20406 86TH PL W.PDFIIIIIIIIIIII
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20406 86TH PL W
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CITY OF EDMONDS LAURA M. HALL
MAYOR
7110 - 210TH ST. SW - EDMONDS, WA 98026 - (206) 771-0235 * FAX (206) 744-6047
COMMUNITY SERVICES DEPARTMENT — PUBLIC WORKS DIVISION
April 26, 1995
Mr. Monty McCaskill
20406 - 86th Pl. W.
Edmonds, WA 98026
Dear Mr. McCaskill:
I have reviewed your account and will allow a credit for the billing period of March in .
accordance with our City policy. The policy states that the customer will be billed at the
retail rate based upon the average water consumption for the same period during the
previous year. In addition, the excess water lost from the leak will be billed to customer at
the City's wholesale rate with a 15% surcharge added for administrative cost. Only one
leak credit will be granted in any three year period.
Should you have any additional questions after you receive your new billing, please
contact Ilene Larson, Utility Billing Clerk, at 771-0241.
Sincerely,
6L W,6-s
Ron Holland
Water/Sewer Supervisor
RH/lk
cc: Ilene Larson
Utility Billing Clerk
wordata\water\9422875
* Incorporoted August 11, 1890 0
Sister Cities International — Hekinan, Japan
Monty McCaskill
20406 86th Place W.
Edmonds, WA 98026
Mr. Ron Holland
Edmonds Utility
7110 210th St. SW
Edmonds, WA 98026
Re: Account Number 422875
Mr. Ho 1 land,
May 23, 1995
RECEIVED
MAY Z b 1993
PUBLIC WORKS DEp7
I respectfully request that my water bill be reviewed and
adjusted. In a recent phone conversation with Charles Day of the
Billing Department it was explained to me that this could be done.
He further explained to me that my normal average usuage was
between 24-29 units and asked if we had been using more water or if
we had experienced any leaks.
I explained to Mr. Day that during this usuage period we had
in fact had some plumbing problems. This was corrected by Mr.
Rooter Plumbing when they visited the residence to snake the
drainage line and give estimates on replacing the faucets in the
bath tub.
The plumber examined the piping system and discovered there
was a leak at the hot water heater. Since there is a drain
immediately under the water heater, I had no idea that I had been
having any problems. The plumber corrected the problem and also
explained that I should contact the appropriate water district.
We have resided in Edmonds for almost 10 years at this
residence and have never used this abnormal amount of water units.
Therefore, it would be greatly appreciated if you would review our
records and adjust if at all possible.
Thank you for your time and consideration.
Sincerely,
0�w';;/7-xi
00
M6nty'R. McCaskill
cc: Mr. Charles Day
NOTICE:
TV I �
.-. .-A /. ��
U - I
The information'shown on the attached
iled for use by the City Of
map(s) was cOMP
Edmondsl its Employees and Consultants.
Th..e City of 'Edm.oncis does not * warrant the
t forth on these
accuracy of anything se
Map(�-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the inform-ation shown on
-map(s), Including, but not limited t . o,
er stub shown. SUC
the lociation of any sew
sewer stubs may or may, not exist and may
at the location shown.
or may not exist
Neitheir the city of Edrno'nds nor its
ernpto-yee-s o-r office-rs -sh-a-1-1 be 11a-b-'Fe for the
n on this map(s), nor for
information give'
tation provided based
any one represen
upon said map(s).
r
CITY OF EDMONDS
CIVIC CENTER — WATER -SEWER DEPART3WNT Call PROSPect 6-1107 wben work
;s ready for inspection. (No Inspec-
SIDE SEWER PERMIT "Is Saturday, Sunday or holldays.) N? 3326
ADDRESS ----------- 2"Q!527 96111..RUce
OWNER ------_-------- PEcelia m.
........................ P9� ki
Permission is granted CONTRACTOR .............. Owner
ewers in a"Oldance W1 -- ------------- for
With MY S 22
go- v.- e--r- -n- 'i -n- g- ----- daYs to REPAIR CT
ATTENTION IS CALLED TO th application On file and- ordinances. or CO3ME a side sewer
NOTE T'lO* I —The owners o, THE FOLLOWING:
be employed to the Property may obtain a permit
construct side sewer in street area. Do nOt cover any Portion of sewer before It has been inspected.
