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1043 MAIN ST.PDF11111111111111 11924 1043 MAIN ST Bult IV OCT.' 19971 c4 N TTi II �I 10 43 BAN VDt-iot4c)5 , wA 2 .e, 9o.001 SM E E ILE v 1. 24)-ol -14 UHM 5rTr=- (No CoNTOURs SHOWN) JI � � - � � is ltjl G4P,AVF—L-mvm STREET FILE rIAIH - —15TRZE—r— NOV-1-H ,.51TF— PLAN CALFlo,_o„ — r1 DEVELOPMENT PROPOSALS ON A SITE WITH WILDLIFE HABITAT The applicant must submit a clearing/tree cutting plan with any development permit. Tree cutting and clearing of native vegetation shall be limited to the footprint of development. (Note that removal of ivy and non-native blackberry bushes with hand tools is an allowed activity per ECDC 23.40.220.C.7.) ALLOWED ACTIVITIES Certain activities are allowed in or near critical area buffers as specified in ECDC 23.40.20. If you have any questions about whether your proposed development qualifies as an allowed activity, please contact a Planner for more information. EXEMPT DEVELOPMENT PROPOSALS Certain development proposals may be exempt from Critical Areas Requirements (ECDC 23.40.230). If you think that a specific development proposal may be exempt, contact a Planner for more information. Meg Gruwell, Senior Planner Name, Title nature Date NOTE: Cited sections of the Edmonds Community Development Code (ECDC) can be found on the City of Edmonds website at www.ci.edmonds.wa.us. • CITY OF EDMONDS CRITICAL AREAS RECONNAISSANCE REPORT Site Location: 1.043,001n Street Tax Acct. Number: O'0;4342'0400e25QO Determination: Study Required Determination #: CRA-2006-0107 Applicant: Lawrence Greene Owner: :Lawrence Greene CRITICAL AREAS RECONNAISSANCE REPORT: STUDY REQUIRED During review and inspection of the subject site, it was found that the site may contain or be adjacent to an Erosion Hazard Area and Fish and Wildlife Habitat Conservation Area pursuant to Chapter 23.40, 23.80 and 23.90 of the Edmonds Community Development Code (ECDC). EROSION HAZARD AREA DEFINED It appears that this property contains or is adjacent to an Erosion Hazard Area. Erosion Hazard Areas include: • Those areas with Alderwood and Everett series soils on slopes of 15 percent or greater; and ' • Any area with slopes of 15 percent or greater and impermeable soils interbedded with granular soils and springs or ground water seepage; and • Areas with significant visible evidence of ground water seepage, and which also include existing landslide deposits regardless of slope. DEVELOPMENT PROPOSALS ASSOCIATED WITH EROSION HAZARD AREAS Development within an Erosion Hazard Area must meet additional criteria. • For erosion hazard areas with suitable slope stability, the only critical area study needed is an erosion and sediment control plan prepared in compliance with the requirements set forth in Chapter 18.30 ECDC as part of the construction documents. This option is at the director's discretion, per Edmonds Community Development Code section 20.80.050.G. • In areas where the slope stability is not suitable, projects within Erosion Hazard Areas will require a report by a licensed Geotechnical Engineer or other qualified professional. • Note that it is important for the report to be prepared by a qualified professional as defined in the ordinance. • Report requirements are given in ECDC 23.80.050, and more generally in ECDC 23.40.090. D Development standards are given in ECDC 23.80.060 and 23.80.070. STUDY REQUIREMENT — FISH AND WILDLIFE HABITAT Since the site is within a mapped wildlife habitat area, the City would like to preserve as much of the native vegetation as possible. "Qc. 189" #P2U Clij' of E(IIri0i1dS Development Services Department Planning Division . Phone: 425.771.0220 Fax: 425.771.0221 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 the application 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). LJ IJ Date Received: City Receipt #: Critical Areas File #: Critical Areas Checklist Fee: $135.00 Date, Mailed to Applicant: A property owner, orhis/her authorized 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 site visit, and make a determination of the subsequent