17021 73RD PL W.PDF17021 73 R D P L W
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City of Edmonds
Critical Areas Determination
Applicant: Carolyn Layton Determination #: CA-2002-38
Project Name: Layton Deck Permit Number: Plan Check #02-212
Site Location: 17021 73'd Pl W Property Tax Acct #: 00-7415-000-014-00
Project Description:
Determination:
Suspended Deck Addition to Single-family Residence
Conditional Waiver:
The proposed deck at 17021 73rd Place West submitted May 8d' has been reviewed and approved.
The potential steep slope critical area on the lot does not appear to be affected by the addition,
since it will not disturb the existing ground.
The following criteria were used in making the determination per ECDC Section
20.15B.140(A)(2):
1. There will be no alteration of the critical area or its buffer.
2. The development proposal will not impact the critical areas.in a manner contrary to the goals,
purposes, objectives and requirements of this chapter.
3. The development proposal meets the minimum standards of this chapter.
This conditional waiver is specific to the plan check number 02-212. Any future development
proposals must be individually reviewed to determine whether a critical area study is required.
Kathleen Taylor May 15, 2002
Name ignature Date
I
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RECEIVED
EAGLES NEST OWNER ASSOCIATION MAR - 7 2002
16924 73RD PL W BUILDING DEPT.
Edmonds, WA 98026
March 1, 2002
David and Carolyn Layton
17021 73rd Place West
Edmonds, WA 98026
Re: , Approval of Construction Plans for Deck expansion and renovation on Lot 14.
Dear David and Carolyn:
I am pleased to inform you that the Board of Directors of the Eagles Nest Division No. 2
Owners Association, a Washington nonprofit corporation dba Eagles Nest Owners
Association, has reviewed and approved the above noted plans for the construction of the
therein referenced improvements on and appurtenant to Lot 14. This approval follows
the review and recommendations of the Association's Architectural Review Committee
and is in accord with and pursuant to Sections 4.5 and 17 of the CC&Rs governing
homeowner construction activity within our community.
It is important that you understand what this approval does not cover. Our review and
approval is limited strictly to the provisions of our CC&Rs. We do not review or approve
the sufficiency of construction materials or methods, engineering studies or the lack
thereof, soil or environmental conditions which may be in existence, considerations of
utility installations or public or private easements or other rights and restrictions which
may be in place or be applicable. We express no opinion regarding and our review and
approval does not in any way limit, excuse or replace your obligation to comply with all
applicable laws, rules, regulations and ordinances. We expect and assume that you will
obtain all necessary permits.
That being said, we wish you good luck on your project. Any material change in your
intended construction from that set forth in the referenced plans will require a new
submission for our review.
Sincerely,
Ann Wood, President
ENOA Construction Approval
memo
Date: 2/28/02
To: ENOA Board
From: ENOA Architectural Committee
RE: Lot 14 Remodel Project
We, the members of the ENOA Architectural Committee have reviewed the design for the
remodel and deck addition on Lot 14 (Layton home) and have determined it to be consistent
the requirements outlined in the CC&R's. Since adjacent homeowners have also
sated their approval we submit the project for approval by the ENOA Board.
memo
Date: 2/28/02
To: ENOA Board
Cc: Dave & Carolyn Layton
From: Wendy Falivena, Jerry & Jeanine Goodman
RE: Lot 14 Remodel Project
I have reviewed the plans for the proposed remodel and deck extension of the home on Lot
14 owned by Dave and Carolyn Layton. As an adjacent homeowner I have no objection to
OF EDo�O City of Edmonds,
Development_ Services Department
Planning Division,
Phone: 425.771.0220
rhC. I g90 Fax: 425.771.0221
The Critical Areas Checklist contained on this form is to
be filled out by any person preparing a Development i
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:
City Receipt #: / l�
Critical Areas File M ,
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant:
A property owner, or his/her authorized representative,..
must fill Put- 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 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 file this application q4 the behalf of the owner as listed below.
�— �1 Gas /
SIGNATURE OF APPLICANT/AGENT � DATE 02—.
