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18815 88TH AVE W
C ty PERMIT NO: 9698
of Edmonds
PRRMIT EXF REs' 41411-
C!lr"U QUAVUlD IDUIDA/Fllrr
�)7 C. 199,
Address of Construction: -,-owe- LID#
Property Tax Account Parcel No. C)
Attach copies of all access and utility ease erifi ed and Approved b
Owner and/or Contractor:
Contractor License (nume"Vi&M Building Permit :2.00 2 2 i?:z,3
No's-ingle Family
Multi-Family'(No. of Units
Commercial (No..of Units
El Public A '
Invasion into City *Right -of Way: El Yes [S( No
*RW Construction Permit #
Cross other "Private Property: e 0
I Yis ;RN
"Attach legal description and copy of recorded easement.
Owner or conyactor signature and acknowledgement statement:
By'signing for this permit I certify that I have read the City's public handout entitled
Oide Sewer Specifications, and shall comply with all City requirements outlined therein.
I, , )�,-?_Ccz
Date
15555) BEFORE ANY EXCAVATION 9
9 CALL DIAL -A -DIG (1 -800-424,
9 FOR INSPECTION CALL 425-771-0220 extensionj
24 HOUR NOTICE REOUIRED FOR ALL INSPECTION REOUESTS
................. .......
FOR OFFICE USE ONLY
...... .. ...
Permit Fee 220. "'—Repair Fee $ Issued-8j:
Trunk Charge $ _7'?�O. Date Issued:
Assessment Fee $ Receipt No:
City Permit Surcharge Fee $5.00 Total Fees Paid $
NOTE IF JOB SITE IS NOT READY FOR INSPECTION WHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION FEE WILL BE CHARGED.
JobSite Ready YES NO —Date: Initial:
Partial Inspection: C40 &II Date: Initial:
Pa
rtial Inspection: Date: initial:
I FINAL INSPECTION APPROVED: Date: Irliti a*i: �4'As-built to Street File: E]
1,� PERMIT MUST BE PO STED ON J OB SITE 'L'�
White Copy: File Green Copy: Inspector Buff Copy: Applicant
L;temp;bldg;forms-,sspennitjlg4/00
!---'----' \
0
E.D,,,,_ ICITY OF EDMONDS SIDE SEWER AS- BUILT
HOMEOWNER
DATE
1/16/03
18815 88TH
DRAWN
BY 1. ABILA
AVE W
CONTRACTOR
HELLEREN
PERMIT
NO. 9698
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Cj-p(-6F EDMONDS
APPROVED BY PLANNING
STREET FILE
PL
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AT 40
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PLANNING DATA
SITE ADDRESS: I '6'B 197 - 13 5-P-4i Ave, vv PLAN CHK#: 02 —
PROJECT DESCRIPTION: " LA/
REDUCED SITE PLAN PROVIDED?( '(Y=es:DNo)
MAP PAGE: CORNER LOT: LYes o FLAG LOT?fj �e�sNo)
ZONING: 2� CRITICAL AREAS DETERMINATION #:
U Study Reguired:
OWalver
L3 Conditional Waiver
SEPA DETERMINATION: IVIA
Q Fee
L3 Checklist
L3 APO list w/ notarized form
LJ (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger)
-14empt cy'-t S
SETBACKS:
Required Setbacks: /
Street: 142 Left Side: Right Side:_ Rear:
Actual Setbacks:
Street: / 0 Left Side: Right Side: 30 Rear:
Street map checked for additional setback required? (Yes / No / DNA)
FEN ZDETACHED SIT CTURES:
ROCKERI :
/TRELLISES:
I
Y WINDOWS / PROJECTING MODULATION:
STAIRS / DECKS:
PARKING: Required:
LOT AREA:
1�
BUILDING HEIGHT: I
DatumPolnt: '!:�A+� _Datum
Maximum Allowed: 2-1�5 Actual
A.D.U. CREATED?AG5 Yes)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: (YM6
OTHER:
Plan Review BY: X--1 24 W,�"
-Z'� , /
1/3 1�
NOTICE:
No--War-raniy...ot
The information shown on the attached
iled for use by the City of
map(s) was coMP
Edmonds/ its Employees and Consultants.
Th.e CitY of *Edm.onds does not . warrant the
cy of anything set forth on these
accura
Map(�_). An . y person or e n.tity -requesting a
copy should conduct an independent
inquiry regarding the inform-ation shown on
ff�e -m a p (s), including, but not Hm'ted to, -h
th . e lociation of any sewer stub shown. Suc
sewer stubs may or may, not exist and may
at the location shown.
or may not exist
Neither the -'ity of Edmoind's, nor its
emp'foyee-s o-r office-rs -sh-a-I'l be 1--ja-b-Ife for the
this map(s), nor for
information g Ven on
any one representation provided based
upon said map(s).