site Ready YES NO Date: Initial.:
Partial Inspection: Date: Initial:
Partial Inspection: Date: Initial:'
FINAL INSPECTION APPROVED: Date:. lz41Z�Q I Initial:
As-builtt.o StreetFile:
t� PERMIT MUST ' BE POSTED ON. JOBSITE t�
White Copy: -File. Green Copy: Inspector Buff Copy: Applicant
L;temp;bldg,forms;ssperTnitjlg4/00.
Side Sewer Drawing
t
The City of Edmonds
EASEMENTNO . .... ---------------------------------------
NEW CONSTRUCTION 01 REPAIRS LID NO . ............. .... ASMT. NO - --------_-
CONTRACTOR_ ...... ---------------------------------------------------- --------------------- PERMIT No.
OWNER............................. ................................. __ .........................
0�, J., LEGAL DESCRIPTION: LOT NO. -1 ........... .................. BLOCK NO. ._ __----_------------------
JOB ADDRESS ........
W
PWW-0001-1 1175 (REV.1 1/78)
......................... ................................................... ........ .................................................... ......................
T,YAAAr n17 Al_)l-ll-l'lnT%J - ------------------------ ................................. I .......... ..........
0 0
Ie)(1,5b,15
LA
Arproved:
Pro ..............................
Pe,+l By ..................
DATE 173-7.01 .....................
f — 3 / - 0 f c_jA,-z1
I
K.
E
n
CITY OF EDMONDS.
SINGLE FAMILY/DUPLEX COVER SHEET
Directions: Applicants are to complete the Information In the WHITE BOXES ONLY (Shaded boxes are for City
use only). This cover shoot must accompany each bull . ding permit application for a new single-family
PROJECT ADDRESS I t5:��J2 �-3 I"
PROPERTY TAX ACCOUNT PARCEL #
DESCRIPTION OF WORK �Ql g.\,hQ
OWNER
PHONE Lt7,9-404077
CONTACT-PERSONI"rW-1�,e- J�E I W-P-A&-r--A PHONE 9>25;- t)C-2 I -7-X�),60CC-t
E.MAI Cory-, FAx4z.C-- �-7 - 0!5-2020-
MAILING ADDRESS?. FAmot-\L SkED1,C)
04-A�X CORRECTIONS 'L CORRECTIONS E-MAIL CORRECTIONS
BY SIGNING THIS STATEMENT I UNDERSTAND THAT I AM THE CONTACT PERSON FOR This PROJECT. 17 IS MY
RESPONSIBILITY TO COORDINATE ALL SUBMITTALS WITH THE CITY AND ONLY I CAN MAKE INQUIRIES ON THE
STATUS OF THE APPLICATION. I UNDERSTAND IT IS MY RESPONSIBILITY TO DETERMINE IN ADVANCE OF PERMIT
SUBMITTAL ANY DISCRETIONARY PERMITS THAT, MAY BE APPLICABLE TO THIS PROJECT. I ACKNOWLEDGE
THAT TO THE BEST OF MY ABILITY I HAVE SUBMITTED ALL NECESSARY DOCUMENTATION IN ORDER TO MAKE A
COMPLETE APPLICATION AND NO DISCRETIONARY APPROVALS ARE REQUIRED.
SIGNATURE DATE
ZONING INFORMATION
ZONE LOT AREA
NUMBER OF DWELLING UNITS'EXISTING DEMOLISHED PROPOSED
DISCRETIONARY APPROVALS CA 1 6-12- Determination W;k. kt-e^
SUBDIvtsiotG2f--j-7,,ca- cu VARIANCE SHORELINE
SEPA Expires OTHER
LOT COVERAGE INFORMATION
EXISTING SIP PROPOSED SI`14bn-� TOTAL S F _40� % 322
HEIGHT CALCULATION INFORMATION
'am's
DATUM 0-1?7)
-7. tLT
AVE MAX C-5-17 �0, A C T IIA �L-�' 'DOI/
SETBACK INFORMATION
flEauffifa FRONT,,,�S' SIDE SIdE, lo. REAR c96'
e&QfD,UA FRONTaR, SIDE t 0 S169 .1b 5/10 REAR
Y S 6-L, E]YES'[]io��T .
