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1530 9TH AVE N.PDFiiiiiiii lill 9854 1530 9TH AVE N ADDRESS: 4Q14 TAX ACCOUNT/PARCEL NUMBER: 2-7 0 3 / gD az/ LSO U BUILDING PERMIT (NEW STRUCTURE):_P� 03 oC�,; COVENANTS(RECORDED) CRITICAL AREAS : © 3 `J' DETERMINATION: ❑ Conditional Waiver ❑ Study Required Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: 1 I L� ) 6 PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED PERMITS (OTHER): ZR 3 055,3 -, PLANNING DATA CHECKLIST DATED: 11" tJ 03 SCALED PLOT PLAN DATED: SEWER LID FEE $: LID #: SHORT PLAT FILE: LOT: BLOCK: SIDE SEWER AS BUILT DATED: UC 0 -1 SIDE SEWER PERMITS) 4: Aoo SOILS REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: WATER METER TAP CARD DA I.-\TEMP\nSTs\Fnrms\Street File Checklist.doc _, 0 F E.D,10,_ E i C.O. 0 CITY OF EDMONDS SIDE SEWER AS -BUILT r d ADDRESS 1530 9TH AVE HOMEOWNER DONNA ERNST DATE DRAWN 9/3/03 BY I. ABILA SCALE N N TS CONTRACTOR ZIMMERLAND CONST. INC. PERMIT NO. 9758 NEW ADDITION SIDE SEWER 3' POLY WATER LINE .5' T ❑ S POLY IS FROM 1 8' 1 HOUSE O� 1 exist poly 1 copper C.O. to 1 . house m x but Off (n z p �C D D 0 m of EDo CITY OF EDMONDS WA,TE_ 'RLINE`AS— BUILT ADDRESS HOMEOWNER 1530 9TH AVE N DONNA ERNST CONTRACTOR SCALE ZIMMERLAND CONST. INC. NTS DATE DRAWN WATERLINE -&t.1890 9/3/03 BY I. ABILA NO, 2003-0582 /o'er • - p� OT PLA,�/ /5,30 9� L/ 7'7�CAmin "C 139 Lod c5'/010,r Gam. e 1:5/a,6 e%v los.o !0� G FERMIOT �r°� E ti %ate -� p,�G�: _� � e/✓ f/o3.o 771 INS IONS'' REO'b -' �► -!T� VIED INTO CALL 425- 0220 ,EXT.1326. I o NTI01V SYSTEM .Stele /emp. Sed,oen �9 00- 1 Con f/-o / le 7CC _= �/oar ZO/d" A017 p/ N\ I Z)els{ gcvrc5e A = /oo. o N 1 40' a E 6= C or F81./oo.a q%s o�l o = /o 4. z _ - � �E�,b -t'lo V- Ave �'ra.c/e = /O/7S 100,031° o dE MAY11,4C/M = 14?6, 75 ACTUAL = le4.36 A/O 6,2Al0//Jl \ �" `ma`s o �- A d ,o ��S�IL..L \� �- � � • �. cs..• Gaga- e0oA) Y c ea ooul� 'A -s . DOTAL �S(�.Y �• 4s 7� Gon/tCGfl�/Y �c7 a \ z 4U / t` �3tCr� F r(xboowNERiC WNW-; % -A S" iNA19E o �.?' " EROSI CONTROL RIGHT-pF=WAY.CONSTRUCTION PE G IDINSPECTIQN RE a h, �t qo CST �,e�a,/ert�e�over- vQl rn °:;APPROVED ' GINEERIN /� �erseC7i;,� �oMecsef $Y EN EN , d�r ole i i p. ST,�y,� 7o exis i =ti A 6�0 d im �/r,jad193,S (� �� STANDAMD DRAINAGE DETENTION SYSTEM WORKSHEET QWNER ,0o.S/,�/A E,RA115T cd,Q.,UG doc�yC CZf ADDRESS 30 IMPERVIOUS AREA 2 7o 3 CALC BYL-1 �F.2 G/�JHI� ci.li) PHONE: �ZS- 773 -�z 9g DATE: l©_ *****DESIGN DATA***** PIPE DIA FDQSNEID G mm:r m PIPE LcmTN mmTm=Km TIG M,kI C .3X TO IX SLOPE PIPE LG ORIFICE LID lIEASIlttED� CONC 2W 13R RISER MIN. Ca1TRpL _ NIN JORIFICE CONTROL CATCH BASIN SYSTEM CROSS SECTION 2'X2'X6' DEEP, 4-6• SPALLS IM EQUAL . FROM CONTROL CB 2'X 2'X 3• I DEEP 3/4• CRUS► ED ROCK FROI COMC L NPRIP 0117ZET RECEIVED If IN 1 8 2003 4IT COUNTER t. Wm v TA N�yI DRAtN ROCK RUNOFF SPREADER. TRENCH FOOTING DRAINS SHALL NOT. -BE CONNECTED Tn DETENTION $Y.'STEM NOTM. 1. Call Engineering Division 