18703 85TH PL W.PDFIIIIIIIIIIII
8061
18703 85TH PL W
ADDRESS: k? PY 4/"""
TAX ACCOUNTIPARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):_,?b,64::;1, 0 3
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: DETERMINATION: 0 Conditional Waiver F1 Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
,;ANNING DATA CHECKLIST DATED:
CALED PLOT PLAN DATED:
SEWER LID FEE S: LID 4:
SHORT PLAT FILE:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) M
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:
LOT: BLOCK:
LATEMP\DSrs\Fomis\Street File Checklist.doc
PLANNING DATA
SITE ADDRESS: 1 &70 3 - 93) - P1, 0, DATE: 3 IV L',
ZONING: K") - rz- PLAN CHK#: Z-33
PROJECT DESCRIPTION:
SETBACKS:
Required Setbacks:
Front: Left Side: Right Side: i o Rear:
Actual Setbacks:
Front: 5 Left Side: 10' Riciht Side: 0' Rear: 2-
CORNERLOT N) _(Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED tt (Y/N)
LOT COVERAGE:
Z S� 3
Maximum Allowed: 35-7, Actual: I Z, 3io
BUILDING HEIGHT:
Maximum Allowed: a5) Actual Height:
Datum Point:--4-L-,- '4AW (co-v—j wA,-,,!,jDaturn Elevation:
SUBDIVISION: NO 101-
CRITICAL AREAS #: 4- -f",e S,4'A'V�`6,
SEPA DETERMINATION:
LOT AREA: 12-. 310 IVO
OTHER:
Plan Review By:
too
/,,0/ res
EIVE
CITY OF EDNIONIA' SIDE SEWER PERMIT
JUL U.8 1996
0 c, PUBLIC WORKS DEPI PERMIT N 3783
Address of Construction: 00 03 gs-
Property Legal Description (Include all easements):
Z2-1 V, e-
Owner and/or Contractor: 4*W Z,41W-C 7:Z_A(1. -
State License No. /0/A_ff_ Building Permit No. q60 Z03
)dSingle Family
0 Multi -Family (No. of Units-)
0 Commercial
El Public
Invasion into City Right_of-Way-.)rNo 11 Yes
RW Construction Permit No
Cross, other Private Property; -<No El Yes
Attach legal description and copy of recorded easement
I cerxtthat I have read and shall corp/ply with all city requirements
as i6dicated on the back of the Permit Card.
Date/
* CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION *
:OFFICE USE. ONLY
FOR INSPECTION CALL 771-OW, PUBLIC WORKS DEPT.
Permit Fee: ;9!�2j'
Issued By
Trunk Charge: 3c), Date Issued:
Assessment Fee: Receipt No.
Lid No.:
Partial Inspection: MCibs INSE", 017 C/o To CAADE AT AN $6 Date7-- Mnit.ial4l'
Comments
Reason Rejected:
Final Inspection Approved: Date'�-26-A Initial
Date Initial
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Green Copy: Inspector Buff Copy: Applicant
Revised 3/90
The City of Edmonds
Side Sewer Drawing
EASEMENT NO . ..................................... %
NEW CONSTRUCTION REPAIRS LID NO . ............... ... -ASMT. NO . ..................
OWNER .... 3.AtW ......
... e.g .............................................. CONTRACTOR --- B.A.M WPJ t
..... T
T
TR ORA ------------ PERMIT NO.S.7.13
JOB ADDRESS ... .......... a ... 5
............... Nn.! ..... LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ....................................
I
PWW-0001-1 1175 (REV.1 1/78)
A ed-
WR�L f?-g .9(. 49.
DATE-4&.-:�:.f,� ...................... By
I I op.
"p 6p. CORW
--- ----- -- --- — ----------
NOTICE:
.Nb---wa rra nty-- OT
The information'shown on the attached
map(s) was compiled for use by the City Of
Edmonds its Employees and Consultants.