steps necessary to complete a development permit application. Please submit a vicinity map, along with the signed copy of this form to -assist City staff in fmding and locating the specific piece of property described on this .form. In addition, the applicant shall include other pertinent information (e.g. site plan, topography map, etc) or studies in conjunction with this Checklist to assistant staff in completing their preliminary assessment of the site. The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees to release, indemnify, defend and hold the City.of Edmonds harmless from any and all damages, including reasonable attormey's , fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or. incomplete information furnished by the applicant, his/her/its agents or employees. By, my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my knowledge and that I am authorized to file this application on the behalf of the owner as listed below. SIGNATURE of APPLICANT/AGENT DATE Property Owner's Authorization By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application, :and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the Owner/Applicant: Applicant Representative: Name Name Street Address RS_c)Z6 City State Zip Telephone: t-Z©f`3, 9- Street Address City State Zip Telephone: Email address (optional): P����� coW-ca!iA .i, email Address (optional): #P20 " Critical Areas Checklist cAFile No: c�A-acxG-©toq Site Information (soils/topography/hydrology/vegetation) 1. Site Address/ Location m Lk3�« 2. Property Tax Account Number:. DD �43 4Zoit� ?��O 3. Approximate Site Size (acres or square feet): 4. Is this site currently developed? _k5res; no. If yes; how is. site developed?.gin i 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 10-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 10-feet over a horizontal distance of less than 33-feet). . Other (please describe): 6. Site contains areas of year-round standing water:. ; Approx. Depth:, 7. Site contains areas of seasonal standing water: ; Approx. Depth: What season(s) of the year? 8. Site is in the floodway floodplain of a water course: 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-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: For City Staff Use Only a� 1. Plan Check Number, if applicable? 2. Site is Zoned? P'S - (, 3. SCS mapped soil type(s)? .4 - Ai Eve 4 L,4^4 Z5- 7d 17. s t� c L AIAcr,4bA - (Arb.,- I" 4. Critical Areas inventory or C.A. map indicates Critical Area on site? )�f wh.lrt IMF ;r Pt4 W"I't 1.4 5. Site within designated earth subsidence landslide hazard area? Flo DETERMINATION STUDY REQUIRED WAIVER Reviewed bv: �t:i - Date: A STR EET RLE CITY OF EDMONDS 250 - 5TH AVE. N. • EDMONDS, WA 98020 • (206) 771-3202 COMMUNITY SERVICES: Public Works • Planning • Parks and Recreation • Engineering 89p-194 September 23, 1991 Samuel Drobner 1043 Main Street Edmonds, WA 98020 Dear Resident: LARRY S. NAUGHTEN MAYOR PETER E. HAHN DIRECTOR On October 11, 1991, the City of Edmonds Water Section will be increasing your water pressure to your residence to approximately 120 pounds per square inch. If not already existing (as required in the plumbing code, Chapter 19.30.020 in the Edmonds City Code Book), you or your plumber must install a pressure regulating valve to protect your water lines and fixtures. This will allow you to adjust the pressure to your needs and protect you from pressure surges. If you have any questions regarding this matter, please call me at 771-3202, extension 317 or Scott Highland at extension 318. Sincerely, Ron Holland Water/Sewer Supervisor RH/lk Enclosure WPRESS/TXTWATER • Incorporated August 11, 1890 0 19.30 CHAPTER 19.30 PLUMBING CODE 19.30.000 ADOPTION OF UNIFORM PLUMBING CODE Uniform Plumbing Code, 1988 Edition (including Appendices A,B,C,D,E and H, but excluding Appendix I), copyrighted in 1988 by the International Association of Plumbing and Mechanical Officials, is adopted and by.this reference incorporated herein as if set forth in full as the "Plumbing Code for the City of Edmonds," subject to Chapter 12 of said