21107 PIONEER WAY.PDF11111111111111
12831
21107 PIONEER
WAY
CITY OF EDMONDS
ASSET INFORMATION SHEET
IeNEW
ADDITION
RETIREMENT
STREET FILE
ASSET NO.
ADDITION TO ASSET NO.
DESCRIPTION
Z/,4_j
SERIAL NO.
LOCATION
D EPA. N2�.
PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
B.A.R.S. ACCOUNT NO.
4DESTIMATED LIFE
INITIATED BY
DATE
I
PROJECT NUMBER Zd= -
PROJECT COMPLETION DATE
COST "I /,o
APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
[;KDEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
G.L. ENTRY
REFERENCE
tnp INITIAL
DATE
VERIFIED BY
PROCESSED
BATCH NO.
DEPARTMENT FILE
.::J-
00
CD
0J
a:
CITY of EDMONDS.
For Inspection Call 771-3202
S I D E
STREET FILE
S E W E R P E R M,I T
PERMIT NO. 070000
EDMONDS
Address of Construction: - Dl� 0 ((\ kL TREATMENT PLANT'.
Property Legal Description'(In'clude all easements):
2
0 0 MV_ _S C-
Owner and/or Builder: -u-) L
Contractor & License No: 's 8' C-
QJE 1 MY 9 Q
Singl:e Family Residence(�Xof_u i AR 1987
Multi -Family 0. nits
PUBLIC WORKS
Commercial (No. of fixture Units,,-_-7)
Z,
Invasion into City Right -of -Way:' No 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 z Yes (If,Yes, easement. required,
attach legal description and county easement number.)
PLEASEJEAD THE ITEMS -LISTED ON THE.BACK
fy that have read and shall comply Date
with t e items i.sted on the back.
Pe.rmit Fee: 0. 019 Issued By: t'7
Trunk Charge: too DatetIssued.
Assessment Fee: Receipt No.:
Partial Inspection:
Comments Date Initial
Final Inspection Approved:, -3 - L9 -B7
Date
Rejected:'
eason
Date, Initial
PERMIT MUST BE POSTED ON JOB SITE'**
Wh-ite Copy - File Green C,poy - Inspe ctor Buff Copy Applicant
Side Sewer Drawing
R
The City of Edmonds
EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION REPAIRS 0 LID NO - --------- -------- ASMT. NO - ------------------
OWNER
-00-mes ------- ----------------- CONTRACTOR .... L-U.r-7--.
JOB ADDRESS Z14-07 ------ PAOtWE, W ----------- LEGAL DESCRIPTION: LOT NO. q0e -------------------------------- PERMIT NO. -74A00
------ ....... BLOCK NO - -- --------- EDM-ONf)S----
----------------------- TREATMENT PLANT
------------------------------------------- E -------------------------
--d A�ME F ADDITION -------- S-EJ&,\14-0-0-j>
Z110'7
PWW-"l -11/75 (REV. 11/78)
46'
98,
4�
,Dp
Ic
I q
�T
Approved:
DAJ�V2V---
--------- By 4 --- ---------
STREEI
Ae%
FILE
m
O"rocET FILE
ia I nc; ';;�
ZL
t4W�Aa&oHT+2.lE�''= 47A
NZOAL, i4EAloOT
r
00
-it, 1-ch
PROiJECT REVIEW CHECKLIST P
''I r,7-jlr—�A
0,72 c V
PRIDITECT ADDRlM.
TECT NAME
PROC
APPLICATION RECEIPT DATE: 113-LV-D�a'
i RM
by: (initial/da
I 5�4
.�Reviewed
,WTR/SWR"I J�ENGNRNG
/77777777
sn=.k rAmny/muLTmz/omsmRcxAL - (circia
7, A,
SETBACKS CHECKED - Pra--min-g
17777777-TRIIIII
VARIANCE/SMMCK AW.
