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STrREET FILE
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MAR 2 3 2012
DEVELOPMENT SERVICES
COUNTER
PORTION OF
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MAR, 2 � 9 '2000
PARKIMG
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03/11/1996 11:09
77 89ja
SOLINDAPPR 0
PAGE 02
N.
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01 '711 It 0
City of Edmonds
Critical Areas Checklist
The Cdtical Areas Cliecklist contsined on
this form i3 to be filled out by any person
preparing a Development Permit
Application for the City of Ednxm* prior
to his/her submittal of a development
permit to the City -
Ile purpose of the Checklist is to enable
City staff to determine whether any
potcntial Critica) Areas are or may M
present -on the subject property. Tbe
infocination neWcd to compkw the
Cheeldist should be euilyawailable from
observation3 of the site or data available at
City Hall (CfificaJ Areas inventories, maps,
or soil surmys).
An applicant, or his/her representative,
must fill out the checklist, sign and date it,
and submit it to ft City. The City wil!
review [he c1mbeldist, make a Precursory site
visit. and make a determination of the
3ubuquent steps necessary to complete a
developrnent permit application. -
With a signed copy of this form. the
N!EKant should also submit a vicinitZ map
or plot plan for indi lots of the parcel
with eaough detail that City staff an find
and identify the subject parcel(s). In
stildidan, the aWficant sh2H indude
other pertinent infornution (eg. she
plan, topography map, etc.) or studies in
conjunction with this Chechrld to as"
suff In compWing their preliminary
saeument of the site.
I have completed die attached Critkal Arm ChecMist and aucst that ft answers provided are
taaual, to the beg of my )mowledge (fill, out the appropriate column below).
Owner / Applicant:
DAWV#V)ft&f'*FC4 WOVI
Nam
P,
Streel Addms
�&r0e,Wfr 1133 ;WD21
,City. State, ZtP Phone
sis"alum _47 t�a
Applicant Repment.ative:
Mo WOF
Name
.1 3qv-,- th Mt,5
Stfed AAdrea
F)A 1 0 P4YI416 J�JAikd 9 0 1,614 q
city, Stdc' ZIP Phone
rM I 1 1(0
sik'MtUM Date
zold . ZoTd-z6z 90Z ULc-KUQ1J 09qLLV V90!60 q6-TJ-.Avw
03/11/1996 11*-09 77890 SOLHDAPPR 10 PAGE 01
CA NO,
Critical Areas Checklist
Site Informiationt (soils/topo&raphy/hydrology/yegetatlon)
I. Site AddrenlLocallon:
�h
2- PCQPftU TaX ACCount NuMbeX.';:E ZLC-t—Do -029 -40/0�F -7c)
3. Approximate Site si" (acre, of square foot):
Z
4. IS this site currently developer a,
�Vyjs; — n(L 7
If yes; how is site developed? PA1f 0
5. Describe the general site to pography. Check 211 that apply*.
- Flat: less than 5-faft 014vation change over entire site.
R*Iling: slopes on site Senompy It= jhsn IS% (a v�cnjegl rise of 10-fcct over a
horizontal distance of 6"ect).
Hilly; slopes pr" on site of more thu 15% and less than 30% ( a vertical rise
0
of 10-fem cwef a borbrant:al distance of 33 to 66-feet).
Steep: grades otireater d= 30% presm on she (a venical rise of to -feet ovet a
hotizanud disunce of loss dkan 33-feet),
Other (Please describe):
6. Site contains areas of year-round msdiaS wrAter: ; Approl. Depth,
7, Site conuins Iran of seasonal nmWing water: Approx. Depth:
Wha 3own(3) -of the Y"Mr?
S. Site is in the floWway floodplain of a water course.
9. Ske contains a creek or an aru wbft watt flows across ft grounds surface? FlqM are year-
round? bi . — Flows are seftanal? h 0, - (Wh&t tinie of year?
10. Site 13 primarily- fore3tecl ki mcadow k-
-; shrubs mixed
ufta landscaped (lawn.shrubS etC)
11. Obvious wc1land is present on site,
For City Staff Use only
I site is zuncd� C6
2. 3CS mappW soil typos)? _,4 1"0
11 - 7 70
3--- WCLI&W inventory or C.A. 1T4P indicalawetWul pnmetsion sit@?_
4.- . Critical Amu invenwqerC.A. tnspiadk4l CrIdWAMonsile?
