21313 93RD PL W.PDFiiiiii iiiiii
9078
21313 93RD PL W
CITY OF EDMONDS
-7 OF
ASSET INFORMATION SHEET
NEW
ADDITION
RETIREMENT
ASSET NO.
ADDITION TO ASSET NO.
DESCRIPTION Uw
WaL4
SERIAL NO.
LOCATION
PLace-
DEPT. NO.
PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
PROJECT NUMBER WOT.3077�
f f
PROJECT COMPLETION DATE
COST 17,r,-, co
B.A.R.S. ACCOUNT NO. . IM - 0 1 q , 3 q ��- , Q Q
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
DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
0 G.L. ENTR
REFERENCE
DATE
ftt-
VERIFIED BY
PROCESSED
BATCH NO. -
t(p) INITI
DEPARTMENT FILE
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CITY of EDMONDS
S I D E' S E W E V P E R 4 IJ
For Inspection Call 771-3202
PERMIT NO.
Address of ConstrucWREF/T-3F/6F_
Property Legal Description (Include all easements):
Owner and/or Builder:
d 114p,
Contractor & License No:
Single Family Residence vl_�
EDMONDS
Mul ti-Family (No. of Units
TREATMENT PLANT
Commercial (No. of fixture Units
Invasion into City Right -of -Way: No._j,,,f�
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 Yes
(If Yes, easement required,
attach legal description and county easement
number.)
PLEW'EREA TH'E EMYSED ON THE BACK
I certify that I have read and shall comply Date
with the items listed on the back.
Permit Fee: �Issued By:
Trunk Charge: 2? 57 iDate Issued:
Assessment Fee: ES-X 112, Receipt No.: 12—,57 2—
Partial Inspection:
Comments Date Initial
Final Inspection Approved: /,,21� Z' 4
�-- Date Initial
Rejected: Reason --Ta-te _5_itiaV
** PERMIT MUST BE POSTED ON JOB SITE **
Wh.ite Copy - File Green Copy -,Inspector Buff Copy - Applicant
The City of Edmonds Side Sewer Drawing EASEMENT NO - --------------------------- ................
NEW CONSTRUCTION Zf-" REPAIRS F-1 LID NO . .................. . ASMT. NO - ------------------
OWNER ------------------------------------------------------------------------------------------------ CONTRACTOR
---------------------------------------------------------------- PERMIT NOD-K1.3-9
JOB ADDRESS -Zi --- . ......... W ------ LEGAL DESCRIPTION: LOT NO. ..q ------------------------------- BLOCK NO - ------------------------------------
-----------------------------------------------------------------
..... .... . --------------------------------------------------------------------
NAME OF ADDITION ---- (-> - -------
............. --------- ---------------- ----- ------------------------------
EDM
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P-rREA 1 M E fNV 7TV �p,
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PWW-0001 -11/75 (REV. 11/78)
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/utie, 9 'Dezq
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Avvroved:
DATE--------- ByL - — - ------------------------------------------------------
fl
NOTICE,
'0"Wa r n
t-y---C)T
N r
The -information on the attached
Hed for use by the City of
map(s) was COM ' P
mpl-oyees and Consultants.
Edmonds/ its E
Th,..e City ofEdrn.onds does ' n ot. warrant the
these
accuracy of anything set for.th on
map('�_). An'y person or entity -requesting a
copy should conduct anAndependent
'ation shown, o
inquiry regarding the inform imIted to/
tRe -map(s)/ including, but not J
-er stub shown. Suc
the location of any sew
sewer stubs may or may- not exist and may
or may not exist at the location shown
Neitheir the �jty of EdmoncJs/ nor its
ice-rs'shalrl be 1.-ia-164-e for thE
empto-yee-s 0-r off
I n on ffs map(5), nor for
information g ve d
entation provided base
any one repres
upon said. map(S).
NOTICE:
N`0Wa r.ra n-Ly ... U I
The -inform ation'shown on the attached
for use by the City Of
map(s) was cOm ' Piled nd Consultants.
Edmonds/ Its Empl-oyees a
Th,.e City of 'Edmonds does not warrant the
accuracy of anything -set for.th on these
r entity -requesting a
rnap(�_). Any person o
copy should c:onduct an independent
i nf orm-ation shown- o
inquiry regarding the
-m(,3p(s),, Including/ but not Jimited to,
th . e lociation of any sewer stub shown, Suc
sewer stubs may or may- not exist and may
or may not exist at the location shown.
r-ity of Edmoinds nor its
Neit-heir the %.. i -c er s -s h. a I- I b e 11 a. b-1--e f o r tL h
empJo,yee*s O*r off'
this map(5), nor for
Information g Ven on
'ded based
any one representation provi
upon said map(S'.
