18508 90TH AVE W.PDF8760
18508 90TH AVE W
ADDRESS:.. 1-9508 901,14, A16 w
TAX ACCOUNTIPARCEL NUMBER: O)OZ150000040p
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS: DETERMINATION: E] Conditional Waiver 0 Study Required 0 Waiver
DISCRETIONARY PERMIT
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORTPLAT
SIDE SEWER AS BUILT DATED:—(o - 15
SIDE SEWER PERMIT(S) #:,!5m
GEOTECH REPORT DATED:
STREET USE ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
LOT:
LID#: 1-11-51
4 BLOCK:
LATEMP\DST"s\Fonns\Street File Checklist.doc
USE: r T
ZON
BUILDING DEPARTAWT Applicant Fill
Inside Heavy Lines
PERMIT APPLICATION JOB
NAMEj(OR �IAME_OF BUS I NES 5 ACORrSS :5-0
LEGAL LOT LOT AREA NO.
dSF,1VISION
_kYES N 0
MAILING ADDRESS I �, 000—
W
VARIANCE OR ADO NO,
COND. USE NO.
CLEP
CITY HONE NUMBER
___TT PROPOSED YARDS
Of
/
1��GHT
Z
D FRONT SIDE REAR
40
Z
NA
ALI COWABLE
1PROPOSED
SIGN AREA SIGN AREA
U
W
ADDRESS
t
OTHER
REQUIREMENTI,
C:
CITY PHONE NUMBER
4
rE PWINO DEPT, APPROVAL DATE
NANIC
TREET R1W
FT. THIS PROPERTY
XISTING STREET R/W DEFICIENCY
ACIDRESS
COMP. PLAN ST. R/-C30/�� FT. Z) FT.
I.
U
<
M
REMARKS
CITY TELEPHONE NUMBER Driveway slopes not to exceed those
0..
Z
inelinntea nn qtandard Dwg. Nn- 110.1;
0
U
7ATE LICENSE NUMIIER CITY LICENSE NUMBER ICIIFCKIEO BY
W
Legal Description of Property (Show Below or Attach Four Copies) STREET AND/OR UTILITY El YES
Z
W
WORK REQ'D 0 No
UNDERGROUND AYES
Z
2
WIRING REQ'Z) NO
0.
111RIPIE
TYPE CONNECTION 0 By
U
PERM
YES RMIT NU
w
SE PTIC SYSTEM
APPVO BY CITY ENS. CJ NO
W
.J
<
0
W
REMARKS
N t;—= rmn
METER SIZE: SIZE BY
ISERVICE 1CLEARANCE ICHECKED
W
REMARKS
4EW RESIDENTIAL GAS
1-1111 TYPE OF CONSTRUCTION
NO. SIGN 1CODE
F_j
F� ADD
OCCUPANCY UPANT
RETAINING SPECIAL INSPECTOR IAR.� locc
DIZIACOLIS. I�EQUIRIZ. GROUP LOAD
WALL
C:]
ALTER E] .-CAV-TE F_j FENCE 0 YES 0
OR FILL PLAN C�IECKIEO 13Y THIS SITE IS LOCATED IN THE CITY
Fa
OF EDMONDS. LOCAL SALES TAX.
P-.- -VE
E] M
REPAIR. INSP *
E].WIM
POOL SHOU�D BE CODED 31.04.
REMARKS
M
NUMBER OF STORIES 11411 BCR OF
DWELLING
UN ITS
0
NATYRE WORK TO BE DONE
FEE
VALUATION
PROPOSED LOSE
PLAN CHECK
0
NO.
PLOT PLAN (INrICATE BUILDING SETBArKS,
Or
ABUTTING STREETS)
BUILDING
U
PLUMBING
0
HEAT & GAS LINE
0 c,
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
I hereby acknowledge that I have read this application; that the I.-
TOTAL AMOUNT DUE
2�
formation given Is correct; and that I am the owner. or the dUly aUth—
Ize4 agent �f the owner. I agree to comply with city and igtato law. regu-
latIng constructlon; and In doing the work authorized thereby, to person
ATTENTION
APPLICATION APPROVAL
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
relrAing to Workmen's Compensation Inxurahc�_.