Code relating to fuel gas piping being superseded by the Uniform Mechanical Code as set forth in section 19.25.000. (Ord. 2725, 1989] 19.30.010 BOARD OF APPEALS Section 201 of the Uniform Plumbing Code, adopted by this chapter, is amended as follows: 201 Board of Appeals. The Board of Appeals created and established in Chapter 10.15 of the Edmonds City Code shall act as a Board of Appeals in making a determination of any appeal arising from actions of, or interpretations by, the administrative authority. (Ord. 2725, 1989) 19.30.020 PRESSURE REGULATORS A. Residential. An approved type of pressure regulator preceded by an adequate strainer shall be installed on all residential occupancies, adjacent to the water shutoff on the interior of any such occupancy which shall reduce the pressure to eighty psi or less. For potable water services up to and including one and one-half inch regulators, provision shall be made to prevent pressure on the building site of the regulator from exceeding main supply pressure. Approved regulators with integral bypasses are acceptable. The strainer shall be readily accessible for cleaning without removing the regulator or strainer body or disconnecting the supply piping. All pipe size determinations shall be based on eighty percent of the reduced pressure. B. Other. Section 1007(c) of the Uniform Plumbing Code as previously adopted is amended as follows: (c) Any water system provided with a pressure regulating device or check valve at its source or other water system (09/30/89) 203 LO STREET RLE CITY COPY FILE# N/A DETERMINATION OF NONSIGNIFICANCE Description of proposal Addition of a garage to an existing single family residence Proponent Dorothy Drabner - 1043 Main Street, Edmonds, WA 98020 Location of proposal, including street address, if any 1043 Main Street, Edmonds, WA 98020 Lead Agency Edmonds Planning Division The lead agency for this proposal has determined that it does not have a probable significant adverse impact on the environment. An environmental impact statement (EIS) is not required under RCW 43.21C.030(2)(c). This decision was made after review of a completed environmental checklist and other information on file with the lead agency. This information is available to the public on request. X There is no comment period for this DNS. _ This DNS is issued under 197-11-340(2); the lead agency will not act on this proposal for 15 days from the date below. Comments must be submitted by Responsible Official Jeffrey S. Wilson Position/Title Current Planning Supervisor Phone 771-3202 Address 250 5th Ave. N., Edmonds WA 98020 Date 0%s�q( Signatur429= - X You may appeal this determination of nonsignificance to Hearing Examiner at 250 5th Ave. North, Edmonds, WA 98020 no later than 11/7/91 by filing a written appeal citing reasons. You should be prepared to make specific factual objections. Contact John Bissell to read or ask about the procedures for SEPA appeals. There is no agency appeal. CITY OF EDMONDS $trr�nrKa, ENVIRONMENTAL CHECKLIST C'O ` 1= 19911 A. BACKGROUND 1. Name of proposed project, if applicable: d ,t_ / 16/Y /a e V e- 2 . Name of applicant: Do 1174 Y, D /1 v A Al - .2 3. Address and phone number of applicant and contact person: %�v Vao/,A,ec /o y;z ~ n 5/ f�n,o.,Js 77S� S6�% '6U�4r %y%I / J $'//y 20 1 Ts SLd /rdl�i an �s �7 fr-OSi1'� 4. Date checklist prepared: 16 " 11 — 5. Agency requesting checklist: City of Edmonds. 6. Proposed timing or schedule (including phasing, if applicable): (STAFF COMMENTS) 7. Do you have any plans for future additions, expansion, or further activity related to or connected with this proposal? If yes, explain. /l/ a (STAFF COMMENTS) CHKLT/1 0-8-9 1. MASTER Page 1 of 26 12. Location of the proposal. Give sufficient information for a person to understand the precise location of your proposed project, including a street address, if any, and section, township, and range, if known. If a proposal would occur over a range of area, provide range or boundaries of the site(s). Provide legal description, site plan, vicinity map, and topographic map, if