Th,.e City of �Edm.qnds does not ' wa rra nt t, ie
accuracy of anything set for.th on t ' hese
Map(�_). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the inform-ation shown on
.___tFe -map(s), Including, but not limited to,
th'e lociation of any sewer stub shown, Such
,not exist and may
sewer stubs may or may
or may not exist at the location shown.
Neither the �ity of Edmonds nor its
empi-o-yee-s o-r office.rs -sh-a-11.1 be 11a.b-'Fe for the
i n on this map(s), nor for
information g ve
any one representation provided based
upon . said map(s).
ACCEPTABLE TIGHTLINE MATERIAL
N-12 ADS
Sch 40 PVC
SDR 35 (ASTM D3034)
4E:IC�47 CA-Lc-*5
381.7
)S"Y(,.l 4 MEA6.N
+
cn Aj
---i
m
m ArrKOVED
m
=4 c=
c"J co
c�
WATER PERVICE INSPEam
RENUI ED. -... C . ALL 771-02
LOT 5, HELLEREW LANE
r-ty%f oir Womot4jo")
eO., WA,
t Or
..................... .........
. e . "�% -,,� \ I
SIN.*
c
1 0 w e es t-ir-
HELLER�K4 HOME��
0
OoTREET i sh.E
RECEIVED
FEB'e.-
PERM! T COUNTER
'At
-*Wb . -.04
ACCEPTABLE TIGHTLINE MATEF41AL
N-12 ADS
Sch 40 PVC
SDR,35.(ASTM D3034)
APPROVED '�k-
L
;oAr u r- mu
W" � rTm SERVIcE IN
4— SPE
QUIRED. CALL 77....
00
J-bE-Mff-'--PL-A,tlkj .
LOT S, HE LL E REN LAWIE
61��ql)IV /i-G L--7�
3 v
38
C*ur: Jw zo *. 0
4k
110"
/100-
IS
L
N 17
^ - — .- 0 W. 'r— I
Ilk, ZIC4. -
jo* Dot qw .-Ws
Ns
irm
#oFZ,4 wyomk-s
r4 &VL
I- J��' C) -.,W
L11 -2 qz.o
- 27-,
m
cay Gopy
RECEIVED
FEB 2 7 1996
PERMIT COUNTER
141CIA64r CA-%-r..:b,
'AC 3TS.40
+
jq ILI, +0
ACCEPTABLE TIGHTLINE MATERIAL
N-12 ADS
Sch 40 PVC
SDR 35 (ASTM D3034)
P L A, tJ
LOT S, H 5 LL. E REN LAWE
2bJ40040#404" eQ.o WA.
-�_;-3 n?-o
- q
I
ol
U,.Lif: I'w z4o: 0
'00000
101,
-t 00
n—S, fez;_
APPROVED
FAZ K Z 7
xz�
IDA r U 64 14 0 0
Ib P4,
WATER VICE INSPEc' 6 406 1
TIONS -11 1
k X A%
RFDIIIRR' rAi i
MUZJ3 A-,m jra.-7— I
vx*,.lkj*c#.w -.ws t,
ko
h:6:1—,4 Z:"RC A/ h401slk S
c -:.- ni .40
1�10 _. ,
13=
The City of Edmonds Water Service Drawing EASEMENT NO . ......... ..............................
NEW CONSTRUCTION REPAIRS F-I LID NO . .................. . ASMT. NO . ..................
OWNER ........................................................... .......... ..................... 6
.... CONTRACTOR ........................ PERMIT NO.
..............
JOB ADDRESS 18.70.2) ............... ....... LEGAL DESCRIPTION: LOT NO . ..... ................................ BLOCK NO . ........ ...........................
— t4 0 MT4A -qlW
21
C- a
0
0
Sr" PL. roved:
PWW-0001-1 1175 (REV.1 1/78) DATE ............................................ B . .......... ...
Y"'Z�lltl ........................
