23723 80TH CT W.PDF111111111111
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23723 80TH CT W
TAX ACCOUNT/PARCEL
BUILDING PERMIT (NEW
COVENANTS (RECORDED) FOR: -
W
CRITICAL AREAS: DETERMINATION: [] Conditional Waiver E] Study Required iver
-N"\ Q a— I 1,<Wa
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DISCRETIONARY PERMIT
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DA
SCALED PLOT PLAN DK
SEWER LID FEE $: LID
SHORT PLAT FILE: LOT:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:
OTHER:
BLOCK:
LATEMP\DSrs\Fomis\Street File Checklist.doc
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VIKING PROPERTIES, INC. Palo 841VC0;i W E
P.O. BOX 1034
LYNNWOOD, WASHINGTON 98046 0. 10, 20' 40'
PHONE : 425-670-2711 S WATER & SEWER
PLOT PLAN INSPECTIONS REQ'D.
BENCH MARK FOR CALL. 426-771-0220 EXT. 1326
THE PROJECT BENCH MARK IS THE CONCRETE
MONUMENT IN CASE LOCATED AT THE LOT 9, 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.
ELEVATION : 200.00
DATUM : ASSUMED
APPROVED AS NOTED
BY EN,GINEERI G
�rm 2:jmm-a
Date: 7-w4-
I I F EDMONDS
SNOHOMISH COUNTY, WASHINGTON
Lovell - Sauerland & Associates, Inc.
bi&e—/Surveyors/Planners/Development Consultants
e-mail: i afoft&�eeringxom - web: isaengineering.com
lkW 33rd Avenue T.. Suite 200 LYM1w00d. TA 98036 - (425)775-1591 (425)672-7998 far
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R/H i AREAS, f I
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------------------
DAM
HIGA-BURKHOLDER
ASSOCIATES, LLC
LAND USE PLANNING I CIVIL ENGINPERING
a Sultv 4M N Evwgtt. WA 96M
1721 Howitt AVWWG fax (425)252-9551
phme (4=)252-2826
0
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 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:
City Receipt#:_
Critical Areas File #: .2 400-3--W2-0
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant--z/—//-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, 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 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 to file t is plicati b h e owner as listed below.
SIGNATURE OF APPLIcANT/AG DATE
ati
Property Owner's A thor' ti
T .
By my signature, I cc. 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
Owner/Applicant:
"O�kZ 'J ZP40 r-J 6)
14ame
-2 � C 3 Z
Street Address
1��VIIA/95 VC14
city State zip
Telephone: -//0!�;- (-/' ef
Email address (optional):
DATE
AppHcant Representative:
cw&)
Name
1 -77,
Street Address
Iff 47 C7 7
city State zip
Telephone: IYZ'5- 7-5-Z
EmO Address (optional): 4h4-0,j okitbi
Critical Areas Checklist.doc/3.192001
0
0
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 4 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: .51 f V I 0��
City Receipt#: I I fto --;� C)
Critical Areas File #: -7003 -002-i
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant 4F--44-6--3 _
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.
Ile 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
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information fiimished 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 plicabon_go#e behal e owner as listed below.
SIGNATURE OF APPLicANT/AG DATE 12->
r
Property Owner's Author' ati
By my signature, I cer* I e 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/AppHcant:
h/*JL�/
Name
2:5 Z
Street Address
16;6"Alm,
city State zip
Telephone:
Email address (optional):
AppHcant Representadve:
Name
�/c;cy/ Tr 4c/-;-
Street Address
&�&Y qT—
city . State zip
Telephone: 1Y 7-572
Email Address (optional): johry,� o4p-bt
V W
Critical Areas Checklist.doc/3.19.2001
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
Pernift 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: 51 f V I g�;)
City Receipt#: 1 7-1 V:�p
Critical Areas File#: COZ-2-
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant:
A property owner, or lus/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, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any action or infractim 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 lication 9D*e behalf e owner as listed below.
