17631 70TH PL W.PDF111111111111
5540
17631 70TH PL W
PLANNING DATA
NAME:
SITE ADDRESS:-1-7to'�bi jrmi pi, yl- DATE: 175-,xc� - o i
ZONING: R-!&- 9� PLAN CHK#: ct)i — 1(oa
PROJECT DESCRIPTION:
A::0-nnrj -r?-5 (w/
CORNERLOT __(Yes&) FLAG LOT ffes&�)
SETBACKS:
Required Setbacks:
Front: Left Side: Right Side: -7 Rear: t
Actual Setbacks:
Front: ��' Left Side: -7. V Right Side: Rear:
Street map checked for additional setback required? (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED _(Yjj�)
LOT COVERAGE:
Maximum Allowed: ___.Actual:
BUILDING HEIGHT: 5
Maximum Allowed: -Actual Height:
Datum Point: Datum Elevation:
A.D.U. CREATED?: tAo
SUBDIVISION: 5:�eA tp,-vjm
CRITICALAREAS#:
SEPA DETERMINATION%'�s�.........
LOT AREA: 00, otim
OTHER:
Plan Review By:-
c.Tfles\permiA4p1md2Ldoc
CODISPOTI COMPANY
C, .0. N S U L'T 1" -N G.
STRUCTU-RAL- A L C.U. L A'T 1, 0 N S
or
ZWINK RESIDENCE ADDITION'.
IMF
.1) ' 1763170" Place West
Edmonds, WA 9$026
MAI 3 2001
Prepared for:
Todd & Jennifer Zwink, Ovvners
-Todd Larry Throndsen, LOT Design Group
CCC.JOB NUMBER 0 1 -021
CO
April 24, 2001
INDEX
DESCRIPTION SHEET
Design Criteria . ............
.................................................................................
FramingDesign- ........................................................... .................................... 2'- 4'
co
The design, responsibility of the Licensed Engineer
is limited to -the contents 6f these calculations. It
shall -be the - responsibility of the designer, Larry
Throndsen, LOT Design Group, to ificorporate the
requirements herein into the construction drawings:
It is assumed the balance of the design riot covered 2646
by th6se calculations is in substantial confoirhance
with the appropriate codes and. variances wi.th'no
opinion expressed or implied regarding.*those areas.
rEXPIkEs. 8-23-
P.0 BOX 2455 KIRKLAND,. WASHINGTON 98083�24.55 PHONE: (425) 822-9709 FAX: (4.25) 822-9742
0OV15POT1 COMPANY CONSULTINC7 Job Name: Zwink Residence
Post Office Box 2455 Job Number: 01-021
Kirkland, Y%A 418085 By: MAC
Date: 4/24/01
Sheet: 1 Of:
0 E 5 1 & N 0 P. I T E R I A
CeOME5- Uniform Building Code - 111r Edition
MATERIALSO LUMBER: Hem -Fir #2 2x framing and as noted
Fb = 550 psi (unadjusted)
Fv = -15 psi E = 1300 ksi
Doug Fir #2 4x framing and as noted
Fb = 6-TS psi (unadjusted)
Fv = 415 psi E = 1600 ksi
Doua Fir #1 &x framing
Fb = 1350 psi (unadjusted)
Fv = 55 psi E = 1600 ksi
6lu-Lam Timber AIT6 24F-V4 4 -V6
Fb = 2400 psi
Fv = 165 psi E = 1800 ksi
CONCRETE: fc = 2500 psi minimum compressive strength at 28 days
REINFORON& STEEL: A5TM A&15 6rade 40 Fy = 40 ksi (min)
ROOF:
FLOOR:
Finish Roofing
4.0
psf
Finish Floor
1/21, Plywood
1.5
3/4" Plywood
Trusses e 16" o1c,
2.5
Joists 0 16"
Insulation
2.5
1/2" 6V415 Ceiling
1/2.. c5y4B ael[N
2.2
t�lscellaneous
miscellaneous
2.5
5um of Dead Loads
5um of Dead Loads:
15.0
psf
LiVe Loads:
Live Loads:
20.0
Live Load
25.0
5now Load
Dead Load e Nalls:
interior:
5.0 psf
Exterior:
10.0 Psf
1.0
psf
2.3
2.0
2.2
2.5
10.0
Psf
40.0
psf
Ylind Loadhig, p = Ce 0 C
(refer to lateral calculations for applied wind loading)
Criteria: 50 mph Basic, Viind Speed; Exposure "B"; Method 2
Seismic Loadina Criteria: Zone 5; Rw = 5.5; Ca = 0.36; 1 = 1
V = (2.5 Ca I / R) V4 = 0.164 IN (For strength design)
(refer to lateral calculations for applied design seismic, loading)
CODISPOTI COMPANY CONSULTING ZHINK RE51DENCE ADDITION
JOB NO.. 01-021
Post Office Box 2455 SHEET . NO Z
Kirkland, NA clbOb3-2455 — OF
FON: (425) 522-q'70q BY MAC VATE
FAX: (425) 522-C1142 CHECKED DATE
lc-t' v A"14 . ' '
Q tael(40 V,&b
7' S-tl es- 1-
' . (", 00 */0 S-5, �- ; V)
!'7'- 3 5- 0 9
7 t- Z,)S
w I'- , . -z- f- -f- 0 t — // / f Lr-
�ul - (�) ( 7 �- Z-i2 - /" /- if-
t-'?
