23702 80TH CT W.PDF111111111111
7229
23702 80TH CT W
ADDRESS:
TAX ACCOUNT/PARCEL NUM13ER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
- I .3F F —�=s --
Lfj—/ — U 4
CRITICAL AREAS: A�� -,Q2 / /)--3 -,
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMINT(S) RECORDED
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
TION: E] Conditional Waiver E] Study Required> aiver
SEWER LID FEE $: LID
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DA
SIDE SEWER PERMIT(S)
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
OTHER:
LATEMP\DSrs\Fonns\Street File Checklist.doc
� 47 C. 116')-
Address of
City of Edmonds PERMIT NO: 9924
Col / I Za I
SIDE SEWER PERMIT PERMIT EXPIRES 4CIM.-tj
T Y" a
Property Tax Account Parcel No. eW4,1�_A?
Attach copies of all access and utility easements Verified and Approved by
loe pyn A/ r r^r%+rar-t^r0 *?,o
VV11%11 "11 W -
Contractor License #: V,
Z"'Single Family
FI Multi -Family (No. of Units
Fj Commercial (No. of Units
Fj Public
ilding Permit #:
Invasion into City *Rig ht-of Way: El Yes 21�o
*RW Construction Permit
Cross other "Private Property: El Yes 2-9000"
"Attach legal description and copy of recorded easement.
Owner or contractor signature ako"acknowledizement statement:. Date
y signing for this permit I ceAffy that I have read the City's public handout entitled
ide Sewer Specifications, and shall comply with all City requirements outlined therein.
W CALL DIAL -A -DIG (1-800-42q-5555) BEFORE ANY EXCAVATION W
W FOR INSPECTION CALL 425-771-0220 extension am
I
24 1901TR NOTICE REOUIRED FOR ALtINSPECTION REOUESTS
NOTE: IF JOB SITE IS NOT READY FOR INSPECTION WHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION FEE WILL BE CHARGED.
. Job Site Ready,YES NO - —Date: . Initial:
Partial Inspection:
Partial Inspection: F Date: Initial:
FINAL INSPECTION APPROVED: Date: lniti4f-7�� As -built to Street File: E]
1,� PERMIT MUST BE POSTED ON JOB SITE t-
White Copy: File Green Copy: Inspector Buff Copy: Applicant
L;temp;bldg-,forms;sspennitjlg4/00
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A () F Epj�o,_
im
1" POLY - 20OPSI
WITH TRACER@ 18" DEEP
CITI r OF EDMONDS WATERLINE AS -BUILT
6 ADDRESS HOMEOWNER
23702 80TH COURT SW VIKIING PROP.
CONTRACTOR S ALE
CAJUN EXC. NTS
DATE DRAWN WATERLINE
7/26/05 IBY 1. ABILA INO. r)nnA—In?-�
0 0
I
I
3" ABS 0
Under construction
concrete slab
6" Sewer
stub
3'deep
/0 @ grade
ye rolled up
i-4 Reducer
CITY OF EDMONDS SIDE SEWER AS- BUILT
A, Ki
ADDRESS HOMEOWNER
23702 80th Court SW Viking Properties Inc.
CONTRACTOR SCALE
m
Cajun Exc.
DATE DRAWN
6/3/2005 BY Nima M.Moghaddam
NTS
PERMIT
NO. 9924
I
I
ED
0
3" ABS N
Under construction
concrete slab
6" Sewer
stub
3'deep
/0 @ grade.
ye rolled up
i-4 Reducer
CITY OF EDMONDS SIDE SEWER AS- BUILT I
ADDRESS 23702 80th Court SW HOMEOWNER Viking Properties Inc.
CONTRACTOR Cajun Exc. SCALE NTS
DATE DRAWN PERMIT
6/3/2005 BY Nima M.Moghaddam NO. 9924
Ll
City of Edmonds
Development Services Department
Planning Division
Phone: '425'771.0220
Fax: 425.771.0221
The Critical Areas Checklist contained on this form is to
be filled out by any person preparing a Development
Permit Application for the City of Edmonds prior to
his/her submittal of the application to the City.