reasonably available. While you should submit any plans required by the agency, you are not required to duplicate maps or detailed plans submitted with any permit applications related to this checklist. LQ-t �) ( STAFF COMMENTS) L �-{ S M ►+m TO BE COMPLETED BY APPLICANT B. ENVIRONMENTAL ELEMENTS 1. Earth a. General description of the site (circle one): Fla rolling, hilly, steep slopes, mountainous, other: (STAFF COMMENTS) b. What is the steepest slope on the site (approximate percent slope)? (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 3 of 26 g. About what percent of the site will be covered with impervious surfaces after project construction (for example, asphalt or building )? /7 S Z S' -e '.".; (STAFF COMMENTS) h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: 2. AIR a. (STAFF COMMENTS) What types of emissions to the air would result from the proposal (i.e., dust, automobile, odors, industrial wood smoke) during construction and when the project is completed? If any, generally describe and give approximate quantities if known. (STAFF COMMENTS) b. Are there any off -site sources of emissions or odor that may effect your proposal? If so, generally describe. (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 5 of 26 J (STAFF COMMENTS) (4) Will the proposal require surface water withdrawals or diversions. Give general description, purpose, and approximate quantities if known. J/4� (STAFF COMMENTS) (5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan. (STAFF COMMENTS) (6) Does the proposal involve any discharges of waste materials to surface waters? If so, describe the type of waste and anticipated volume of discharge. (STAFF COMMENTS) b. Ground: (1) Will ground water be withdrawn, or will water be discharged to ground water? Give general description,. propose, and approximate quantities if known. O h& �t 7� w li .` c 4e7 a r v t CHKLT110-8-91.MASTER Page 7 of 26 d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any: /LSO /'• c (STAFF COMMENTS) 4. Plants a. Check or circle types of vegetation found on the site: deciduous tree: alder, maple, aspen, other: T e-,e f evergreen tree: fir, cedar, pine other: f/ shrubs grass pasture crop or grain wet soil plants: cattail, buttercup, bulrush, skunk cabbage, other: water plants: water lily, eelgrass, milfoil, other: other types of vegetation: tj/V c /C- S Ile (STAFF COMMENTS) b. What kind and amount/ of vegetation will be remove or altered? 00t /x S S w 02a r rc c✓! lt- i 3 %- CHKLT/10-8-91.MASTER Page 9 of 26 b. List any threatened or endangered species known to be on or near the site. Al 0 y e- (STAFF COMMENTS) C. Is the site part of a migration route? If so, explain. D (STAFF COMMENTS) d. Proposed measures to preserve or enhance wildlife, if any: A/v Ne (STAFF COMMENTS) 6. Energy and Natural Resources a. What kinds of energy (electric, natural gas, oil, wood stove, solar) will be used to meet the completed project's energy needs? Describe whether it will be used for heating, manufacturing, etc. fi' / Z S e /9 /0s2 N (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 11 of 26 (2) Proposed measures to reduce or control environmental health hazards, if any: (STAFF COMMENTS) b. Noise (1) What types of noise exist in the area which may affect your project (for example: traffic, equipment, operation, other) ? (STAFF COMMENTS) (2) What types and levels of noise would be created by or associated with the project on a short-term or a long-term basis (for example: traffic, construction, operation, other)? Indicate what hours noise would come from the site. AlOle MAL 60'n f1i2NC7/bh /5brr0; /i of (STAFF COMMENTS) (3) Proposed measures to reduce or control noise impacts, if any: 'C (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 13 of 26 (STAFF COMMENTS) f. What is the current comprehensive plan designation of the site? /?e Jr, de (STAFF COMMENTS) g. If applicable, what is the current shoreline master plan designation of the site? (STAFF COMMENTS) h. Has any part of the site been classified as an "environmentally sensitive" area? If so, specify. -Z/ 0 ( STAFF COMMENTS) C/ Tz�;- jS GGd,��r �i1�+7� GG 1,�1r�COc�.