971-OM) for a tightlim and detention system inspection 64 before bacMiIIiIIg MW for final inspections, 2. Responsibility for operation and maintenance of Q5m APPROVED BY rosponsl'bility of the property owner sY on private property is the - a=mulated in the -storage pipe must be flushed 7/ 04--/ `�3 0 PLANNING DATA TE: SITE ADDI PROJECT REDUCED SITE PLAN PROVIDED?: (Yes/No MAP PAGE: CORNER LOT: es / o FLAG LOT: ftes / o ZONING: Y CRITICAL AREAS DETERMINATION M 03 --711 ❑ Study Required: giver ❑ Conditional Waiver %-e—, 7> SEPA DETERMINATION: ©{{- ❑ Fee ❑ Checklist , Rlist w/ notarized form Gt4-e- pn eietpE &I -I pfavkl5 ❑ Exe(Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger) mpt SETBACKS: be, m Required Setbacks: / d �e� � Street:_'35 Left Side: Right Side: 10 Rear: Actual Setbacks: _ OFr > Gi GGesfiB�'� Street: b Left Side: Right Side: Rear:�� _Street map checked for additional setback required? es / No / DNA CL3 DETACHED STRUCTURES: e�o 5-h ❑ ROCKERIES: U klO-n- G dp ❑ FENCES/TRELLISES: ❑ BAY WINDOWS / PROJECTING MODULATION: ❑ STAIRS / DECKS: PARKING:. Required:2 Actual:2 LOTAREEA:I QOO CO Xls� Calculations: '9(go —+- y10 + /Ann .J. 1 es0 -r 20n og I' p ( BUILDING HEIGHT: / v Datum Point: WA,4tt-- �' CS am rSUBDIVISION: ��'1�� LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: Yes / No - ��� ��Qj/��GOTHER: ot* Maximum itum Elevation: .tual Height: 77, SJ tTg _.-to NewBPPlanningDataForm.DOC Critical Areas., C heckl ist Site 1nforfiiatiofi:(.,,0i1s/fn n ;-%kvT /kwy,4 1 —% jr bln , jL%j 06y / c6t:ta— 1. Site Address/ Location: 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Property Tax Account 'Number: r. ly —,2 Approximate Site Size :(acres or square feet): o, 4 Is ffiis'site currently &Veloped? -Z: Kyes; — no. If yes; Aow is site developed? Describe the general site topography. Check all that apply. Flat: less than 5-feet elevation change over entire site CA File No: ob--1 4 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 lessthan33-feet). Other (please describe): - Si te contains areas of year-round standing water: Approx. Depth: Site contains areas of seasonal standing water: IV Approx. Depth: What s'e'ason(s) of the year? A4 Site is in the floodway floodplain of a water course. Site contains a. creek or an area where water- flows across the grounds surface? Flows are year-round? AJ Id Flows are seasonal? 'What time of year? Site is r�ily`,.forested .------- ;meadow. ,,--.. ;shrubs mixed urban=ap'ed(lawn, shrubs 46)' Obvio us wetiand is vresent on site: ZA� 01IP; , T. —ForiCity Staff Use.only 1. Plan Check Number, if appli( 2. Site is:,Z6fied? 3. SCS dapped soil typ I e(s)? 4. Critical Areas jnvY ��r or t.