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 for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
�,IGNATURE OF OWNER rM DATE
r i
PLEASE PRINT CLEARLY
Owner/Applicant: ' Applicant Representative:
Name
(-102-1
Street Address
G-D 00 OS W Pr q <�-y a-�o
City State Zip
Tel tfaS —1 `f }- —� !&— a--(
Email address (optional): W yfvv% d c 4ttbi.covo
Critical Areas Check] ist.doc/3.19.2001
Name
Street Address
City State Zip
Telephone:
Email Address (optional):
Critical Areas Checklist CAFileNo:
Site Information (soils/topography/ hdrology/vegetation)
1. Site Address/Location: (70L. W., eNko tV f)S
2. Property Tax Account Number: (9 4-74( S O O 0 0 1 LE 0y
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? X yes; no.
If yes; how is site developed? e—S I bop-n,-L _
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site..
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal
distance of 66-feet).
Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of 10-feet
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: Approx. Depth:
7. Site contains areas of seasonal standing water: /y 8- ; Approx. Depth:
What season(s) of the year?
8. Site is in the floodway N A- floodplain N!- of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
N l_ Flows are seasonal? (What time of year? ).
10. Site is primarily: forested_; meadow ;shrubs ; mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site: N �'
. For City, Staff Ilse Only
1 Plan Check Number, �f applicable?
Critical Areas Check] ist.doc/3.19.2001
r Critical Areas Checklist
CA File No: O A '15 q
Site Information (soils/topography/ hydrology/vegetation)
� . Site Address/ Location: (10 `a 1 'l 3 — P L • W .. EWk 0 iU f) S R
2. Property Tax Account Number: C9 0-7 4 (4 00 00 1 LE 00
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? "� yes; no.
If yes; how is site developed? ktS 1 b0P11A,,-L
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal
distance of 66-feet).
Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of 10-feet
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):
R1
7.
•
8.
Site contains areas of year-round standing water: lJ N' ; Approx. Depth:
Site contains areas of seasonal standing water- N t - ; Approx. Depth:
What season(s) of the year?.
Site is` in the floodway (V fr floodplain tJA— of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
N I! Flows are seasonal? (What time of year? ).
10. Site is primarily: forested meadow ; shrubs ; mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site: N A'
Critical Areas Check] ist.dod3.19.2001 �T V .p
'4C. I % 9 �
City of 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:
City Receipt #: / &
Critical Areas File #:
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant:
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 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 file this application o the behalf of the owner as listed below.
�-- �I �s L
SIGNATURE OF APPLICANT/AGENT DATE oZ--.
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 for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
SIGNATURE OF OWNER ( v DATE
Owner/Applicant:
Name
Street Address
GDA WOOS W Pt-
City /State Zip
Telephone: Lk aS / -7 `E 1- -4-1 !&- a -I
Email address (optional): AQG to n d c 4 #bt . cow►
Applicant Representative:
Name
Street Address
City State Zip
Telephone: 0
Email Address (optional):
Critical Areas Checklist.doc/3.19.2001
City of Edmonds
Critical Areas Determination
Applicant: David & Carolyn Layton Determination #: CA-02-38
Project Name: Permit Number:
Site Location: 17021 73rd Pl. W Property Tax Acct #: 00 7415 000 014 00
Project Description:
Non -Project Specific
Determination: Study Required:
During review and inspection of the subject site, it was found that the site has some potential for
steep slopes on portions of the property and/or adjacent to the property pursuant to Chapter
20.15B of the Edmonds Community Development Code (ECDC).
Based on these findings, prior to submission of any development permit, you will be required
satisfy the requirements of ECDC 20.15B by completing the following:
Steep Slope Hazard Area Delineation Requirements:
To determine if a Steep Slope Hazard Area does exist, a topographic survey prepared by a
Licensed Land Surveyor delineating Steep Slope Hazard Areas must be completed. The
topographic survey may confirm the need for further study or it may indicate that there are no
steep slopes on the property.
In any case, a slope of 40% or more with at least 20 feet of rise will be classified as a Steep
Slope Hazard Area. A 50-foot buffer is required from both the top and toe of the slope. A 15-
foot building setback is required from the 50-foot buffer.
