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CITY OE EDMONDS
WATER SERVICE; AS -BUILT
ADDRESS
18529 Olympic View
Drive
PERMIT
NUMBER 201151
HOMEOWNER Brown
CONTRACTOR N / A
DATE 03/09/01
DBRAWN Jeanie McConnell
PLANNING DATA
NAME: lJ�n, �✓�5�
SITE ADDRESS: �1c �2� l/ �� DATE: 114/-f
ZONING: PLAN CHK#: / 7 Z� Z
PROJECT DESCRIPTION: — LIC L O
CORNER LOT_,i) (Yes/No)
SETBACKS:
Required Setbacks:
Front: 2 S Left Side:/0 Right Side:/o -Rear: Z S
Actual Setbacks:
Front: Left Side:— Right Side: — Rear:
Street map checked for additional setback required? (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED---- (Y/N)
LOT COVERAGE:
Maximum Allowed: �S % Actual:`""
BUILDING HEIGHT:
Maximum Allowed: 2� Actual Height:
Datum Point: Datum Elevation:
A.D.U. CREATED?:
SUBDIVISION:
CRITICAL AREAS #: / O / ,
SEPA DETERMINATION:___X��l�
LOT AREA:
OTHER:
Plan Review By:
Ofi le Apenni ft^plandat. doc
690. 194
Cityof 'Edmonds',
FILE H
R Tp WAYr,rCONSTRUCTION
�E7 y�aPERMIT Ip`: Permit Number:�D
ti .AA Issue Date:
ENGINEERING
A. Address or Vicinity of Construction: 18529 olympie Vieo Orive I
B. Type of Work (be specific): Install New Service
C. Contractor: Washington Natural Gas Company Contact: Gary Swanson
Mailing Address: R1 5 Mercer Street, Phone: 224-2080
State License #: Seattle, WA 98111 Liability Insurance: Bond: $ .
D. Building Permit # (if applicable): Side Sewer Permit #,(if applicable):
�. ,• i. 1 ... - , _'... ti lwz:,- rys.' A;6J,..1..• - .. ' �•., ...�. i.. w+•,4. :�.....y. ...G:- E. ❑ Commercial : ` ❑''Subdivision �] Ctty Projeclt ®UtihtyTPU]1 , GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut : ® Yes ❑No (2 b. Size of Cut: 2 x 4 H. Charge $
@ Gas and W ter
APPLICANT TO READ-AND'.SIGN
INDEMNITY: Applicant understands and by his signature to this ap6cati6n;jogrejsljo hold thej ity of Edmonds harmless from injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeen,, that ma`' be made aga((' hetCti of Edmonds, or any of its departments or employ-
ees, including or not limited to the defense of any legal proceedings inchrdefen4e�c$s&ifid a14ory fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIAL$ FOR A PERIOD •OF ONE YEAR FOLLOWING THE FINAL INSPEC17ON
AND ACCEPTANCE OF THE WORK. ES77MA7ED RESTORA77ON FEES WILL BE HELD UN77L THE FINAL STREET PATCH IS COMPLETED BY.
CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT
Construction drawing of _proposed work require wi* permit application.
A 24 hour notice is required for inspection; Pl*s Tall the Engineering Department- 771-3202.,
Work is to be inspected during progress dQt completion.
Restoration is to be in accordance w' iy codes
Street shall be kept clean at all times
Traffic Control and Public Safety shall be in accordance with City regulations. as required by,.the Cify`Engineer.
All street cut ditches shall be patched with asphalt or City, roved material prior to the, end of the working day;
NO EXCEPTIONS. ~ !
I have read'the-above statements am u;therstdtld-the'permitk:requirements-and thbtpirik co,6 of the permit will be available
on site at all times for it}g t urposes. _a, r'
OOl11111 1,
Signature: Date: October 22, 1991
(Contractor.or Agent)
CALL DIAL -A -DIG PRIOR 1'0 BEGINNING. WORK
FOR CITY USE ONLY
NO WORK SHALL BEGIN PRIOR' TO PERMIT ISSUAN
Engrg. Div. 1991
FIELD INSPECTION NOTES (Fund III - Route copy to Streek;,Dent.)�
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 1983
VVhshkxjtqn
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Addendum to City of Edmonds
Right of Way
Permit Application
Submitted by: Kerry Walsh
Engineering Aide
Washington Natural Gas
Q ,/ 622-6767 x2761.
OLY V w 'DR pager 995-6914
WNG to window
Water main depth
unknown
A" gas main
I
(e2 14) (: �? e A-< 3 1
Key:
-w- water
-g- gas
-ss- sewer
$ water hydrant
O water valve
815 Mercer St. (P.O. Box I969), Seattle, WA 98111 (206) 622-6767
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010 ill/ D -S LEGAL DESCRIPTION .
for -cal At 'thnt port.iort of thb Northwesterly halm or vaontod Olympia Avenue
adjoining the fallowing d6scribec3 propertyt
.All that portion of the Southwesterly 10 Feet of Lot eight (8),
Block C. and of Tract forty-three (43). All in. Edmonds Sea View
Tracts, according to plat;thereof recorded in volume 3 of plate,,
page 760 lying Easterly of the Edmonds -Beverly Park Road,
6.
