20605 MAPLEWOOD DR.PDF11111111111111
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20605 MAPLEWOOD
DR
November 15, 1995
Mr. James Walker
City of Edmonds
Engineering Department
250 5th Avenue North
Edmonds, WA 98020
RE: Entrance to M.J. Thompson—
,_(20605 Maplewood).,, � roperty from 88th Ave. W.
Dear Jim:
We are applying for a waiver for the maximum roadway slope at the above
location. Through the L. I. D. process the owner of the property was given the
opportunity to access her property.from 88th Avenue West. This opportunity is
made practical with a waiver of the standard maximum slope of 15% to 20% for
a limited distance.
Your consideration in this matter is appreciated
Sincerely,
John W. Mellor, P.E.
11-03-1995 13:34 1 206 340 4337 MERRILL LYNCH-SEATTLE
MAPLEWOOD DRIVE (14TH AVENUE
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LO TE END OF PIPE W/2*x6" POST
SEE RETAINING WALL SECTION
XTEND E6TING SIDE SEWER.��6 ON SHEET 6 FOR TYPICAL
AP.&�QCATE END OF PIPE WALXWAY SEC nON
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DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
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5. VENTILATION
A. There are openable windows in each room.
See drawing.
c. Bathrooms & laundry room have fansof the
required size.
d. Kitchen has more than the required s.,�.'ze fan.
6. HEAT
The living room, bedroom 'and the bathroom each have
a baseboard electric heater with controls for heat.
See vents in living room, bathroom & bedroom.
Mary Jane Thompson
20605 Maplewood Drive
ADU - 2000-68
File #00-414
RECEWED
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
I Jj
At��ssory Dwelli.ng Unit Inspection Items
ROOMS
1. a. Over ;-00sq. ft.
b. Over 150 sq.ft.
c. Qver.7ft.
Ceiling height 7 ft. 7"
e.
f. Not applicable
g. Main rooms each have an outside door
h. 36" wide at toilet - 5.,ft. in front
i. Hot & cold water, 30" in front of refrigerator
more than 5' in front of stove
Outsi de steps - handrail - 36"'above steps
k. Not applicable
SMOKE., DeAect$pl n
bedroom
2., b. in living room
c. 2 smoke detectors no.basement
1 3. EMERGENCY ESCAPE
boors in e-ach.big room.open directly to the outside.
4. NATURAL LIGHT
a. Bedroom- 5'10' X 3'4" is more than 1/10th
-of floor area
m 5' X 3'7" plus 2'1" X CC is more
Living roo
DATE
September 25, 2000
City of Edmonds,
PLAN REVIEW COMMENTS
BUILDING DIVISION
TO: Mary Jane Thompson
20605 Maplewood Drive
Edmonds, WA 98026
FROM: Tricia Bennon, Plans Examiner
RE: File #00-414
Site Address: 20605 Maplewood Drive
Owner: Thompson
During review of the plans for the above noted projects, it was found that the following
information, corrections, or clarifications are needed.
I . Provide window sizes (height and width) for all windows to verify natural light and
ventilation requirements.
2. Provide a 50-cfin (minimum) exhaust fan in the bathroom. U2.Z.,
3. Indicate location of thermostat. Note: Eachunitmustb e provided with it's own thermostat
to control heat.
4. Show location of hot water heater.
Please resubmit 2 copies of revised plans/documents and written responses to corrections to a
Development Services Coordinator.
Thank you.
REECEEIvEt)
OCT 0 4 2,29
DEVELOPMENT SERVIC ES CTR.
CITY OF EDMONDS
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City of Edmonds
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 be easily available from
observations of the site or data available at
City Hall (Critical Areas inventories, maps,
or soil surveys).
An applicant, or his/her representative,
must fill out the checklist, sign and date it,
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 signed copy of this form, the
applicant should also submit a vicinity map
or plot plan for individual lots of the parcel
with enough detail that City staff canfind
and identify the subject parcel(s). In
addition, the applicant shall include
other pertinent 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 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 / Applicant:
p ppip,
o
Street Address
Applicant Representative:
Name
Street Address
City, State, ZIP Phone City, State. ZIP Phone
atur��
Signature
Date
RECEIVED
NOV 1 4 1994
CA FILE NO._2Y:,..:2, /7_
Critical Areas Checklist
PLANNINU*** DEPT.
