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1108 EMERALD HILLS DR.PDF
iiiiiiiiiiiiii 11224 1108 EMERALD HILLS DR ' CITY OF EDMONDS - SIDE SEWER PERMIT WATER -SEWER DEPARTMENT PERMIT /Ca 7t j8 252 for side sewer inspections BEFORE covering any portion of the construction.1 \Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday Inspections./ ADDRESS LOCATION OF CONSTRUCTION....... -...-1 1.nR.. =�'•�° :?�.d.-Hill .�-• l rii.Y'........-- •--- _....................................................... PROPERTY LEGAL DESCRIPTION.......................................LOt_ 3� �...Eme.ra1� Hills .................................................,.................................... ................. ........................•---.................------.............OWNER AND/OR BUILDER ..... .T: A :RTA(',TiiR................................................:� CONTRACTOR'S NAME & ADDRESS .......... U,.i.�R .............................................................................. ....---....---------...--•--------- ...................................................... P sion is granted .---......._.....��X.. �:Z ... 19-76.. for re y sanitary gran..................�-.........-.--.-. pair and/or connection of a side sewer to the city sanita sewer Wm in accordance with City of Edmonds ordinances. ATTENTION IS CALLED TO THE FOLLOWING: NOTE No. 1—The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct side sewer in street area. Do not cover any portion of sewer before it has been inspected. NOTE. No. 2—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office. NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit. NOTE No. 4—Tap of side sewer must have at least 30 inches coverage at property line and 12 inches inside property line; minimum grade of 2%. No bends in grade sharper than 'A will be permitted. NOTE No. Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper work which may develop within one year of completion. NOTE No. 6—It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the main sewer or its appurtenances except to in- sert the pipe into the wye. DISAPPROVED Date..._.... .................•-..... B Date .......---..- a........ a......... By.... ❑ Y .......... Date .................................... By ................ APPROVED Date. _�.-.., ....................... By..._..._' :.::..:.:..:.. E o << Remarks: ................................. ,�...-••-••-•--•••........•---.••........... -••-••--•z...................................................................... ..•-•••••---•-•-•--------•-••••------•......--••-•••- --------------------------------------------------------------------------------------.....----------------------.........----------•-------------------•---------------------•-----...............,.....------...........--------••----•--•-•--....-••--••. _ — BOTH ermit Copi MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection I,• ••--•�------- - --- o .......:.......... hereby certify that the side sewer installation constructed under this permit (Owner of Contracting rm Perfcrming Construction) is, in accordance with all governing ordinances of the City of Edmonds. � f Dated this...,,./..0........... day of_.-__1....................