PERMIT APPLICATION REQUIREMENTS
To: Applicant
From: Ly Engineering Ifispector
Owner gz7�Z Plan Check No: q
Address: Date:
After review of the subject permit application, the following requirements must be met
1. Construction hours are:
WEEKDAYS - 7:00 A.IVL-10:00 PALWEEKENDS/HOLIDAYS - 10:00 A.M.-6:00 P.1VL
2. A separate RIGHT-OF-WAY CONSTRUCTION PERMIT is required for all work on public property. (ECDC 1&60) *
3. Truck haul route plan must be submitted and approved prior to permit issuance.
4. Builder/owner is responsible for containing all temporary runoff and erosion control on site.
(ECDC 18-30.030d)
S. NO WORK SHALL BE DONE WITHIN 15 FEET OFSTREAMS OR 10 FEET FROM ANY CLOSED DRAINAGE
FACILITY. BUILDER/OWNER IS RESPONSIBLE FOR IDENTIFYING CONDITIONS ON THE DRAWING. (ECDC
1&30.50G)
FILTER FABRIC FENCE SHALL BE INSTALLED AND INSPECTED PRIOR TO CLEARING AND CONSTRUCTION.
(ECDC 1830)
INSPECTIONS ARE.REQUIRED ON STORM DRAINAGE SYSTEMS, TIGHTLINES AND CATCH BASIN
INSTALLATION. INSPEMONS ARE REQUIRED PRIOR TO RACKFILLING. (ECDC 1&3o)
Repair or replace all defective existing curb, gutter and sidewalk adjacat to the property. If an Intersection is involved, a handicap ramp,
may be required. Contractor shall meet with die City Engincering.staffto determine the extent of repair prior to Issuance of the permiL
(ECDC 1&90)
Driveway slope shall not exceed 14% without a waiver. Every attempt should be made to keep the slope below 14%. Waiver granted to
- % (ECDC 18.80.0601))
10. Driveways must be paved from property line to City RIGHT-OF-WAY. A separate permit Is required. (E-CDC IU0.060C)
11. INSPECTIONS ARE REQUIRED ON DRIVEWAYS AND SMEWALKS pRIORTO AND AFTER POURING. (ECDC 1S.30)
12. No buming of construction refuse without a permit fi*m the Fire Department
13. Connection to City water system is required. 'Mere 6 a separate charge for the watw mew.
(ECDC 7.20)
A. A back water valve is required ifdownstdrs plumbing is below the elevatkm of upstream nunhole.. (ECDC 7.20)
IS- Water and sewer main lines should be separaW by 10 fed minkninn (ECDCI&10)
16. connectiO to the City sanitary system is required. A epatatimpermitisreq*a
Ems T,
Fea pald: Yet__ NcL_ Charg;-!���, ODMC may.
1. Undetzroundwiring is required an all new.construction, and for additions6 alterations, and repairs thatexceed 5(r/. of the total messed
value Of the structure. (ECDC 1&90)
.8. AFRiALENGMEMGDWpCnONISREQu&-Drpm'OCTf
IF
I
TO 1ULING DIVISION GRANTING OCCUPANCY
OF THE BUELDING OR SIRUCTURE. (ECDC 1&9-0.-)
OPOJECT REVIEW CHECKLIST*
PROJECI NAME (�E� PLAN CHECK #:
-1 __T_T
PROJECTADDRESS:
RECEIPT DATE: -,9 -R
EVIEW
D*'BY: (nitial/Date)
I
PLAN.
I
WATER
t! I
COMMENTS
FIRE.r.',IBILOG.
I
SEWER. STREET
.!ENG.]..
Setbacks/Variance/Setback Adjustment
Conditional Use Permit
ADB Requirements
Other Zoning Requirements
4
Underground Wiring Required
Lot Slope 15%
6
SEPA Environmental Checklist/Hydraulics Permit
7
Tree Cutting Plan
Plat/Subdivision Requirements
4....
Legai Description Verification
Quit Claim/Street Dedications
Easements - Public/Private
Engineering Storm Drain Review Fee gi2
ng neering 2.2 Inspection Fee
. . . . . . . . . . . .
Drainage Ian (On -Site)
Setback - Top of Bank, Stream, Water Courses
A 6:::
Setback - Storm Drain Line
Open Ditch - Existing
XW q
Culvert Required
Culvert Size
Shoulder Drainage/Shale Open Runoff
21.