Site Information (soils/topography/hydrology/vegetation)
1. Site' Address/Location: -f
2. Property Tax Account Number: 6-0 6 ;7,00-1 - -4 -!P, 8 - e2
3. Approximate Site Size (acres or square feet): 0 0 6 5?59-
4. Is this site currently developed? i---yes;—no. If
If yes; how is site developed?
5. Describe the general site topography. Check a4at 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 66-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: )t-o ; Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? Flows are seasonal? - — (What time of year?
10. Site is primarily: forested - - meadow ' A_�, ; shrubs
mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
For City Staff Use Only
I 'Site is Zoned? AS 12- ......
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p soil type(s)? Ln/l. i�:4 .7
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.3..-. Wetland inventory or C. A. map indicates wetland present on site?
4., CniiticAl Areas inventory or C.A. map indicates Critical Area on site? Ali
:5. - Site within designated earth subsidence landslide hazard area?
6. Site desi.,nated on the Environmentally Sensitive Areas Malp A/O
DETERMINATION
STUDY -REQUIRED
y WAIVER
:Reviewed by:
PWner
CONDITIONAL WAIVER
— I r- F�-
Date
R� OWZQ/93
APPLICATION
for
The City of Edmonds SIDE SEWER PERAHT EASEMENT No . ..........................................
NEW CONSTRUCTION g3l" REPAIRS C] cii:�)
...................... S-6-L ..... .. . . ........ PERM
LU OWNER Ciq .01A) ........ C-A ....... —Ft� --- 4.1 5-0-t-j ............ CONTRACTOR ...... C>15 ............ i T No.4 Q4� .......
ADDRESS ..... (15.� ......... ��WOOD QA21 .. LEGAL DESCRIPTION: LOT N, . ...... 7��.� ....... ............. BLOCK No . ............................................
...................................... ..
NAME OF ADDITION .... .............
..............................................
4
13d
0 0
Approved:
A PIP' R 0 V E D.
8-,L,-'P - 2 9 1969
DATE................................................ By ............
CITY OF EDMONDS
CIVIC CENTER — WATER -SEWER DEPARTMENT
SIDE SEWER PERMIT
Call ]FROSPect 6-IL107 when work
is ready for inspection. (No hupee.
tiOns Sn"U'dS I Y, Sunday or holidays.) N2 3480
ADDRESS ------------------- 2,Q-6..().5 .. ----- MaP_J_P_w_ood__1)r_ive
-------------------------------------------
OWNER ....................... Calvin C. Thompson
----------------- .................. - -------------------------------- CONTRACTOR ............ QA��qdq 5�g3j�gXa
..........................
Peri.pission is granted ------------- ��P.t._29 69
- ----- ................ 19 ......... for --------------- - ------- days to REPAIR or CONNECT a side sewer
with City. Sewers in accordance with application on file and governing ordinances.
ATTENTION IS CALL D TO THE FOLLOWING:
NOTE No.'I—Tbe owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must
be employed to construct side sewer in street area. Do not cover any Portion of sewer before it has been inspected.
NOTE No" 2—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE; No. 3—Top of side sewer must have at least 30 inches coverage at Property line and 12 inches inside Property line; minimum grade of 2%.
No bends in grade sharper than % will he permitted.
NOTE No. 4—Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for
failure due to improper work which may develop within one year of completion.
NOTE; No. 5--It is unlawful to alter or do any other work than is provided for in the Permit, or to do any work on the main sewer or i ts appur-
tenances except to insert the pipe into the wye.
RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
MAILING ADDRES§
CITY ZIP JTELEPHONE
1P 7
NAME
ADDRESS
CITY
N.AME
ZIP I TELEPHONE
cc ADDRESS
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l'- CITY ZIP TELEPHONE
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0
0
STATE LICENSE NUMBER EXPIRATIONDATE I CHECKEDBY
PROPERTY TAX ACCOUNT PARCEL NO.
