21109 PIONEER WAY.PDF1111111111 lill
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21109 PIONEER
WAY
-'IL�SSET INFORMATION SHEET
CITY OF EDMONDS
EJ"'NEW ASSET NO.
ADDITION ADDITION TO ASSET NO.
RETIREMENT
DESCRIPTION
SERIAL NO.
LOCATION
D PT. NO.
FA
PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
B.A.R.S. ACCOUNT NO.
ESTIMATED LIFE
PROJECT NUMBER
PROJECT COMPLETION DATE
COST
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
2"DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
0 G.L. ENTR
REFERENCE
itnp INITI
DATE
VERIFIED BY
PROCESSED
BATCH NO.
DEPARTMENT FILE
C I T Y of E DM ON DS
For Inspection Call 771-3202
Address of Construction:
S I D E
STREET FILE
S E W E R P.E R M I T
�.PERMIT NO.
. LJ"
Property Legal Description (Include all easements):
J/ # L6 70
Owner and/or Builder:
U, �01 ON DS
Contractor & License No: e6L JJ 6 b LTREA i .'v]ENT PLANT
------------
Singl:e Family Resi I dence
7 9 _v E QD
Multi -Family (No'. of Units
'A"t" 1981
Commercial (No. of fixture Units,
-WORMS
Invasion� into City Right -of -Way: No Yes. (If Yr�s, Right -of -Way
Construction Permit required. Call One*-Call-C.ente�,(1-800-424-5555) before any
excavation.)
Cross other Private Property: No Yes Of Yes, ea'sement required,
.attach legal description and county eas-ement number.)
PLEAS-E--READ THE ITEMS LISTED ON THE BACK
I der1ify that have read and shall comply Date
with the item listed on the back.
Permit Fee: 30-00
T , runk Charge: 2S_- 00
Assessment Fee:
Partial Inspection:
Comments
Final Inspection Approved:
lqr
00
Rejected:
CD
a)
eason
Issued By:
Date Issued: 37-
Re I ceipt . No.: 061
40
Date Initial
Initial
Date Initial
PERMIT MUST BE POSTED ON J6B SITE
0: White Copy - File
Green Copy - Inspector-.,.'
. Buff Copy - Applican t4
The City of Edmonds
Side Sewer Drawing
EASEMENT NO - ------------------ ---------------------
NEW CONSTRUCTION g REPAIRS E] LID NO - ------------------ ASMT. NO - ------------------
OWNER ----- At-V\,?-5 ............................... CONTRACTOR ----------------------------------------------------------- PERMIT NO. Q.71-4 13
JOB ADDRESS ----- \04-Sr-� - ------------------ ------ LEGAL DESCRIPTION: LOT NO . ..... ----------------------------- BLOCK NO. YIOI-A-le ------------
--------------------------------------------------------------------------------------------
0,\k 6kb e-*,Qc,
II � , 3�e'
U-it4T ?Vkt I j 30,
NAME OF ADDITION -------------------------------------------------------------- ......
Approved:
PWW-0001-11/75 (REV.11/78) DATE a-7 .................... By�f.-V-
g-
---------------------------------------------
E
p 1. S. W.
209' _L11 .1 IC
-- — — — — — SHEE 0 F 2 5 �Vi
9
f SEAWOOD
IN THE S 1/2, SW 1/4t OF SEC. 19, T.27 N., R.4 E., w. m.
— — — — -- R,�, 0,0 IVO
&Ice
r�L EDMONDS, WASHINGTON
__j
7 1 /0 4
0 ?".
IS 0', "',4
LEGEND
5
/(-.,Sf SID.. & S.., W.(. rI.II
I amilom.-a 0 Elo$nmc 1* iROPI PIPE
3
C
ExlSIwG CASICD MONUMENT
I -cc( I I� cs.r Io*
_S S.R,
_j @ 00STING SURrACE -Olni-E-T
To
low', 0 Z, 7.1 SE , 0
SET CASCO St
— — — — — — 110.Cft 6^004 StIz cw COU-11 10.0 I..Icl Q.,to. L'CP4UuEmT
F
54T
UOTC -01 MENSIONS a BEARIP#GS SmO*p4 IN P&A91
THESIS ARE rRom PREVIOUSLY RECORDED PLATS 6
DOCUMENTS.
?�Y2
I 'pf -pre
I tr
5
CURVE DATA
C-rX r-FS 44 � I .
I � 1 /001
4 ll
Z102o )
J&
2- 1024 4p
.6
9 -,St. Ifae. I
As'"ft—g.A.1 -1r, '0
'If 14 6'
of
21100 'If
+ 7
1 44
1 0
15:_01'
146.56*
39.06'
it 2. 29*
20.00*
23.46*
34.59' 1
qovo�00*
2O.W
20.00*
31.4 2'
(D
71-18-11.
35.00.
25.1
3.54'
13-17-25-
560-06' 1
63.25-
179.91'
N, — — — —
I LEGAL DESCRIPTION
Thais pooloris of tracts 6 1? BI.S.Aldw-arld Mww No, 9 act. to the
>-I u 7' 17' Plot thereof as recorded i. ohj IO.Pogo 6 recodi of Snohomiih Co. WIS.
dtscf;bed at follo.l.
