21904 HIGHWAY 99.PDF11111111111111
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21904 HIGHWAY 99
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ADDRESS: le::A -1 U 'I - r7 UJI,
TAX ACCOUNT/PARCEL NUMBER: 6
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: W- — 14 ' I - r iw DETERMINATION: [] Conditional Waiver F-1 Study Required (Zwaiver
DISCRETIONARY PERMIT #'S:-A66 - 6713 - r),:?� , 4-61-3 - Z67 - q �2
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR: -
PERMITS (OTHER): --
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #:- /g
SHORT PLAT FILE: LOT: BLOCK:
<!;;Ile?
SIDE SEWER AS BUILT DATED: 0 Z) SIDE SEWER PERMIT(S) #: I ZQ -:2
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
OTHER:
LATEMP\DSTs\Forms\Street File Checklist.doc
#P20
Critical Areas Checklist CA File No:
Site Information (soils/ topography/ hydrology/ vegetation)
1. Site Address/ Location: 21904 Highw" 99, Fdmnnd_q, WA 98026
2. Property Tax Account Number: 5807-000-040-06-00
3. Approximate Site Size (acres or square feet): .07 Acre
4. Is this site currently developed? x yes; — no.
If yes; how is site developed? Single -story, commercial structure
5. Describe the general site topography. Check all that apply.
Flat. less. than 5-feet elevation change over entire site.
X 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 contain�; areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows.afe year-round.?
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:
For City Staff Use Only
1. Plan Check Number, if applicable?
2. Site is Zoned? C,(-Q
3. SCS mapped soil type(s)?
4. Critical Areas inventory or C.A. map indicates Critical Area on site?
5. Site within designated earth subsidence landslide hazard area? N01- - ta,4.,0,_JL_d YCK I ;k
a� A-
LAI',
DETERMINATION
STUDY REQUIRED -WAIVER
Reviewed bv. 01-- _". � 0 * Dafp- I I —
Critical Areas Checklist/3.25.2004
.0 #P20
City of monds
Development'Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
The Critical Arc6 Checklist contained on this form is to
be filled out b� any person preparing a Development
Permit Application for the City of Edmonds prior to
his/her submittall of the application to the City.
I
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 corr�plete the Checklist should be easily
available from observations of the site or data available at
I
City Hall (Critical areas inventories, maps, or soil
surveys).
Date Received: it (%I
City Receipt #: iop� 0115 *3 4 1
Critical Areas File #: 6.200V_,DJA,1L
Critical Areas Checklist Fee: $135.00
Date Mailed toADDlicant: //-823-04/.
A property owner, or his/her, authorized representative,
must fill out the checklist, sign and I 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.
Please submit a vicinity map, along with the signed copy
of this form to assist City staff in finding and locating the
specific piece of property described on this form. In
addition, the applicant shall include. other pertinent
information (e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant.staff
in completing their preliminary assessment of the site.
The undersigned applican� and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, inden'mify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, Jarising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete infori1nation furnished by the applicant, his/her/its agents or employees.
By my signatur�, I certify that the information and exhibits herewith submitted are true andcorrect to the best of my
knowledge and that I am authorized to file this application on the behalf of the owner as listed below.
SIGNATURE OF APPLicANT/AGENT DATE
Property Owner's Authorization
By my signature', I certify that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my per'rmission for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
A - 0,
SIGNATURE OF OWNE ���-%c 0 V 0. DATE
i I \%.--\ 9,-
Owner/
Briar Development
Name
2211 Rlmlaud!Drive
Street Address �
llellinaLham I WA 98226
city State Zip
Telephone: 360-650-8382
Applicant Representative:
Name
Street Address
City State Zip
Telephone:
Email address (optional): Email Address (optional):
E
STREET FILE
C) 2- -gq 0
CITY OF EDMONDS
BUILDING DEPARTMENT
I WORK 51 C-7 (`3
APPROVED DATE: /A2/o --I
BLDG. OFFICIAL
RECEIVED
DEC 3 0 2002
PERMIT COUNTER
APPROVED BY PLANil
..0"M
()L -fi,
RECEIVED
DEC 3 0 2002
f4 PERMIT COUNTER
1114 "= I /
I
qI
ell Sk),
,"� 0
L]
The City of Edmonds
APPLICATION
for
SEDE SEWER PER3HT
t' CARD No . ......................................
OUTSIDE tg INSIDE REPAIRS F-I EASEMENT No . .......................................
OWNER ......... ......... C.04.1 . .......... ...... JPJ CONTRACTOR ......... .............. 06A.S.4 V .................... PERIVHT No(g/.
