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By order...' uilding Official for the
44,
0 'Edmonds
All Persons', -Are Ordered to
U
-Pursuant, to Section 202(d) of the Uniforn-i l3luildini.I!, Code the Building Official,10t4the
City of Ednionds hereby orders all work to STOP at the, site listed below.,'., -
A#%
Addres
For the following feason(s):
ADA A#AW#%JDPAVr1-.`,,
Ak
A7r
WARNING
The failure to stop work, or (lie
resuming of work Without �'p-ermis-
sion from the Building �Official,,
or the renioval,7mutilation, or
punishable by fine a I nd imprison-
ment.,
.r
N 0 IT
TO PERAMHMTTEE -tET FILE
El PARTIAL AP�ROVAL
PE�'VIOLATION
CORRECTIONS REQUIRED
PERMIT
NUMBER
IJOB ADDRESS 0 6 7— a — '76 c,) I
NO PERMIT - STOP WORK - REMOVE CONSTRUCTION OR OBTAIN
PERMIT AND MAKE WORK COMPLY WITH BUILDING LAWS.
CONSTRUCTION IS NOT IN ACCORDANCE WITH APPROVED PLANS
AND PERMIT - STOP WORK. MAKE EXISTING WORK COMPLY WITH
APPROVED PLANS AND PERMIT OR REMOVE IT.
0 STOP WORK - UNTIL AUTHORIZED TO CONTINUE BY INSPECTOR.
CORRECTIONS LISTED BELOW MUST BE MADE BEFORE WORK CAN
BE APPROVED.
0 WORK DESCRIBED BELOW HAS BEEN INSPECTED AND IS APPROVED.
CONTACT INSPECTOR AND El RECALL FOR INSPECTION.
ARRANGE FOR APPOINTMENT.
rl N
THE ACTIONS OR CORRECTIONS INDICATED ABOVE ARE REQUIRED WITHIN
DAYS OR PENALTIES IMPOSED BY LAW MAY BE APPLIED.
FOR INSPECTIONS CALL: 771-3202
j, BUILDING DIV.
4fQfPECTOR El PUBLIC WORKS
CITY OF DATE FIRE DEPT.
EDMONDS
090-194-
City of Efton&
Critical Areas Checklist
The Critical. Areas Checklist contained on
this form is to be filled out by any person
prepanng a P�yelopvmt Permit
iiAetrty of Edmondsprior
Asiher, stib&-' itta"l, 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 can find
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 I Applicant:
RM W, a- =� a K -t 00-110 W- FI-I 11�'
(a /o EItyr
Street Addrm
State, ZIP Phone
Age "-- Stu
5i7ature Dee
Applicant Representative:
6'.0c) K-1xiv,
Street Address
CA FILE NO.
S'f IL%ritical Areas Che'c'kfist
Site Information (soils/topography/hydrology/vegetation)
I . Site Address/Location: SQ(cZo AyoAue-' &)P-bt t5:jW1e,"C4-
2. Property Tax Account Number: (o 0 go - oo -4- - C) / o
3. Approximate Site Size (acres or square feet): 'Z 24[1)0 sg, 4RZ4
4. Is this site currently developed? / yes; — no. U
If yes; how is site developed? 412-6-A A=LA��s
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
horizontal distance of 66-feet). ro& F*Efr ?*ILE
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-f6et).
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: 0-10, Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway ri o floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? VU0 Flows are seasonal? _ (What time of year?
10. Site is primarily: forested meadow _; shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wedand is present on site: V�Z
RevOlION94 '
CA FILE NO.
STREET FILFritical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site AddressALocation: '2-6(az-o AiAanye
2. Property Tax Account. Number; & o oo - oo 7- - 0 / 0':�-
3. Approximate Site Size (acres or square feet): -s-7. IeC4
4. Is this site currently developed? /yes;_no. U
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
>4, — 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: Approx. Depth:
7. Site contains areas of.seasonal standing water: Approx. Depth:
What season(s) of the year?
