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MURRAY TOBIASON, KA-S5A*-& -T-OUJI-3 "OUNS C-,ITC. P%A'j'
Planning - Civil Engineering - Landscape Architecture 1>f-A,QA-&�,M 4 -re75a P"AtJ.
626 - 128th Street Swhyest Sub 107 - Everett Waftom 9M04-WW -r^.,A *,cwt- . 4ol (o - 00 1 - 0 1 - c;,olg.
Phone (206) 513-25M - Fax(2D6)742-2822 Scqle: 1 I'= ZO Date: It 11912 Job No.: 7-2- 013
IBY: V(n Checked: Jift/ Sheet I of
)0" SV
TO-TkL, 401(0-6o S-� 5000 S-P
T)C-51C-,'N PE-V— CI -Ty 5-TAWVAIP—r>S
2 4 Z:) 4 0 " LC-.ti C-n -T t-i 17-
'T%j p4e- I L Cb zk>,l r-noct:Or� :S*,Ij�q_
A-TT^Cfr\e;j��>
C-Y,\S'T%wCn
-TC) BC— u—c—movev->.
MURRAY- To IASON, INC.
Planning - Civil Engineering - Landscape Architecture
626 - 128th street ftmvwwA stxb 107 - EyerA Wastirom 9="M
Phone (M) 513-25M - Fax (206) 742-2822
V-P,S5/N-t,ju
jDate: l0j%jC)(0 jJobNo.: 2;
IChecked: jpy' I Sheet I of
Table 1 — Detention Pipe8lzes
Impermeable
Required
AreaSq. FL,
Vol"Cu Ft
2000
50
2500
62
3000
75
3500
87
4000
100
1-4500
112
125
Note: Allowable Pipe
Materials:
Impermeable
Area Sq. Ft.
2000
2500
3000,
3500
4000
4500
r_5_0�
4
Pipe Diameter
15" 18" 24"
30"
40 28 16
10
50 35 20
13
60 42 24
15 Required pipe
70 49 -28
18 -length In fee'f
.180., 56 32;
21
90 63 36
23
100 70 C_4�0
25
Reinforced Concrete
Aluminized Steel
Aluminum
CMP Asphalt Coated
N — 12 ADS (Not permitted on roads)
Table 2 — Outlet Orifice Sizes
Outlet Orifice Diameter (Inches)
5/8
5/8
3/4.
3/4
7/8
7/8
Table 3 — Rectangular Catch Basin Requirements
Detention Max. size, Catch Basin
pipe diameter knockout Type
< 180 20" Type 11, CB 15
18" to �4' 26" <:ajDC B 16'
24" to 36" 36" Typell,CBig 19(48"Basin)
360 to 42" 42" Typell,CB.19 1.9(54"Basin)
*Source: Assoc. Sand & Gravel Co. Standards
5
Revised 3/16/95
STANDARD DRAINAGE DETENTION SYSTEM
WORKSHEET
CALCBy:
ADDRESS 150-7 mt-vcv�eu- P-oAt> PHONE: 334— 17-04,
LALE C%7-45'a
DATE: NOV. 19,
****DESIGN DATA
IMPERVIOUS AREA PIPE DIA PIPE LG ORIFICE
(030 S-cl
OCTENTION PIPE LENGTH LOCKING LID
FINISHED tG ITYPICAL)
MINIMUM
TI TLI r 6. aEtj&VCf0P
X
OF
TIGHTLI E
CONC BOX OR RISER
.5% TO I%' SLOPE
--4n OUTLE T 16"
ILE T CONTROL
SL r;:N . 13 13UTLET Pvr
, 164
714 2OUtLET CONTROL
OVT IA. --Sass MIN,
UPPER CATCH BASIN QRIFICE
CONTROL CATCH BASIN
SYSTEM'CROSS SECTION
2'X2'X6'.DEEP, 4-6- SPALLS OR EOUAL
FROM CONTROL CO
2'X 2'X 3' DEEP, 3/4' CRUSHED RUCK XISTING GRADE
I I e -./ %�-rz
FROM CONTROL OUTLE
11
UTFLOW TRENC HIM 10' LnNG.
