21100 PIONEER WAY.PDF1111111111 lill
12830
21100 PIONEER
WAY
CITY OF EDMONDS
Z"NEW
ADDITION
RETIREMENT
ASSET INFORMATION SHEET
STREET FILE
ASSET NO.
ADDITION TO ASSET NO.
DESCRIPTION
SERIAL NO.
LOCATION
z
ml
PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
FA
PROJECT NUMBER
PROJECT COMPLETION DATE
COST
B.A.R.S. ACCOUNT NO. 3///
ESTIMATED LIFE
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
Y'DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
G.L. ENTRY
REFERENCE
wp) INITIAL
DATE
VERIFIED BY
PROCESSED
BATCH NO. -
DEPARTMENT FILE
-;S-
oo
CD
-0
a)
Of
CITY -of. EDMONDS 89C91YED Sm� S EV E R P E R-M�l T
For Inspection Call 771-3202 TPEWL Er -0 7 6' 01
MAY 2 01988
Address of Construction:' 2zz figar. WnRNP/0 , 1
Property Legal Description (Include all easements):
01(?6
Owner and/or Builder:
Contractor & License No:
.1
Single Family Residence'
EDMONDS
Multi-F'amily (No. of Un I its TREATME'NT PLANT
Commercial (No. of fixture Units
Invasion into City Right -of -Way: No '1� Yes — (If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No Y Yes — (If Yes.' easement required,
attach legal description and count�yeasement number.)
PLEASE R AD- HE ITEMS LISTED ON,THE BACK
I cert'ifyt�61- 1,\hav� rQ�A and shal'I comply
with the items listed on%e back.
Permit Fee:
�0.
Trunk Charge: 7S.00
Assessment Fee:
Issued By:
Date Issued: h .7 A
Receipt No.:, C�-'/
/41,01t
Date '
Partial Inspection:
Comments Date Initial
Final Inspection Approved:
Date- Initial
Rejected:
Reason —ffa-- -!—nitial
te
PERMIT MUST BE POSTED ON JOB SITE
Wh.ite Copy File Green Copy -'Inspector ..,BU.ff Copy.- Applican
T�e City of Edmonds Side Sewer Drawing
EASEMENT NO - --------------------------------
NEW CONSTRUCTION REPAIRS LID NO - ------------------ ASMT. NO. ---- -------------
OWNER------------------------------------------------------------------------------------------------ CONTRACTOR ... ......... ........................... PERMIT NO.
JOB ADDRESS - ------- - W- - lk-� �- ------------ LEGAL DESCRIPTION: LOT NO. --------------------- ...... BLOCK NO - ------------------------- - ---------
- - I
? � 'D \,� �- F, -�,
PWW-0001-11175 (REV.11/78)
.............................................................................................................................................
NAMEOF ADDITION ..................................................................................................
f
vk Approved:
DATE ............... By
0 i\i
TRwATMENT '?LA147
STANDARD DRAINAGE PLAN
C ATCH 5 A,5 I VA:
Am5 Im I S-30 (0 IL
WOUAL)
1% k.
TKCr4Cw Lorwra-rH
TI!
-nc.WTUWK- LCvg'L. Tlk=NCJ4
4!?EPLF CAP
TZE w/ 4"Low. LEGS
- SYSTEM CROSS—SECTION
MIRAff I SOOX
"-V kj I V L_ L"--i—
TC ISFF_� L/,YED �
COVER
3/4*— WASMED
GRAVE I
,4�01AM FERF P
2
TRENCH CROSS—SECTION
INFILTRATION SYSTEM
PAGE I OF 2
for /Jel-o'n
JT
location ieL
plan by
phone -
date__.j7_/_-2
NOTES
1. Call Engineering Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the responsibility
of the property owner(s). Preventive
maintenance consists of preventing
soil and other materials from'ente,ring
trench during construction as well as
after construction. Catch basins should
be cleaned of floating material and
sediment at regular intervals (at least
twice p r ar).