•---------------•---------------- Check BEFORE you dig for: Water ❑, Gas ❑, Telephone ❑, Power ❑, Sewer ❑, Other ❑ �/ �/ Water Service Drawing The City of Edmonds --ASP,MEN'r NO . ................................. .... ..... NEW CONSTRUCTION REPAL IS LID NO . .................. . ASMT. NO. ................. .......................... PERMIT NO PLW�.allq.( 07... OWNER......... P.M:1�5.r . ................................. . ... CONTRACTO JOB ADDRESS ... --- PILL— D R, . LEGAL DESCRIPTION: LOT NO . ...... ............................... BLOCK NO. ................................... .. . ....... S ............... NAMEOF ADDITION ............ ................................................. ........................................... .............. Ull ---.>- N --3 1 Approved: INAN-0OU 1 -11175 (REV. 11178) ................ By . ................DATE .... CITY OF EDMONDS Sj M�iAHEY 7110 - 210TH ST. S.W. • EDMONDS, WA 98026 • (425) 771-0$T )-744-60557n RF MAYOR COMMUNITY SERVICES DEPARTMENT - PUBLIC WORKS DIVISION fnc.1890 December 1, 1997 Jay Pedersen 1108 Emerald Hills Dr Edmonds, WA 98020 Subject: Water Leak Credit (#212275) Dear Mr. Pedersen: I have reviewed your account and will allow a credit for the billing period between August 19, 1997 through October 21, 1997 in accordance with our City policy. The policy states that the customer will be billed at the retail rate based upon the average water consumption for the same period during the previous year. In addition, the excess water lost from the leak will be billed to customer at the City's wholesale rate with a 15% surcharge added for administrative cost. Only one leak credit will be granted in any three year period. Should you have any additional questions after you receive your new billing, please contact Ilene Larson, Utility Billing Clerk, at 771-0241. Sincerely, Jim Waite Water/Sewer Supervisor JW/lk cc: Ilene Larson Utility Billing Clerk wordata\water\credit97\#212275 • Incorporated August 11, 1890 • Sister Cities International — Hekinan, Japan November 24, 1997 Dear Jim Waite, On October 17, 1997, 1 received a letter from the City of Edmonds regarding a leak in our water system. The next day I received our water bill for $1108.05. 1 found the leak to be outside of the house between the house and the meter, since a good portion of the water line was buried under our driveway I replaced the entire line. There was no visible indication anywhere that there was a problem. I have included the receipts to fix the problem, what is not included is the labor to dig and backfill a 120 ft. ditch; 3 days at approximately 6-8 hrs. a day. I would greatly appreciate any help to reduce my water bill I. Thank You Yours trul Jay Pedersen 1108 Emerald Hills Dr. Edmonds WA. 98020 425-672-2706 ABLE PLUMBING, INC. P.O. BOX 2160 EVERETT, WA 98203 BOB: (425)337-2758 JM: (206)546-4940 INVOICE # M6464 JAY PEDERSON JOB: 1108 - Emerald Hills Dr. Edmonds 98020 DESCRIPTION: (11-10-97) installed new water service from meter to house. SERVICE CALL: ------------------------------------$ 60.00 LABOR: 2 men - 4 hrs.