NEW
RESIDENTIAL
ADDITION
E] COMMERCIAL
REMODEL
APARTMENT
0 REPAIR
GRADING CYDS
M DEMOLISH
TANK
EjGARAGE
CARPORT
ROETAINING WALL
R CX.RY
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
'1___4
NUMBER
NUMBER OF
OF
DWELLING
STORIES
UNITS
DESCRIBE WORK TO BE DONE
0
PLUMBING / MECH
COMPLIANCE OR
CHANGE OF USE
SIGN
FENCE
1W]
PERMIT EXPIRES f�, 5/c/
USE PERMIT
ZONE
NUMBER
JOB SUITE/APT#
ADDRESS��
PLAT NAM E/SU BDIVI SION NO.
LOY NO.
LID NO.
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved 0
RW Permit Required 0
Street Use Permrt Req'd 0
EXISTING — PROPOSED
Inspection Required 0
Sidewatk Required C3
=erground
REQUIRED DEDICATION— FT
Wiring required
METER SIZE
LINE SIZE
NO. OF FIXTURES
PAV REQUIRED
YES 0 NO 1:1
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REMARKS
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OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
0
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ENGINEERING REVIEWED/DATE
FIRE REVIEWED BY DATE
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VARIANCE OR CU
SHORELINE OR ADB#
INSPECTION
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I PBOND
OSTED
YES flo
SEPA REVIEW
SIGN AREA
_ H E18 HT
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWED PROPOSED
(XIS-t7il
EXP
LOT COVERAGE
REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT UR SIDE REAR
32:
'e"V151?n"�
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"PARKING
aOT AREA
PLANNING REVIEWED BY DATE
REQ'D [PROVIDED
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( X FT)
Ej OTHER
r)-,. P7 -r�
RENEWAL L,/, I
CRITICAL
AREAS
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HEAT SOURCE , I GLAZING % LOT SLOPE %
1�:_ LCC_�VX(A I
PLAN CHECK NO: IVESTED DATE
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK To
t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
.j SEPARATE PERMISSION.
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PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
U)
;APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
N INTEREST, AGREES TO NDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
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ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
_j DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
01 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.*
x
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS� REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED -
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
SIGNATURE (OWNER OR AGENT) DA:T SIGNED
A17ENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
5/98
CHECKEDBY I TYPE OF CONSTRUCTION CPPE OCCUPANT
U GROUP —,7
SPECIAL INSPECTOR JAREA OCCUPANT
REQUIRED[:] YES LOAD
REMARKS
PROGRESS INSPECTIONS PER LIBC 108/FINAL INSPECTION REQ'Dj
Ih4 I Afe7i i 1 0 11 ly tin Am
VALUATION
FEE
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
GRADING/FILL
.
7
Sz"SURCHARGE
0
ky', - V I -CM
"efl&.-RE"EW AES
4
ENG. INSPECTION FEE
LANDSCAPING
INSPECTION FEE
PLAN CHECK DEPOSIT
RECEIPT I
RECEIPT
TOTAL AMOUNT DUE
APPLICATION APPROVAL
CALL
This application is not
a permit until signed by the
Building Official or his1her Deputy: and Fees are paid. and
FOR INSPECTION receipt is acknowledged in space provided.
OF IALS SIGNATURE
DATE
(425)
�5
771-0220
RELEASED BY
DATE
EXT 333
4
771-0221,�
FAX
ORIGIPAL- FILE
PINK - iOWNER
YELLOW - INSPECTO�
GOLD - ASSESSOR
CITY OF EDMONDS.
SINGLE FAMILY/DUPLEX COVER SHEET
Directions: Applicants are to complete the Information In the WHITE BOXES ONLY (Shaded boxes are for City
use only). This cover Sheaf must accompany each building permit application for a now single-family
residence.