)AX
CITY OF EDMOND
AL
-T7--7"--- -
a
�4.f
"os st
ao
"ek >
eel
�p
SITE PLAN, SCALE:
NOTE: DO NOT USE INFILTRATION SYSTEM
ON SLOPES OVER 15 PERCENT (15
FOOT RISE PER 100 FEET HORIZONTAL)
,0/0-10 ,�
7"eS
�?064 overk"�,.s "k ;-4 "
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE 2 OF 2
Ak a ,
USE MWPERMIT
CITY 0 EDMUNDS ZONEAS __8 NUMBERSTREET FILE
CONSTRUCTION PERMIT APPLICATION JOB
NAME (OR NAME OF BUSINESS) ADDRESS AMY
ne L,C, 5 -tr Lx-- a a 4:2, LEGAL DESCRIP N CHECISUBDIVISION NO. LID N07,
cc
MAILING ADDRESS
CITY TELEPHONE NUMBER PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
7 EXISTING REQUIRED DEDICATION
NAME PROPOSED
cc
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED 11-� W
W
(LU) ADDRESS STREET USE PERMIT REQUIRED 0 Z
Z
SEE ENGINEERING MEMO DATED LU
cc
CITY TELEPHONE NUMBER 0 -f 7
REMA
NAME
Cr ADDRESS
0 (.0
METER SIZE BUILDING SUPPLY SIZE RE UNITS
0 -
CITY TELEPHONE NUMBER
17
Z .5,.
0 . e"A') 5-s�/.0 - -3 f6" -t"" REMARKS
STATE LICENSE NUMBER
, 0, /-=, /_ 4 A) 4 f 2 Y�l SIGN AREA ENV. REVIEW ADS NO.
Legal Description of Property - Include all easements ALLOWED PROPOSED COMPLETE EXEMPT
(show below or attach four copies) SHORELINE 0
Z
2
VARIANCE OR CU PLANNING REVIEW BY DATE
L)
Z6 44 C
W
0 1 _0
YARDS HEIGHT LOT COVERAGE i
Z
Xvz--,, 46�
FRONT SIDE HEAR Z
REMARKS
NEW RESIDENTIAL 0 PLUMBING
ADDIALTER COMMERCIAL HANICAL
1:1 REPAIR
CHECKED BY TYPE OF CONSTRUCTION ICODE HEIGHT
DEMOLISH x _FT)
V NX6 -
REMODEL SPECIAL INSPECTOR AREA OCCUPAN" OCCUPANT
REQUIRED GROUP 7_�' 73 LOAD
WOOD STOVE I V 0 YES ONO
INSERT REMARKS
Z
I(MIlL rjy 7&4 P a
& SUJ_ ffi�,,_c4jeU y
NUMBER OF STORIES /!Pelt
0 NATURE OF W K DOr4E-(AT' rACH PLOT PLAN)
VALUATION FEE
X-In e, e-
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
1IMZ22!=!2!!M
This Permit covers work to be done on private property ONLY. GRADINGIFILL
Any construction on the public domain (curbs, sidewalks,
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
(n successors in Interest, agrees to indemnify, defend and hold
26 harmless the City of Edmonds, Washington, its officials,
m employees, and agents from any and all claims for damages of
M:
< whatever nature, arising directly or Indirectly from the issuance
of this permit. Issuance of. this permit Shall not be deemed to PLAN CHECK DEPOSIT 90
0 modify,.walve or reduce any requirement of any city ordinance
x 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 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
Code of the State of Washington relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is
tign_lnsurpnce.. INSPECTION acknowledged in space provided.
SIGNATURE (OWNER OR AGENT) DATE SIGNED DEPARTMENT
CITY OF OFFICIAL's SIGNATURE DATE
EDMONDS
771-3202 RELEASED BY: DATE
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3. PINK — Owner GOLD — Assessor
102-78
PROJECT HAW PRaMT ADDRESS:
Devip 6)1V5) .2110D
APPLICATION RECEIPT DATE: IS 7-
Reviewed by:,(initial/date)
COMMENTS
PLANNING
WrR/SwR STREET ENGNRNG
FIRE .
