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117 5TH AVE S.PDFIIIIIIIIIIII 5170 117 5TH AVE S 1 0 TAX ACCOUNT/PARCEL NUMBER: BUILDING PERMIT (NEW STRUCTURE): COVENANTS(RECORDED)FOR: CRITICAL AREAS: I l "1 f -_ DETERMINATION: ❑ Conditional Waiver ❑ ` Study Required�aiver DISCRETIONARY PERMIT #'S: 17,�/ / /' S DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: �' • �:�1/�Q/L'I/L�� PLANNING DATA CHECKLIST DATED: / SCALED PLOT PLAN DATED: �l SEWER LID FEE $: SHORT PLAT FILE: SIDE SEWER AS BUILT DATED: --)( SIDE SEWER PERMIT(S) #: SOILS REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: FOR: WATER METEg TAP CARD DATED: LOT: BLOCK: LATEMP\DSTs\Forms\Street File Checklist.doc PLANNING DATA New Commercial / MultiFamily Proiects SITE ADDRESS: 1 17- Ate. 5 • ZONING: 3G USE(S) PROPOSED: Ce ALLOWED?: Vt( LEGAL NONCONFORMING LAID USE DETERMINATION ISSUED (Y" CUP File: — To Allow What Uses?: — ADB FILE #: o q - 35' PARKING: �rc„r rrt.� ,��{�•- - �,1,98 ° * / �° ; 3 .q r 3 s p�u.c. _ Usez, 4 ,5zz " No. Spaces Re 6,Fg X floor ar mployees, etc.) = R, Use: Nb—. Spaces uired• X (floor area, # employees, etc. =— Use: No. Spaces Required: X (floor area, # employees, etc.) Use: No. Spaces Required: X (floor area, # employees, etc.) _ Total Required: 3 Actual Provided: mrrLJ S SPar.cr �Dr1� SETBACKS: Required Setbacks: Front:_Left Side:y Right Side: o Rear: c� Actual Setbacks: Front: 21 Left Side:oRight Side: Z' 'Rear: ' Street map checked for additional setback required? (Yes/0o MAXIMUM FLOOR AREA: tat - r Maximum Allowed: 3 y14- /1'_ctua1: I "/ ram, BUILDING HEIGHT: 0, Maximum Allowed: 25, Actual Height: 17. S' a Modulation Allowed?: 5; yzi (+s l Modulation Height: Datum Point: No rn ti ► 41,r- nor r,", A Datum Elevation: Elevator Penthouse > 3 feet over height limit? — If so,VAR# oz Q LANDSCAPING: z a Matches ADB approved: y" 7 Bid Provided? yu Bond Amount (100% bid): t, 4; bra = *49'&J8 w: V. z A � F CRITICAL AREAS M 7-,z4 ,t, SEPA DETERMINATION: elllpo- w m z SHORELINE REQUIRED?: Na a m Continued ... I:\library\^PlandatNewComm.doc DATE: F//7164 PLAN CHK#. Cq -154 NAME OF BUILDING PERMIT APPLICANT: Ro `j"Y,,.,-j PROJECT DESCRIPTION: ICJ 1i r to r�+r ADB FILE #: 04. 35 OR DATE WAIVED: PLANS MATCH APPROVED PLAN: It& SUBDIVISION: — LOT AGGREGATION REQUIRED?: Iva REDUCED SITE PLAN (8.5X11) PROVIDED FOR STREET FILE? _11x17 �.�,b� I,;- A-r 8'1 5 ,1 /1 . 9- Plan Review By: I:\library\^PlandatNewComm.doc CITY OF EDMONDS Grease Removal Equipment Application Business Name: f tAoTw ob L-Lc- Date Submitted: 4- , 2ce .Q4-- Address•_ 14— G 4y, - CS. C7 `r� Suite No.: Svc, # ,/�����,, Business Owner: 4 h4�)I�.bWrWo,— Mailing Address: iJ3�CP, 97""0 4L22— J Contact Person/Title:'SCA 4P.RWIL4.a,— CL kL5-� phone: 550 Days/Hours of Operation: - -'-r - 5 A, Total Number of Meals Served Per Peak Hour (assume all seats filled): 550 Number of Seats: Dining: t Lounge/Bar: Banquet Rooms: _ Deck/Patio: J S_ Building Occupancy Permit Capacity: Health Dept. Permit Capacity Inventory of Kitchen Equipment and Plumbing Fixtures for this Establishment: (Grills, burners, ovens, hoods, deep fat fryers, wok stations, soup kettles, sinks, pre -wash sinks, dishwashers, disposers, mop sinks, floor drains, etc.) SuuP (J AcjU x �Qse ts�,gg1-� What proportion, if any, of the dishware used is of the disposable type? 146' How is waste oil/grea�se(�handled, 'stored, and recycled/disposed? e9, C S 1 T,, P Lj rf 9,-n Estimate gallons of waste oil/grease produced per month: 153 Q<iS If recycled, by which company? e19eedo ect-"� Howes are vent hoods cleaned and where does the cleaning waste go? -54-t �• e � U� -p r tLL� L n D G h . 44- �1De, — .1 — Contact the Pretreatment Technician at 425-672-5755 to discuss the type and size of equipment you must install, and then complete the appropriate accompanying worksheet for either a Grease Interceptor or a Grease Trap. 0 Grease Trap Sizing Worksheet Facility Name: ( fed `rw i Q ( fa rrrve,r L h r,A.r.r ea.u' Address: 117 0 4 Ye, . S . Suite No.: • A Grease Trap plumbing permit is required ($165.00 fee). Contact the Pretreatment Technician (425-672-5755) if you have any questions and also to get signature approval on this form. • Dishwashers are not allowed to be connected to a Grease Trap. • Food disposers are not allowed in a facility served by a Grease Trap and must be disabled or removed. Solids must be screened out and placed in the solid waste container. Fixture Capacity in Cubic Inches x W x inks) Fixture Capacity in Gallons (Cu. In. _ 231 Drainage Load (75% of Total Capacity) Flow Rate for a 2-Minute Drain Period #1 Pr&Wo4b 231 = al. x .75 = at. - 2 = m — c.i. _ 231 = al. x .75 = al. _ 2 gpm #3 x x x = c.i. _ 231 = al. x .75 = al. _ 2 =_gpm #4 x x x = c.i. - 231 = al. x .75 gal. _ 2 = gpM Grease Trap #1— Total drainage flows from maximum of 4 fixtures gpm #1 x x x = c.i. _ 231 = al. x .75 = al. _ 2 = gpM #2 x x x = c.i. - 231 = al. x .75 = al. _ 2 = gpM #3 x x x = c.i. - 231 = al. x .75 = al. _ 2 = m #4 x x x = c.i. _ 231 = al. x .75 = al. _ 2 = gpM Grease Trap #2 — Total drainage flows from maximum of 4 fixtures gpm MINIMUM SIZE OF GREASE TRAP(S) REQUIRED I gpm Number of Fixtures Connected to a Grease Trap 1 2 3 4 Grease Trap Size in m 2 0,,J 25 35 50 Upsize for factors such as high volume dishwashing, high oil/grease content on menu, etc. (For City use only below this line) Remarks: Size Approved: 20 gpm Approved by: � � �� Date: 2-2,6 -D� Pretreatmei# Technician APPLICATION The Cityof Edmonds for SIDE SEWER PERMIT NEW CONSTRUCTION EASEMENT No 0 REPAIRS 0 OWNER .._� 1 [i1��0 1Ji �........................... ..... CONTRACTOR...------------......----.....-----...._............................ PERMIT No. . ADDRESS ...................................................... LEGAL DESCRIPTION: LOT No............................................... BLOCK No... .......................................... E 0 Lu U. 0 NAME OF ADDITION Am a.,"_.�z DATE................................................ BY--------••--•--••-------------....................................... USE CITY OF EDMONDS ZONE CONSTRUCTION PERMIT APPLICATION Q. OWN R��NAr O/F,BUSINESS JJ'' �,yf1 {�. �7' / I r L ? ADDRESS +)V (/l ���n Il IJF.LT��t{S� C�j• LEGAL OE MA J7t DORESS r w of tl T-O7�S? ritwro CQ AD ESS IP �. TELEPHONE NUMBRATIO R YCCCJEEEL$/ { i .e ^� S /t�� FyPI—/0 Leoal Description Of Property - include all easements Property To' c�3 i�o 0 31 00 Parcel No. el No. PRESIDENTIAL NEW 12ZPLUMBING 70 El ADDITION �9COMMERCIAL MECHANICAL OREMODEL O APT.BLDG. El SIGN O GRADING FENCE El El REPAIR CIDS L—X_FT) DEMOLISH O HOPOOL T TUBSPA INSERTTOVE GARAGE r7 RETAINING WALL/ O CARPORT ROCKERY RENEWAL NUMBER NUMBER OF CRITICAL 1 OF DWELLING AREAS I STORIES UNITS NUMBER ' DE CRIBE WO K TO BE DONE ( ACM PLOT PLAN) I PERMIT t l.