Tract D Of Cddt 1hcwI v%#bdN40� Ne. S.15.85.' at rqCWd9d "dw
Avd1lars I'llo No. 6509230331:
0 r
3 9 l- ALS Parcel no. 4 of Cd-OSdI Short "b4brislon No. 3-29-aO at locwd.d
10 v.d0.; At.rditor, ra. No. 11303J)DO91-
Ilk,
I If.
/9 .1 1 1, I'll, I "It.(.
sit
AL Tact I ?;.Plot of T"my par% No. 4. a, ffcwdv# % Vovm@ 2p
fb I wgiX-) In. $'on po
/a& w --I 3t... #I 3L frr 11 a' 0. 1 10. ffcwdt of Soch—:,h, C�jg
EXCEPT the Cott 99.36 feet of the 14�th 15.00 feet lhrroof.,
r L-Z AND CXCEPT that PwIl— a' old tract 17 dead.# to the Clly of Cel-ame,
J�lg g c
ju x wIf 20' .t 11 . US% CI.T. %toder Atpolliw. ri. mo. a5o92303jz far, rood.
,2' V"? �A � IS I . .. '30112".
r— 7. Sub)Sct to 909"�12 and rs.telclieris of "ord.
9 AN Itu0t- I, Smoh"Ish C�ly. Wasmgion.
10 - mon nt
_g5 SCALE- V-5o`
CA31 SURVEYOR'S CERTIFICATE
X1. tons, r. Ulddl.1—. R.91.1.,.d t—d 4. h..by C_Ilfy I a,
-Ki I thfortplett 1. btoped vpc� " actual �y a,,d s,,bdI4.901 of S.ello, It.
j! To. ship 7 (wth. Ro,qq 4 Egg, ,�M, ad the, he mw1w"mil
.11 0.9 Sol �d
Al 21)lcl lot C"Orl, 110%.d m the 9,c4 so he" hor.o..
IS Acc(SI a vt.t. cS.1%
A, .. LIJI 0
00
106342)
Q_
&a
9;11.1;od t—d
"Ice, .0. 1:ld. Irl -1� A, At.crclel... Ic.
;Isr 31
Construction hours from 7:00 a.m. to 10:00 p.m. on weekdays and
10:00 a.m. to 6:00 p.m. on weekends and holidays.
MEMO TO: Building Division
FROM: Engineering Division
SUBJECT: q rIONEF— �e
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 all temporary runoff ' and
erosion on site and may not impact neighboring properties in any
way.
8)
f-
A) I
PROJECT REVIEW CHECKLIST
PRaIECT NAM? �'�Acq--&occ� PMJECT XbDRESS: 2-1jo,9?Q)y-)C-eroV
APPLICATION RECEIPT DATE: 2-+
Reviewed by: (initialldate)
PLANNING
WTR/SWR STREET ENGNRNG
FIRE
TuILDING
/7////R77///////
1111TIT111
SD=z Pmny/mMTIPLE/Ca44=xAL (Circle One)
SMACM CHECM - Plaruiing
7T/-/F/7T/7
VARXAWM/SMTAM AW.
IT177TI777TI11111
11111177
0ONDITIOM USE PERMIT
/////////
////////
2
—17TFI 771-7
—77T/777T
7 7 7 7 7 7 7 7 7 7
ADB MWUMUM, CHECKM
/////////
////////
3
OTHER ZONM REQUIREPMTS
7T/77.—�,
7TT177T177T1=TTT7777T17
—
4
EMPONMERrAL FEATURES
5
ACCESS STOP?, & VEHICLE ACCESS
77777T/T
�6
DRAINAGE PLAN (On
T=
77777TIT
77777TIT
777,7717
I
77777777
STREET FILE
8
LEGAL DESCRIPTIM VFRTFICATICN 41�
T7177177777771777777177
/////////
/////////
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" ' /
Oux� CU` UM/DEDICATI6NS X6 "
/////////
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77777777777777777—
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10
TITRI111
EhSDINT - PUBLIC/PRIVATE
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MCMATE SEWER CONNECTIM IF NO LID#
11H11
77TTT17
12
777777—
77777777
TLAT/SUBDIVISICN MQUIRM-OM
13
T17TIT
771111111
RIM -OF -MAY CONSTRUCTION PERMIT REQD
14
1 .7777777777777
1117
77//////
BOND REM FOR PUBLIC IMPROVEMENTS
15
SOILS CONDITIMS & GROUND
/=777777777
777777777
WATER FIE1D CHECKED
if All, Y(//
16
STRMT PAVING REQUIRED
17
1cm AM GUTTER REQUIRED
777TIT717711111
77TI77TIT
18
SIDEWALK REQUIRED
77T17T
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7TI77TT17
19
L . I 1*1� �'
-CURB . CUT FOR DRIVEWAY REQD
TR111111
/////////
20
1 i� � " ��5' e! : 7: ti ".'
