23721 80TH CT W.PDF111111111111
7242
23721 80TH CT W
ADDRESS:
TAX ACCOUNT/PARCEL
BUILDING PERMIT (NEW
COVENANTS (RECORDED) FOR:
CRITICAL AREAS:- DETERMINATION: F] Conditional Waiver quiI7�<Waiver
E] Study Re
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DA
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DA:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORTPLAT
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:-9-0
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:
OTHER:
LID #:
LOT: BLOCK:
LATEMP\DSTs\Forms\Strect File Checklist.doc
44C. 10"
PERMIT NO: 9931-
'City of Edmonds RES
PERMIT
SIDE SEWER PERMIT
Address of Construction:
Property Tax Account Parcel No.�Z
Attach copies of all acc utility
Owner and/or Contrado
Contractor License #:
Pe5ingle Family -A
0 multi -Fami y T"). of Units
F� Commercial,(.Nbr. of Units
Fj Public
LID #
ft'- _t5unaing irermit
Invasion into City *Right -of Way: El Yes 0 No
*RW Congtrucilon Permitc#
Cross other "Private Pr�perty: 0 Yes Ej No
"Attach legal description and cop' of recorded easement.*
y
4r 5e,
_f�-()wner 6fpontractor signature affPcknbewledgemont statement: Date
f
y signind or this permit I certify that I have read- the City's public handout entitled
Side Sewe' witK'all City"requiirements outlinedAherein.
r'Sp�cifications, �nd shall ca�41y
Y
2,* CALL DIAL -A -DIG (1-800-42911,5555)BEFORE AN.- -EXCAVATION 2
V'FOR INSPECTION C)�LL425-7-1.1-0220'exten'§i*��
.24 HOUR NOTICE REOUIRED FOR ALL INSPECT109"REQUESTS
. ... .. ........ .. . ....................
Partial Inspection: Dati: Initial:
Partial Inspectio''h:: -11, Initial:
FINAL INSPtt.TION APPROVED: Date: �h Initial:��As-built to Street File:
15,, PERMIT MUST BE. PO.STED ON JOB SITE 1,�
White Copy:� File- -Green Copy: Inspector Buff Copy: Applicant
L;temp:bldg,forms,ssp�nnitjlg4/00-� �-*,Ix
4—
-7
E.D * CITY OF EDMONDS AS- BUILT
0 6 IADDRESS
t
'�O TL CoUr�- SO/
HOMEOWNER . �v . �.ls I CONTRACTOR SCALE
V(V4hcl I NTS
DATE V DRAVdN PERMIT
At 1890 1 9�31 l'o-s- IBY jM I NO. qq 3
� I () F E,0,1,_
4s
ci
NG HEIGHTS PLAT
23721
23723
23725
23727
238 ST SW
rO PATIO
ss
CITY OF EDMONDS SIDE SEWER AS-BUILTI
A
t:) ADDRESS HOMEOWNER
ta - 23721 - 80 CT SW I-VIKING HEIGHTS
CONTRACTOR SCALE
NTS
DATE DRAVM PERMIT
03/31/05 By SIBREL 04/07/2005 NO. , 9931
C
7
FAMILY
)ENCE
th
ALL EXPOSED 0PACtS
BE COVERED'.mWITH02,21
X,
'M
MAINTAIN PLAT
G-
6
- FAMILY
DENCE
h COURT
D
FAMILY\ -cc
)ENCE C,
th COURT
A7 �-07,9 I- D
9 -- )-d 7 z,, )- R I I'V
C �z le, 3 OCT 2004 S1,
60 )-a '�' -? 11GHTLINE
,4 L,-e k- - �- M PERMIJ&q*i,��E
0,0- mATERIAL
VV? a �6 ec 6
SDR 35 N
-- 3 t)- )- S- SCH 40
N - 12
OWNER/CON TRACTOR F810 HANCO/R-L
VIKING PROPERTIES, INC.
P.O. BOX 1034
LYNNWOOD, WASHINGTON 98046
PHONE : 425-670-2711
r1V
co
z
z
;z
G)
E
0' 10' 20' 40'
S WATER & SEWER
PLOT PLAN INSPECTIONS REQD.
r%Ai I A0r.-771.nqqn r-YT 1,49A
BENCH MARK F R
THE PROJECT BENCH MARK IS THE CONCRETE
MONUMENT IN CASE LOCATED AT 'ME LOT, 8, 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 : ASSUMED
APPHOVED AS NOTED
13Y ENGINEERINg
j -m I= ml 1.4 --
Date:----
Lovell - Sauerland & Associates, Inc.