Ile 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 complete the Checklist should be easily
available from observations of the site or data available at
City Hall (Critical areas inventories, maps, or soil
surveys).
Date Received:
CityReceipt#:_
Critical Areas File :2 00-3-002-0
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant 4--V-03
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 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 applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indernnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information famished by the applicant, his/her/its agents or employees.
By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file this application o e beha
7o e behaLL"e owner as listed below.
DATE
SIGNATURE oF APPLicANT/AGENT
tio
0
e aul
""7
Property Owner's Author* atl
By my signature, I cer* I authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for e 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.
SIGNATURE OF OWNER —DATE
I . - I ;; PLEASE PRINT CLEARLY
Owner/AppUcant:
I —
Wom Zi 0
14ame
-Z �
Street Address
1�6waAlg?5 V_4
city State zip
Telephone:
Email address (optional):
AppHcant Representative:
Name
1-701
Street Address
qT-
city State zip
Telephone: qz'5- Z,5-2- -22�2-,-
Email Address (optional): )ohfy,� o4pbt
V
Critical Areas Checidist.doct3.191001
0
11
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
The Critical Areas Checklist contained on this form is to
be filled out by any person preparing a Development
Perrnit Application for the City of Edmonds prior to
his/her submittal of the application to the City.
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 complete the Checklist should be easily
available from observations of the site or data available at
City Hall (Critical areas inventories, maps, or soil
surveys).
Date Received: I O�2
City Receipt#:_ I-V3 0
Critical Areas File #: -700-3 1
Critical Areas Checklist Fe 0
Date Mailed to Applicant: I
A property owner, or his/her authorized representative,
must fill out the checklist sip and 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 firiding 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 applicant, 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
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information furnished by the applicant, his/her/its agents or employees.
By my signature, I cer* that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file t plicatio e owner as listed below.
to 4filet
SIGNATURE OF APPLicANT/AG DATE
jo;Property Owner's Author* ati I
By my signature, I cer* I C authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for e 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.
SIGNATURE OF OWNER DATE
PLEASE PRINT -CLEARLY,
Owner/Applicant:
"OLiz 1J)/
14ame I
Z
Suvet Address
4;6"A/95
city State zip
Telephone:
Email address (optional):
Applicant Representative:
1,>rT
Name
77, / Hc;6yi 17— 4&/-;-
Street Address
42A
city State zip
Telephone: zi5-2- - 24!��?- ��
Email Address (optional): Ight-P oko-bt
Critical Areas Checklist.doet3.191001
City of Edmonds Date Received: 5 f V
Development Services Department City Receipt#: 7-i V:�Q
Planning Division Critical Areas File #: Z--cr-,,�3 — 00z -2-
Phone: '425'771.0220 Critical Areas Checklist Fee: $45.00
Fax: 425.771.0221 Date Mailed to Applicant 44-1/-xZ3
The Critical Areas Checklist contained on this form is to
be filled out by any person preparing a Development
Pernrit Application for the City of Edmonds prior to
his/her submittal of the application to the City.
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 inforniation
needed to complete the Checklist should be easily
available from observations of the site or data available at
City Hall (Critical areas inventories, maps, or soil
surveys).
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 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 applicant and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, inderrinify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attomey's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information furnished by the applicant, his/her/its agents or employees.
By my signature, I cer* that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to ffl�le
he behal e owner as listed below.
SIGNATURE OF APPLIC IA7G DATE Xz /0
'IC
or
Property Ownerls�Auth o1r* ado
b;h
c . I e
By my signature, I * fy ii authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permmii Sion for e 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.
SIGNATURE OF OWNER
PLEASE PRINT CLEARLY
Owner/AppHcant:
4, V , ) / rf"---m
Name
-Z � Z F
St-eet Address
1;6VdA/r5
city state zip
Telephone: C"
Email address (optional):
DATE
AppHcant Representadve:
C-VT
Name I . .
1 -77, / Hc� Tr- 4a;r
Street Address
crr—
city State zip
Telephone: q
Email Address (optional): )oh4,x o4p-bt
V
Critical Areas CheddisL&0.192001
*ILE 111.
