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18030 69TH PL W.PDFIIIIIIIIIIIIII 14942 18030 69TH PL W C ity of Efto'nd's PERMIT NO:' �8362.', cir'nu QUA17UD DUIDX41rrr ..PERMIT EXPIRES-74//O/'' Address- of Construction: 113o 10 (0 cl 4- h.: LID # Property TaxAccount Parcel No. �2a 4 Attach copies of all access and u i1i y ea ements Verified and Approved by Owner and/or Contractor: Z Contractor License#: (A)�_-__S:rA -I-)(- D.5.:�P-)D -Building Permit #: aco 01-7 Single Family F� Multi -Family (No. of Ufii.t's'- F� Commercial (No. of Units, Fj Public Invasioninto City *Right -of Way: 0 Yes P�No *R W. Construction Permit Cross other "Private Property: Yes No "Attach legal description and copy of recorded easemeni Owner.o ntr 2 ature and acknowledgement statement: 's public handout entitled y it certify that I have read theCity it B signi g for �e f2 Of fiF5 3 ide Sewer Specifications, and shall comply with all City requirements outlined therein. DAte 9 CALL DIAL -A -DIG (1-800-425-5555) BEFORE ANY EXCAVATION 2 .9 FOR INSPECTION CALL 425-771-0220 extension 3Z9%V 24 HOUR NOTICE REOUIRED. FOR ALL INSPECTION REOVESTS. J. tl/ PERMITIVIUST BE...PGSTED!.ON JOB SITE T,17 White.Copy: File Green Copy:, Inspector Buff Copy: Applicant �;temp;bldg;forms;ssperrnitjlg4/00 Ld fy LO Im u It z iol L L u > 0 CL La %,D Ld �u 4 4 J a_ u za a- LO z v Ld z 0 NCTICF- NO WARRAMTY OF ACCURACY The Informatic'n shown cn thc�. Vachod mar) ww corapiled! fol- uze bY ft City of Edrnc:7,_'�, anruconsu!'a,ms. The Civ,;of Edmonds doas nciwarrant:-_ c �cnrtii on thk, map. Ajiy p-mad or enl.!I.y L C-'7,r shOL:" C01'10.06 vn inds;�,,,:,dluk inquiry rcp-diwi thc C.9 the Mp, bui na, limkon ti, tho 1�cOcn of -r stub c..,,ci stul):! may w r,#4 iiwi wds! ai�d may or 2t -- . 3 or th- local*-�;., la, Neit'lici th,' Ci' Zy of Edrpoads ncr 11� c z'.. b" li��nd f "� thc ifil'ovtoc'.61 givuli i oil tNs m2p, no'r'fcr zn y- or2J repr�sentatki,: providea bL�;-,;d scild nmp CITY [IF EDMONDS SIDE SEWER AS -BUILT ADDRESS 18030 69TH PL W PERMIT NUMBER 9362 HOMEOWNER xxxxxxx CONTRACTOR VESTSTAR DATE 04/12/01 DRAWN ISMAEL ABILA BY Irl 1016 CZ7 tz fcK 1),% bif thn CIIV of Edmcr�- no, Warr.- j,. Ail; co:., .. . v- , co M, rile,i fit, cit; Otfi— nc! :Lb!6 fc C tcl ay 19023(-) 0'1� pz w q, 3 (a 2- A/07--,O .' lh(- -5;,C)IL. -T6 Wr.—, r"Vwt-t-; -3�W.19 Is 14j� Vt 41bb 0 sub seem RECEIVED 3 DEC 0 5 2000 35+ 'P%ELoPMENT SERVICES CTR. CITY OF EDMONDS 6L7.- ig L < xs A:rewwao- -!5zw -JILV oo ONSpro vroTrt'-mill ckxj FACI U k -r\ 0 6 7EMPORAR a7U ON ENTRANCE (PER DETAIL) SERVICE INSM Mgaf: Lot 3 ulymple View Crest WANN116016 Address: /5030 6ctZOPL kj IMPERV10094MMAt"M %FnA41)28N Anewoes Tax Parcel 0: Proposed Buihfmg Pad 1 Proposed Garage 685 Proposed Pado & docks 140 SF Proposed Walkways 125 SF Proposed Drive 975 SF Owner. Westar Development Co. Joe TOTAL 29M.5 SF 16927 SO Ave. NE Kenmore WA 99M Lot Size 8023 SF 425-M-2757 gk,,e AS d"'OTED EROSION CONTROL AND DRAINAGE PY6 -rc)., E;,4ku L- 70 r7LI5 tw C/L4tt�6 CC,,V*nrP W 0 � amp wo mldb sob 4NM I 41%W Ik *or 'I . - Lra. GRADING CALCULATIONS CUT 187 CY FILL 0 Cy IMPORT 0 CY 187 ITOTAL LOT SLOPE 21% Legal: Lot 5 Olympic View Crest Address: /aa3o (,ctV�pL It) Assessoes Tax Parcel #: ScAL.r Owner. Westar Development Co. Inc 16927 841h Ave. NE Kenmore WA 98028 425487-2757 0 L" c;o 36-S RECEIVED E—Z 5 .9 2000 DEVELOPMENT SERVICES CTR. CITY OF EDMONDS ! 