This application Is not a permit until
NOTE: Permit Limit One Yecir
AUYHORIZES ,
ONLY THE
signed by the Building Official or his Dep-
(Except DEMOLITIONS which
W ORK NOTED
-ceipt is ac-
uty; &nd fees sure paid, and rL
.hall be ompleW in ninety days: MOVED -IN RICMDINGS hall be corn.
pl,t�d I
/-�h,.)
knowledged in space provided.
Lt
INSPECTION
1_�
S:7�JLORE JOW
DAT SIGN 0
DEPARTMENT
-
DIR CT . SO A URE
�ERCQaENT)
CITY OF
EDMONDS
NOTE.- Applicant Subject to
775-2525
This Permit covers work to be done on private propiirty ONLY.
Any construction on the public domain (curbs, sidewa!ki, driveways,
ORICI14AL -File YELLOW - 1nn;-*C:or
marquees, etc.) will require separate permission .
PINK-0,ne, COLD-Asse�sc-
NOTICE:
w*a r-r a n o
formation . 'shown on the a-ttached
The -in
-led for use by the City of
map(s) was cOm ' pi
Edrnonds� its Emp[oyees and Consultants.
Th,..e City of Edrn.onds does. not. warrant the
accuracy of anything set for * th on these
rnap(�). An . y person or entity -requesting a
copy should conduct an independent
inquiry regarding th*e inform'ati - on shownlor
-rnap(s), Including, but not limited to, -1
er stub shown, Suc
the location of any sew
sewer stubs may or may- not e.xist and may
or may not exist at the location shown.
Neither the city of Edmo*nds nor its
empl-o-yee-s o-r office-rs -shal-1 be 11a-b-l'-e for the
I n on this map(5), nor for
information give'
any one representation provided based
upon'said map(s),
APPLICATION
for
Thb City of Edmonds SIDE SEWER PERMIT EASEMENT NO - ------------------------------- ............
NEW CONSTRUCTION W REPAIRS LID NO. ....... ASMT. NO - - ----------------
OWNER------ ----------------------------------------------------------------------------------------- CONTRACTOF - -- — ------------------------------------------------------ ...................... PERMIT NO . ..... --------------
JOB ADDRESS -.14e�4'r=b-6-6 7-1-3r�-ru4 ttt:-'�4 F- - "" - LEGAL DESCRIPTION: LOT NO. --- -4
--- ------------------------------------ ................................... BLOCK NO - ------------------------------------
0
0
9
------------------------------------------------------------------------------------------------------------------------------------------------------------------
NAME OF ADDITION ----- 17P"n-L - ------ F== - ------------------------------------------------------
-----------
..... By ............. ---------- fi7.ig
zl'�
S 'VER"PERMIT
ITY, .:OF EDMSONDS DE", IEW
�AA
WATEWSEWER DEPARTMENT'
PERMIT
14"
WI 1,757 for';sidet scwer� :insp.cctibns,AIhFORE, covert . ng-any- portion of -the; construction
2525,
Inspection -will,be prbvid-ed withfn� 24 hours, after, requst.
NO,-Sat.j Sum, or holiday Inspections,)
O�.
LOCAMN.OF -CONSTRUCTlo* .... .. 900, Avenui-A West
N. ............ ... :! ............................. ............................................................
'kfM0P,ERTY-%- 1�k Sb R1 P n 0 � ........... I I ....... I .........
jivil-4. T01 Pi,rc;' # 2.
............................... .......................................................................................... ......
...............................................................................................................................
7 ........... .................................................. ............................ ............ ........
............... KALCER HOMES'
..........
77 ... 7* ----- ........ .... OMWER AND/0R.-BUILDER: ... ............................................................
........... .
C,&."N.Excavators�
�:6 kAuTo _AIDDRES&
................................................................... I ...... ............................
77 .... 7,777,1 --- 7 7 ............................. T..: .........