---------------------------$400.00 MATERIAL: poly pipe -----------------------------$ 80.00 2 - 1" swt X 1" poly adapter ------------ $ 10.00 3' - 1" foam insulation ---------------$ 3.00 8' -.1" tupe "L" copper pipe ----------$ 8.80 1 - 1" copper 45° elbow ---------------$ 3.00 2 - 1" copper 90" s-------------------$ 8.00 4 - #16 stainless steel hose clamps ---$ 8.00 1 - 1" X 3/4" copper reducer ----------$ 2.00 6' - 3/4" type "L" copper pipe --------$ 5.70 1 - 3/4" male adapter -----------------$ 1.50 SUBTOTAL:-----$590.00 TAX: ----------$ 50.74 TOTAL:--------$640.74 BILLED: 11/20/97 THANK YOU! "THIS BILL IS DUE UPON RECEIPT. LATE FEES ARE 1.5% OR $5.00 WHICHEVER IS GREATER. THERE WILL BE A MINIMUM FEE OF $25.00 FOR ALL RETURNED CHECKS. • MILLER S EQUIPMENT & RENT -ALL, INC. 'We rent most ng anyth'I SELL P R 0 P F 00 1" 22901 HIGHWAY 99 778-OlZIll 1 HOURS WE EKDAYS SATURDAY SUNDAY EDMONDS, WA 98026 7:3":.00, 8:0076:00 .9:00-6:09 CONTRACT IINVOICE 4 1 C L'i iii .1 J 5J 1 1 DATE AND TIME IN 1 6 15 iiL S DR TIME OUT 10:16 ELAPSED TIME 101t:ll EMERALT) HILLS DR WRITTEN BY CHECKED IN BY V.L. OR JOB PHONE DRIVER'S LICENSE NUMBER PART NUMBER 'n DESCRIPTION f: 6 FA r "WE SELL TIME" C WE CHARGE FOR ALL TIME OUT IT rent'A CLEANING CHARGE REWAL eauw%nIT WILL BE MADE ON 4Ai, i.-4INCZ member R E W ITEMS RETURNED UNCLEAN o A *A ffA MINIMUM RENTAL $4.00 ASM ,now 530.00 PER HOUR OF WASMMUrON DAMAGE WAIVER: By his initials hereon, or by separate written confirmation, Lessee accepts or declines damage watm charge of $.25 minimum per day or a percentage of rental equal to current applicable as REJECTS ACCEPTS described in paragraph 11 on ==racl. Initials,. tnitlabi;.... I hereby acknowledge receipt of equipment subject to the stated terms of this agreement which I have read. *�O x IF OTHER THAN LESSEE, SIGNER REPRESENTS HE IS AGENT OF AND AUTHORIZED TO SIGN FOR LESSEE. '115 0 4. R CUSTOMER COPY STREET FILE a90.19y City of. Edmonds Critical Areas Checklist The Critical Areas Checklist contained on this form is to be filled out by any person preparing a Development Permit Application for the City of Edmonds prior to his/her submittal of a development permit to the City. The purpose of the Checklist is to enable City staff to determine whether any potential Critical Areas are or may be present on the subject property. The information needed to complete the Checklist should be easily available from observations of the site or data available at City Hall (Critical Areas inventories, maps, or soil surveys). RIECEIVED APR 2 1 1992 PERMIT COUNTER An applicant, or his/her representative, must fill out the checklist, sign and date it, and submit it to the City. The City will review the checklist, make a precursory site visit, and make a determination of the subsequent steps necessary to complete a development permit application. With a signed copy of this form, the applicant should also submit a vicinity map of the parcel with enough detail that City staff can find and identify the subject parcel(s). In addition, the applicant is encouraged to include any other pertinent information or studies in conjunction with this Checklist to assist staff in completing their preliminary assessment of the site. I have completed the attached Critical Area Checklist and attest that the answers provided are factual, to the best of my knowledge (fill out the appropriate column below). Applicant: Name Title Street Address City, te, ZIP Phone Signature Date Applicant Representative: Name Title Street Address City, State, ZIP Phone Signature Date Critical Areas Checklist Site Information , Project Name: The Z-1 5 Permit Number: Site Location: J/D S Z� d //s Property Tax Account Number: JIX 30 -D00 -032-0 00(0 Approximate Site Size (acres or square feet): Have you filled out a Critical Areas Checklist for a project on this site before? /VD General Site Conditions 1. Has the site been cleared or logged? 