SINGLE FAMILY/KILTIPLE/CCMMERCIAL - (Circle One)
SETBACKS CIMCKED - Planning
VARIANCE/SE'ITAACK ADJ�
BUILDING:
/777_77177
77777777.
77/777777
7T777T
CONDITIONAL USE PERMIT
2
ADB REQUIREMENTS CHECKED
7777/7
'7T
3
7T/77
ITR7
1711111111
OTHER ZONING REQUIREMENTS
4
ENVIRONMENTAL FE ATURES
5 -
ACCESS SLOPE & VEHICLE ACCESS
TR77TIlT
DRAINAGE PLAN (On Site)
/////////
7
u u
77777T777777777
777777T/7
S111EET FILE
8-
LEGAL DESCRIPTION VFRIFICATION
9
777T1T17TTffff[111
QUIT CTAIM/DFDICATIONS
10
/77777777
EAS04DM - PUBLTC/PRIVATE '770
7777Z[
MT11111
CALCMTE SrLWER CONNECTION IF NO LID#
//////
/////////
12,
pjAT/SUBDrVISION REQUIREMENTS
7TTRI
13
7TI777TIT
H111111111�
RIC-JIT-OF-WAY CONSTRUCTION PERMIT REQ0
14
BOND REQD FOR PUBLIC IMPROVEMEMS
15
SOILS CONDITIMS & GROUND
WATER FIETD CIfECKED -
77777777
///I/�
I
16
STREET PAVING REQUIRED
1777T71W
f777U777
/////////
4--.4000"
4�77
17
CURB AND af= REQUIRED
T"111111
_71177777
18
SI DEWALX REQUIRED
777777
//////
77TF17Tff
/////////
/////////
-
19
.
MRB CLTr FOR DRIVEWAY REOD
STREET NAME SIGN REQD
//77/7
-177TR
177777
P\
7777777777
20
21
777777T77
7777771-7
OMER SIGNING RECO
//////
- - - __
22
777777
"f11111
-
SIDE SEWER AVAILABILITY
23
EXISTING WM MAIN SIZE Or—j�sl
VATER METER SIZE
=77/77
24
25
-
SERVICE LINE SIZE a
T177-
TlTfR77T
11171111
777/777T/7
26
177171111
71111111
77TR77777
HYDRANT REQUIRED
HYDRANT SIZE EXISTING
_11-77T
5A
IT1771-1111
27
—
28
117TF
CROSS CONNSCTION INSPOCTION REQD
VaTER METER CHAJM REM
-177TI-1111
29
30
1111771171
FIRE'LINE CHARGE REQD - SPRINKLER
31
STREET CUr
32
11177T
77-1111111
OPEN D17t3i EXISTING
33
REM
34
CMIVERT. RMD
3�
SIZE
36
CATCH BASIN REQD
37
INDICATED ON SITE PLAN
38
SHOULDER DRAINAGE MAINTAM
SHALE OPEN RUNOF?
J77111111
39
MISC:
40
REVIEWED BY s
PLANNING MGR. MGINEERING MGR. PUBLIC,/MRKS MM.
MEMO TO: Building Division
FROM: Engineering Division
SUBJECT:
After review of the subject building permit application, we have the
following comments:
1) Connection to City water system required.
2) Connection to City sanitary sewer system required.
3) Right-of-way permit required for any work on City property.
4) Driveway slope not to exceed 14%.
5) Back water valve required if downstairs plumbing is below
elevation of upstream manhole.
6) Water and sewer lines to be separated by 10 foot minimum.
7) Builder/owner responsible for co*ntainina all temporary runoff and
erosion on site and may not impact neig�boring properties in any
way.
8) Construction hours from 7:00 a.m. to 10:00 p.m. on weekdays and
- -- I J- --J L-IZA--
'71
I
A'p
co ot
cl, 0 IVA,
AF)
0
4b .
C"
N
46..
cotl icar
on4t"-Js
I
41S
p CID
/va -/,I c**-
uo,v/o- -
4
A 'p.
% "4
plo"4� OPAI-A
e
X011