�;map indicates Critical Area on.site? �aopev&" 5. Site A P ei Je-:P 0�-kjftL-� Within designated earth subsidence landslide hazard area? 1� .,:, —.. - LI to I 6W (n P P Ln- , _�- t e) AC� LSE DETERMINATION STUDY REQUIRE115. WAIVER Rivie*d Critical Areas iChecklist.doc/4.22.2003 M ���-�°f ED"0 City Edmonds Development Services Department Planning Division Phone: 425.771:0220 C. 1 ago Fax: 425.77.1.0221 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 Rec&d••. J i 3 1 R 5_ City,<<IZecel #•2l CriticahfAreas FileVi Criti6al7'A�eas',Ch6 klistiFiee. "$1M00 Date Mailed.,to Applicant: ' A property owner., or, .his/her authorized. representative, must fill out the checklist; sign and date it, andJsubmit it to the City. The_Citywill' r''eview 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 withthe 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 attomey's fees, arising from any action or infraction based ' in whole or part upon false, misleading, inaccurate or incomplete information furnished 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 fi,Ie`63 application on t1A behalf of the owner as listed below. SIGNATURE OF APPLICANT/AGENT XC DATE 511 ­3 /O Property Owner's Authorization ' 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 fort ublic officials and the staff of the City of Edmonds to enter the subject property for the purposes of inspection and 96stiog attendant to thi"pplication. SIGNATURE OF OWNER Owner/Applicant: Name 15uo -- 9�44 Street Address sZX /DAD City /State Zip Telephone: Email address (optional): Critical Areas Check] ist.dod4.22.2003 DATE ✓ / /.3 Applicant Representative: Name Street Address City State Zip Telephone: Email Address (optional): FDA► ZQne�B; 18712 V ry 18703 — 1eez6 18702 187TH ST SW s d' r 18707 / m 16711 1es31 1es2e 18701 m g 3 $ 18704 m QO 'aid ° 18715 18711 m g a P 18717 18709 18718 18718 Z 1871 Q?Q 18732 '° ��i ,e717 18719 a 1871e 1e730 c�V ^-^,..... -_m 9802 18725 1 18728 8730 912 ..«.�,... ...._ .,,........ M..,...,..,,,.. ........ e,.. .. _ 1 18803 _ 18812 �'n 18811 18809M1B814 �µ M 18810 3 18805 18809 18732 18802 18609 y� 18812 18806 tSON ? �t �� 18816 N a 1B81B a 18823 18824 18823 tBB18 t8B22 1B82t 18825 1B8o8 18B 18827 18817 U $ s 18823 1882E 18810 18812 ( 16902 18904 18908 m /,y 18831 18829 0 18901 18909 1890e ISM 18920 18912 18910 18908 18920 18909 18831 O 18908 m 18914 a0 °D m 18910 18914 iB915 18811 18922 1 m 18922 18914 _yy 18920 18012 m 18918 18922 & 8313 bi m 9921 -- 16929 0421 m 18924 ` m m WATE ST 19005 18 190TH ST SW �3B 19013 9816 9615 N 19011 9425 9322 9308 9210 1800 18016 $ 9021 10017 9719 9711 9611 8811 � 18018 19107 1801 19028 9829 9823 Salo 9715 9609 19026 ,.1 19018 19024 1821 C RRY ST TM P� Sw yQj a �,y 19026 N m 19105 O of 19102 19102 19 $ ffi 19110 9 ,g�'tG e3o3 19105 loll 1620 1610 p R m 19117 19121 191jS A(s� 8225 191zs 1911 19120 1661 19130 19128 19128 85 1676 / 19129 19125 787� 1912 1698 1523 1551 1542 19210 �+ 1590 ¢ 11; 19204 19210 1670 / / O m 19222 19213-- N 9118 1561 1592 19212 19214 19200 m 19226 U 18223 19218 19222 19210 18216 a m G. p 19225 Am�yy 1620 1 19232 1640 /irk lJ/ 19228 T 19226 19230 19220 19225 1438 O �, � Ol 7g�1 1530 . %' / 1506 , 1029 19308 m 1 °ej 1441 19318 19309 19311 ^+ ffi g 1620 lip, 1516 19314 mN ^y"0 1d29 1002 1 1 m 9609 1606 F F . 