> 1JE E FIL NUMBER r SUITE7 e �N SUBDIVISION NO LID NO \ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING REQUIRED DEDICATION _ PROPOSED TESCP Approved ❑ RW Permit Required ❑ Street Use Permit Read ❑ Inspection Required ❑ Sidewalk Required ❑ PRV REQUIRED YES ❑ NO ❑ 51ON AREA SEPA REVIEW ADS N0. ALLOWED I PROPOSED COMPLETE JEXEMPT SHORELINEa EXP VARIANCE OR CU PLANNING REVIEW BY DATE SETBACKS — FEET I HEIGHT I LOT COVERAGE SPECIAL INSPECTOR AREA OCCUPANT REQUIRED LOAD ❑ YES SPECIAL PROGRESS INSPECTIONS PER UBC 305 FINAL INSPECTION REQUIRED PLAN CHECK FEE BUILDING HEAT SOURCE: GLAZING PLUMBING O Plan Check No. MECHANICAL This Permit covers work to be done on private property ONLY. GRADINGIFILL Any construction on the public domain (Curbs, sidewPlka, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE Permit Application:180 Days Permit Limit:1 Year - Provided Work Is Started Within 180 Days STORM DRAINAGE FEE "Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE y successors in interest, agrees to indemnify, defend and hold v, harmless the City of Edmonds, Washington, its officials, x employees, and agents from any and all claims for damages of iwhatever nature, arising directly or indirectly from the Issuance of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT 0 modify, waive or reduce any requirement of any city ordinance ) i nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT OUE �. ' / �d provision." L `- 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• AUTHORIZES THE signed by the Building Official or his/her ed thereby, no person-" be employed in violation of the Labor Code of the State of Was fngton relating to Workmen's Compensa• ONLY WORK NOTED Deputy; and fees are paid, and receipt is tiort Insurance and RCW 18.27. INSPECTION acknowledged in space provided. IGNPTURE 1 NER OR. GENT) DATE SIGNED G DEPARTMENT CITY OF OFFICIAL SIG✓ATUR[ / DATE �J EDMONDS �..... �, CALL FOR RELEASED BY DATE &fTENTION INSPECTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ��� _Owwo 11 ORIGINAL — F,le YELLOW — inspector A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC CHAPTER 3. PINK — 0,n-•er GOLD — Assessor rh c .189j 1 GARY HAAKENSON CITY OF EDMONDS MAYOR 121 5TH AVENUE NORTH • EDMONDS, WA98020 • (425) 771-0220 • FAX (425) 771-0221 Website: wwwxi.edmonds.wa.us DEVELOPMENT SERVICES DEPARTMENT Planning • Building - Engineering November 23, 2004 Scott Abrahamson 117 5t' Ave S Edmonds, WA 98020 RE: Order to Correct — 117 5a' Ave S / Permit #2004-0464 A final inspection was performed at 117 5th Ave S on September 17, 2004. Final approval was given on the project; however, it has been brought to our attention that an extra stall was added in a location that was not approved. You are required to install the parking lot striping per the approved plan. Your permit file with the City will not be closed out until the extra stall is removed. I have enclosed a copy of the approved plan, and a plan showing the existing conditions on this site. The following options are provided as a possible way to make this correction. Option(s): 1. Paint extra line(s) black and place removable planters to prevent customers from illegally parking. 2. Hatch entire area as shown in the attachment. Please call for a final engineering inspection at 771-022o, ext.1326, once the striping has been corrected. If you have any questions, please feel free to contact me at T71-022o, ext.1322. Thank you, Jaime Hawkins Engineering Technician c: Permit *2004-0464 Street File Incorporated August 11, 1890 • C:-i-.. '-! -- T I -I-"•--- T-- -- I � c �z � ------- _-- _ o a I I oj; r c./)7— I I hU 11flrLOM PAID MSA — � 1 • (24) NW "-BAKERY N pz E z W Gy �ORm 1 z r A O d -0 cc1 U eo Z m� PAwan (4) Y p w H J 6 W Q W rxr few wcrU) Un z PMp10 (� O a C� EO+ a g rD PUKOW rowiEC Scott & Cindy Abrahamson , 0 OXV MAL 0) % Shell Creek Grill � A D e 0 uun 526 Main Street W A+' lz Edmonds, WA. 98020 425.775.4566 ;OUTH NORTH CONTENTS no= rim nu Plan / Equipment Layout DATE NOTE SEE SHEET A/2 FOR: M6/2004 FINISH SCHEDULE HS .osn'0/ "VAW SM EQUIPMENT SCHEDULE/LEDGER P".""0A" MAIN BUILDING PLUMBING SC14EDULEAEDGER DECEIVED Drawing No. E SHEET CS/1 APPROVED BY PLANNING .1UN I , 2004 A-1 --------------- '4 t �20 Y+✓.D . I w O I DP r• � D ncLs) : I '112) 1. PA,,,,.r Ekisrr►•c /N� AN iJ PLAce _ I (%4• D"STORAGE MOY6A$(,E PC.A4TEQ� + A (� PAENCIASeD I F 20 M� PA*RK IC� S (JME�Q TIO REA a p W )I 2. HA TC to L N T 1 ►2eRG A � A S I"H0M IN INFE NCE ►NZ .AGX 46 ri IK6 so•,ao•■ao• AGGIIEGATE OONUMTE FIJWTERs TYPICAL (NEW TOTAL 10) )UTH As U Pa14K/ qf,. w �c S E� lAl i T •`�'� i PARIWG (4) I w b N 1 k t5 J F— W Q t3 W I W F— $ U) � PARIWG (3) e.r O� err Q A A 0 r/ 1,171 4c Scott & Cindy Abrahamson Shell Creek Grill +snmu LmT 526 Main Street Edmonds, WA. 98020 425.775.4566 NORTH CL a O 0 W to C a Z N 0) 14 r Q 3hr Q Q Qa o r; eD ~ O Qi O Ca QmE AM z 0 0 CD F� z F+ n E-E M 0 v �440 W z oz a CC EO 0- CONTENTS Lnoost PLAN / ms M n I - .- CITY OF EDMONDS APPLICATION to the kRCHITECTURAL DESIGN BOARD OWNER ADDRESS kFSEN ATIVE CJr -W r FILE ARCHITECT/DESIGNER ���� ���'/ �• PROPERTY ADDRESS LEGAL DESCRIPTION If'/ PLANS SUBMITTED FOR APPROVAL: DATE FILE ! Z3 # l AJD13 ' 7l-g t SITE PLAN BUILDING PLANS (3): ELEVATIONS LANDSCAPE PLAN ENVIRONMENTAL DATA RECEIPT 0 SIGN EXHIBITS FEE RECPT # PLAN MODIFICATIONS TO FILE NUMBER: HEARING DATE CO — 7 — g PHONE ZIP CODE 1:7111(Foz(�7 X'�(°(�C��PHONE (� -�� �3 '/ W14 ZONING 1. Building Plans - Preliminary Final Site Plan V`Landscape Plan lj Elevations V 2. Sign Elevations Site Plan Landscape Plan 3. Modification of previous approval EXISTING USE OF PROPERTY DESCRIPTION OF PROPOSAL APPROXIMATE DATE WORK WILL BEGIN ON PROJECT ESTIMATED TIME FOR COMPLETION OF WORK l(:2)1179 RELEASE/HOLD HARMLESS AGREEMENT: The undersigned applicant, his heirs and assigns, in consideration for the City processing the application agrees to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages and/or claims for damages, including reasonable attorneys; fees, arising from any action or inaction of the City whenever such action or inaction is based in whole or in part upon false, misleading or incomplete information furnished by the applicant, his agents or employees. PERMISSION TO ENTER SUBJECT PROPERTY: The undersigned applicant grants his, her or its per- mission for public officials and the staff of the City of Edmonds to enter the subject property for the purpose of inspection and posting attendant�t this application. s ( ignature of; Applicant) IRA PAUL & PARTNERS, P.S. - ARCHITECTURE/RESEARCH/URBAN PLANNING September 22, 1981 Mary Lou Block Planning Director City of Edmonds 505 Bell Street, Edmonds, Washington Re : Brusseau's, 5th and Dayton, Edmonds, Washington Dear Mary Lou : In accordance with our discussions on the project as referenced above, this letter is to request that we be allowed to delete two parking spaces, of the existing five required parking spaces now in place at the restaurant site, on the basis of the In -Lieu Fee concept as defined by the City of Edmonds ordinance 17.50.070 (Downtown Area Parking Requirements). The two spaces which we are asking to delete, appear to presently have a significant potential for traffic hazard and pose some degree of risk of injury via accidents between pedestrians and automobiles, or parked and moving cars. It appears that we