"r STREET :f-7 �-p
HOUSE ...................
..........
...... ... t ....................... _ ...... AVENUE LOT 'No . .................................................. L ...... BLOCK No. ....................................
LLU
FJJI
Date
BACKPILL WORK ORDER ISSUED ...................................
SEWER WOkK ORDER ISSUED ..........................................
................................................. ---------
NAME ADD. -!� 1-7c- - -
DEPOSIT, $ .............................................
Approved:
DATE ...
..................
APPROVED
OCT 00 1964
-------------------
#P20 CA File No
Critical Areas Checklist
Site Information (soils/ topography/ hydrology/ vegetation)
1. Site Address/ Location: 21904 Highway 99- Edmondn_ IWA 98026
2. Property Tax Account Number: 5807-000-040-06-00
3. Approximate Site Size (acres or square feet): .07 Acre
4. Is this site currently developed? x yes; — no.
If yes; how is site developed? Single —story " commercial structure
5. Describe the general site topography. Check all that apply.
Flat less than 5-feet elevation change over entire site.
X Rolfing: slopes on site generally. less than 15% (a vertical rise of 10-feet over a horizontal
distance of 66-feet).
Hill slopes present on site of more than 15% and less than 30% (a vertical rise of 10-feet
y
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. Site is in the floodway floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
Flows are seasonal? (What time of year? Y
10. . Site is primarily: forested — ; meadow ;shrubs mixed
urban landscaped (lawn, shrubs etc)
11. Obvious wetland is present on site:
------------------ For City Staff Use Only
1.
Plan Check Number, if applicable?
2.
Site is Zoned? C��(
3.
SCS mapped soil type(s)? ,2!;� ( St IJO'a o
2�_(a!7:Z0 'cE�j2_Aea -
4.
Critical Areas inventory or C.A. map indicates Critical Area on site? t1jC:>
5.
Site with -in designated earth subsidence landslide hazard are a? NQ+ , fy-�Q�, _%_C! V�_-K X
e-L i C'2'� +0
DETERMINATION
STUDY REQUIRED WAIVER
Reviewed b y- P.:::, Date: I— :1 —00
Critical Areas Checklist/3.25.2004
#PZO
of Edmonds
Development Services Department'..
Planning Division
Phone: 425.771.0220
The Critical Area's Checklist contained on this form is to
be filled out by any person preparing a Development
Pemu't Application for the City of Edmonds prior to
his/her submittal pf the application to the City.
'Me purpose of the Checklist is to- enable City staff to
detenTu*ne wheth I er 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 o6servations of the site or data available at
City Hall (Critical areas inventories, maps, or soil
surveys).
Date Received: I
Cit�Receipt #.
Criiiic"al Areas File #: 9i — 6
Critical Areas Checklist Fee: $135.00
Date Mailed to ADDlicant: !/ —,2 -5 — 0
A property owner, or his/her, authorized 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 deterrmination of the
subsequent steps necessary to complete a development
permit application.
Please submit a vicinity map, along with the signed copy
of this form to assist City staff in finding and locating the
specific piece of property described on this form. In
addition, the applicant shall include other pertinent
information (e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant.staff
in completing their preliminary assessment of the site.
The undersigncdlapplicant, and his/her/Its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
I
attorney's fees, Arising from any action or ifraction based in whole or part. upon false, Misleading, inaccurate or
i
incomplete information ftimished by the applicant, his/her/its agents or employees.
I
By my signaturej I certify that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and t1lat I am authorized to file this application on the behalf of the owner as listed below.
SIGNATURE OF A�McANVAGENT DATE
Property Owner's Authorization
By my signature,11 certify that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my perinission for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of isp�,ction and posting attendant to this application.
SIGNATUREOFO"ER DATE
Owner/AppticAnt:
I
Briar Development
I
Name 1
2211 Rimland Drive
Street Address
tellingham WA 98226
City State Zip
Telephone: 360-650-8382
Email address (optional):
Applicant Representative:
Name
Street Address
city State zip
Telephone:
Email Address (optional):
Nov 30 04 11:44a., American Environme;ntal-Co 2013 522 4099 p.2
Nov 04 04 12:42p American Enviro,merital Cc 20E; 52?- 4099 P.1
eceived
PUGET OUIND CLE,,kN AIR 2C
AGENCY Suite 500
0 9 0 10 Union Street,
Sl:aftic,WA 9SI()I-2039
130 10 ... 7'...
0 vwNv.pscleanair.or9 Agen0l Use 00V
'TENT ............
