1011 VISTA WAY.PDF11111111111111
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1011 VISTA WAY
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DEPAR'I1!�TT CHEST
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R BUILDING- PERMIT REVIEW
\/►ST.�.��.y Address
Street Right -of -Way Existing REQD —
Access Easements Existing REQD —
Utility Easenent.Existing REQD
Lot per Subdivision Plat\ )tkTUn,tr-1j�A�ssessor Map,
Site Plan Checked for Accuracy
Underground Wiring Reqd.
Check Accuracy of Legal Description�co7
Environmentally Sensitive Area
Envirorunental Checklist Reqd.
Flood Hazard Zone
Shoreline Management Area
..Slope, Soil, Vegetation
Stream, Creek, Drainage Basin
Existing Zoning Per Code
Amenities Design Board Approval Reqd. ADB # Approval
Board of Adjustment Approval Reqd.
WA= .
-� lm
Existing Water Main Size
Water Main Reqd.
Service Line Reqd.
Hydrant Size Existing
Hydrant Reqd. Per Fire Code
Detector Check Meter Reqd.
Cross Connection Inspection
Fire Department Comments
Water Meter Charge Reqd.
Review by:
Septic Tank Permit Reqd.
Sanitary Sewer Availability
Drawing No.
Side Sewer Availability
Sanitary Sewer Connection Fee Read.
Review By:. Date.:
Date:
Size
Permit No.
Proj
File No.
Open Ditch Existing Reqd.
F Culvert Reqd. Size
c4 Catch Basin Reqd. Indicate on'Site°Plan
o. Shoulder drainage ni<iintain collection at- swale open runoff
H
v' .LUiole regd. Indicate on Site Plan
Soil Conditions and Ground Water Field Checked_
ke."riew by Date
Street.Paving Reqd.
H
Curb and Gutter Reqd.
w Sidewalk Reqd:'
w Curb Cut for Drive�Tay Reqd.
P� Right -of -Way Construction Permit Reqd.
H Bond Reqd. for Public Improvements
Street Name Sign Reqd.
Other Signing Reqd.
Q . Pre Perniit Site Inspection made on lr�l�i
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BY: SE ER
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STREET
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ENGINTEERING
Special Requireiiients listed in memo to ComTunity Developinent. Deparumnt,
Building Division
BY Date
o All itens filled in on Building Permit- Application
f4 BY Date
a' Drawings Stamped and Notations Ntide
w BY Date
Approved by Public 1%7orks Department
evi_sed: Iv 10-1977
.N
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CITY OF EDMONDS
v
PUBLIC ORKS DEPARTMENT, ENGINEER * DIVISION
APPLICATION FOR RIGHT-OF-1'IAy COrJSTRUCTION PERMIT
THIS PERMIT MUST BE AVAILABLE AT THE JOB SITE FOR INSPECTION PURPOSES
Applicant to Complete Parts A and B
A, Permit.to be issued to:
For Work at :(address or vicinity), l
Type of Work to be done: ll/ &,le, pipp- b � S►� � � AA41AI
(attach drawing when applicable)
UPI D ► t—k E'EK. D t2Arau Ally -OAF
Time Required -- Start: &441(, 1Q]� Finish:_ ,1, 137g
T
Owner: Mg,
Name
Mailing
edAAd�drness A
K�GLI t�� 1D A ,
City State Zip
Contractor:
Name
Mailing Address
(<,.« mn,)6JA '
City State Zip
TT FILE
Telephone Number
State License Number
Telephone Number
B. INDEMNITY: Applicant understands and by his signature to this application, agrees
to hold the City of Edmonds harmless from any injuries, damages, or claims of any
kind or description whatsoever, foreseen or unforeseen, that may be made against
the applicant or the City of Edmonds, or any of its departments or employees,
including or not limited to the defense of any legal proceedings including defense
costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and
materials for a period of one year following the final inspection and acceptance
of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until
the final street patch is completed, at which time a debit or credit will be
processed for issuance to the applicant.
