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126 PINE ST.PDF1111111111111112746 126 PINE ST ADDRESS: -0i.26 si 0 TAX ACCOUNT/PARCEL NUMBER: 62015-e210 6?1V &V/ Dl BUILDING PERMIT (NEW STRUCTURE): COVENANTS (RECORDED) FOR: CRITICAL AREAS:— 0 0" " DETERMINATION: []Conditional Waiver ❑ Study Required [Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DA EASEMENT(S) RECORDED FOR: PERMITS 07 /ilmo PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: SEWER LID FEE $: LID SHORT PLAT FILE: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: GEOTECH REPORT DA STREET USE / ENCROACHMENT PERMIT WATER METER TAP CARD DA OTHER: 2-aa LOT: BLOCK: LATEMPOS'CsTormsk.Street File Checklist.doc 4- IV APPROVED BY PLANNING tA 1p Sit- ?(%.fj is 0-4 Co "e+ c. S Co 4— A-m e iv% g-'- A ru-% S fvaw " fi �r.. -6*4 +*Olt ; t4 e8rf% ia Vj c rA Pdrw %A- OL.'m too, J+ t 44 C A%c VAI —T S. mr ft"4 OW04 4�84wdy?-- (Isla �Tl OWNERVICON I It. 4 TO IS 71RESPQ S184 j r-nublUN CC NTROL AND OF 4INAGe GOUrb& V 1V On ACTURI, kv L t r Va 401) Cl 'ERS/D SID ut8 WO SPLASHBL KS Z 0� pe Q 30 F . '9 4 ARPR&ED, AS NOTE B INE RING S 4! it 3 Date: --RECEI ED *N INLERII U . J 3 003 N 3 W PERMIT CO NTER OTOMET-M.L. . 51 L E= L. e - 'LO Ir '��t...t.l ,•�M-i',✓'uF �d,.•.�'Mtn..rSYlk�'v{,.,•F'i�.x.�.-.f:......:'t�.: ti,_. ri'�rr#", ; 4i �.i'fr� "c� r..�q �ttr . �... ^' Kv. �ti:s.; � �;. r .. .. •7''�' wa„T '.t� N. h.:hr�'Yf iNL',t...-!�, .:.r r ,^5 h,.•,r+' �+;+nYa-tti4` ''..i.:�;., ,'�•v+.,. �.�,. ..r � i- =� �vr•o••.p:�.,, 9.��atd(-tiq�.t*., •tdat^�1str:. • 4 CITY OF EDMONDS rmit No. V-/�l COMMUNITY SERVICES DEPARTMENT. STREET FILE Issue Date RIGHT-OF-WAY CONSTRUCTION PERMIT A. • Owner:-_ B. •Contractor: Name Name Mailing Address_ _ ' l �' i' Mailing Address City State Zip City State Zip P - ? State License Number Telephone •Numbei • Address or Vicinity of (3{onstrluctio'n�_2 - �` =' � `� 1 r -' Type of Work to be Doneet.'.ii .� �;v.•, f'�`f,F /S' --33-S-6 Work in Connection With: ;0"Sub or Plat ,[]'"Single Family ❑ City Projects H ❑ Commercial ❑ Multifamily ❑ Utility Q Pavement Cut: 2�Y ❑ N I a APPLICANT TO READ AND SIGN V 0053 a Q INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds >4 harmless from any injuries, damages, or claims of any kind or description whatsoever, forseen or unforseen, that may be made against the City of Edmonds, or any of its departments or employees, including or not limited to the defense A of any legal proceedings including defense costs, court costs, and attorney fees by reason of granting this permit. a THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. O ! �' U Funds held from the Security Deposit; (estimated .restoration fee) will be held until the final street patch is completed by City forces, at which time a debit or credir w' ill be processed for issuance to the applicant. • A 24 hour notice is required for inspection; Please call Public Works: 771-3202 • Work is to be inspected during progress and at completion. • Restoration to be in accordance with City Code. • Street to be kept clean at all times. • Traffic Control to be in accordance with City regulations. • All street -cut ditches must be patched with asphalt or City approved material prior to end of working day; no exceptions. I understand the above and that"this permit must be available at the job site for inspection purposes at all times. Signature - - — lam. %r_ r' j cam/ Date: Z D r- /0wner.or-Contractor This Permit Must Be Posted at the Job Site For Inspection Purposes Call DIAL -DIG Prior To Beginning Work f �. ISSUED BY: PERMIT FEE: --71V . (. 