NOTICE OF .......... �
Ageno;.V Use 0"'y Demolition Dernglition 01'
b -to-, Re oval FriahleAsb-t I
p 1.0, ect 7 )e: i ble .4,
[3 Fri
phone: 360.650.838
Proper", owner: Eiriar Development Company Bellingham State WA Zip: 98227
Box 9704 1
,,4ailiniz,aAdress' PO —:IT(- 11 I-N — John Asselin
.. ....... ...... .............. . ... .... VTIT st ction LLC owner/CEO: Conti -actor
c. Asbestos ob No.:
contractor: American Environmental Con ru MOM: (206) 523-4441
P.O. BOX 81005 (206) 522-4099 4 38
Mailing Addr%:ss: Fax:
:__� Seattle state* I Zip: 99026
Citv: .. Edmonds Zi
Citv:
D. site
Address: 21904 HighwaY 99 '360.650.8213
Local Pho 0:
site es tANO
Michele Lo
Man was Fria''ble j!',`S�'CstOs Q(Yes ONO
at of AsbeStO5 bestos Identified -
. .. ........ .. .. 0. of I sunev: of the surve),
9 --- :R 7-15 04 Was Nonfriable As whe n fi-iable asbestos
E. Asbestos sullve'y �®ri Attach a COPY
Cl T.1.0 'O"'emmed structures:
Certil,"tion has no I been identified.
A ERA Building E\,). Date' I-NA1.04-om-13-05
Inspector: Nickolas Novvicki e Dept.)
01M on proje" Training Fire (Lis F ch cc) of Ordur)
4 ANERA S_cy is -qmi "I red before an deir No. of ordered Demolition (atla
I start structurrs: c le in place during demo? Yes No
Date: 11-15-04 will nonfriabie bestos
Information"- .5 J110ding a r i on back If yes, list type and qty.
Demolition conlractor
Contractor: Donovan Excavating Work Days: Sa Su
orn letion Date: Hours: Q Yes
G. Friable Asbestos Start Date: Co Will all friable asbestos 0 No
Pro'ect Information: Linear Ft. S uarc Ft. materials be removed?
,,CMO%Ied: other:
Total Qtv. to be P puct I ns. — --F-, "I
In,,ulation: Bour\Furnace ins :'!�Te.vwu�rmedCo Other
Thermal Syste I . .. ......... ... . ...... .
g Paints L-1 las"" other.
Surfacing Mail: FiruProfflin V 1
fliio,�Iing or 1160fing Ma
Misc. Mat'i Cement Bd. 1ce-m-crit �Pipc NotificiltiOn period P rej ect Dcm olition
FCC —SU-5-h laro C
ries:
eTnolition Project Cllte',"` ,k7 —s25
7F,�. Asbestos"' A. prior Notice
,'i'gle.Fami1v Residence: S* B. S50
A. L3 Asbestos Removal Project Ont� B. 10 Day
, or %vitliout asbestos removal proirct) tile above boxi!5
0 lition Project (will' demolition must wait 10 da s their donlicile-
B. DeMO ation; _. I. ' as I b Min
remo%.al can be .11 11, ion notific: - — e usin,9 tile restae"c' mixed.jise
I, W to has been or is -wil, units. or at:
III Asbestos miv o�Nned =by �T)5mily w ram UU
famills residence - rental r er lnulfi-
vote.- If the sil �le f,,3ily residence does not include 10D s
I or IB ?Ilav 1)e checked. A s!inE
A -- _1111__ . os Removal Pro ect Asbestos Derno 10 Sloo
2. All 0 er DcmoJ l7itin, ,%, i tb No Asbest , Residence)'. 10 Days SIC
ects other th n Sin le Famil Prior'Notice $100
Friable Asbestos Pro Ure feet of asbestos IOD S $200 S250
159' linear feet aildfor 'a 48 - 159 s
3. 10 51� I uare feet Of Asbestos 10 Da S S750
4. 260 160 - 4,999 feet of asbestos prior Notice rwice Project Fee
5. >1.00 linear feel and-lor >5,000 s uarc
rgency Demolit On Project writtenemerPency ucstl
cct or Em. ide a
6. Emerg ncy Asbestos p ' ity owners must PrO'v
12 mpt fiom ernienzenCy fee., ho%%.Cvcr. PTO Use nly
(Sin le-ramil-v Rcsidenecs are cNe . . . . . . . . . . . . . . .. .. .. .. .. trate & complete. Age9l
is & ,pplcmenial data is. to the best of my knOWICd9e, *ec'
.ti ai c. Information conlaint ".this riot&'GaLi
1. tifyt American Envinolnumental ConStrUCtIon LLC
160 (Revised 9/0;) T,
Pug,
,i Sound Clean Air AgtncY Form No: DEC 14 2004
PER
0 STREYbuRESS
CITY OF EDMONDS
.7110-210TH ST.S.W. - EDMONDS, WA 98026 - (206) 771-0235 - FAX (206) 744-6057
COMMUNITY SERVICES DEPARTMENT - PUBLIC WORKS DIVISION
<"St. 189\�)
April 24, 1996
Ken Woo
21904 Highway 99
Edmonds, WA 98026
Dear Mr. Woo:
FILE
BARBARA FAHEY
MAYOR
I have reviewed your account and will allow a credit for the billing period of
April 15, 1996 in accordance with our City policy. This will include water and sewer as
this is a commercial account. The policy states that the customer will be billed at the retail
rate based upon the average water consumption for the same period during the previous
year. In addition, the excess water lost from the leak will be billed to customer at the
City's wholesale rate with a 15% surcharge added for administrative cost. Only one leak
credit will be granted in any three year period.