PERF PIPE TO i� LEVEL
PERF D CAPS
H SMALL BE LINSF WITH HIRAF
i PIPE W1 EN
TR
NPRAP 0Urjrr PRU01 To PLACEMEN WASHED DRAIN ROCK
RUNOFF SPREADER. TRENCH.
FOOTING DRAINS SHALL NOT BE CONNECTED TO DETENTION SYSTEM
1. Call Engineering Division (771-0220) for a tightline and detention system inspection
before backfilling and for find inspections. APPROVED BY
2. Responsibility for operation and maintenance of drainage systems on private property is the
responsibility of the property owner. Material accumulated in the -storage pipe must be flushed
out and removed from the catch basins to allow proper operation. Ile outlet control orifice DATE
must be kept -open at all times.
0 -
3 0,9 --:?)
10
RECORDED
Chy of Zdmond% Building DMolon
IN Sth Aveuve North
Zdmandsv WA 98620
97 JAN 30 PH 12: 04
C�p 40
AUDITOR C1 =a
SHOHOMISH COUNTY, WASff:l
DEPUTY—-_
0
Mn
r-
rn
n
DECLARATION OF RESTRICMVE COVENANT
M -4
C,:� =
MMTI-FAMMY RESEDINTLAL
M M
1,
Rdellinco 0%
d(2) K - enneth & Lois Nils" Adds' , tional on pg.
Graot*s): QU I MA agde
Leo Description (abbreviated): SK Twn Rng.
OR Lotj!------Block I Plat —City Park Addit-i-ga.
0
Assessor's To Parcel nWo): (1) 4096-001-018-0005 (2)
Astessorps Tax Parcel EN not yet assigned
VVMRW 4 Kenneth and Lois Nilsen and James and. Ester Rasband
art *0 Owdt" of the following described raM estate in the City of Edmonds, to wit:
Property Address;_- 516 4th Avenue South, Edmonds
Lqd De@Crjp*n: Lot 18, Blockj, City Park Addition to Edmonds, according to
he
Plat -thereof re.corded in Volume -9 of Llats-,-Page 10, in Snohomish County, Wa
hington
Assessor's Tu Pareel M # (s): 4096-001-018-0005
WHMMAS, the above owned owners are "rout of imposing a restrictive covenant upon
smi Premim tn COMPlisoce with Section 19,00.640 of the Edmonds Community Development Code.
FTWINFIUM", 4:
City orldwonde, Ift ding Division
250 Sth Avenuo North
Zdwojm4* WA 98020
WITNZSS]tTH, that for and in consideration of the premises, the above named owner$ do
hwaby dWars and grant to the City of Edmonds as Grantee the following restrigavt Covenant, tO-
wit:
That at the time of the execution of this Covenant Ow Grantors have agreed to the Ordinance
of the City of Edmonds provide that so build'ag for multiple family bousing may be erected on
subjeo property containing more than __ ZQ __ units.
Said Covenant sball be binding upon all prmnt and future owners of said real estate ad their heirs,
successon ad asolps.
DATED this cpq day of J9,MA
LA;*
State of wasmiqw.
county of
I e*r* the I know or have sadsfactory evidate that E�Z Te A Wx WO signed
& e
this InstmMsnt. on oath stated that he/she was outhorizvd to execute the instrument and
acknowledged it w the (611e) of (name of party
on b4sw on whom instrument wa executed) to be the ftw and voluntary actor ouch pa rortk
uses and purposes mentions In this Instrumont. Subscribed and oworn to before me this ;zq
dayof TAA.)U&M�4 19 ey-
TRAVIS L ST4
MAR PUBUC
MISSION
2006 NO atok
PROVO , UTAH
COM
19701300 400
in and for the ststo OF W0011! 100-1.
expires—
I - 1 4 % 1) - 4 ,, 1F.V-1yi3 I
CRy *Md000ds, Building Division
MW Stk Avenue Naftb
ldsewK WA 91020
WITNUUTHP thot for and in consideration of the promises, the abavv Named Owner$ do
bw*by dodat* and grant to the City of t4monds AS Grantee the (6110wifel f#1t?101v* cOvInAnit to*
Wit:
That at the done of the necutiou ofthis Covwant " Grastors havo agreed to the Ordislance
of dw My of Zdmonds pro" that qn, build'ing for multiple family how6vil mey be erected on
eubjert props"y containing more than 12. units.