Critical Areas Checklist
--------------------------------------------------------------
Site Information (soils/topography/hydrology/vegeta,ti,on)
1. Site Address/Location:
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? _Zyes; no.
If yes; how is site developed? - Yad_�a- s17_-s eAl Ao�, d"O=
5. Describe the general site topography. Check all that apply.
1,,-' Flat: less than 5-feet elevation change over entire site.
A1,1k � 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
I 0-feet over a horizontal distance of 3 3 to 66-feet).
Steep: grades of greater than 3 0% present on site (a vertical rise of I 0-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains a.reas of year-round standing water: Approx. Depth:
7. Site contains areas of seasonal standing water: A]
Approx. Depth:
What season(s) of the year?
8. Site is in the floodway , AjQ floodplain_AZ6 of a water course..
9. Site contains a creek or an area where water flows across the grounds surface? Flows are.year-
round? AlMd!5'— — Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow ;shrubs mixed
urban landscaped (lawn,shrubs etc) g"7W rA,!a-- .7V 11,liez-,
IL Obvious wetland is present on site:
---------------------- --------- — -- -For City Staff Use Only ------------- — -- — -- ---
1. Site is ZOed?em-
..... . .......
2.. SCS mapped soil type(,$)?11&_S Njawzqtj 2,
_7T__
:3. Wetland inventory or C.A. map indicates wetland present on site?
4-.- Critical Areas inventory or C.A. map indicates Critical Area on site!
5. Site within designated earth subsidence landslide hazard area?
6. Site designated on the Environmentally Sensitive Areas Map? -0
CONDITIONAL. WAMkl-
Dite
�u_chk.doc: Rev 10/03
0
0
City of Edmonds
RECSIVED
JAN 0 6 19.909
COMMUNITY SERVICES
CRITICAL AREAS.CHECKLIST
The Critical Areas Checklist contained on this form is
to be filled out by any person preparing a
Development Permit Application for the City of
Edmonds prior to his/her submittal of a development
permit to the City.
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 complete the Checklist should
be easily available from of the site or
data available at City Hall (Critical Areas inventories,
maps, or soil surveys).
An applicant, or his/her 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 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 assist staff in completing their preliminary
assessment of the site
I have completed the attached Critical Areas Checklist and attest that the ans:wers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/Applicant:
J--ovu A^ raz
Name / . . �_/
Street Address
City State Zip
Applicant Representative:
Name
Street Address
city State
q
Telephone Telephone
We
Sign,q
71
T_�
-Da e
Signature
Date
Zip
OWNER/CONTRACTORk') RESPONSIBLE MAINTAIN PLAT INSTALLED EROSION CONTROL
FOR EROSfON'C0N*fR0L0D DAMAGE ....... ....... �.. = -Q (
'q- "�;;' ... ........ . .... ........ ............
ry
.0
23
-0o' 83P51
ALL EXP SURFACtS qQ8-36'51 W 15.12- 1
BE COVERgD WITHIN DAYS SINGL
C10 m
REE
TRACT 997 ("-IQ �<2 23701 8f
b lb
96 A
..............
Zn
....... co
.46'. o.8 92 N_
36 50 . .... ...
io)
B
C .51' C
6' PDE#10 B
8
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8 SINGLE AMILY
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31DENCE 10 RES
no 'i : �\ RESID NC.
80th COURT W. ' ' P 2�703 8
0 \23702 80th COLFT W.C�, C,4
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0-) A \6.00.
QX
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7'
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f . N 89-2 -.3
46.50' f
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B
- 6 P SE11
-7
ACCERI'ABLE TIGHTLINE APPROVED BY PLANNIN G-1 ------ 6 2M
MATERIAL N -,"I -
6 24%
co
SDR 35 Q)
0
SCH 40 SCALE: 1"=2
0WNER/C0NTRACff0%
WING PROPERTIES, INP-0 HANCOR W E
P.O. BOX 1034
LYNNWOOD, WASHINGTON 98046 01 101 20' 40,
PHONE : 425-670-2711 ATER & SEWER PLOT PLAN DE 2 2o04
BENCH MARK INSPECT!ONS REQD. FOR VELOPMENT SERVIC6,
CALL 425-771-0220 EXT. 1326 C'Ty OF EDMONDS6 CTF?'