rr f-C 7 0 ff
(Z- 5-6 7 0
5p
2 -z-5-v -7000 lc7-,4—
f
A AV
A't If
(/,/g ?76
�'+-q /sbvnzt'� -
/t4'- �' - �; 6 ? 0 #
ck- 24w-v /,-S:F
(/ . iv;vwv�
61ce, - � /2- '), 4 1� �- cz-
&O/Vr evAle-,
(,A41,q
AA
CODISPOTI COMPANY CONSULTING
Po5t Off ir-c Box 2455
Kirklond, VqA clbO63-2455
FON: (425) b22-q'70q
FAX: (425) b22-q-742
J05 ZHINK RE51DENCE ADDITION
JOB NO. 01-021
SHEET NO. OF
BY MAC DATE 't /'t V6?
CHECKED DATE
1�je(Al Ge
M A
C,
ING ROOM
raua 1111% kx "t%zvt%kxrj
cq
91— 899 101-10 99
E)USTING, .9 1 J
�T Wil 00
DINING m
%4
.7]R CLOSET
/-NA
>
OK/- ori w �j
109 - 6" ' L 699 cz
japc r rO B 6
W/C ;o
IILY ROOM
20'- 6V)
CODISPOTI COMPANY CONSULTING JOB ZHINK RE51PENGE APPITION
Po5t Office Box 2455 JOB NO. 01-021
<irkland, VqA cibO85-2455 5HEET NO. OF
FON: (425) b22-ci-70cl 13Y MAG DATE
FAX: (425) 822-cl-742 CHECKED DATE
A4 //V 6
0, wA-�
V---,') r 5-,P,4 /V IV6 I/V �W -V 1) /r-Lv O/Z-
(�o 71 4-0) 7 /p
6 H-r—
>
171-1& P-OfS' AlOf- �N41V(,C� WIN 7ffi C 111�e�,p 0 -roD,
/2-6
( t�wv 7)�� /4�P,!5 &-b
11V5 C47(0 /V &)r-r-t,--E7 11V'-"'�AY&�
I
N1
C G, I
Z
I
')5�
25�
STREET
FILE
25'SETBACK
106.9X - N 870 139 34" W
7. 5E S� �-ETIB �AA �CKW
tAG
AREA—
NEW
EXI.TlNG
2.5
i
LIVING AREA
R 0
00
IANE---�
r
REMODEL
LIVING ARE)
z
*.—EXISTING
ROOF Ll NE
z
z
- I
cl)
00
25'
-T
38.0'
7.5, SETBA K
EXI STI N G 1 106.9l'- N 87" 139 3399 W
LIVING AREA 1,750.00 SQ.FT.
GARAGE AREA .192.00 SQ. FT.
PROPOSED ADDITION & REMODEL GUTTERS/DOWNSPOUTS
LIVINGAREA 365.75SQ.FT. TO CONNECT TO EXIST. SYST.
(REMODEL 222.25 SQYT. Pl,US ADD. 143.50 SQ11'. 365.715) SQYTA
GNRAGE AREA 4 13. 2.5 SQ. FT.