Catch Basin Required
:'22
Driveway Slope & Vehicle Access ok.
23-
Sidewalk Required
24
Curb & Gutter Required
- - - - - - - -
17
Curb Cut For Driveway Required
26
Street Paving Required
27
Right -Of -Way Construction Permit Required AA�>
28
Street Name Sign Required
. . . . . . .
Lf
29
Other Signing Required
30
Bond Required For Public Improvements
. . . .
.31
FEMA Map Check/Water Table
. - - - - - - - - - - - - -
. . .... .. .... %
Side Sewer Availability TL3
.33
Calculate Sewer Conne6tion Fee If No LID #
. . . . . . . . . . .
24
Reate Street File 1/.%S
1
1:35
1
Existing Water Main Size
36
Water Meter Size
"Via
Service Line Size
Water Meter Charge Required
0
39
:.�40
Hydrant Required
Hydrant Size Existing
.'41
Fire Line Charge Required -_Sprinkler
42
Street Cut
I NQ (D
31-7
T-11
43
,Miscellaneous
4T]
Reviewed By:
FIRE
FILE:DATA1 23/PROJCKLS.SFN
PLANNING ENGINEERINAV-"'�r_ =fC;W&ORKSi_
�U_
VE 2 . 14
jpjJBL
IC %(3,RKS DEP1
A L %, U M U U(- t, U li I A t, f 3
1
21
2
22
3
23
4
24
5
25
6
26
7
27
8
9
28
29
RW PERMIT DATE ISSUED RECEIPT
10
30
11
31
12
32
13
PAID $ RECEIPT # DATE
33
SS PERMIT # OIL E RECEIPT I
DATE-ISSU D JZB
14
PAID $ RECEIPT DATE
34
f
15
35
16
36
17
37
METER SIZE PAID s DATE RECEIPT #
18
38
19
39
20
40
ROJECT REVIEW CHECKLIS6
PROJECT NAME:��/ZLZ7—/`
PLAN CHECK #:
e-
PROJECT ADDRESS:_.. RECEIPT DATE:
REVIEWEED,
BY: (Initial/Date)
—!EN
PLAN.
WATER
COMMENTS
FIRE'.,
BLDG.,
SEWER, STREET
--ENG.....
SetbacksNariance/Setback Adjustment
.............
Conditional Use Permit
ADB Requirements
Other Zoning Requirements
. . . . . . . . . . . . . . . . . . . . . . . .
. .
M,
4'
Underg ound Wiring Required
Lot Slope 15%
SEPA Environmental Checklist/Hydraulics Permit
Tree Cutting Plan
. . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . .
7
Plat/Subdivision Requirements -3 -Z,(V-15-�-
7:9
Legai Description Verification
Mvi��, K.
:10
Quit Claim/Street Dedications
........ ........ ...
Easements Public/Private
. . . . . . . . . . . . . . . . . . ... ........
.1
Engineering Storm Drain Review Fee
. . . . . . . . . . . . . . . . . . . .
2:�
Engineering 2.2 Inspection Fee
37
Drainage Plan (On -Site)
'N'r-10 WE
Setback - Top of Bank, Stream, Water Courses
......... .
Setback - Storm Drain Line
Open Ditch - Existing
Culvert Required
.......... . . . . . . . .
Culvert Size
Shoulder Drainage/Shale Open Runoff
. . . . . . . . . . .
Catch Basin Required
:22
23
Driveway Slope & Vehicle Access
Sidewalk Required AAj
1,24
Curb & Gutter Required
25
Curb Cut For Driveway Required
1..:27
6
Street Paving Required
Right -Of -Way Construction Permit Required /--k-
Street Name Sign Required
28
Other Signing Required
29-
30
Bond Required For Public Improvements
.31
FEMA Map Check/Water Table
. . . . . . . . . . . . . .
. . . . . . . . .