6W TEMPOFMRy COAISTRUCTIIO�- 7 IMPERVIOUS SURFACE CALCULATIONS Prop Building Pad 1028.5— SF Proposed Garage 685 Proposed Patio & decks SF Proposed Walkways 125 SF Proposed Drive 975 SF TOTAL 2953.5 SF .ot size 8023 SF MPervious Surface 37% OWNERICONTRACTOR IS RESPONSIBLE FOR EROSION CONTROL AND DRAINAGE I WPM ------ ---- RECEIVED DEC 0 5 2000 A)6N�,,jtr&ERV10ES CTR. DS 1A, 4 : fit V V. PC kc t PC kv� 40ft K-, 7' v en -VD Moo W ZONE SETBACKS: IMPERVIOUS SURFACE CALCULATIONS 1028.5 SF Proposed Building Pad FRONT Proposed Garage 685 SIDE Proposed Patio & decks 140 SF Proposed Walkways 125 SF REAR Proposed Drive 975 SF OTHER HEIGHT P1 TOTAL 2953.5 SF Lot Size 8023 SF Impervious Surface 37% Legal: Lot 5 Olympic View Crest Address: /1b030 (�:q=t)PL4) Assessor's Tax Parcel M c�o 70 6+000 j-7-C>,C> APPROVED Y PLAN ING Owner: WZ Development Co. Inc Scale: 1"--201 16927 84" Ave. NE Kenmore WA 98028 425487-2757 HEIGHT CALCULATIONS Original Current Propose A 350.50 348.15 356., B 360.90 360.90 356., C 358.00 354.48 356.! D 349.50 346.65 356.; Average Grade 354.73 352.55 356. Datum = MH #4 351.90 cut / fill 2.18 -2. Height of Structu 25.00 25. jMa)dmurn Allowe 379.73 379: /2z 1 115.6r,", - . - 4i z/ GRADING CALCULATIONS CUT .242 CY FILL -116 CY BALANCE 0 Cy TOTAL 126 LOT SLOPE —20% HEIGHT CALCULATIONS Original Current Proposed A 350.50 348.15 354.00 B 380-90 380-90 354.00 C 358.00 354.48 354.00 D 349.50 346.65 354.00 Average Grade 354.73 352.65 354.00 Datum = MH #4 351.90 cut / fill 2.18 0.00 Height of Structu 25.00 25.86 Ma)dmum Allowe 379.73 379.66 O� IAJ GRADING MAN Legal: Lot 5 Olymgic View Crest Address., 18030 69' PL W Assessor's Tax Parcel M 009060000500 N RECEIvED Scale: 1"--2010" Owner. Westar Development Co. Inc FEB 2 21 2001 16927 84'b Ave. NE DEVELOPMENT SERVICES cTR- Kenmore WA 98028 CITY OF EUNIONDS 425487-2757 :'Lo-7 )..z 42- x 12-A X, 4- 4, x 12- C-Q -r CUT (00 kaG 6 57 0 lin9 7 zo; Ltoo, C)c, 7,, 5 -z- 13, 7 % -Z�-7 FEB 2 2 2001 DEVELOPMENT SERVICES CTR. CITY OF EUMIONDS a+7 ;i x c) 2D J1 0 -7- LVAT5 -c Oki s � -rcG RECE�VED 2001 FEB 2 DEVELOPMENT SERVICES CTR. CITY OF EUMONDS ;W-b 'Cli ci ILS) rf) cq ILA lilt) no lz HL10 it do L T! L . . ........... LP ro Zn IL LL Ll It L If F IT RECEgvEj I 'Coo �WT 2001 FEB 2 #nAn' A ^'%"Amr fir r%lftm DEVELOPMEN SERVICES C' CITY OF EU-MONDS t1l Tb) Ln to, RECEUVED. FEB 2 2 2001 DEVELOPMEW SERVICES CTR. CITY O� EDMIONDS PV67-0,' 64W NOW @Rio ,m 40M 606 ,W rl -00 woo -I GRADING CALCU—LATIONS CUT 187 CY FILL 0 CY IMPORT 0 CY 187 ITOTAL LOT SLOPE 21% AJ&— - Legal: Lot 5 Olympic View Crest Address: /ao3lp 6c�V�pL Assessor's Tax Parcel #: S C#V L.-6 Owner: Westar Development Co. Inc 16927 8411 Ave. NE Kenmore WA 98028 425487-2757 "ON -am. 4 RECEIVEr) 3 &-S DEC 0 5 2000 DEVELopMENI- SER 0 VN CITY F CDMO ICES CTR. 6S -3 or -S 07 TEMPORA13Y CONSTRUCT1044k IMPERVIOUS SURFACE mc� LATIONS Proposed Building vad 1028.5 SF Proposed Garage 685 Proposed Patio & decks SF Proposed Walkways 125 SF Proposed Drive 975 SF TOTAL 2953.5 SF Lot Size 8023 SF ERICON Q1, �jjtSpeN E FOR EROSION CONTROL AND DRAINAGE VOT-0 .' J9-t(- -��VIL 76 -i�� ,7v- 41ftb -3 6 r- R saw snow ECEIVED DEC 0 5 2000- VELOPMENT SERVICES CTR. OF EDMONDS -360 4 35+M5 c- IL,7-2-4;V��C4t� 66 As F11-527 --/-Cl Woe �JoTeel Au, -n -110 ONG IrD VVTrC1k,-n u CE TE S Sp9pc Iffl," Legal: Lot 5 * Olympic View Crest REOUIRED. CA 771-0219 Addrm: /95036) 6c�Zff PL kj WHERVIOUS SURFACF. CALCULATIONS Ammor's Tax Parcel 0: proposed Buidng Pad 1028.5 SF Proposed Garage 685 Pmposed Pago & dedts i4o SF Proposed Walw1ays 125 SF Proposed Drive 975 SF Owner. Westar Development Co. he TOTAL 29W.5 SF 16927 90 Ave. NE Kenmore WA 98= Lot Size 8023 SF 425487-27.57 e7lzwle— lm� 3T% AS XOTE, OWNEpjCONM(!.TOR IS RESPONSIBLE FUH EROSION CONTROL AND DRAINAGE &.6tical Areas Checkfi* ---------------- ----------------------------------- Site Information (soils/topography/hydrology/vegetation) 1. Site Address[Location: 2. Property.Tax Account Number. 