JUIA161 1. S jq� 76 conn �Sew
........... ...................... : .......... ........... ... ........ for repair and/or eetl.oa of- a. side, sewer, tot ithe),city,, sapltar� er ;j
h,%C4Y of,Edmonds ordinanee&,
4
'LEDt T %THE�,-FOLLO
1NG.:
�W,
—Th6iowners. of th'e*, tiropert, to construcf,' sewer': inside proper.ty.11ne., A, licensedt Side Sewer Contractor must,,,be employed, fo;:constru'et
NOTE No: 'T I I � �, 1. y, rpay.,obtaln a. permit - ' ..: , I'
�slde, sevver,in,-str6et area. Do not� cover any,, portion'of :sewer before it has,been, Inspected.
-2- kit worW�peri'�"_ Wir city
NOTE Hght-of-way requlres,an�Invazion 'oL,RJ9ht-of:WELy Permit obtainable -from the City �Engineer's, office.
NOTENo , 3—Obtainjfulli'ilniormatlon� regardin'g Ordinance 1.1.16.030.and, Regulations governing side. -sewers, when you get permtt�,
NOTE No. �4 Top,, ofside_sewer�musV�have �at leazt� 30 Inches'coverage -at �r�roperty line zLnd 12 InchesInsIde�'proper*ty line; 'minimum.'grade of 2%'. No� �ends In
grade,*.
sharper Ithan..I/g��%�,111�:be,.permitted�,
NOTE No. �.1,1�:-Tf6neheoln,�street,�.must be. water' settled! an dl,surface,of. street - reitored to, originsll condition. Cofitractors sha,11 be responsible for failure, Aue,: to iffip�oper
- work,..whichi may- develop within- one year� of xornipletion;
�-�-�i3OTE-No.-.6-:-It-ts,unlawfill,�to alter, or,do.any other work than is'tprovided for! in -the pern-dt,, or to, do any work on the, main sewer or JtSj'a, p a
iirtithe �plpe- into, the mye. pip rtenance ey..cept to in-
-71
ISA13PROMEU .... . .... 4,
..... . . ........ BY ................ Date ............ Date ................................... .............
'APPRO�ED''
...... 15_7 . ....... ByZi.
..... ... ................. . .......................................... ..............................................
ju.. ........................................................
inar" ......
.............................................
........... ................................................................................. ....................... ............. ............................ .......
.................. ........ ...........
-BIUST'B Si
WS,
e ,, 1
4, OP ��nedt./.By. Gwnbr of Firm, Per -forming �onstructionr,PRIOR To),RequeSt, For, lnspecftbn�
......... hereby 6 tif t
er - hatAhe, side'sewer installation constrcte&under this, permit .
y
-,.(Owner.,,,of Contracting,- Firm, 'Per ons ruct ion.)
�D�D'
A I
f�rtp-nlrg C t
nsta1ledqin'accPr. an=wit allgb
d h ihg,,ordihance§-of -the CitY'iof"Ednaonds.,'
Datedthis ............................. day., of ...................................
.................... . ......
:C * I
you:,'dig b Waier,:,[]�' ',Gas�:E] Velephonee E],,. -Power E]
V", fieeli,4EF'ORE..
Sewer. er:E],
_41
APPUCATION
,The City of Edmonds for EASEMENT NO - ----------------------------- --------------
SIDE SEWER PERMIT
NEW CONSTRUCTION [-] REPAIRS E] LID NO. .-AV-
OWNER ---------- ke' ----- /--/*L/--*?x--c--;-2 --------------------
JOB ADDRESS ------ ------
a
1 z,.5'-
CONTRACTOR - ------ x ------- ---- PERMIT NO.
LEGAL DESCRIPTION: LOT NO - ------- ----------------------- BLOCK NO - ----------------------- ------------
- I If-
......... . ------------- 2 ----------------------------------------------------------------------------------------------------------
NAMEOF ADDITION ------------------------------------- ---------------------------------------------------------------------------------
RECEllr-n
JUIV 15 1976
eubk "is Vapt.