NOTE N to construct sewer Inside Property line. A licensed Side
0- 2—obtain full information regarding Ordinance 11-16-03() and Regulations Sewer Contractor must
No bends in grade sharper than % governing side sewers when you get permit.
NOTE NO. 3—Top of side sewer must have at least 30 inches coverage at
NOTE No- —7renches In street che de property 1133e; minimum grade Of 27..
will be Permitted. Property line and 12 In s Ins,
t Must be water settled and surface Of street restored to original
failure due 0 Improper work which 'nay develop within one Year Of completion. condition' Contractors hall be responsible for
NOTE No. 5--It is unlawful to aJter or do any other work than is Provided for In the permit, or to do any work on the main sewer or Its appur-
) tenancl, eNcept to insert the Pipe Into the wye.
APPLICATION
for
The City of Edmonds STR FILE SEDE SEWER FERNaT EASEMENT No . .............
NEW CONSTRUCTION 0 REPAIRS
OWNER ............
ADDRESS . ......... U ................... ---------
9
CONTRACTOR........ .................................................................... PERMIT No.
LEGAL DESCRIPTION: LOT No . ............. . ............................... BLOCK No . ............................................
'to .. f
NAME OF ADDITION ........... T�� ..... . .......... C,.J-1 . . ......
fia e 7
C,2
,7
AP,PROVED
JUL 22'%g
Approved:
DATE ....... ----------- By ---
. . . ......... ------------
. ...... .... V� ...... ----------
low�ommmw W an"Wissilp" 40I.We
VETERANS ADMINISTRATION
1. CASE NO.
CERTISCATE OF REASONABLEA UE
LOAN GUARANTY SERVICE
2. THE REASONABLE VALUE OF THE PROPERTY HEREIN IDENTIFIED IS ESTABLISHED -AS SET FORTH HEREIN, THIS CERTIFICATE WILL REMAIN EFFECTIVE
AS TO ANY WRITTEN CONTRACT OF SALE ENTERED INTO BY AN ELIGiBLE'VETERAN WITHIN THE VALIDITY PERIOD INDICATED BELOW. THE
REASONABLE VALUE IS PREDICATED UPON COMPLETION OF THE NECESSARY REPAIRS ITEMIZED IN ITEM 10, OR COMPLETION OF PROPOSED
CONSTRUCTION AS PROVIDED IN ITEM 11, AND UPON SUCH OTHER, CONDITIONS RECITED BELOW AS MAY BE APPLICABLE.
3. ESTABLISHED REASONABLE VALUE OF
PROPERTY
4. AMOUNT OF REASONABLE VALUE
ALLOCATED TO LAND
5. EXPIRATION OF VALIDITY PERIOD
6. REMAINING ECONOMIC AIFE OF
PROPERTY IS ESTIMATED TO BE
NOT LESS THAN
it -be
la Ulm- 3P.-
tS
'YEA:
7. PROPIRTY ADDRESS I N.mb4, nd city, county. and State)
8. LEGAL DESCRIPTION (LIse rovc,u-, If necessary)
a* a awl of ft to pla of f1ft Rujol, 0 0" OW gusla
va, Co.$ I'm upooft SW M" %villuo,ourp"" 40rom :MAW
00 if so"It of dw a 20, *9 44 if ow, st $00, 11a
Moll
PLOf'SIZE, U* 5 IM t
9A. 'CONSTRUCTION (Check one)
(111�;�EXJSTING PROPERTY —PREVIOUSLY OCCUPIED (2),PROPOSID Odeni0 Plans ant!�, El _(�YEXISTIN40 PROPERTY — NOT PREVIOUSLY 4) ALTERATIONS,-,
(if (1) G') 0 IMPROVEMENTS.
checked, also chrA or In r
-Specifications and Otkc OCCUPIED (if check'd also
Item 9C) Pxhibiu) check (k) or (2) fit I'tL 9C) OR, REPAIRS
otma, ftt. 0194e, #48sit:4, *j t0k, 3,%fts6*'p as'..