3. Approximate Site Size (acres or square feet): 4, -7 a- 4. Is this site currently developed? z,,� yes; no. - hes; how is site developed? 0A,'e77 SE FZ 5. Describe the general site topography. Check all that apply. Flat: less than 5-feet elevation change over entire site. A�' Rolling: slopes on site generally less than 15% (a vertical rise of I 0-feet over a horizontal distance of 66-feet). ,4,,—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 3 0% present on site (a vertical riseof I 0-feet over a -00"horizontAl distance of less than 33-fect). Other (please describe): 6. Site contains areas of year-round standing water 00 Approx. Depth: 7. Site contains areas of seasonal standmig wat er: /00 Approx. Depth: What season(s) of the year? B. Site is in the floodway floodplain of a 'water course. P C 9. Site contains a creek or an area where water flows a9ross the grounds surface?/flows a�e year- round? Aj 1A, Flows arr- seasonal? Id (VAat time of year? A 10. Site is primarily: forested meadow shrubs mixed urban landscaped (lawn,shrubs etc) 11. Obvious wetland it, present on site: P0 0.- ; - ; " . - : .. wo U., Ct� ik , *W 4�* m0i: UP 1, Y: *.Vi, "A4 4ef-I C--f OLCA - V-&� 10eYS�Wf C"I GWM It i L.�f, ATTACHMENT 12 RECEIVED City of Edmonds . MAY 2 0 1999 DEVELOPMENT SERVICES CPJTICAL ARF.Aq CHFCRTTIRT :ie Critical Areas Checklist contained on this form is be filled out by any person preparing a evelopment Permit Application for the City of imonds prior to his/her submittal of a development -m-lit to the City. .-le purpose of the Checklist is to enable City staff to -termine whether any potential Critical Areas are, or av be, present on the subject property. The &mation needed to complete the Checklist, should - easily available from observations of the site or da available at'City Hall (Critical Areas inventories, aps, or soil surveys). An applicant, or his/her 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 develo*pment 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 assist staff in completing their preliminary assessment of the site iave completed the attached Critical Areas Checklist and attest that the answers* provided are factual, to the !st of my knowledge (fill Out the appropriate column below). wner/Applicant: une reet Address ty State Zip lephone mature Applicant Representative: Name lg+y cz �t Street Address A/)LA City State Zip .e pdon%janalcad.doc Date (over) tj .0 1 ri / 4 ri r-) r) ir-0. 141 14 4 114 0 14 j I U 14 1NQL.MUjN-'�UUVMM I I= rl LC-7 - 87D 10 Ul NELSON-COUVRETTE &ASSOCIATES, INC. CONSULTING GEOTEcHNjcAL ENGINEERS, GEOLOGISTS ANo ENVIRONMENTAL SCIENTISTS Facsimile Transmiftal To: LYLL MAR 10 2a,08 Company:,0Tq 0�- folw4D5 ENGINEERING Phone - Fax: (2�2g) 721 From: Company: Nelson-Couvrette & Associates, Inc. Phone: 425486-1669 Fax: 425-481-2510 B U I LD I H6. Date: Pages Including Cover Page: NCA File #: cc: Comments: MAR 1 6 2000 U�)/ Ltd/ �UUCJ A. U. 4 �J 44J40 I 4.J.L U I IF-".;)Ul 11 -�L)U V Mr- 1 1 Q rMQC. ril NELSON- COUVRETTE & ASSOCIATES, INC. CONSuLrwa GeorEcmrvic-4� EN(SINSERS. GEOLOG'SrS AND ENVIRONMENTAL SOENns rs 17311-135th Avenue NE. A-500 Project: 0 Woodinville, WA 98072 (425) 486-1669 - (425) 337-1669 Owner: �V) Fax (425) 481-2510 1E V �4r Location: Weather: Purpose of Visit: FIELD REPORT File No. 14.19 q Date : a-/ I Report No P9 Page: I of L4 By: A4) k -10 tVALLTL C-LU Wk- A4 ON AJCMht tof &=r %AIIJ LILL. Lf-,Ltz�e t--)F If - Wep&-S C0MTf--0,'-T'J,:)J Cz)MAS4 �)Io� Ofiit*-y U'r, nb-r "L, Com vrf- 04 .")