Engineers/Surveyors/Planners/Development Consultants
e-mail:- infoOlsaengineering.com - web: lsaeu&eering.com
INW 33rd Avenue T., Suite 200 Lynnwood, WA 98M - (425)775-1591 - (425)672-7998 fax
DRON FU No.
=W4 (� �
JTT I CMJMTMT I DA76.03 FJL — 1"= 20' 656-0-04
0
4,M
tItSIHIGA-BURKHOLDER
fMl�
TOMASSOCIATES, LLO
P�=j LAND USE FILANKII40 I CIVIL ENGIMPBRING
1721 Hevdtt Avwum 0 SURS 4M M Evw@M WA 95201
phme (425)252-2=5 f" (425)252-9351
Critical Areas Checklist* CA File No: G?)
Site Inform. ation (soils/ topography/ hydrology/vegetation)
i. Site Address/Location: E22 1 -7 61— -.5, C,2- /,x!!5r
2. Property Tax Account Number: OE) 4,519 --061 f) -14 00
3. Approximate Site Size (acres or square feet): -7/ 1 -70c� - lay
V
4. Is this site currently developed? Zyes; _ no. Tc-,c, 5, F. lr-<
If yes; how is site developed?
S.- Describe the general site.topography. Check all that apply.
±L"' Fla t.- less than 5-feet elevation change over entire site.
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 horizont!al
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 - P0 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 se a*sonal? (What time of year? 4ILr
.4
1-0. Site is primarily: forested meadow ;shrubs ;mixed
urban landscaped (lawnshrubs; etc)
11. Obvious wetland is present on site: Yj,
Critical Areas Checklist.doc/3.19.2001
0
pjrz:.�l � V �� .�: -D
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.
The purpose of the Checklist is to enable City staff to
determine whether any potential 0itical 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:— 3 If V 1 g
City Receipt#:
Critical Areas File #: --2 CC) 73-�-2-0
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant: —d/-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 fi-om 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 authorize to file
b�ehalfe owner as listed below.
>
SIGNATURE oFAPPLlCANT,/AG DATE
0
r G7
Property Owner's Author* ati
By my signature, I c fy : I e authorized the above Applicant/Agent to apply for the subject land use application,
'� Wn I
and grant my permission for 4 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
Owner/Applicant:
"O!�Z
14ame
4� -3 Z 4L F -50�
Street Address
4;�9vOW5
city State zip
Telephone:
Email address (optional):
Applicant Representative:
")01/&) 1/ R
Name
/ -77, /
Street Address
. Zf-441 qr-
city State zip
Telephone: 7-572- -2,5-�Zc
Email Address (optional): I ohl-,v o4p-bt -5WI,c-oww,
Critical Areas Checklist.dod3.19.2001
0
City of Edmonds
Development Services Departinent
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.
The purpose of the Checklist is to enable City staff to
deteimine 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: 31 f V 10-'119
City Receipt#:_ 1 2- (to ";5 o
Critical Areas File #: -1-o0-3 -c'
x)2-i I
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant_��3 —
A property owner, or his/her authorized representative,
must fill out the checklist, sign and date it, and submit it
to the City. Ile 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 forni. 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, inderrinity, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising fimn any action or infi-action 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 is plicati owner as listed below.
ANT/A — . 7
SIGNATURE oF APPLic DATE XZ /0 --s
"C
Property Ownerls�Autho * ati
By my signature, I c fy t 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
PLEASE PRINT CLEARLY
Owner/AppUcant:
hl*w 1J-)/
Name
-Z 1; C3 Z F - �S�
Street Address
V14
city State zip
Telephone:
Email address (optional):
Applicant Representative:
Name
1 -77, / Hcio,'i 77— AgE
Street Address
crr-,
city State zip
Telephone: qZ!T - 7-572 -221��24-,-
Email Address (optional): loh4,2D 1) okp-bt
Critical Areas Checklistdoc/3.192001
'4C. 189",
0 . 0
City of Edmonds
Development Services Department
Planning Division
Phone:
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.
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: 6112/1 (D�2
City Receipt#: 1 7-1 V:�p
Critical Areas File #: Z-cn,�3 - 002:
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant: 4�-�/eZ3 -
A property owner, or his/her authorized representative,
must fill out the checklist sign and date it and submit it
to the City. Ile 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 fumished 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 too file I owner as listed below.