�+ts7lrJllu/ ��IJStTI(J\�' Tp i. Approximately how many people would reside or work in the completed project? e s i C/�P r (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 15 of 26 b. Approximately how many units, if any would be eliminated? Indicate whether high, middle, or low-income housing. (STAFF COMMENTS) C. Proposed measures to reduce or control housing impacts, if any: (STAFF COMMENTS) 10. Aesthetics a. What is the tallest height of any proposed structure(s), not including antennas; what is the principle exterior building material(s) proposed? � S ` vt A, L (STAFF COMMENTS) b. What views in the immediate vicinity would be altered or obstructed? yvy4z- (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 17 of 26 d. Proposed measures to reduce or control light and glare impacts, if any: (STAFF COMMENTS) 12. Recreation a. What designated and informal recreational opportunities are in the immediate vicinity? (STAFF COMMENTS) b. Would the proposed project displace any existing recreation uses? If so, describe. v %l/ (a - (STAFF COMMENTS) C. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant,, if any: (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 19 of 26 b. Is site currently served by public transit? If no, what is the approximate distance to the nearest transit stop? (� e S (STAFF COMMENTS) c. How many parking spaces would the completed project have? How many would the project eliminate? (STAFF COMMENTS) d. Will the proposal require any new roads or street, or improvements to existing roads or streets, not including driveways? If so, generally describe (indicate whether public or private). o (STAFF COMMENTS) e. Will the project use (or occur in the immediate vicinity of) water, rail, or air transportation? If so, generally describe. (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 21 of 26 16. Utilities a. Circle utilities currently available at t site: electricit natural gas, water Tefuse servi telephon ry sew septic system, other: (STAFF COMMENTS) b. Describe the utilities that are proposed for the project, the utility providing the service, and the general construction activities on the site or in the immediate vicinity which might be needed. le 67 if (STAFF COMMENTS) C. SIGNATURE The above answers are true and complete to the best of my knowledge. I understand that the lead agency is relying on them to make its decision. �v-//- Date Submitted CHKLT/10-8-91 WASTER Page 23 of 26 The City of Edmonds APPLICATION for SIDE SEWER PERMIT ASEMENT No ..................... NEW CONSTRUCTION ❑ REPAIRS ❑ 3a) Samuel Drobner Self OWNER............................................................................................................. CONTRACTOR................................................................... PERMIT No..._e�.?��.`�iS� ADDRESS 1043 MBin....arti'eet...................................................... LEGAL DESCRIPTION: LOT No...............................................StBLOCK No........40 City of Edmonds oNAME OF ADDITION ...................... .................................................................................................................... J I� l I. N I � w j Approved: J4 DATE.,(./..�..��...V�...�............... By....... ...... T-1 ....................... a, CITY OF EDMONDS CIVIC CENTER— WATER -SEWER DEPARTMENT Call PRospect 6-1107 when work Is ready for Inspection. (No inspee- ; 1V SIDESEWER PERMIT Lions Saturday, Sunday or holldays.) 