PROJECT ADDRESS Z;Cb6 n-'�7 323e42:&jAASn-l1 E� —4-
PROPERTY TAX ACCOUNT PARCEL #
DESCRIPTION OF WORK
OWNER PHONE 1-1 -17 9T
CONTACT PERSON PHONE 1
E-MAIL
MAILING ADDRESS
1:1 FAX CORRECTIONS MAIL CORRECTIONS E-MAIL CORRECTIONS
Y SIGNING THIS STATEMENT I UNDERSTAND THAT I AM THE CONTACT PERSON FOR THIS PROJECT. IT Is MY
ESPONSIBILITY TO COORDINATE ALL SUBMITTALS WITH THE CITY AND ONLY I CAN MAKE INOUIRIES ON THE
BY A TUB OF THE APPLICATION. I UNDERSTAND IT 15 MY RESPONSIBILITY TO DETERMINE IN ADVANCE OF PERMIT
S U a M I T TAL ANY DISCRETIONARY PERMITS THAT MAY BE APPLICABLE TO THIS PROJECT. I ACKNOWLEDGE
THAT TO T HE BEST OF MY As LIT F:VETI=IVTTAEPID ALL NECESSARY DOCUMENTATION IN ORDER TO MAKE A
I
COMPLETE APPLICATION AND No FIE IEGUIRED.
SIGNATUR _=LS ARE I ATE
ZONING INF MATION
ZC — i2==-- LOT AREA
NUMBER OF DWELLINd.UNITS' EXISTING ;W— DEMOLISHED PROPOSED
DISCRETIONARY APPROVALS CA Determination
SUBDIVISION CU VARIANCE— SHORELINE
SEPA_ Expires OTHER
City Use Only
LOT COVERAGE INFORMATION
EXISTING SF PROPOSED SF— TOTAL SF 1% .
HEIGHT CALCULATION INFORMATION
DATUM ..A 8 C.: D
AVE MAX. ''ACTUAL
SETBACK INFORMATION
REQUIRED FRONT SIDE
SI6E' 10 REAR
PROPOSED FRONT_ ey- sio.c. REAR
SAN 10 FLAG:LOT Y O..S
-ES f." I)EDIC. YES
ADU STATEMENf REOUI ES []HO Ri6bRIDING IS
jFF COMMENTS: . ".eol-7— vie-4-e- ' meed 41�:rallo'
e, A155. :fjled� "Xcr-Apo 2gLae'l -
ENGINEERING INFORMATION
DRIVEWAY SLOPE % GRADING CYDS
EASEMENTS
EXISTING IMPERVIOUS AREA CONSTRUCTED BEFORE 1977 SO.FT
EXISTING IMPERVIOUS AREA INSTALLED 1977 OR LATER SO.FT.
PROPOSED NEW NET IMPERVIOUS SURFACE
City Use Only
SIDEWALK REQUIRED []YES [:]NO DRAINAGE PLAN REQUIRED [-]YES [:]NO
UNDERGROUND WIRING REQUIRED [-]YFS [:]NO
STREET DEDICATION F T. LID#
STAFF COMMENTS:
SPECIAL INSPECTIONS REOUIRED FOR THIS PROJECT (City Use Only)
SOILS, STRUCTURAL,
DSTART OF WORK OPLACEMENT OF REINFORCEMENT
DEXCAVATION & GRADING [:]PLACEMENT OF CONCRETE
OSHORING INSTALLATION & MONITORING [:]BOLTS INSTALLED IN CONCRETE
[3PROOF ROLLING [IS . T.RUCTURAL MASONRY .