CNFLLOT. 0.: E; ION FLA. OT[]Y0SE]k0'ST:,DEDIC.
STATEME T REQUIR . FD []YES [@'NO'. RECORDING #
STAFF COMMENTS: Nrj4-. ex Plr-C4- LL 0 lo -.1
ENGINEERING INFORMATION
DRIVEWAY SLOPE % "7-7
GRADING CYDS- LJOO
EASEMENT
EXISTING IMPERVIOUS AREA CONSTRUCTED BEFORE 1977 SQ.FT
E XISTING IMPERVIOUS AREA INSTALLED 1977 OR LATER SO.FT.
PROPOSED NEW NET IMPERVI'OUS SURFACE !jn ra
City'Use Only -�;
SIDEWALK REOUIRED []YES J�BNO DRAINAGE PLAN REQUIREDE]YES
UNDERGROUND WIRING REOUIRED �E]YES [:]NO
STREET DEDICATION IVO FT. LID#
STAFF COMMENTS:
SPECIAL INSPECTIONS REQUIRED FOR THIS PROJECT (City U.se Only)
SOILSO
START OF WORK
EXCAVATION & GRADING
OSHORING INSTALLATION &.111IONITORING
PROOF ROLLING
PLACEMENT OF FILL & CO MPAPTION
SUBSURFACE DRAINAGE
VERIFY SOIL BEARING
PILE.PLACEMENT
EROSION CONTROL
DGENERAL SITE MONITORING BY THE
GEOTECHNI . CAL ENGINEER OF RECORD
EIGENERAL SITE M ONI TORING BY TH E
GEOTECHNICAL ENGINEER OF RECORD
'DURING WET WEATHER CONSTRUCTION
0 FINIALGRADING A FIELD REPORT
E]OTHER
NO
STRUCTURAL:
OPLACEMENT OF REINFORCEMENT
PLACEMENT OF CONCRETE
OBOLTS INSTALLED IN CONCRETE
[]STRUCTURAL MASONRY
0STFtUiCTURAL STEEL ERECTION
HIGH STRENGTH BOLTING
WELDING (WABO CERTIFIED ONLY)
COTHER
V, PLAN CRECK 0 -L,'�-7 I'
APPLICANT
�:Cja \A. ��V " C,
DATE RECEIVED So I L
BUILDING CONSTRUCTION INFORMATION
CODE EDITIONS 1997 UBC, UMIC, UPC, WSEC. VIAG WITH AMENDMENTS
DESIGN CRITERIA WIND EXPOSURE 0 WIND SPEED 80 MPH SEISMIC ZONE 3
Floor Live Load Root Snow/Live Load Balcony Live Load -
Floor Dead Load RoolOsed Load Balcony Dead Load
NUMBER OF STORIES BASEMENTS FLOOD ZONE_
LOT SLOPE SOILS REPORT PROVIDED 0 YES 0 NO
FLOOR AREA (MEASURED TO EXTERIOR FACE OF EXTERIOR WALL)
Existing P osed Total
Living Space T Q -7 Z4 /0-7
Garage
Carport
Deck/Covilf9d Porch
Other —
ENERGY CODE COMPLIANCE INFORMATION
EUELJME M GAS, OIL ELECTRIC OTHER
Liw
io FORCED AIR [:]HFAT PUMP []HYDRONIC [:] OTHER
.-V ennr. IWO
U. of. U
PRESCRIPTIVE: List Optic. s7rt-----
TARGET UA APPROACH: Provide UA Calcustions
SYSTEMS ANALYSIS: Provide Computer Analysis
f" ENERGY1VENTILATION WORKSHEETS PROVIDED
W
WINDOW SCHEDULE PROVIDED
VENTILATION CODE COMPLIANCE INFORMATION
FOR CITY USE ONLY.