11��0 2525 ADDRESS.............10 43---Main-- Street owNER Samuel_-Drobner-------•---------------------------------------- CONTRACTOR Owner Permission is granted ...November 8 , Ig 67 for ________________________ days to REPAIR or CONNECT a side sewer with City Sewers in accordance with application on file and governing ordinances. ATTENTION IS CALLED TO THE FOLLOWING: NOTE No, 1—The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct side sewer in street area. Do not cover any portion of sewer before It has been insp ected. NOTE No. 2—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit. NOTE No. 3—Top of side sewer must have at least 30 inches cove No bends in grade sharper than % will be rage at property line and 12 inches inside property line; minimum grade of 2q,. permitted. NOTE No. 4—Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper work which may develop within one year of completion. NOTE No. 5—It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the main sewer or its appur- tenances except to insert the pipe into the wye. • i L S7(7 Ef T, =� CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS PO A07X 5, PR a h.✓e •2 Z MAILING ADDRE Z CITY ZIP TELEPHONE NUMBER vz u 77 $- J 416 NAME qAF%i N S.P,ry fco s ADDRESS CITY ZIP TELEPHONE NUMBER 77 Faso NAME go /tiI •S- cc °ADDRESS r ts//y CIxT ZIP TELEPHONE NUMBER o r.),.on�r 95 6 77�-097 O STATE LICENSE NUMBER b I-r aO /10 It Le aD-escription of Property - include all easements d/ y.2 S 6 -2 7 �7r� �/ W 0 a S o�ow►i ,,•,�'o�hT w J Tax Account Parcel No. NEW RESIDENTIAL PLUMBING ADDIALTER COMMERCIAL El MECHANICAL REPAIR a APT. BLDG. SIGN DEMOLISH GRADING CYOS. ❑ FENCE x_FT) CARPORT swim REMODEL GARAGE POOL. WOOD STOVE/ INSERT ROCKERY RETAINING WALL/ OCKERY❑ RENEWAL Z (TYPE F USE, BUSINESS OR ACTIVITY) EXPLAIN: Q ��r � e w NUMBER OF ST IES NUMBER OF„�, o O�O DWELLING m0 l� UNITS DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) SP— 0VA&AS USE ZONE PERMIT S— NUIIABER JOB ADDRESS hLI A11A : l G_T _EGAL DESCRIPTION CHECKI SUBDIVISIbt4 NO. LID NO PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved ❑ RW Permit Required ❑ EXISTING REQUIRED DEDICATION Street Use Permit Req'd O PROPOSED Inspection Required ❑ Sidewalk Required ❑ REMARKS ENGINEERING MEMO DATED METER SIZE REMARKS nt�I E NO. OF FIXTURES SIGN AREA 4 SEPA REVIEW ADB NO. ALLOWED PROPOSED COMPLETE EXEMPT SHORELINE p EXP VARIANCE OR CU *,�LANNING REVIEW BY /' ,/DATE SETBACKS — FEET HEIGHT LOT COVEf�AG FRONT Z O SIDES REAR �S /S 3S r CHECKED BY TYPE.OF CONSTRUCTION CODE HEIGHT .'r SPECIAL INSPECTOR REQUIRED AREA 1625 OCCUPANCY 1 GROUP /r/ OCCUPANT LOAD YES REMARKS PROGRESS INSPECTIONS PER UBC 305 6t/xim-9 AR NAL INSPECTION REQUIRED VALUATION rn' �0 ��• AwP,E aD a�W PLAN CHECK FEE BUILDING , PLUMBING // Plan Check No. (7w MECHANICAL This Permit covers work to be done on private property ONLY. GRADING/FILL Any construction on the public domain (curbs, sidewalks, STATE SURCHARGE driveways, marquees, etc.) will require separate permission. Permit Application: 180 Days Permit Limit: 1 Year - Provided Work is Started Within 180 Days STORM DRAINAGE FEE "Applicant, on behalf of his or her spouse, heirs, ssigns and ENG. INSPECTION FEE successors in interest, agrees to indemnify, defer►d and hold W harmless the City of Edmonds, Washingtd'pits officials, m employees, and agents from any and all ciaims'•fordamages of E whatever nature, arising directly or indirectly from the issuance of this permit. Issuance of this perrhit shall not be deemed to PLAN CHECK DEPOSIT omodify, waive or reduce any requirement of any city ordinance TOTAL AMOUNT DUE = nor limit in any way the City's ability to enforce any ordinance provision." I hereby acknowledge that I have read this application; that the information given is correct; and that I am the owner, or the duly ATTENTION 'authorized agent of the owner. I agree to comply with city and state laws regulating construction; and in doing the work authoriz• THIS PERMIT AUTHORIZES ed thereby, no person will be employed in violation of the Labor ONLY THE Code of the State of Washington relating to Workmen's Compensa• WORK NOTED tion Insufance. INSPECTION DEPARTMENT SIGNATURE (OWNER OR AGENT) DATE SIGNED CITY OF ATTENTION i IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC CHAPTER 3. t02W :,, �.: ram ......:...... .. .. . EDMONDS CALL FOR INSPECTION 771-3202 S L4 /?f "APPLICATIO APPROVAL This application is �ffjcjaj apermituntilsigned by theBuildinor his/her Deputy; and fees are paid, and receipt is acknowledged in space provided. OFFI�%I L'S SIGNAT RE ORIGINAL — File YELLOW — Inspector PINK — Owner GOLD — Assessor p to Z Z Z 5 a t7 Z 0