Work is subject to inspection and restoration in accordance with City Code. A
24-hour notice is required for inspection by Engineering. Call 775-2525, ext. 220.
I understand that this perJwn6r
st be availabl at the job site for inspection
purposes at all times.
Signature: Date:-`�Zf,
or Agent f
TO BE COMPLETED BY ISSUING AGENCY:
Date Issued: -?J (":et Permit NoFee:
Security Bond:
Time Authorized:
APPROVED B
10-771v (Revised)
Date A At I
-�/�����
C o'i/ ue---!/l
sY.Q.M.YVOQAS DATE)_-j''W6, SUBJECT ........
PLOT
^PL-1A.(.T .....-P.L�.A- __-_.__-_--_p--__.. SHEET NO..--�.... _^OF .-J .._ ..
' CHKD. BY_-•----_-- DATE------------.- ._._LOT --- 5... _-.Y AT-ERV�_E-7Y-_17C-DR JOB NO.__�.1_14�_............
-------------------------------------------------- ---FDhAO-tJ•t?-5-t_.WA!5+k].4, gT.O.N----- ---------....------------
toll - VisrA WAY
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CITY OF EDMONDS —
ENGINEERING DEPARTMEO
APPLICATION FOR RIGHT-OF-'%Y CONSTRU T
c I at4 P mmTT FILE
(A:7rlicznt to Cc.-.-,)Zete A & 7- cv:d SuCm.,t in DuDZ--'ccte)
A.
Permit to be issued to:
For work at: (address or vicinity)
Type of work to be done: /6Z�-`-��.>>';�
(Attach Drawing ?.-hen Ap plicable)
A�-► n��2
Time Required Start: � e
— ',/ Finish: -'-; , )-
Owner: 'J1-1�-C.1127 ,/,LA r,9 .S
Name
Mailing Address
City State Telephone Number
Contractor:
Name State License 'Number
Mailing Address
City State Telephone Number
INDEHNITY: Applicant understands and by his signature to this application, agrees
to hold the City of Edmonds harmless from any injuries, damages or claims of any
kind or description whatsoever, foreseen or unforeseen, that may be made against
the applicant or the City of Edmonds, or any of its departments or employees,
including but not limited to the defense of any legal proceedings including defense
costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and
materials for a period of one year following the final inspection and acceptance
of the restoration by the Engineering Department.
'Work subject to inspection and restoration in accordance, with City Code. A
24-hour notice is required for inspection by the Engineering Department.
Call 775-2525.
Signature: ' --_»_<
/.,Oi;her or Agent Date Signed
C,
DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
p r\ p,
Permit Issued (Date)-uL'In -1�2 Permit Number-7.1 jf3o
Fee: q160 Bond:
Time Authorized:
Subject
to inspection and restoratton. -All work to be til accurd
with
Ord. No. 1394-A. A 24-hour notice is re ed for inspecti(
For
inspection call 775-2525,
JNE
ext.
220.
�h 40'A
ELI�
'DATE
nce
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STREET FILE
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3- 3/- 77
CITY of EDMONDS --- PUBLIC WORKS DEPARTMENT
Routing of Building Permit Applications
Proposed Property Address of Application: 1011 Vista Way
DEPARTMENT
COMMENTS
DATE
WATER
z
%
STREET
SEWS R.
19
N O T E S 11'�- —.76
BUILDING
DEPARTMENT COMMENTS
��.-ill ^=CEIVED
BUILDING DEPARTMENT
Applicant Fill
USE PERMIT
ZONE NUMBER OCT 20 19
ZO'
PERMIT APPLICATION
Inside Heavy Lines
JOB
I
ADDRESS % PubliCWorks .
%
C�i
NAME (OR NAME OF BUSINESS)
VARIANCE_ OR COND. USE NO.
ADB NO.
HEIGHT
,
ly
MAILING ADDRESS �(
r7 ^� �yyy, -�D CZ
PROPOSED YARDS
LOT COVERAGE
;
CITY
TELEPHONE NUMBER
FRONT SIDE REAR
'.