(Elx I STI NG 512.-5 SQ. FT. 1-1, US A DD. 12:1.0 SQ. F 1'. = 635.5 SQ. FY
635.5 LESS REMODEL AREA 222.25 413.25 SQY'll.) APPROVED AS NOTED
NEW RESIDENCE (AFTER PROPOSED ADDITION & REMODEL) BY ENGINEERING
LIVING AREA 2.115.75 SQ. FT. 4111
GARAGE AREA 41-1.25 SQ. FT. Date:
z
00
RECEIVI
MAy - 3 201
PERMIT COUN
LOT 11 SEA LAVvrN ACRES ACCORDING TO PLAT THEREOF RECORDED IN
VOLUME 19 OF PLATES, PAGE 6 RECORDS OF SNOHOMISH, STATE OF
WASHINGTON. APPROVED By PLANNING
Todd & Jennifer Zwink
17631 70thPl. W. Edmonds, WA. 98026 SITE PLAN
Phone 425.742.4407 SCALE I" = 20'— 0"
STREET FILE
NX
)P/11
CITY, OF
CONSTRUCTION P
PERMIT
NUMBER 1439&595
11 AFFLIUATIUN
��AADDRESS
,O" 1 -1 C. _11 041 1 Lo
%Description of PrdpbAy - include all easements
Silk below or attach two copies)
NEW
RESIDENTIAL
YPLUMBING
2"ADDIALTER
El COMMERCIAL
MEC ... IC.L
REPAIR
APT.BLOG.
SIGN
EXCAVATE
FENCE
DEMOLISH
OR FILL
I- x _FT
REMODEL
CAR OAT
0_ GARAGE
EJWOODSTOVEI [] RETAININGWALL/
INSERT ROCKERY
RENEWAL
NUMBER OF STORIES A OF
DIN LUNG
UNIE'Sa
NATURE OFIWOR4 10 BE DONE (ArTACH PLOT
LErAL OESCT1P_T1ONC"ff71�,I0N
NO 1IU
110
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. 7
APPROVED
EXISTING REOUIRED DEDICATION
PROPOSED- __
SCP
BY
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRZD
STREET USE PERMIT REOUIRED.
SEE ENGINEERING MEMO DATED REVIEW BY
REMARKS
METER SIZE
IBUILDING SUPPLY SIZE
IFIXTURE UNITS
REMARKS
SIGN AREA
ALLOWED PROPOSED
ENV. REVIEW
CCMPLETE I EXEMPT
ADO NO.
I SHORELINE*
VARIANCE OR CLI
;aNNING REVIEW BY
JDATE
SETBACKS -FEET ____r��VERAQE
FRONT SIDE REAR
MtMAKKb
CHECKED BY
I TYPE OFCON.STRUCTION
CODE(n I
H111 HT
SPECIAL INSPECTOR IA.EA
REOUIR D
0 YESE NO
Cc.PA.CV JOCC.PANT
10 F'OUP
LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC 305
PLAN CHECK FEE
BUILDING
PLUMBING
/'4
MECHANICAL
perty ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewplkB,
STATE SURCHARGE
driveways. marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
ENERGY CODE
" Applicant, on behalf of his or her spouse, heirs, asSiQnS and
successors in interest, agrees to indemnify defend and hold
he rmless t he City of Edmonds, Washington, its officials,
5
a mployees. and �igents from any and all claims for damages of
Z,
whatever nature, arising directly or Indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
modify. waive or reduce any requirement of any city ordinance
r
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provislon."
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
authorized agent of the owner. I agree to comply with city and
state laws regulating construction; and in doing the work aulhoriz.
T�IS PERMIT
AUTHORIZES
t r n person will be employed In violation of the Labor
ONLY TH E
Code fthe%�te glon relating to Workmen's Compensa.
��
WORK NOTED
[ad
tion I sur ce-\
SID GENTI)
INSPECTION
DE�AATMCNT
CITY OF
EDMONDS
771-3202
ATTENTION
I'
IT S UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTIO14 HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
10247
APPLICATION APPROVAL
This application Is not a permit until
signed by the Building Official or his
Deputy; and fees are paid, and receipt is
acknowledged In space provided.
ELEASED 8V DATE
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
x
dpo
LA 10� 0-M
VN.0'6* k)X; �jl� FU
met
IDT
Ali V,f%
, Z6"-Ol
4A16
%0
hi
----------------------------
JUL 1.