SIGNATURE oF APPLI GENT DATE
Property Owner9s Author' ati
4 r 14)
By my signature, I cer* I e au thorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission 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.
SIGNATURE OF OWNER
Owner/AppHcant:
4�20tkZ 'J ) / -
Name
2:5 41L
Street Address
4;6w,1JV95
city State zip
" '?67
Telephone:
Email address (optional):
DATE
Appticant Representadve:
'�,6
CIJIAJ I
Name
-77, Tr- 4a:r
Street Address
. &-4,6;Y M-
city State zip
Telephone: 1Y Z 5' - Z! 5 -9 ZS: �;Z-
Email Address (optional):. johl!?� o4obi
U W
Ctitical Amu Checklist.&0.19.2001
0 0'. ,,.
Critical Areas Checklist
--------------------------------------------------------------
Site Information (soil s/topography/hydrology/veg�tation)
1.
2.
3.
4.
Site Address/Location: HCV5� .2-3filLA �51AV,
Property Tak Account Number:
Approximate Site S ize (acres or square feet):
Is this site currently developed? _k!-f
yes; no.
If yes; how is site developed? 1IMSg— 5/77s eN -S,6- 19XTIOAI dll=
5. Describe the general 'Site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Al Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a
a
horizontal distance of 66-feet).
A11,01- Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of
I 10-feet over a horizontal distance of 33 to 66-feet).
All,*. 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).
IVIA ` Other (please describe):
6. Site contains areas of year-round standing water: ItQA1,A ; Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s.) of the year? A/
8. Site is in the floodway Ajo floodplain Aj LQ 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? - A10FA14F- (What time of year?
10. Site is primarily: forested meadow ;shrubs mixed
urban landscaped (lawn,shrubs etc) 'ga1W )o,� .7V
11. Obvious wetland is present on site: 1WA1z4_:--
---------------- — -------------- — --- 7 -------- -----For City Staff Use Only ------------- ------- — -
J. S I ite is Zoned! A
.... .. .. .. ........ . .
.2. . SCS mapped soil type(s)?::Iwu(�
.5 Wetland inventog*or C.A.. map indicates. wetland present
4.- Critical Areas inventory or C.A. map indicates 6ritical Area on site�
:3. site within designated eaiihsubsidence landslide hazard area? Ido
C: Site designated on.the Env.ironmentally Sensitive Areas Map?
CONDMONAL WAIVER:
Dite'
lu-chkAoc; Re� 10101
0
0
M
City of Edmonds
RECSIVED
JAN 0 6 19909
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 -observations 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 completd-,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 infor m-ation (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 answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/Applicant- Applicant Representative:
I —,,a AIA,�Vra;4;,O
Name Name
23tea'7
Street Address
Street Address
city State Zip city State Zip
Telephone Telephone
Si' na
9 16e Signature
Date
(over)
0 S
... ry
23.00'
1� tx
FAMILY -8 10* N 88'36'51 w
)ENCE 0)
C5
&L Expd§Ef)PWRFA .4
BE COVERED WI S
-0
S4 bdLc
6-w x" C?
1.
1'3 7 W '24-',37-"-W-9 -5
23' F-0. 0-0 4 S 4 A'
36.50, 45.39
OWNER/CONTRACIZ4'1�'r
B
FOR EROSION CO,-d-RCIL AND D� M�40E C .5 7
6' PDE#10
FAMILY
8
DENCE A
h C 10* SINGLE FAMILY 6 0
OURT W. SINGLEI
�ESIDENCE <
MAINTAIN PLAT INST�LLED ERbZ)N C6\jTR0L 23 80th COURT W. RESIDE
D ?o 23702 80th
3nw
ca
PDE#3 D
Uwj
X 36. W
, "I., /" "'36
n6x I w N 89*21
C LA ..... . V Z
iO Put'p 1
46.50- 464C ;z
36.50
C)) 0
-9
L6'p S
B
FAMILY\ 9\
)ENCE OW
p -C)l
0 1: SINGLE rAMILY 0/ 11E
3: 3::,, -)
th COURT co C�: SING
Z�
A RESIDONCE 10 PFqin
9 -- )-d 7
R �ED
1� � -7 - R IVED
'4 OCT 19 2004 CITY COPY I' Vi
V V? JJII�j 6� 04
�4MIT COUNTER N I
IT CO
q 3 PE IT COUNTErj
SCALE : 1'=20'
OWNER/CONTRACTOR
VIKING PROPERTIES, INC.