L
.. ` �
(�
SIGN AREA
PROPOSED
REVIEW
z
2
\
ALLOWED
JL
❑ COMPLETE ❑ EXEMPT
Z
NAME
2
-
^
,REMARKS-
U
_
a
W
ADDRESS
F
PLANNING DEPT. APPROVAL - DATE
U
C
CITY
TELEPHONE NUMBER
Q
LEGAL LOT
LOT. AREA
NO.
❑YES ❑ NO
]SUBDIVISION
NAME
S W-V.�_
STREET R/W
R/W FT. DEFICIENCY THIS PROPERTY
C
EXISTING STREET
0
ADDRESS
COMP„PLAN ST. R/W FT, FT.
F
U
a
'REMARKS -
m
CITY
TELEPHONE NUMBER
H
2
0
U
STATE LICENSE NUMBER
CITY LICENSE NUMBER.
_
CHECKED BY
l7
2.
- �.s -7'
it
I♦j
Legal Description of Property Below
or Attach Four Copies)
STREET AND/OR, UTILITY WORK
R/W PERMIT. REQUIRED
W
Z
,(Show
-
REQ'D. ❑ YES ❑ NO
❑ YES ❑ NO
UNDERGROUND
yl
2
-
WIRING REQ'D. ❑ YES ❑ NO
0
•
0
LM
_ I
TYPE CONNECTION ❑ YES
VERIFIED BY
a
SANITARY SEWER ❑ NO
In
SEPTIC SYSTEM Q YES
PERMIT•NUMBER
W
APPVD BY CITY ENG.
❑ NO
,
.J
Q
REMARKS'
U
J
'
METE7 SIZE
SERVICE SIZE CLEARANCE
CHECKED BY
W
J
REMARKS'
Q
3
NEW
RESIDENTIAL '.
EIGAS.
LINE
FIRE ZONE
TYPE OF CONSTRUCTION.CODE
SIGN
NON-RESIDENTIAL11:1
❑
,
❑ ADD ,
DEMOLISH
RETAINfNG
EI
SPECIAL INSPECTOR
REQUIRED
OCCUPANCY
GROUP*
OCCUPANT
LOAD
.
EXCAVATE V'ATE
❑ ALTER ❑ OR FILL
WALL _
FENCE
1 X FT)
El
JAREA
❑ YES- ❑ NO
F'
W
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
❑OF
REPAIR 'PRE -MOVE
SWIM
EDMONDS. LOCAL SALES TAX
0
t,
INSP..
❑ POOL
$HO LD BE CODED
2
,REMARKS
NUMBER OF STORIES
NUMBER OF
0
DWELLING'
,
�-�
UNITS
NATURE OF WORK TO BE DONE
VALUATION
FEE
2
PROPOSED USE
PLAN CHECK
O
NO.
d
PLOT PLAN INDICATE BUILDING SETBACKS,
ABUTTING STREETS)
BUILDING
U
W
1��IL�
1 '
..
PLUMBING
.
0
III
0
HEAT & GAS LINE
\,
.FENCE
—
SIGN
C
^+� T
RETAINING WALL
_
' ���
SWIMMING POOL
'
CITY of EDMONDS --- PUBLIC ,WORKS DEPARTMENT
Routing -of Building Permit Applications
Proposed Property Address of Application: 1011 Vista Way
DEPARTMENT.
COMMENTS
DATE
—
W A T E R
-
dam"
a
S T .R E E T
S E W E R
�i"
E�
B01LDI"NG DEPARTMENT Applicant Fill
. PERMIT
USE �l� •,•��
ZONE �� -. ! r\ r NUMBER 1
1
+ Inside Heavy Lines
APPLICATION
JOB
-.PERMIT
ADDRESS
.. •,!�^y.r �;7 r •- r
NAME (OR NAME OF BUSINESS)
,q }
VARIANCE OR•COND. USE NO.