P 77 -Z /0 --!-I> -
SIGNATURE oF APPLicANT/AG DATE
r
Property Owner's Author' atio
By my signature, I certify I e 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
PLEASE PRINT CLEARLY
Owner/Applicant:
I —
"OLAI J)/
14ame f
C-3 Z F
Stred Address
1d;6V0A/e5
city state zip
Telephone:
Email address (optional):
DAIS
AppHcant Representative:
C->f T
> i mi 6-5: i Z.
Name
1-701 Hc;4-,,t7r-Aa;;-
Street Address
qr- 4--)11 -
city State zip
Telephone: 7-572-
Email Address (optional):. joht-P,� o4p-bt -51wilic-ox-
0itical Ams Checklist.&O. 19.2001
A
N -\
#1LE NO.
Critical Areas Checklist
---------------- ---------------------------
Site Information (soils/topography/hydrology/veg�tation)
1. Site Address/Location: RL'V-6'� �3,q/-A S7 Sa),
46d
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet): 3S 2/-f
4. Is this site currently developed? —Zyes; no.
If yes; how is site developed? 5/77s &N 401<r1AA1 d1f= .d0,e&*2e7;K
5. Describe the general site topography. Check all that apply.
Flat: 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
I 0-feet over a horizontal distance of 33 to 66-fe e*t).
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: AjdAZj!E_ Approx. Depth:
What season(s) of the year?
8. Site is in the floodway AJL9 floodplain of a water course..
9. Site contains a creek or an area where water flows across the grounds surface? Flows are.year-
round? NOM5� — Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow ;shrubs mi xed
urban landscaped (lawn,shrubs etc) 1�vd7W 7�� .7v lloWx-,
11. Obvious wetland is present on site:
--------------------------- ---- — --- ----------------- For.City Staff Use Only ------------- ------- --- —
t Z,
e is oned!
?
.2.. SCS mapped soil type(s) WWI 1�
1 1 W.
etland inventory or C A map indicates wetland present on site?
4. Critical Areas invenio'ry or C.A. map indicaies Critical Area on site?
w ithin designated earth subsidence landslide hazard area? tdo
:;6. 'Site des - ignated on the Environmentally Sensitive Areas Map?
DETERMINATION
. . .... ..... DY R.EQUIRED
Reviewed by:
1=_chk.doc; Rev 10/T
CONDITIONAL WAIVER.
bate
0
0
City of Edmonds
R E C MEN' I V E D
JAN 0 6 1999
COMMUNIN OWES
CRITICAL AREASCHECKLIST
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 detennination 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 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 . a n.'s:wers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/Applicant:
—7—oAlq 1% PaN - 211�'
Name
236 17 AWY
Street Address
RMA ME., 11 - 1-0 W,
City State Zip
Applicant Representative: -
Name
Street Address
city State
q2 �,- — �",_7,q_ //�
-YY-L- Z L% 2,
Telephone Telephone
Si na e
9
z
T
I e
Signature
Date
Zip
A
tn'"Aw'I
-E tFAM& 8
31DENCE
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)th COURT W. 0 SINGLE
r) RESIDENCE
RESIC
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ALL EXPOSED S�R \C)
23702 801
BE COVERED WO-tN,,2/-,.
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36.W',/
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OWNER/CONTPACTOR iS FULP I N 89
46 v 46.,'
FOR EROSION CONTROL A
GE
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RESIDENCE
< czn X 23723 80th COURT W. R
-S
MAINTAIN PLAT INSTALLT SQ<A1 23704 �78CItl
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D /23725 80th COUR7 W. 0 23706 80t
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7 ACCEPTAbLE TIGHTLINE
r- d-0 q 1# SDR 35 MATERIAL ED
D �-o SCH 40 OCT 19 2004 R CE ED
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PE-YR�Mco. R
OWN ER/CON TRACTOR SCALE 1"=20'
MKING PROPERTIES, INC. W E
P.O. BOX 1034 01
LYNNWOOD, WASHINGTON 98046 10, 20' 40'
S WATER & SEWER
PHONE : 425-670-2711 PLOT PLAN INSPEOTIONS REQ'D.