*- dok-ftk F'06L 0 -111f- Sn'F- &1(*)6 ISO .4 U-11- ()8r2rAPk- 6-U.JPYIN) -501L. r1f I A-f i-AL 5001'� UX4, OF VIL IAD f"A 'CD-'JLRU> t-)a -n 12- 1' of A,�b CAff9-C-'- /'?"5Lr7- J)3r*1A OF '-L.Jsggf� foc'K. 15,d)9. f"o U-4. -ra -T4- -coiL �iu- f�o(, 1bJALQXT)oA) -rK- i=iLL (-OJLP W ROM 1 -1-o.2" &JiTH A ,V2- el DtPonfrj'" C4)l) JADP� I t1- ?LAC4- *6rS WgPf- TAW/. 19;L-L �ALSO OWhEC, 0-ci -I)VL fIL-L 01 LOTS 15- -T4 b J& H 19 RAD E4143 C>1t&0 On"� I-1v2- FU-r loe - Lw5f� SILL )OF"" L).S -MAT, �kp)- !5rOCTKAL ftLl- �iAl) AM VI-4cfP Q� LOTS 10 A4 D L-L- ISML44� 1'�*T- H.A0 r ki'f'o 1Wo&W--" fbk LID 10; 91 L-L- TT Al A-T'F.b T)fAT Q? 51 TO OF 0 -EdCAAAL ffILL L4- fWAU)ATE'D FiLA- co L�yr-s 10 1 It. A�D 2-0 - -f� &THOt4S 0991- 'Ex 6n�r,- -10gli A. i-�AcKkE --rfl-f0Lt,4 IN- Loo,4� wCr -MP5o)L- I'D UPo-sf- -irAf- , n-L -o bf, f;'(pJfc> I -ry 4 ", wily. 'i TC WT f co L)L Loy Q�oi�-L f ")C' C ='. 10 -PUC4- bfal;r�' liSl'f, C 414--. -T A �CE-d A r-14A:VQ,, -M VFgY J)f* &W& SOL llo,) PMAWS Od 10TS )2 Attachments: Signed: Distribution: MOW IV . w1w 7 03/10/2000 10:45 4254612510 NELSON- COUVRETTE & ASSOCIATES, INC. GEOrECHIVICAL EfYCINEERS. CEOLOGISTS PIG AND ENVIRONMENTAL SCIENriSrS �0-'SUL 17311-i35th Avenue NE,A-500 Woodinville, WA 98072 (42S) 486-1669 - (A25) 337-1669 Fax(425)481-2510 . Project: Owner: Location: Weather: NtLbUN—UUUVKLllL r-Rur- UID FIELD REPORT FileNo. 2-6�-M. - Date: 3/2100 Report No. 14 Page: 2 Of Purpose of Visit: By: AD k. -"' G w- M Er oL Mk:�kn oF -r-W to, -r SW C092 UJF- A OD L-&r 1:71 - ^— 7 -TJ4 -,,4 -15-57 MAXIMA r4y' kEtL!5w� Ehf, TW— f'(-�cp -15 0 0 0: AS7 D L )V�V&p )f3 OfI010A 11tE r( -fte fw OF nt AID--6 -0, (-*AV or)3 to rq+ 1 ni'l lOTr" &k� 19, WE— VEX-0-hA&V VJF— IM F-VALL)ATE 1-Mf- IFX4�054-iD ftg4�)C, e fv&-mU-.5 ME OxcIrVAIED, BUiLbRib .4 Attachments: Signed% Distribution: NasmCotm,?Erm & AssoctoEs. INc. �-'% Tw GeoNaffolL &MAM GMom - �cm" cA&4.r%mmc"lw cromffw IN-PLA CE MOISTURE AND DENSITY TESTS mom PROJECT NAME: 0Lk?tAflC Vleu) C-RF,51- JOB NUMBER: 2 (o 419 cl LOCATION: EDMO14DS REPORT No.: fg IPAGE OF PROCTOR METHOD: ASTM D - 698-91 ASTM D - 1557-91 TESTS CONDUCTED BY: Al)r, — PASS I APPROX.' TEST GENERAL FEETTO DATE NO, LOCATION GRADE APPROX. FILL % DEPTH MOIST WET TY DENSI, DRY MAX % % OR DENSITY DE NSITY COMP. SPEC COMMENTS BLOWS FAIL 10 C,7 .5a.5179, FL4 (p 12. 7 13 7 9 !lqS- c 2 1 &2 1 rZ 12 1 97 $5 2) t'e-'r, I c 9 e Z arg 95- 1-2 PA 5 it c 10 F'o 194- 32 95 -2 2. 1 z 2, 133.( It' 9, 0 12- 1 9s gs- - ftoeig -s zz -r -21,6 � licli 121 F-, 9 �l U I - ZAI zo f A�S5 (p 10, (t 24, 3 121 1 glim c IN C7 c cs - --------- SECTION I TO SHIP 27 ORTH, RANGE 4 EAST, Wl L L A ME ]�'cs 36714 &sm e W/ A7r Urr. ex. 5rR + L) 366 a L) ;wc OV ex sm ex sm 69Z6 3yo rl F u 7 352 V 350 R 0 2- -ft U-M-) SMAIL.