S.- Site within desigru" arlh subsidena landificle bazald arcs'r AZO
C. �--Site&signated an thot Envinitirnantdly Seatifive Are" Map? 4:��C)
111-4-1 -*11
'STUDY REQUMED
WAlVGR
Reviewed
pivolipw
CONDMONAL WAIVER
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THIS ORIGINAL DESIGN(S) IS THE PROPERTY OF
RAINIER INDUSTRIES, LTD. AND IS PROTECTED BY
FEDERAL COPYRIGHT LAWS. ANY REPRODUCTION
OR CONSTRUCTION OF A DISPLAY PRODUCT
x
m
<
LYMPIC AVE S
SIMILAR TO THE EMBODIED HEREIN IS EXPRESSLY
U)
WA 98188
510
FORBIDDEN. SHOULD SUCH CONSTRUCTION OCCUR,
x
x
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0
(A
RAINIER INDUSTRIES IS DUE $1000.00 AS
x
)251-1800
COMPENSATION FOR THE TIME AND EFFORT IN
m
(A
5)251-5065
CREATING EACH INDIVIDUAL DESIGN(S).
)869-71 2
ALL R.IGHTS RESERVED.
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OBEET FILE
of
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ul- - � 19,98
APPLICATION CARD No . ......................................
for
The City of Edmonds SEDE SEWER PERMT EASEMENT No . .......
---- -- ----
OUTSIDE 0 INSIDE E] REPAIRS 0 t *
A
OWNE....................................................................................................... CONTRACTOR ---- .................................................................................... .......... PERMIT No.
4,4 STREET A41 ...... go .. ....... I ... I ........................ BLOCK No . ..........................................
HOUSE No . ............ ....... ------ I --------------------- ------------------ I AVENUE LOT No . ...... ..... * --- W ...
NAME ADD. ....... .........................................
.. .... ... ... ... .... .. .... . . ....... ---- --- --------- .......... .... ... ... ..
4F
-li I / ---� -`1
Date
4-
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ ..................
SEWER WORK ORDER ISSUED ..........................................
Approved
DATE................................................ By
n ED
59"
CITY OF EDMONDS*
*-Y��- V, �Z
121 5' Avenue North - Edmonds, WA 98020
Phone: 425.771.0220 - Fax: 425.771.0221 - Web: www.ci.edmonds.wa.us
DEVELOPMENT SERVICEs DEPARTMENT: PLANNING DivisION
ADMINISTRATIVE DESIGN REVIEW
-STAFFDECISION-
U)-
BLD-2009-0166 Project Proposal:
Johnny's Fine Wine & Cigars has submitted a sign application for their business located at 23423
M
Highway 99. The sign is a internally illuminated boxed cabinet sign.
M
Property Owner Applicant
Johnny Phan Same as owner.
-TI
1005 196" PI SW
Lynwood, WA 98036
M
Design Review Process:
The proposed project requires a Design Review. Projects that remain under the SEPA threshold
are reviewed by staff with the building permit and the design review is considered an
administrative Staff Decision subject to the requirements of ECDC 20.60 (Sign Code) and
20.95.040 (Staff Decision — No Notice Required).
Analysis:
1. Location. The project site is located at 23423 Highway 99. The site is zoned CG — General
Commercial.
2. Sign type. The proposed sign is an internally illuminated boxed cabinet sign which is a permitted
sign type in the CG zone.
3. Size. Sites within the CG zone are permitted I square foot per lineal foot of attached wall for walls
signs. The building frontage is approximately 40 feet, therefore the site is permitted 40 square. feet of
signage. The proposal is for a 2 feet by 8 feet sign or 16 square feet of sign area.
4. Color. The proposed sign color of a light green background with purple and burgundy letters is
acceptable.
5. Height. The proposed sign is to be placed on the face of the building which is consistent with ECDC
20.60.030B.