-ro-om— 1W
Sidd Cavenamt oball be hbWn1 upon allipmms and f6ture owners of said rosJ estate and their hairs,
nweamen md smetm.
19.21,7
DATED, this day
0
slon
TA
SuU of Wasidetton PUBLIC
C
I *of* do I knew or him ctn it signed
this Ituitrmnent. on oath stated fti hdshs was authoriacd to execute Ow instrumodt and
ukwwtedpd it an the (0t1s) of (nms G(Party
06 104fiff on whom instrument was 00400d) to be the free Md VolunfOrY 1101 of Ouch peft fiv the
wa and rponi MM"li no in this last lbod and sworn to before me this
19
-M
day M
El
No"
My tommiselon,
andf6r 8 ofWakington.
1r&1k �000
,97o I lei 0 0 4 0 0
City of Edmonds
I RIGHT-OF-WAY CONSTRUCTION
PERMIT ?�._ i � "3
Permit Number.
Issue Date: �'�A__�
A. Address or Vicinity of Construction:
A "A 10
11L .4
lype o kUY al!� "I 4e, F z. "— — A %f-
�62 tie,.� DsOeA A/gAe
ilo-'Oyl 60-214--l-l� - &2k I
C. Contractor: "3. 7�7jv._ -41 �act: _J'J �J
R
MailingAddress:
ALI( Rd JA one:
State License #: Liability Insurance: V,�t:, Bond: $
-6 A5 10A 4-Mo & b
D. Building Permit # (if applicable): 6ti (yi 3-S Side Sewer Permit # (if applicable):
E. El Commercial F] Subdivision City Project E] Utility (PUD, GTE, WNG, CABLE, WATER)
0 Multi -Family [�J Single Family Other
INSPECTOR: 1,444& INSPECTOR:
F. Pavement or Concrete Cut Yes [:]No G. Size of Cut:
APPLICANT TO READ
)4 �A_
SIU,
H. Chargq�,$ '?�Q �)a
INDEMNITY: Applicant understands and by his signature to this application to hold the City of Edmonds harmlessfrom injuries, damages, or claims ofany
kind or description whatsoever, foreseen or unforeseen, that may he made against the City of Edmonds, or any of its departments or
employees, including or not limited to the defense of an), legal proceedings including defense costs and attorneyfees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC-
TION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREETPATCHIS COMPLETED
BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT W/I L BE PROCESSED FOR ISSUANCE TO THE APPLICANT
Two sets of construction drawings of proposed work required with permit application.
A 24 hour notice is required for inspection. Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
Al I street cut trench work shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and understand the permit requirements and the pink copy of the permit will be
available on siteoft all times for iWpection purposes.
Signature:
(Contr2ictor or Agent)
Date: rZ.19-14?
I de Arz
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
I
APPROVED BY,
TIME AUTHORIZED: VOID AFTER DAYS
SPECIAL CONDITIONS:
.�Ljtjatd &OT
RIGHT OF WAY FEE:
DISRUPTION FEE/FLYND I It:
RESTORATION FEE:
T OTAL FEE- 30
RECEIPT NO.:
ISSUED BY:
FIELD INSPECTION NOTES
Comments:
Diagram.:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION 1:1 YES El NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
1-7
4 ..... -7
w.,
77 7
Citv of Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number.
IssueDate:
A. Address or Vicinity of Construction: !!57)q 5 18 "74*:
pow
0-1 B. Type of Work (be specific):
9 46;-- -
412 Ma"-
C. Contractor: q0,W_,.3 AZv-"4 Q@fitact:
Mailing Address: I-1-al m4ykft
Q LA J�Whone: (2, i/
State License #: 7ZA5 OA4A�e677 Liability Insurance: VZ�g Bond:$—&
,0
D. Building Permit # (if applicable): T006-S Side Sewer Permit # (if applicable):
E. E] Commercial Ej Subdivision City Project E] Utility (PUD, GTE, WNG, CABLE, WATER)
0 Multi -Family [� Single Family Other
INSPECTOR: az= INSPECTOR:
F. Pavement or Concrete Cut: Yes []No G. Size of Cut: x H. Chargq�,$ '?Q 00
Al?PLICANT TO READ RD A-GO'7
INDEMNITY.- Applicant understands and_hy his signature to this application to hold the City of Edmonds harmlessfrom injuries, damages, or claims ofany
kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its departments or
employees, including or not limited to the defense of any legal proceedings including defense costs and attorneyfees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC-
TION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINALSTREET PATCH IS COMPLETED
BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT
Two sets of construction drawings of proposed work required with permit application.