STREET NAM SIGN R=
777777T/7777777777
7777777777
21
—77777777777777
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22
777T17
777777TI7
77TTIT177
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SEWER AVAILABILITY
23
WATER MAIN SIZE
11117775
24
�WATER MEMM SIZE
77TPT
177177777
TT177TI77
25
'SMMCE LINE SIZE.
777TIT777111111
TT177777777=
////////
26
HYDRANT REQUIRED
777777777
77777777
11111TIT17
27
TT M17
17TI—ITIT
HYDRMU SIZE EXISTING
//////
28
7TIT9
CROSS CONNMCTICN INSPECTION REM
ja
29
—
7/////
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30
WATER METER CHARGE REM
FIRE LIM CHARGE REOD -.SPRINKLER
777
STREET CE)T
32
OPEN DrICH EkisTrNa
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if
33
REM
34
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7TT717TI7
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CULVMP R".
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SIZE
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36
CATCH BASIN REDD
37
IMMATED ON SITE PLAN
38
StOKD—ER DRAINAGE MAINTAIN
—17TTITTITT771T
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SHALE OPEN RUNOFF
39
MISC2
717177717111711111-7
7 ..:
40
PXVIEWM BY:
PLANNING MGR.
CITY OF EDMONDS
USE 'WVPERMIT
ZONE < NUMBER
CONSTRUCTION PERMIT APPLICATION
JOB
ADDRESS
NAME (OR NAME OF B ..
_S_
4 C-,
LEGAL DES CRIPTION CHECK
Z r
SUBDIVISION NO.
P
LID NO.
A/
OTS'
U-) 0 Vik le__s n
1)
LU MAUNG ADDRESS
Z
3:
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
0
UITY
TELEPHONE NUMBE
-7-7y 7"301EXISTING
REQUIRED DEDICATION
OSED�LK
NAME
ov\ 750 kv� V--,
ADDRESS
t:
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED 0
STREET USE PERMIT REQUIRED 0
LU
LU
Z
U3
3
0
SEE ENGINEERING MEMO DATED
.21
Z
TELEPHONE NUMBER -,_j
REMARKS
NAME
,5e__C,_WoC&
V
ADDRESS
0
METER SIZE
BUILDING SUPPLY SIZE FIXTURE
UNITS
a:
LU
2 CITY
Z.
TELEPHONE NUMBER
77 ?' 73 to 9
REMARKS
STATE LICENSE NUMBER
W C) t�5 C_
SIGN AREA
ALLOWED PROPOSED
ENV. REVIEW
COMPLETE EXEMPT
AD8 NO.
,5 (Z-&
Legal Description of Property - Include all easements
Z (show below or attach four copies)
SHORELINE 0
Z
Z
CL
x -t -
VARIANCE OR CU
PLANNING REVIEW BY
DATE
_j
Ic 5 ev
U)
LU
YARDS
FRONT SIDE
HEIGHT
LOT COVERAGE
J
REAR
REMARKS
'9EW
_N RESIDENTIAL PLUMBING
rM
0
ADDIALTER COMMERCIAL MECHANICAL
REPAIR El RETAINING WALL SIGN
EXCAVATE FENCE
DEMOLISH 0 OR FILL x _FT)
H
CHECKED BY
ECKED BY
jW/1 177-/1/
j
TYPE OF CONSTRUCTION CODE
1
yf::
HEIGHT
2-5-'
PRE -MOVE INSPJ SWIM
REMODEL EICOMPLIANCE INSP. POOL
SP CI
E AL SP
SPECIAL INSPECTOR
E
.REQUIRED
0 YES 0 NO
AREA
OCCUPANCX
GROUP K_
OCCUPANT
LOAD
WOOD
STOVE 1
INSERT APT.BLDG RENEWAL:
_3
M S
[REMARKS
Mtn '11 57111
Z
6
.0 NUMBER OF STORIES
UM BER OF
3
WELLING
FN
:0
D 13 1
UN ITS
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
S (V\ei
(0- F&VA" �,j re- I'( dcKt
VALUATION
FEE
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADING/FILL
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
ENERGY CODE
"Applicant, on behalf of his or her spouse, heirs, assigns and
a uccessors In interest, agrees to Indemnify, defend and hold
u harmless the City of Edmonds, Washington, Its officials,
J
E employees, and agents from any and all claims for damages of
C whatever nature, arising directly or Indirectly from the issuance
of this permit. Issuance of. this permit shall not be deemed to
modify,.walve or reduce any requirement of any city ordinance
nor limit In any way the City's ability to enforce any ordinance
provision."
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
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-
ed thereby, no person will be employed In violation of the Labor
Codeof the State of Washington relating to Workmen's Compensa-
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
tign Insu INSPECTION
_Mnce.
A"TURE (OWNU OR EN11
PENT)
DATE SIGNED DEPARTMENT
— t CITY OF
EDMONDS
771-3202
ATTENT16N
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING -OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
102-78
F
I I Of ri us
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