- R cn C=> C=� CUL K C= 2kif(9q L ?,Lfog:�- s J70r: 'PA&L 40F T ECE�IIED' E R FP ERMIT EXPIRES USE PERMIT CITY OF EDMONDS 7CONSTRUCTION ZONE f NUMBER PERMIT APPLICATION JOB ADDRESS SUITE/APT# OWNER NAME/NAME OF BUSINESS PLAT NAM E/SU BDIVI SION NO. LOT NO. LID NO.,l6'179;7r7Mr-� 4 LID FEE $ IX I MAILING ADDRESS PUBLIC RIGHT OF WAY PER OFFICIAL ST TESCP Approved 0 RW Pennit Required W z ec.34 0 ,ETMAP EXISTING Street Use Pernift Req'd /a, Inspection Required Sidewalk Required 0 CIT ZIP TELEPHONE q" '� 0 REQUIRED DEDICATION FT Underground Wiring required NAME METER SIZf LINE SIZE,, NO. OF FIXTURES PRV'REQUIRED YES NO 0 z uj ADDRESS REMARKS OWNER/dONTRACTOR RESPONSIBLE FOR EROSION CONTROLJDRAINAGE: z z a z W ZI CITY P TELEPHONE ENGINEERING REVIEWED/D FNAME /_"/C, V. ADDRESS S ix 717 It FIRE REVIEWED BY DATE Lu CITY ZIP NE z E U. 0 VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND REO'D �POSTED STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY YES SEPA REVIEW COMPLETE EXEMPT IV 'GN AREA ALI]'OWED PROPOSED HEIGAT ALLOWED PROPOSED PROPERTY TAX ACCOUNT PARg:EL NO. I "y _j EX P if Cg/N'EW 0,11RESIDENTIAL PLUMBING MECH L6TCO ERA'6"E ALLOWED REOUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (FT.) FRONT URSIDE REAR PROPOSED COMPLIANCE OR n ADDITION C] COMMERCIAL 11*7 'e� '.j! .4' 11/11� z CHANGE OF USE PARKING REQ'D I FRO�.IDED LOT AREA PLANNING REVIEWED BY 6ATE REMODEL APARTMENT 0 SIGN C]j.-GRADING FENCE REPAIR CYDS X FT) y REMARKS. DEMOLISH TANK EI)GARAGE RETAINING WALL RENEWAL CARPORT El ROCKERY 0 z i.- (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: CHECKED BY TYPE OF CONSTRUCTION V COP OCCUPANt,'., .1 t7 7 GROUP NUMBER OF NUMBER 0 F DWELLING CRITICAL AREAS �V' Lu SPECIAL INSPECTOR OCCUPANT 0 STORI UNITS NUMBER 1AREA REWIRED YES LOAD DESCRIBE WORK TO BE DONE T, REMARKS PROGRESS INSPECTIONS PER UBC 108/1FINAL INSPECTION REO'D 0 7 L-74 i'. I cri U H." V m l -Trvi-, fi x'*_P( _Pc Woot fZ'h1( 7A _f! 'bl' t5v" VALUATION . F EIV PLAN CHECK FEE HEAT SOURCE GJ A 71Mr, -4 LOT SLOPE % C'Y - G4 . _ ' 2 :!.!5, e , . I. BUILDING PLAN CHECK NO: VESTED DATE PLUMBING 76 .0 I MECHANICAL 7( THIS PERMIT AUTHORIZES ONLY THE WORK NOTE(). THIS PERMIT COVERS WORK TO t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADING/FILL 2 73 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. STATE SURCHARGE cc PERMIT APPLICATION: 180 DAYS W PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION PP [CANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS ENG. INSPECTION FEE A L _j ERESTAGREES TO �NDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF LANCISGAWNG_ i'D'M"O'NDS, 2 WASHINGTON, TS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANYAND INSPEeTION-FEe cc ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY .x RECEIPT x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT DEEMEDTO MODIFY, WAIVE OR REDUCE ANY REOUIREMENTOF ANY CITY ORDINANCE _j 0 NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION., X, R CEIPT TOTAL AMOUNT DUE L I HEREBY ACKNOWLEDGE THAT � HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT; AND THAT Am THE OWNER, OR THE DUL� AUTHORIZED AGENT OF THEOWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application ittlihot a permit until signed by the CALL 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. _M I INSURANCE AND RCW 18.27. WORKMEN'S,T _f�S�T ON, 1 1 1 OFFICOLS'SIGNATURE DATE., SIGNATUR �OWNE.010�AqENT) DATE SIGNED 1/ (425) $V( 771-0220 1 1 XJ1, RE' EA S.ED BY DATE TI E�Ntilqh EXT,333 It I IT IS UNL6FUL TO U� UN UL,1,UrT A BUILDING OR STRUCTURE UNTIL 771-0221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI_ ORIGINAL - FILE YELLOW - INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK -OWNER GOLD - ASSESSOR 5/98 K CITY OF EDMONDS SINGLE FAMILY/DUPLEX COVER SHEET