A 24 hour notice is required for inspection. Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut trench work shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and understand the permit requirements and the pink copy of the permit will be
available on siteyt all timesfor iffpection purposes. f
Signature:
t
Date: -I--
CALL DIAL -A -DIG PRIOR TO BEGINNIN.'G WORK
f('nntractor or Aa,-nt)
The City of Edmonds Water Service Drawing EASEMENT NO. � ...........................................
NEW CONSTRUCTION REPAIRS F� LID NO . .................. ASMT. NO . ..................
OWNER ('ONTRArTOR PFAMIT NO.
.......... I .....................................................................................
JOB ADDRESS .............................
...............
PWW-0001-11175 (REV. 11178)
LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ....................................
NAMEOF ADDITION ........................................................................ I .................................. I ............
C
Pewt-;*1 11-2-1?-?7
Approved:
DATE ...................... By .... 4 .....
...... ..... . .. —
CITY OF EDMONDS
9 0
Address of Construction: *�,# is:- k 8 Ll�� A,,v—
P erty Legal Description (include all easements):
AJd I'-\,) a ij ��A tow v-i V\A
Clwn�p . 'a�ncl/or Contractor: Kct isbo_n
State License No
Single Family
Multi -Family (N
0 Commercial
El Public
SIDE SEWER PERMIT
r1l, 8 5
PERMIT 0
1-H 0 0 8`�,
Building Permit No. I-)
Invasion into City Right -of -Way: x No I El Yes
RW Construction Permit No.
Cross other Private Property: F No El Yes
Attach legal description and copy of recorded easement
I O'ertify that I have read and shall comply with all city requirements
�s indicated on the back of the Permit Card.
D /e
* CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION *
OFFICE USE ONLY
FOR INSPECTION CALL.7;4-3202, PUBLIC VVORKS DEPT.
-7-21 -Oo-Z&50
Permit Fee$ /�00. Issued By
Trunk Charge: Date Issued: 2 lS
Assessment Fee: Receipt No.: _�9.ZG6_:5
Lid No.: —
Partial Inspection: Date —Initial —
Comments
Reason Rejected: Date —Initial —
Final Inspection Approved: Date Initial Z4--
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Green Copy: Inspector Buff Copy: Applicant Revised 3 90
The City of Edmonds
OWNER ..................................
5.. t.B - u -
JOB ADDRESS ...... ... ............. ....... & ... r� .......
Side Sewer Drawing
NEW CONSTRUCTION
EASEMENT NO . ............. ..............................
REPAIRS E] LID NO . .................. . ASMT. NO - ------------------
CONTRACTOR .................................................................................... PERMIT NO. eeal
LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ....................................
..................................................................................................................................................................
,:---'T 4 A. � � ". , -t NAME OF ADDITI ..... .......... ..................................................................................
+
(3 +
7
0 + V -c-
3'De-e-p
3 -�4 4
PWW-0001 -11/75 (REV. 11/78)
TREATMO�ENT PLANT
Approved:
DATE ..... 3 .......... 27-0. ........ q7i .......... By
A:� .............................