7Tf///777T/7///T/
CONDITIONAL USE PERMIT
2
-
777TIT
777777777
777-77777
77777777T7
ADB, REQUIRDI CHECM
/////////
3
-
77T777/77
TTT17717
T/77777/77
OTHER ZONING REQUIR&ENTS
/l/M
4
7T7777
ENVIRONMENTAL FEATURES
/////
5
Z-
777777T77
ACCESS SLOPE & VEHICLE ACCESS
6
7TT777TIT
7TI777TIT
77T77T/7
DRA.INAGE PlAN (On Site)
7
STREET FILE
8
IMIGAL DESCRIPTION VFRIFICATION
J/////
Y/////
777777TIT
/////////
777TI17T
111111il
1
9
QXJTT eLATM/DFMCATTONS
111117
771777177
10
EASEMENT - ll1JB14TC/PRTVAT0
777777777
TITTR77T
7TIT7777
1
11
CADCULATE S R-� M COM*XwPION TP NO LID#
77777
//////
77777777
/////////
77777777
/////////
7777777
////////
1
12
7777-77
-7 7TF1777
7777-7-7 77
PiAT/suEorvisTON RB--)UfREMRS
13
RTGIIT--OP-WAY CONSTRUCTION PERMTT R"-
14
777777
7T///7T/7
777777T/7
77771111
BOND REM FIOR PUBLIC IMPRDVPMWf'3
/////////
////////
is
SOILS CCINnITIMIS & GROUND
7777777/7
WATER FIEM CHECKED
/////////
16
777T/7
7 F17TI77T
777717
STREET PAVING REDUTRED
17
777T7/R7
aM AND GU`MER REIQUIRED
/////////
18
777/7T77T/-/7T/7777777T/7
SIDEWALK REX)UIRED
19
CUM CUP FOR DRIVEWAY REOD
�o
7 77777TI-7
-17777777
7
STREET NAME SIGN REQD
21
OTHER SIGNING REQD
-17TI7
77777777T
777777T/7
117777777-
22
SIDE SEWER AVAILABILITY
/77777T/7
23
EXISTING WATER MAIN. SIZE
I=
-77��
777TRIIII
24
fl-TI77777
7777777TF
WATER METER SIZE
25
SERVICE LINE SIZE
17777T
-177777i7T
1111177TF
26
HYDRANT REQUIRED
27
7-77-77
177777-IT
HYDRANT sin Exi8T3NG
//////
/////////
28
777/7
-177777TIl
777-777777
CROSS'CONNECTION INSPECTION REM
fit
29
-
MTER METIER CHARGE P=
777T/-//-/-/7
30
777777=
FIRE LINE CHARGE REQD - SPRINKLER
31
STREET CUT!
32
OPEN DITCH MISTING
7T/777/77
33
REQD
77T/7
F7777777
34
CULVERT F=
35
IIIITTFIT7171-R711
SIZE
36
CATCH BASIN REOD
777T77
37
777777777
INDICATED ON SITE PLAN
38
SHOULDER DRAINAGE MAW, AIN
T17711
SHALE OPM RUNOFF
39
T/ TF1 7-T 7
T/ 7 T1 TTI T
140
MISC:
cf)
REVIEWED BY:
PLANNING MGR, ENGINEERING MGR. PUBLIC WORKS MGR.
CITY OF EDMONDS ZONE
CONSTRUCTION PERMIT APPLICATION JOB
NAME (OR - NAME OF BUSINESS . — I ADDRESS 07
t )) M1 fl 's WC_ LEGAL DESCRIPTIZ)W—CHECK
TELEPHONE NUMBER
77r-73(o
�-Vlm
ADDRESS
CITY TELEPHONE NUMBER
NAME
ADDRESS
CITY TELEPHONE NUMBER
72 V- 7263 ef-
STATE LICENSE NUMBER
's e_&u_D [)
Legal Description of Property - Include all easements
(show below or attach four copies)
Z— 6 -�- ?`�_ / / P/ A � 0 )�' Sod- U)o 0 4
9 NEW
%__ MBING
ADD/ALTER. �IANICAIL
REPAIR
ElDEMOLISH x _FT)
EIREMODEL L_r P-.0"O"Z
WOOD STOVE
INSERT L APT. BLDG RENEWAL
NUMBER OF STORIES NUMBER OF
DWELLING
[UNITS
NATURE OF WORK TO BE DOWE (ATTACH PLOT PLAN)
__ 15 / ki 4; (4Z rez re Y i40'
O/Z--
PERMIT
NUMBER
� �11?leer cd4l
RIVISION NO. D NO.
yo- � r
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
[EXISTING_ REOUIREDDEDICATION
PROPOSED
R I cc
IGHT OF WAY CONSTRUCTION PERMIT REQUIRED 0 W
STREI )UIRED 0 Uj
Z
0
SEE ENGINEERING MEMO DATED Z
1 /10 W
METER SIZE , IBUILDING SUPPLY SIZE IFIXTURE UNITS cc
W
REMARKS
13:
SIGN AREA I COMPENV. REVIEW I ADB NO.
ALLOWED I PROPOSED LETE I EXEMPT
VARIANCE OR CU PLANNING REVIEW BY DATE
YARDS
HEIGHT I LOT COVERAGE
Z
FRONT SIDE REAR IS 251 Z
REMARKS 5
CL
CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT
db� 1 --7-/1/ 1 lqez i5-j
SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT'
REQUIRED GRO LOAD
0 YES 0 NO I I up R 3
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
0
Z
Q,6�-C� r-�v tqs-?, LtBcl 0
jos =j
0c�,�� t4-� &_G,
VALUAYION I FEE
This Perm * It covers work to be done on private property ONLY.
