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1121 OLYMPIC AVE.PDF11111111111111 12438 1121 OLYMPIC AVE CITY OF EDMONDS ASSET INFORMATION SHEET U NEW ❑ ADDITION ❑ RETIREMENT ASSET NO. CD •�o� �� ADDITION TO ASSET NO. S-5o0c1o2 cl-3o-7o DESCRIPTION C` SERIAL NO. LOCATION DEPT. NO. 1 v I * * PURCHASE ORDER NO. PURCHASE ORDER DATE COST PROJECT NUMBER wUS s U'st PROJECT COMPLETION DATE C`T— -7� COST `JSo2 CD B.A.R.S. ACCOUNT NO. �I. I' GCVO, �� 3 V, 00. ly ESTIMATED LIFE "l U 1(S INITIATED BY DATE APPROVED BY *SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST 'SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT ACCOUNTING ONLY DEPRECIATE MONTHLY DEPRECIATION AMOUNT ANNUAL DEPRECIATION AMOUNT G.L. ENTRY REFERENCE t P INITIAL DATE VERIFIED BY PROCESSED BATCH NO.- DEPARTMENT FILE 0 1 FlLmLm 1 I ILL - CITY OF EDMONDS NEW ❑ ADDITION ❑ RETIREMENT ASSET INFORMATION SHEET ASSET NO.�� ADDITION TO ASSET NO. 0 DESCRIPTION VV SERIAL NO. LOCATION DEPT. NO. I * * PURCHASE ORDER NO. PURCHASE ORDER DATE COST �vo�s o ga *PROJECT NUMBER PROJECT COMPLETION DATE l— 30 Lel COST 12 1 .3 7!S B.A.R.S. ACCOUNT NO. �� UU • _ I 'q,3 VS.-OU , 69 ESTIMATED LIFE Vi S- INITIATED BY DATE APPROVED BY "SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST *SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT ACCOUNTING ONLY VERIFIED BY DEPRECIATE MONTHLY DEPRECIATION AMOUNT PROCESSED _ ANNUAL DEPRECIATION AMOUNT BATCH NO. 41 G.L. ENTRY REFERENCE DATE b P INITI DEPARTMENT FILE STREET USE PERMIT CITY OF EDMONDS ZONE p 12 NUMBER CONSTRUCTION PERMIT APPLICATION joe /�—� SUITEIAPT11 OWNER NA :/NAME OF UC SWESS ADDRESS 1121 ww�// I� L�n i� CL LEGAL DESCRIPTION CHr,CK SUI1DIVISION/N�O' 1.117 NO (/ .Cr - /° 3- 3 �9 ui MAILING OPAF,,S `��' "L 0 2 TESCP O PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. CITV ZIP IT EPH NE NUMBER ArPROVED 11Y EXISTING __...___.....____ REQUIRED DEDICATION NAME O 7_ eEki RIGHT OF WAY CONSTRUCIlON PEHMII B[OU11WU ❑ O STIWE I U!,L• I'I:IIMI I IICOUIIII: U U AIJIJIICSG _ K-� l/ SEE ENGINEERING Mr:Mp DATED IEW BY Z V a (;I I Y /_II' I LLI.PI IONL NUM1104 ' i1rLL� '^ C' v OCN REMARK ,//,� �/ NAME `� `C"1e"e .Aver%1 cc ADDIIF ", •YfrG Eil'6�N�ciz�-6 �sr��r/a✓ �' Z� .C� METER SI E el BUILDING SIC{PPLY SIZE FIXTURE UNITS Uj CITY LII' IELEPtiUNF NUMUEIi O L4 REMArkV 1 3 O STATE LICENSE NUMBER 6 J h SIGN AREA ENV, REVIEW ADB NO. Legal Description of Properly - include all easements ALLOWED PROPOSED COMPLETE EXEMPT Z (show below or attach two copies) / SHORELINE N O / CL vVARIANCE OR CU PLANNING REVIEW BY 0.pTE o � a SETBACKS — FEET HEIGHT LOT COVERAGE Z 2 w FRONT 1 SIDE r/C' REAR ZS' �5 JS V Z Tax Account Parcel No. REMARKS g EW y ESIDENTIAL El PLUMBING / ADD/ALTER COMMERCIAL El MECHANICAL REPAIR APT. BLDG. SIGN EXCAVATE, FILL FENCE CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT DEMOLISH OR GRADE ( x_FT) :Ir`/V 05 �l REMODEL CARPORT ❑ sWIM SPECIAL INSPECTOR AREA OCCUPANCY VV OCCUPANT POOL REQUIRED GROUP LOAD WOOD STOVE/ RETAINING WALL/ C1 YES L: NO INSERT ROCKERY RENEWAL REMARKS O- (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: PROGRESS INSPECTIONS PER UBC 305 o a V) NUMBER OF STORIES NUMBER OF � G.