0 O Time Authorized: Void after l00 days. Security Deposit: w Special Conditions: Receipt No.: Fund III Fee: F�.. Amendments: Street Cut Dimensions: 04 x O w NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. July 1985 FIELD INSPECTION I Comments: Diagram: (Fund I I I - Route copy' to Street Dept.) I mu CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO Partial Work Inspection by P. W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: o■ Eng. Div. July 198 • PLANNING DATA TE: SITE ADDRESS: PROJECT DESC REDUCED SITE PLAN PROVIDED?: es No MAP PAGE: '-� <SZ CORNER LOT: Ye / No FLAG LOT: Yes / No) ZONING: CRITICAL AREAS DETERMINATION #: ❑ Study Required: ,(giver ❑ Conditional Waiver CHK#: 63—Ds l SEPA DETERMINATION: ❑ Fee ❑ Checklist ❑ APO list w/ notarized form ❑ (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger) /,ZKExempt SETBACKS: Required Setbacks: ! ! i S-j-- 04 Street: !7 _Left Side: Right Side: Jr< Actual Setbacks: / Street:-17,'0,15 Left Side:© Right Side: Rear: Ajo Street map checked for additional setback required? (Yes / No / DNA) ❑ DETACHED STRUCTURES: ❑ ROCKERIES: ❑ FENCES/TRELLISES: ❑ BAY WINDOWS / PROJECTING MODULATION: ❑ STAIRS / DECKS: ato �O � T - 1 / J r' lvo ->-- LA,ova.-,_( PARKING: Required: Actual: e%i/ ) V/�� LOT AREA: SD (SKM rk.— LOT COVE �°ISt �b 4 la Calculations: S'S` 0 76sa '�3% BUILDING HEIGHT:��� _—�7 -— Datum PDi� Datum Eleva n: —t O i Maximum ed: Actual Height: A.D.U. CREA D : No Yes SUBDIVISION: LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: (Yes / Nol Plan Review NewBPPlanningDataForm.DOC • CITY OF EDMONDS 250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771.3202 STET COMMUNITY SERVICES: Public Works • Planning - Parks and Recreation • Engineering 890 19y August 1, 1990 KHB Construction 7720 - 46th P1. W. Mukilteo, WA. 98275 Attention: Korey Berg Dear Korey: FILE LARRY S NAUGHTEN MAYOR PETER E. HAHN DIRECTOR 44�j oz//.?o r As you know, the construction of curb, gutter and asphalt path along the frontage of Pine Street was a requirement of Short Plat S-33-86. I am unable to sign off engineering approval for final occupancy on the house at 110 Pine until the conditions of a short subdivision are meta I am enclosing a line drawing prepared by Dan Smith for Mr. Locke showing what was expected. At this time, it appears that items 1, 2, 4, and 5 have been completed per Dan's requirements. However, the thickened edge was not removed and repaved, per condition 3. Additionally, the westerly driveway approach at 110 Pine does not meet City standards and must be reconstructed by removing the overlaid asphalt, removing the curb, repouring the depressed curb section, and repaving the path (and roadway, if necessary) with asphalt. Thank you for your immediate cooperation. Sincerely, GORDON C. HYDE Engineering Coordinator GCH/sdt Enclosure KHBCONST/TXTST530 Alberts • Incorporated August 11, 1890 • Sister Cities International — Hekinan, Japan 4n in VI W W W W W W xxx Yl In 4n O O O M1 O O n vaa AAA aacv 3 • ' - \ � �1� � Z � p rr'�1 is S ?frJG- Si �. Izr FAGS OF COP-6 TO IF LoCk-c- Floe, Lrn)E gst'wif--r rarw acttvjD cueg 3, SACO COT OUT ntl-l<«1W