have ample available on -street parking in the im- mediate vicinity of the restaurant, which has continuously operated without parking difficulties since 1978; the restaurant use is to maintain a similar nature after remodeling, with major changes to be in the service related areas and kitchen, to improve the ability to operate it more efficiently, thus customer patterns should-. remain constant. In addition, the proposal does not detract from the possibilty of future central parking lots. A nice feature of our proposal, as per the attached site plan, would be the inclusion of four mature trees, along with decorative iron grates, in the area now occupied by the two parking stalls under discussion. We feel that this will add significantly to the enhancement of the site for both patrons of the restaurant and citizens of the community in general. Our thanks for the kind attention to this request, please advise if we can furnish any.o er materials to assist in the review process. Yours Very ruly, IRA PA V,/& PARTNERS, P.S. I Ira aul, Architect IP/cas cc. Jerilyn Brusseau 2134 THIRD AVENUE - SEATTLE, WASHINGTON 98121 J206) 682-6633 •8899 BEVERLY BLVD. • LOS ANGELES, CALIFORNIA 90048 - (213) 275-5311 0 9 IRA PAUL & PARTNERS, P.S. • ARCHITECTURE/RESEARCH/URBAN PLANNING BRUSSEAU'S RESTAURANT : EDMONDS Color pallette of new construction is to precisely match the existing building colors. This will apply to exterior wall surfaces of the building and new awning elements which will be integrated into the exisitng awning pattern. The low planter elements will be painted to match the light cream color of the existing building wall surfaces. The Brussea's sign presently on the angled surface awning will be moved to a new position on the new entry awning facing perpendicular to the present position, and parallel to the street front exposure. r 2134 THIRD AVENUE - SEATTLE, WASHINGTON 98121 - (206) 682-6633 •8899 BEVERLY BLVD. - LOS ANGELES, CALIFORNIA 90048 . (213) 275-5311 r� rres of-yrnNQ ww+- - — ur _ •. - i � � elrenr �1 H- Om[ • .va P.t� im M�'�icM tUu.aW& Q � _ �'jD firt�N 9�br'6• � — k� —6 - j2 Gd��Tl t' 1 E�IS�1`r- �M1Ovy�eT _ B�irljjNQ ' �/.'Ljc— Fifth Avenue South #_ a ;' La Ira � • ILA ar Memo to ADB Members Page 2 - October 7, 1981 be turned in and approved by the City Engineer prior to Building Permit review. Owner will be. required to sign a 'support of LID form' for future improvements in 242nd Street S.W. ADB-67-81 DOCES ENTERPRISES Review of remodel of existing facility at 24111 Highway 99. (.CG) New parking arew as.presented appears.satisfactory. ADB=68-81 THE CALLISON PARTNERSHIP Review of site, elevations and landscaping for remodel of buildingat.120 5th Avenue South..(BC) The parking lot as shown.is-acceptable. Permanent curb stops must be provided for all parking stalls. Also, the city -shall require that the sidewalk panels that are broken or damaged along the Dayton Street and 4th Avenue property lines be replaced. ADB-69-81 DAN AND MEL:BROOK Review of sign, Yankee Trader" at 117 5th Avenue North. (BC) No comment. ADB-71-81 JERILYN CHENEY BRUSSEAU . Review of landscaping, awnings and parking addition to "Brusseau's" at 117 5th Avenue South. (BC) Existing curb cuts on 5th to be removed and sidewalk to be brought to city standards. ADB-72-81 DANIEL BRADY Review of proposed professional office building at 8326 196th Street S.W. (RM-2.4) The parking/backout-areas to be paved per City standards. DS/mt `�— D BUSINdk LICENSE APPLIZJCATION"J %OU CITY OF EDMONDS 250 5TH AVENUE NORTH EDMONDS, WASH. 98020 S� �-�T F'LEEPHONE (206) 775-2525 INSTRUCTIONS 1. PRINT APPLICABLE LICENSE CLASS, FEE AND PENALTY PAID IN ANNUAL FEE BOX AT RIGHT. PENALTY DUE ON RENEWALS RECEIVED BY CITY CLERK AFTER FEBRUARY 15. 2, NEW BUSINESS: COMPLETE ALL LICENSE APPLICATION BOXES. LIC. RENEWAL: REVIEW LICENSE INFORMATION BELOW. PRINT CORRECTIONS AND ADDITIONS AT RIGHT. 3. SIGN AND RETURN APPLICATION WITH FEE (AND PENALTY). 4. LICENSE WILL BE MAILED TO YOU UNLESS YOU ARE NOTIFIED TO APPEAR FOR APPLICATION REVIEW. 1 . = • LICENSE RENEWAL REVIEW BELOW INFORMATION, PRINT CHANGES AT RIGHT. ANNUAL FEES TYPE BUS. CLASS FEE PENALTY HOME A $10.00 $ 5.00 SMALL B 15.00 7.50 'GENERAL C 50.00 25.00 2. APPLICANT NAME SOCIAL SECURITY NO. DATE OF BIRTH PLACE OF BIRTH HOME ADDRESS 3. BUSINESS IDENTIFICATION BUSINESS NAME NATURE OF BUSINESS BUSINESS PHONE WASH. STATE TAX NR. EMPLOYEES =CUPANCY 'OVER 10 EMPLOYEES, OR EMPL WORK OVER 120 MAN -MONTHS PER YEAR. CLASS FEE PAID PENALTY PAID 151C TYPE ORGANIZATION IF BUSINESS IS: TYPE C PACITY C HOTEL/MOTEL L NR ROOMS/UNITS C CORPORATION O APT. BLDG. A R APTS D L - LTD. PART OFFICE BLDG. 0 lNR OFFICES E P • PARTNERSHIP RESTAURANT R NI' F SEATS S S - SOLE OWNER HOSP./NURS. HOME H OF BEDS SCHOOL e F, iR OF STUDENTS 4. BUSINI BUSINESS 5. EMERGENCY NOTIFICATION NAME AREA TELEPHONE (1) (2) OFFICIAL USE ONLY U.F.I.R. CODE BLDG. PERMIT OCCUP. C.U. PERMIT LAND USE I ZONING STAFF ACTION REVERSE APPL. NO.: �•/ � (ate_ SIDE DATE: � � �6� •% $ APPLICATION FOR: NEW ❑LIC. LICENSE Q BUS. RENEW YEAR U J LICENSE NUMBER ACTIOfta LA - NEW /(11 LB - RENE111WAI LC • CHANGE LD • DELETE /-,CLAISJ LJg, EFFEC. DATE REASG. LIC. NO. SI" 6 RECEIPT NO. DATE PAID t PRINT 'X' 1 IN SPEC. BO FOR ISSUE U FEE PAID PENALTY. PAID C O R R E C T S, LICENSE Will S ' v 'LC' ACTION. LICENSE APPLICATION AND CHANGES PLEASE PRINT CLEARLY 2. APPLICANT LAST NAME, FIRST INITIAL SOCIAL SECURITY NUMBER s s A D 1 A Is3 U �y DATE OF BIRTH PLACE OF BIRTH / MO. DAY YE,�R' r�Cl STAID 2�i�ISI IUIM I T/�HOME ADDRESS BLDG. NUMBER STREET APT. NO. CITY, / �� ZIP CODE d I✓d 1, d nC 3. BUSINESS IDENTIFICATION BUSINESS NAME (FULL) f u -CIS e u-C NATURE OF BUSINESS (DRUG STORE, CPA, ETC) BUSINESS PHONE WASH. STATE TAX NR. ANf2yo CUPANCY (REGISTRATION) NR. EMPLOYEES CAPACH Imo' 4 ENTER APPLICABLE TYPES AND CAPACITY T? 476USINES$ ADDRESS _ BLDG. NUMBER jjVREET APT. N0. .LICENSE MAILING ADDRESS BLDG. NUMBER STREET APT. NO (7 �1 CITY ' SjQTAJZIP CODE 5. EMERGENCY NOTIFICATION (IN EVENT OF FIRE, BURGLARY, ETC.) LAST NAME, FIRST INITIAL AREA CODE TELEPHONE (1) ss 6 77 y s'o LAST NAME, FIRST INITIAL AREA CODE TELEPHONE (2) L.L_ — 5S OFFICIAL USE ONLY U.F.I.R. PRIM. UNITS BUS. BLDG. PERMIT OCCUP. - CODE 5, 3 Irll 5'I I I I I� COND. USE PERMIT LAND USE ZONIN� APPLICANT'S CITY CLERK'S SIGNATURE SIGNATURE ❑. APPROVED ❑ DISAPPROVED DATE BUS. TITLE RETURN CITY CLERK FORM CC-1 (10/76) TO S DATE veyo BUSINg LICENSE APPLICATION .\ • t ': CITY OF EDMONDS 250 5TH AVENUE NORTH _T 7 ga,g4 EDMONDS, WASH. 98020 TELEPHONE (206) 775-2525 5u�-iET FILE INSTRUCTIONS 1. PRINT APPLICABLE LICENSE CLASS, FEE AND PENALTY PAID IN ANNUAL FEE BOX AT RIGHT. PENALTY DUE ON RENEWALS RECEIVED BY CITY CLERK AFTER FEBRUARY 15. 2. NEW BUSINESS: COMPLETE ALL LICENSE APPLICATION BOXES. LIC. RENEWAL: REVIEW LICENSE INFORMATION BELOW. PRINT CORRECTIONS AND ADDITIONS AT RIGHT. 3. SIGN AND RETURN APPLICATION WITH FEE (AND PENALTY). 