ADB NO.'
J
HEIGHT
-
E
W
Z
MAILING ADDRESS
�, ���
PROPOSED YARDS -�f�*�
!
LOT ,►rC.1/O VERAGE/'Te
ff
•' ! FRONT ' SIDE :" REAR
CITY
TELEPHONE NUMBER
•1
Y� }..��„•� /)\ I,^••.
-' '�' `� l� (
SIGN AREA
ALLOWED PROPOSED
ENVIRONMENTAL REVIEW
❑.COMPLETEXEMPT
'
NAME
REMARKS /► )/
4v. + .. _1'
W
F
Z
,
ADDRESS
PLANNING DEPT.'APPROVAL
✓! f tt I �l�
nyy�f \ N
T�h!•� 1
l +�'�'(.... �•..---'•
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0:
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CITY
TELEPHONE NUMBER ,
LEGAL LOT
LOT AREA
SUBDIVISION NO. "
RYES El NO
//7i 1/ t./ ?^'
NAME �
l
STREET R/W
;_- A.,,, U
EXIST-ING STREET R/W FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W "�. FT-. OFT.
CC
0
ADDRESS -
f
u •
Q TELEPHONE NUMBER
E CITY
F
Z
0
U STATE LICENSE NUMBER ICITY LICENSE NUMBER
N01
i? • J
al Description of Property .(
ow or Attach Four
NEW
®
DENTIAL
RESIDENTIAL
a GAS
LINE
�
❑
NON-RESIDENTIAL
SIGN
Fl ADD
❑
DEMOLISH
RETAINING
❑ WALL
❑ ALTER
❑
ORCFILLTE
❑ I ENCE-X—FT)
❑ REPAIR
1 I
NSP.
wim
❑ POOL
NUMBER OF STORIES-!
NUMBER OF
DWELLING
UNITS
NATURE OP. .WORK TO BE DONE'.
OSED'USE •'.
PLAN INDICATE BUILDING SETBAC
ABUTTING STREETS)
REMARKS
s'1or:?s n9:4# not to exceed tP?;
,
• CHECKED Y
olz_ Ki
STREET AND/OR UTILITY WOR K R/W PERMIT REQUIRED
R EQ'D.. ❑ YES FJ NO ❑ YES &NO
UNDERGROUND ,
WIRING REQ'D. •9 YES-i ❑'NO
TYPE CONNECTION YES VERIFIED BY
SANITARY SEWER ❑ NO
SEPTIC SYSTEM ❑ YES� PERMIT
}NUMBER
APPVD BY CITY ENG.
a NO
REMARKS
METER SIZE SERVICE SIZE ]CLEARANCE CHECKED BY
REMARKS
ry
FIRE ^ZONE_ .TYPE OF CONSTRUCf'ION CODE
SPECIAL INSPECTOg- AREA OCCUPANCY OCCUPANT
REQUIRED GROUP _ LOAD
El YES ❑'•NO'.
PLAN"•cHEC KED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE DE
R19MARK
VALUATION
FEE
PLAN CHECK
NO.
O�
KS.
BUILDING
'
PLUMBING
HEAT & GAS, LINE
0�
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
.
r1ovember 1 , 1976
.STRELY
PILE
HEHO TO: HARRY 11IIITCUTT
B11ILDIIIG OFFICIAL
FROM: LEIF R.• LARSOld "
CITY. ENGINEER
SUBJECT: BUILDING. PERMIT APPLICATIntj FOR WOODHAVEN "(PUANE r' . _ POODS)
AT 1011 VISTA WAY
1) Coordination of location of building with utilities is the responsi-
bility.of the contractor.
2) Connection to sanitary sevier required.
3) Lot. .drainage to he contained on site or directed -to Ci ty. storm.
syste.
4) Driveway slopes not to exceed 14 percent.
1•IJN:RIIA:mj .