�i'YSllL �f,Q 6 61�i9 E�Yi6Y LUD,E m o DWELLING co O UNITS VfVj.. -' NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN) 5 FINAL INSPECTION REQUIRED C G VALUATION FEE O PLAN CHECK FEE BUILDING PLUMBING Plan Check No. 3 Q MECHANICAL This Permit covers work to be done on private property ONLY. GRADING/FILL Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE Permit Application: 180 Days Permit Limit: 1 Year • Provided Work is Started Within 180 Days "Applicant, on behalf of his or her spouse, heirs, assigns and N successors in interest, agrees to indemnify, defend and hold w harmless the City of Edmonds, Washinaton, its officials, TO: Permit Coordinator, Building Division FROM: Dan Smith, Engineering Inspector ADDRESS Z OWNER LAN CHECK # After review of the subject building permit application, we have'the following comments: 1. Construction hours are: WEEKDAYS at EEKENDS/HOLIDAYS..10:00a.m.to1p 6:00 .m. 2. A Right -of -Way Construction Permit is required for any work on City property. 3. Connection to City water system required. Fees paid. 4. Connection to City sanitary sewer system required; obtain separate permit. Fees paid. 5. Water and sewer lines to be separated by 10 foot minimum., 6. Driveway must be paved a minimum of 20 feet back from City right-of-way; separate permit required. 7. Driveway slope not to exceed 14%. 8. Back water valve required if downstairs plumbing is below elevation of upstream manhole. 9. Builder/Owner responsible for containing all temporary runoff and erosion control on site. Construction may not impact neighboring properties in any way. 10. No burning of construction refuse without approval from Fire Dept. 11. Street to be kept clean of debris, dirt, mud, and construction materials. Contractor responsible for dust control. 12. Inspection required on drainage system, catch basin installation, driveways, and sidewalks. A final engineering inspection is��•J required pr'or to thehe building ivision granting occupancy. 13. Repair or replace all efective existing curb, gutter, and sidewalk. If intersection is involved, installation of wheelchair access may be required. 14, BLGPER/TXTFORMS NORIR - PL:OT.. `::PLAN I z �eO� "9 'dlrq,n s +o be Go p e r �10wr 5P OL`(MPtG :AYt=Nut- . NoAWE 2TN:- �: �O I r- .. .• MiveWA,� :.�N �o o 00,X �� .. TIES: DtRTLY Atdv Arpm0\1E >PAM \• ,I _��br ���I NT .•hut=.A-[I,ot� �-. :::.Fbiw ,t t sQ AVM': . r� ill � b • • 4 .... - .. ,�� ;��.�� pG�• 43 Mix::••�tp4��;IA'r. ;-':1� 1:,� . t GAtzAGE F- 4. ,lk - �o a-f h .a . eS rak ;D.I Pe Quo.-- � � i '• ;�� --- , � -�� ;-,'. . �� ,'r•�. -, _. �•: -; -. C G°' e1^ • O� \ t,'�'��� .. �yt ► �y wr .W.aS 1i�o e t th �\ r ,ry a :T�tn c+C;' . M , • gas{ied: l'th:e o - �` l4tla.-:Ft:.:.. 7 14 1 �' Ld . . � fig• . � �1PUE-:..,•.,� ,,y � ;ps. e�=i.33z. ., . rn. ... • •._.