ZONE PERMIT
CITY OF EDMONDS NUMBER
CONSTRUCTION PERMIT APPLICATION
OWNER NAME NA F BUSINESS j<ff-l"40d 1V1&f4FN ADDRESS
_.,V_ �I` T 1,EGAL DESCRIPTION CHECKI SUBDIVISION N1
" VVV
-97-11 L,44b
-
.1
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP ;'E'5CP
EXISTING — REOVIREO DEDICATION Sir"t
inspftfion
PROPOSED
Ap"Od 13
I Per.il R.,._d 13
US& pgfmi, Req, , 0
Req.-d 0
Rquir.d 0
ZIP
U sqAo q
TELEPHONE NUMBER
(bo 1)
SIAME
wam�
h)vj A3A
Sid-1k
METER SIZE
I LINE SIZE
0. OF FIXTURES
I
PRV REQUIRED
YES 0 NO 0
ADD as
1.91 VOL16
4,
961S
RE��� tlelLI;jys,�
�-ITY
,5eaAL
ZIP
131 q
ONE NUMBER
I
NA
(A—.4
JJ�
oed
xk�kwi
ENGINEERING MEMO DATED REVIEWEDBY
CITY ZIP
Atvo>
TEL�;TE NUMBER
�-Z ?JV_Wq
_/ DBY
I
AM
W
tzooaz
T
9A5X;�A d..
SIGN AREA
ALLOWED I PlIOP081D
SEPAREVIEW
COMPLETE JEXIMPI
V
P
ADS NO.
Geghl Oescription of P operly clude all eaiemerds
L2,17 * J8 ila 64 AML
41"1"1411
SHORELINE#
edma,-;Ivb
Ly L-L-4—
VARIANCE OR CU
PLANNING REVIEW By
DATE
SETBACKS - FEET
FRONT SIDE REAR
EIGHT
I LOT COVERAGE
P'-P-rty
�Sx Ac-unl 0 0 0 0
" No.
P.re
REMA
NEW RESIDENTIAL El PLUMBINGIMECH
COMPLIANCEOR
El ADDITION COMMERCIAL E] CHANGE OF USE
REMODEL APT. BLDG. SIGN
GRADING FENCE
El REPAIR CYDS. I x ----.Fn
COOSTOVE SWIM POOL
DEMOLISH El w Ho
INSERT T TUB/SPA
GARAGE M RETA NING WALL/
CARPORT L-J ROCI.IERY RENEWAL
. .... .... .11-TVI FXPI AIM-
VAA-v 4
CHECKED BY TYPE OF CONSTRUCTION
CODE
OCCUPA
SPECIAL INSPECTOR
REQUIRED YES
I AR
40CA z3a)
OCCUPANT
LOAD
REMARKS
PROGRESS INSPECTIONS PER USC 108
NUMBER NUMBER OF
OF DWELLING 0
STORIES UNITS pye
DESC5WE WORK TO BE DONE (ATTACH PLOT PLAN)
jneS2-;-0U fill -jqrUCNMV,5, a
FINAL INSPECTION
REQUIRED
/-�wi -k
VALUATION
PLA CHECK FEE
Bull [NO
HEAT SOURCE:
GLAZING
I %
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRAOINGIFILL
Any construction on the public domain (curt:,s, sidewpike,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs. assigns and
ENG. INSPECTION FEE
S ccessors in Interest, agrees to indemnify, defend and hold
Murmless the City of Edmonds, Washington, Its officials,
S employees, and agents from any and all claims for damages of
x Whatever nature, arising directly or indirectly from the issuance
of this permit. issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
modify, waive or reduce any requirement of any city ordinance
OZ nor limit In any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
R/c,
provision."
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
authorized agent of the owner. I agree to comply with city and
THIS PERM IT
This application Is not a permit until
state laws regulating construction; and In doing the work authoriz.
ed thereby, no person will be employed In violation of the Labor
AUTHORIZES
ONLY THE
signed by the Building Official or his/her
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
Deputy: and fees are paid, and receipt Is
nd PCAN-+&Z7. _
INSPECTION
acknowledged In apace provided.
A E DATE 61 NED
DEPARTMENT
CITY OF
OFF I L $SIG E
4
��WUR
1Z Aih
EDMON DS
CALL FOR
BY. %-" DATE
NINSPECTION
'0[EASED
-------------------- —
IT S UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNITIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220
ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC
SECTION 109
PINK — Owner GOLD — Assessor
10247
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13PIH� 462.SZ,
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MURRAY TOBIASON, INC.