8. 1 Site is in the floodway ri o floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? VI-0 Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site: V10
RevO11004
690 -199-
City of Edmon&
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 Edmondsprior
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 win
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 can find
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'
coglunction with this Checklist to assist
staff in completing thew 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:
WAR MEZ1,11111111,
RM `
6/0 F-'Jn-V SLY
Street Address
State, ZIP Phone
ignattire Date
Applicant Representative;
L-AI-"r->PL-A't'4 P.S.
Name
(000
Shied Address
PITT
WAA-�, Ize
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Iflo COX
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City of Edmonds
Plan Review Corrections
Project Name 47-�q
rOMAY- 7— Date
1113190
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Reviewer Ael Aumm4 77/--30�� Department
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go - 19
CITY OF EDMONDS
250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771-3202
COMMUNITY SERVICES:
Public Works * Planning * Parks and Recreation * Engineering
November 29, 1990
Eddy Chu
504 NW 163rd Street
Seattle, WA 98177
Re: Cedar Stone Apartments
Mr. Chu
LARRY S. NALIGHTEN
MAYOR
PETER E. HAHN
DIRECTOR
On August 28, 1990 Your applied for a building permit at my request
after remodeling the roof of the Cedar Stone Apartments at 20620
76th Street in the City of Edmonds without the necessary permits.
On September 131, 1990 1 return the Plans with a request for
corrections. To date You have not responded to the request for
corrections on Your Plans. I should remind you this work is already
complete and a permit has not been issued as required by section
301 (a) of the Uniform Building Code as adopted by the Edmonds
Community D evelopment Code.
I have enclosed a copy of the original request for Your review and
response. I must have Your response so we can complete the permit
application and issue the necessary permit for the work You have
completed. Please responded to MY Office By December 10 with
corrected Plans. If no response is received by the deadline I have
established above, I will forward Your file to the City Attorn's
Office for. citation for violation Of the
Development Code. Edmonds Community
I You have any question about this
at 771-3202 action feel free to contact me
Richard R. Mumma
Building Official
City of Edmonds
CC: City Attorney
enclosure: COPY Of Plan correction from 9/13/90
Chu.rrm
0 Incorporated August 11, 1890 o
Sister Cities International — Hekinan, Japan
M E M 0 R A N D U M
DT: December 11, 1990
TO: Kate Healey, City Attorney's Office
FM: Dick Mumma, Building Official
SB: Cedar Stone Apartments
I have had no luck trying to secure a permit for work done at the
Cedar Stone Apartments at 20620 76th W. in Edmonds. I received a
call on August 23, 1990 from a tenant, complaining of a leaking
roof. The work to the roof was completed without a permit. The
plans submitted do not reflect a design that is in compliance with
the building code. I would like Mr. Chu to be cited for building
.....-without the required permits. I have included a history of events
and a copy of the files.
My records reflect the following events took place at the Cedar
Stone Apartments.
8/23 - Received a call from a tenant of the Cedar Stone
complaining roofer were working on the roof. The apartments
were all flooded and the roofers were now installing 'new
sheathing and roofing over wet insulation.
8/24 - Second call received from tenant of the Cedar Stone.
When were we going to do something about the roof?
8-27 - Jerry Saterlie posted a Violation Notice requesting the
contractor/ owner apply for the necessary permits to remodel
the roof. Contractor drew a sketch on site to explain the
extent of remodel. Jerry required building application with
plans. Work was 95% complete.
8-28 - Eddy Chu, building owner, submits building permit
application with plans.
9/13 - I reviewed plans and return to Mr. Chu for correction.
Review of plans revealed the proposed design was not in
compliance with current code.
9/27 - Mr. Chu called for info about additional requirements
on plans. Mr. Chu asked f or my FAX number. He was going to
send revised plans to me. I also when over the requirements
for overflow scuppers.
11/29 - A letter was sent to Mr. Chu setting a dead line of
December 10 for Mr. Chu to return the corrected plans.
�C%Ty 0
CITY of EDMONDS BUS SS qrFF
+45&N _6PPLICATION
wrl DA*�
Civic Center - Edmonds, Washingt
City Clerk Phone 775-2525 on 9 LICENSE NO.