1 9515 1514 .`' 1a26 1449 FOREST DELL DR tool e5o7 g f030 1512 df 1y,�ry 1422 1p 8520 1428 9055 l , 1038 K 1439 1 9125 1432 Q 1010 /o1e 14a1 lazo 1430 1427 S 1430 laze tole t023 ,p� 1421 1422 1420 1020 1031 Q 1440 1416 1109 19516 1043 O�' 1428 1417 ez7 1aIS 1030 1402 y 1308 1424 1047 1412 19518 0� 1304 19516 19511 Sundstone i, i302 ;� 1410 N m 19s20 A 1410 1011 1055 1407 O b 1409 1 PUGET 0A P.A.1�3Q,gAl�V�,,,,�.�„ 1962s 9f0 912 0 1324 BOB 1323 � ' � " m N m 914 1316 1312 1313 `r goo ^•• 916 Edmonds 13�1309 1304 1305 1306 1305 t The City of Edmonds APPLICATION Ic- for FILESIDDE SEWER PERMIT EASEMENT No. .......... NEW CONSTRUCTION REPAIRS ❑ t"15 �01) OWNER....... / ..................................... CONTACTOR .......... .................................................................... PER IT No I F-1 ) .............. ......... LEGAL DESCRIPTION: LOT No . ......... ......... BLOCK No. ............... ......................... ADDRESS 0 ........ ....... .... c • NAME OF ADDITION ................................ A P Pz? 0 . 0 Ir NOV 14 1967 40 APPROVED SEP 221,%7 q V? A), Approved: DATE ..... .... ... ........... By j9�if III cl �71 0- .10 a CITY OF EDMONDS Call Plloepect 6-1107 when work CIi7IC CENTER — WATER -SEWER DEPARTMENT is ready for inspection. (No inspec- lions Saturday, Sunday or holidays.) NO: 2540. SIDE SEWER PERMIT ADDRESS.............. 15.3Q.-N.in h---Aveenue...Yort.h........---------------........----.......................------................---..............----...................... owrrER....... ax n Sal sbur'y-------------------------------------------- CONTRACTOR ................. Owner .............................................. ... Permissibn is granted .... NOVeiilbeX'_ 4._. 19...67., for ........................ days to REPAIR or CONNECT a side sewer With City Sewers in accordance with application on file and governing ordinances. ATTENTION IS CALLED TO THE FOLLOWING: NOTE No. 1—The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct side sewer Instreetarea. Do not cover any portion of sewer before it has been inspected. NOTE No. 2—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit. NOTE No. 3—Top of side sewer must have at least 30 inches coverage at property line and 12 Inches Inside property line; minimum grade of 2%. No bends in -grade sharper than % will be permitted. i� :: No. 4—Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper work which may develop within one year of completion. NOTE No. 5—It is unlawful to alter or do any other work than Is provided for In the permit, or to do any work on the main sewer or its appur- tenances except to insert the pipe into the wye. a �F o 116WEEP Co., INGO SH 6-8400 P.O. BOX 160 - 13440 S.E. 30th ST. - BELLEVUE, WASH. 98004 PLAT OF SURVEY FOR: Mrs. Martin Salisbury A1.1 that pvvtion of the SW 1/t� of the SE l/4 of Sec. 13, 127 