THE PROJECT BENCH MARK IS THE CONCRETE
MONUMENT IN CASE LOCATED AT THE LOT 19.. VIKING HEIGHTS
CENTERLINE OF 238TH STREET S.W. AT
APPROXIMATELY THE MIDPOINT OF THE IN SE1/4, SECTION 31, T.27N., R.4E., W.M.
PROPERTY. CITY OF EDMONDS
ELEVATION : 200.00 SNOHOMISH COUNTY, WASHINGTON
DATUM U,
Lovell — Sauerland & Associates, Inc.
Consultants
/Sumeyon/Plamners/Deve)[60ment
UWL' idAbAengineeringxom - web: iseen&eering.c'm
APPROVED AS e
tM 33rd Avenue 1r, Suite m Ly .. wood. YA gm - (425)Tm-im - (425)m-79ge fax
BY ENGINEERING DRAWN rjL S= -r NO.
4r JTT JTT 3.6.03 20' 4656-0-04
I mcum I MIR
Date:
In.
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W ROUND
PER LEG
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11111 HIGAMBURKHOLDER
1KQUjx
NWASSOCIATES, LLC
LAND UBG PLAN"I"S I CIVIL ENGINEERING
1721 Hewitt Avwme a %jK* 401 0 Evwvtt. WA 95201
phone (425)252-2M fox (425)252-9551
LILI & ASSOCI"TES 486274E, P.01
0.0 abl-- C-V5LJ
UAILY FIELD REPORT
�- _ "". 1, W. repuri f,40
LIU & ASSOCAAT�,,S, INC. 4AOa5 J. UU 6
U.19i'leerli-G. FMOUNFill-V (,C0109) & ):culh Scmice VT" TIrrG - r) git-0 I5_3te__' -Miy,ii Wi&,;,
26 11 �50A 2! 18/2005
IV" _-_
19213 Kenlake Place NE e I
Kenmore, Washington 9S028 'i 2,30P Sunny
Phone: (4,15 ) 483-9 J 34 Fax� (425 1 4.�6-2
-746 Vehi,;Ie ffirs on -Site Z_112—fga-u— VITSTN'rs
Job Lowion
Lots 14 throuqh 19 - Sunrise Ridqe 2-Oxx - 238th Strer�-,. SVJ, EcIrrionds kinq operties
V Pr
ki
n ralC�ontractor� �3enerzil Contrer-lor Superintendent RC-CQIvC-,J Uf1ChoCK,Cj ljy
Viking Properties
Ted Coleman
Eartmwork Contractor
Tart�%vOrk- C)r!actOf §Q_P(_'�TczF11_,d ��F_, k��
Caiun Excavating
At the request by Ted Coleman with Viking Properties, I come or s-te to verify the footing bearing soiI5 for the
houses to be built on the subject lots, At the time of my silte visit the foot;nq trencnes oil 11'sese los !iave all been
excavated out down to the footing level.
1",10 foottrig trenches over about the eastern halveg of.the building footprints al)e CUL 111tc 1�qht-gray, gr:4velly, silty tine
S-ind, whiie the footings Over about the eastern halves of the buildirg footprints are cut into brown si:ty fine sand'.
A steel T-bar manually pushed into the footing bearing soils Can aenetrate no more than a couple of illcl-te,
; into tile
gray gravOy silty sand, but c-an penetrate up to about 8 to 10 inches into the brown silty sand
I inforro Bab. the foreman with Viking Properties. that the loose disturbed soils pushed irito the footing trenches
StIOUld be removed. and tne Swlinial brown silty fine sand In the footing irencties over abOLIt the eastern ria-11v s ol tl1c,
biiiding footprints should be compacted to a non -yielding state with a vibratory mechanical compactor. If the above
are done. it is my opinion that the footing bearing soils will be able to renclar an allowable bearing capaJty of at ieast
3,000 psf.