U1104"ke st 01". boati K *000010, 51044us
�e
95. If (2) or (3) In Item 9A Is checked, list name of Inspector if compliance
NAME 00 COMPLIANCE INSPECTOR
Inspection Is to bo made by VA, Also list nnmo of warrantor.
7�
9C.'jH1 REASONABLE LUI ESTABLISHED HEREIN FOR Tilt RELATED PROPERTY IS (Check (1) a# (2))
III BASED UPON OBSERVATION OF THE PROPERTY IN ITS (2) PREDICATED UPON COMPLETION OF THE NECESSARY
"'AS
IS" CONDITION, REPAIRS REQUIRED IN ITEM 10.
(NOTEj-' The Vetetans Administration il—A rtm alsume any responsibility fw`th� condition of thi'L p ' roperty., The rorrec . t any defects now exisd I he 0i'that may,#Velop.�
will be the responsibility at th., pi,rrhasr.)
77.
9D. EQUIPMENT (Easily removable) Itons identified by asterisk (*) are not to be paid for from proceeds of the loan.
ITEM
VALLIE'�
ITEM
!�'VALUE
10., NECESSARY REPAIRS (U,,
MYA COMPLIANCE INSPECTIONS REQUIRED
Item 913.)
-(If checked, complete LENDER WILL, CERTIFY, TO SATISFACTORY COMPLETION
11�Proposed construction shall be ccnoleted in accordance with the plans and'ip'ecifications Identified in Items 9A and 9D above, relating to'boilit on-Sita.*and
"64-site improvements upon which this valuation is based and shall otherwise conform fully to the VA Minimum Property kequireffien' c , , "
_ts..
plailon, must be evidenced by either —
(A) VA final Compliance Inspection Report (VA Form 26-1839), or
�(:S,) YA acceptance of FHA Complianco Inspaction Reports (FHA Forms!205 or other':eVidenco of completion under FHA 's' ision 616"
�pery
to proposed construdion,
0 * STREET FILE
SNOHOMISH HEALTH DISTRICT
DIVISION OF SANITATION
3011 Rockefeller Avenue, Everett, Washington
APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT
(Submit 3 Copies)
Permit to be issued to: ......... L&) . ........... 7�4.2221ZJ�_ 1,1'
--------------------------------------------------- --_-------_-
For installation at: (street address) ------- .. . ....
-------------------------------- ......... -----------------
Addition or Subdivision ----------- ...... Lot ------------ --- Block. ---------------
Type of Building: New--)(-..,-- Existing ------------ Single family residence ------ Number of bedrooms..._,-?. _---_-----
Other: (specify type or use) ---------------------------------------------------------------------------------------------------------------------------------------------------------
Builder- ....... --- C,.� . . ..... Address—ZZ,-c ----- J-0-
-t 4,rL!-
Designer -------- Q -------- _1,a --Address .....
......... ........ 5 ... ...
Soil Log Hole No. 1.
........ Ty'/e .......... "a4z 'e
- -----------------------------------------------------------------------------
SoilLog Hole No 2 ---- - -------- ee Z!5� --- ------------ --'t --------------------------------------------------------- --------------------------------
-------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Elevation of Water Table, if encountered. (Distance from ground surface) - ----------- ......................... ..............
Corrections to control surface water if needed ---- ---------------------------------------------------
U, ----------------------------------------
........................................... I ............................................................................... -------------------------------------- ---------------------------------------
Specify if any removing or grading of topsoil in field area ... 12-1--;
....... rll_zl�
- 4-06
.......... --nl 4.-n. ........ ----------------------------------------------------------------------------------------------
Percolation:
Test Hole No. I —Average Rate _----------_---- d ... < ------------_------------- ----- (Fall in minutes/inch-bottom 6" test hole)
Test Hole No. 2—Average Rate ---------------- 7 ------------ ---------------------- (Fall in minutes/inch-bottom 6" test hole)
Test Hole No. 3—Average Rate ---------- _,4� ... ------------------------------------ .__ (Fall in minutes/inch-bottom 6" test hole)
Average percolation rate on which to base drain field design --------- --------- ------------------------
Septic tank requirements based on present rules and regulations:
Septic Tank Size_3__;._. --- W ---- ------------ gallons.