L-nq(-:- ff- C(0 Sr, A-ssCO /TG FG�fT' E� iZ rt 0 C rO 4-0R-5 AV rVf— GO V P.' 9,Y-* i q(,-G 044 A(2 gAme -rgpfl✓ NJ70 ZAUO At, II/ P,f1jr, Si CJF�B PcV- A S kET"Lit G<<%S Gt-asc •g M Ge ✓S,a� Pe in :: • . V R Pavement i v , Top of curb of approach CEMENT CONCRETE CURB or BARRIER CURB I I I I I II i, TREET� F II ILE CITY ' ®F E ®' M ® IllM ®S i LARRY S. NAUGHTEN I I 250 5th AVE. N. • EDMONDS, WASHINGTON 98020 • (206) 771.3202 i MAYOR I I I � q COMMUNITY SERVICES ' I PETER E. HAHN RIRECTOR I u I ( I I I June 11, 1987 I I I I Mrs. Marion Locke I I I 126 .Pine Street Edmonds, WA 98020 II r a i Dear Mrs. Locke: i I'f II I I reviewed the letter Mayor,'Naughten had'wri,tten you.rega,rding sewer ; services to your residence Iloc�ated'on 2ndlAve:'IS and Pine Street. ;; I ., Periour records'and conversations with other sItaff members, yIou have I I never or any previous owner,Ilever paid a LID costs for any sewer services. You were ,pro'vide;d al copy of the as=built,on,the 2nd Ave. S. I I I r ,. I � I. I: trunk line which showed� a sewer connection. This connection Iis only a teelto this line. You''must'dig up the st�eet'and run the line from your residence to that stub' or tee. You will be required to,pay a $300.00 connection fee, a side sewer permit fee of $35.00, a 4trunk charge of $25.00. In addition of the expense to run your sewer service you will also need a $30.00,'permit to work in Ahe City right -'of -way. ) I I I You j al,so indicated the (need 'to pump. Youl wi l l i need a pump from each service address you provide.. A trap willlalso,be necessary to prevent anylodors from entering' your residence. Thislmay depend on how you make the connection. In the past, other,residents have found this necessary. I I P I I ' Should you require .any laddi,tional.information,,feel free'to contact Bob Alberts, City Engineer,or Archie Brena, Water/Sewer Section Supervisor. I Sinlerely, ' I ' BOBBY R. MILLS Superintendent of Public Works G ia- R dt. I I I I cc: Bob Alberts ,' I Archie Brena , Jeaflnine Graf I LOCKE/TXTM6061 I I , I , ' I f PUBLIC WORKS PLANNING PARKS AN8 RECREATION ; ENGINEERING I I I ,I I I I • STREET14LE CITY OF E D M O N D S LARRY S. NAUGHTEN MAYOR CIVIC CENTER • EDMONDS. WASHINGTON 98020 • (206) 775.2525 February 26, 1987 Mrs. Marian Locke 126 Pine Street Edmonds, WA 98020 Dear Mrs. Locke: RECEIVED MAR 2 1987 ENGINEERING RE: Petition to Council and Mayor This is in response to your February 15, 1987, letter regarding a sewer hook-up at your property. After talking to the staff in the Engineering Division, I am informed there is a sewer stub available at this location. The sewer bill you have been paying over the years is for un-sewered service. It does not include any assessments or costs for the original installation of the sewer pipeline which are associated with projects where the costs are directly paid for by the property owners (LID's.), which this project was not. In situations similar to yours, it has been the responsibility of the property owner to pay all costs to connect to the sewer stub. The City has not been extending the service lines from the stub at no cost. If you wish to further discuss this matter and the City's policies, staff or I would be happy to meet with you. Sincerely, L e__4J Larry S. Na ghten Mayor LS/PH/dc cc Engineering LOCKE2/PUBWORKS INCORPORATED AUGUST 11, 1890 � 0 ___ W Uf 0 coo