Decision:
Based on the facts and conclusions of this report, staff finds that the design review for this project (File
No. BLD-2009-0270 is APPROVED.
reviewed the app�Vation for compliance with the Edmonds Community Development Code.
I
Lien, Planmr�ivisi
Date
Page I of 2
File No. BLD-2009-0270
Johnny's Fine Wine & Cigars
23423 Highway 99
Appeals: Design review decisions by staff under the provisions of ECDC 20.12.030 are only
appealable to the extent that the applicable building permit or development approval is an
appealable decision under the provisions of the ECDC. Design review by staff is not in itself an
appealable decision.
Page 2 of 2
0 0
PLANNING DATA r FILE
-- Sign5
Name:
Date:
Site Address:
Plan Check #: 131- D-2000— 0
Project Description: LVm JU AW N OALi- sf &A)
Reduced Site Plan Provided: YE I NO)
Zoning: C&
Comprehensive Plan Designation: (,0br.1kr \)e-VAbfrV1Q,"A
Map Page: 5t
Lot: (YES / NO)
Flag Lot: (YES NO)
ADB File # (or date waived):
TOTAL AreaWr Type of
Type of Sign
Allowed in
Matrix
conditions
Allowed
area per
Unit
TOTAL sign
area
Proposed
zone?
met?
unit
allowed for
sign area
Example
Wall W110ternal
111unnnatlon
Yes WIth
condihoos
Yes
I sq. ft.111neal
tt. attached
41 ft. attached
Wa//
41 square feet
20 square feet
wall
Sign # 1
L4)�
L
I .
Ig
Sign #2
Sign #3
TOTAL Sign Area for TenanVSite
Max Permitted:
Previous Total:
Proposed Total:
Sign Height
Sign Type:
Max Permitted:
Actual Height:
Sign Type:
Max Permitted:
Actual Height:
Sign Type:
Max Permitted:
Actual Height:
Siqn.L�Zhtinq
Sign Type: 1&k�
Proposed:
Allowed in Zone:
Sign Type:
Proposed:
Allowed in Zone:
J,- �
PLANNING DATA STREET FILE
-- Signs
Sign Colors
Proposed: m, v-esLv\
Acceptable?
Vj�r-V 6,veo,� .,j 'A' k/v� 4wt
Requires ADB Approvab
Sign Locabofy
if freestandi ng and 3-feet or ov er
(unless a fence) meets setbacks?
Required Setbacks
Street:
Side:
Side:
Rear:
Actual 5ethacks
Street:
Side:
Side:
Rear:
Landx f 5i
4ns
Size:
Location:
V
Critical Areas Determination
0 Study Required
Wwaiver
Other
0 VN
01V
v\, cLr-Q—�
Plan Review By:
ROVED BY TJ�INU
4:6'- 4
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lllVo'CF 27982 FAsr,%Wm SarahTy4m
UaM -,WA*40 f-AX, JQW -A*-3iW4
WL�Aqybod DONV
Alr,- rdmd-tkim.rur wmram- !a Your v--*wBih0ijy.
1p 49
STREET FILE
RECEIVED
MAY 0 7 X39
DEVELOPMEW SOWES CTA
CrTY OF EDMONDS
Page I of I
is
f
INVOICE - 27982 FASTSIGNS or weLLevw PFtow mcmi Sarah Tyner
r - (425) 74"Ml FAX (429) MY-1674
1W x 96" Omega Board OAPMOWD qAPPROWOVATHCHAWAS f-RMlRQ0F
OweLLCHKX MCNEMEW
At FXlSTSldNkT,%@, we take piide in prvdsion, but the final examination for accamey is your responsibility.
Am Imcours galutwl.t tl)r dkt wurmn� flrwun*dkrj lwwulcit As%vil W%.-P Mu. 11WILls"th fl=iheM Wxjjkkji� *dQN.Agd ZebLrl: �*md�
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salwUll!
City of Ed monds rtment
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AP�R(GVZ "LAN
RECEIVED
MAY 0 7 2009
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
file:HCADocuments and Settings\johnm\Desktop\27982—RE-PROOFjpg 4/16/2009
Johnny Phan
Illuminated Plexi Box Sign/ Outdoor Electric Sign will be installed in the front of the building.