P.O. BOX 1034 ACCEPTA -E- 0.
LYNNWOOD,* WASHINGTON 98046 MATERLq 10, m, 40'
SDR 35 S WATER & SEWER
PHONE : 425-670-2711 SCH 40 PLOT PLAN INSPECTIONS REQ'D.
BENCH MARK N - 12 FOR C&L 425.771-0220 EXT. 1326
g&HANCOR
THE PROJECT BENCH MARK IS ONCRETE
MONUMENT IN CASE LOCATED AT THE LOT. 8.. VIKING HEIGH TS
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
Lovell - S auerland & Associates, Inc.
APPROVED AS NOTED En&eer3/Surveyor�/PIA=ers/Development Consultants
BY ENGINEERING e—maiL, infoOlsaengineering-com - web: lsaen&eeriq,com
19" 3&d Avenue Ir., Suite 200 - LY=WOOd. WA 98M - (425)775-1591 - (425)672-7998 fax
DRON ICE= WE WAU ME NO.
Date: Id f-I Zwj JTT I JTT 1 3.6. 1"= 2 , 1 4656-0-04
LILI ASSOCIATES 4862746 P.02
'DAILY FIELD REPORT
Job Mo. Fleici Rep. Pa0e r 0
1AU & ASSOCIATES9 I-N(:. 4AD85 J. Liti I of 1 2
Vngincc. . rin I g( . rcolo&� - , --5;iV W&;k . .... ...
Miles T�T)e or) lto Tate,
24 1 2:05P 11/1014 Wed.
19213 KcitliVe Placc NE Travel Time (Hrs) Time Off Site Weather
Kcrimorc. Washington 99028 1 12:45P cioudy
Phonc: (425) 483-9134 Fax: (425) 480-2746 Vehirle Hr3on P-e— We Charged
1.75
Project Job Location Client
Lots 8 11hru 13 Sunrise Ridge Vikin
General Contrwtor General Contrecitor Superintendent Umhen4d ny
Viking Properties Ted Coleman -6y"'
lFarthwork Contractor Earthwork Contractor FUI,�J�W
-uaiun txcavaunp . I
The footing trenches for the honnes to be constructed on the 3 norlhern lots of the subject lots have also Men
completed down to the footing level today, The. footing trenches are all exuvated into the gray fresh till of very -
dense, silty fine to Medium send with some.gravel and occasional cobble. Groundwatcr has not been en-cuuntered
and there is no standing water within the footing trenches.
it is rr opinion that the undisturbed fresh till soils vvill be able to render an allowable beatring capacity of at least
1-1�00 pst, Loose, disturbed soils shed Into the footing trenches by oonSt LICtion traffic should be removed down
to undis'urbed fresh till soils prior to pouring concrete for the footing foundations.
-0
UPIATS' MV
o L
W -9
V -200.4
SE6lC'E$*'CTR.
CITY OF DMONL)S
�;ODV to: (,()ntlnuHd
1) Ted ColemanNiking Propetlies on Noxt
'k Pane
RECEIVED
IRES
PERMIT EXP
use
PERMIT
ZONE NUMBER 0q17
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION IOB SUITE/APT#
ADPRESS
O�NEJN M NAMEOFBUSI S
PLAT NAME/SU S ON LOT NO LID NO.
Ir M- 0. ILI no PrA LID FEE $
W AILING ADDRESS Tt5ur Ap rove
z PUBLIC RIGA 1AY COR OFFICIAL STREET MAP RW Per It Required
c
Us
3: Street me Permit Reqrd
0 D;4/ Inspecd n Required
ZIP HONE EXISTING 0
TELEP Sidewalk Requireil
N I--'- FT Undergiowd
Wiring required
REQUIRED DE61'(�ATIO
EQUIRED
N E ML314t LINE: S�IZE NO. OF&FI)7,URES V
'4lil I . 1 11:1 NO 13 Z
6AC-JAA a? rl,� I I, 11 1 YEXS 5
REMARKS
E APQRESS-
x N. . OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE
0
M
-.PITY Zip ITELF?HO
NE
NAM CBL#4
EMbINEERING REVIb*fD BY DATE
0 �DRESS
FIRE REVIEWED BY DATE
I ZIP TELEPHONE x
0 LY ),�f 1
VNI I ZZ _.? 7/
2&L I ::;)- / VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND
S UC___ DATE CHE _ 6� DY REQ�D POSTED
0�' � _ VD BY
)rvl- \—, 1W -03 ES " JkO
NJV' . % SEPA REVIEW
� 11 3 W1, . SIGN AREA HEIGUT.