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TO: Permit Coordinator, Building Division 77-7 —�O
FROM: Dan Smith, Engineering Inspector
ADDRESS !20,zo-" OT
OWNER R, li?W,
PLAN CHECK #
After review of the subject building permit application, we have the
following comments:
1. Construction hours are: WEEKDAYS ........... 7:00 a.m..to 10:00 p.m.
WEEKENDS/HOLIDAYS..10:00 a.m. to 6:00 p.m.-
2. A Right -of -Way Construction Permit is required for any work on
City property.
3. Connection to City water system required. Fees paid.
4. Connection to City sanitary sewer system required; obtain separate
permit. Fees paid.
5. Water and sewer lines to be separated by 10 foot minimum.
6. Driveway must be paved a minimum of 20 feet back from City
right-of-way; separate permit required.
7. Driveway slope not to exceed 14%.
8. Back water valve required if downstairs plumbing is below
elevation of upstream manhole.
9. Builder/Owner responsible for containing all temporary runoff and
erosion control on site. Construction may not impact neighboring
properties in any way.
10. No burning of construction refuse without approval from Fire Dept.
11. Street to be kept clean of debris, dirt, mud, and construction
materials. Contractor responsible for dust control.
12. Inspection required on drainage system, catch basin installation,
driveways, and sidewalks. A final engineering inspection is
required prior to the building division granting occupancy.
13. Repair or replace all defective existing curb, gutter, and
sidewalk. If intersection is involved, installation of wheelchair
access may be required.
BLGPER/TXTFORMS
ZONE 11�45� F
CITY OF EDMONDS NUM6E'Ay EF�
E
0 1
CONSTRUCTION PERMIT APPLICATION JOB
OWNER NAME/ AME BUSINESS AUUHt:bS
LEGAL DESC CHECK SUBDIVISION NO. LID NO.
MAILING ADDRES
.Vrz ��e / /X /I -
CITY ZIP LfiPHONE NUM06"Adill
;7 D
IV,6�5_
A/ L�3"VVI-fZ 7�
Z� �lrl rr e.) , (/
ZIP [TELEPHONE NUMBER
C�l 0 <` 1 -7 4 c--Z C
NAME P (,_�
, A
ADDRESS
3 /1-XI L'�_
CITY ZIP TELEPHONE NUMBER
ST,gE LICENSE NUMBER
YA / / I- c - - 4 A -- / - 7 >
Legal Description of Property - include all easements
(show below or attach two copies)
Tax Account Parcel No.
"NE W Lk:J-RESIDENTIAL 9--P-LUMBING
ADD/ALTIER 1:1 COMMERCIAL 1:1 MECHANICAL
REPAIR 1:1 APT. BLDG. El SIGN
EXCAVATE. FILL FENCE
DEMOLISH OR GRADE ( x _FT)
CARPORT swim
REMODEL GARAGE POOL
F WOOD STOVE/ r7 RETAINING WALL/
INSERT 11 ROCKERY E] RENEWAL
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
NUMBER OF STORIES NUMBER OF
DWELLING
I IMITQ
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
I nFIfe'sIdewq- I
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP
EXISTING *0 REQUIRED DEDICATION APPROV90 DY
PROPOSED
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED 0
STREET USE PERMIT REQUIRED 0
SEE ENGINEERING MEMO DATED V1=4EW
ZUZ—Ly C_
REMARKS / / I
IZE
REMARKS
PPLY
UNITS
T #
a:
W
SIGN AREA
ENV. REVIEW
0.
ALLOWED PROPOSED
C OMPLETE EXEMPT
I
NE#
VARIANCE OR CU
PLANNING REVIEW BY
DATE
SETBACKS — FEET
HEIGHT
ILOT COVERAG� Z
FRONT 2,5' SIDE
1;'Z-1 REAR
3��/v Z
REMARKS
AD
UHECKED BY
TYPE OF CONSTRUCTION
CODE
HEIGHT
/
e
I -\J- _&
61a
2-5
SPECIAL INSPECTOR
AREA
OCCUPANCY
-
OCCUPANT
REQUIRED
GROUP
LOAD
M YES C NO
REMARKS
PROGRESS INSPECTIONS PER UBC 305 Z
15Z11,91 _Z;K411-
/ -7 tgOelt /47&
FINAL INSPECTION REQUIRED
VALUATION FEE
PLAN CHECK FEE
BUILDING
'PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGWILL
Any construction on the public domain (curts, sidewolks,
STATE SURCHARGE
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Worl� 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
20
harmless the City of Edmonds, Washington, its officials,
i
cr
.Z
0
X
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
modify, waive 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 acknowle;—ge 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
THIS PERMIT
AUTHORIZES
ONLY THE
Code of (he State of Washington relating to Workmen's Compensa-
WORK NOTED
t ion Insutance.