Should you have any additional questions after you receive your new billing, please
contact Ilene Larson, Utility Billing Clerk, at 771-0241.
Sincerely,
RonVl'i
Water/Sewer Supervisor
RH/jh
cc: Ilene Larson
Utility Billing Clerk
wordata\water\credit96\#450250
0 Incorporated August 11, 18§0 9
Sister Cities International — Hekinan, Japan
OU1 -4
PLANNING DATA
New Commercial / Mulffamily Prowects
SITE ADDRESS: 2-t 9 C 4 - 9 ZONING: K-6 2—
V
USE(S) PROPOSED: ALLOWED?:
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED
CUP File: To Allow What Uses?:
ADB FILE #:
PARKING:
Use:
No. Spaces Required:
. X
(floor area, # employees, etc.) =
Use:
No. Spaces Required:
. X
(floor area, # employees, etc.) =
Use:
. No. Spaces Required:
X
(floor area, # employees, etc.) =
Use:
No..Spaces Required:
X
(floor area, # employees, etc.) =
Total Required:
Actual Provided:
SETBACKS:
Required Setbacks:
Front: Left Side: —Right Side: Rear:
Actual Setbacks:
Front: Left Side: —Right Side: 'Rear:
Street map checked for additional setback required? Yes/No)
MAXIMUM FLOOR AREA:
Maximum Allowed: Actual:
BUILDING HEIGHT:
Maximum Allowed: Actual. Height:
Modulation Allowed?: Modulation Height:
Datum Point: Datum Elevation:
Elevator Penthouse > 3 feet over height limit? If so,VAR#
LANDSCAPING:
Matches ADB approved:
Bid Provided? Bond Amount (100% bid):
CRITICAL AREAS #:—
SEPA DETERMINATION:
SHORELINE REQUIRED?:
Continued ...
1AfibmryN^P1andatNewConim.doc
DATE: PLAN CHK#:
NAME OF BUILDING PERMIT APPLICANT:
PROJECT DESCRIPTION:
ADB FILE #: 7s - 4t,
OR DATE WAIVED:
PLANS MATCH APPROVED PLAN:
SUBDIVISION:
LOT AGGREGATION REQUIRED?:
REDUCED SITE PLAN (8.5X11) PROVIDED FOR STREET FILE?
OTHER:
Pian Review By:
C/
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1Alibrary\APlandatNewComm.doc
9 STFOET FILE
CITY OF EDMONDS LAURA M. HALL
MAYOR
250 - 5TH AVE. N. EDMONDS, WA 98020 - (206) 771-0220 - FAX (206) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works * Planning e Parks and Recreation a Engineering
9 0 199
February 14, 1992
Mr. Ken Woo
Edmonds Pet Shop
21904 Highway 99
Edmonds, WA 98020
Dear Mr. Woo,
PETER E. HAHN
DIRECTOR
As requested in your February 10, 1992 letter, the City will be working
with the representatives of Top Foods to leave the area in front of
your business in its present state. As part of the Top Foods project,
no curb and gutter or sidewalk will be installed across the face of
your property on SR 99. Since customer parking for your business is
being provided in the Top Foods parking lot, no customer parking should
be allowed within the SR 99 right-of-way. With the busy traffic on SR
99 and with an exit from the Top Foods property being adjacent to your
northerly property line onto SR 99, customer parking is not recommended
in front of your business within the SR 99 right-of-way.
The City staff is going to work with the Top Foods representative to
provide a delivery access from the Top Foods parking lot adjacent to
your southerly property line. It would be your option to use this
delivery access.