PROPERTY TAX ACC LINT PARCEL No. C. _f COYPLFTE EXEMPT ALLOWED PROPOSED 'ALLPWED PROPOSED
_0 &5 4- Cal,
EXP'%31
RESIDENTIAL PLUMBIN i 6 1 /MECH LOT COVERAGE REQUIRED SETBACKS (FT -A -PROPOSED SETBACKS
NE ALLOWED PROPO FRO�p SIDE,, REAR
FROF LII�SIDErREAR
COMPLIANCE OR :)
COMMERCIAL 45vo Wo is (0 15 a0,10%tF ;ko
ADDITION CHANGE OF USE
PARKING LOT ARE LANNING REVIEWED BY DATE
N)tp
REMODEL MULTIFAMILY SIGN RE 'D PROVIDED 71s7l
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ING
REPAIR CYDS X FT) REMARKS 4r -P/vj:i(T j0ro-jej- P—IC,
OTHER
.0 0 ISH TANK
z V,EM L
91ARAGE RETAINING WALL F RE SPRINKLER
C C
ARPORT ROCKERY RE ALARM
(typE OF USE,rSS OR A XPLAIN: CHECKED BY TYP%I%C(PNSTRUCTi6N OCCUPANT
EC n J�b I , P �IA 0 -0 — ------ GROUP
. I .
NUMBER OF CRITICAL OCC
NUMBER DWELLING AREAS SPE I ONSEA J_ UPANT
OF U UMBER 0— ' CAD
OM STORIES NITS N 3 RE S -f
I A 5581b
DESCRIBE W010rTO BE DONE Q : I f I I I
REMARKS z
PROGRESS INSPECTIONS PER UBC 108/iSC109/IRC109 FIRAL INSfECTION REO'D g
n
OIL
-ro Ile
Ra
K( P VALUATION
oc:;�/
Description FEE Description FEE'
Plan Check State Surcharge
op nin
Liz!�9 A LOT SLOPE % City Surcharge
EAT Building P� mit
PLA CHECK NO: ST
'I ID DAT§ Plumb ing Base Fee
Mechanical 150 vxlfo
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT c4ERS WORK TO
t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
a Grading
3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
I= SEPARATE PERMISSION.
Engr. Review
Lu PERMIT APPLICATION: ISO DAYS
ILI PERMIT LIMIT I YEAR - PROVID . ED WORK IS STARTED WITHIN 180 DAYS Engir. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
APPLICANT, ON BEHALF OF HIS . OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Rev! Plan Chk. Deposit
;N INTEREST, AGREES TO INDEMNIFV� DEFEND -AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire InspAtIon Receipt #
cc
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL.N.0T BE LandscaWnsp. Total Amt. Due
DEEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDIN ANCE
0
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY . ORDINANCE PROVISION.* Recoi6hb Fee Receipt #
I A6
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI&�ION; THAT THE INFORMATION APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH crr* AND STATE LAWS REGULATING CONSTRUCm CALL This application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, I 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 C
,gMPEYSATION INSURANCE AND RCW 18.27.
-S 1A9 OFFICIALS SIGNATURE DATE/
1,"TU!IE f0WR AGENT��� DATE SIGNED 1425)
ltwo.v
771.02220- cr EA D
ATTENTION Off 1333
ITIS UNLAWFULTO USE ORICCUPYA BUILDING OR STRUCTURE UNTILAFINAL,
INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU- ORIGINAL -FILE YELLOW- INSPECT&
PANCY HAS BEEN GRANTED. UBC109/lBC110/IRC110. PINK -OWNER GOLD -ASSESSOR
09/03 nocoa uAon _Vtv I ARP RAAICIN(%v A (%.nPIF_4.q
41 1 4�
A
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall ..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
Commercial Final ......
HEATING:
Gas Test ....................
Gas Piping .................
Equipment .................
Commercial Final .......
EXTERIOR SHEATHING:
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING ...
INSULATION ...................
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................