BENCH MARK FOR CALL, 425-771-0220 EXT. 1326
THE PROJECT BENCH MARK IS THE CONCRETE
MONUMENT IN CASE LOCATED AT THE LOT 9., 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
Lovell— Sauerland & Associates, Inc.
APPROVED AS NOTED ftgme—/Surveyors/Plamen/Development Consultants
BY ENGINEERING e-mil: in o@lsa�eering.com - web: isaengineering.com
IkW 33rd Avenue T., Suite 200 LYnnvOOd, TA 98036 - (425)775-1591 - (425)672-7998 fax
DRAWN Fc—m=m D= SCAU Fu NO. —
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LIu & ASepcxATES,k
' ^ 48e2746
p'mo
,~- ~_` ^^-
DAILY FIELD REPORT
'
Job N6.
19213 Kenlite Place NE
Travel Time (Hrs)
Time Off Site
Weather
1,75
,-'~P--_-- --_ '
Cajun E�xcavatinu
The footing trenches for \hehnmesto�boconstmuhad_unthe3nm1henn�|ots�ofihe subject lots have also beer)
--'------------food��|�va|�wUay The�x�no|nenche�8reaUnxo�vatod|oW|kogmy�eoUdUcrvery-
dense,
'c�n�����VoVm�nu���' � � '_ _� _
aUtyOneh)mOd\unnsandw6thxomegr8ve}ando�C��on�|coc�Je�� ��mundwahcr�has �not been onuuunevx1
� . _ '
and UknrW is no standing waterw�h|p the footingtrenches.
_
|�� und
isturbed � ------------' \Nmthe �nd �annkno oun�ox�pn�afOc�hnuWberemoved down
'��00 �Loose disturbed . ls � - �-'-'_--_~_--- _ � - - _--- '
to wndiyturbed fresh0\ o��phm1n� hxthe �� �mdab�o _
` ` �
_-_-__-_ -_---'--' '_-_--_-
--
- -------__ __-_-' �
�
----..... --
-
' -----_--' �---'-___ ...... � _'-__ ' � ' �-_-- __� �» yK��K0��~
u-'----' ------`-------'� ' -'--- —� '- -- ��
r;O,mto'
to: []Cominxmj
1)Ted Coleman/Viking Properties °) on Next
.. u` I paAe
LIU & ASSOCIATES 4- . 4862746 P.02
DAILY FIELD REPORT
LRJ & ASSOCIATES, I-N(.-. 4AD85 J. Llu I of 1 2
icrring('rcolo&%-& arth cience Miles
Tme On SRe Me
24 12:05P 11110104. Wed,
19213 XcidOe Place NE Travel Time (Ws) Time Off Re Weather
Kenniorc. Wishington 98028 1 12:45P Cioudy
e
Phone: (425) 483-9134 Fax: (425) 486-2746 vehlr.le H rs on Sit
TobUcWion 1.75 Mie—nr—
Lots 8 thm 13 Sunrise Ridge Viklnq Properties
Gameral contractor General ContreGtor Superintendent hanked ny
\Akina Pronerties Ted Coleman
ualun t:xcavaung . I - -1 ---
The footing trenches for the homes to be constructed on the 3 northern lots of the subject lots have also been
completed down to the footing level today. The. footing trenches are all excavated into the gray fresh till of very -
dense, silty fine to medium tend with some gravel and occasional cobble. Groundwater has not been cricoLintered
and there is no standing water within the footing trenches.
... .... ... .
it is m opinion that the undisturbed fresh till soils will be able to render an allowable bearing capacity of at least
Loose disturbed soils pushecl into the footing trenches by constmiction traffic should be r r ov d down
to undisturbed fresh till soils prior to pouring concrete for the footing foundations.
.. ... ......
7t17
R
...... .. ....
............ .
�,ODV TO: . I D Continuod
1) Ted Coleman/Viking Propeilies 2) On Noxt
4) Pep —
'.k' is. ' I
41, C. 1 0 V
O'ce PERMIT NO: 9933
of.Edmonds
PERMIT EXPIRES
SIDE.SEWER PERMIT 7
Address of Construction
Pro' 0. e�vt
perty Tax Account'Parcel N
Attach copies of all access and,utility easements' Verified and Approved by
Owner and/or Contractor: V, 4 1,." 11 -0
Contractor License, Building Permit.