?AGENT)
S GNA PR I WNER 0 E)AWTESI EYD
INSPECTION
DEPARTMENT
70
CITY OF
EDMONDS
ATTENTION
CALL FOR
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING 08 STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-3202
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
to^ I: -
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
STREET FILIj
CITY OF EDMONDS
USE
ZONE NUMBER
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/�)AME Pf BUSINESS
joa SUITE/APTn
ADDRESS
cc
LEGAL DESC RIPTIO UHLGK��
SUBDIV ISION NO.
LID NO.
g
MAILING ADDRESS
Z7
e�n�c
113
0
7,�e_ ,7_�L-aLee
CITY ZIP A Zc/ MBER'
WLEPHONE NU
_F/
PUBLIC RIGHT QF WAY PER OFFICIAL STREET MAP.
TESCP
APPROVED BY
P?14165. 172 e -/;V,77
EXISTING REQUIRED DEDICATION 0!!::k
NAME
11-4
PROPOSED
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED El
ADD ESS
STREET USE PERMIT REQUIRED 0
Z
LU,
t:
X
2, Ise& r
SEE ENGINEERING ME EW BY
MO DATED
- a
Z
�z
CITY ZI
TELEPHONE NUMBER
_7L / 7 _
11,qZZI ,E
7,9
REMARKS
NAME
17 �7 V, bV161
Cr
ADDRESS
5�t/
71y
1 F141-el- ef-441� - Z-�,//7z)WA�s
0
-3
CITY ZIP MBER
METEa-SLFE I/
-5/-17/
BUILD12 �VPPLY SIZE
IXTURE UNITS
a:
I'_
TELEPHONE NUMBER
/_S
a:
Z
0
REMARKS,
STgE LICENSE NUMBER
ITC )/
SIGN AREA
ENV. REVIEW
PROPOSED
COMPLETE EXEMPT
ADB NO.
I-,-
Legal Description of Property - include all easements
Z
(show below or attach two copies)
ELINE #
Ze v
VARIANCE OR CU
PL�NNING REVI
U,
0 4-- 3-6 91 5
SETBACKS - FEET
EIGHT
LOT COVERA 7
G
0
W
FRONT 7 REAR
SIDE' _Z_ JK
-e-Y
Z
Z
<
Tax Account Parcel No.
REMARKS
-1-1
1
:
P-NEW
0--RESIDENTIAL
PLUMBING
ADD/ALTER
COMMERCIAL
MECHANICAL
El REPAIR
APT. BLDG.
El SIGN
EXCAVATE, FILL FENCE
171
CHECKED BY
TYPE OF CONSTRUCTION
CODE
HEIGHT
DEMOLISH OR GRADE I- x _FT)
CARPORT swim
REMODEL. E] GARAGE E] POOL
SPECIAL INSPECTOR
AREA
OCCUPANCY
OCCUPANT
REQUIRED
GROUP
LOAD
FWOOD STOVE/ [-] RETAINING WALL/
-I INSERT RENEWAL
El YES NO
REMARKS
Z
0
ROCKERY
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
PROGRESS INSPECTIONS PER UBC 305
Z
Cc
0
Cn
NUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE (AT"TACH PLOT PLAN)
FINAL INSPECTION REQUIRED
5,F
VALUATION
FEE
PLAN CHECK FEE
BUILDING
Z 4, C2 n,--)
4-
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADING/FILL
Any construction on the public domain (curts, sidewelks,
driveways, marquees, etc.) will require separate permission..
STATE SURCHARGE
4—
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
(Wn
harmless the City of Edmonds, Washington, its officials,
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 I)EPOSIT
0
modify, waive or reduce any requirement of any city ordinance
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
state laws regulating construction; and in doing the work authoriz-
THIS PERMIT
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
Codeo he State of Washington relating to Workmen's Compensa-
WORK NOTED
Deputy; and fees are paid, and receipt is
- _ns tance.
I INISPECTION
acknowledged in space provided.
SGNA R I INNER 0 AGENT) OATE SYNEO
DEPARTMENT
CITY OF
OFFICLAUS SIG ATURE DATE
?;
EDMONDS
ATTENTION
CALL FOR
EASED BY: nATF
INSPECTION
14 ;Zf _6 �/ 0
j
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
771-3202
_y)
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
102-87