Measures: 8 feet long x 2 feet height x 9.5 inches deep, with approximately 12 inches high letters
Material: Back LIT Film
Description: 3M Back LIT FILM, 3M Cold LAMINATE
Text: Johnny's Fine Wine & Cigars
Color: light green background with purple & burgundy text
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MAY 0 7 2009
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
D,2006 Edition IRC w,'WAC Amendments
L92006 Edition IBC wrWAC Amendments
02006 Edition uPC w,'WAC Amendments
and Appendices A, B, G� I
E32006 Edition 11,vil- wfWAC Amendments
02006 Edition lFGC w/WAC Amendments
%, endments
02006 Edition IFC wPvNAl Am
02006 Edition VIAQ WAC 5 1-13
[32006 Edition WSEC WAC 51-11
CITY OF EDMUNUZS
[3UILDING DEPARThMEW
T?RESS
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DATP_
BLDG. OFFICIAL_
FERRET NUMBER
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BUI'LOINo
MAY 2 8 1997
MEMORANDUM
Date: May 28, 1997
To: Jeannine Graf, Building Official
Sandy Chase, City Clerk
From* John Westfall, Inspector
Subject: Non-conformina Use / Unlicensed Business: 23423 Highway 99
Fire Inspectors asked for, and were denied permission to inspect a new
occupancy/unlicensed business at subject address yesterday. Previous occupant is
Meyring & Associates, "132" use, now moved to the basement level of the structure.
Information from tenant at Meyring is that business persons at "Psychic Reader" are
operating upper floor space as business and residence (B?/R3).
cc: Lt. Woods
-Z
7
City of Edmonds * Office of Fire Prevention
CITY OF. EDMONDS
250 5TH AVENUE NORTH - EDMONDS, WA 98020 - (206) 771-0220 - FAX (206) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works * Planning 9 Parks and Recreation e Engineering
May 28, 1997
Cody & Cindy Ryu
23423 Highway 99
Edmonds, Washington 98026
RE: Commercial business @ 23423 Highway 99
BARBARA FAHEY
MAYOR
The purpose of this letter is to inform you, as owners of the subject property, that the City
Fire Inspector has observed violations at the subject building. If this property has recently
sold please provide the City with the name and mailing address of the new owner.
If you are still the responsible party for the property you need to be aware that the new
tenant "Psychic Reader has not applied for the following required licenses and permit
approvals: City business license, change of use permit, Architectural Design Board
approval fdr exterior changes and sign permit. Further, since entry has been denied to Fire
Department Inspection personnel we are unsure if interior remodeling work has occurred
without construction permits. As owner of the building we would like your consent to
enter the building during normal business hours for further inspection'
Please respond in writing as to your decision to grant access to* Fire Department
Inspection personnel and your intention to resolve these items as owner of the property.
If you have specific questions please call me at 771-0220.
Thank you,
Building Official
cc: Psychic Reader
Fire Marshall
City Clerk
0 Incorporated August 11, 1890 o
Sister Cities International — Hekinan, Japan
r K Uri ;
Z:)k1MU)-1VVr Lzalv r Hut a v i
SepteinOer 25, 1997
JEANNINE L GRAF. BUILDING OFFICIAL
(475) 771-0221 PAX
CODY & CINDY RYU
SR. ACCOUNT AGENT
15215 AURORA AVE N
SHORELINE, WA 98133
206-362-2692
RE: Commercial Property 23423 Hilway 99 Edmonds, WA 98026
We are the owners of the property named above. Psychic Readings by Marie
WaS a tenant until August 1997. Since they were violating the lease agree.
ment in several aspects. we were able to get a writ of restitution and evict
the tenant,
Once they left, we found extensive damage, as well as evidence they had been
living there and bathing there. We remved the kitchen and bathing facili.
ties, as we'll as mend a lot of ho-les and other damages.
Please let me or my husband Cody know when you need access to the property.