For development of any kind which is proposed within the critical area, 50-foot buffer or 15-foot
buffer setback, it must be shown that the development will not adversely impact the Critical Area
or its buffer, by doing one or possibly both of the following depending on the outcome of the
study:
For development proposals which will occur within the 50-foot buffer, but no closer than
10 feet from the top or toe of the slope, the 50-foot buffer requirement may be reduced to
10 feet if a study is completed by a licensed geologist or geotechnical engineer which
clearly demonstrates that the proposed buffer alteration will have no adverse impact upon
the site, the public or any private party. All Critical Area Studies, except those done by a
licensed geotechnical engineer, must be completed under a three party. contract where the
City hires the professional required, and the applicant pays for the study (pursuant to
ECDC Section 20.15B.140).
1
2. If development must occur within the critical area, buffer, and/or buffer setback, and is
not identified as an exception per ECDC Chapter 20.15B, a Reasonable Use Exception
and Variance must be obtained pursuant to ECDC 20.15B.I70A and 20.15B.040C.
If the property owner wishes to apply for a specific development permit which they feel
would not impact the Critical Areas located on the site, they may submit their proposal to
the Planning Department for review. If the Planning Department finds that the proposed
development permit will not adversely impact a Critical Areas or its buffers, a conditional
waiver may be issued on a project by project basis.
2
... -- - -� '�`"{. vr. ,'�•"`Y ':'ld ��' 'titiC�'f jr vi' "•.
CITY of EDMONDS SIDE SEW:.E`R"' or(RRAIT
For Inspection Call 771-3 PJ� - PERMIT. NO. 00 � T G
Address of Construction: I 0 Z.1 `7 3
Property Legal Description (Include all easements):
l.'_.-�-
1-I 1 c, s +4
-X e,-sF
Z
Owner and/or
Builder: =,j_,n,.,
V0
Contractor &
License No: 7-7�
J Q AN z7:3 nT 5 ZIT
Singl:e Family Residence
Multi -Family (No. of Units ) LYNNWpOD LINE
Commercial (No. of fixture Units )
Invasion into City Right -of -Way: No ><—' Yes (If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No V- Yes (If Yes, easement required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS LISTED ON THE BACK
I certify that I have read and shall comply
with the items listed on the back.
RECEIVED
JAN 08 19i�
PUBLIC WORKS Date
Permit Fee: 3C • 6-0 Issued By: 's.�,,��-��
Trunk Charge: 2,c; r,-, G Date Issued: 1— 5 — 26
Assessment Fee: L/4D Receipt No.:
Partial Inspection:
Comments Date Initial
Final Inspection Approved: 3 -a0 D
Date Thitial
oRejected:
Reason Date Initial
v
a
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy - File Green Copy - Inspector Buff Copy - Applicant
The City of Edmonds Side Sewer Drawing EASEMENT NO - ............................................
NEW CONSTRUCTION R-' REPAIRS F-1 LID NO_ ------------------ ASMT. NO. ------------------
OWNER------------------------------------------------------------------------------------------------- CONTRACTOR ------------------------------------------------------------------------------------ PERMIT NO. --- I -Le...
JOB ADDRESS I..----: U-- ------ -715 - ---------- v4-
-- --------------------
PWW-0001 -11/75 (REV. 11/78)
LEGAL DESCRIPTION: LOT NO. ------- t-4 ---------------------- BLOCK NO. ............................ ------------
--------- --------------------------------------------------------------------------------------------------------------------------------------------------
NAME OF ADDITION ...
----------------------------------------------------- ......
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RDATE I:n..O. -: ..... q..b .............. B,(-. ------------------------------------
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CI'I`t% OF EDMONDS Permit No.. /�' I5
COMMUNITY SERVICES DEPARTMEN 11 EET FILE
RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date
A. • Owner: B. • Contractor: C#,40gx1q GVsuCD A
Name N133 •�/�A/!/ ST
Mailing Address Mailing Address
City State Zip City State Zip
s o,E2 c.G /Dl 662 ti4 7�4-5/y6
State License Number Telephone Number
C. • Address or Vicinity of Construction: 1761�b�
Type of Work to be Done:
w�lIi'-,SW h3 c16 CA
D. • Work in Connection With: ❑ Sub or Plat ❑ -Single Family ❑ City Projects
❑ Commercial ❑ Multifamily ®' Utility
E. • Pavement Cut: ❑ Y N F. • Size of Cut: X tr
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of . Edmonds
harmless from any injuries, damages, or claims of any kind or description whatsoever, forseen or unforseen, that may
be made against the City of Edmonds, or any of its departments,or,iemployees, including or,not limited to the defense
of any legal proceedings including defense costs, court costs, and 4iforhey fees by reason of granting�thisrpermit.