u1 O O �H aaa er ev er ev er r r� • STREET 'FILE-" -- ____ N o A wa AL-Y © PA7-W � YiO(�- 5v W F or C0 0-5 To -f- LoCk.15- ?2o?, LiNE as4o -T rA-rw 15Eaffi-b cue-5 3, 1940 CuT ou T ritfU«ty t-vCtc of Pf cue ST., tis m-tvLT 4-510pel74 FL,qT- 6IZ -Pa ro C-09-3 WRUC A-V'Tne- CL)2P> r0o'(i Q 415�hgcti PJd,(A1 121M TApM If,4TO ZXo Ad[1FInIE 5T. 1Ni 25czi1e� CLAP-b P0V- s14-tTGtt Shy rc6.4w� � • - 2" u�ss B Gt—RSC Fj �F2, ��5�150 e,., M C 2 14 r, 51"T Pavement io V R a Top of curb at approach LY4- CEMENT CONCRETE CURB or BARRIER CURB %REST FIB:. :F� Iffic (9&,-7 '"W MEMO TO: FROM: SUBJECT: SEWER CONNECTION CHARGES \ 2- Co treet A ess) �S-V-P- (Legal Owner) Single Family Residence Subdivision Plat PRD Multiple Commercial LEGAL DESCRIPTION: Z.F.F. Calculation: ----2 Z.F.F. x Connection Fee Lateral x( Lateral Charge Equivalent Count (when applicable) Unit(s) x($25.00 Trunk Charge Permit TOTAL. st ., 'J.� � w .. •. t.• � - ....-. y ... 1 � - �. a: '. � � � -r ♦.r •+ .�q� ...... .:_��,�..✓ •, Y`Y ..r +. .-.. . � Yw [ .r I f.'.u� �. . �. �� • n, 4 .l�'_. ... � .. -, ^uV , ..... City of Edmonds Permit No: .70 3 RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date: 9= �ro - 40 3 A. Address or Vicinity of Construction: �•Z (0 Y, N T . B. Type of Work (be specific):. C. Contractor: fylpI I: �,,,./( Mailing Address: 1�1j-7-T' k aw !',? E wItd.� etv-j 41cjetvic t: b1R49 State, License #: 0'15 6A I : Owp9 Z D. Building Permit # (if applicable): OO () E. ❑ ' Commercial ❑ Subdivision ❑ Multi -Family �f Single Family INSPECTOR: 11v`7 f1i�I,Mlr J Phone: Liability Insurance: Bond: $. Side Sewer Permit # (if applicable): ❑ 'City Project ❑ EUC (PUD, VERIZON, PSE, AT& T, OVWD) ❑ Other INDEMNITY. • Applicant understands by his/her signature to this application' he/she ,holds the City. 1 dmonds harmless from injuries, damages or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or any of its departments or employees, including but not limited to the defense of any legal proceedings including defense costs and attorney fees by reason of granting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL. THE FINAL STREET PATCH IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT ... ` ♦ Traffic control and public safety shall be in accordance with City regulations as required by the City Engineer. Every flagger must be trained as required by (WAC) 296-155-305 and must have certification verifying completion of the required training in their possession. ♦ Restoration is to be in. accordance with City codes. All street -cut trench work shall be patched with asphalt or City - approved material prior to the end of the workday — NO EXCEPTIONS. ♦ Three sets of construction drawings of proposed work are required with the permit application. CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK I HAVE READ THE ABOVE S$ATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGk� THA T I MUST MAKE THE PINK COPY OF THE PERMIT A VAILABLE ON SITE AT ALL TIMES FOR INSPECTIONS y Signature:Date.•�—'�©— (Contractor or Agent) �• , ` ��� p,� FOR CITY USE ONLY Approved by: �j� C.