32
Side Sewer Availability YL-5
33
Calculate Sewer Connection Fee If No LID #
.34-
-
Street File
,Create
35
Existing Water Main Size
36
Water Meter Size
. . . . . . . .
. . . . . . .
Service Line Size
. . . . . . . . . .
.37
.:38
Water Meter Charge Required
Hydrant Required
................ -
. . . . . . . . ...
.....
A0
Hydrant Size Existing
Fire Line Charge Required - Sprinkler
:::41
Street Cut
42
Miscellaneous
Reviewed By:
FIRE
FILE:DATAl 23/PROJCKLS.SFN
I
PLANNING
ENGINEERINd PUB I WORKS
A&
-,% r% R- r- 9- 1 07 1
:7' HILL
DEPI
PERMIT APPLICATION REQUIREM
To: Applicant
From: Lyle Chrisman, Engineering Ifispector
Ownerqeum6w Plan Check No: 4?5 A0
Address:
Date: le.JL)#,)
After review of the subject permit application, the following requirements must be met:
I - Construction hours are:
WEEKDAYS — 7:00 A.IVL-10:00 P.M.WEEKENDSIHOLIDAYS — 10:00 A-R-6:00 P.M.'
2. A Separate RIGHT-OF-WAY CONSTRUCTION PERMIT is required for all work on public property. (ECDC 1&60)
3. Truck haul route plan must be submitted and approved prior to permit issuance.
4. Builder/owher is responsible for containing all temporary runoff and erosion control on site.
(ECDC 18.30.030d)
5. NO WORK SHALL BE DONE WITHIN 15 FEET OF STREAMS OR 10 FEET FROM ANY CUOSEDDRAINAGE.
FACILITY. BUILDERIOWNER IS RESPONSIBLE FOR IDENTIFYING CONDITIONS ON THE DRAWING. 09CDC
I&30.50G)
FELTER FABRIC FENCE SHALL BE INSTALLED AND INSPECTED PRIOR TO CLEARING AND CONMUCTION.
(ECDC 18.30)
INSPECTIONS ARE REQUIRED ON STORM DRAINAGE SyS=K% TIGHTLIN
ES AND CATCH BASIN
DWALLA117 . ON- INSPECTIONS ARE REQUIRED PRIOR To RACKpILLING. (ECDC ISJO)
Repair or replace all defective existing cub, gulter and sidgwaik adJacent to the Property. If an interzation is Involved, a handicap ramp
mqbGrequited. Contractor shall meet with the CIV Engineering staffto determine the extent of fqWr prior to Issuance Of die permIL,
(ECDC 1&90)
Driveway slope shall not exceed 14% without a waiver. Every attempt should be made to keep the slope below 14% Waiver granted to
Vo. (ECDC I&SO.060D)
0. Driveways must be paved ftm Pro" line to City R1GHT-OF-WAY. A separate Permit 13 fequire& (EMC IU0.060C)
I - INSPECT70NS ARE REQUIR I ED ON DRIVEWAYS AND SIDEWALKS PRIOR TO AND AFTER POURING. (ECDC 1&30)
2. No burning of construction mfime without a Permit tram the Fire Department
3. COMWOn to City water system Is require& 'There Is a wpmft duM fbr the water meter.
(ECDC 7.20)
4. A back water valve is required If downstairs plumbing Is below the elevation of upstream manhole. (ECDC 7.20),
5. Water and sewer main lines should be separated by 10 fed minimum. (ECDC 1&10)
the City sanitary ryum Is required. A NP " Atm permp?equh-ad.
Fees paid: Yes Nq� Charp
_5b (ECDC 1&10�.
7. Underground wiring is required on all new conStructicak and for additions, alterations, and repairs that exceed 50% ofthe total assessed
value of the structure. (ECDC 1&90)
3. A FTNAL ENGINEERING INSPECTION IS REQUMED PRIOR TO THE BUILDING DIVISION GRANTING OCCUPANCY
OF THE BUILDING OR STRUCTURL (ECDc IL90)
MnMQR= c%-r
n q REE. FILE
SOJECT REVIEW CHEC
PLAN CHECK
PROJECT ADDRESS: Pak.-
<j RECEIPT DATE:
E IE D BY
nitla Da
6
...,.:COMMENTS;'-...:..