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.
• A 24 hour notice is required for inspection; Please call Engineering: 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.
is 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 " 'e above nd that this perm 't m st be available at the job site for inspection purposes at all times.
6�
Signature:/S I/
Date:
/ Owner or Contractor
Permit Must be Posted at the.Job Site For Inspection Purposes
Call DIAL -A -DIG Prior to Beginning Work
y, APPROVED BY:
a
Z Time Authorized: Void after I i 2 ^ days. .
O
W Special Conditions: N A
'V� RELEASED BY: _
PERMIT FEE:
Restoration Fee:
Receipt .No.:
Fund III Fee:
Street Cut Dimensions: x = $
Date l ' Y' 9 INSPECTED BY
Date
w NO WORK TO BEGIN PRIOR TO. PERMIT ISSUANCE
Eng. Div. March 1989
FIELD INSPECTION NOTES
(Fund I I I - Route copy to Street Dept) _? '
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. July M
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CITY OF EDMONDS
ASSET INFORMATION SHEET
NEW
❑ ADDITION
❑ RETIREMENT
ASSET NO.
ADDITION TO ASSET NO.
DESCRIPTION ,
L V 1 V
SERIAL NO.
LOCATION Q \
Rck-cp—
DEPT. NO.
* * PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
* PROJECT NUMBER Uy Ce n a o Cg) q
PROJECT COMPLETION DATE 03 -3112-1)
COST U
B.A.R.S. ACCOUNT NO. l l VOy-y G3
ESTIMATED LIFE
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
0 G.L. E
REFERENCE DATE
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PERMIT COUNTER
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September 26, 1989
TO: Permit Coordinator, Building Division's
FROM: Dan Smith, Engineering Inspector
ADDRESS aZ 6O
OWNER
PLAN CHECK #
After review of the subject building permit application,..we have the
following comments:
1. Construction hours are: WEEKDAYS.... ...7:00 a.m. to 10:00 p.m.
WEEKENDS/HOLIDAYS..10:00 a.m. to 6:00 p.m.
2. A Right -of -Way Construction Permit is required for any work on
City property.
3. Connection to City water system required. Fees paid.
4. Connection to City sanitary sewer system required; obtain separate
permit. Fees paid.
5. Water and sewer lines to be separated by 10 foot minimum.
6. Driveway must be paved a minimum of 20 feet back from City
right-of-way; separate permit required.
7. Driveway slope not to exceed 14%.
8. Back water valve required if downstairs plumbing is below
elevation of upstream manhole.
9. Builder/Owner responsible for containing all temporary runoff and
erosion control on site. Construction may not impact neighboring
properties in any way.
10. No burning of construction refuse without approval from Fire Dept.
11. Street to be kept clean of debris, dirt, mud, and construction
materials. Contractor responsible for dust control.
12. Inspection required on drainage system, catch basin installation,
driveways, and sidewalks. A final engineering inspection is
required prior to the building division granting occupancy.
13. Repair or replace all defective existing curb, gutter, and
sidewalk. If intersection is involved, installation of wheelchair
access may be required.
A,� ? z�n L2� l
BLGPER/TXTFORMS
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' CITY OF EDMONDS
USE PERMIT
�_�� NUMBER
CONSTRUCTION PERMIT APP4,tQC TIO,N
ADDRESS / 0
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OWNER N4ME/NAME OF BUST ESS �vJ U U "r
LEGAL DESCRIPTION CHECK
SUBDIVISION NO.
LID NO.
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MAILING ADDRESS
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
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APPROVED BY
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TELEPHONE NUMBER
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EXISTING REQUIRED REO�UI�R*fE�DEDICATION ____
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REMARKS
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STATE LICENSE NUMBER
SIGN AREA
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ADB NO.
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ALLOWED
PROPOSED
COMPLETE
EXEMPT
(show below or attach two copies)
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RENEWAL
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MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADING/FILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
ENERGY CODE
Permit Limit: 1 Year • Provided Work is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
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successors in interest, agrees to indemnify, defend and hold
R37
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harmless the City of Edmonds, Washington, its officials,
s
employees, and agents from any and all claims for damages of
a
whatever nature, arising directly or indirectly from the issuance
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of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
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omodify,
waive or reduce any requirement of any city ordinance
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nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
I hereby acknowledge that I have read this application; that the
information given is correct; and that I am the owner, or the duly
ATTENTION
APPLICATION APPROVAL
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
state laws regulating construction; and in doing the work authoriz-
AUTHORIZES
This application is not a permit until
ed thereby, no person will be employed in violation of the Labor
ONLY THE
signed by the Building Official or his
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
Deputy; and fees are paid, and receipt is
tion Insurance.