RECE:Hver)
MA R 0 3 � 2W4
DEVELOPMENT SEpVICES CTR.
CITY OF EDM6NDS
Co� 7
r
Sl� �'J_
�A �S&4;
wMes 1117/
1) Ted Coleman/Vilking Propertic-S 2) ori Next
4)
i parip
MAINTAIN PLAT INSTALLED EROSION CONTROL
OWNER/CONTRACTOR IS RESPONSIBLE
FOR EROSION Co ��Q
f, �t, M�� DAMAGE
..................
.... ....... . . ....... .. ............
Cv
..... ......
23.00'
ALL EXPOSE RFACESi T
88'36'51 W 75.
WITHIN 2 DAYS
BE COVE
C5 SINGL
8
C10
RES
TRACT 997
23701 8f
b
(.5' A
.......... .............. ..... ..........
N
746 .8
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SINGLE AMILY
-E FAMILY q
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RESID NC
C'4 2�703 8
0 23702 80thl COL FT W.
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ACCEPTABLE TIGHT�INE -V
V-e6U21
MATERIAL C 0 COUNTER
SDR 35 %-"f JL. — SCALE - 1"=20
OWNER/CON TRACTOR SCH 40
VIKING PROPERTIES, INC. N-12 W E
P.O. BOX 1034 F810 HANCOR 01 10' 20' 4
LYNNWOOD, WASHINGTON 98046 ofe4l ve
PHONE : 425-670-2711 WATEp & SEWER PLOT PLAN
SpE(,�,r,f)NS REQ'D. OCT 2 !" 2004
IN ' � I *i I DEVELOPMENT SE.jjV
BENCH MARK rfp 425,771 1326 FOR
'ME PROJECT BENCH MARK IS THE CONCRE LOT 19 m Es cTR-
MONUMENT IN CASE LOCATED AT THE VIKING HE1G9TLt"5-' EDO
CENTERLINE OF 238TH STREET S.W. AT
APPROXIMATELY THE MIDPOINT OF THE IN SE1/4, SECTION 31, T.27N., R.4E., W.M.
PROPERTY. CITY OF EDMONDS
ELEVATION : 200.00 SNOHOMISH COUNTY, WASHINGTON
DATUM : ASSUMED
APPROVED AS NOTED
BY ENGINEERIN
T M 9"O'n
Date:
IIIIIIIIIIIIIIIffma Lovell—Sauerland & Associates, Inc.
ften—/s—yors/planner's/Development Consultants
LIIIIIIIIIIIIIIIIII 0 e-mail;- info@lnenOneering.com - web: lsmen&eering.00m
.19M 33rd Amue Wj Suite 2DO Lynnwood, TA GM - (425)715-1591 (425)672-7998 fax
DRAWN
"C
JTT I CM717 1 "3136-03 FJL 1.= 20' 1 nz No
1 4656-0-04
L
DATE RECEIVED? [PERMITEXPIRES
USE PERMIT
ZONE !?
CITY OF EDMONDS :�& NUMBER
JOB SUITE/APT#
CONSTRUCTION PERMIT APPLICATION ADDRESsa-�,qo�'. /
ME/NAME 0 " F "NESS Y+SU
NAME/SU IVISIONIa. LOTNO./� LD NO,
P iq
LING ADDR!fS I L�D FEE $
TESCP Approved
PUBLIC Ridd OF WA�41`1 OFFICIAL STREET MAP' RW Permit Required
1Z Street Use Permit Req'd
a q d
tc I �Ty 'TELEPHONE TING 'Z PROPOSED Sidewalk Required
ZIP EXIS Inspecti n Re uIre
REQUIRED DEDICATION "00' FT 1 Underground % "o
(10rS ;q I 1 1 vvinng requireo jp_
METE SIZE LINE SIZE NO. OF FIXTURE RV EQUIRED�
YES � NO
S
us
REMARKS z
z
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
PTS —�%_x I
ZIP TELEPHONE
, ETYL14e�,
CB,L # _41 vi LAW-
-1 EERING REVIEV&4fBY
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AKRESS Am
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39 DATE
FIRE,: REVIEWED BY ul
TELF 'I . .1 cc
ZIP PHONE M
'76
Lo ry und 1 6 VARIANCE OR CU SHORELINE OR A09!t' 11 SPECTION
STA'NLXICENSE NUMBER EXPIRATION DATE, CHECKED F - BOND
POSTED
�Y S
ONO $
------- SEPA REVIEW SIGN AREA HEIGHT
COMPLETE EXEMPT ALLOWED PROPOSED "'ALLOWED PROPOSED
-60 EXP 2-1
(�fNEW A21Ji RESIDENTIAL LUMBING7 . MECH LOT. COVERAGS>V- RidUIRFD SETBACKS (FT? 4�P�IDPOSED SET13ACKS (Fr.)