( Time Authorized: Void After tv l l tXV Special Conditions: Right-of-way Fee: } r7fl f 3" Disruption Fee/Fund 111: Restoration Fee: Total Fee: . Receipt No: 22 7 _ 9 Issued by: 1A4e AxW.k`f w s UPON COMPLETION OF PERMITTED WORK, AN ENGINEERING FINAL INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE EDMONDS COMMUNITY DEVELOPMENT CODE'(- tl ` 'ate /425-n7,71-0220, Ext. 1326) FINAL APPROVAL OF PERMITTED WORK: >Fc. �-�G _ DATE: zG u Ins ector's Signature For inspection requirements see Engineering Inspection Information handout. NO WOIZK SHALL BEGIN PRIOR TO I'EIZMIT ISSUANCE City Of EdmondsPermit No�50 •' RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date: LO 0 A. Address or Vicinity of Construction: U., +90r, B. Type of Work (be specific):Po"�4Yf�—' i2gtt2S►.1 A02" ontractor: Qe C.Ke K 0,, J1 T f. G, f Contact: ri 7. DMailing Address: Z (oC- Ov" Phone: 206 - 7 78 !c qO q 2a, -S'112 - Lo , S St> � x R e O to License #: dto c IZ a et L Q �t x a., � r � . ' '` .Liabilityty,Insurance: l m.11. ' Bond: $ M000, u,/i • c/P-vkq, OP`l (0 GII S. 3:.tv rD.) Building Permit # (if applicable): Side Sewer Permit # (if applicable): E. ❑ Commercial ❑ Subdivision ❑ CityProject ❑ EUC (PUD, VERIZON, PSE, AT& T, OVWD) ❑ Multi -Family Single Family ❑ Other INSPECTOR: F. PAVEMENT CUT: ❑ YES ❑ NO G. SIZE OF CUT X_ CONCRETE CUT: ❑ YES ❑ NO ; INDEMNITY: Applicant, understandsi by his/her signature .to this application he/she holds the City of EA nds harmless from 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 its departments or employees, including but not limited to the defense of any legal proceedings including defense costs and attorney fees by reason of granting this permit.' 0.. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL. STREET PATCH IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. : Traffic control and public safety shall be in accordance'with City regulations as required by the City Engineer. Every flagger must be trained as required by (WAC) 296-155-305 and. must have certification verifying completion of the required training in their possession. ♦ Restoration is to be in accordance with City codes. All street -cut trench work shall be patched with asphalt or City- " approved material prior to the end of the workday - NO EXCEPTIONS. ♦ Three sets of construction drawings of proposed work are required with the permit application. CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK I HAVE READ THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE. THAT I MUST MAKE T - PI=COPYE , ERMITAVAILABLE ON SITE ATALL TIMES FOR INSPECTIONS Signature: 1 r f Date: g ( ntr ctor Agent) . a FOR CITY USE.•ONLY Approvedby: e;i Right-ofway�Fee,LZ 2! Time Authorized: Void After / % / Disruption Fee/Fund 111: Special Conditions:_ Restoration Fee: '10w is , wesio "fin? h '�?li�1G ' Total Fee: _ 7 tt - O/W ,rti 4A M10. W- 11 wit 4 20-Receipt'No: � b ��i av 19 aCNLC4t t ( on bld UPON COMPLETION OF.PERMITTED• WORK, AN ENGINEERING FINAL INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE EDMONDS COMMUNITY DEVELOPMENT CODE/ e, 425-771-0220, Ext. 1 �6) FINAL APPROVAL 'OF PERMITTED WORK: G ?, DATE: Z d Ins tor's Signature ITSP& For inspection requirements see Engineering Inspection Information handout. NO WORK tiHALI_ RI;GIN PRIOR TO PF;RMIT ISSUANCI: �11 � ~ 09StrJ �X3 � N 0 N w 2 1 . ..._- m v I p :N I .� J J I 4 2 O U 0 Z S I 0 I I Q O 1 I � nUQ m m cfj •S -?