The downStairs tenant, Max Meyring, also has access when he is available,
Si nCerely,
0�f *
Cin
151�t2lrora Ave N
Shoreline, WA 98133
(206) 362-2692 during office hours
560 12th Ave N
Edmonds, WA 98020
(425) 672-7884 evenIngs and mekends
P.S, We received your May 28 and July 28 letters today, September 25
from Max Meyrino who had them all this timg
145e-- kY,- clue-i 61v Ilvef 7��
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COMMUNITY SERVICES DEPARTMENT
Public Works * Planning/Building o Parks and Recreation - Engineering - Wastewater Treatment Plant
C �is 1�3
July 28, 1997
Cody & Cindy Ryu
23423 Highway 99
Edmonds, Washington 98026
RE: Commercial business @ 23423 Highway 99
As a follow-up to City letter dated 5/28/97, the purpose of this letter is to inform you, as
owners of the subject property, that violations have been observed at the subject building.
If this property has recently sold please provide the City with the name and mailing
address of the new owner.
If you are still the responsible party for the property you need to be aware that the new
tenant "Psychic Reader" has not applied for the following required licenses and permit
approvals: City business license, change of use permit, Architectural Design Board
approval for exterior changes and sip permit. Further, since entry ha s been denied to
Fire Department Inspection personnel we are unsure if interior remodeling work has
occurred without construction permits. As owner of the building we would like your
consent to enter the building during normal business hours for further inspection.
Please. respond in writing as to your decision to grant access to Fire Department
Inspection personnel and your intention to resolve these items as owner of the property.
If you have specific questions please call me at 771-0220. Be advised, you are occupying
the building without approval from the City of Edmonds.
Thank you,
J&ne L. Gra
Building Official
cc: Psychic Reader
Fire Marshall
City Clerk
0 Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
FASEM=* AGREF14ENT
s agreement entered into thisc=D— day of A.D.
INC., and DENNIS A BAI ER and LEONE -AAKER,
�h.`19741qaAd between METRING & ASSOCIATES
411n*:1atd wife,z.p a Partnership,
arty of the First Part, and S & S INVESTMFNTS,
Second Part:
ar.t *.'of --.the
ereas,'th6 party of the First Part is the owner of that portion of Tract 28,
pli . je-`�of Skelton's Lake McAleer 5 Acre Tracts, as per plat recorded in Volume 6 of
4plats,i. on page 21, records of Snohomish County, Washington, described as follows:
tUginning at the intersection of the East line of Tract 28*and the Easterly right-
0
OfAVay of Primary State Highway #1; thence-S 23 51' W along -the Easterly right-
d-Fay for 130.0 ft.; thence S 66009' E for 64.97 ft. to the East line of Tract
28; thence N 2042'1611 W along the East line of Tract 28 for 145.33 ft. to the
'True Point of,Beginning.
Whereas, the party of the Second Part is the ownerof that portion of the
North 330 ft. of the West 140 ft. of Tract 29, lying Easterly of Primarl state
.04hway #1, Skelton's. Lake McAleer 5 Acre Tracts, as per plat recorded in Volume
page 12 1 ., rec=,da;.�,of srAihomi-s3itounty-, Washington.
Whereas
hereto being
d e s c r �ib e cf 'ea
the said two parcels of land are adjacent parcels and the parties
adjacent owners hereby mutually agree to declare the following
A pe _ nen n-exc usive easement for ingress and egress across and upon
the following described parcel:
That p.ortion of Tracts 28 and 29, plat of Skelton's Lake McAleer 5 Acre
Tracts, as per plat recorded in Volume 6 of Plats, on page 21, records of
Snohomish County, Washington, described as follows:
Beginning at the intersection of the East line of Tract 28 and the Easterly
right-of-way of Primary State Highway #1; thence S 23051' W along the Easterly
right-of-way for 50.0 ft. to the True Point of Beginning; thence continuing S 230
511 W for 22.0, ft.; thence S 66009' E for 35.98 ft. to the East line of Tract 28;
thence continuing S 660.09' E into Tract 29 for 28.99 ft.; thence S 23051' W for
5S.0 ft.- to the West line of Tract 29; thence N 87017'42" E at' right angles to
the West line of Tract 29 for 22.36 ft.; thence N 23051' E for 71.06 ft.; thence
N 66009' W for 61.98 ft—to the West line of Tract 29; thence continuing N 66 0
691 W into Tract 28 for 24.99 ft. to the Point of Beginning.
Said easement agreement shall be binding upon the heirs and/or assigns of
both parties.
