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910856.pdfUSE PERMIT CITY OF EDMONDS ZONE NUMBER ' CONSTRUCTION PERMIT APPLICATION JOB �p Z� � ADDRESS � SUITE/APTN OWNER NAME/NAME OF BUSINESS I. LEGAL DESCRIPTION CHECK SUBDIVISION NO, LID NO. zMAILING IDDRESS �y�+Tf ) 6 �%{ `75 y l— [A/PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved ❑ ! Q RW Permil Required ❑ } /CITY q ZIP TE/L-/�EPHONE NUM(/By'ER jp EXISTING _--- REQUIRED DEDICATION Sir", "" Per", Req'd ❑ 6� rJ O2_© "��- - PROPOSED Inspection Required ❑ NAME Sidewalkk Required ❑ z j. REMARKS w f{ w ADDRESS O �. z x Q CITY ZIP TELEPHONE NUMBER NAME I ENGINEERING MEMO DATED REVIEW BY tG { 2 ADDPESS METER SIZE BUILDING SUPPLY SIZE NO. OF FIXTURES f a JJJ l.- ZIP TELEPHONE NUMBER w i r Q CI Y pp• �} q • z p j(/ O 7b 7 o Q REMARKS 3 O O STATE LICENSE pNUMBER �p C66�{l`��ll mSIGN AREA ' 15O®L9kfl M EPA REVIEW ADD NO. ff�opp ALLOWED PROPOSED COMPLETE IEXEMPT Legal Description of Property - include all easements SHORELINE n I . Z E%P O VARIANCE OR CU PLANNING REVIEW BY DATE U L7 o SETBACKS --:FEET HEIGHT LOT COVERAGE K z WFRONT SIDE REAR g J Tax Account Parcel NO. REMARKS NEW RESIDENTIAL PLUMBING ADDIALTER COMMERCIAL (y�jj MECHANICAL OREPAIR APT. BLDG. L) SIGN CYDS. FENCE CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT El DEMOLISH GRADING REMODEL CAR GARAGET swim SPECIAL POOL REQUIRED INSPECTOR AREA OCCUPANCY OCCUPANT GROUP LJ ' LOAD ❑YES r» WOOD STOVE RETAINING WALL/ RENEWAL REMARKS INSERT ROCKERY O (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: PROGRESS INSPECTIONS PER UBC 30S j m NUMBER OF STORIES NUMBER OF Wo DWELLING id UNITS DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) �S"t ii FINAL INSPECTION REQUIRED VALUATION FEE H PLAN CHECK FEE t BUILDING PLUMBING Plait Check No. MECHANICAL lob 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. srATEsuncHARGE Fermit 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 i. v, successors in interest, agrees to indemnify, defend and hold w harmless the City of Edmonds, Washington, its officials, j employees, and agents from any and all claims for damages of -i i pi whatever nature, arising directly or indirectly from the issuance PLAN CHECK DEPOSIT 11 of this permit. Issuance of this permit shall not be deemed to modify, waive or reduce any requirement of any city ordinance 'J�.► „;¢gyp ° nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE ,JL! � �'�"!I provision." I hereby acknowledge that I have read this application; that the ATTENTION APPLICATION APPROVAL I1 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 I State laws regulating construction; and in doing the work authoriz- LITHOO LY TIRES signed by the Building Official or histher ed thereby, no person will be employed in violation of the Labor WORK NOTED Deputy; and fees are paid, and receipt is { Code of the State of Washington relating to Workmen's Compensa- acknowledged in space provided. Lion lnsujance. INSPECTION SIGNATURE (OWNER OR AGENT) DATE SIGNED DEPARTMENT OFFI I '' SI r _ CITY OF O to `- EDMONDS CALL FOR RELEASE Y'. ATTE TION INSPECTION CCUPY A BUILDING OR STRUCTURE IT IS UNLAWFUL TO USE OR O 771-3202 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 J CHAPTER 3. roam X A 1 .. 21 a r 7 "- , RECORD OF INSPECTIONS,. INSPECTOR DATE APPROVED .,. SETBACKS .............. FOUNDATION: Footing ................ :Wall.. ... Pier/Porch ............. Retaining Wall.......... PLUMBING: }. Underground .......... Rough -In r CF i HEATING: Gas Test .............:. Gas Piping ..........::. Equipment ............. CF ..........r .......... FRAMING ............... , INSULATION ............ j •- SHEETROCK NAILING ... SPECIAL INSPECTION ..: FINAL APPROVAL�t FOR OCCUPANCY ... , rc:-- "— 910 I