PERMIT COUNTER
J,
us' PE AMIT
ZON NUMBER 9jW5"`*
CITY OF.EDMONDS
CONSTRUCTION PERMIT APPLICATION \A) SUIIEIAPT,
OWNL, NAMEINAME Of BUSINESS ADDRESS
It 'Imbea
W MAiLING Al"RESS, ' -_
7&
CITY ZIP "I 1U1111
U11"
NAME
ADDRESS
IRA I
CITY ZIP TEI IPHONE NUMUER
*7 7
NAME
ADDRESS
0
ZIP TELEPHONE NUMBER
Z 9%EQ 1529-2
STATE. LICENSE NUMBER
80
Lsgal Description of P
roprerty - include all Pasements
below or attach two copies)
SCIC, ai�A ChUk
Tax Account Parcel Noir.-S-P
PLUMBING
RESIDENTIAL
NEW R
OMMERC, MECHANTAL
4', -
F ADWALTEA COMMERCIAL F
[] LAPT. BLDG.
REPAIR L7 SIGN
F EXCAVATE. FILL FENCE
DE L_ x _FT)
MOU! H OR GRA
CA PO-T IM
.R
"AGE SXO L
WOOD STOVIII RETAINING WALL/
INSERT L_J ROCKERY RENEWAL
0 (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
____rNUMBEP OF
NUMBER OF STORIES
1 D ELLIVG
0/r, UWNITS Ole
0. NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
LEGAL OESC91_PTIOK"C"
115,01,10
LIO
PUBLIC RIG -IT OF WAY PER OFFICIAL STREET MAP.
EXISTING IEOURED DEDICATION —
PROPOSE
TESCP
APPROVEDBY
RIGHT OF WAY CONSTRUCTION PERMIT AEOUIRED 0
STREET USE PERMIT REOUIRED 0
REVIEW BY
SEE ENGINEERING MEMO DATED
REMARKS
METER SIZE 1BUILDING
SUPPLY Bill _71.1TURE
UNITS
REMARKS
SIGN AREA
ALLOWED I PROPOSED
ENV. REV;EW
COMPLETE I EXEMPT
ADO NO.
SHORELINE,
I —
VARIANCE OR CU
PLANNING REVIEW BY
A
7tyk,
SETBACKS — FEET
REAR .2
FRONT SI.E:7
OT COVERAGE
REMARKS
CHECKED BY
I TYPE 01 CONSTRUCTION
00
I e <;
SIS
HEI H
SPECIAL IW-.1ECT
REOUIRED
r: OR
1 YES 'JI
1 AREA OCCUPANCY
GROUP
JOCCLIPANT
ANT
LOAD
REMARKS
PROGRESS INSPECTIONS PER LIBC 305
FINAL INSPECTION REOUIRED
A4 -f VALUATION FEE
PLAN CHECK FEE
BUILDING Q I
4�3 c)
PLUM81NG
Plan Check No. I-101
MECHANICAL
This Permit covers work to be done on private property O:iLY.
GRADINGIFILL
Any construction on the public domain (curts, sidewplks,
STATE SURCHARGE
df!veways, marquees, etc.) will require separate pormissici.
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work is Started Witnir. 18C Days
A I plicant on behV of his or her, spouse, heirs, a3signs and
Successors i� interes . agrees to i-amnity. defe:�d and hold
harmless the City of Edmonds, Washington, ;is officials.
employees. and agents from any and all claims for Damages of
whatever nature, arising directly or indirectly from t-rle issuance
of this permit. Issuance of this permit shall not be deemed to
modify . waive or reduce any requirement of any city ordinance
T not limit in any way the City's ability to enforce any ordinance
Provision."
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
-50 7S3
I ��ereby acknowledge that I h;ve 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 TI�TSH.PIR%T
st ate laws regulating construction; and in doing the work authoriz- AU R."
ed thereby, no person will be employed In viola!lcn of the Labor ONLY THE
Code of the State of Washington relating to Workrnfwn's Compensa- WORK NOTED
tion Insurance. INSPECTI-�ri
SIGNATUkE iOWNEA OR AGENTI 0 EPARTMEPT
_4 CITY OF
EOM0140S
L
This application is not a permit until
signed by the Building Official or his
Deputy: and fees are paid. and receipt is
acknowlq�lged in space provided.
OFFICIAL'SWA U E DATE
F_
CALLFO
A17ENVON INSPECTION
EL BY:
Z40,,000;l9
IT S UNLAWFUL TO USE O!� ',)CCUPY A BUILDING OR STRUCTURE 771-3202
UNI'll. A FINAL INSPECTION ;-,i'S PEEN MAD� AND APPROVAL OR ORIGINAL — File YELLOW — ector
A CE�11T.IFICATE OF OCCUPANCY HAS EIFEN GRANTED. 111C
E i
PINK
j
'�k
t
4
0
RECOM OF INSPECTIONS
7.