T27N, R3E, W.M. Described as follows: Commencing at the intersection of the centerline of Second Avenue and Lake Avenue as shown on the original plat of North Edmonds, according to Plat thereof recorded in Volume 2 of Plats, Page 75, records of Snohomish County, Washington; Thence N 51026' W along said centerline of Lake Avenue (vacated) 290.00 Feet to the true point of. beginning; Thence N 72056' W 163.23. Feet to the East boundary of Charles Avenue; Thence N 0012' W 60.70 feet to t the SW corner of a tract of land conveyed to 0. Bruse, under auditor's file No. 1043539; Thence N 89048' E 242.48 Feet; Thence S 38034' W 139.98 Feet to the true point of beginning. Situated in Snohomish County, Washington. S 7iZ�� ALE �TiN'U PoA-E qOF :c- 7-ai S-��c►ST�n/C� ��sr2.�T �lSTL2lBlA.T(oM S`(STCM i i.- p2o�osEo SNEW t�E�Esra 1005, I�E Pc w �E i . L E l5:,a-sEMC-cr Q JeE4 zo E R u.S 7-" ,�DJYIDNl/S Li PC12�:i /t v �U 400 � AMA-1 :f3d2� F�-ND !'�-•�C� / X ��;,�,��i/D.iJ�T �3iv.c� po c.E 7`0 �t/,EGi1 o2 X ,2 " C TS To . Le-,�wX, 1-76;'J . AR DATE RECEIVED i' % ; •+ �• ` � � -.: PERMIT EXPIRES CITY OF EDMONDS USE ZONE /;. "... y PERMIT /�.-... _, UMBER CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRESS _ 14 A �-, y t A / OWNER NAME/NAME OF BUSINESS PLAT NAMEISUBDIVISION NO. - _ LOT NO. LID NO. MAILING ADDRESS LID FEE $ O`) � 7 _* /a/ �? A 1' PUBLIC RIGHT OF WAY PER OFFICIAL STREET RW Pern I ed CITY~ ZIP __.. TELEPHONE -MAP EXISTING"' "' PROPOSED W� - Street Use Pert itift Read ; troPectron Required sidewalk tree 0 dew qu �! ,. / :- ,.' f % j va. p f f 6, '•' Jti ".. .✓' ... » ,�+' ......,.._...._-.... REQUIRED DEDICATION FT Underground wiring required 13 NAME 1 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED (7 Y ,p .l !c 63.1 YES ❑ NO Clz �u C _ V ADDRESS F J A �I�raa'�. f REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE = P f✓F.iVI'/�'�'�,....._, r�`' r. ��""1 � 'd� �%"v t .-. a J6t.e'i�l�.`! fat= C�TY ZIP TELEPHONE ,'/�C• ri141t�f.. ' NAME CBLf� + •+ a.%' �.,.., rid.•) f K . ,'� ir,.. / � � � ENGINEERING REVIEWED BY DATE C ADDRESS y f,+.J 7 CITY FIRE REVIEWED BY DATE ull ZIP TELEPHONE STATE LICENSE NUMBER EXPIRATION DATE C�H CKED Y VARIANCE OR CU SHORELINE OR ODE# INSPECTION BOND POSTED _y q `y / °! QC, L In r q 1< J ✓? � j � ❑YES O .. -r.. .M $ SEPA REVIEW SIGN AREA HEIGHT . PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXtlEMMP«T� ALLOWED PROPOSED ALLOWED PROPOSED ❑ NEW ® RESIDENTIAL PLUMBING / MECH LOT COVERAGE PROPOSED REQUIRED SETBACKS (FT.) FRONT SLIDE REAR PROPOSED SETBACKS (FT.) UR S199EE REARCOMPLIANCE O ® ADDITION ❑ COMMERCIAL OR ❑ ALLOWED •. C. ��n r V e �FRONT f ��� `n • �) ry Z CHANGE OF USE �" 7 i% REMODEL ❑ MULTIFAMILY ❑ PfiRKING REQ D PROVIDED[,j;;�EAJ PLANNING REVIEWED BY ATSIGN NGREPAIR •�� r .