P TYPE OF BUSINESS ANNUAL FEE
4STR UCTIVqVkfET Ir
YEAR
LIC. EFFEC. DATE
IREASG. LIC� NO.JSPEC.
Dif. Ot PubliclWorks.
/A (A) HOME OCCUPATION $15.00
AFTER FEB. 15
$ 22.50
Lj (B) OUSINESSWITH $20.00 $ 30.00
All items wesi ted
0.,
DATE PAID
A� 1 0 3 EMPLOYEES
or application will not be ac-
PRINTPX'
S EC. BOX
0 (c) BUSINESSWITH
4 TO 9 EMPLOYEES
$22.00 $ 33.00
cepted.
FOR ISSUE OF
Sign and return application
FEE PAID
PENALTY PAI
I
CORRECTED
LICENSE WITH
0 (D) BUSINESSWITH10
OR MORE EMPLOYEES
$75.00 $112.50
with fee. Renewals received
'LC' ACTION.
after February 15 must pay
7, -J - e, � NEWAPPLICATION (LA)
penalty in addition to fee.
0 RENEWAL
(LB)
NEW BUSINESSES AFTER
0 CHANGE
(LC)
JULY 31, 1/2 FEE.
(PLEASE MAKE ANY NECESSARY CHANGES) 0 DELETE
(LD)
NAME OF FIRM
BUSINESS PHONE
NO.
OF EMPLOYEES
---�6CWIL
-) -.) (() -- /,�56 3
o/
MAILING ADDRESS
NATURE OF BUSINESS
-7-
C 0
BUSINESS ADDRESS 7 C)
INDIVIDUAL
PARTNERSHIP
CORPORATION
c�-O --- --2 A u
(S)
(P)
(C)
OWNERS NAME
HOME ADDRESS
f� c-. D. -P,� TTE 11.5 k)
-T
1;�(-)
131 U L0
/)7 0 A,1,0 S
HOMEPHONE
-7 -�
ATE OF BIRTH
PLACE OF BIRTH
SOCIAL SECURITY NUMBER
�, - 5
5
61& -2S90
EMERGENCY NOTIFICATION (1) NAME&TELEPHONE — I
-7
0
(PLEASE LIST TWO) (2) NAME& TELEPHONE
W 7/
WASHINGTON STATE TAX NO. APPLICANT'S SIGNATURE�--J 6-CILLJ-7. (/d I'tZtt7�JC2-�
DO NOT WRITE BELOW THIS LINE
STAFF REVIEW: FILL IN LAND USE CODE, LIFIR NUMBERS, ZONING. ETC. CHECK APPROVAL OR DISAPPROVAL, DATE, AND
SIGN. IF DISAPPROVAL, PLEASE COMPLETE "COMMENT" SECTION. ROUTE TO NEXT DEPARTMENT ON LIST.
PLANNING DEPARTMENT DAT LAND USE CODE ZONING CODE
tK- APPRO . VE ID DISAPPROVE SIGNATURE
CONDITIONAL USE PERMIT
COMMENTS EM E=
BUI DING DEPARTMENT DATE 16 -F) I
PP
ROVE 0 DISAPPROVE
SIGNATURE
COMMENTS:
CAPACITY: (NO. UNITS, APTS. OFFICES, SEATS, BEDS, STUDENTS)
Building
0
Hotel/Motel
(L)
Permit 0
11:1= EJ
Apt. Bldg.
Office Bldg.