4. LICENSE WILL BE MAILED TO YOU UNLESS YOU ARE NOTIFIED TO APPEAR FOR APPLICATION REVIEW. LICENSE RENEWAL REVIEW BELOW INFORMATION, PRINT CHANGES AT RIGHT. OF BIRTH HOME ADDRESS SECURITY NO. iANNUAL FEES TYPE BUS. CLASS FEE PENALTY HOME A $10.00 S 5.00 SMALL B 15.00 7.50' *GENERAL C 50.00 25.00 3. BUSINESS IDENTIFICATION BUSINESS NAME NATURE OF BUSINESS BUSINESS PHONE WASH. STATE TAX NR. EMPLOYEES I ORGAN. ' OCCUPANCY J 'OVER 10 EMPLOYEES, OR EMPL WORK OVER 120 MAN -MONTHS PER YEAR. CLASS I FEE PAID I PENALTY PAID TYPE ORGANIZATION IF BUSINESS IS: TYPE CAPACITY C HOTEL/MOTEL L NR OF ROOMS/UNITS 0 C - CORPORATION APT. BLDG. A NR OR APTS D L • LTD. PART OFFICE BLDG. 0 NR OF OFFICES E P • PARTNERSHIP RESTAURANT R NR OF SEATS S S - SOLE OWNER HOSP./NURS. HOME H NR OF BEDS SCHOOL S NR OF STUDENTS BUSINESS ADDRESS LICENSE MAILING ADDRESS 5. EMERGENCY NOTIFICATION OFFICIAL USE ONLY NAME AREA TELEPHONE (1) (2) U.F.I.R. CODE BLDG. PERMIT OCCUP. C.U. PERMIT LAND USE ZONING STAFF ACTION C F�I. APPL. NO.: DATE: APPLICATION FOR: ' NEW ❑ LIC LICENSE BUS. RENEIV YEAR J LICENSE NUMBER ACTIOtil ( LA NEW BUS Jll LB - RENEWAL LC •CHANGE LD •DELETE - l 9, 1 1 1 1 1 1 1 1 1 CLASS YEAR LIC. EFFEC. DATE REASG. LIC. N0. SPE RECEIPT NO. DATE PAID A&d - 11 _ 5 � PRINT 'X' IN SPEC BOX FOR ISSUE OF FE PAID PENALTY PAID CORRECTED ' LICENSE WITH I __ L i I 'LC' ACTION. LICENSE APPLICATION AND CHANGES, _- PLEASE PRINT CLEARLY J SOCIAL SECURITY NUMBER DATE OF BIRTH PLACE OF BIRTH M0. DAY YEAR CITY STATE j(• Il''1l I I I I` ICI HOME ADDRESS � 3. BUSINESS IDENTIFICATION BUSINESS NAME (FULL) NATURE OF BUSINESS (DRUG STORE, CPA, ETC) BUSINESS PHONE ' WASH. STATE TA NR. ANTICIPATED TYPE OF OCCUPANCY 1 (REGISTRATION) NR. EMPLOYEES ORGAN. TYPE CAPACITY In �cC 1L rl I II t— ENTER APPLICABLE TYPES AND CAPACITY T t � I 4. B ,—SINE—SS ADDRESS B '447BER [STREET LICENSE MAILING ADDRESS BLDG. NUMBER STREET 1 e _1 t1 LAI L�� � i 1 ,b' C 11 C ', 1; CITY STATE L• I;. il. APT. N0. i t I APT. N0. i 1� ZIP CODE I 1 I I c( I 5. EMERGENCY NOTIFICATION (IN EVENT OF FIRE, BURGLARY, ETC.) LAST NAME, FIRST INITIAL,. AREA coos TELEPHONE LAST NAME, FIRST INITIAL AREA CODE TELEPHONE (2) 5S OFFICIAL USE ONLY U.F.I.R. PRIM. UNITS BUS. CODE V COND. USE PERMIT LAND USE II I_J CITY CLERK'S APPLICANT'S' SIGNATURE SIGNATURE APPROVED � DISAPPROVED GATE BUS. TITLE / FORM CC-1 00: 76t RETURN TO CITY CLERK 11,10(cl(cl ti BLDG. PERMIT 5S OFFICIAL USE ONLY U.F.I.R. PRIM. UNITS BUS. CODE V COND. USE PERMIT LAND USE II I_J CITY CLERK'S APPLICANT'S' SIGNATURE SIGNATURE APPROVED � DISAPPROVED GATE BUS. TITLE / FORM CC-1 00: 76t RETURN TO CITY CLERK 11,10(cl(cl ti BLDG. PERMIT OCCUP. GRP. ZONING DATE CITY of EDMONDS BUSfSS LICENSE APPLIGAT,(ON Civic Center • Edmonds, Washington 980 DAT LICENSE NO. City Clerk Phone 775 2525 TYPE OF BUSINESS ANNUAL FEE AFTER FEB. It CLASS YEAR LIC. EFFEC. DATE REASG. LIC. NO. SPEC. ❑ (A) HOME OCCUPATION $ 15.00 $ 22.50 INSTRUCTIONS: Q Is 7 fall 11 11111111 E (B) BUSINESS WITH $20.00 $ 30.00 • All items must be completed RECEIPT NO. DATE PAID 1 TO 3 EMPLOYEES or application will not be ac- (o p O s 06 PN INSPEC. BOX ❑ (C) BUSINESS WITH 4 TO 9 EMPLOYEES $22.00 $ 33.00 cepted. • Sign and return application FEE PAID 2 p;0 O PENALTY PAID I FOR ISSUE OF CORRECTED LICENSE WITH 'LC' ❑ (0) BUSINESS WITH 10 OR MORE EMPLOYEES $75.00 $112.50 with fee. Renewals received ACTION. J� NEW APPLICATION (LA) after February 15 must pay penalty in addition to fee. ❑ RENEWAL (LB) NEW BUSINESSES AFTER ❑ CHANGE (LC) JULY 31, 1/2 FEE. (PLEASE MAKE ANY NECESSARY CHANGES) ❑ DELETE (LD) NAME F FIRM BUSINESS PHONE NO. OF EMPLOYEES GV/itlQAJ ; 7 7 / —(0,,F3 2 R E CA I V E D MAILING ADDRESS 0 �;/l NATURE OF BUSINESS 71982 MAY E'er A4 o nl .D SX (r.� A • cl p o BUSINESS ADDRESS QIr7_ STN 07W—` INDIVIDUAL PARTNERSHIP CORPORATION �cv�s tVA F✓ (S) T) (C) OWNERS NAME HOME ADDRESS A HOME PHONE ATE OF By)R�TH PLACE OF BIRTH SOCIAL SECURITY NUMBER 7 7 / - (,P'2D F3 - vl."?al k/ ./ vjez 1 C25-- *,'16- 5��6 EMERGENCY NOTIFICATION (1) NAME & TELEPHONEAn (PLEASE LIST TWO) (2)�Cni rlr7iz/zis NAME & TELEPHON_ . WASHINGTON STATE TAX NO. r:f t- Lid✓ APPLICANT'S SIGNATURE DO NOT WRITE BELOW THIS LINE STAFF REVIEW: FILL IN LAND USE CODE, UFIR NUMBERS, ZONING, ETC. CHECK APPROVAL OR DISAPPROVAL, DATE, AND SIGN. IF DISAPPROVAL, PLEASE COMPLETE "COMMENT" SECTION. ROUTE TO NEXT DEPARTMENT ON LIST. PLANNING DEPARTMENT DATE 5 B LAND USE CODE ZONING CODE r- APPROVE ❑ DISAPPROVE 71 SIGNATURE 10 CONDITIONAL USE PERMIT COMMENTS E m BUILDING DEPARTMENT DATE Building ❑ Hotel/Motel (L) IVAPPROVE ❑ DISAPPROVE SIGNATURE —0_� !: Permit ❑ Apt. Bldg. (A) ❑ Office Bldg. (0) COMMENTS: Occupancy ❑ Restaurant (R) Group ❑ Hosp/Nurs Home (H) CAPACITY: (NO. UNITS, APTS. OFFICES, SEATS, BEDS, STUDENTS) 13-1 ❑ School (S) FIRE DEPARTMENT DATE L V,APPROVE ❑ DISAPPROVE SIGNATURE COMMENTS: 1 I M M I a I a - roll, Indiffilimm P�E DEPARTMENT d_' ff APPROVE ❑ DISAPPROVE DATE 246 '- Z SIGNATURE 1- �'� �'` COMMENTS: PUBLIC WORKS DEPARTMENT ❑ APPROVE ❑ DISAPPROVE DATE �a SIGNATUR COMMENTS: DI GA CD DGTI 1DKI "rn r`ITV r�I CI",L, 0 • CITY OF 200 DAYTON ST. • EDMONDS. WASmNGTON 98020 • (208) 175 25^,1, DEPARTMENT OF PUBLIC WORKS March 16, 1981 Dear Resident: HARVE H. HARRISON MAYOR On February 17, 1981, the Edmonds City Council passed Resolution 488 for construction, reconstruction and repair of deteriorated sidewalks. A public nearing will be held in the Council Chambers at the Civic Center on April 21,198.1 at 7:30 P.M. You are invited to attend this.hearing for discussing repair of portions of deteriorated sidewalk_ abutting your property. The improvement of —sidewalks in need of repair at the expense of the abutting property owner is provided by City Ordinance, Chapter 7.20 and Revised Code of Washington, Chapter 35.68. The areas needing repair have been marked in paint on the sidewalk adjoining your property. Reconstruction and repair of these sidewalks must be completed on or before September 1, 1981. In the event improvements are not completed within the above specified time, the City will perform and complete the improvements at: the expense of the abutting property owner. This action is in response to many citizen reouests and pedestrian falling accidents which have been increasing in recent years as a result of sidewalk deterioration and increased pedestrian traffic. Sincerely, F RED F. HERZBERG Director. of Public Works w� ! ;Fig) R 3 1 i48 ('ublic vuorks UUPL. CITY OF E®MONDS CIVIC CENTER • EDMONDS, WASHINGTON 98020 • (206) 775-2525 COMMUNITY DEVELOPMENT DEPARTMENT March 31, 1978 ,:Dennis Brusseau 117=5th Avenue South Edmonds, Wa. 98020 BUILDING PERMIT #780048-GREASE INTERCEPTOR This in answer to your letter of March 13, 1978. After consideration, including review by the City Engineer, your request to exempt the grease interceptor requirement is approved, based on use of the kitchen facilities as you have described them. Any future change to the plumbing and its use will require review of the Code requirements. I r 4 / L Harry M. tcutt Building Official HMW/ae cc: Public Works HARVE H. HARRISON MAYOR S7, ;LEA FILE � March 29, 1978 MEMO TO: Harry Whitcutt Building Official VIA: John LaTourelle, Director Community