�J/j� PERMIT/10[1RFSS: ( a 6 �t 4Y
Date 11 . JL(J • LECAL. DESCfIhTln
MASON/ MW
BUILDING PERMIT REVI.EH -_ BrIrlEEP,IPIG DEPARTMENT' CiIECK LIST
Instruction:
Check Accuracy of I.enal Description
Check Ana.inst Assessor's Map for Lenal Subdivision
Does it conform to City Approved Suhdivisinn?.
i
Rev ie0er's
lnitia. s
1.. This lot included in.'Suhdivision/flat No.: Vy Arw.%j tew mA NaL
2. Site Inspection made on:
3. 1211are oro nd 'r•ratrr a d soil 1 conditions? 5�PI }J[�
Aiar
4. Site Drainane Cherked?
5. Storm Sevier Avai 1 alii 1 i tv:_ Sht..r of. f'vrg, rlo*4WjN ,ject
Roadside Ditch �y
6. Trading s, Final Contours:
7. Septic Tank System Desion Approved:
8. Sani tare Sevre.r.livai Lahi 1 itv Sht L of r.�/p. rloPro,ject PLAT
Side sewer availability: _(r,
9. Sanitary Sevier Connection Fees?
10: !later ruins A Fire 11vdrants (Indicate Size Plain)A
Check Fire Dept.'s Comments
11. Sidevralks: (Site inspection shovrs,conditions of sidewalks as fo11ovrs)
12. Curbs:_ __ CurhL�Cuuts,/Drivew s (Ch�ecKdri-veways for safety, location,
grade and
13. linder.ground Iairiiin:^� Street Lights:
14. Street Right-of-way A I,ldg, setbacl:s:� jnj 3 Sht._ Of nffici'al Street'Map.
15. Existing.01i}.ity Ease'rients?_ 10 ► l Y—QUM
1G. Access Fasements:
17.
Site Plan checked for 'accuracy?
_ ��.� 1-7 +
18.
Special Requirements listed in Memo to:Bldg. Dept.
19.
Commercial & Apt. Re-nuirements form completed?___
��...
20.
Drawings stairilied. A notations made_?
21.
All Items filled in rm 11,1dg.' Permit Application?
22.
Bands posted for site work?
23.
Rioht-of-way Invasion eerniit required?`
�1
COMMENTS:
4
I
APPLICATION
The City of Edmonds for EASEMENT NO_ ____________________________________________
SIDE SEWER PERMIT
NEW CONSTRUCTION N REPAIRS E] LID NO. ----- ASMT. NO . ..................
OWNER .... --- - — --------------------------------------------------- CONTRACTOR ........................... PERMIT NO.
JOB ADDRESS .. ........................(..................................... LEGAL DESCRIPTION: LOT NO . ........... - ----------------- --- BLOCK NO. ...........................
0
NAME OF AT)nT-rTc)m Mt{-4pK
Approved:
DATE jlZ17 ................... Byoi6l�W ............. 4,,- W,2��- j-j
ClIT! '-OF`'ED'M�1i SiS�IDE1S'EaWER' ;P,ER�M`IT f '
j k 5.1
WATER -SEWER DEPARTMENT ' t J F y'
a n.
ru
•k'' - •.] E� it J f- 5 `r 1 , le riti .P -
:,r PER1ViIL
y
f t r � r v: f `. 1 ;m , rr+• 1� •'t f
- CaIII'
.'176 2626 for aide sower lnepectlone�IfFFOREt1coveNnge.any por[lonp oP- the conetructlon1 {, 4,M�
\Inspection. . will -be/provided! wlthfn` 24 hours .after-requat r�NOj$at $un. -ror holiday Inepectlona
! ibii Vista 1Wav
r -^• ` j
M• ADDRESSI LOCATION tOF :CONSTRUCTION " , , y , ' t < ° .
Lat 5... Wgterview:::Manor r `;
gPROP,ERTY ;LEGAL. DESCRIPTION ... . 'J
" Ta00DHAVE
..... OWNER. AND/,.OR;BUILDER..