Directions: Applicants are to complete the Information In the WHITIF BOXES ONLY (Shaded boxes we for City use only). This covet ghost must accompany each building permit application for a now single-family !eq!d0ftes. PROJECT. ADDRESS to PROPERTY TAX ACCOUNfPARCEL 0. rTnq 6 q — -)-o DESCRIPTION OF WORK - 4\ IS I PHONE. OWNER :j k CONTACT PER�ON' PHONEC20b):::�49 -2-7 5 -7 E-MAI FA�47_5�> 4-57 -- 7-75 -7 MAILINGADDRESS /672--17 .5�'4-7-ZoeALLF= dFAX CORRECTIONS 0- MAIL CORRECTIONS E-MAIL CORRECTIONS ey SIGNING THIS STATEMENT I UNDERSTAND THAT I AN THE CONTACT PERSON FOR Tills PROJECT. 17 is my RESPONSIBILITY TO COORDINATE ALL SUBMITTALS WITH THE C17T AND ONLY I CAN MAKE INQUIRIES ON THE STATUS OF THE APPLICATION. I UNDERSTAND IT IS MY RESPONSIBILITY TO DETERMINE IN ADVANCE OF PERMIT .TIONARr RMIT: THATTMAY BE APPLICABLE TO THIS PROJECT. I ACKIlOWLEDQE SUBMITTAL ANY DISCREY Ael THAT TO THE E OF I#Y Adl#§_ AVE UBMIT ED ALL NECESSARY DOCUMENTATION IN ORDER . 70 MAKE A B COMPLETE APPLICAll AND 0 CREAWLAA*-APPROVALS ARE REQUIRED SIGNATURE =79= DATE /ZZ /670 ZONING INF6RMATI N' LOT AREA NUMBER -OF DWELLING UNITS' EXISTING— DEMOLISHED PROPOSED—.. DISCRIETIO Y AP ROVALS CA Determination L�_Q MT- U V 'SHORELINE SUBDIVISION, !� VARIANCE SjFPA EX Ire$' OTHER- — Am e-, vvi,4� LOT COVERAGE INFORMATION EXISTING SF PROPOSED - TOTAL SF HEIGHT CALCULA TION INFORMATI 57- _Q C DATUM ANYAD AI VE S74.T AaWFWA�10N REQUIM FRONT c>11;_ SIDE Sidi.7L- REAi;l 4_-V'� FRONT SID SlDt,':;��, 10' REA 0 0Y*i [3*Ei tqNO.. gL4q,-LO; N St'61201C. E MFNT REQUIR . E 0 -[_]*9SM'NO`. RECORDING # STAFF COMMENT$: ENGINEERING INFORMATION DRIVEWAY SLOPE y. GRADING CYDS EASEMENTS, 5 EXISTING IMPERVIOUS AREA CONSTRUCTED BEFORE 1977 _SO.FT EXISTING IMPERVIOUS AREA INSTALL - ED 1977 OR LATER. 141c, _SQ.FT. PROPOSED NEW NET IMPERVIOUS SURFACE City* as Only SIDEWALK REQUIRED 0 YES MNO DRAINAGE PLAN REQUIRED PUMjY'ES ONO UNDERGROUND WIRING REQUIRED E)YES [:]NO STREET DEDICATION- be_11-32-- FT. LID# STAFF COMMENTS: SPECIAL INSPECTIONS REOUIRED FOR THIS PROJECT (City Use Only) gnILSO START OF WORK EXCAVATION A GRADING SHORING INSTALLATION &MONITORING PROOF ROLLING PLACEMEN i OF FILL & CO MPACTION SUBSURFACE DRAINA GE. [3VtRIFY SOIL BEARING PILE PLACEMENT EROSION CONTROL DGENERAL SITE MONITORING BY THE GEOTECHNICAL ENGINEER OF RECORD 0 GENERAL SITE MONITORING BY TH E GEOTECHNICAL ENGINEER OF RECORD -DURING WET WEATHER CONSTRUCTION FINAL GRADING 0 FIELD REPORT OTHER OPLACEMENT OF REINFORCEMENT 0 PLACEMENT OF CONCRETE OBOLTS INSTALLED IN CONCRETE S TRUCTURAL MASONRY 0STR.U*CTURAL STEEL ERECTION E]HIGH STRENGTH BOLTING WELDING (WABO CERTIFIED ONLY) DOTHER IAPPLICANT' V��Q�'w " - PLAN CIIZCK # DATS RISCISIVED BUILDING CONSTRUCTION INFORMATION CODE EDITIONS 1997 UBC. UNIC, UPC, WSEC, VIAQ WITH AMENDMENTS D1610H CRITERIA WIND EXPOSURE 0 WIND SPEED 50 MPH SEISMIC ZONE 3 Floor Live Load' Afj� Root firlow/Live Load — alcony Live Load G70 Floor Deed d_t Roof Dood'Lood Balcony Dead Load_LC2 NUMBER OF STORIES — BASEMENTS— FLOOD ZONE --- LOT SLOPE % al % SOILS REPORT PROVIDED 0 Tis 0 NO FLOOR AREA (MEASURED TO EXTERIOR FACE OF EXTERIOR WALL) Existing P Dead M-7 Living Space U Garage Carport DockiCovOrsd Porch Other — ENERGY CODE COMPLIANCE INFORMATION FUFL TYPE QJ�GAS, OIL 1:1 ELECTRIC 1:1 OTHER OFORCED AIR OHEATPUMP 0HYDRONIC. []OTHER FNERGY CODE METHOD OF CO PRESCRIPTIVE: List Option FOR CITY USE ONLY 1311'�TARGET UA APPROACH: Provide UA CSICUAtions Coiling Insulation-FL-3 Wall InSuI8tWaLj?