9 Ns. eA�-� -T-0 W -a 40v% S
Tc- P%'&Q
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4ol to - 00 1 - 0
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Planning - Civil Engineering - Landscape Architecture
626 - 128th Street Southwest, Suite 107 - Everett, Washington 98204-M8
Phone (206) 513-2500 - Fax (206) 742-2822
Scale: Z 0
1 Date: III 1() 12 (,
JJObNo.: 7-2.0$
Bv: V (-i
I Checked: JPV
I Sheet I of I
0
I
A CONDUM IN IUM VdUme .113 of 0:;.4!31
HENRY EL WHALEN. Lwr.!) A�0f
IN SECTION 26, T. 27 N. R.3 E., W. M. : !r. kE-1
CITY OF EDMONDS, SNOHOMISH COUNTY, WASHiNGTON
30, w
HOWELL WAY E C
3t,
3 C'
3QOO*
- -----------
517 4thAVE.SO. 20.41,
CONDOMINIUM
BUILDING
LLJ
(n
w Z'o
w .1::
>
z
wi
If)
519,4thAVE
CON
BUILDING-*:--�-
4- 130.00*
00' 30'
plur'
AII&I %
-07
CzIq". Ina me"t villb plasii�r� �.cj 12 Load Flog in sidewalk,
West of 3.9.c","r of subiscl propowt,
Datava-M.L.L.W.-
a
_.�61RVEYOR'S -CERTIFICATE
LEGAL DESCRIPTIOW'.
;��4 NIERIESV, CZ,,YIFj.T"r�XHIS PLAT OF PARSVIEW TWIN A
AT A, POINT 160 FEET WnT'AND 132 FEET 3 V HE R
UPON.'AN ACTUAL SUMVCY OF THC PROPtRT C IN
OF SOUTH HALF OFTHZ MORTHEASE.4111ARTIM O�
:_T�r:CCURSj[;k'#Mp.OISTANCE5 AMC SHOWN CORRECTLY TV
77: OF
.4:T . 'isir:OPOM THE GROUND AS SHOWN AND THAT I "A
CUARTER 01' SECTIO 2f.TOW"3"IP1_
iI6NUMtHT3 &me-.
THENCE WEST 130 FEET TO THE EAST LINE Oj!THA'rXERLAIM��MTX-5-_,, Hj.pRoV "C STATUTES GOVERNING COUDOMIN
DEEDED TO TUC CITY Of EDMONDS STOCIED 4CCPl!!RFR!.n!�CffTSmo"O !S
...... vm -at.Alls-SAID? CAST: -
EXISTING EILEV
A:
62.99'
B:
62.94'
C:
61.94'
D:
62.72'
AVE: 62.65'
EXCAVATE 200YARDS
BACKFILL:
NEW GARAGES 60 YARDS
OVERDIG 40 YARDS
NORTH SIDE YARD 50 YARDS
BURM CREATED AT ALLEY
50YARDS
APPROVED AS K6j �LO
V---e al
B u i LI ril t�
1
J AN I G E;�-'9 7
00
BE
/ -;p w I I /- 1411
70wJ
4TH AVE S.
NORTH
Lmollft"
DATUM 62.52CB IN STREET
i FN Fa 5a Cl
ING PLAN 1/9/97 Cwtractor: Rasband Homes, Inc.
SCALE: 1 " = 20"
SUBDIVISION BLOCK CITY PARK ADDITION
LOT 18 Address: 516 4TH AVE SOUTH
LOT SIZE: 8, 184 SQ. FT.
PLANNING DATA
NAME:.