It is the intent of the Washington State Department of Transportation
to eventually widen SR 99 to seven (7) lanes with sidewalks. It
appears your building is within eight to nine feet of the State
right-of-way. The future face of curb for the future traffic lane will
be approximately sixteen (16) feet from the face of your building. We
would anticipate no parking would be allowed in front of your business
because of safety concerns when SR 99 is widened. Presently, there is
a project to widen SR 99 in which the latest schedule we received shows
widening in front of your property in 1993. Since SR 99 is a State
highway, the State, of course, could restrict parking at any time.
Please consider and plan for parking in the future when SR 99 is
widened.
If we can be of any assistance, please call.
Sincerely,
ROBERT J. ALBERTS, P.E.
City Engineer
RJA/sdt
c: Scott Snyder, City Attorney
KENWOO/TXTST530 * Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
*STREET FILE
iv
010
-7 —7 44c, 2-2— 6)
RECEIVED
FEB 12 1992
ENGINEEMNG
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rEstablished 1970
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L.,j C.� L, Lck 1,P C_
�-e
Edmonds Pet Shop &Aquarium
21904Highway99 - Edmonds,WA98020 - (206) 774-6226
OF EDMONDS.
when work
-SEWER'DEPAN
--'C NTER," WATER rxENT
CIVIC E is ready
'0 11837.
-Sw da,
tion urdayi I v-,or holidays.),
S P
IDE-SEWER" ERMIT
........................................................................... 7
.............................................
6- _C
..............
0. ........... ONTRACTOR_� ...... Tudker..A. t _UC-ti
-CONNECT a side sewer -
41A�isslo'n Is-* ....... 1 19.6.4., for .................... :_dii,3�s. to REPAIR o
r
ln'�iw_ ordand&-with.. applicaflon-,on Me and governinig ordinances.
W_
THE FOLLOWING:
the -property may obtain a permit -to construct sewer inside property'll 'A licensed Bide�.Sewer Contractor, must
sew r- before - - haa bee -Insiiected
of -of ne. -it
be employed7tojeonstruct �slde sewer in street� area. Do not cover any. portion: _e
No.-,`Z—L 613tiazi full -,-,In- ega, I rdi - ng wers when you- _get�permlt.
formation r Ordinance 11.16.030 and, Regulations'governinge-_ .14
ty, I ;'minfinum,gra de of -2%_
s*ide' sewe'i--,inl6it. have at leiit'30 -inches -coverage �at.pFoperty -line' and.12. inches Inside proper I ne
J�To�,Iiends.'In -grade shaive.rhth.Rn '/a will be -permitted.,
Ron
�.-c�"NOTE:-No� 4 -must be water, settled'and-surface of street. restored -to original condition., Contractors shall..be res sible for
Trenches in, street
elop within- one year-76f completion.
-failure due to Improper- work which. may dev
other- �oik-then is provided' for In -the pqmft� or, to do. any. work on the --main, sewer,or its ap-,
lo.-.5�-R-Is_unlawful to alter or doany� w wye,
puiteriances �except to,insert the pipe Into the
DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATIOK
OWNER NAMEMAME OF BUSINESS
Briar Development Co.
MAILING ADDRESS
2211 Rimland Drive
CITY ZIP TELEPHONE
Bellingham 98226 1360-650-8360
NAME
ADDRESS
CITY
ZIP ITELEPHONE
AMIN&
'N 7-7
PERMIT EXPIRES
USEEj�� PERMIT
ZON NUMBER",e��
JOB SUITE/APT#
ADDRESS
PLAT NAME/SUBDIVISION NO,
LOT NO.
LID NO.
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESOP Approved
RW Permit Required
Street Use Permit Roq'd
EXISTING — PROPOSED
Inspection Required
REQUIRED *DICftFtz1hLS21 =�JON R6QUIRRE
Sidewalk Required
Underground
Wiring required
METER SIZFS
TR937ETOI B9OCR.F99ftF&
E
D UIRED
—
YE"
S NO 0
REMARKS ---- -- —7 '"
OWNER/CONT2AC?A(?9RTX13l!4IPffl EROSION CONTROL/DRAINAGE
0 WATER METER TO BE REMOVEn im
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ENGINEERING REVI�) BtJf,.MOLITION INSPECno*TE
0 CH.E&O�T ON BACK OF JOB
ADDRESS
26322 79th Avenue South
C.MW.
FIRE REVIEWED BY DATE
W
CITY zl�
Kent 98q32.:
TELEPHONE
253-852-.17715.