Development Department FROM: Leif R. Larson, P.E. Director of Public Works SUBJECT: GREASE INTERCEPTOR AT 117 FIFTH AVENUE SOUTH In reference to your memo of March 13, 1978, we are concerned that various use changes may cause the need for a grease interceptor. Based upon the assurance that no changes in the plumbing would be done without a permit from the Building Department, the intended operation will not require an interceptor at this time. RHA:ly CITY OF EDMONDS PUBLIC WORKS DEPARTMENT TO: SUSPENSE DATE: LU ~ Q W ix o�1d DIRECTOR Investigate and Report Take Appropriate / ✓ ADMINISTRATIVE SECRETARY ASST. CITY ENGINEER Action Prepare letter/memo for my signature BUILDING &GROUNDS SUPT. EQUIPMENT RENTAL SUPT. For Information STREET DIVISION SUPT. Previously Ref'd Status of Action? Return to: TREATMENT PLANT SUPT. WATER/SEWER SUPT. COMMENTS: w )L o �i g e , L/ F'Ss 9 FROM: LEIF R. LARSON, P.E. DATE: (3/77) 0 1� fir' ' I . MR 14 Public WarKS uupt- March 13, 1978 MEMO TO: Leif Larson, Director Public Works FROM: Harry M. Whitcutt Building Official SUBJECT: GREASE INTERCEPTOR -BUILDING PERMIT #780048 117-5th Avenue South Please review the attached to determine if we can administratively exempt the installation of an interceptor. HMW/ae attachment DENN I S BRUSSEAU - 20031 88TH AVENUE W - EDMONDS, WASH I NGTON 98020 13 March 1978 Mr. Harry M. Whitcutt Building Department City of Edmonds, Washington Dear Mr. Whitcutt: I am writing to you regarding the Uniform Plumbing Code, Section 711 , as it pertains to our bakery -delicatessen at 117 Fifth Avenue South, Edmonds. It is our intention to provide the following services: bread baking, serving of coffee,sales of cheeses, precooked meats, pre -packaged gourmet foods, as well as cookbooks, gourmet cookware and baskets. We will combine the freshly baked breads with the pre-cooked meats and cheeses to sell sandwiches for take-out as well as for on -premises consumption. Section 711 of the Uniform Plumbing Code states ".......an approved grease interceptor ........ is required ....... where grease may be introduced into the draining or sewerage system in quantities that can effect line stoppage or hinder sewage treatment or private sewage disposal ." Because we will not be introducing grease in quantities to effect line stoppage or hinder sewage treatment, we feel that our business should be exempt from the requirement for a grease interceptor. Thanking you in advance for your kind consideration of this request, Dennis Brusseau ���� � iUr.ff��'✓tr FILE DATE: ' ?.tE�10 T0: Building Division Community Development Department FROM:' Engineering Division Public 1'dorks Department SUBJECT: 1 / / IN 19 After review of the subject building permit application, we have the following comments: (1) Coordination of the location of any structure with respect to utilities, streets, property lines and driveway graces is the resnonsibili.ty of the contractor. (2) The contractor is required to keep the abutting streets clean- ed of dirt and debris caused by the construction. (3) A "Right -of -Way Construction Permit" is required, from the Engineering Division of Public Works, for any work within the Public Right -of -Way or public easement. Driveway slopenot • exceed 14%. m" , I --I L MIEWI-1 =Wlklrbls� 1 Air N P11 S/77 _ mg BUIIDING PERffT REVIEW. -;TT� AM I C"Th (address) te -Street Right -of -Way Existing REQD Access Easements Existing N�' REQD H a Utility Easement Existing w Lot Per Subdivision Plat Assessor Map w Site Plan Checked for Accuracy Underground Wiring Reqd. H Check Accuracy of Legal Description z Review by4W AL r Date 1 w Existing Water Main Size 12 G2 Water Main Required N Service Line Required 1✓ e c y c-� Hydrant Size Existing fJ�l P4 Hydrant Reqd Per Fire Code Size w Detector Check Meter Reqd. VO Cross Connection Inspection 0 N Fire Department Comments Water Meter Charge Regd. Nlc- Review by ,Q Date 1-24-76 Septic Tank Design Approved )J A Date Septic Tank Permit Reqd. Permit No. Sanitary Sewer Availability. Proj . Drawing No. AJA- File No. Side Sewer Availability GmQE"s C R-acu.i2E•o' F15C w Sanitary Sewer Connection Fee Reqd. O 3 Review by 2— Date w Open Ditch Existing, Regd. Culvert Regd. J Size x Catch Basin Reqd. IVA Indicate on Site Plan -- Shoulder drainage maintain collection on swale open runoff H Manhole re d. q I/' r. Indicate on Site Plan — Soil Conditions and Ground Water Field Checked Review by �� - Date Revised: lv10-1977 Page 2 � • H W W w E, Street Paving Reqd.�' Curb and Gutter Reqd. Sidewalk Reqd. Curb Cut for Drri y Reqd. Right -of -Way Constructicm Permit Reqd. Bond Reqd. for Public Irnpravements Street Name Sign Reqd._ Other Signing Reqd. ' e A .. Pre Permit Site Inspection made on z BY: SEWER H W W WATER a H H STREET PT_ ENGINEERING '4 Special Requirements listed in memo to Community Development Department, Building Division BY $ Date o All items filled in on Building Permit Application 24 w BYfW Date Drawings Stamped and Notations Made BY45b! Date Approved by Public Works Department Revised: 1v 10-1977 � EC'! FILE 0 CITY OF R®MONDS HARVE H. HARRISON MAYOR CIVIC CENTER • EDMONDS, WASHINGTON 98020 • (206) 775-2525 COMMUNITY DEVELOPMENT DEPARTMENT STREET FILE March 31, 1978 Dermis Brusseau 117-5th Avenue South Edmonds, Wa. 98020 BUILDING PERMIT #780048-GREASE ID]TERCEPTOR This in answer to your letter of March 13, 1978. After consideration, including review by the City Engineer, your request to exempt the grease interceptor requirement is approved, based on use of the kitchen facilities as you have described them. Any future change to the pltmnbing and its use will require review of the Code requirements. i atcutt M. Building Official HMW/ae cc: Public Works N� MEMO TO: VIA: FROM: 0 Harry Whitcutt Building Official E March 29, 1978 John LaTourelle, Director Community Development Department Leif R. Larson, P.E. Director of Public Works SUBJECT: GREASE INTERCEPTOR AT 117 FIFTH AVENUE SOUTH RECEIVED c W R Z 0 1978 City of Edmonds community iDeo. Dept. In reference to your memo of March 13, 1978, we are concerned that various use changes may cause the need for a grease interceptor. Based upon the assurance that no changes in the plumbing would be done without a permit from the Building Department, the intended operation will not require an interceptor at this time. RHA:ly DENN I S BRUSSEAU - 20031 88TH AVENUE W - EDMONDS, WASH I NGTON 98020 A 04 ?;V e13 March 1978 Mr. Harry M. Whitcutt Building Department City of Edmonds, Washington Dear Mr. Whitcutt: I am writing to you regarding the Uniform Plumbing Code, Section 711 , as it pertains to our bakery -del icatessen at 117 Fifth Avenue South, Edmonds. It is our intention to provide the following services: bread baking, serving of coffee,sales of cheeses, precooked meats, pre -packaged gourmet foods, as well as cookbooks, gourmet cookware and baskets. We will combine the freshly baked breads with the pre-cooked meats and cheeses to sell sandwiches for take-out as well as for on -premises consumption. Section 711 of the Uniform Plumbing Code states ".......an approved grease interceptor ........ is required ....... where grease may be introduced into the draining or sewerage system in quantities that can effect line stoppage or hinder sewage treatment or private sewage disposal ." Because we will not be introducing grease in quantities to effect line stoppage or hinder sewage treatment, we feel that our business should be exempt from the requirement for a grease interceptor. Thanking you in advance for your kind consideration of this request, Dennis Brusseau t.�l-, yP .itiC'�AV k.�Eu -- - - - - -- -�- o<•) ,El, ,oal, (i7 (� non❑ DISH WSH'G "O1n0°"1Of,n � (m <m (m g DINING AREA o <m� (n)(y) , PAW AMA I r+ I L SERVICE AREA C. ® _ I (r) I 1.l ,cam— (M) ! 21 (n) ps BAKERY (30 n/srTv a�w S) CED Ic I (v)om \ YA km W.U.G T -1 - f T 1- -I-T IA n� T �� �" i�•"ghP) I I I I I I I I I I I I r _,. I I I I I I p I I I► (,,, I- I I I =1= =1= I I-T I I I I I I W (m OUTSIDE x «.Fxr Q 3 w 1111, °"' Li z - (_) (m P- (» < o O-Ot I (m DINING ARE ACCESSIBLE PARKING --- �— --- —---------- .--i--•--}-----�� T Scott & Cindy Abrahamson SIDEWALK 0— u % Shell Creek Grill 526 Main Street smaT o� an n Edmonds, WA. 98020 196 Sq.Ft. EXTERIOR SERVICE AREA 425.775.4566 REVCE9EE�1 9 700 Sq.Ft. OUTSIDE DINING AREA FIFTH AVENUE SOUTH NORTH JUN 1 1 2004 Proposed Floor Plan / Equipment Layout BUILDING DES S l t e Plan NOTE SEE SHEET A/2 FOR: FINISH SCHEDULE SCALE 1/8' = 1'—O" 1,698 Sq.Ft. MAIN BUILDING EQUIPMENT SCHEDULE/LEDGER PLUMBING SCHEDULE/LEDGER ` REVISED 05/11/04 RESTROOM(S) SEE SHEET CS/1. ,y REVISED 05/25/04 PARKING #P20 City. Edmonds Development Services Department Planning Division Phone: 425.771.0220 Fax: 425.771.0221 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 the application 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). Date Received: fJ �5' City Receipt #: Critical Areas File #: 4— Critical Areas Checklist Fee:$135.00 Date Mailed, to Applicant: 5-13-7-004 A property owner, or his/her authorized 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. Please submit a vicinity map, along with the signed copy of this form to assist City staff in finding and locating the specific piece of property described on this form. In addition, the applicant shall include other pertinent information (e.g. site plan, topography map, etc.) or studies in conjunction with this Checklist to assistant staff in completing their preliminary assessment of the site. The undersigned applicant, and his/her/its heirs, and assigns, 'in consideration on the processing of the application agrees to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or incomplete information famished by the applicant, his/her/its agents or employees. By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my knowledge and that I am authorized to file this application on the behalf of the owner as listed below. SIGNATURE OF APPLICANT/AGENT DATE ,l . ;�Q . 0 Property Owner's Authorizati By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application, and grant my permission for the public offic' arrd-he sta o e City of Edmonds to enter the subject property for the purposes of inspection and posting t to this applicatio . SIGNATURE OF OWNERS4-- PLEASE PRINT CLEARLY Owner/Applic nt• Ne;ne �Imt Address f City State Zip Telephone:t____i_�^ O7D Applicant Representative: z-'so Name Street Address cC��Lte-vz wig— °��2� City State Zip Telephone: "2D (.P :9S a -jLS &5 Email address (optional): Email Address (optional): Critical Areas Checklist Site Information (soils/topography/hydrology/vegetation) 1. Site Address/Location: 2. Property Tax Account Number: 3. Approximate Site Size (acres or s 4. . Is this site currently developed? JL--y-es; If yes; how is. site developed? 5. Describe the general site topography. Check all that apply. Flat:less than 5-feet elevation change over entire site. CA File No: 04-W 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 over. a horizontal distance of 33 to 66-feet). Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a horizontal distance of less than 33-feet). Other (please describe): 6. Site contains areas of year-round standing water: k— ; Approx. Depth: 7. Site contains areas of seasonal standing water: A—; Approx. Depth: What season(s) of the year? 8. Site is in the floodway K — floodplain of a water course. 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round? Mio Flows are seasonal? (What time of year? ). 10. Site is primarily: forested ; meadow • shrubs ; mixed urban landscaped (lawn, shrubs etc) Bra 11. Obvious wetland is present on site: 1. 2. 3. 4. 5. For City Staff Use Only Plan Check Number, if applicable? 0H ` 0Xq I Site is Zoned? (3 C SCS mapped soil type(s)? 14 P 5 - f 1dY(wo 40 - V Ndu ,-, Critical Areas inventory or C.A. map indicates Critical Area on site? No nR Site within designated earth subsidence landslide hazard area? NO r(e. DETERMINATION tUIRED WAIVER Date: of �G CITY OF EDM(WS USE PNW7- ad "EET BUILDING PERMIT APPLICATION JOKE ER FILL NAFAE (OR NAME OF BUSINESS) ADDRESS �,{)1 I ADDRESS 17 - Jh �� - q5 W LEGAL DESCRIPTION SUBDIVISION SHORT SUB NO. E 1. �i / x��` MMM��� W MAI G �DR Z 0 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP C TV E EJiONE NUMBER �(// � EXISTING Z PROPOSED 60 W DEFICIENCY OF RIGHT OF WAY 0 _ Z U FA CH KED D W ADD E Z F SEE ENGINEERING MEMO DATED W U.04 C CIT TELEPHONE NUMBER REMARKS NAME E METER SIZ 0 ADDRESS VVBUILDING ICUPPLfY SIZE FIXTU E UNITS C F W U F Q REMARKS Q FCITY TELEPHONE NUMBER Z 0 U STATE LICENSE NUMBER CITY LICENSE NUMBER SIGN AREA ENV. REVIEW ADS NO. ALLOWED PROPOSED COMPLETE' EXEMPT D-6- l X/ SHORELINE Legal Description of Property (Show Below or Attach Four Copies) VARIANCE OR CV PLAN G EVI DAT o ! 0 �/ YARDS LOT COVERAGE (� a_ Z C 5 FRONT SIDE REAR Z N REMARKS Z W 0 a J Q W W J •e ❑ NEW RESIDENTIAL F] PLUMBING CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT ❑ NON-RESIDENTIAL ❑ MECHANICAL ADD DEMOLISH SIGN SPECIAL INSPECTOR JAREA OCCUPANCY OCCUPANT REQUIRED GROUP LOAD ALTER EXCAVATE FENCE ❑ YES El NO [:]EXCAVATE OR FILL 1 X—FT) REMARKS Z Z REPAIR VE INSP./ swim a COMPLIANCE INSP, Lj POOL JJ Z NUMBER OF STORIES NUMBER OF m 0 DWELLING O F UNITS a NATURE OF WORK TO BE DONE ( TTACH PLOT PLAN) C U A( lvz W J W mfly0 PLAN CHECK FEE VALUATION FEE BUILDING PLUMBING MECHANICAL This Permit covers work to be done on private property ONLY. Any construction on the public domain (curbs, sidewalks, driveways, FENCE marquees, etc.) will require separate permission. SIGN Permit Application: 180 Days Permit Limit: 1 Year -Provided Work Is Started Within 120 Days RETAINING WALL Ln N "Applicant, on behalf of his or her spouse, heirs, assigns and SWIMMING POOL W successors in interest, agrees to indemnify, defend and hold harmless J 2 the City of Edmonds, Washington, its officials, employees, and m agents from any and all claims for damages of whatever nature, a z arising directly or indirectly from the issuance of this permit. Issu- o ance of this permit shall not be deemed to modify, waive or reduce TOTAL AMOUNT DUE any requirement of any city ordinance nor limit in