_�' I --a> 11 SYSTEMS ANALYSIS: Provide Computer Analysis �d Floor Insula1Jon_f?_:;.j Fi .- I I Door U-Valua_ f 40 rCk-FNERGYIVENTILATION WORKSHEETS PROVIDED Window U-Vsluo_p4 2-j- L_j Skylight U-Volull NDOW SCHEDULE PROVIDED Glazing %—L-7 VENTILATION CODE COMPLIANCE INFORMATION KITCHEN FAN CFM_LW - BATHROOM FAN(S) CFM 5:D LAUNDRY FAN CFM WmOLF HOU SP VENTILATION SYSTEM OEXHAUST OPTION FRESH AIR TO BE PROVIDED TO 0 WINDOW VENTS WALL PORTS EACH HABITABLE ROOM WITH: EXHAUST FAN T . 0 BE CONTROLLED WITH 24 HOUR TIMER AND SIZED AS FOLLOWS: 11 1 - 2 BEDROOMS: 60 - 76 CFM 04 BEDROOMS: 100-160CFM 0 3 SEDR06MS: 80 - 120 CFM 0 5 BEDROOMS: 120-160 CFM OVAC INTEGRATED OPTION 0 DEDICATED HEAT RECOVERY VENTILATI ON 0 PTION SEPARATE PERMITS (City Use Only) 0RIGHT' OF WAY CONSTRUCTION PERMIT []MECHANICAL PERMIT OENCROACHMENT PERMIT 0FLUMBING PERMIT 13STATE ELECTRICAL PERMIT 0WATER METER []FENCE PERMIT SIDE SEWER PERMIT 0 RESIDENTIAL FIRE SPRINKLER PERMIT 0IFIRIGATION (SPRINKLER SYSTEM) OTHER OOTHER Any request for modification. variance of other administrative deviation (1116FIFISIter "Variants') must be specifically called out and identified. Approval of any Plot Of Plan 90111,111111111111 Provisions wh I Ch do not comply with the city code and for which a VSFlsnc* has not been specifically ide.tilied. requested and considered by the APPIOPFiStO City Official In accordance With the proplists provision of city code or state low does not approve any Items not to Code :Pecillcotion. PERMIT ISSUANCE APPROVALS (Cit PLANNING REVIEW &APPROVAL CONDITIONS OF APPROVAL: Use Only) EN GINSERIXG REVIEW & APPROVAL CONDITIONS OF APPROVAL: DATE BUILDING RZVIZW & APPROVAI;�::� �_�Addn&"Alfz CONDITIONS OF APPROVAL: of E CITY OF EDMONDS SINGLE FAMILY/DUPLEX COVER SHEET Directions: Applicants are to complete the Information In the WHITE BOXES ONLY (Shaded boxes are for City use only). This covet shoal must accompany each building permit application for a now single-family PROJECT. ADDRESS PROPERTY TAX ACCOWPARCEL 0 Lo q - mZI-) 0 DESCRIPTION OF WORK :J�, A 0 W N E R PHONE PHONEC��fo)f�4CJ -Z7 5 -7 CONTACT PERSON / 19PI-r2= -7 E-MAIL FA�4;7-5�> 4W/ --,75 MAILING,ADDRESS Ej/FAX CORRECTIONS 0. MAIL CORRECTIONS E-MAIL CORRECTIONS BY SIGNING THIS STATEMENT I UNDERSTAND THAT I AM THE CONTACT PERSON FOR THIS PROJECT. IT 18 My RESPONSIBILITY TO COORDINATE ALL SUBMITTALS WITH THE CITY AND ONLY I CAN MAKE INOUIRIES ON THE STATUS OF THE APPLICATI UNDERSTAND IT 15 MY RESPONSIBILITY TO DETERMINE IN ADVANCE OF PERMIT UBMITTAL AN I �AFI ;R TS T HA A BE APFE.SCABL`E TO THIS PROJECT. I ACKNOWLEDGE 0 S 0, CRET '0 M I I M Y T H 'NTA71ON IN ORDER TO MAKE A THAT To THE 8 EST F Y ABI. I Y I A V E SU 8 MITTE 0 ALL NEC SA R Y DOC UM E COMPLETE APP LCA7, A No D C , E �APP R OV ALS ARE R EGUIR ED. DAT E 1_7_ SIGNATURE!�� I ' ' f F ZONING INF RMATIU V,. Z ONE LOT AREA '7, NUMBER OF DWELLING UNITS' EXISTING DEMOLISHED PROPOSED DISCRETIONA�Y'AP' ROV . ALS CA Determination __ - _CU 'SHORELINE SUBDIVISION �! VARIANCE A Ex 1r9a7 OTHER-- 1--Aov7e- vvf4�plet.441111 up.s. oat, LOT COVERAGE INFORMATION EXISTING SF PROPOSED, TOTAL SIF -�I. HEIGHT CALCULATION INFORMATION -�j5D. 5- DATUM AVE MAX. zj IJI� 3-7 11EQUM12 FRONT :�)S7 SID sidt 7A_ REA SID SIDE eaQED= FRONT REA s [3YES . MNO-��j .. MNO FL -AG -'LOT Y N ST.'DEDIC, ADU S rATEMEN OYES 0' 6ORDING I R E* STAFF COMMENT$: [ENGINEERING INFORMATION DRIVEWAY SLQRE-!