Amount of Square Feet of
Signature — Designer
)i osal Field .......
V---------------------------
e� Date ..... ----- --------
DO NOT WRITE BEW 7HIS LINE (To be completed by Issuing Agency)
Permit issued (date)/e --- J.--AZ3 ------ ----------- Permit Number .... 1-9`176 ----------------------
Remarks: .......... ---------------------------------------------------------------------------------
BROWK
i��PF ials 5-
4L.
-1 WOWS HOLLePMi
t4e?,$ G. '�P. +
20- +0
120.0 1
x,2 o. 0_'
CITY COPY
B U110 ING
AUG - 1 1997
HSIGHT D#IUM
-APPROVED BY PLANNING
e,'4,19 7
PLANNING DATA
NAME: (75B 9
SITE ADDRESS: Zo4o& f4tkpt 6-J, -DATE: 7/ 1� ��2 7
ZONING: S -I -z- PLAN CHK#: 97- 2-og
Igo dl "tA, W
PROJECT DESCRIPTION:
CORNERLOT /\FO (Yes/No)
SETBACKS:
Required Setbacks:
Front: ?-5' Left Side: 10' Right Side: I o Rear:
Actual Setbacks:
Front: 45' LeftSide: 10, RightSide:'7V Rear:
Street map checked for additional setback required? Iva - -eo,.�� (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED (Y/N)
LOT COVERAGE: 3,)
W7,
Maximum Allowed: -3 5v. Actual: I ?,� IV' 12- 4it
126-1c,4-11- 171�1
BUILDING HEIGHT:
Maximum Allowed: 2-5-, Actual Height:
Datum Point: MO Datum Elevation: loo,
Wj4o- co(cs wat na- k,,c f, Aej
0- 11-" -
A.D.U. CREATED?---:?
<j
SUBDIVISION:
CRITICALAREAS#: 97-? - [,)a. vv-
SEPA DETERMINATION:
LOT AREA: ps�� S�,-5 12,0 - (r, - W) (A)� no e&y,,o- ac,,�s �.r
OTHER: k F,4� e2q fmt em a24 tv-k- xye-i ru, A4-- A Aw-fl, S ,dv ,-1
ki-j c*�Vn
51-_� U01- 11-A 0�-' -#L OVA ft,�A-
Plan Review By:—
c:TJ1esNperrnit%1�P1andaLdoc
bal 2, #_Ile — . . "
L,,�-'14_ ;At
4111/ Or vr-k
.IW-W�7 (%Ipj - >Y� I s IlL
/0 A4
- k-vY) -,-# #I -
-", 11 � rfj ol
V-011 xy, -
('07 �� -xol2Pj
OG
S+4-G, - COO - cD I - 0:-�-c7
Ar CO 0 L L P-
zo
STREET FILE
r K I VAT r-- .. 1, D-R IN F-� I . PIC
N3i
fit
G I I E
P L
r r
L A
BUILMIN r.,
AUG -- 1 1397
HEIGHT- D#,7UM
APPROVED BY PLANNING
R—A PILL NU.
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetalCion)
I/ .,A� . i, /
I. Site Address/Location: �'Zll , 4 " 4",
2. Property Tax Account Number:
RECEIVED
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed?. es; _ no-, JAN 2 9 1997
If yes; how is site developed? itij�� �6,vrljv COMMUNITY SERVICES
.5. Describe the general site topography- Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a
horizontal distance of 6&feet).
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 30% present on site (a vertical rise of 10-feet over a
horizontal distance of less than 33-feet).
Other (please describe)-
6. Site contains areas of year-round standing water A/� Approx. Depth:
7. Site contains areas of seasonal standing water: /1/,\ Approx. Depth:
What season(s) of the year?