EIPLACEMENf OF FILL & CO . MPACTION [--]STRUCTURAL STEEL ERECTION
0SUBSURFACE DRAINAGE [:]HIGH STRENGTH BOLTING
[:]YERIFY SOIL BEARING [-]WELDING (WASO CERTIFIED ONLY)
1:1 PILE. PLACEMENT DOTHER
OEROSION CONTROL
EIGENERAL SITE MONIT ORING BY THE
GEOTECHNICAL ENGINEER OF RECORD
DGENERAL SITE MONITORING BY THE
GEOTECHNICAL ENGINEER OF RECORD
DURING WET WEATHER CONSTRUCTION
1114AL GRADING & FIELD REPORT
EDOTHER
PLAN CIIIECK III &I—L-
"PILICALN ----12Z I a -
DATE RECEIVED D
BUILDING CONSTRUCTION INFORMATION
CODE EDITIONS 1997 UBC, UMC, UPC, WSEC, VIAO WITH AMENDMENTS
DESIGN CRITERIA WIND EXPOSURE 8 WIND SPEED 60 MPH SEISMIC ZONE 3
Floor Live Load Rool SnowILIve Load Balcony Live Load
Floor Dead Load Roof Dead Load Balcony Dead Load_
NUMBER OF STORIES BASEMENTS_ FLOOD ZONE_
LOT SLOPE % — SOILS REPORT PROVIDED [] YES 13 NO
FLOOR AREA (MEASURED TO EXTERIOR FACE OF EXTERIOR WALL)
Existing Proposed Total
Living SPSC8
Uarage
Carport
Dock/Covered Porch
Other —
ENERGY CODE COMPLIANCE INFORMATION
FUFL TYPE GAS. OIL [] ELECTRIC
FORCED AIR [:]HEAT PUMP
ENERGY CODE METHOD OF COMPLIANCE
1:1 PRESCRIPTIVE: List Option I----
11 OTHER
11HYDRONIC [3 OTHER
0 TARGETUA APPROACH: Provide UACalcuations
11 SYSTEMS ANALYSIS: Provide Computer Analysis
ENERGYIVENTILATION WORKSHEETS PROVIDED
WINDOW SCHEDULE PROVIDED
FOR CITY USE ONLY
Calling Insulation
Wall Insulation —
Floor Insulation
Door U-Valus
Window U-Value
Skylight U-Volue
Glazing %
VENTILATION CODE COMPLIANCE INFORMATION
KITCHEN FAN CFM_. BATHROOM FAN(S) CFM_ LAUNDRY FAN CFM
WHOLE HOIIqF VENTILATION SYSTEM
0 EXHAUST OPTION
FRESH AIR TO BE PROVIDED TO 11 WINDOW VENTS DWALL PORTS
EACH HABITABLE ROOM WITH:
EXHAUST FAN TO BE CONTROLLED WITH 24 HOUR TIMER AND SIZED AS FOLLOWS:
1:1 1 - 2 BEDROOMS: 50 - 75 CFM 11 4 BEDROOMS: 100 - 150 CFM
El 3 BEDROOMS: 00 - 120 CFM El 5 BEDROOMS: 120-180 CFM
E] NVAC INTEGRATED OPTION
DEDICATED HEAT RECOVERY VENTILATION OPTION
SEPARATE PERMITS (City Use Only)
E]RIGHT OF WAY CONSTRUCTION PERMIT OMECHANICAL PERMIT
[DENCROACHMENT PERMIT E]PLUMBING PERMIT
0STATE ELECTRICAL PERMIT EIWATER METER
OFENCE PERMIT 0SIDE SEWER PERMIT
DRESIDENTIAL FIRE SPRINKLER PERMIT 13IRRIGATION (SPRINKLER SYSTEM)
OOTHER_ OTHER
Any request lot modification, variance or other administrative deviation (herinafter *variance")
must be specifically called out and Identified. Approval of any plat or plan containing provisions
which do not comply with the City Code and for which a variance has not be on 6 pacifically
identified, requested and Considered by the appropriate city official In accordance with the
appropriate provision of city code of state law does not approve any Items not to code
specification.
PERMIT ISSUANCE APPROVALS
PLANNING REVIEW & APPROVAL___
CONDITIONS OF APPROVAL:
(City Use Only)
DATE_
ENGINEERING REVIEW st APPROVAL
CONDITIONS OF APPROVAL:
DATE
BUILDING REVIEW & APPROVAL 0
CONDITI�JS OF APPROV
E;�, �
DATE
6;N
4 W/U M
CITY OF EDMONDS
USE
PERMIT
NUMBER
CONSTRUCTION PERMIT APPLICATION
joB SUITE/APT #
ADDRESS
C>(
OWNER NAME/NAME OF BUSINESS.
LEGAL DESCRIPTION CHECKI
SUBDIVISION/NO.