JNSPECTOR
DATE APPROVED
SETBACKS .............
FOUNDATION:
Footing ................
Wall ...................
Pier/Porch .............
Retaining Wall ..........
PLUMBING:
Underground ..........
Rough -in ...............
CF... : .................
HEATING:
Gas Test ...............
Gas Piping .............
Equipment .............
CF....................
-&RAMING .............
SHEETROCK NAILING ...
00=
SPECIAL INSPECTION ...
FINAL APPROVAL
FOR OCCUPA .....
NCY
Critical Areas Checklist
CA File No: 6A -0 � - �5
Site Information (soils/ topography/ hydrology/ vegetation)
1.
2.
3.
4.
Site Address/ Location:
Property Tax Account N
Approximate Site Size (acres or square feet): 1000 r"4 7-
Is this site currently developed? jZyeS; — no.
If yes; how is site developed?. �5 ��
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 ver . tical. 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: P? 0 ; Approx. Depth:
7. Site contains areas of seasonal standing water: 0 Approx.Pepth:
What season(s) of the year? 41A
8. Site is in the floodway IVA floodplain _ of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
/It/-+ Flows are seasonal? — (What time of year?
10. Site is primarily: forested : meadow shrubs mixed
urban landscaped (lawnshrubs etc) t,,-
11. Obvious wetland is present on site: pq 0
DETERNffNAnON
P
a bm 2:-2h6LO i
IL4
Critical Areas Checklist.doc/3.19.2001
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
goZ
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). RECC- WE-:b
MAY -- 3 2001
Date Received:
City Receipt#:
Critical Areas File e�A - Of 5
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.
PERHII� eatifiTtm
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, ind&mnify, 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 inforination 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 APPLICANVAGENT
DATE
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 DATE
Owner/Applicant:
eel
Name
1-76-3 70
Street Address
E 7 -/, , � �, S k-/11- �t3o Z- 6
City State Zip
Telephone: -H 7 V z- - c/-/ 6) 7
Applicant Representative:
Name
Street Address
City State Zip
Telephone:
Email address (optional): /7/a e
4e Email Address (optional):
Critical Areas Check] ist.doc/3.19.2001
APPLICATION
for
The City of Edmonds SIODE SEWER PERAUT
NEW CONSTRUCTION Lj.,- REPAIRS F]
OWNER X ....... r— s, P.. 4 e.. F4
ADDRESS ......... 2,0 .................. . .......................
p�??ROVED
VEB 27 1970
jw
MW PLAV EASEMENT No . ..........................................
4 / D le�
CONTRACTOR ... ................. PERMT No..
LEGAL DESCRIPTION: LOT No . ........ // ............................... BLOCK No . ....................... q� . . ........
......... ...
NAME OF ADDITION ...... ... /
.... . ............... . �,
.... .......................................................................
Approved:
DATE,� ........
CITY OF EDMONDS
Can 1PR-sPCCt 6-1107 when work
CIVIC CE14TER — WATEIR7SEWER DEPARTMENT is ready for inspection. .(i�o insp
tiOns Saturday, Sunday or holidays.) N2 ',35--88
SIDE' SEWER PERMIT
ADDRESS�. .
..... .... 70th..Rlaae ... West ....................................
OWNER ....... ........... �rjpr.ie .... A ...... C.an.t�re.jl
.. . .. .... .. .. .. .. .................... CONTRACTOR ........... W�Ls_te
YM ... S.ejaex
Perinission is granted ......... Fahruary ... 27 ....... 19.70., for
A,%qtll City Sewers In accordance with application oil file and ------ ................. days to REPAIR or CONNECT a side sewer
governing ordinances.
ATTENT10N IS CALLED TO THE FOLLOWING:
NOTE No. I —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 In street area. 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.
NOTE No. 4—Trenches In street must be water settled and surface * f street restored to original condition. Contractors shall be responsible f
failure due to Improper work which may develop within one year of completion. or
5—It Is unlawful to aJter 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.