SL
q�
//0
Approved:
DATE-------------------------------------------- By
------------------- ------------ yi7,yg
JUL 14 2005 12:50 PM FR BERNSTEIN INU SEATTLE42 1375 TO 914257710221 P.02
0
Atta Ave_ W
io .
l2rit. AM.?PdLttL*7; 00(o 3 95 coo.00 lf..00
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RECEIVED
loo;�
JUL 1-'4+2005 r..
ti
—PEMAT COUNTER
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TU
7717
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777�
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7-7-7 ---
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TOTAL PAGE.02
EXEMPTION 190M CONTRACTOR R%;ISTRATION
VERIFICATION FORM
The undersigned property owner or contractor has applied for a building pen -nit from the City of
Edmonds and claims that he/she/it are exempt from providing contractor registration in accordance with
the provisions of RCW 18.27. The property owner, by their signature below hereby verifies to the City of
Edmonds that:
Value of work under $500.00. The aggregate contract price of labor and materials
and all other items required for the project is less than $500.00 and is not part of a larger
opertation to be undertaken on the property. The person employed to do this work has not
advertised nor otherwise put himself forward to the permittee to be a contractor or
qualified to engage in the business of a contract. RCW 18.27.090(9).
Work performed personally on own property. The undersigned verifies that all work
done under this permit will be done by the permittee personally on his/her own property
and that the improvements constructed on the property are not being undertaken with the
intention and purpose of selling the improved property.
Commercial property exemption. The permittee is the owner of commercial property
and the owner's own employees will perform all maintenance, repair and alteration work
on the property. No work will be done by contract under the pen -nit. RCW 18.27.090(13).
Licensed architect, engineer, electrician or plumber. All work performed under this
permit will be performed by an architect, civil or professional engineer, licensed electrician
or licensed plumber operating within the scope of his or her license. RCW 18.27.090(14).
General Contractor. The owner is the General Contractor for the project and is required
IP to hire a minimum of two licensed subcontractors (unrelated building trades or crafts). Tile
general contractor is responsible to verify all State licenses of subcontractor. RCW
18.27.010
THE UNDERSIGNED PROPERTY OWNER HEREBY VERIFIES THAT ALL
INFORMATION PROVIDED ON THIS FORM IS TRUE AND ACCURATE TO THE BEST OF HIS
OR HER KNOWLEDGE AND ACKNOWLEDGES THAT IF ANY OF THE INFORMATION
PROVIDED ON THIS FORM IS FALSE, HE OR SHE UNDERSTANDS THAT THE BUILDING
PERMIT WILL BE IMMEDIATELY REVOKED AND ALL FEES PAID FORFEITED.
Dated this day of 20
PROPERTY OWNER/PERMITTEE
WITNESS: C-1
Print:-.- 67ket-7--ey
RECEIVED
JUL 12 2005
PERMIT COUNTER
LATEMMUILDINGTORMS\exernp contractor regis verif fonn.doc03/28/01
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ENGINEERINC; DEPARTMENT
APPLICATI,N FOR PIG11T-0E-'.'!AY CONSTRUCTION4PMIT
(AprZ,"o,:z�-t to C,—vZete A rnd in DuvZ1:-,rte)
Permit to be issued to: Z 17 e-
For work at: (address or vicinity)
Type of work to be done:
(Attach Dra,,,ing V.-hen Applicable)
Z::
Time Required Start: Finish:
--7
Own
er:
Name
/) 0
�tailing Address
7 7f //J
City/ State Telephone r-:umber
Contractor:— 'e-
Name
State License 'Number
Maiiing Address
City State Telephone "LIMber
I
-INDE'INITY: Applicanz understands and by his signature to this application, agrees
to hold the Citv of Edmonds harmless from any injuries, damages or claims of any
kind or description %,,hatsoever, foreseen or unforeseen, that rnay be made against
the applicant or the City of Edmonds, or any of its departments or emDloyees,
including but not limited to the defense of any legal proceedings including defense
costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and
materials '�r a period of one year following the final inspection and acceptance
of the restoration by the Engineering Department.
Work subject to inspe —
,z lon and restoration �n accordance with City Code. A
24-hour not1cf\is reAV�Ired for ins�ection the Engineering Department.
Call 775-25251 YnLb/^ 1'7 '7 Y�
Signature:
r or Ag(iint
D a t�e./S j. g n e d
DO NOT WkIT,� BELOW THIS LINE (To be cc-pZ'eted by Issuing Agency)
Permit Issued (Date) 77
Fee:
Time Authorized:
'� 1 -.-2 ,
Permit Number 44
Bond:
ENG I N E EI) I S AFYPOVAL DATE
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