STATE LICENSE NUMBER EXPIRATION ATE
VARIANCE OR CU
SHORELINE OR ADB#'
INSPECTION
REQ'D
BOND
POSTED
JDEKC**02002 -1/d7/2
PY'ES ONO
SEPA REVIEW
C OMPLETE EXEIVIP
SIGWAREA:
ALLOWED PROPOSED
HEIGH T
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5807-000-040-06-00
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NEW RESIDENTIAL PLUMBING/MECH
ADDITION COMMERCIAL COMPLIANCE OR
E] CHANGE OF USE
REMODEL MULTIFAMILY SIGN
LOT COVERAGE
ALLO'WED PROPOSED
REQUIRED. SETBACKS (Fr.)
FRONT SIDE REAR
PROPOSED SETBACKS (FT.)
FRONT URSIDE REAR
PARKING
REO'D PROVIDED
LOT AREA
PLANNING REVIEWEb,B7V DATE
GRADING FENCE,
REPAIR CYDS X FT)
I
REMARKS
DEMOLISH TANK OTHER
GARAGE r RETAINING WALL- F RE SPRINKLER,
'n
CARPORT El ROCKERY ME ALARM
(rYPE OF USE, BUSINESS OWACTIVITY) EXPLAIN:
CHECKED BY
TYP F CONSTRUCTION
CO
OCCUPANT
Demo existing structure
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1 2 A
GROUP
NUMBER
NUMBER OF
CRITICAL
SPECIAL INSPECTION ARtA
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—
OCCUPANT
LOAD
OF One
STORIES
DWELLING One
I UNITS
AREAS 04-146
NUMBER
DESCRIBE WORK TO BE DONE
Demo building, slab and footings, cut
REMARKS a
PROGRESS INSPECTIONS PER UBC 108 IBC109 [IRC109 FINAL INSPECTION REOT
sever line, salvage�:parrot'head'and'grade are
to drain.
-A'2&i41&
VALUATION
Description,
Description
FEE
A!:
Plan Check
State Surcharge
HEAT SOURCE
GLAZING %
LOT SLOPE %
City Surcharge
PLAN CHECK NO:
VESTED DATE
Rlurnbi . ng'
Base Fee
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK To
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Grading
Engr. Review
i PERMIT APPLICATION: 180DAYS
PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD 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 MODIFY; WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
Fire Review
Plan Chk, Deposit
Fire Inspection
Receipt #
Landscape Insp.
Total Amt. Due
L
Recording Fee
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
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLAT ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN!S COMPENSATION INSURANCE AND RCW 18.27.
CALL
FOR INSPECTION_
APPLICATION APPROVAL
This application Is not a permit until signed by the
Building Official or his/her Deputy: and Fees are paid, and
_ recelptiseckn owledged in space provided.
9(F
.XIjIALS S)GOATURE DATE
SI�A�w R 0)1`AGEN� DATE SIGNED IA05
02 MAN
771-0220
RELEASED BY
A17ENTION Off 1333
ITIS UNLAWFULTO USEOROCCUPYABUILDING OR STRUCTURE UNTILAFINAL
INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU-
PANCY HAS BEEN GRANTED. UBC109/IBC110/IRC110. OR�GINAL-FILE YELLOW- INSPECTOR
09/03 r%r%r-'e%#% 11 A r%r% %10%1 1 A r%1-T 09 A LF111,14% . 0%0%r%1r-f% PNK-OWNER GOLD -ASSESSOR
AkLL
", RECEIVE,)
A 3 Wm,
f*ERMIT
4
EkPINES
CITY OF EDMONDS
USE PERMIT
ZONE
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NAME
METER SUE LINE
SIZE
NO. OF FIXTURES
PRV REQUIRE . D
YES C3 NO 13
ADDRESS.
REMARKS
OWNEP/CO R RESPONSIBLE FOR EROSION COkMOUDRAINAGE
CITY �Pv/ ITELEPHO.
N_ I
NAME
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ENGINEERING REVIEWED BY DATE
ADDRESS
/172-0
CITY ZIP
kyj 01
1�,,LEPHIRA�I -
C-7Z - 3 70 C
FIRE REVIEWED BY DATE
VARIANCE OR CU
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INSPECTION
REO`O
13YEs GKo
86NO
POSTED
s ..w
STATE, dCENSE NUMBER N
�2
< 7-7 r
DUFCKED. 13Y
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SEPA REVIEW
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HEIGHT -
ALLOWED PROPOSED
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EXP,
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RESIDENTIAL.
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PWM91NG MECH
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ALLOW90
REQUIRED SETBACKS (Fr;�
'FRONT
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.