`FIRE
P p LAN. WATER
7Btp.G.. SEWER
STREE
FNG-
ponaltional Use Permit
Y,, ADS fleguirements
'Other Z ning Requirements
0
Unift
Agground Wiring Required
Lot I
t ope 15%
SEPA Environmental Checklist/Hydra
T 1Cutting Plan
red
PIMU/Spbdivision Requirements t7-�t
Description verification
QU taim/Stre t Pedi ations
C
Eaheinents 4-PutWOrivate
n 1 e r
Drain Review Fee
�Eri - ineerina Storm
E .9 n, e inj
�neerinq 2.2 Inspection Foe
Drainage Plan (On -Site)
Setback - Top of Bank, Stream, Water
Setback - Storm Drain Line
Open Ditch - Existina
1 Culvert Required
Culvd-rt Size
0hbulder Drainage/Shale Open Runoff
Cc tch Basin Required W.-b 0
Drive -A ess 'dp
Permit
A
Sidew lk Required
Curb G- utter Required &IZ)
CurOjCut For Driveway Required
StM. Paving Required
-Way
R19M Of Construction Peimit Required
Name Sion. uired
Stre#t
. . . . . . . . . . . . linkrig Required
Ired for Public lmp�foibim—ents
Chepk/Water Table
bill!
Availa Iry
ewer Connection Fee If No LID #
4
-et File 1Kpa-,
,W-,,4tQ,pEMdter Siz
56 Line Siza,
106%,v1d
- �Meter Charge Required
nk Re'- q.uIred
At Size Existino-
ne Charge Required - Sprinkler
!6w ed By:
FIRE PLANNING
WE
11
44
ENGINEERING PU6LIC WORKS
-AK
ILI, 40
APPROVED BY PLANNING
-31
QArui,-+ Py- moo
Q
LOT 5, kELL E REN LXWE
C%V%f or frobAOM133
IN
38 c?
4:34, cl 0
3 W
C-kLw: Jlw zo 0
540
q, 6.vt
17X Ailk ( hiJ.kr- W *. -
R
,Fcelveo
Oe'FE82 7 gg_
PERMITC Tra
c -:- 3eq.140
I� 2 5'" rz, - .4
Lb-::
0
%ff 7 AM ony
CIT
3va .4 0
3 9% Z, . 1300
ILI, 40
APPROVED BY PLANNING
2:4 ^,.0
�j
QA,r u a,.+
i bib
.5_lT.E7.*__FL__A.l" . .
LOT 5, kELL EREN LAWIE
c_tv%f Div w0*40hat3l
1-04.
38 9
f4�,, cl 0
GO
CALAF: J-. ZQ'. 0
Av—
REC — ED
. 2 7; WS
ERMIT COUNTEn
l000
L -90
- i _-,� e s
u0i ADORE
ox-
CITY
V'r,
NAME
ADDRESS
0
GY
0
cr CITY
Z
8
STATE LICENSE NUMBER
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
A/e Ilew. �Iowrs -z-j'-er.
�'Oj
ZIP
C)M
0 G
ZIP PHONE NUMBER
? ? c ?-(-A - 1 :7 3- -'z �- 3 /
/ / //T 1� 9111170
,ripti
6� of Property - include all asements
4 5" c4 �� Ue�(eAA �ck\A
_j Property
Tax Account
ParceiNo.
R'NEW
RESIDENTIAL
El PLUMBING
ADDITION
COMMERCIAL
MECHANICAL
APT. BLDG.
REMODEL
SIGN
GRqlgb
FENCE
REPAIR
C YOS.
