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910916.pdf. - us E PERMIT CITY OF EDMONDS ZONE NUMBER CONSTRUCTION PERMIT APPLICATION JOB 1 // l� / ,,sUITF/APTk ADDRESS 7t ® t T(,,.,,f ✓: VVb OWNER NAME/NAME OF BUSINESS e l �V /n fA-T-rLEGAL DESCRIPTION CHECK IO SUBDIVISN NO. LIO NO w MAILING ADDRESS Zvi© t?5 G. 5 w Z PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved ❑ f ZIP TELEPHONE NUMBER RW Permit Reon-d ❑ CITY rr....yy EXISTING REQUIRED DEDICATION _ Steal Use Permit Req'd ❑ � Inspection Required ❑ PROPOSED Sidewalk Required ❑ CT Z NAME REMARKS w z w ADDRESS Z x CITY ZIP TELEPHONE NUMBER NAME t• ENGINEERING MEMO DATED REVIEW BY I. ADDRESS ,ems' ' 60 O 2 10 �Q� 1 T� ' 0 METER SIZE BUILDING SUPPLY S12E NO.OF FIXTURES CITY 4 J+ t vA] S�ZIP C/ TELEPHONE NUMBER F &LL—,'' V V L 4 J b < REMARKS 3 O STATE LICENSE NUMBER I..'. ' C6& J 2,44 IC SIGN AREA SEPA REVIEW ADB N. YV r " ALLOWED PROPOSED COMPLETE EXEMPT Legal Description of Property - include all easements SHORELINE« ,I o EXP n VARIANCE OR CU PLANNING REVIEW BY DATE N o SETBACKS -FEET HEIGHT LOT COVERAGE ? z a z � FRONT SIDE REAR g Tax Account Parcel No. REMARKS ElNEW RESIDENTIAL D PLUMBING ADD/ALTER El COMMERCIAL L��3Jjj MECHANICAL ElREPAIR APT. BLDG. LJ SIGN ❑ FENCE CHECKED BY TYPE OF CONSTRU GRADING CTION CODE HEIGHT DEMOLISH GrOS. REMODEL GARAGE swim SPECIAL POOL, REQUIRED INSPECTOR REA OCCUPANCY OCCUPANT GROUP LOAD ❑ YES ❑ WOOD STOVE! RETAINING WALL/ RENEWAL REMARKS O INSERT ROCKERY Z (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: PROGRESS INSPECTIONS PER USC 305 o m NUMBER OFRIES NUMBER OF o DWELLING asUNITS DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) �yV\Q �t t✓L�G► f �- FINAL INSPECTION REQUIRED { yam`_ VALUATION FEE PLAN CHECK FEE 1r H BUILDING s. ' r1`,-A— r 6;, _ PLUMBING Plan Check No. &66.e7� MECHANICAL This Permit covers work to be done on private property ONLY. GRADINGIFILL j Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE Permit Application: 160 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 y a Successors in interest, agrees to indemnify, defend and hold w harmless the City Of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of swhatever nature, arising directly or indirectly from the Issuance PLAN CHECK DEPOSIT 0 of this permit. Issuance of this permit shall not be deemed to modify, waive or reduce any requirement of any city ordinance ° nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE 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- LITHOONLY IZETHE signed by the Building Official or his/her ...� 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. ,) ti n Insurance. INSPECTION SIG NA7VR (OWNER OR A E 1 DATE SIGNED DEPARTMENT OFFICIA -SIGNATURE DATE j Q j CITY D ,/. _j 1,! v[.v ( t l EDMONDS 'tJi� RELEASED BY DATE .� . CALL FOR I A TENTIOINSPECTION N UPY A BUILDING OR STRUCTURE 771_3202 ORIGINAL -File YELLOW - Inspect IT IS UNLAWFUL USE OR OCC UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR o A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED, USC PINK - Owner GOLD -Assessor CHAPTER 8. 102•B7 • f . RECORD OF INSPECTIONS D A ...INSPECTOR 'DATE APPROVED, .'':.. SETBACKS ... ........ FOUNDATION: Footing .............. .. . Wail.................... Pier/Porch Retaining Wall PLUMBING: .i Underground ....... , Rough -in ... CF ................ HEATING: Gas Test....... . Gas Piping..... .. Equipment.....: ...... .............. FRAMING .............. < SHEETROCK NAILING ... SPECIAL INSPECTION ... FINAL APPROVAL f� - FOR OCCUPANCY ....... . 1 T