any way the z City's ability to enforce any ordinance provision." ATTENTION APPLICATION APPROVAL hereby acknowledge at I have read this application; that the in - THIS PERMIT formati0 given is corr t; nd that I am the owner, or the duly author- is application is not a permit ized age t of the ow er. I gree to comply with city and state laws regu- AUTHORIZES until signed by the Building Official or lating c structio , and i doing the work authorized thereby, no person ONLY THE his Deputy; and fees are paid, and will be ployed iol on of the Labor Code of the State of Washington WORK NOTED receipt is acknowledged in space pro - relating 0 vvorkme 's ompensation Insurance, vided. SIGMA (OW R OR AGE ) DATE SIGNED INSPECTION DEPARTMENT DIRECTOR'S SIGNATURE CITY OF ) /" EDMONDS DATE THIS SITE IS LOCATED IN THE CITY 775-2525 OF EDMONDS. LOCAL SALES TAX SHOULD BE CODED 31.04. ATTENTION ORIGINAL — File YELLOW — Inspector IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE OCT 7 RECIY INK — Owner GOLD — Assessor UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 1 II�iU A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC 304, 306. 1 o2-7e DATE RECEIVED �> PERMIT EXPIRES CITY OF EDMONDS USE ZONE PERMIT U BE CONSTRUCTION PERMIT APPLICATION JOB surTE/APT# ADDRESS OWNER N"E/NAME OF BUSINESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. W/ U 15 MAILING ADDRESS K/ LID FEE t PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING PROPOSED REQUIRED DEDICATION FT roved HW Pormlt HeWMeO RW Pe rrdt Required Street Use Peimtl Raga Inspection Required Sidewalk Required end a arequired CITY ZIP g©� vvv TELEPHONE �y �� S 7V NAME �L4& METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES CI NO O =_ ADDRESS — r' 1 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE = z CITY n Q ZIP t{ TELEPHONE ' CJ NAME CBL q C ENGINEERING REVIEWED BY DATE ' .. ADDRESS FIRE REVIEWED BY DATE Io Q CITY ZIP TELEPHONE STATE LICENSE NUMBER EXPIRATION DATE r ^2j v S LO .J L. �C E Y : VARIANCE OR.CU. `% SHORELINE OR ADSdI' INSPECTION .1EQ'D AYES ONO BOND POSTED $ SEPA REVIEW COMPLETE ; EXEMPT":, EXP SIGN AREA., ALLOWED. PROPOSED, �, HEIGHT iA`LOWED PROPOSED PROPERTY TAX ACCOUNT PARCE) NO. ❑ NEW ❑ RESIDENTIAL PLUMBING/MECH ❑COMPLIANCE OR ADDITION }❑ COMMERCIAL CHANGE OFUSE ❑ REMODEL ❑ MULTIFAMILY .. ❑ SIGN. ❑ REPAIR �' GRADING ❑ FENCE CYDS ( X FT) LGE OT COVERA. pLLOWEp pROPO$Ep' ' - REQUIRED SETBACKS (FT.) FRONT 31DE' REAR PROPOSED SETBACKS (FT.) FRONT. j UR SIDE REAR i l PARKING, REQ'D" PROVIDED ; " = LOT AREA'' PLANNING REVIEWEd 8Y DATE V o REMARKS OTHER ❑ DEMOLISH ❑ TANK ❑ ,. O GARAGE RETAINING WALL FIRE SPRINKLER ❑ CARPORT �' ROCKERY ": ❑ FIRE ALARM ' ' Q (TYPE OF USE, USINESS 0,ACT ITY),EXPLAIN CHECKED BY PE dl'CONSTRUCTION GODS OCCUPANT GROUP O O NUMBER NUMBER OF 7. CRITICAL OF DWELLING . AREAS ,. STORIES UNITS �/ NUMBER Mk v SPECIAL INSPECTION REQUIRED.;O.�S• AREA,.:, OCCUPANT LOAD DESCRIBE WORK TO BE DONE r REMARKS 1 PROGRESWINSPECTIONSRER U8C 108%FINAL INSPECTION REO'D 9 VALUATION Description '; %ffE Description FEE - / P Plan Ch , k '' State Surcharge HEAT SOURCE GLAZING % „-> LOT`SLOPE %_s f ' BuildinpPermit s City Surcharge PLAN CHE NO: VESTED DATE PIUmI)litg'` Base Fee Mechanical I_ t THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Grading Engr. Review 2 W d PERMIT APPLICATION: 180 DAYS PERMIT LIMTC 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # v ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY OFROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE Landsca Ins �y DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Pe P Total Amt. Due = NOR LIMIT IN ANY WAY THE CnY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - Recording Fee Receipt # ..--- CKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION ORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL "IVENIS . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application is not a permit until signed by the IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building ONicial or his/her Deputy: and Fees are paid, and ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION race pile admovAedged in space provided. ENSATION INSURANCE AND RCW 18.27. F S ATURE DATE (OWN OR AGENT) 'DATE SIGNED (425) 771-0220 RELEASED BY AATE AiTtNTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE - YELLOW -INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER - GOLD -ASSESSOR 09/03 PRESS HARD -YOU ARE MAKING 4 COPIES DATE RECEIVED Id4lPERMIT EXPIRES 'CITY OF EDMONDS USE PERMIT ZONE NUMBER STRUCTION PERMIT APPLICATION JOB SUITE/APrtp ADDRESS /NAME OF BUSINESS FMAILING PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE S ESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING _T PROPOSED TESCP Approved RW et mdiUse RequirPamilt d Street Use PamJt Heq'd tnspectlonHequIred C� ZIP TELEPHONE OZO52 REQUIRED DEDICATION FT Sidewalk Required C� Vnderweund Wmprequired Q NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED w1 1 � I YES NO 13 Q C ADDRESS REMARKS z z NDE�R/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE O��/ W/ J /'�JAoftt CITY ZIP TELEPHONE .��^ Q Q NAME CBLII ENQINEERING REVD BY ,. DATE ADDRESSis7 o • FIRE REVIEWED BY DATE CITY ZIP TELEPHONE i< SVARIANCE STATE LICENSE NUMBER a� ; _ OR CV 7 SHORELINE OR ADS#' INSPECTION i EQ'D BOND POSTED �j y% 1� (S �C w� �( } i ro-' JS �S ONO S �. SEPA REVIEW :- SK4N AREA HEIGHT PROPERTY TAX AC OUNT PARCEL NO. COMPLETE . $XEMPT ALLOWED PROPOSED. ^^�LOWED PROPOSED 01, ❑ NEW RESIDENTIAL EfpLUMBING /,po --LOT COVERAGE `PROPOSPD REQUIRED SETBACKS (FT)-- PROPOSED SETBACKS (FT.) ALLOWED FRONT 51DE y REAR FRONT UR SIDE REAR O ❑ADDITION ; COMMERCIAL COMPLIANCE ORS ❑ CHANGEOFUSE. N�! O,`. O :(-; ` �� �� z z REMODEL MULTIFAMILY ❑ ❑ SIGN oL /- PARKING • READ 'PROVIDED LOT AREA PLANNINQ REVIEWEV DATE FENCE q '� a1 '; G/1�* GRADING ❑ REPAIR ❑ CYDS ( Fr REMARKS ❑ DEMOLISH ❑ TANK ❑ OTHER ❑GARAGE RETAINING WALL FIRE SPRINKLER ❑ ❑ 2 CARPORT ROCKERY .' FIRE ALARM (7OJ OR P YCHECKED 0 C NSTRUCTION C OCCUPA ITYpt ,.- GROUP NUMBER NUMBER OF CRITICAL INSPECTION AREA OCCUPA E� m OF ( DWELLING AREAS O STORIE8 UNITS. `} NUMBER 4/ASPECIAL REOUIRED,❑,YE$r 0 - LOAD DESCRIBE WORK TO BE DONE ,< ' P OQRESS,INSPEC11ONS:P.,ER USC 104/FINAL INSPECTION REGI'D 9 • � ev&�" PA_j A, R_ LA� P_jM' VALUATION n-"� � Description - ` 1' -;, EE Description FEE /V !C F 4A Plan -Check �(� State Surcharge � HEAT SOURCE CC G % `` �LO71 PE % a t ��.