149 Date of most recent action: Soils / Topography 2. In the.Snohomish County Soil Survey, what is the mapped soil type(s)? 3. Describe the general site topography. Check all that apply. Flat: less than 5 feet elevation change over entire site. Rolling: slopes on site generally less than 15% (a vertical rise of 10 feet over a horizontal distance of 66 feet.) Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of 10 feet of horizontal distance.) Steep: grades of greater than 30% present on site. Comments HydrologyNegetation 4. Site contains areas of year-round standing water: ND 5. Site contains areas of seasonal standing water: NO Approx. Depth: 6. Site is in the floodway ND floodplain N4 of a water course. 7. Site contains a creek or an area where water flows across the grounds surface? flows are year-round? NO Flows are seasonal? NO 8. Site is primarily: forested ; meadow ;shrubs L ; mixed 9. Obvious wetland is present on site: 10. Wetland inventory or map indicates wetland present on site: V D 11. Critical Areas inventory or map indicates any Critical Area on site: All For City Use Only STUDY REQUIRED: Critical areas study is required. CONDITIONAL WAIVER: Critical areas study not required if specked conditions satisfied. WAIVER: Critical areas study is not required. Determination Number. C—A-- 9 Z' Z-% Reviewer Planner Date Rev 3/27/92 Is VE I � A CITY OF EDMONDS V T PUBLIC WORKS DEPARTMENT .S 1 QCc- ' RIGHT - OF - WAY CONSTRUCTION PERMIT . A.— Z,. A. *Address or vicinity of Construction �-Gft&3 tAL_L 12 • Owner: Name nA'?G! Mailing Address City, State, Zip Code • Contractor: ' u. C1% (A Name Mailing Address C._ Y e-,i w&i In vn q kP 3 4, City, State, Zip Code Issue Date 9L E • Permit Issued To: I LA S 0 03 um%1 F� C. 0 ItJ) `i • Type of Work to be Done: 2� 1J • Work in Connection With: ❑ Sub or Plat X, Single Family ❑ Comml. / Ind. ❑ Apt. Condo. • Pavement Cut: A Yes ❑ No State License Number 7 7 ¢- -mot) ,- Telephone Number * * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * * B. APPLICANT TO READ AND SIGN INDEMITY: 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 City of Edmonds, or any of it's 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 to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call 775-2525, extension 220. I understand that this pe[pyt ust a available t he job site for inspection purposes at all times. Signat re' ate Owner br Agent tit * THIS PERMIT MUST BE POST AT THE JOB SIT FOR INSPECTION PURPOSES CALL DIAL - DIG PRIOR TO BEGINNING WORK C. Issued By: Time Authorized: Void after 30 days Special Conditions: Ammendments: Permit Fee: I S V(1 Security Deposit: Receipt No.: Fund III Fee: Street Cut Dimensions X = * * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * * Eng. Div. December 1978 CITY OF EDMONDS PUBLIC WORKS DEPARTMENT RIGHT OF - WAY CONSTRUCTION PERMIT A. *Addressor vicinity of Construction Emara.ld Hills Drii?n Play-. 4 • Owner: 163--067,,001 Name , , r INr M NATU-NiL GAS CO nn; 1 c;6 A17 R,r Mailing Address ?? 