Coiling Insulation
Wall Insulation
Floor Insulation= —
Door U-Vsluo .4-
Window U-Vslus
Skylight U-Volue
Glazing %---2-L
KITCHEN FAN CFM I sOO BATHROOM FAN(S) CFM,50 LAUNDRY FAN CFM 100
WHOLE HOUSE VENTILATION SYSTEM
EXHAUST OPTION
FRESH AIR TO BE PROVIDED TO WINDOW VENTS WALL PORTS
EACH HABITABLE ROOM WITH:
EXHAUST FAN TO BE CONTROLLED WITH 24 HOUR TIMER AND SIZED AS FOLLOWS:
0 1 - 2 BEDROOMS: 60 - 75 CFM BEDROOMS: 100- ISO CFM
El 3 13EDR06MS: 80 - 120 CFM 0 6 BEDROOMS: 120-160 CFM
HVAC INTEGRATED OPTION
0 DE61CATED HEAT RECOVERY VENTILATION OPTION
SEPARATE PERMITS (City Use Only)
C]RIGHT OF WAY CONSTRUCTION PERMIT OMECHANiCAL PERMIT
C]ENCROACHMENT PERMIT 0PLUMBING PERMIT
STATE ELECTRICAL PERMIT WATER METER
EIFENCE PERMIT 0SIDE SEWER PERMIT
EIR I ESIDENTIAL FIRE SPRINKLER PERMIT 01FIRIGATION (SPRINKLER SYSTEM)
0OTHER OTHER
Any request lot mod I IlIC811011, Variance or other administrative deviation (herinalter 'variants*)
must be Specifically called out and Identified. Approval of any PI&I Of Plan containing provisions
which do not comply with the city code and for which a variance has not been specifically
identified, requested and considered by the appropriate city o . Ificial In accordance with the
appropriate provision of city code of state low does not approve any Items not to code
specification.
PERMIT ISSUANCE APPA()VALS'
PLANNING REVIEW & APPROVAL
CONDITIONS OF APPROVAL:
(Cit Use- Only)
D AT 9
ENGINEERING REVIEW & APPROVAL
CONDITIONS OF APPROVAL:
DATE
BUILDING REV IEW & APPROVAL
CONDITIONS OF APPROVAL:
fj a-t4 DATE
of
VED
IT EX I I I
I'M RM PIRI
)"�o )n
�11 Ust PERMIT
ZONE'L��) Cp
CITY- OF EDMONDS NUMBER 0 7
CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT#
ADDRESS A�
WNER NAME/NAME OF BUSIN I ES.S
PLAT NAME/SUBDIVISION NO. LOT No. LID NO.
f2E1(,LM
.41
r__ n <�__ I LID FEE $
z
MAIL", G ADDRESS TESCP Approved 0
PUBLIC RIGHT OF WAY PER OFFIC STREET MAP RW Permit Required 0
x
0
Street use Permit Req'd 0
va Cr EXISTING PROPOSE Inspection Requked,,,
ZIP TELEPHONE Sidewalk Requir ad
; .
Cl 9(
REQUIRED DEDICATION I\ FT Underground
A-2ic: -Wlrtng required
0 [A40 Lpo!�4 4(
NAME METER LINE SIZE NO. OF FIXTURES PRV REQUIRED
N
0
YES NO
Q2-
REMARTS, z
ADIRESS z
I TOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE 0
/CONt66 z
ww
ZIP ITELEPHONE
4,141,
jf�
1.44 wto?* 14-W
NAME
�:_K e.<� "kk ENGINEERING' REVIEWED/DATE
M
ADDRESS . A/C16)
0
)rN
x
FIRE REVIEWED BY DATE
r-
z
0
CIT ZIP TELEPHONE, LL
'VARiACE OR CU SHORELINE OR ADB# INSPECTION BOND
TATE LICENSE NUMBER, EXPIRATION DATE CHECKED BY REqD POSTED
Pf'�v(, (F 0 L-L i 0 0 YES 40
HEIGHT
LL_
- SEPA REVIEW SIGN AREA
PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED � PROPOSED ALLOWEDj I PROPOSED
lm��
uj
0 0 q. 6q
EXP
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT)
NEW RESIDENTIAL' PLUMBING MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT UR Sl E REAR
COMPLIANCE OR /0
ADDITION [3.�'COMMERCIAL
CHANGE OF USE
E'
PARKING LOT AREA PLANNING REVIEWED'By 6AT _j
F1 REMODEL C3.-APARTMENT_ IOVIDED
REJ" PF
_f_ 50
FENCE
REPAIR c X FT) REMAR
C%
so
f-1 DEMOLISH 0 TANK 0 OTHER
-fK - A 4,9r.
