910405.pdfCITY OF EDMONDS
USE
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PERMIT
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CONSTRUCTION PERMIT APPLICATION
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.OWNER NAE%NAME OF BUSINESS
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ADDRESS
15925 7 5TH PLC •
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RICHARD HANKINSON
LEGAL DESCRIPTION CHECK SUBDIVISION NO
LID NO
MAILING ADDRESS
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15925 75TH PLC • W.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP, TESCP Approved
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CITY ZIP TELEPHONE NUM BER
EXISTING
REQUIRED DEDICATION
RW Perrell Required
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EDMONDS 980201 7 4 3 -1 8 3 4
Street Us Permit Req'd
lo,pedtion Required
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NAME
PROPOSED
Sidewalk Required
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ZIP TELEPHONE NUMBER
NAME
RELIABLE SHEET METAL/DBA
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ENGINEERING MEMO DATED REVIEW BY
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ADDRESS
3810 19 6 th St • S.W. 48 METER SIZE BUILDING SUPPLY SIZE 71XTURES,
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CITY ZIP TELEPHONE NUMBER w
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LYNNWOOD 98036 670-1256 REMARKS 3
STATE LICENSE NUMBER
ARCOIL* 1 41 LE SIGN AREA SEPA REVIEW ADB NO,
ALLOWED PROPOSED COMPLETE EXEMPT
Legal Description of Property -include all easements ;
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VARIANCE OR CU PLANNING REVIEW BY DATE
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SETBACKS —FEET I HEIGHT LOT COVERAGE _
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Tax Account Parcel No. REMARKS a
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NEW RESIDENTIAL PLUMBING
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ADD/ALTER COMMERCIAL MECHANICAL
APT. BLDG. LJ SIGN
REPAIR
GRADING FENCE CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT
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DEMOLISH CYGS (_x_FT) EC 60
CARPORTSPEG70R AREA OCCUPANCV OOCADUPANT
FI swim SPECIAL
GROUP
REMODEL GARAGE pOOL, REQUIRED
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WOOD STOVE/ r7 RETAINING WALL/
RENEWAL REMARKS O
INSERT ROCKERY
PROGRESS INSPECTIONS PER UBC 305
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(TYPE OFUSE, BUSINESS oRACTIVITY) EXPLAIN:
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NUMBER OF STORIES NUMBER OF
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DWELLING
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UNITS
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DESCRIBE WORK TO BEGONE (ATTACH PLOT PLAN)
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INSTALL GAS FURNACE AND HOW WATER FINAL INSPECTION REQUIRED
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HEATER (80,000 BTU - FURN .) VALUATION
PLAN CHECK FEE
60 FT. GAS PIPING
BUILDING
IN 134SEMEWr PLUMBING HWT
IF
Plan Check No• MECHANICAL FURN
This Permit covers work to be done on private property ONLY. GRADINGIFILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission. STATE SURCHARGE
Permit Application: 180 Days STORM DRAINAGE FEE
Permit Limit:1 Year- Provided Work Is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE
successors in interest, agrees to indemnify, defend and hold
a harmless the City of Edmonds, Washington, its officials,3.00
PIPING-1-4 OUT S
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employees, and agents from any and all claims for damages of
`x whatever nature, arising directly or indirectly from the issuance PLAN CHECK DEPOSIT
Issuance of this permit shall not be deemed to
0 of this permit.
modify, waive or reduce any requirement of any city ordinance
i nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE $35. 00
provision."
I hereby acknowledge that I have read this application; that the ATTENTION APPLICATION APPROVAL
information given is correct; and that I am the owner, or the duly
authorized agent of the owner. I agree to comply with city and THIS PERMIT This application is not a permit until
state laws regulating construction; and in doing the work authoriz- AUTHORIZES
THE signed by the Building Official or his/her
ed thereby, no person will be employed in violation of the Labor ONLY
WORK NOTED Deputy; and fees are paid, and receipt is
Code of the State of Washington relating t0 Workmen's Gompensa-
acknowledged in space provided.
tioInsurance. INSPECTION
SIGNATURE IOWNER OR AGENT) DATE SIGNED DEPARTMENT OFFI IA.15'NATURED TEram/
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�.ZI-q(DITY MONODS J("177CALL
FORRELEAY: DATE
ATTENTION INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE 771'320Z
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
PINK — Owner GOLD — Assessor
CHAPTER 3.
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