%)N.3AV ONZ m - - H1 br0/Y L 0,00 - LO' oo Q° ry^l to g H12�oro r— 90201--= CITY OF EDV IIONDS -ee��q• La p. W, DEPT. ENGINEERING DIV. rXAMINED BY ( �. DATE___—. rd REMARKS SHORT SUBDIVISION FOR MARIAN LOCKS EDMONDS, WASHINGTON L Lowell-®suerland & Assooistes, Yno. 8 ENGINEERS • SURVEYORS • PLANNERS 23106 100TH AVE. W. • EDMONDS WA. 98020 • PHONE 775.1591 DRAWN d�duEO Dnn F.O. W.Au FIE No. JTT/99,P.5¢ /"-50' I" NE'/a , SECTIoAa 2�;,T Z-7 N._ R. O E. W tom_ • � DATE RECEIVED 2 7 � � ~ D 16I PERMIT EXPIRES SE CITY OF EDMONDS ZONE (� Nu BER CONSTRUCTION PERMIT APPLICATION AOB SUITE/APTr ADDRESS %, OWNER NAME/NAME OF BUSINESS �/ PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS LID FEE S PUBLIC RIGHT PER OFFICIAL STFjEET MAP RW Pe Approved HT OF W RW Permit Required Street Use Permit Read CITY ZIP TELEPHONE EXISTING �� PROPO D Inspection Required 13 Sidewalk Required p 101 REQUIRED DEDICATION FT Underground VVV wiring required p NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED pr �� YES 0 NO 0 C ADDRESS REMARKS = V OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CQNTROL/DRAINAGE W CITY ZIP TELEPHONE NAME Q f CBL#`,......,:, ��JVV CFt� ✓�i {1i IN,EIE�G REVIEWED YY D TE C ADDRESSTP ZI'Ns'II{ Ay. r, 1 _ ;FIRE ,REVIEWED BY DATE W CITY ZIP TELEPHONE O VARIANCE OR CU `SHORELINE OR ADS#: '. INSPECTION BOND STATE LICENSE NUMBER " EXPIRATION DATE CHECKED BY' . •REO'D POSTED d1 ; ❑YES ONO $ s A " 3EPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCO PARCEL NO. COMPLETE,, EXEMPT, ALLOWED . PROPOSED +}ALLOWED PROPOSED v EXP •� 0 ti,rS ' 2S 1 �� �► G/MECH LOT COVERAGE REOUIRED SETBACKS (FT) PROPOSED SETBACKS (FT.) RESIDENTIAL PLUMBIN ❑ NEW ❑ ALLOWED".. PROPOSED : FRONT . SIDE REAR FR�OsNT UR SIDE REAR ❑ ADDITION ray \❑ COMMERCIAL ❑ COMPLIANCE OF USE ��� Z 3 � w S Z O Z�7 ^ } a0 /�0 d PARKING LOT AREA PLANNING REVIEWED,BY DATE ❑ REMODEL > :' : ' ❑ MULTIFAMILY ❑ SIGN REO'D I PROVIDED?nr o L 13103 GRADING.. FENCE 2 Z . 6r ❑ REPAIR ❑; CYDS ❑ ( X FT) REMARKS / i f fad 2 ❑ DEMOLISH ❑ TANK ❑ OTHER GARAGE RETAINING WALL FIRE SPRINKLER WI O CARPORT ❑, ROCKERY ❑ FIRE ALARM . , C (TYPE OF USE, BUSINESS O ACTIVITY) EXPLAIN . r ��r�MMass NMCIA�s AI A_ CHECKED BY, TYPE OF CPNST19UCTION CODE OCCPANT tj 5 GROUUP V i I] NUMBER NUM R OF CRIT OF DWELLING AREAS SPECIAL INSPECTION AREA - OCCUPANT O STORIES UNITS NUMBER REQUIRED YES LOAD DESCRIBE WORK TO BE DONE REMARKS ._ PROGRESS`INSPECTIONS'PER UBC`108/FINAL INSPECTION REQ'D 9 VALUATION . )Ylq Description FEE Description FEE i% Plan Check �tw 7 �'F• State Surcharge �/ EAT SOURCE G % il.OT,�SLOPE %=:t !T zj /,` BUilding,Permif 'r' / � City Surcharge . PLAN CHECK NO: j VESTED DATE ?Plumbir)g'f-mixf Y I Mechanical THIS Pl RMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading SEPARATE PERMISSION. s G�-, Engr. Review �.�/ PERMITAPPLICATION: 180 DAYS d PERMIT LIMIT- 1 YEAR- PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection 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 .901 FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE 9 DEEMED TO MODIFY, WAVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due �r = NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.