�&--4asement area is to be kept op�n and unobstructed at all tires and
will nDt be u5ed as a parking area. . Sai ascment &-rea 15 for t af thr.
. I ; , , :,'_ , : '.,RECE I V E D
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owndri� and the �k�
..XVo :ad'
Japefit praper�y
IN Wrrmss wHEuOF, WE have hereunto set our hands and seals. MAR 2 0
DEVELOPMENT SE" i CES CTR.
STATE OF WASHINGTON)
County oL,4a,-;J
before me the undersigned,
19 1-7
On this __9 day of- 0
*...potary Public in and for tlgtL of' wasbA.ngton, duly commissioned and sworn,
peared M.B. Meyring and -Albert Chenoweth, to me '.known to be the
Ter. fp and I
President and Secretary -Treasurer of Meyring Associates, Inc.
and
vviW-iplatioir-that executed the foregoing
be the free and valitntary
t1ij*said instrument to
0
0
That portion of Tract 28, plat of Skelton's Lake McAleer 5 Acre Tracts, as per
plat recorded in Volume 6 of Flats, on page 21, records of Snohomish County,
Washington, described as follows:
Beginning at the intersection of the East line of Tract 28 and the Easterly Right -
of -Way of Primary State'Highway # 1 (Highway 99); thence S 23051' W along the East-
erly Right -of -Way for 130.0 feet; thence S 66009' E for 64.97 feet to the East
line of Tract 28; thence N 2042'16" W along the East line of Tract 28 for 145.33
feet to the True Point of Beginning;
EXCEPT That portion of said Tract 28 described as follows:
Beginning at the intersection of the Easterly Right -of -Way of Primary State High -
Way # 1 and 'the East line of Tract 28; thence S 2042'16'.' E along the East line of
Tract 28 for 55.90 feet; thence W 66009' W for 24.99 feet to the Easterly Right -
of -Way of Primary State Highway # 1; thence N 23051' E along the said Right-of-
way for 50.0 feet to the Point of Beginning;
TOGETHER WITH 'that portion of said Tract 29 described as follows:
Beginning at the intersection of the Easterly Right -of -Way of Primary State High-
way # I and the West line of Tract 29; thence S 2042'1611 E along the West line of
Tract 29 for 80.49 feet to the True Point of Beginning; thence continuing S 20 42'
1611 E for 64.84 feet; thence N 23051' E parallel with the East Right -of -Way of
Primary State Highway # I for 58.0 feet; thence N 66009' W for 28.99 feet to the -
True Point of Beginning.
SUBJECT TO easements and reservations of record.
LI
USE
ZONE
JOS
CITY OF EDMONDS ZONE
CONSTRUCTION PERMIT APPLICATION jos
OWNER NAME/NAME OF BUSINESS ADDRESS
I 'o—A, i I M,& 9--r I LEGAL ",
-3-4
PERMIT
NUMBER 980J., 36
NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING —REQUIRED DEDICATION
PROPOSED
METER SIZE F LINE SIZE
TESCP Approved
0
RW Permit Required
Street Use Permit Req'd
Inspection Required
0
Sidewalk Required
11
Er
PRV REQUIRED
W
YES 0 NO 13
0
Z
NUMBER
NAME
ADDRESS
a:
ENGINEERING MEMO DATED REVIEWED BY
00
194M ntymptc Ave 15
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CITY C) ZIP
TELEPHO NE NUMBER
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_rIA14V I LA V/A
16-345-2-61 -hoco
IRE MEMO DATED REVIEWED BY
0
STATE LICENSE NUMBER PIRATION DATE
Legal Description of Property - include all eas t
VARIANCE OR CU
ADBN
I "k I
SHORELINE a
? /A_
SEPA REVIEW
SIGN AREA
HEIGHT
IC
Z
COM PLETE EXEMPT
ALLOWED PR OPOSED
ALLOWED P ROPOSED
0.