� r` Buildin' :Permit City Surcharge PLAN CHEC •— / 6, j VESTED DATE Plumbing Base Fee Mechanical LC --- t THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN Grading 7 (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. s Engr. Review PERYR APPLICATION: ISO DAYS Engr. Inspection d PERMIT LIYrC 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review. Plan Chk. Deposit —' IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF 2 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE �-yy S DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due OAP = NOR LIMIT IN ANY WAY THE CRY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged In space provided. WORKME ' PE "ON INSURANCE AND RCW 18.27. OFFICIA IGNAT E DATE TORE MANE OAT GNED %425) I' 'L - 26 771-0220 REL S BY AT ATTENTION EXT 1333 //� IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL V14(a A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE • YELLOJy-IN ECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER - GOLD -ASSESSOR 09/03 PRESS HARD -YOU ARE MAKING 4 COPIES le-INDATE RECEIVED _- n PERMIT EXPIRES u E .. PERMIT `' j'�� k ZONE 1 Ci(,/�-~ (SUiE/ I CITY OF EDMONDS NUMBER CONSTRUCTION PERMIT APPLICATION SUITE/APT# ADDRESS '�� A yr OWNER NAME/NAME OF BUSINESS PLAT NAME/SUBDIVISION N0. LOT N0. LID NO, �� � � � � � LID FEE $ MAILING ADDRESS TESCP Approved 13 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required Req'd ... A A /Y' Street Use Permit Required 0 CITY ZIP TELEPHONE EXISTING PROPOSED Sidewalk Sidewalk Required � Underground REQUIRED DEDICATION FT ------ Wiring required O ,,�^nn 15 lY ` METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED NAME YES ❑ NO ❑ _ uj W Z ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAQE Z _ W CITY ZIP (TELEPHONE NAME CBL# �6 G ADDRESS 7//6- 74/sT SUJ CITY ZIP TELEPHONE STATE LICENSE NUMBER EXPIRATION DATE (r) 4: - * --U-bS PROPERTY TAX ACCOUNT PARCEL NO. ❑ NEW ❑ RESIDENTIAL 0 PLUMBIN MECH ❑ ADDITION COMMERCIAL COMPLIANCE OR ❑ CHANGE OF USE ❑ 'REMODEL ❑ MULTIFAMILY ❑ SIGN ❑ REPAIR ❑ GRADING CYDS ❑ IENCE X FT) ❑ DEMOLISH ❑ TANK OTHER ❑ GARAGE ❑ CARPORT KERY WALL ❑ ROCKERY FIRE SPRINKLER ❑ FIRE ALARM FPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: 0_6;;:gz `'f4d '?- NUMBER OF NUMBER OF DWELLING CRITICAL AREAS STORIES UNITS NUMBER DESCRIBE WORK TO BE DONE/ /h;�nLIL Pac�-rd v I � 1 At 1! sK .1n =-r_Je�77 tip/ ) 7 . A) 7" ;S'o HEAT SOURCE_____r GLAZING % LOT SLOPE % 1..4 PLAN CHECK NO. VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REOUIRE SEPARATE PERMISSION. PERMITAPPLICATION: 180 DAYS' PERMIT LIMIT. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD 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, 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 PROVISION." I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION; THAT THE 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 STATE LAWS REGULATING CONSTRUC- TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE Of THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMQSNSAT,kq�~AN9E AND RCW 18.27. OR I DATE SIGNED .41 DATE FIRE REVIEWED BY DATE U. VARIANCE OR CU SHORELINE OR ADBH POSTED I �SPECTIONBOND $ -----. SEPA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED i EXP x LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE REAR PARKING LOT AREA I PLANNING REVIEWED BY D 3 o. REQ'D I PROVIDED k) p ►T CHECKED BY TYPE Cr T CO E OCCUPANT �� . GROUP �//✓`1 SPECIAL INSPECTION JAREA OCCUPANT REQUIRED ❑ LOAD YES l7 REMARKS PROGRESS INSPECTIONS PER UBC 108 / ISC109 / IRC109 FINAL INSPECTION REO'D 9 VALUATION $ 33 Description FEE Description FEE Plan Check �� State Surcharge G Building Permit City Surcharge 4:2 Plumbing Base Fee w Mechanical Grading . Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscape Insp. Total Amt. Due J� Recording Fee Receipt #� �1 GALL FOR INSPECTION (425) 771-0220 APPLICATION APPROVAL This application is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid, and receipt is acknowledged In space provided. OFFICIALS SIGNATURE DATE Z c EASE Y D E � ATTENTION EAT 13 , I7 IT I$ UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTILAFINAL IL 4 INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCU- ORIGINAL - FILE YELLOW- INSPECTOR GRANTED UBC100 / IBC1101 IRC110 PINK -OWNER GOLD - ASSESSOR PAM, T HAS BEEN 09/03 PRESS HARD -YOU ARE MAKING 4 COPIES 196 Sq.Ft. EXTERIOR SERVICE AREA 700 Sq.Ft. OUTSIDE DINING AREA FIFTH AVENUE SOUTH Proposed 24'-6' 4'-0' Scott & Cindy Abrahamson Shell Creek Grill +srn1r u526 Main Street Edmonds, WA. 98020 425.775.4566 --=Zz0n2?2M NORTH Floor Plan & Site Plan SCALE 1/8" = 1'-0" 1,698 Sq.Ft. MAIN BUILDING I II fAc'--% or wA L L--------------- C NO irxn' b !-,ir \Ain! ! STY L, I H ,, l! 1?2-o 12 41 M' rwgT WAS -IN cow �► •, � � 1 � �`i�H� ' ICY �i��f. ---___ - - � �� �� i�• 4l�I,L I --- i s trrtn�T�t2 L M IJ Tur7 WN _( Nora o ___ _ _._ .. _ - :I 13 IN�A, 1141r. AK � �1=� - -- I - ME3 rY Ll hl ALl� i _ I I - fN Cm ,I K�Vtyl,��f_ W_)T �WNb NJPW TO M4TGH r �T _.. ' hs CL":> i 2r16, 11 Tt���I�� It�� MILL K/WH" �_ rcr L wwv �� Tn MATui N-f; X2 m.LTowN4 r�j�Lr �JHW � - �, ocrvM,-,, ,7\,orprlY uNp - -- -- - NOFTH f.5 C_� LEGAL 1DC6CKFT10N LET- T � No M 4o r T ., Io6FTHpz.�- WlTH THr-Wr"2- T 94, 7 ? gPF q' [,gr --31 J P, THf- N&? ITN 46, mr. A_- IN ma*, 6r f�VHP` J A60F�i N� To fLAT �� N o LNG - 2 I E3L 1 I Lh( H 6 I)M T),f� V- IhV, � CI; f C 2�C�0 rsl - 5yz �� I r� �T L. • �Kwr- 4r , MFX EL A- L '5) WtA - 2 1, M # 4 X r11K LAe6r-r- mr, - � CCU - LAH tI �f � Z400 r,5d) f✓. I+�� 2 �Yw - �/w �YWr2 - IHr%), YVrt(wn -L rx • lYl(�AL FtzAN41 NCa rxvla:? - UV�, LOAF v� 25 r2sr- • G 113 M16C. NOLPh __ 1 Nan! VOWNSPOUT� TD S' c fV6 Tv C'- Rkj I Nil G - WAU-"7 Z 2 4_ wow 727 F. ' —rr CIrY nF r-C Y fr f�-1(I.-�I H� CCU &CH I HG OfZII HA ,:�;, I HMWAT�LY Hm r_( Ao1T cr or ��AMY 4-• wn� C INI� z2y VIIMH ( nF �rE v m TA T w/ WOI`- f VATVr 5 WC7L'-12 TKI M C ! Nrj�rjvi`') A�,, ->F H vN i loll t IDS l (� * FIND}. G Cn f FPjCrolZ TD C�-z---KrJ HAT" W/ N jG�---- `.�11�j'I=�i%�'� 7 AU_ 61.LL71nMCC_ &'MFt5( `'2F_� �-Qg�?1 LF Vn f f M4�)V�L CATS ONLY. pfT1C�NAL 11_ c c � �r n1E �r�I; rz r�,UW c�-0K_ q Mylc k I NET -�c �� r� I��u� O Ell-ALL vICFA A ►HTW-� TTI? A�2 Q � 1 b lo LUL 73 ccfo o o -- s O o ILA vo o, o �- INS F'Wh m fir N 'b� ST�L Rt1 nerAl� 1 11 1 11 , V, 2 � �T NzV._ F1EV. 4 = I �d' r�) WesT �1�V LL, rr_ LLJ W o o � 00 °�--o O �. o o 0 O �� O o-- � - -2 / ' - m ^-7-7, '7tS' ' SN I 'll" E T FILE RECEIVED |UN 1 Y VOM6 �"." . ^ �"°^ DEVELOPMENT SERVICES :Tn 0,01 nnn � ®. \_ uuu �. 01 �►m1 v � ♦ ICI ' ® , . C ' � � 0101"o M j U 100. A �I"►.ii i I I I I I I 0 PARKING (T) PARKING (2) n1r ACCESSIBLE PARKING l ri•��-9a r!• ra 3" ACCESS AISLE o .ram• ra � PARKING (4) I r-s• U J � Q N w o PARKING (3) na e..�• LJ ♦�♦ it►lilts li���1� /r���1i 1i1��11 � � �� ��►�7i �� ILr�J► 1��iJ1 JL� �Li/iJ� 1Lr,��► 1 r r Ld W z 0 r Q 0 CIA �. SIDEWALK PLANTQ� TYPICAL (NEW TOTAL TO) Scott & Cindy Abrahamson % Shell Creek Grill STREET LIGHT EXISTING CURB CUT 27' STREET LIGHT 526 Main Street Edmonds, WA. 98020 196 Sq.Ft. EXTERIOR SERVICE AREA 425.775.4566 700 Sq.Ft. OUTSIDE DINING AREA FIFTH AVENUE SOUTH NORTH Proposed FIoor PIan Equipment Layout Site P I a n NOTE SEE SHEET A/2 FOR: FINISH SCHEDULE SCALE 1/8" = 1'-0" 1,698 Sq.Ft. MAIN BUILDING EQUIPMENT SCHEDULE/LEDGER PLUMBING SCHEDULE/LEDGER -IECEIVED REVISED 05/11 /04 RESTROOM(S) SEE SHEET CS/1 APPROVE) BY PLANNlN(, REVISED 05/25/04 PARKING ,j W1 j 1 2004 Q. m Z n W Cd m � N _ Z Na !� � .N mom N ='m" I� C.7 OQ�a m w cp �00 4Nwa 0 F F A00W�cfl z�PqUi U rj � r►; O� Ate' U�z�, U) CIO A w x0 E+ E-I oz A � w W x a CONTENTS FLOOR PUN / S14S PLAN DATE 04/16/2004 REV. 05/11/04 REV. 05/25/04 REV. 06/10/04 Drawing No. A-1