800103o
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BUILDING DIVISION
Applicant FillP
IT APPLICATION
Inside Heavy Lin15"11C;
-7�ESCRIPTION
SUBDIVISION
SNT SUB NO.
y MAILIN AD RESS
t
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OF wAY PER OFFICIAL
STREET MAP
CITELEPH
AMPOSED
ONE NUMBER
STING
^�`ICIENCY
L
OF RIGHT OF WAY
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F ADDRESS
PUBLIC IMPROVEMENTS REQUIRED
=
$
DRAINAGE IMPROVEMENTS REQUIRED
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[ CITY TELEPHONE NUMBER
DRAINAGE PLAN REQUIRED
❑ 1
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UNOERGROUND WIRING REQUIRED
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NAM[ y/� /-y/,�/_-•
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CONNECTION TO SANITARY SEWER
SEPTIC TANK PERMIT REQ'D ❑
❑
NO,
Q ADDR[MSt
ELEVATION OF PROPERTY CORNERS
REQ'D
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SEE ENGINEERING MEMO DATED
OU Y _ B R
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CITY LICENSE NUMBER
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SIGN AREA ENV. REVIEW ADS NO.
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A-WEO PROPOSED CO MPLET EXEMPT
SHORELINE
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lu
0
REMARKS
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VARIANCE OR CU PLANNING REVIEW BY DATE
se
VARY LOT COVERAGE
® NEW RESIDENTIAL GAS
LINE
FRONT SITE ROD
N CODE HEIGHT
FIRE ZONE TYPE OF CONSTRUCTI;RECUPANCY
❑ N-RSIDENTIALIE) SIGN
ADD ❑ DEMOLISH ❑
TAINING
WALL I
CIALINSPECTOR AREA
REQUIRED OUPOCCUPANTRESPE
ALTER ❑ EXCAVATE FENCE X��FT)
OR PILL
D BY THIS SITE IS LOCATED IN THE CITY
N CHECK
S. LOCAL SALES TAX
REPAIR O
„SPMOVE 'ooL
SHOULD BE CODED 31.04.
ULD BE
SHOULD
Z NUMBER OF STORIES NUMBER OF
DWELLING
REMARKS
-'rV CG`E� CJ ` Ci
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UNITS
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a N.ITU RE WORK O SE DONE
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PLAN CHECK FEE VALUATION FEE _
� PLOT PLAN
^
BUILDING
PLUMBING
MECHANICAL
�J
FENCE Z
o •'Applicant, on behalf of his or her spouse, heirs, assigns and
SIGN
successorsin interest, agrees to indemnify, defend and hold harmless
i the City of Edmonds, Washington, its officials, employees, and
RETAINING WALL
[ agents from any and all claims for dama
gents of whatever nature,
It
x arising directly or indirectly from the issuance of this omit. Isxu-
p
SWIMMING POOL
Q ante of this permit shall not be deemed to modify, waive or reduce
J any requirement of any city ordinance nor limit in any way the
—
i City's ability to enforce any ordinance provision."
1 hereby acknowledge that I have read this application; that the in•
TOTAL AMOUNT DUE
formation given is correct; and that I am the owner, or the duly author-
ized agent of the owner. I agree to comply with city and state laws regu•
ATTENTION APPLICATION APPROVAL
lating construction; and In doing the work authorized thereby, no person
will be employed in violation of the Labor Code of the State of Washington
THIS PERMIT This application is not a permit
relating to Workmen's Compensation Insurance,
AUTHORIZES until signed by the Building Official or
NOTE: Permit U n® Year(Except DEMOLITIONS and FILL
ONLY THE his Deputy; and fees are paid, and
PE without c ditto 1 use permit, which shall be completed in 90
WORK NOT[D receipt IS acknowledged In Space pro•
s; M VED-IN BUIL N shal completed in six months.)
vided.
RNA R N[R Ap[N SI NE
INSPECTION
O[PARTM[NT DIRECTOR'S SIGNATURE
JOATI
CITY of
-
,This
EDMONDS DATE
Permit covers wort, to be done on privets pproperty ONLY.
Any on the domain (curbs, sidewalks, drlvaWays,
LL
775-2525 .7• Ic •' C.I��
....ion public
maa'Wnaa, etc.) will require separate permisslan.
ORIGINAL — Flle YELLOW —Inspector
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE PINK — Owner GOLD — Assessor
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC 304, 306.
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WORK- FENCE I!
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APFIR 0' ED DA 3 i.; -�C•
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FOR
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8.00!03 OF
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PLCN-1 �R-a�T. 11-
GLANTZ SUPPLY, INC.
is MECHANICAL CONTRACTORS
3332 SPRUCE PHONE 206/252-2442
EVERETT, WVASHINGTON
98201
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800 ! �?
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RECORD OF INSPECTIONS
Date Passed
i;. 1A.
FOUNDATION
House
4..
Porches, piers
Retaining walls1
Garage, carport
PLUMBING
+ti;
Underground ---
i
Rough -in
:!
Water service
HEATING SYSTEM
FRAMING
WALLBOARD
�le�
FINAL