GARAGE TAINING WALL E] RENEWAL
15L CARPORT 0 RE
�gOCKEgy
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
CHECKED BY-' TYPE OF CONSTRUCTION CODE OCCUPANT
GROUP
cn
W
a
NUMBER NU413ER OF CRITICAL' SPECIAL INSPECTOR JAREA -PL: OCCUPAN
OF DWELLING AREAS "
%IL LOAD
In
0
R. EQUIREDE]
STORIES UNITS NUMBER YES
<
DESCRIB E WORK TO,BE. DONE
REMARKS
PROGRESS INSPECTIONS PER UBC 10810INAL INSPECTION REO'D
4 1 In
r., IV& 1::� (Vol W42. 19E, ,x-n 4
-Av
7-_ -t-
epvc LA -a icn, a
VALUATION
FEE
PLAN CHECK FEE
ao-7 Lt,
HEAT SOURCE GLAZING`/, LOT SLOP%*/t/, B . UILDING
PLAN CK NO: VESTED DAfE PLUMBING
0-.57/
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK'NOTED. -THIS PERMIT COVERS WORK TO
-
BE DONE ON PRIVATE PROPERTY ONLY.ANY CONSTRUCTION ON THE PUBLIC RADING/FILL
DOMAIN .(CURBS, SIDEWALKS,'DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
STATE SURCHAR GE
Cc - N: 180 DAYS
III � , PERMIT APPLICATIO
PERMIT LIMIT:1 YEAR - PROVIDED WORK IS STARTED.WITHIN 180 DAYS . ENG. REVIEW FEES 5�7
SEE BACK OF PINK PERMIT FOR MORE INF RMATION
ENG. INSPECTION FEE
"APPLICANT, ON BEHALF OF HIS OF! HER SPOUSE, HEIRS,'ASSIGNS AND SUCCESORS
W IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND.HOLD 'HARMLESS THE CITY OF
_j
2 EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND 4"GP&64Q"EEt�C_� 04,AI-1
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
RECEljy1r
FROM THE ISSUANCE OF THIS'PERMIT ISSUANCE OF THIS, PERMIT SHALL NOT BE PLAN CHECK DEPOSIT 19il ZJ -744
ORDINANCE 0_7
01 DEEMED To MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY
A
0 NOR LI MIT IN ANY WAY TH E CITY'S ABI LITY TO "FORCE ANY ORDI NANG E P ROVI SION.-REG EIPT
TOTAL AMOUNT DUE I
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
This application is not a permit until signed by the
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO. PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid. and
IN VIOLATION OF THE LABOR CODE OF -THE STATE OF WASHINGTON 'RELATING TO FOR -INSPECTION receipt is acknowledged in space provided.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
CIALS I N URE DATE
ER -RAG I
E 0 ER 'R. AG NT DAIEF)IGNEDI J425) 10L)
1.
E�02L I
T;NTIO 2a
D 771-0220
qA
R�LEASE BY
ATT NTI ON EXT 333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A: CERTIF,- ORIGINAL - FILE - YELLOW - INSPECTOR
_)F OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
CATE FAX PINK - OWNES . Wi-GOLD - ASSESSOR