(A)
(0)
Occupancy
0
Restaurant
(R)
Group
0
Hosp/Nurs Home
(H)
0
School
(S)
FIRE DEPARTMENT DATE q( U. F. 1. R.
gr APPROVE 0 DISAPPROVE SIGNATURE E:0�7/ ��
COMMENTS:
POL!�-,E DEPARTMENT
t?'A-PPROVE 0 DISAPPROVE DATE SIGNATURE
COMMENTS:
PUBLIC WORKS DEPARTMENT
e--
0 APPROVE' 0 DISAPPROVE DATE SIGNATURE
MMENTS:
PLEASE RETURN TO CITY CLERK
CITY OF EDMONDS air
CONSTRUCTION PERMIT APPLICATION
OWNER N E/NAME BUSINESS
IX: . ()-.( /7 a
-
UJ MAILING -ADDRESS
Z
3: 14
0 1504 0 Vj I - 5-r
CITY ZIP TELEPHONE NUMBER
NAME
W
Cr
NAME
ADDRESS
ZIP
C-09yLat-K)
NUMBER
CITY ZIP TELEPHONE NUMBER
Z
STATE LICENSE NUMBER
EMEA 14("k 0
Legal Description of Property - include all easements
Z (show below or attach two copies)
2
-710
W
Tax Account Parcel No.
ElNEW RESIDENTIAL E] PLUMBING
ADDIALTER COMMERCIA T CHANICAL
REPAIR APT. BLDG. V\ ( SIGN
EXCAVATE, FILL FENCE
DEMOLISH OR GRADE (_X
CARPORT
REMODEL GARAGE roo,%
WOOD STOVE/ E] RETAINING Wpkrl�
INSERT ROCKERY I)NEWAL
Z
0 (TYPE OF USE, BUSINESS OR ACTIVITY) EXeLAIK:
PERMIT
NUMBER
JOB SU ITEIAPT I
ADDRESS 76 LJ
WLEGAL DESCRIPTION CHECKI SUBDIVISION 00. ' _FL I ToN 0.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAD. TESCP
EXISTING — REQUIRED DEDICATION APPROVED BY
PROPOSED
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED D
STREET USE PERMIT REQUIRED 0
SEE ENGINEERING MEMO DATED REVIEW BY
REMARKS
METER SIZE IBUILDING SUPPLY SIZE
REMARKS
FIXTURE UNITS
SIGN AREA ENV. REVIEW
ALLOWED I PROPOSED I COMPLETE I EXEMPT
0
Z
cr
W
W
Z
a
Z
U.1
Cc
VARIANCE OR CU PLANNING REVIEW BY DATE
I F&yVr_W 1 0
SETBACKS — FEET HEIGHT I LOT COVERAGE Z
Z
FRONT SIDE REAR
REMARKS
rkv
06
CHECKED BY TYPE OF CONSTRUCTION ICODE I HEIGHT
kS SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT
P
REQUIRED GROUP LOAD
I S 0 NO
E YE KS
P 0 Z
PROGRESS INSPECTIONS PER UBC 305
CO NUMBER OF STORIES NU ' OF
OL
Uj
0 -BRELLIRIG
ca I UNITS (0
9 NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN) I
FINAL INSPECTION REQUIRED
VALUATION F
PLAN CHECK FEE
BUILDING
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewalks,
STATE SURCHARGE
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work is Started Within 180 Days
"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,
m
employees, and agents from any and all claims for damages of
a:
<
whatever nature, arising directly or indirectly from the issuance
M
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
0
modify,,waive or reduce any requirement of any city ordinance
0
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 the duly
ATTENTION
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
ed thereby, no person will be employed in violation of the Labor
ONLY THE
Code ofqje State cj Washington relating to Workmen's Compensa-
WORK NOTED
tion.-Insu.UDnce. I P-%
I NSPECTION
SIGNATUR (0 N SIGNED
DEPARTMENT
AG PN JOATE
Ovo
CITY OF
'EDMONDS
mirm"
ATTENTION
CALL FOR
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
771-3202
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
102-87
I ///-P- N,
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his
Deputy; and fees are paid, and receipt is
acknowledged in space provided.