LID NO,
MAILING ADDRE
Z
10, L Z, &
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCP Approved 11
RW Permit Required 11
4� r;
d, 0
CITY ZIP
TELEPHONE NUMBER
C)
EXISTING —REQUIRED DEDICATION
Street Use Permit Req'd 13
PROPOSED
Inspection Required 0
Sidewalk Required 0
NAME
cc
METER SIZE
LINE SIZE
NO. OF FIXTURES
W
PRV REQUIRED
YESO NOO
UL)j ADDRESS
REMARKS
Z
CITY ZIP
TELEPHONE NUMBER
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NAME
T6
cc ADDRESS W—A
ENGINEERING MEMO DATED REVIEWED �By
2 L4 q S7�'_ 3 5 fq 0 F_ _S LIJ
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CITY ZIP
TELEPHONE NUMBER
'&IaL
-'D �_3 7 -3 F
�IRE MEMO DATED REVIEWED BY
cr
STATE LICENSE NUMBER EXPIRATPN YAT5
"i C, U) 0111 4
VARIANCE OR CU
ADB#
SHORELINE #.
Legal Description of Property - include all easements
SEPA REVIEW
SIGN AREA
HEIGHT .
L r.. C L 1� j�06
Z C, IT- i Q /u
COMPLETE EXEMPT
EXP
ALLOWED: I PROPOSED
ALLOWED I PROPOSED
cL _� - - C) (� - L o +
0
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V)
LOT COVERAGE
REQUIRED SETBACKS (Fr.)
PROPOSED SETBACKS (Fr.)
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ALLOWED PROPOSED
FRONT SIDE REAR
FRONT UR SIDE REAR 0
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Z
2
Z
Lu
'j Pr9perly
Tax Account
C) _0
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LOT AREA
PLANNING REVIEW BY
DATE
Parcel No. C?.. 0
REMARKS
NEW RESIDENTIAL PLUMBINGIMECH
COMPLIANCE OR
ADDITION COMMERCIAL CHANGE OF USE
APT. BLDG.
REMODEL SIGN
CHECKED BY
TYPE OF CO.NSTRUCTION C
OCCUPANT
GROUN
GRADING FENCE
REPAIR CYDS. I x _FT)
E] WOODSTOVE SWIM POOL
DE" INSERT HOT TUB/SPA
SPECIAL INSPECTOR
OCCUPANT
REQUIRED [3 YES
LOAD
GARAGE RETAINING WALL/
CARPORT 1:1 El RENEWAL
REMARKS
0
PROGRESS INSPECTIONS PER UBC 108 Z
ROCKEAY
Z
0 (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
8 NU MBER
u j
IUMBER OF
U M
CRITICAL Cl,k VJ)
0 OF
L NG
TDE L I
' L
AREAS
INUMBER
ST RIES
U N IT
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
Ns
t
FINAL INSPECTION REQUIRED
C�
VALUATION
FEE
1j
PLAN CHECK FEE
BUILDING
HEAT SOURCE:
GLAZING
I
BING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADING/FILL
Any Construction on the public domain (curbs, sidewelks,
STATE SURCHARGE
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
w successors in interest, agrees to indemnify, defend and hold
'Wn harmless the City of Edmonds, Washington, its officials,
m employees, and agents from any and all claims for damages of
cc whatever nature, arising directly or indirectly frorrit the issuance
4
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
TOTAL AMOUNT DUE
0
x nor limit in any way -the City's ability to enforce any ordinance
provision."
I hereby acknowledge that I have read this application; that�the
information given is`dorrect; and that:l am the owner, or the U1
authorized agent"Of -thed"er. I -agr6ie to'comply with city aund*',
ATTENTION APPLICATION APPROVAL
state laws regulating construction; and In doing the work authorizP
'in
THIS PERMIT
AUTHORIZES This application is not a permit until
ed thereby, no person will be employed violation'of the Labor
ONLY THE §ighed by the'guilding Official or his/her
'
Code of the State of Washington relating to Workmen's Comptinsa-
WORK NOTED Deputy; and fees are paid, and receipt is
tion Insurance aria RCW 18.27.
INS'PECTION adknowiedge!�in space provided.
SIGNATURE (OWNER OR AGENT) PATE SIGNED
DEPARTMENT
OFFI 'S SIGNATURE
CITY OF C IPL DATE
EDMONDS
ATTENTION
CALL FOR RELEASED BY: DATE
INSPECTION
IT IS UNLAWFUL TO USE 0 ROCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220 ORIGINAL — File YELLOW Inspect 01
.A CERTIFICATE OF , OCCUPANCY HAS BEEN GRANTED, UBC
SECTION 109
PINK — Owner GOLD Assessor