1_l�:�nrs. riTarl^.innton 9FI007 City, State, Zip Code • Contractor: 'Cum As Abovp Name Mailing Address City, State, Zip Code r _ Permit No. Issue Date • Permit Issued To: • Type of Work to be Done: Instal 1 r<? • Work in Connection With: ❑ Sub or Plat ❑ Comml. / Ind. ❑ • Pavement Cut: ❑ State License Number Telephone Number Single Family Apt. Condo. Yes ❑ No �r 1r NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE B. APPLICANT TO READ AND SIGN INDEMITY: 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 City of Edmonds, or any of it's 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 to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic Section of City Code.` Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call 775-2525, extension 220. I understand that this Signature: —"I-- i site for inspection purposes at all times. z4 / 1./n1 Owner or tent` * THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES CALL DIAL - DIG PRIOR TO BEGINNING WORK C. Issued By: Time Authorized Void after . Fen days Special Conditions: Ammendments: Permit Fee:� Security Deposit: Receipt No.: Fund III Fee: Street Cut Dimensions X_ NO. WORK TO BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. December 1978 FIELD INSPECTION NOTES (Fund. 111 - Route cony to Street Dent. r^mmen"+- c • Diagram: STRUET FILE r,p? r 1980 Dir. 0! P! " , , Contractor called for inspection Yes31-01 .Mork Disanproved By: Date: By: TDate: Work Approved By: Date: 6 Inspector: Ena. nil. December 1978 STREET FILE DATE': is i oil Development: DeparClflenL P, 0 1 Ens,ineeri . n c-x T) i'v i s i o n PuhLic DeparcmenL SLTBjECT: LCle revie,..: or the c;l!hjc'CL building Permit ,jppjjcaLi t: le 011, we have C017"MeIl,�s —� t .�c 16 4 la� lam A 4 USE rr PERMIT BUILDING DIVISION Applicant Fill ZONE()``I �{ NUMBER PERMIT APPLICATION Inside Heavy Lines .1DB NAME (ORNAME OF BUSINESS) ADDRESS / [LEGAL DESCRIPTION I SUBDIVISION { SHORT SUB NO. - LLB W MAILING ADDRESS 3 llo� c-_w?CRAL?� HILis 0 CITY ELEPHONE NUMB I- V U W ADDRESS ♦- 2.5 U E CITY NAME E 0 ADDRESS F U Q ' It 'CITY I- Z 0 U CTATF 1' 1[ Z 0 H d C U N W O J Q q W J e R ELEPHONE NUMBER !t>/ -4 t—L r- ONE NUMBER on of Property (Show Below or Attach Four Copies PUBLIC. RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING PROPOSED DEFICIENCY OF RIGHT OF WAY PUBLIC IMPROVEMENTS REQUIRED ❑DRAINAGE IMPROVEMENTS REQUIRED ❑DRAINAGE PLAN REQUIREDUNDERGROUND WIRING REQUIREDCONNECTION TO SANITARY SEWERSEPTIC TANK PERMIT REQ'D ❑ NO. ELEVATION OF PROPERTY_ CORNERS& FOOTINGS REQ'D SEE ENGINEERING MEMO DATEDCHECKED BY 4METER SIZE BUILDING SUPPLY SIZE REMARKS SIGN AREA ENV. REVIEW ADB NO. ALLOWED IPROPOSED COMPLETEI EXEMPTSHORELINE IREMARKSVARIANCE OR CU PLANNING REVIEW BY DATE ❑ NEW © RESIDENTIAL GAS LINE �,f ❑ NON-RESIDENTIAL ❑ SIGN I XI ADD PIN ❑ DEMOLISH ❑ RETAINING SPECIAL INSPECTOR ❑ ALTER EXCAVATE El OR FILL ❑iENCE X—�) REQUIRED YES ❑ NO FARE,'WALL PLAN CHECKED BY ❑ REPAIR El._NSP,PRE-MOVE swim POOL REMARKS ZNUMBER OF STORIES NUMBER OF 'p<:D DWELLING � UNITS NATURE OF WORK TO BE DONE InW m�� � t v/Py f�oL.0 Pl_AN CHECK FEE PLOT PLAN YARDS LOT COVERAGE FRONTSIDE REAR FIRE 20NE TYPE OF CONSTRUCTION CODE HEIGHT BUILDING PLUMBING GIECHANICAL ENCE. OCCUPANCY OCCUPANT GROUP LOAD THIS SITE IS LOCATED IN THE CITY OF EDMONDS. LOCAL SALES TAX SHOULD BE CODED 31.04. VALUATION I FEE UI Y tt 0 3 U_ J m 7 IL It W F Q 3 r Z W f F C Q a W 0 -- F Z W f a 0 W W 0 PUBLIC WORKS DEPARTM T CKLIST BUILDING PERMIT (address) (date) �. Street Right -of -Way Existing REQD z Access Easements Existing REQD H x Utility Easement Existing REQD w Lot Per Subdivision Plat Assessor Map w Site Plan Checked for Accuracy z Underground Wiring Reqd. H 0 Check Accuracy of Legal Description z Review by Date w* Existing Water Main Size Water Main Required Service Line Required Hydrant Size Existing x Hydrant Reqd Per Fire Code Size w Detector Check Meter Reqd. Cross Connection Inspecti SRCQUl12E� AP 16OED VACUUM 8REAK6k S 7n 8,6 1N S 01U Ac-Hoses ic I Bs oo FILLAZ) i4 Fire Department Conments '� ftGa ' s F �'/ .-GT W4M.& F d c.i tc..L Water Meter Clyrge Regd. Review by 3 Date Septic Tank Design Approved Date Septic Tank Permit Reqd. Permit No.. Sanitary Sewer Availability ProJ. Drawing No. File No. Side Sewer Availability w Sanitary Sewer Connection Fee Reqd. 3 Review by Date w M Open Ditch Existing Regd. Culvert Regd. Size 94 Catch Basin Reqd. Indicate on Site Plan Shoulder drainage maintain collection an Swale open runoff H U' T�bnhole reqd. Indicate on Site Plan Soil Conditions and Ground Water Field Checked Review by Date :c -h 4 C-021 Revised: 1.v1O-1977 INTER -OFFICE COMMUNICATIONS DATE S 19a 2- C) r�4 TO FROM t_j-- - v F W I LLC I K S,&Aj FORM 41 - LITTLE-0 SUBJECT: 0 13- F_—meeALP w(_L5 -x)lztaE- Pooz_ PERmi-r j->A-jFb ?47-79 Ckos_S coo4mgc-rcp , olj j// __s /4 -r7q474K Yd U il C/) mm v 14 ' APPLICATION the City of Edmonds for EASEMENT NO- ------------------ ------- - SIDE SEWER PERMIT NEW CONSTRUCTION REPAIRS ❑ LID NO ................... ASMT. NO................... OWNER ..J.'. -.... 81 I�CKMORE=-------------------------- CONTRACTOR `J ' ................ M F,E_... PERMIT NO. SSI'Z' - SOB ADDRESS .�.�B..-Et�l,C—O H1LL-S L7f�- LEGAL DESCRIPTION: LOT NO.---------32 -------------- BLOCK NO. ......... .-------------------------- ------------------------- - 1 /75 M LAIN s7R��i - Tho City of Edmonds APPLICATION for SIDE SEWER PERMIT NEW CONSTRUCTION 56 REPAIRS ❑ OWNER ''s/• !7_ _a--JolVe Lr JOB ADDRESS .-/ EASEMENT NO. ------ LID NO. T. - --------------- CONTRACTOR -------------------------------------------- PERMIT NO. 5 LEGAL DESCRIPTION: LOT NO. ...... ZXZ --------------------- BLOCK NO. ___-_-___-_-____-_______-__-___-___- -------- --"S--------------------------------------•------------------------------•----------------------- NAMEOF ADDITION _• -------------------------------------------------- --•---------------_------- Appmved: DATE__ RFCFiwn JUL 12 1976 Public Works VO BY--------------------------------------------------- j i j7 0 0 3 A I Q /e. o a `' •s (Cz2EEN HEI-T) C/yn.��ld- 1//EC[Al ) yin • �::... STREET-tfiLEI VII, � ® j5 CITY OF EDMONDS USE PERMIT [) ZONE — NUMBER Cj� " 4�� CONSTRUCTION PERMIT APPLICATION J0B SUITE/APT# OWNER NAME/NAME OF BUSINESS ADDRESS _ i LEGAL DESCRIPTION CHECK •��j, SUBDIVISION NO. LID N0. w MAILING ADDRESS Z p G 3 rid r J PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. PU TESCPApproved D D CITY ZIP TELEPHONE NUMBER, EXISTING REQUIRED DEDICATION RW Permit Required Street Use Permit Req'd ❑ lore l PROPOSED Inspection Required ❑ Sidewalk Required ❑ O NAME Z REMARKSCr W 1•- W ADDRESS Z Z a ~ S G CITY ZIP TELEPHONE NUMBER w . , ., NAME (� .. ENGINEERING MEMO DATED REVIEW BY cc O ADDRESS METER SIZE BUILDING SUPPLY SIZE NO. OF FIXTURES UIX ccCITY ZIP TELEPHONE NUMBER W r Z 7 1?717 REMARKS 3 O O STATE LICENSE NUMBER 