P ALLOWED PROPOSW FRONT SIDE. REAR FRONI, LIR SIDE REAR
z
(7 COMPL ANCE OR 2
r7 ADDITION COMMERCIAL I
.[:] . 13 CHANGE.OF USE L L 4 b'Pm 11141A,
_Ile PARKING . �_ LOT P, Ebegi DATE
I LANNING REVIEW
REMODEL MULTIFAMILY SIGN REO'0-� PROVIDED L
" 1 :� Ilew
kfi., GI 111�� )Mrq FE 1.-71-3 'Q4<1 JL 0
CYDS /L-N Plt"\'X FT)
REPAIR
o OTHER:,
DEMOLISH TANK
GARAGE RETAINING WALL . . ca,F= SPRINKLER
kCARPORT ROCKER,?, F RE ALARM
(rYPE OF USE, BUSINfBG�911 ACTly"EXPLAIN: CHECK 8 TYPE 0 C S RUCTION 'UPANT
DE�% OCC
��Iaz, GROUP
NUMBER NUMBER OF CRITICAL fRgB:3
OF DWELLING AREAS SPECIAL INkIPEITION OCCUPANT
S RIES 1�� UNITS NU IV
TO REOIJ!RED YES LOAD
DESCRIBE WORK TO BE DONE 7--
REMARKS
PRrrRpqqll-s C108/.IBC109`1IRC109 FINAL INSPECTION REO'D
.21 - 9
LA J
03
7
Mcz W
Kc \-j VALUATION
nz Cn/
7_Q
Description, QFEE Description FEE
Plan' C heck State Surcharge
00IV-'s) C/ - R 'A r. ��
AEAT SOOCE eLAZIN4 % j;o 'LOT,�LOPE % 'i � m t,� �1
\1\ A I af '�Puilding City Surcharge
A131 it �o
EST ATE
'P
PLAN CHECK N�O: r-lumbing Base Fee
--- -1
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COV FIS W RK TO
Grading
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN
3
(CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
—
Engr. Review
PERMIT APPLICATION: ISO DAYS
Engr. Inspection
PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRSASSIGNS AND SUCCESORS
IF
Fire Review
Plan Chk. Deposit
& 0
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HO D HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt # Z*171
IALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapelnsp.
Total Amt. Due liza
I&—
0 NOR LIMIT IN ANY WAY THE CITY$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
—
Recording Fee
Receipt # C.
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_
CALL
This application Is not a permit until signed by the
TION; AND IN DOING 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.
WORKMEN'S COMPENSATj9)HNS0rj\NCE AND RCW 18.27.
. ,7
FF IALS SIG TURE DATE
SIG URE (OWNER.0 A ' NTi ATE SIGNED
(425)
I
L 1�1
'71 A
771-0220
R SED BY DATI
ATTENTION
M1333
X
ITIS UNLAWFULTO USE OR OCCUJABUILDING OR STRUCTURE UNTILAFINAL
01
INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU-
j
PANCY HAS BEEN GRANTED. UBC109/IBC110/1RC110.
ORIGINAL - Fit E YE I ON INAECTOR
09/03 r%r%P-P%P% BOA r%r% %00%88 A r%r- 21M AI,0'11L§,P% PINK - OWNER LD-ASSESSOR