:Owner 1
CONTRACTOR'S) NAME !&-ADDRESS "'..
' February 2 , : 1
Permission�is granted .r--; -.,.19 '% ,for;repalr?and/or4conneation of:,a side sewer tot the ,city'sa terry .sewer'.`'
i 4svvf-,en 'inlaccordance with,,City.ofEdMonds.ordinances.
AliENT70N I$;CAL'LEI)`TO THE!FOLLOWINO 1. jl
NOTE;.No 1'=Thel,ownere].0 the,property,-may,obLstn.+s4permlt to, construct .sewer lnalde•property;,llne :A: 1lfcenseiL;$Ides.$ewer Contractorq,mustbeuemployeditm'construct.:
�+ sldwsewer'in,streetaarea.:'.Do not,cover any.portlonofE.sewer.,before:ft ;has: been`alnapeeted -
;'NOTEi;No 2=All work;perPormed'yln oily right-of-way requires;-an:Invaslon �of.�R.Ight-of-Way P.eimlt obtalneble from-tha:City,'Englneer7e:otYlce. ' 1
- :.NOTEj;Nol3-Obtalrt'fullMnformationregarding �Ordlnance' 11:16f03O'andRegulafion'-;,g6verningyaiiie sewers?whem,you�get'pormit 'y'.�
•. ��NOTE', 0 '4-TopfJof-side`-aeweratnuet)have':at'deasd-.,30.1n'eheat'coverage`at:property,-�11nelendl421',Inches�fnslde;-..'property line;r;minimum,**.grade oY'2.%- .'No )bends ln7gradei
;eharPer'than`-1jW.,wllt •be�permitted - - -�
'+-NOTE,'No.: 5---Trenche8J,in etreet,musG:be::water,,settled.;and't*surfaur .ce•:of:latreet reatared; to,torlglnsl condltlon.i'';+Contractors: ehall�rbe� responelblasfonrfaileAdue,'tor:lmproper
work,which'-
maYidevelop within•one:year of -completion..'
a {
' NOTEf_No 8=It.l8;ainlawful,to alter -or dotany'other, work, than 'la provlded forin the,peork--on,ahe,
mainraewer;or ttetappuctenanoee-except:fo in f
. `eert'•the pipe intol,the•wye ;' - - 4
DISAPPROVEDR j n ! Date` By Date. ��� By Date By
4r•, - —7
AP,PROVEDl,-,: •. Date. ;� 2 ... .../ BC ,G _ i
1 Remarks. ..... r i
- r' _
. .
BOTH Permi Copies' MUST B`'sSi'gned;'By: Owner oP Firin Performing' Construction PRIOR To Request: For Inspection
I, ':. ..cal.. / �Y� hereby certify,"that the eideysewe',instalhition constructed under.:this,permit-;�
(•O er of, ContractlnR Firm Performing Construction) -
W o,installe�n accordanee with al ; eo erning ordinances Of the City -of;Edmonds
F' Dated this ' ° day„+of
4Check. BEFORE•lyou dig for s`Water fp,' Gasp Telephone+r�,/ Power p; Sewer Ip, Other
b t. i
A APPLICATION
The City of Edmonds for EASEMENT NO- ------ ------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION ;K REPAIRS [I LID NO. --' -------- - ASMT. NO_ __________________
OWNER ---- --------- -0JO.ObAW—itX ---------------------------------------- CONTRACTOR �—t,M .... -------------------- PERMIT NO.,�-�.
JOB ADDRESS ----------------------------- LEGAL DESCRIPTION: LOT NO. — ------- G -------- --------------- BLOCK NO. - ------- --------------------------
................................ -- --------------------------------- - ------------------------ ----------------------------- ------------------------------------
NAME OF ADDITION ------- '�V IV—W. ------ N4U — --------------------------------
) ,I "L *,)WE, pt
Approved:
RECEIVED
FEB 22 1977
Public. Works Dept.
DATE-------------------------------------------- By