8. Site is in the floodway— 11�)— floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? ._ PLlli Flows are seasonal? (What time of year? Y
10. Site is primarily- forested Meadow _;shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site: j%J4�
—For City Staff Use Only
1. Site is Zoned? /2--
f
2. �CS mapped soil type(s)? 41,oaX-"=w t)eoft/ Lt� 2-19010
3. Wetland inventory or C.A. map indicates wetland present on site?
&I. :-,Critir-al Axeas inventory or C.A. map indicates Critical Area on site?
5. 'Site within' designated earth subsidence landslide hazard area?
6. Site aesipated on the Environmentally Sensitive Areas Map? Vo
DETERMINATION
��Y REOUIRED CONDITIONAL WAIVER
WAIVER'
Reviewed by:
Plainer
& t DA
Rev 0 1/0094
op
go -I o
City of Edmon&
0
Critical Areas Checklist
The Critical Areas Checklist contained on
this form is to be filled Out by, any person
preparing a Development Permit
Application for the City of Edmonds prior
to his/her submittal of a development
permit to the City.
The purpose of the Checklist is to enable
City staff to determine whether any
potential Critical Areas are or may be
present on the subject property. The
information needed to complete the
Checklist should beeasily available fro*m
observations of the site or data availableat
City Hall (Critical Areas inventories, maps,
Or Wil surveys).
An applicant, or his/her representative,
must fill out the checklist, sign and date it,
0
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
development permit application.
With a signedcopy of this form, the
applicant should also submit a vicinity map
or plot plan for indivFd—ual lots of the parcel
with enough detail that City staff can find
and identify the subject parcel(s). in
addition, the applicant shall include
other.pedinent 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.
I
I have completed the attached Critical Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner I Applicant: Applicant Representative:
Name
Name �F—
itreet Address �treet Address L
LI-L
City, State, Zip
Phone City, State, ZIP Phone
Signature
Date gignature t e
OVERLOOK.' PK r�15 on_LL Sw c�
71 Fir
165M I
185TIl 9
PL SW
Sw
iluTT IB71H I TH ST w
PK ST
'N tBITH PL SW Iw
i88TH w —3
1140
S! sio
Id4 LIP
5w .0 1
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KE P ST Sw (SURM
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7 1 192ND
Z; 10 41 60TH 1,
4
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1— PL ST Co
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197
DR
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MELODY LN
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BROoKil c ------- ---
19911L I
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_17
B KETTS ASP R ST ST
RAC VISLA 200TH
LANDJUG—
I CA' ACE LN
ju 201§T
_]CASCI _ I
BEACH _FN SIERRA �T' ow 20?ND 20211U 1`1 W
ST SW
wy rL 5- �1\
Ali- 2.31RW-D' 11
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MAPLE
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10
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W LNUT 1000 =+
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WILDLIFE 20 PRUCE S 2 41H.EL pl.
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SANCTuARY —�o T
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1 (5146)
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1 4 0% 6 00
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700 HILLS (5067)
00 3:
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PLAT ef 01 02
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2071h PL. S.W. a
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ON L AN, F (A ?0v
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0110'65 1 01 la WA os
I 1 0 1 01
ST S.W (MAIN ST)
f— 7 s 8 -�84
24.6
Garage
Carport
14 �o r)
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49-
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BD
BD
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242
20-&l Garage
""I Carport
49
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t. & 7DR KIT 3a&
24B
LR
BD BD
24,5'
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SCALE: 1 inch= I
BUILDING DEPAIMMENT Applicant Fill
PERMIT APPLICATION Inside Heavy Lines
NAME (OR NAME OF BUSINESS)
W Mr. and Mrs. Vikelis
W MAILING ADDRESS
Z
3: 2o4o6=86th Pl. W.
0 CITY 98020 ELEPHONE NUMBER
Edmonds, Wa 9A00 IT ?78-1?89 -
I- Ole M. Dropping
U
W ADDRESS
i 16821 - 52nd Ave. W C
U
2
M CITY
TELEPHONE NUMBER
Lynnwood,Wa 98036
?43-7816
NAME
Ole M. Dropping
0 ADDRESS
I..
