970653.pdfI. !'FFl> ...
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USE PERMIT
CITY OF EDMONDS ZONE NUMBER
CONSTRUCTION PERMIT APPLICATION JOB S7ft
(`IV NEji NAME NAME OF BUSINESS ''-� ADDRESS L G
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A 41 INGAor"Fels
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ZIP TELEPHONE NUMBER
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ZIP TELEPHONE NUMBER
LICENSE NUMBER C•r
EXPIRATION DATE
C/
Parcel NO �IM
Rt / ) (/!Q L-IU"`-' :1
NEW RESIDENTIAL UMBINGECH
ADDITION ] COMPLIANCE OR
COMMERCIAL CHANGE OF USE
REMODEL APT BLDG. SIGN
❑ GRADING ❑ FENCE
REPAIR CY05 (—x_F
�DEMOLISN ❑ WOODSTOVE ❑ SWIM POOL
INSERT HOT TUB/SPA
u CARPORT ROCKERYG WALL/ ❑ RENEWAL
(TYPE OF USE. BUSINESkOR ACTIVITYi EXPLAIN:
NUMBER NUMBER OF CRITICAL
OF DWELLING AREAS
STORIES UNITS NUMBER
DESCRIBE /WORK TO BE;pp)NE (ATTACH PLOT PLANT /7
) 70 659
SUITE API +
Gt-
LEGAL DESCRIPTION CHECK
SUBDIVISION NO
LID NO
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING REOUIRED DEDICATION____
PROPOSED -- —
TESCP APPrgvotl ❑
RW Permq Regeec0 Cl
Streel Use Fee—negd ❑
InsPecoon RequlleU ❑
Sid...11, Ae 11ed ❑
METER SIZE
LINE SIZE
NO OF FIXTURES
PRV REOLIIFlED
YES ❑ NO ❑ 3
c
FlEMAIIKS -
ENGINEERING MEMO DATED REVIEWED BY
FIRE MEMO DATED REVIEWED BY
SIGN AREA -
ALLOWED I PROPOSED
SEPA REVIEW
COMPLETE JEIEIAIT
EXP
ADB NO.
SHORELINE,
VARIANCE OR CU
PLANNING REVIEW BY
DATE
SETBACKS -FEET
FRONT SIDE REAR
HEIGHT
LOT COVERAGE
REMARKS
CHECKED BY
TYPE OF CONSTRUCTION CODE
a
/N
OCCUPANT
GROUP
SPECIAL INSPECTOR
REOUIRED
O YES
AREA
OCCUPANT
LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC 108
FINAL INSPECTION REQUIRED
�"-� (i
PLAN CHECK FEE
y
U c<ZGU �'
HEATSOURCE
GLAZING
BUILDING
PLUMBING
heck No.
Plan Check
MECHANICAL
f
{-,
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
-
Any construction on the public domain (curbs, sidewalks,
'y
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
=3
Permit LImII: 1 Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENO. INSPECTION FEE
v, 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
.�
< whatever nature, arising directly or indirectly from the issuance
7 of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
S
`
8 modify, waive or reduce any requirement of any city ordinance
o 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 duty
authorized agent of the owner. I agree to comply with city and
TH15 PERMIT
This application is not a Permit until
state laws regulating construc ; an doing the work authoriz-
ed Thereby, no person will a amp iolation of the Labor
AUTHORIZES
ONLY THE
signed by the ButOfficial or his/her
Code of the Slate of Wa Ington ati o orkmen's Compensa•
woRK NOTED
Deputy; and fees are paid, and receipt is
lion Insurance and RC 1E
INSPECTION
acknowledged in space provided.
TURE ,OWNER OR ENTI DATE SIGNED
EPARTMENT
CITY OF
D;j
OFFICIAL'S SIGNATURE DATE
LA
EDM0NDS
ATTENTION
CALL FOR
INSPECTION
BE 5 D BY ` DATE
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771 aOwwo
"' LL
ORIGINAL Flle YELLOW- Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED, UBC
A j
SECTION 109
10287
PINK - Owner GOLD - Assessor I{A
1. e
2XII
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.CITY OF EDMONDS
BARBARA FAHEY
121 STH AVENUE NORTH • EDMONDS. WA 9e020 • (425) 771-0220 • FAX (425) 771.0221 MAYOR
COMMUNITY SERVICES DEPARTMENT
I
A 0 Public Works • Planning/Building • Parks and Recreation • Engineering • Wastewater Treatment Plant
nc.18
August 28, 1998
Norman Nelson
15729 75`s PI W
Edmonds, WA 98026
Re: Permit #970653
According to Building Division records, your contractor failed to call the City Inspector for
the required inspection on your plumbing and/or mechanical permit. Plumbing and
Mechanical permits are valid for 180 days from the date of issuance. We understand you
may not be aware that the City requires an inspection. This inspection is required per the
Uniform Building Code to assure minimum life safety requirements have been met on the
permitted work.
If the job was canceled, please mail/fax a note to us and we will close out your file
immediately. We have already sent a written notice to your contractor reminding them of
the required inspection with no response. Unfortunately, it is the homeowners'
responsibility to make sure the inspection is completed prior to the permit expiration date.
Please call for the required inspection within the next 15 days (425-771-0220 x333). Please
note, the City's recourse in forcing compliance is the civil penalty ordinance which is used
as a last resort to gain code compliance.
(If our records are incorrect, please contact the Building Inspector to close your file)
O Than you for your cooperation,
Lara Knaak
Permit Coordinator
® cc: Building Official
EXPMECH.DOC
• Incorporated August 1I, 1890 •
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