-• ,,: �✓', ? L G I G CYDS ❑ FENCE ❑ Q _ Z) ( X FT) + REMARKS j d , t"F` . "� OTHER ❑ DEMOLISH ® TANK ❑ 6✓ ... f G iz, ��,J�a � j„(� -f e. lr� h✓f GARAGE RETAINING WALL FIRE SPRINKLER ❑CARPORT ❑ ❑ Z G ROCKERY FIRE ALARM (TYPE OF USE, BUS! EPS OR ACTIVITY) EXPLAIN: r� CHECKED BY TYPE O NST UCTION COq OCCUPANT,,, " �iE' / L� ,,,� r' GROUP fir' - o NUMBER OF 7 STORIES C NUMBER OF DWELLING p UNITS CRITICAL AREAS �S . NUMBE SPECIAL INSPECTION AREA OCCUPANT LOAD yys v REQUIRED YES DESCRIBE WORK TO BE DONE �^ ,{ �. Z.,1o1/7rai/(Ac'�TCrki W *ie%A.• REMARKS 2 r PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D 9 / �a"� c arieel a.r:��r"TTe7�1 r_. �ivlJ�. dg Iu1 `� W z'. r%["tJ� L.t n ;Yra a t��a C.i ') e w �2 - s 7,C'j VALUATION Nq . t eVAe.)a/41 of e'I:•�4mq � Qf'-��� oI "�rtin!=:" Description FEE Description FEE A10a,.: , rI'D tQ�lfi91�t k b 1I��4aLkt,iion +"'I'exsnd. '(Cetn•' OA1 Plan Check '"� /✓' "" 4b� State Surcharge � HEAT SOURCE I GLAZING % t/.% LO ,TaLOP % Building Permit . J :•' ' •-w City Surcharge I l 7 PLAN CHECK N �- +,r VESTED DATE Plumbing !G' �) '.� _:` Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t BE DONE ON PRIVATE PROPERTY ONLI ANY CONSTRUCTION ON THE PUBLIC Grading k w DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. s Engr. Review ua! PERMIT APPLICATION: 180 DAYS IL PERMIT LIMIT..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 2 IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection CLAIMS FOR DAMAGES OF WHATEVER Receipt # IALL 9 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 CRY ORDINANCE Landscape Insp. Total Amt. Due M = NOR LIMIT IN ANY WAY THE CRYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt #/J L � �J��• ,`/ , 7 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 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 LABORCODE OF -THE STATE OF WASHINGTON RELATING TO WORKMENS CO SATION I SURANCE•Aq RCW 18.27. FOR INSPECTION receipt is acknowledged in space provided- (425) OFFIC LS SIGNATURE DATE SIGNATURE WRIER R' GEr ( \R (1 E \_-..__ DATE SIGNED 1` Y / 7 1 -0220AECEASEk . DATE ATTENTION M 1333 IT IS UNLAWFIJ1:- TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL f �S/� �'� 6'�� ✓ ! A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -;FILE • YELLUv r. CTCa CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 ; PINK - OWNER' • GOu vSESS:1P 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN -AGCO-K—,N: CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEMAME OF BUSINESS dDOAJ AIA E,12AJ S i ' MAILING ADDRESS I /53o q ±ti ,je ,A./, CITY ZIP TELEPHONE 4EZ>A40dDS (?8pz0114ZS-774-4838 NAME ADDRESS 400 A vE A CITY ZIP TELEPHONE SAoNOA41VI 93290 360% NAME CBL # Z114N R1_(WdD 61,45T, '. %tiC' LI ADDRESS 3 "" T ZIP I TELEPHONE i�M 9290204zs-7;7-54®5 STATE LICENSE NUMBER EXPIRATION DATE I CHECKED BY Z /MMEcli 061 k S' 5//zA ��IH PROPERTY TAX ACCOUNT PARCEL NO 14 NEW ❑ ADDITION ❑ REMODEL ❑ REPAIR ❑ DEMOLISH 5 GARAGE CARPORT, (TYPE OF USE, E RESIDENTIAL ❑ COMMERCIAL (❑ MULTIFAMILY 10�I GRAJ2)Na' CYDS ❑ TANK ❑RETAINING WALL ROCKERY OR ACTIVITY) EVLA1N: NUMBER NUMBER bF OF ' DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE G01) ShUCA06 o ❑ PLUMBING / MECH COMPLIANCE OR ❑ CHANGEOFUSE ❑ SIGN ❑FENCE ( X FT) ❑ OTHER ❑FIRE SPRINKLER FIRE ALARM T L CRITICAL AREAS NUMBER rle(A/ aecq( r� l PERMIT EXPIRES USE PERMIT 771� ZONE NUMBER V 3 (� �3 JOB SUITE/APTB ADDRESS /5J% 0 9 a A ae Al. PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP OP RW Pe Approved rMt Required .