OFFICIAL'S SIGNATURE DATE
RELEASED BY:
DATE
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
DATE RECEIVED
OD
PERMIT EXPIRES
USE PERMIT
CITY OF EDMONDS ZONE NUMBER 9,90 76.3
JOB SUITE/APT#
7CONSTRUCTION PERMIT APPLICATION ADDRESS --V�
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OWNER NAME/NAME OF BUSINESS G�j
r_&�_ 10 Xle !Z� I-" 4C PLAT NAM E/SU BDIVI SION NO. LOT NO. LID NO.
cc MAILING ADDRESS LID FEE $
W TIESCP Approved 0
z PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required 0
3:r
0 ��062,a Zn- A we_ Street Use Permit Req'd 0
CITY ZIP TELEPHONE EXISTING — PROPOSED Inspection Required 0
Sidewalk Required 0
Underground
REOUI RED DEDICATION — FT
be�4 Wiring required 0
NAME METER SIZE LINE SIZE OF FIXTURES PRV REQUIRED
t- YES 0 NO 0
0 M
W
ADDRESS REMARKS z
z
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE a
z
M
CITY ZIP, TELEPHONE
NAME
ENGINEERING REVIEWED/DATE
ADDRESS
cC FIRE REVIEWED BY DATE W
l' CITY TELEPHONE !E
z LL
0
0
C , 0 A oc 7,z f 5,1
16, CU SHORELINE ORA B# INSPECT;
STATE LICENSE NUMBER EXPIRATION DATE CHE�KED BY Vj . ) /NJ BOND
)tl I REO No P STE
0 YES
-7 KT I aw �t III
1�; (1) ( A W SIGN AREA HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMP ALLOWED f PROPOSED ALLOWED ,PROPOSED
-P - c)
s EXP N -
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
n NEW RESIDENTIAL C1 PLUMBING MECH ALLOWED PROPOSED FRONT DE REAR FRONT UISIDE REAR
o COMPLIANCE OR z
ADDITION COMMERCIAL 'AA 1 10 N A E
CHANGE OF USE — z
PARKING LOT IREA I Pap "IEWED BY DATE
REMODEL ?RTMENT EJ SIGN REO'D I VID
14 , ",'_00_ /V (px d2llqq
REPAIR E] GRADING CYDS 0 FENCE X FT) REMARKS
�(OE R
f DEMOLISH C3 TANK
Z o GARAGE ROETAIEFING WALL RENEWAL
0 CARPORT R CK ly PI . A
P (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
6HECKEDBY ITYPqCOSTRUCTION COPE: OCCUPANT
M
0 GROUP
NUMBER NUMBER OF CRITICAL V
OF WELLING AREAS SPECIAL INSPECTOR JAREA OCCUPANT
NITS _ /0 NUMBER REQUIRED[] YES LOAD
o STORIES
DESCRIBE WORK TO BE DON&—.-
0 REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D
-S 7; 7t 0 0
C VALUATION FEE
PLAN CHECK FEE 4: z1b
I -
E GLAZING % LOT SLOPE % BUILDING 00 C)
NO: VESTED DATE PLUMBING
n --7
9
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE GRADING/FILL
SEPARATE PERMISSION.
t STATE SURCHARGE
M PERMIT APPLICATION: 180 DAYS
W
PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
"APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS ENG. INSPECTION FEE
0
uj IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
_j LANDSCAPING
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND INSPECTION FEE
M ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
It RECEIPT
x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT
DEEMEDTO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANYWAYTHE CITY'SABILITYTO ENFORCE ANYORDINANCE PROVISION.- t
TOTAL AMOUNT DUE RECEIPT
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 APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL Building Official or his/her Deputy: and Fees are paid. and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
I -
SIGNATURE (OWNER 0 1 AGE . N DATE SIGNED (425) OFF SIGPNJA 1. URE DATE
0
.e" /0 -, I 4A -101�,7qllf
51 20 'RELEAS BY DAT
771-02
ATTENTION EXT 333 2-
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 7/
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 771-0221 . . . . . . ORIGINAL - FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR
5/98
.C111,44 < 771oV.C!'
'1�
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Cr
I
ZONE PERMIT
CITY OF EDMONDS I NUMBER
CONSTRUCTION PERMIT APPLICATION nice
ADDRE55 7
OWNER NAME NAME OF BUSINESS . I -
NAmE
S-640-0— Ill PHRI Ir RIr.HT OF WAY PER OFFICIAL STREET MAP.