COMPLIANCE OR
PROPOSED
SIDE REAR
FRONT. LIR SIDE. RE#%R
ADDITI I ON
COMMERCIAL
CHANGE OF USE
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REMODEL
MULTIFAMILY
SIGN
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REOD PROVIDED
LOT AREA
PLANNING REVIEWED BY ZATE.
REPAIR Cj GRADING FENCE
X Fr)
REMARKS
0 DEMOLISH 0 TANK OTHER
77
MINING WALL
GARAGE RE FIRE SPRINKLER
4J..CAAPQRT
ROCKERY FIRE ALARM
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STORIE
NUMB ER OF * V '
DWELLING.
UNITS �VIA
CRITICAL
AREAS
NUMBER eA
SPECIAL INSPECTION
AREA
OCCUPANT
REQUIRED
YES
LOAD
CA
..DES iSEWORKT0 BE DONE
q
REMARKS
op
OQ/a
KS
PROGRESS INSPECTIONS PER UBC IGO/FINAL INSPECTION REM
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IvALOAF814
$
Description
FEE
Deecriptlon
FEE
Plan Check
E.TDesc
State S
-State Surcharge
HEAF i;IUR8E
Got -G
Lar Z08PE
Building Per
Tf
City Su
City Surcharge
PLAN CHECIJ NO-
aA
_J23- -
!9.:v 7ZJ
VESTED DATE
Plu.mbing
Mechanical
THIS PERMIT AUTHORIZE111 ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DOME ON PRIVATE PROPEIVY ONLX AMY CONSTRUCTION ON THE PUBLIC
DOMAIN SIDEWALKS,
Grading
(CURBS, DRIVEWAYS, MARQUEES, ETC.) VALL REQUIRE
:t:
SEPARATE PERMISSION.
PERMIT APPLICATIOft..1 90 DAYS:'
Engr. Review
P.IERKIT LIMM tYEAR- PROVIDED WORK IS STAINFED WITHIN ISODAYS
SEE BACK OF PINK PERMIT I;OA MORE INFORMATION
Engr. Inspection
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
!I
IN INTEREST. AGREES TOINDEMN1#y. DEFEND AND HO CITY OF
EDMOP '-�"ITS OFFIC1ALS,.E9l`LOYEE% =SS THE
408, WAS14INGMM AGE FROM ANY AND
FOR 6AMAdifS rNGDIRECTLY
Fire Inspection
Aece ipt
ALL CLAIMS OF WHATEVER NATUM ARIS G DIRI OR INDIRECTLY
-..FROM
III
THE ISSUANCE OFTHIS PERMMI ISSUANCE OF THIS, PERMIT SHALL NOT BE
7:. -
DEEMED To. MODIFf, WAIVE OR REDUCE ANY REOUIREME14T OF ANY CITYORDINANCE
NOR LIMIT IN ANY V*(THE COVE A61 ITFORCE ANY ORDI kNIA PROVISIPM.",
Landscape Insp.
Total A". b
I HEREOYACKNOWLEDOETHAT,l HAVE. READ -MIS APPUC#nON;.THAT THE INFORMAT16W'f.
Rebordin Foe
Receipt*.
GWEN. is CORR ti
wr AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED"AGENT'Of f:'�
*LAWS
APPUCATICINAPP1110VAL
TkIE-OWNER., I AGREE TOWMPLY WITH CdY.AND STATE REGULATING CONSTRUC!"��*',.
TAPh.. MD IN DOING THE WORK AUTHORIZED THEREUY. NO PERSONVILL BE EMPLOYEd'. 1,
. CALL
.: -
*19 epoldit]lon I� , iwl �Mi eigned by the
- &A" Offletel or Moor: 0;;: a0id'Feee
IN VIOLATIOM.OF THE LABOACOMOF THE STATE OF WASHI NGTON RELATING� TO
M"AAN .
#9RIWEN#8 CoMPENSA 6E AND ACW 18.27.
.
V6,
R IIN90EdnON
... i I . %:; . ,
. , are paid, and
i receipt is ackhomidabdinsPaceprooded.
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;II0khURi jOWN E GENT)
DATE S!9NED
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12110
.. .1
ATURE DATE
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IFS I x1rr :, ... . . , .
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IT IS N
U LAWFUL TO USE OkbCCOPY A BUILbIN6:6R STRUCTURE UNTIL
:.