cc
EXP
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0
LOT COVERAGE
REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS
Lu
0
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT UR SIDE REAR
0
�
w�
Property
Tax Account 45,70-000-OZ95-0109
LOT AREA
PLANNING�REVIEW BY
DATE
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ParceiNo.
v 4
REMARKS
'KEW RESIDENTIAL PLUMBINGIMECH
COMPLIANCE OR
&COMMERCIAL
ADDITION CHANGE OF USE
0'
REMODEL APT. BLDG. g'SIGN
HECKED By
TYPE OF CONSTPUCTION
I
CODE
OCCUPANT
GRO&
GRADING FENCE
CYDS. X_ FT)
REPAIR
�1`!!v �ky
DEMOLISH WOODSTOVE SWIM POOL
INSERT HOT TUB/SPA
SPECIAL INSPECTOR
AREA
OCCUPANT
REQUIRED OYES
-LOAD
GARAGE RETAINING WALL/
0
REMARKS
CA ROCKERY RENEWAL
PROGRESS INSPECTIONS PER UBC 108
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
NUMBER
NUMBER OF
CRITICAL
Lu
0
OF
DWELLING
AREAS
INUMBER
(D
STORIES,
UNITS
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
NAL INSPECTION REOUIRED
VALUATION
FEE
q
LAN CHECK FEE
BUILDING
800
HEAT SOURCE:
GLAZING %
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY.
G&Z1GffiWL—
()0
Any construction on the public domain (curbs, sldewplks,
driveways, marquees, etc.) will require separate permission.
STATESURCHARGE
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
ENG. INSPECTION FEE
'. Applicant, on behalf of his or her spouse, heirs, assigns and
w
successors in interest, agrees to indemnity, defend and hold
harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
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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, waive or reduce any requirement of any city ordinance
:r
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
Ll
I I i t CH-
provision."
-1-D-
I hereby acknowledge that I have read this application; that the
ATTENTION APPLICATION APPROVAL
information given is correct; and that I am the owner, or the duly
I n I
a 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
ust
e ed thereby, no person will be employed in violation of the Labor ONLY THE signed by the Building Official or his/her
d
Code of the State of Washington relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is
Cc
ion Insurance aria RCW 18.27. acknowledged in space provided.
ti 0 INSPECTION
SIGNATURE JOWNER OR AGENT) DATE SIGNED DEPARTMENT
CITY OF OFFICIAL'S SIGNATURE DATE
EDMONDS
CALL FOR REL�ASJErY: WTE
ATTENTION
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-0220 id... I yFi I 0W — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED, VOC
8ECTION 109 PINK — Owner GOLD — Asseasor
E RECEIVED
s
PERIMT UE1,RE
RES
CITY OF EDMONDS
USE PERMIT
ZONE NUMBER ZOO
C CONSTRUC�ION PERMIT APPLICATION
ON4
JOB SUITE/APT#
ADDRESS
OWNER NAME/NAMEOF BUSINESS
FMAILINGADDRESS
PLAT NAME/SUBDIVISION NO.
If NO.
LID NO.
LID FEE $
um.
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3:
Hwy 99'
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved 0
RW Pernift Required C3
0
EXISTING PROPOSED
Street Use Permit Req'd 0
inspection Required 0
Sid"alk Required 0
CITY ZIP
TELEPHONE
9
gw;- 387o
REQUIRED DEDICATION— FT
Underground
wiring require 0
NAME
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV �EQUIRED
YES 0 NO 0
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ADDRESS
�:REMARKS
OWNERICONTRACTOR RESPONSIBLE FDA EROSION CONTROL/DRAINAGE
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CITY ZIP
TELEPHONE
NAME
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ENGINEEPING REV11WED/ ATE
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FIRE�'REVIEWED BY DATE
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CITY 2jV_ I fELEPHOINE
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VARIANCE OR CU
SHORELINE OR ADBi
INSPECTION
REO'D
BOND
POSTED
STATE LICENSE NUMBER, .-EXPIRATION DATE
CHECKEDBY
0 YES 0 NO
SEPA REVIEW
COMPLETE EXEMPT
SIGN AREA
ALLOWED PROPOSED
HEIGHT
ALLOWED PROPOSED
PROPERTY TAX ACCOUNT PARCEL NO.