$ GRADING CYDS_A EASEMENTS EXISTING IMPERVIOUS AREA CONSTRUCTED BEFORE 1977 SO.FT E I XISTING IMPERVIOUS AREA INSTALL - ED 1977 OR LATER- 601- Q.FT. PROPOSED NEW NET IMPERVIOUS SURFACE City'Use Only ES NO SIDEWALK REQUIRED []YES. ff]N . 0 DRAINAGEpLAN REQUIRED UP UNDERGROUND WIRING REQUIRE[) nYES [:]NO STREET DEDICATION_,29Kj,_e-11 -72- FT. LID# STAFF COMMENTS: SPECIAL INSPECTIONS REQUIRED FOR THIS PROJECT (City Use Only) SOILSO START OF WORK 0 EXCAVATION A GRADING El SHORING. INSTALLATION A MONITORING PROOF ROLLING PLACEMEN OF FILL & CO MPACTION El SUBSURFACE DRAINAGE. EI VERIFY SOIL BEARING El PILE . PLACEMENT 0 EROSION CONTROL EGENERAL SITE MONITORING BY THE ]GEOTECHNICAL ENGINEER OF RECORD EGENERAL SITE MONITORING BY THE IGEOTECHNICAL ENGINEER OF RECORD DURING WET WEATHER CONSTRUCTION EIFIN�ALGRADING A FIELD REPORT DOTHER STRUCTURAL: EIPL ACEMENT OF REINFORCEMENT OPLACEMENT OF CONCRETE BOLTS INSTALLED IN CONCRETE OST.RUCTURAL MASONRY []STRUCTURAL STEEL ERECTION 13 HIGH STRENGTH BOLTING 13 WELDING (WABO CERTIFIED ONLY) DOTHER PLA14 CRECK 0 "PLICANT SbL", DATE RECEIVED BUILDING CONSTRUCTION INFORMATION CODE EDITIONS 1997 UBC. UMC, UPC. WSEC. VIAG WITH AMENDMENTS DESIGN CRITERIA WIND EXPOSURE 13 WIND SPEED 80 MPH SEISMIC ZONE 3 Floor Live Load Root inow/Live Load-0'257 B&IC:ny Live Load — [;7 Floor Dead Load_a Root Dead Load In Bale ny Dead Load_Zi2 NUMBER OF STORIES BASEMENTS FLOOD ZONE_ LOT SLOPE % %. SOILS REPORT PROVIDED 0 YES 0 NO FLOOR AREA (MEASURED TO EXTERIOR FACE OF EXTERIOR WALL) Existing PfoRosed T I I Living SPACO 2�r Garage 13 2> (it f5 Carport Dock/Covered Porch Other — ENERGY CODE COMPLIANCE INFORMATION FIIFIL TYPE Q�GAS. OIL 1-1 ELECTRIC 11 OTHER 10 FORCFDAIR []HEATPUMP []MYDRONIC [:] OTHER ENERGY CODE METs4nn OF COMPLIANCE PRESCRIPTIVE: List Option el", TARGET UA APPROACH: Provide UA Calcustione 1:1 SYSTEMS ANALYSIS: Provide Computer Analysis 0--- ENERGYIVENTILATION WORKSHEETS PROVIDED 0,-4iNDOW SCHEDULE PROVIDED VENTILATION CODE COMPLIANCE INFORMATION FOR CITY USE ONLY Coiling Insultillon-fl, 3 Wall Insulation-e-.: -2�, Floor Insulation-R- Door U-Valus- Window U-Valus Skylight U-Valuis Glazing KITCHEN FAN CFNI 100 BATHROOM FANtS) CFM__ 6Z LAUNDRY FAN CFM Inn WHOLE HOUSE VENTILATION SYSTEM EXHAUST OPTION FRESH AIR TO BE PROVIDED TO WINDOW VENTS WALL PORTS EACH HABITABLE ROOM WITH: 0 EXHAUST FAN TO BE CONTROLLED WITH 24 HOUR TIMER AND SIZED AS FOLLOWS: C] I - 2 BEDROOMS: So - 76 CF1M 191 BEDROOMS: 100 - 150 CFM 3 BEDROOMS: 60 - 120 CFM 5 BEDROOMS: 120-160 CFM VAC INTEGRATED OPTION rIDEDICATED HEAT RECOVERY VENTILATION OPTION SEPARATE PERMITS (City Use Only) DRIGHT OF WAY CONSTRUCTION PERMIT OMECHANICAL PERMIT DENCROACHMENT PERMIT OPLUMBING PERMIT STATE ELECTRICAL PERMIT 0 WATER METER 0FEkCE.PFRMIT SIDE SEWER PERMIT 13RESIDENTIAL FIRE SPRINKLER PERMIT 0 IRRIGATION (SPRINKLER SYSTEM) 0 OTHER [DOTHER Any request for modification. variance or other administrative deviation (herinafter "Variance") must be specifically called out and Identified. Approval of any plat or Plan COntAIRIng Provisions which do not Comply with the City Code and for which a verlAncs has not been specifically identilied, requested and considered by the appropriate city official In accordance with the appropriate provision of city Code Of state low does not SPPFOv$ any Items not to code specification. PERMIT ISSUANCE APPROVALS (Cit PLANNING REVIEW at APPROVAL CONDITIONS OF APPROVAL: - Use Only) DATE EN GINEERING REVIEW & APPROVAL CONDITIONS OF APPROVAL: DATE 31113,411 BUILDING REVIEW & APPROVAIj:��- Ad.4,,�DAT9_.LQQ CONDITIONS OF APPROVAL: �Q if