INSPECTION
acknowledged in space provided.
SIGNATU (OWNER OR AGENT)
DATE SIGNED
DEPARTMENT
--L—P I1
CITY OF
OFFICIAL'S SIGNATURE DATE
D 8
EDMONDS
ATTENTION
771-3202
RELEASED BY: DATE
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
PINK — Owner GOLD — Assessor
102.87
43, DATE RECEIVED
/
"PERMIT EXPIRESUSE
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PER
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THIS PERMITAIJTHORIgS ONLY THE WORK NOTED. THIS PERMITCOVERS WORK TO Mechanical
t BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC
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'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS TrattIC Mitigation Plan Chk Deposit,
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Fire Inspection Total Amount Due
= NOR LIMIT IN ANY WAY THE ClTrS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION Landscapelnsp. Receipt#
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GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
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TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building OHiclal or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION A receipt is acknowledged In space provided.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
F CU LS SIGNATUR DATE
SIG U E ( WN AGENT) DATE SIGNED (425)
J ®� Q%�a��-- 771 -0220 RELEASgQ BY TE
ATTENTION EXT 1333 X4�
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL ✓�/� / ,La/ /'
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10/01 FAX :'' PINK - OWNER - GOLD - ASSESSOR
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inspection Required be
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VALOATION s
Description
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Description
FEE .
Plan Check.
HEAT SOURCE GLAZING % LOT SLOPE-% Building
PLAN CHECK NO: VESTED DATE .,Plumbing,
Mechanical
THIS PERMIT AUTHORUMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO "
t BE DONE ON PRIVATE PROPERTY ONLY ANY CONSTRUCTION ON THE PUBLIC
7 DOMAIN (CURBS, SIDEWALKS; DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading Recording Fee
SEPARATE PERMISSION.
a Engr. Review City Surcharge v
5 PERMIT APPUCATION:.1SO DAYS
d PERMIT LIMIT. 1 YEAR - PROVIDED WORK 18 STARTED WITHIN 1S8 DAYS ' Engr..Inspection State Surcharge
BEE BACK OF PINK PERMIT FOR MORE INFORMATION g.
•APPLICANT, ON BEHALF, OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Traffic Mitigation Plan Chic Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Review Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
oFROM THE ISSUANCE OF, THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Fire IITSpeC110n Total ArnOUnt DUB
DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
* NOR LIMIT IN ANY WAY THE CRYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Landscape Insp. 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- . This application Is riot a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED.THERESY, NO PERSON WILL BE EMPLOYED CALL Building Ofncial 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 spice provided. -
WORKMENS sATION INSURANCE AND RCW 18.27.
OFF NAT D E .
AGENT) DATE 8 GNED ', (425)
=TUR(OWNERR
. 1� va•..— 771-0220. . .ele
RE SED BY,, JJ. pp
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SEE BACK OF PINK PERMIT FOR MORE INFORMATION
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2 EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Review, Receipt III
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE Fire Inspection Total Amount Due 9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
= NOR LIMIT IN ANY WAY THE CITY^8 ABILITY TO ENFORCE ANY ORDINANCE PROVISION.•
Landscapelnsp. Receipt# /
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
R. 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 Official or hisftw Deputy: and Fees are paid, and
ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION ecelptIsacknowledgedInspace provided.
LTnN
S COMPENSATION INSURANCE AND RCW 18.27.
OWN A DATES NEq (425) OFFl SIGNATURE DATE
L-0220
g 0
/ 771
RELIJD BY DATE
ATTENTI N Off 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL yx
771-0221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CPSRTIFI-
YE
ORIGINAL - FILEYELLOW - I PELTR
OWASSESSOR
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PINK - OWNER GOLD
10/01
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MAY 0 9 2002
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RECEIVED
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RECEIVE®
MAR. - 7 2002
BUILDING DEPT.