• Recording Fee Receipt # I HEREBY WLEDGE THAT I HAVE RD THIS APPLICATION; THAT THE GIVEN ISCORRECT, AND THAT 1 AM THE OWNER, OR THE DULY AUTHORIZED AGENTTION 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. WORKMEN'S CO ENSATION INSURANCE AND RCW 18.27. OFF GN E 0TE M NER A ,��� DATE SIGNED (425) -7— 77 -rd- 614,5 ASED BY DATE ATTENTION Off 1333 ` IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL l% A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- oRIGINAL•FILE •YELLOW-INSPE oR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - owNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN -ACCOUNTING DATE RECEIVED ' � PERMIT EXPIRES CITY OF EDMONDS USE PERMIT ZONE NUMBER7 CONSTRUCTION PERMIT APPLICATION JOB surTE/APT# ADDRESS OWNER NAME/NAME OF BUSINESq ' PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. 15 MAILING ADDRESS 7 LID FEE $ O I re l.. PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TE CP Approved RW Permit Required CITY ZIP TELEPHONE EXISTING^� PROPO E ReWd 4ro epec�nRpeequ�ired %, REQUIRED DEDICATION ''- Skterrelk Required Q p"mtW01"d lJ Wwnereawred p NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 0 NO 0IC r, C UA ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE aU a ZvZ W CITY ZIP TELEPHONE � NAME CBI_# 4 t _.4. ENGINEERING ISVI t NSPECTI ((tom ATE G ADDRESS r. O 0TLIA A1 ` V S CITY .! FIRE• REVIEWBY \ DATE a ZIP TELEPHONE E SEWER MUST BE CAPPED AT O PROPERTY LIN d STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY VARIANCE OR CU SHORELINE OR ADB#jr TER' METERr INSPECTION BOND $R ED TED PROPERTY TAX ACCOUNT PARCEL NO SEPA REVIEW ;COMPLETE, [XE. ft SIGN AREA ,"' L D P" A�WWP gum GHT (A'I� O SED EXP xD ❑ NEW RESIDENTIAL _ _ .. ❑ PLUMBING / MECH LOT COVFF��AAG ALLOWED : �ppp REQ ll SF,TBACK� ( ) FRONT SIbE REAM '� Ali D ETBACKS (Fi) FRbRf3 IBA REAR t7 ❑ ADDITION �❑ COMMERCIAL COMPLIANCE OR ❑ r<�►!C II+:iYs;L,11Jt1 t�aUl1. ,.' NTS z z s CHANGE OF USE _. 3 z ❑ REMODEL / ❑ MULTIFAMILY ❑ SIGN PARKING REO'D PROVIDED LOT AREA PLANNING REVIEWED,BY DATE S a ❑ REPAIR OGRADING ' ' PENCE El I CYDS X FT) REMARKS DEMOLISH ❑ TANKGARAGE ❑ OTHER SPRINKLER WALL ❑'. ❑ ❑ CARPORT ROCKERYRETAINING FIRE ALARM (TYPE OF USE, BUSINESS OR ACTN N: a CHECKED BY TYPE CO OCCUPANT ]��Tb GROUP NUMBER NUMBER OF CRITICAL ' m OF DWELLING AREAS �Qv SPECIAL INSPECTION' AREA OCCUPANT O STORIES UNITS : NUMBER J REQUIRED ' f []YES LOAD DESCRIBE WORK TO BE DONE PROGRESS INSPECTION&PER'UBC 108/FINAL INSPECTION REO'D m • '. VALUATION ... ._ Description FEE Description FEE - Plan Check ; u State Surcharge HEAT SOURCE GLAZING% jLOT:3LOPE % ..ti Buildirtg,l?ermit' " t City Surcharge .r- k.' r PLAN CH O: VE T D ATE- -° Plumb tng:u Mechanical THIS PERMIT AUTHORS ONLY THE WORK NOTED. THIS PEF&ITICOVERS WORK TO t BE DONE ON PRIVATE PROPERTY ONLY ANY CONSTRUCTION ON THE PUBLIC (CURBS, Grading 3 DOMAIN SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE t SEPARATE PERMISSION. s Engr. Review W PERMIT APPLICATION: ISO DAYS n PERMIT LIMIT. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection 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 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY 9 FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WANE OR REDUCE ANY Landscape Insp. = REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Total Amt. Due Recording Fee I i Receipt # % I 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 n receipt IsacknoededgedInspaceprovided. WORKMEN'S ENSATION INSURANCE AND RCW 18.27.. 25)9,-7—O371-022 O S SIG f RE DATE DSIGNED Y A ATTENTION 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- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 ORIGINAL- FILE • YELLOW - INSPECTOR 04/02 PRESS HARD -YOU ARE PINK -OWNER GOLD -ASSESSOR MAKING 5 COPIES GREEN -ACCOUNTING