GRADING/FILL
Any construction on the public domain (curbs, sidewalkt,
STATE SURCHARGE
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
ENERGY CODE
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in Interest, agrees to indemnify, defend and hold
(u4i
harmless the City of Edmonds, Washington, its officials,
2
employees, and agents from any and all claims for damages of
<
whatever nature, arising directly or Indirectly from the Issuance
of this permit. Issuance of. this permit shall not be deemed to
PLAN CHECK DEPOSIT
0
modify,.walve or reduce any requirement of any city ordinance
TOTAL AMOUNT DUE
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 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 relatlng to Workmen's Compensa-
WORK NOTED
t I o n k9—urin'bie. 'In A
SI ATURE NEVR ATE SIGN D
INSPECTION
DEPARTMENT
;E�N
CITY OF
EDMONDS
ATTENTION
771-3202
IT IS UNLAWFUL TVUSE OR OCCUPY A BUILDING OR STRUCTURE leel'001Z
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
102-78
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
MEMO TO: Building Division
FROM: Engineering Division
SUBJECT: '09 6) 7 fl'"VE69 WAI
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.containing al,l temporary runoff and
erosion on site and may not impact neighboring properties in any
way.
8) Construction hours from 7:00 a.m. to 10:00 p.m. on weekdays and
in -no A-m- tn 6-00 D.M. on weekends and holidays.
40-00.
rl-OT
000
-0,
+ + �-.f 61106 15514
�,W. glaWT i z5'. +Z4
k-TOAL, qEltpW
7-0.-00
cr
MCI
-71 Od
bc-4z4
'IVA 3-Nipm
'10W DN.INKV7d
xq, camim
:Osnq
ov
TE
daORM Kido �s
NTV.T,t4m
bMd ELLIS NO CIELLVDI
8E
.......
aOM NISW H3LV3
TE
YLUZLL
HZIS
/////////
ILLLLLL
SE
ILLLLUL
cm
6Fa,—)m �follawdo
ILLLUL
ILLLLLL
ZW-LLLLLL
-FE
ILZLZLL
ZLLLU-LLL
/////////
LLLLI LL- 1ILLLLIL
00 - --
. UOM NOI HdSiff NOI SS=
TZ
JF
E)N,,Lsixa azis amam
TZ
UaHl 99 amam
TZ
gjjLLLZjLjLVLLLL
uiLgj-LL
flILLLLLL
111711
TZ
IILLULLL
/////////
LUZLLLLL
LLLL-IL
//
Zzig jUVR-M--J,-W4 �%UJSDN
////////
LLLLLLL
IL
rdMS EIGIS
cz
TZ
ILLLLLLL
DMINDIS HEW
TZ
LLLL=
�� /)
LLLLLLL
/////////
/////////
UOM NDIS mm maws
TZ
9ILLLL
LL1LLLL.LLLL11L
/////////
/////////
111T11
(mumimmu Uod Jw 9TIO,
LLLLLLLL
1LLLLLU-j1LLLLW-
/////////
/////////
uauirmH xTegais
TT-
FT
LLLLLLLi-
LLLLLL
ILLL
IMM &VAM CW 9HW
T-11111111
LLLLLLLL
/////////
JILLLILL
/////////
//////
inOm DRIAW J-'EgHJS
Ll
T,
ILLLLLL
/////////
LUJIUL
/////////
//////
—
aDmo criaid usum
aNn(xg I st\yoilicmm SIMS
TT
111111LL1LLLLLLL
mou a omHi zioa 0= GN09
7/—//////
/////////
iLLLLLL
LILILLII-Ij—1
iLLLU-
T-XM Limmd NoIjznu.LsiZ5--7,vm-ao--amrd
TT
1111111L
////////
////// //
//////
#Girl ai NOIaZONNM Ust-us sLyroTio
FT
OOIN
TT
11111111-LUILILLL
7T
SNOI-LVOICOG/WIYM LIM
6
TI-OlartraA Noiadiwma iV.791
1
.1 1
a7id a-14RULS
T
////////
LILLLLLL
11111"QL
(9:jTS UO) NVId ZDVNIWG
:., I I..