�.�..• EXISTING PROPOSED Street Use Permit Req'd Inspection Required sidewalk Required, REQUIRED DEDICATION FT Underground WiMg required . METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES O NO 13 z REMARKS = OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE �N cw�o: G) n1vAe. /'•1 — ..I / /ki96- BY FIRE REVIEWED BY DA w VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND RE ', POSTED I - (3 YES,29,NO S SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWE PROPOSED � LOT COVERAGE REQUIRED SETBACKS ( PROPOSED'SETBACKS (FT.) ALLOWED ROPOSED FRONT SIDE REA � FRONT L/R SI E REAR (7 0 1$. 6 s� 0� Z-5 `�5 � 1 lleR RKING AREA P NING REVIEWED BY DATE [LOT REO'D PROVIDED 2 2' f', 7h;119 d 5' defz?CAAd a.ra k l&+ -'{o GxC t e of !J� CHECKED BY ITYPE OX•18"SIRIICTION I CODE, I OCCI v GROUP SPECIAL INSPECTION AREA OCCUPANT REQUIRED ❑ YES ( LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D 4 VALUATION 3 " �^ 404 Description FEE Description FEE do @ : p QA DIA16- tE' G, -Ppd ur • p Plain / '� State Surcharge ..S HEAT SO RCE IVIA A GLAZIN % LOT SLOPE % 5A Building Permit City Surcharge PLAN CHECK O: VESTED DATE Plumbing �C 0 t:)1` Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLYL ANY CONSTRUCTION ON THE PUBLIC i I DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading g SEPARATE PERMISSION. Engr. Review I PERYR APPLICATION: ISODAYS PERMIT umm 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 IN INTEREST, AGREES TO INDEMNIFY; DEFEND AND H HARMLESS THE CITY OF '. EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AGENTS FROM ANY AND Fire Review Plan Chk. Deposit Fire ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARTS N� DIRECTLY OR INDIRECTLY Inspection Receipt # FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THCS PERMIT SHALL NOT BE DEEMED TO MODIFY, WANE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due Jr— ! NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CRY AND STATE LAWS REGULATING CONSTRUC- ND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL T� application is not a permit until. signed by the . IN V10 ON OF THE LABOR CODE OF THE STATE OF. WASHINGTON RELATING TO WORKME CO CE AND RCW 18.27. FOR INSPECTION Building OMcIW or his/her Deputy: and Fees are paid, and receipt Is acknowledged In space provided. OFFICIALS SIGNATURE D TE (425) GNATUR ( AGIs DATES IG ED 771-02201 kTTEN AIELEAdliffBY D E �-- / ' EXT 13313 i 7 V W 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 04/02 PRESS HARD -Vnll ARF MAKIMr, A (%nPI1:Q • YELLWIr- INSPEGTUFi • GOLD -ASSESSOR - ACCOUNTING ,