Parcel Es All that portion of the Northeasterly 40 feet of Lots seven (7)
and sixtoen (16), Block C, Edmonds Sea View Tracts* according
to plat thereof recorded is volume 3 of platEj, page 76, so
measured along the Southeasterly line of said Tract 16, lying
Easterly of the Umondo-Beverly Park Road.
Pa -0. 21 9 t All that portion of the Southwesterly 10 friet of Lot oight (8)t
Block C, and of Tract forty-three (43), Edmonds Son View Tracts,
.._...., lying Easterly of Edmonds -Beverly Park,Poad.
Parcel DO The Northwesterly one-half of vacated. Olympic Avenue ad,ointng
Tract.above described as ?areal B.
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Parcel Fs Basement foi- road. purposes over Lot nine (9), Block C and Tract'
forty-three (43); Edmonds -Sea View Tracts, as granted by Robert
Steen and Dayle Steen, lake wife, to Jean Werrbach and William
Werrbach in volume 494 ofwdeeda, page 76, under auditor's file
No. 1027678, described so follows t
A strip 15 feet wide lying 7� feet on each sides of the following
doscri bad , oentor-lino t
Beginning at a point on the East line of Edmonds -Beverly Park
Road, 179.3; feet Northerly as measured alor.E tho nast line of _said
Poad from the Horthriesterly corner of Tract described as Parcel. �
" C above; thence South 550299 East 83.92 feet; thence South 16.261
East 105.2 feet; thence South 6*461 West 127.76 feet to the North j
line of Traact._ described. as Parcel. C•above.
Situated l.n Snohomish County, Washington.
CITY OF EDMONDS
USE PERMIT %� Q
ZONE ^�
--� [..,.. NUMBER � > / ✓t—'
CONSTRUCTION PERMIT APPLICATION
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OWNER NAME/NAME OF BUSINESS ®1)'% E1Y49 A&„ �i
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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.
EXISTING 'REQUIRED DEDICATION
TESCP Approved ❑
RW Permit Required ❑
CITY IZIP
TELEPHONE.NUMBER
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PROPOSED
Street Use Permit Req'd ❑
Inspection Required ❑
NAME
Sidewalk Required ❑
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
YES ❑ NO ❑'
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TELEPHONE NUMBER
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ENGINEERING MEMO DATED REVIEWED BY
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STATE LICENSE NUMBER EXPIRATIO DATE
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VARIANCE OR CU
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SHORELINE R
Legal Description of Property - include all easements
SEPA REVIEW
COMPLETE I EXEMPT
EXP
SIGN AREA
ALLOWED I PROPOSED
HEIGHT
ALLOWED I PROPOSED
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LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SETBACKS'(FT.)
FRONT SIDE REAR
-PROPOSED SETBACKS (FT)
FRONT L/R SIDE REAR
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LOT AREA
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Tax Account 1 r��j /� -� /' �-� __ i
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NEW RESIDENTIAL PLUMBING/MECH
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❑ ❑ COMPLIANCE OR
ADDITION COMMERCIAL CHANGE OF USE
eLi1: G C C ti u" G„
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APT. BLDG.
REMODEL SIGN
CHECKED BY
TYPE OF CONSTRUCTION
-„"„p
COD
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G UP
❑GRADING FENCE
REPAIR CYOS. ( x_FT)
G'�'a-.-' Iritt/,(
WOODSTOVE
DEMOLISH D INSERT El SWIM POOL
HOT TUB/SPA
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OCC PANT
SPECIAL INSPECTOR
AREA �,-y
REQUIRED
❑ YES
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LOAD
GARAGE RETAINING WALL/ �Z` L`^ C
CARPORT ElROCKERY RENeWAr
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REMARKS
PROGRESS INSPECTIONS PER UBC 108
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(TYPE OF USE. BUSINESS °r'TIVITY) EXPLAIN:
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NUMBER NUMBER OF CRITICA
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OF DWELLING AREAS q[tl
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STORIES UNITS NUMBER
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
kl' �. ( 1- \ EA �A IL%.0Lk
INAL INSPECTION REQUIRED
VALUATION
FEE
F011 HS)I lOCCG/A/477GW 0/7
PLAN CHECK FEE
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BUILDING
HEAT SOURCE:
GLAZING
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PLUMBING
[Plan Check No. i / 'R 7—
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGWILL
Any construction on the public domain (curbs, sidewplks,
STATE SURCHARGE
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENO. INSPECTION FEE
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successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
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employees, and agents from any and all claims for damages of
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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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modify, waive or reduce any requirement of any city ordinance
limit in the City's to
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nor any way, ability 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/her
Code of the State of Washington relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is
tion Insurance aria R .27. INSPECTION acknowledged in space provided.
SIGNATURE (OWNER O I�GENT � � DATE SIGNED DEPARTMENT
OFFICIALS SIGNATURE
QATE
%� ( CITY OF
� — 1 ' � �'"— ```� Cq EDMONDS
A TENTION CALL FOR Rf<Lti AS I l7 DATE
INSPECTION
IT S UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE ��� 0220
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
ORIGINAL — File YELLOW — Inspector
Li
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
SECTION 109 PINK'- Owner GOLD — Assessor
CITY COPY
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