/
.......A FINALINSPECTIONM AS BEEN kAbE ANO A0PR6vAL. OR, A C" eRTIFIT
t'CATE 6F OCCUPANCY HAS BEEN-GRA14Te& UBC SEdTl6N 109
OAIGI NsF9cjO
04162
'PRESS HARD -YQU
PI 661.641*1wessoA
MAKINGS COPIES GREEN.- ACCOUNTING
.,ARE
;ECE
.��ATE IVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
0 ER NAME/NA%F BUSINEJ
10129 Ae. reRd dooks
MAILING ADDRESS
0 2 110 y
CITYE j i� f Z
t0VX ;P 02�TELEPHONE
NAME
ADDRESS
CITY ____F_
zip TELEPHONE
NAME &t
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CITY . ZIP TELEPHONE
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PERMIT Mt0'1RES
6SE PERMIT
ZONE A / -
JOB SUITVAP`r#
ADDRESS 11 A- ,IV -02
PLAT NAME/SUBDIVISION NO.
LOT bro.
LID NO.
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCIP Approved
RW Pennit Required
Street Use Pennit R.wM
EXISTING PROPOSED
Impaction Required
Sidewalk Required
REQUIRED DEDICATION— FT
Underground
1 winng required 13
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
I
I
13
YES E3 NO 11
3
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
Z
ENGINEERING REVIEWED BY DATE
FIRE REVIEWED BY DATE ul
YXS- 7"74 ff 3,s-
STATE LICENSE NUMBER EXPIRATION TE
114
A/C 0 -7 7 C- 4�
)CECKED
BY
VARIANCE OR CU
SHORELINEORADB#
:-t
t2Lry _";�
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REQ 2/
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BOND
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PROPERTY TAX ACCOUNT PARCEL NO
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SEPA REVIEW
COMPLETE EXEMPT
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SIGN AREA
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ALLOWED I PROPOSED
14 14
NEW 1:1 RESIDENTIAL b PLUMBING MECH
COMPLIANCE OR
ADDITION COMMERCIAL
0 2( EOFUSE
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1:1 LTIFAMILY
1:1 REMODEL ZIGN
E] REPAIR" GRA I DING FENCE
cyo§ 1:1 ( — x FT)
DEMOLISH TANK OTHER
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CARP.ORT""'*":,,�-i'�"�.".� ; FIRE ALARM
'VERAGE
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FRONT SIDE REAR
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PROPOSED SETBACKS (FT.)
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PARKING
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JJ�LANNING REVIEWED BY DAT4
ft Noe
REM
"E OF U%E, BUSINES6,9R ACTIVITY) EXPLAIN
ooKs ol�C_
NUMBER AUAdSER OF CRITICAL
OF I DWELLING :r AREAS
STORIES I UNITS NUMBER /7//14
DESCRIBE WORK TO BE DONE NO 0 In ",,Z-
2x t�t sill . .4 r e-
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HEATSOURCE., GLAZING % LOT SLOPE %
I PLAN CHECK NO: VESTED DATE
/� I--) —f-/ / / I —
THIS PERP—Arr AuTHORIZES ONLY THE WORK NOTED. 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 APPU CATION: 180 DAYS
PERMIT LIMIT! 1,YEAR; PROVIDED WORK IS STARTED WITHIN 1180,DAYS
SEE MCK 6 PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHA�`LF' OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHIN&ON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
ANCE 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 crlys ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
I HERE13Y 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
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE PF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURWE AND RCW 18.27.
DATE SIGPED /
4 -7 J1 ~2-A / D -3
CHECKED BY
I TYPE OF, NSTRUC [ON
WD
C�07E
7
OCCUPANT .
GROUP -14
SPECIAL INSPECTION
REQUIRED [] YEs
JAREA
OCCUPANT
OAD
REMARKS
PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REG-0
VALUATION
Description
Plan Check
FEE
Description
State Surcharge
FEE
Building Permit
470
City S rcharge
Plumbing
Mechanical
Z0
rGrading
Engr. Review
Engr. Inspection
Fire Review
Plan Chk. Deposit
Fire Inspection
Receipt #
LandscapeInsp.
Total Amt. Due
Recording Fee
Receipt #
OMQ 1-
CALL
FOR INSPECTION
771-0220
APPLICATION APPROVAL
This application Is not a permit until signed by the
Building 0111clal or his/her Deputlir: and Fees are paid, and
rerelpt Is acknowledged In space provided.
OF ..IALS SIG TURE DATE
-10
tI 10 3,
4--EL-EflAqEn
BY I I dATE(
)MENTION � I/ EXT 1333 — 4.1V
11" IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL..OR A CERTIFI- ORIGINAL - PV- YELLOW - 1146PE41OR
CATE OF OCCUPANCY HAS BEEN GRANTED. VBC S&TION 109 PINK-OVKER - GOLD -ASSESSOR
04/02 PAES!9 HARD -YOU ARE MAKING 5 COPIFES GREEN - ACCOUNTING
CD
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