ZIP TELEPHONE NUMBER
EXISTING — REOUIRED DEDICATION
9 4 14 PROPOSED
. I V\ -'s �
0 1 '414M - 4�1 -.5 2-
rr ADDRESS
0
CZ CITY
ZIP
E NUMBER
i'_
Z
T'
0
STATE LICENSE NUMBER
EXPIRATION DATE
Legal Description of Property - include all easements
Z
T
_j
'u Property
Tax Account
Parcel No.
El
NEW
RESIDENTIAL
PLUMBING
ADDITION
COMMERCI AL
MECHANICAL
APT. BLDG.
El
REMODEL
SIGN
F�
GRADING
F NCE
WYCL
REPAIR
— CYOS.
x AJLFT)
WOODSTOVE
r_�ftllo'sec
WIM PO L h4
DEMOLISH
INSERT
I I HOT TUB/ P
GARAGE
RETAINING WALL/
CARPORT
ROCKERY
RENEWAL
Z
0 (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
NUMBER NUMBER OF CRITICAL ' '
OF DWELLING AREAS ZM_ .
STORIES UNITS 10 1 NUMBER
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
METER SIZE LINE SIZE I NO. OF FIXTUi
ENGINEfRING MEMO DATED
9 4 0;� 44,
SUITE,APT
I- - F-A " 12_,4 A
TESCIP Approved 13
RW Permit Required 0
Street Use Permit Req'd E3
inspection Required 0
Sidewalk Required C3
M
W
PRV REOUIRED
YES 0 NO 0
cc
W
uj
I
%..
Z
w
SIGN AREA SEPA REVIEW
ALLOWED PROPOSED COMPLETE EXEMPT
EXP I
Pl,A"ING REVIEW BY
WRIANCE OR CU
SETBACKS — FEET HEIGHT I LOT
FRONT SIDE REAR I
ECKED BY TYPE OF Cc
REVIEWED BY
ADS NO.
IV/,
Z
SPECIAL INSPECTOR
OCCUPANT
REOUIRED 13 YES
[AHLA
LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC 305 Z
a e k- (o Al e. em / 0.4 1 oL rD,+ fA If r3i i Qw&
P-eAA CXM_-1k, +0 TA 64
FINAL INSPECTION
REQUIRED
VALUATION
FEE
PLAN CHECK FEE
BUILDING
HEAT SOURCE:
GLAZING
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY,
Any construction on the public domain (curbs, sidewpiks,
driveways, marquees, etc.) will require separate permission.
GRADINGIFILL
STATE SURCHARGE
STORM DRAINAGE FEE
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
2 harmless the City of Edmonds, Washington, Its officials,
f
m 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
0 modify, waive or reduce any requirement of any city ordinance
hbr limit in any way the City's ability to enforce any ordinance
provision."
ENG. INSPECTION FEE
MIM7
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
1
il 6 1 A 6k # I k A #kI 11 41 ok # *k
"wreuy ac now a ge a —.0. 0 OFF �= V"! a W
information given is correct; and that I am the owner, or this duly
ATTENTION
APPLICATION APPROVAL
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
T his application is not a permit until
state laws regulating construction; and In doing the work authoriz-
AUTHORIZES
THE
.
signed by the Building Official or his/her
ed thereby, no person will be employed in violation of the Labor
Code of the Stat�,of`V9_as'I7M9 relating to Workmen's Compensa-
ONLY
WORK NOTED
Deputy; and fees are paid, and receipt is
tion Insurance apd RCW 18.27�Kll
INSPECTION
acknowledged in space provided.
SIG ORE !9.VyNjRR OR AGENT.1� ATE SIGNED
DEPARTMENT
CITY OF
DATE
L
EDMONDS
J46kSIGNATURE
1 - 0
CALL FOR
ELEAS�15'Etn DATL
p
ATTENTION
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220
ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
PINK — Owner GOLD — Assessor
102-87