1111111ZL.L11111
acials
sauuvaa -xjN2KNOHIJ%�m
LL
NOZ ua=
uj
1111111[L
smewmIWERI RGY:
z
LLMI-1111
asn iLiaNm
ZLLLL11-1-LL
HNUMS/30mvim
T
buTumTd SXDV=S
LLLLLL1-ZL
Vo rinwa alotus
11111ILL
///////g
Hula
DmcNa
aams
/WA
ONINNVrId
Acqf
(aTep/TVC TA91d
:ELLva adimau NOLLYDrlddV
warudd
asrDrum MIAMI J=Wd
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
MAILING ADDRESS
C).
TELEPHONE NUMBER
CITY
"Seec�R(e
NAM��
RESS'
TELEPHONE NUMBER
_ao
NAME
-S (!!-" C)
ADDRESS
-? ,
CITY TELEPHOP NUMBER
,�) Qet�4 e
TTATE LICENSE NUMBER
'Seq a- L,-) 6 (x5V
U76al Description of Property - Include all easements'
(show below or attach four copies)
Z1NEW
�9 RESIDENTIAL
R PLUMBING
E] ADDIALTER
0 COMMERCIAL
1:1 MECHANICAL
1:1 REPAIR
E] RETAINING WALL
SIGN
DEMOLISH
REMODEL
EXCAVATE
OR FILL
PRE -MOVE INSPJ
COMPLIANCE INSP.
FENCE
I- x _FT)
swim
POOL
WOOD STOVE/
INSERT APT.BLDG
RENEWAL
5 NUMBER OF STORIES NUMBER OF
-2
[DWELLING
UNITS
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
, S /* ^ C, I-e- ; I V r(:E� %
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.
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 anck
successors In Interest, agrees to Indemnify, defend and hold
u0i harmless the City of Edmonds, Washington, Its officials,
i employees, and agents from any and all claims for damages of
cc
< whatever nature, arlsing directly or Indirectly from the Issuance
of this permit. Issuance of. this permit shall not be deemed to
modify, waive or reduce any requirement of any city ordinance
0
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
USE NWPERMIT
ZONE NUMBER
JOB
ADURF5S 2-110-7 Lloff e-ele WAY
LEGA� DESCRIPTIQN CHECK[ SUBDIVISION NO. I LID NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING DEDICATION
PROPOSED 10=�
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED 0
STREET USE PERMIT REQUIRED 0
SEE ENGINEE��MEMO TE
REMARKS
METER SIZE IBUILDING SUPPLY SIZE IFIXTURE UNITS
REMARKS
SIGN AREA ENV. REVIEW
ALLOWED I PROPOSED I COMPLETE I EXEMPT
VARIANCE OR CU
REVIE W BY
I NO.
ELINER
DATroF
Uj
Uj
Z
0
Z
W
Ir
Uj
YARD.� 5;' HEIGH�.�LOT COVERAtE OF
Z
FRONT REAR
BY
HEIG
SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT
REQUIRED GROUP LOAD
0 YES ONO I I I I
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
GRADING/FILL
STATE SURCHARGE
ENERGY CODE
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
n f I Van
I Orma t 1 0 n g
Information given Is correct; and that I am the owner, or the duly
'r' Or t he d U'y
ATTENTION
a u t ho"z ad a ant 0' Wit h c ity and
authorized agent of the owner. I agree to comply with city and
g
S ta te law s e u 'a z_
state laws regulating construction; and In doing the work authoriz-
g n ' 'Vork a h r
THIS PERMIT
AUTHORIZES
a d t he re n 0 a rS I of t he Labo
ed thereby, no person will be employed in violation of the Labor
by r p r
ONLY THE
Code of the State of Washington relating to Workmen' om p S
I s Compensa-
WORK NOTED
tign. In u nce.
_Surance.,
j
4ATTNTION
iNSPECTION
TURE (0 NER OR
Sr
IGNED
SIGNED
DEPARTMENT
7AG
JDATE
-7
CITY OF
01� X
EDMONDS
61
771-3202
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTUREJ
UL
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
102-78
VALUATION
APPLICATIO
This applic
signed b
De t
ack,
DFFW�\
RELEASED _L
ORIGINAL
PINK — Own�e
0
Z
a
_j
D
co
J 1 -86
MEMO TO: Building Division
FROM: , Engineering Divi�i(
SUBJECT: aq� L,!97 lz'olt�6--Xe- akV
After review of the subject building permit application, we have the
following cam-ents:
1) Connection to City water system required.
2) Connection to City sanitary sewer system required.
3) Right-of-way permit required for any %urk 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 containing all temporary runoff and
erosion on site and may not in -pact neighboring properties in any
way-
��A#�Mws - �
v"y
-7!0
zli� co
mo
HN6oHT
-11 -co
.(Ozii
Tu-
ODD
M -TM