1-/_ ,9 �•i �^ y /4 /yf�C INZALLOWED SIGN AREA SEPA REVIEW ADB NO. -------"— / Legal Description of Property - include all easements PROPOSED COMPLETE EXE PT SHORELINE # Z O EXP K.C';� t3 2 VARIANCE OR CU NNING REVIEW BY r / W a SETBACKS — FF�ET , [ R5 HEIGHT LOT COVERAGE i z c9 FRONT,t�J SIDE REAR J Tax Account Parcel No. R MARKS 1/23o , > > NEW © RESIDENTIAL PLUMBING / D�� All1��„y/ ADD, LTER COMMERCIAL MECHANICAL l / 4 T 0/1- REPAIR APT. BLDG. El SIGN / , / • FENCE GRADINGCARPOR CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT DEMOLISH swim REMODEL GARAGE SPECIAL INSPECTOR AREA OCCUPANCY GROUP OCCUPANT LOAD POOL, REQUIRED ❑ YES _ �. WOOD STOVE/RETAINING WALL/ RENEWAL INSERTTROCKERY REMARKS " (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: PROGRESS INSPECTIONS PER UBC'305 Z p J 'L/ •�" /� ;* D5 NUMBER OF STORIES NUMBER OF l /�/'��"� ? UNITSLING O DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) FINAL INSPECTION REQUIRED VSLUATION FEE - PLAN CHECK FEE BUILDING 4�",' PLUMBING � f Plan Check No. MECHANICAL c, This Permit covers work to be done on private property ONLY. GRADINGIFILL Any construction on the public domain (curls, sidewalks, SURCHARGE driveways, marquees, etc.) will require separate permission. STATE Permit Application: 180 Days 'pRM DRAINAGE FEE Permit Limit: 1 Year - Provided Work is Started Within 180 Days . • "Applicant, on behalf of his or her spouse, heirs, aSS1gr1S3'nd &G.INSPECTION FEE N successors in interest, agrees to indemnify, defend affd hold W harmless the City of Edmonds, Washington, its officials, and agents from any and all claims for damages of iwhatever employees, nature, arising directly or indirectly from the issuance PLAN CHECK DEPOSIT of this permit. Issuance of this permit shall not be deemed to 0 J = 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 APPLICAf-1 N " 40VROAL information given is correct; and that 1 am the owner, or the duly authorized agent of the owner. I Iagre� tpy�cQ�nplytlt)cl��an , }�I$ PERITf� ; l ` ^ ` t ''This �p�ptication Is �t�a p rmlt until �� state laws regulating construction; a d• n doing the O�k'authOri2•.; ed thereby, no person will be employed in violation of the Labor fi ONLY THE R NOTEB� Z 't � signed by the Bulldin Official or his/her Qe�ut)/; 8ndlfies:ara 00jd,6and receipt is Code of the State of We relating to Workmen's .1 acknowledged in space provided. ti n Insurance. SIGNATURE (OwNER OR AGENT) DATE SIGNED INSPECTION DEPARTMENT �,. ( OFFI AL'S SIGNATURE DOE -..> //el/+-°^>��� IZ CITY OF EDMONDS �� 1� ��;i,l✓ --- - �—_ ATE CALL'FOR -- .__ I eA ATTENTION INSPECTION '?, IT Ic UNl AwFUI TO USE OR OCCUPY A BUILDING OR STRUCTURE 771-n9m ^^ ^ y^^:',�"�,.*y��^*fig ;.'°"'r.,'_ , .. ma. a . :a, - - - - , �� - I - 1� - -. I � - --I- ,,, � � s - � -- � , . . .- ",-", , -14�,,_;�,��-�—��t-4-�L� " I ill�': - -t ^ , 4 �?-1 11 1-' 4Z�4.Z- �'-'��T� ,-�-','-�14-.��'. �r,k4 �' - - I , , ��,- )-t,�, L - - - \J -;-;,-,�,� -. -- �,7<-�-�,��;--- --'�-�' �-�4.J,��-' � ,,-'j,,�-'�m-� , 1 1j, �, Dc-� .vl,�,,��,4��( r-, �.- � , �: ,- -.'�� �",i��l �41 �:�:!,��-- , " - - , , -I'-- I - .1 . I I . , . , , " ,. . �; I I T - I I I . -��Z - - - I , � � - . ; . " . , I 1�,-f:, , �, � -7-7 - , . I , , , . � - ; ,� I I � , ,/. 11 � IA;I'�� ; , ,� - , ,& 1, �, "� - 7 . . , , .. 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