U 16821 - 2nd Ave. W. C
5
2
<
X CITY
I-
TELEPHONE NUMBEW
Z
0 Lynnwood, Wa 98036
743-7816
U STATE LICENSE NUMBER
CITY LICENSE NUMBE'
223-0lPS-AL-,Iakj AC-3M
'Legal Description of Property (Show Below or Attach Four Copies
West 1201 of East 240'; Bleek 099 69-
Z CV- Lo-r --* 1
2 Pine Ridge Addition; Edmonds, Snohomish
'U County, Wa.
J
W
Ask
USE W PERMIT
ZON Efy I -), NUMBER
ADDRESS 0
LEGAL LOT LdVft<REA 4,Sd5DIVISI0N NO.
El NO M�C--,> swys; HA-f
STREET R/W
EXISTING STREET R/W FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W O/A- FT. 0 FT.
REMARKS
BY
STREET AND/OR UTILITY WORK R/W PERMIT REQUIREb
REQ'D. 0 YES C: 1 0 YES ;�-O
WIRING REQ'D.
0 YES X - 0
TYPE CONNECTION
ES
VERIFIED BY
SANITARY SEWER
C1 NO
I 'fu
SEPTIC SYSTEM
YE
RMIT NU
APPV*D BY CITY ENG.
NO
RE?JARKS
No q,N 0
--ro Doc. -
METER SIZE
I BUILDING SUPPLY SIZE
SIGN AREA SNV. REVIEW
ALLOWED I PROPOSED I COMPLETE I EXEMPT
REMARKS
ADB NO.
VARIANCE OR CU
PLANNING REVIEW BY
DATE
GAS IIIIIIIIIa
NEW RESIDENTIAL LINE
YARDS FRONT SIDE REARI
LOT COVERAGE
FIRE ZONE
TYPE OF CONSTRUCTION
NON-RESIDENTIAL SIGN
ADD 111:1
DEMOLISH RETAINING
1:1 WALL
ALTER EXCAVATE FENCE
OR FILL I— X—FT)
REPAIR PRE -MOVE swim
INSP. POOL
1
ICODE
SPECIAL INSPECTOR
REQUIRED
C3 YES 1:1 N 0
AREA
OCCUPANCY OCCUPAN-1
GROUP LOAD
1 1
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
NUMBER OF STORIES
NUMBER OF
REMARKS
DWELLING
UNITS None
NATURE OF WORK TO BE DONE
Building new garage
PLAN CHECK
VALUATION,
FEE
PROPOSED USE
Z
2 parking cars
NO.___
PLOT —PLAN I&DICATE BUILDING SETBACKS,
r
ABUTTING STREETS)
M
BUILDING
U
0 Contract and description of work
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attached
PLUMBING
HEAT & GAS LINE
0
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
I hereby acknowledge that I have read this application; that the in. TOTAL AMOUNT DUE
formation given is correct; and that I am the owner, or the duly author-
APPLICATION APPROVAL
ized agent of the owner. I agree to comply with city and state laws regu- ATTENTION
lating construction; and in doing the work authorized thereby, no person
will be employed in violation of the Labor Code of the State of Washington THIS PERMIT
relating to Workmen's Compensation Insurance. AUTHORIZES
NOTE. Permit Limit One Year(Except DEMOLITIONS and FILL ONLYTHE
PERMITS wqjhQujjconditionaI use permit, which shall be completed in 90 WORK NOTED
ays; 9VED-IN BUNDINGS shall be cbmpleted in six months.)
P I G N A U E (0 W );Z R VOR N T) DATE SIGNED INSPECTION
DEPARTMENT
This application is not a permit
until signed by the Budding Official or
his Deputy; and fees are paid, and
receipt is acknowledged in space pro-
vided.
DIRECTOR'S SIGNATURE
XIE,3
CITY OF
EDMONDS
DATE
NOTE. Applicant Subject to Plan aeck Fee 775-2525
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This Permit covers work to be done on private property ONLY.
. Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
ORIGINAL - File YELLOW - Inspector
GOLD - Assessor PINK - Owner
CITY OF EDMONDS -,
CONSTRUCTION PERMIT APPLICATION
OWFER NA_MEINAMEOF BUSINESS
(on /I
MAILING ADDRESS
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41p"lfENUMBER
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< CITY ZIP TELEPHONE NUMBER
NAM
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7-6w 3 (3 1 fl:,Ip- 1, 51,
ZIP TELEPHONE NUMBER
913 5 5
1A 6
Z 78270
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STATE LICENSE NUMBER , EXPIRATION DATE
M A,5-rA e_.�A v - j - N
Legal Description of Property - include all easements
n
Property
Tax Account
Parcel No.
1:1 NEW [R(si�IECH
COMPLIANCE OR
19 E]
ADDITION COMMERCIAL CHANGE OF USE
EIREMODEL Ej APT. BLDG.
SiG4, i
GRADING FENCE
REPAIR — CYOS. I x —FT)
WOODSTOVE SWIM POOL
DEMOLISH F� INSERT
HOT TUB/SPA
GARAGE RETAINING WALL/
1:1
CA ROCKERY RENEWAL
(TYPE OF List BUSINIMSJORAFTIVITY) EXPLAIN:
NUMBER NUMBER OF CRITIC
OF DWELLING AREAS
STORIES UNITS NUMBE
DESCRIBE WffK TO BE DONE (ATTACIP PLOT PtAN)
USE
ZONE Z PERMIT
NUMBER 971
JOB
ADDRESS --IT— r-51
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCIP APProved
0
EXISTING - REOUIRED DF
1
RW Permit Re quired
Street Use Permit Req'd
0
0
Inspection Required
. Sidewalk Required
13
0
PROPOSED
IMETER SIZE
LINE SIZE
I NO. OF FIXTURES
PRV REOUIRED
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14
YES 0 NO 0
DATED REVIEWED
VARIANCE OR CU
SEPA REVIEW -
COMPLETE I EXEMPT
EXP
LOT COVERAGE
ALLOWED I PROPOSED
1417.
LOT AREAO
1Z 490
By
ADBV.-� SHORELINE
SIGN AREA HEIGHT
ALLOWED I PROPOSED ALLOWED 1PROPOSED.
IEOUI RED SETBACKS (FT.) PROPOSEQ SETBACKS (FT.)
FRONT SIDE REAR FRONT URSIDE REAR
zt:;, Iv. 7_91 +5, 6,5 Z'
710
PLANNING JIEVIEW BY: DATE
OUIRE LOAD
I __r__ JOCCUPAIT I
PROGRESS INSPECTIONS PER USC 108
FINAL INSPECTION REQUIRED
VALUATION FEE
PLAN CHECK FEE
6L!L BUILDING
HEAT SOURCE: GLAZING
IN)
PLUMBING
I
Plan Check No. qj- — zo�)
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewpiks,
STATE SUIRCHAR&
driveways, marquees, etc.) will require separate permission.
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
ENG. INSPECTION FEE
successors in interest., agrees to indemnify, defend and hold
20
harmless the City� of Edmonds, Washington,' its officials,
m
employees, and agents from any and all claims forfdaMag!es of
a:
whatever nature, arising directly or indirectly from- y t6els6uance
of this permit. Issuance of this permit shall not be d44med to
PLAN CHECK DEPOSIT
modify, waive or reduce any requirement of any city ordinance
TOTAL AMOUNT DUE
0
norl . imit In any way the City's ability to -enforce any ordinance
provision."
I hereby acknowledge that I have read this application; that the
in
information given is correct; and that I am ' the owner,/�Or the duly.
ATTENTION
authorized agent of the owner. I agree to comply with city and
state laws regulating construction; and In doing the work authoriz-
THIS PERMIT
AUTHORIZES
ed - thereby, no person will be employed In violation of the Labor
ONLY THE
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
tion Insurance aria FICIN 18.27.
INSPECTION
SIGNATURE JOWNER OR AGENT) E SIGNED
DEPARTMENT
F
CITY OF OF
EDMONDS i
ATTENTION'
CALL FOR RE
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR -STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
-
7711",Q22 0
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC,
SECTION 109
i
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his/her
Deputy; and fees are paid, and receipt is
acknowledged in space provided.
IGINAL File �E[ LOW — Inspector
PINK — Owner GOLD — Assessor *