� .. ` Ara! Ali -17 Ot 'rr P r • ' t. ��,' i-•� , .. ram, '. w N7� 7-J` ':S•t•�,RM Ail - �1.': ;: 1 • ' • . •.., f- - . • :��:�•.��p;�1�.� .:.:::� ...� ..'.. ;-..,'.... PCB.:-�.� • .0L`�MPIG �^ _1y1AXu4tUN�, :µE1QNT�' ' x�4:-j,t���'`:. DEs14rl:, E.i µ' .�;:•.-. .4 ::': A::: �f:. rr';`9' `a�^'by.:ln.��'� G , S►i1-. CAS %✓.f... u� a�y�.•.•lrhn.: �A! �.,,y J, .f... •Y.. 41�:3�;. f1r p��rr� ' ^ c..i5.G?-Arr- £L .s 1130IG �'® 20.0' PLOT PLAN t`-201 et.- t29 oFF of CpLYMP!G A,VF-tIUE. NO2T14 NoTa : STREET FILE /�F 4ARA6F- EL= PR.1vEWA`( RN) DOWtJSPotSTs T! Ev D! Qe'GT L-Y 1I13TO t~ x 1 gT 1P•t ct At-4v P~F'P2©�lED �{zA!r.�P.4e Ste' 3s t: t;Xt-lTtt--4 4FLAQE P?". Ti To-rAt. ptV-r-.OF 13i.t + 21 MA)(- AT . 115s.1 \S% uPPeP- RP- t 41 s �..+�-�..• �,r .. may__,__ . _a,• ^eL: t29' LE L__ of S art oUN*:>':��. ! { 2l 0LYMP1e-- A-VE MUE., NJOP-TH 76(t - 000 - 00 5 - 0000 MA - IMUM. Ne-t4 AT : ! rg& - CITY of EDMONDS SIDE S-EVIA PEAN.1T For Inspection Call 771-3202 PERMIT NO. 008 Address of Construction: 9 0 k At—, u� Property Legal Description (Include all easements): L,pT_-7— 3ell ={EDMONDS Owner and/or Builder: ITREATM Contractor & License No: R (0'gf`�`_0, RorfgLrD C' S Ilq IrW . Q_0N�j— uCj`0q Single Family Residence 1— I? Multi -Family (No. of Units ) Commercial (No. of fixture Units ). Invasion into City Right -of -Way: No Yes (If Yes, Right -of -Way Construction Permit required. Call One -Call -Center (1-800-424-5555) before any excavation.) Cross other Private Property: No Yes (If Yes, easement required, attach legal description and county easement number.) PLEASE READ THE ITEMS LISTED ON THE BACK I certify have read and sha `comply with th lotems listed on the back. Permit Fee: 2 Trunk Charge: zs— Assessment Fee: /_D10 477- Issued By: Date Issued: Receipt No.: RECEIVED MAY 16 1ftfo PUBLIC WORKS'Date 0 Partial Inspection: Comments Final Inspection Approved: (Qg�j �► Date Initial Rejected: eason ** PERMIT MUST BE POSTED ON JOB SITE ** Date Initial Date Initial Wh.ite Copy - File Green Copy --Inspector Buff Copy - Applicant The City of Edmonds Side Sewer Drawing EASEMENT NO_ ............... _____________________________ NEW CONSTRUCTION REPAIRS ❑ LID NO_ ------------------ _ASMT. NO. ------------------ c. ♦ 1 OWNER------------------------------------------------------------------------------------------------ CONTRACTOR ------------------------------------- --------------------------------------------- PERMIT NO. COS -I 2-7 C)� ----P �- ------------------------ JOB ADDRESS �__�__°�1 ____-�____�... � �--- _______ LEGAL DESCRIPTION: LOT NO. _._____.__. ._ BLOCK NO. ______._--_.__.______.__._______.__. ------------------------------------------------------------------------------------------------------------------------- EDM_ONDS.- - NT NAMEOF ADDITION---------------------------------------------------------------------------------------- 7 yl� PWW-0001-11/75 (REV.11/78) Approved: DATE ----•--------------- B Y