( X _FT)
DEMOLISH
WOODSTOVE
INSERT
SWIMPOOL
HOT TUB/SPA
GARAGE
r7 RETAINING WALL/
CARPORT
�_J- ROCKERY
:,RENEWAL
rh NUMBER UMBER OF CRITICAL
0 OF rtELLING AREAS
Lu
to STORIES 0 U NUMBER
0
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
k
USE
ZONE PERMIT caeo2o-3
NUMBER
JOB SUITE/APT #
1ADDRESS "7/) -.;--1 — 4. a- _/. �
PUBLIC RIGHT OF WAY PER OFFICIAL STREET 4AP.
TESCP Approved
C3
EXISTING
REQUIRED
RW Permit Required
0
—
DEDICATION
Street Use Permit Req*d
13
PROPOSED
Inspection Required
Sidewalk Required
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV RE UIRED
E
YES NO 13
REMARKS
w
Z
ENGINEERING MEMO DATED 0/
EWEDBY
SIGN AREA
SEPA REVIEW
ADS NO.
ALLOWE.D.
PROPOSED
COMPLETE
1EXEMPT
SHORELIN
V,
—
EXP
VARIANCE OR CU
PLANNING REVIEW BY
DATi
yv , ��"* 4�
/ ''I ., AW '.
SETBACKS — FEET
\j
HEIGHT I
LOT COVERAGE
FRONT 25' SIDE
1
1 2-,;,l
_/Q I Ift"
SPECIAL INSPECTOR
REQUIRED I a'!'� s , ; -3
13 YES ,-- -1, , e
PROGRESS INSPECTIONS PER LIBC 305
PLAN CHECK FEE
BUILDING
70
HEAT SOURCE;;n
kri (�O�
G;ffING
%
6b"
PLUMBING
Plan Check No . `� :Kz
MECHANICAL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curts, sldewolks,
driveways, marquees, etc.) will require separate permission,
GRADINGIFILL
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors In Interest, agrees to Indemnify, defend and hold
harmless the City of Edmonds, Washington, Its officials,
employees, and agents from any. and all claims for damages of
whatever nature, arising directly or Indirectly from the Issuance
of this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirement of any city ordinance
nor limit In any way the City's ability to enforce any ordinance
provision."
ENO. INSPECTION FEE
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
I hereb acknowled a that I have read this applications that the
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information given is correct; and that I am the owner, or the duly ATTENTION A PLICATION 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 Insuoice and RCW 18.27. INSPECTION acknowledged in space provided.
4SIGLNAT(o GEN DATE SIGNED DEPARTMENT OFFI!�VrIGNA%
4194 CITY OF
EDMONDS
CALL FOR RELEASED BY: E
TENTION INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771; 220 ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC
CHAPTER 3. 6 PINK — Owner GOLD — Assessor
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0 'INESS PROGRESS INSPECTIONS PER. UBC 305 3
(TYPE OF USE. BUS 91R ACTIVITY) EXPLAIN:
NUMBER UMBLEIR OF CRITICAL ELL 40�6e
0 OF I)WEL NG AREAS
W, STORIES _rflo 0 NUMTS INUMBER
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) y
FINAL INSPECTION REOUIRED
VALUATION FEE
PLAN CHECK FEE
BUILDING
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Plan Check No. MECHANICAL 102-
This Permit covers work to be done on private property ONLY. GRADINGIFILL 154
Any construction on the public domain (curbs, sidewolks,
driveways, marquees, etc.) will require separate permission. STATE SURCHARGE 4 "516
Pennit Application: 180 Days STORM DRAINAGE FEE
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days . -361
"Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE :50
w successors in Interest, agrees to Indemnify, defend and hold
ow harmless the City of Edmonds, Washington, Its officials,
x employees, and agents from any and all claims for damages of
Cc 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
0
I 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 th.9 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 Insu0ce and RCW 18.27. INSPECTION acknowledged in space provided.
R AGEN DATE SIGNED DEPARTMENT
OFFICIA IG VATEY
EDMONDS Q
If
J 4, CITY OF r� _//00�`/Rzo
CALL FOR RE16-S-ED BY: f I 6ArE
&TENTION INSPECTION W06
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-9220 ORIGINAL — File YELLOW — Inspector
A - CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC
CHAPTER 3. PINK — Owner GOLD — Assessor
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