Me - �-A
Mli
. wt�-�
A AL
SMET FILE
r
J U L�
PERMIT COUNTER
lo
I
'PATE RECEIVED
P�ERMIT EXPIRES 4z
CITY OF EDMONDS
USE PERMIT
ZONE NUMBER��,�e/-
JOB SU #
ADDRESS
CONSTRUCTION PERIVIMAPPLICATION
OWNER NAME/NAME OF BUSINESS
PLAT NAM E/SUBDIVI SION NO.
LOT NO.
LID NO.
LID FEE $
MAILING ADDRESS
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING — PROPOSED
REOUIREDDEDICATION— FT
TESCP Approved
Rw Pemill Required
Street Use Permit Req'd D
ruipect:on Required 0
Sidewa k Required 0
Underground
ng requ re 0
CITY ZIP
TELEPHONE
&I -7
NAME
METER SIZE
LINE SIZE
NO. OF FIXTURES
-7 AfEtA_)
PRV REQUIRED
Y ES NO
z
ADDRESS
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
LU
z
z
0
z
CITY ZIP
F.�, - � .
TELEPHONE
44 ;VO
lei; 4 e,
NAME
ENGINEERING R.EVIEWEDIDATE
ADDRE—f"'
Ii,1-\
yl) fklx A-i
FIRE REVIEWED BY DATE
w
LL
C ILY
ZIP
TELEPHONE
71 - I C, -
STATE LICENSE NLIMBfR
EXPIRATION DA`EE
C_
CH CK
7A
VA N EORCU
E OR ADB#
INSPECTION
RE
0 YES Q�LNO
BOND
POSTED
SEPA RE�IEW
COMPLETE I EXEMPT
EXP,
SlGqAREA
ALJ;�O� I PROPOSED
HEAHT
ALLOWED I PROPOSED
PROPERTY TAX ACCOUNT PARCEL NO.
0 0
NEW RESIDENTIAL PLFMBIIN/ MECH
0 1 19"iANCE OR
ADDITION COMMERCIAL , CPL ;EL
CHANGE OF USE
REMODEL C] APARTMENT SIGN
GRADING FENCE
r REPAIR CYDS FT)
LOT -COVERAGE
ALLOWED PROPOSED
oz ;,�') C Y,
REQUIRED SETBACKS (FT.)
FR6� SIDE REAR
I
ii��To -I V,� , -
PROPOSED SETBACKS (FT.)
FRONT URSIDE REAR
, -)
17A., -7 i�
z
z
n
-
PARKING
REO'D PROVIDED
LOT AR&A I
PLANNING REVIEWED BY DATE
C) 5ho ir� I
REM,
DEMOLISH TANK OTHER
GARAGE R ETAINING WALL
CARPORT Cl ROCKERY RENEWAL
(TYPE OF USE, BUSINESS OR A IVITY4�-=Xlo IN.
5>
1 4
CHECKIEDBY
TYPE OF CONSTRUCTION 6
1 11)_
OCCUPANT
GROUP
NUMBER
OF
STORIES
NUMBER OF
DWELLING
UNITS
1, / -
CR ITICA"I J //I,
AR
NU
SPECIAL INSPECTO�R
REQUIRED o , :S
AREA")O, �CY4 q,
t
OCCUPANT
LOAD
DESCRIBE WORK TO BE 50NE
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D
0
iAi�-,
I 1/y
LEVAL 16) rMA MAILK L206 P
A �Dq It4)
A— A
%/Al I 1AT1r)M
I PLAN CHECK FEE
ZAACI
HEAT SOURCE GLAZING % LOT SLOPE %
BUILDING
4-10
PLAN CHECK NO: VESTED DATE
ol— 16) Z__
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
1,_ BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
GRADING/FILL
UPA14ATE PERMISSION.
STATE SURCHARGE
cc
ul PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
ENG. INSPECTION FE E
7)
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
/7 _`;Vo
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
INSPEtfteN FEE
0.
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPO
RECEIPT
_j DEEMED To MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANYWAYTHE CITY'SABILITYTO ENFORCE ANYORDINANCE PROVISION.-
.1
TOTAL AMOUNT DUE
R CE PT 7-- V�/
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.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
SIGNATURr& _ DATE SIGNED
�NE�OR AGW-n
(42!
OFFiqIALS SIGNATURE DATE
L14 �AIZ
771-0220
4,4211
-RELEASED
M
BY DATE'
ATTENTION
EXT 333
IT 13 UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI_
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
ORIGINAL - FILE YELLOW - INSPECTOR
PINK - OWNER - GOLD ASSESSOR
5/98
-