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EXP
19 NEW C] RESIDENTIAL PLUMBING MECH
LOT COVERAGE
ALLOWED PROPOSED
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FRONT SIDE REAR
PROPOSED SETBACKS (FT.)
FRONT UPISIDE REAR
0 ADDITION COMMERCIAL COMPLIANCE OR
CHANGE OF USE
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ED BY /D��:E��
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TYPE OF CONSTRUCTION
OCCUPANT
171
R EE�rA I
GROUP
Al
NUMBER
OMBER OF
r CRITICAL
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OF
DWELLING
AREAS
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STORIES
UNITS
NUMBER
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LOAD
DESCRIBE WORK TO BE DONE
_ROV#7� Rze—Asna 15�cj=s
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REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REOID
an Ea4, _-Tide- dr' bei i Or �n g
o,,.,r av-s1le
If
0 1 ellyide=( bc Vt Ilia Zkles-
VALUATION
FEE
PLAN CHECK FEE
HEAT SOURCE GLAZING % LOT SLOPE %
BUILDING 9' 9,
PLAN CHECK NO: VESTED DATE
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADING/FILL
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
STATE SURCHARGE
PERMIT APPLICATION: . 180 DAYS
PERMIT LIMIT. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
to 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
ENG. INSPECTION FEE
bo
Lu IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
_j
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
CAD
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF 4Hf&.PE RMIT, SHALL NOT BE
RECEIPT +
PLAN CHECK DEPOSIT
_j DEEMEDTO MODIFY, WAIVE OR REDUCE ANY REQOR��ENTQ�"ANi'tlT�,"PRDlf4ANCE
PROVISION."
0 NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANC'
RECEIPT C'.
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 AUTHORIZED AGENT OF
'APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
This application is not a permit until signed by the
CALL
It
TION; AND IN DO NG THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
Building Official.or his/her Deputy: and Fees are paid. and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION receipt is acknowledged in space provided.
WORpMEN'S COMPENSATION INSURANCE AND RCW 18.27.
. I I - ; ,
SIGNATUR� OWNER 0 AGEIT) DATE SIGNED
, OFFICIALS SIGNATURE DATE
(425)
Ax
771-0220
DATE
ATTENT16h
ARELEABY
EXT 333 5/
IT IS.UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL.:OR AQ&RTIFI_
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTI PN 109
ORIGINAL -FILE - YELLOW- INSPECTOR
FAX PINK - OWNER - GOLD - ASSESSOR
5/98
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RECORDING CERTIFICATE
FILED FOR RECORD THIS DAY OF
19— A.D. AT —M.
IN BOOK OF SURVEYS AT PAGE — AT THE
y ' "C-, I'Ve.
REQUEST OF
VC
RECORDS OF -:W4;l/ 7"Xs� COUNTY, WASHINGTON.
P"Al V. AIIZ41,41"3
SURVEYORS CERTIFICATE
THIS MAP CORRECTLY REPRESENTS A SURVEY MADE BY ME OR
UNDER MY DIRECTION IN CONFORMANCE WITH THE REQUIREMENTS
OF THE SURVEY RECORDING ACT AT THE REQUEST OF
IN THE MONTH
0 F 19
un,
iV L L /13
CERTIFICATE NUMBER
�pe,
stef s
F of e' MEyRINCj.&
(206)778-3 �101, ASSOCIATES, INC.
23423Highway99 EdmondsWX 98020
RO. Box 32 Lyn'nwood WA 98036;
ICHK D BY, 1,f91Y
IAWN BY JlLfW, DATE 4-17
ASM411101 IS# COIINrK.
PLAT OF SURVEY FOR.'
'S", S. C
Ca
BASI&OF BEAR I NGS: SW4 r,0A')aA*A4lrlele
BEING A PO ' RTION OF THE., -:`f4`:'-Q0A-RTER,
QF THE QuARTER OF SECTION
w.m::
.TOWNSHIP Z7 "-NORTH,, RANG E:44-
DATEI/ B/&& PG,'Z 7 JOB NO.a
IF
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