Vsingle Family
Multi -Family (No. of Units
E] Commerciall(N9. of Units
F� Public';
Invasion into City *Right -of Way: El Yes 2-go
*RW Construction Permit #
Cross other "Private Property: El Yes . �o
"AIttachlegal descripti.on'and -copy of recorded easement.
Owner/Contractor
A"iAowner or contractor signature and ;4Uowledgemeint statement:. Date
jwy signing forthis permit I ' certifyifi4t thave read the'City's 'public handout entitled
Side Sewer Specifications, and shall comply with all City requirements outlined therein.
.2 CALL DIAL -A -DIG (f-800-41,4"5555) BEFORE ANY EXCAVATION W.
.2 FOR INSPECTION CALL 425-7.7.1-0220 extensionTL3�Lrkr`
24 HOUR NOTICE REOUIRED FOR ALL INSPECTION REOUESTS .
. .. ....... .
....... ..... ....
..... . . ..... . : I . . . . I . : ... ...
FOR OFFICE USE ONLY ...
.... . ..... . . . .. ..... . ... ... .. . .... .. ..
........................................ . ...
Permit Fee $ A� Repair Fee $ Issued By
"hA2Z)77aAP
Date Issued:
Assessment Fee $ Receipt No:_
.00
City Permit Surcharge Fee Total Fees Pa id $
-NOTE: IF JOB SITE IS NOT READY FOR INSPECTION WHEN
INS PECTOR ARRIVES A $45 RE -INSPECTION FEE WILLBE CHARGED.'(,��
Job Site Ready YES NO —Date: Initial:
Partial Inspection: Date: Initial:
P pa
artial Inspection: Date: Initial:
Initial:. 7-fM As -built to Street Fil
FINAL INSPECTION APPROVED: Date: E]
13,.PERMIT MUST BE POSTED ON JOB SITEtz-
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HOMEOW7R CONTRACTOR SCALE
DATE Ati DROqN PERMIT I NTS
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DATE DRAWN P RMIT
03-311-2005 By I, ABILA NO. 9933
IJATE RECEIVED
�'PERMIT
EXPIRES
CITY-OFEDMONDS
USE
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I PERMIT
�"NUMBER,5:�W— 0716
CONSTRUCTION PERMIT APPLICATION
JOB
ADDRESS
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W F USIINESS
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NAME/SUB I
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LID FEE $
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TESCP Approved
RW Permit Required
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CITY
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EXISTING PROPOSED
Inspectio Required
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REQUIRED DEDICATION
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METER SIZE
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REMARKS
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Building Permit
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EST DATE1
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THIS PERMIT AUTHORIZES ONLY THE V THM -
Grading
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E DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC
:OMAIN
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(CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES,'ETC.) WILL REQUIRE
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SEPARATE PERMISSION.
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Engr. Review
6
. PERMIT APPUCATION: 180 DAYS
Engr. Inspection
IL
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, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY; DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
W
Fire Inspection
Receipt #
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
Landscapelnsp.
Total Amt. Due 10171
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
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
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 Pr'r�% LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION receipt Is acknowledged In space provided.
WORKMEN'S INSURANCE AND RCW 18.27.
'OOMPENIATION
SIRW �URE OWNE RAGE DATE SIGNED
(425)
F LS S1 TURE DATE
.
771 -0 220
III
LEASED BY TE
ATTENT16N
M 133
TWO
ITISUNLAWFUITOUS OR OCCUPYA BUILDING OR STRUCTURE UNTILA FINAL
qRINK
INSPtCtION HAS BEEN MADE ANDAPPROVALORA CERTIFICATE OF OCCU-
PANCY HAS BEEN GRANTED. UBC109jIBC110/.IRC110.
ORIGINAL - FILE YELLOW - IN4PECT0R
09/03
P - OWNER7 GOLD - ASSESSOR
PRF-qq 14ARn _vni iARF MAKINr.*A rnPIF-q
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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 ..................