SITE ADDRESS:-5/+& 6_4 4ve. 5. -DATE:
mf-&,f - �- - 9 6 -17 7
ZO N I N G: —PLAN CHK#: 2 4�,
PROJECT DESCRIPTION: COn 5't� &f - --9- ",,) ff 5, 161AI "I-, 6_11
CORNERLOT -(Yes/No)
SETBACKS: - p-m Z_, +
Required Setbacks:
Front: 15, Left Side: IQ, Right Side: la, Rear: i c3
Actual Setbacks:
Front: No' LeftSide: 11V RightSide: 11' Rear: 3 3'
Street map checked for additional setback required? (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED -(Y/N)
LOT COVERAGE: 4o 83' 33 ZO
Maximum Allowed: +5,Vo Actual: 6
2,3 A' ff P,,
BUILDING HEIGHT:
Maximum Allowed: Z'6, Actual Height: Z,5-,
Datum Point: -fmA--,h Lz..tv". Datum Elevation:_65, 35-, M L_L_ �j
"n VA& jXj1e_.,
A.D.U. CREATED?: _N6
SUBDIVISION: C,!:, Pwv- -h EA�,�j,
CRITICAL AREAS #: 9(
" - / Y/ -
6AX-W �_ (Vo ! -
SEPA DETERMINATION: , 4 D Lt
LOT AREA: 19 9 1 F3. & 7
OTHER: (_-km& P�P_?" 011wi -
6
Plan Review By:
PERNUT APPLICATION REQUIREMENTS
Applicant
om: Jamal Mahmoud, Engineering bispector
-vner. Plan Check No: 9
1dress: -51 Lf �Z 5 1 Y 24 Att Date; - f9s�
fter review of the subject permit application, the following requirements must be met
Construction hours are: WEEKDAYS — 7:00 AAVL-10:00 P.M.;WEEKENDSIHOLIDAYS — 10:00 A-K-6:00 PAL
A separate RIGHT-OF-WAY CONSTRUCTION PERMIT is required for all work on public property. (ECDC 18.60)
Truck haul route plan must be submitted and approved prior ta. permit issuance.
Builder/owner is responsible for containing all temporary runoff and erosion control on site (ECDC 1830.030d).
NO WORK SHALL BE DONE WITHIN 15 FEET OF STREAMS OR 10 FEET FROM ANY CLOSED D9AjXAcE
FACILITY. BUELDER/OWNER IS RESPONSIBLE FOR IDENTIFYING CONDITIONS ON THE DRAW64G.
(ECDC 18.30.50G)
FILTER FABRIC FENCE SHALL BE INSTALLED AND INSPECTED PRIOR TO CLEARING AND CONSTRUCTION.
(ECDC 18.30)
INSPECTIONS ARE REQUIRED ON STORM DRAINAGE SYSTEMS, TIGHTLINES AND CATCH BASIN
INSTALLATION. INSPECTIONS ARE REQUIRED PRIOR TO BACKFILLING. (ECDC 1830)
Repair or replace all defective existing curb, gutter and sidewalk adjacent to the property. If an intersection is involved, a handicap ramp
may be required. Contractor shall meet with the City Engineering staff to determine the extent of repair prior to issuance of the permit
(ECDC 1&90)
Driivew slope shall not exceed 14% without a waiver. Every attempt should be made to keep the slope below 14%. Waiver granted to
R--t_ r _ %. (ECDC 18.80.0600)
Driveways must be paved from' property line to City RIGHT-OF-WAY. A separate permit is required. (ECDC 18.80.060C)
INSPECTIONS ARE REQUIRED ON DRIVEWAYS AND SIDEWALKS PRIOR TO AND AFTER POURING. (ECDC 18.30)
No burning of construction refuse without a permit from the Fire Department
Connection to City water system is requirecL 'There is a separate - charge.for thevater meter (ECDC 7.20)..
A back water valve is required if downstaiis plumbing is below the elevation of upstream manhole. (ECDC 7.20)
Water and sewer main lines should be separated by 10 feet minimum. (ECDC 18.10)
Connection to the City sanitary system is required. A separa permit is required.
LID# 51- Fees paid: Yes No Charge�
(ECDC 18.10)
Underground wiring is required on all new construction, and for additions, alterations, and repairs that exceed 50% of the total assessed
value of the structure. (ECDC IS.")
A FINAL ENGINEERING INSPECTION IS REQUIRED PRIOR TO THE BUILDING DIVISION GRANTING OCCUPANCY
OF THE BUILDING OR STRUCTURE. (ECDC 1&90)
PUrANDW
neo- (_4 11,;iul �P-/ (a ;.—., i�� tm
ENGINEERING
ROUTE TO .5M On ZA, Back dd?_)��Total Day�_Mailed
L &
71t7x,
RESUB #1 ON TOJM " Back Add? Total Days_Z
RESUB #2 ON TO Back Add? —Total Days___
1. Site/Drainage Plan & Calcs, OK
2. Grading Plan/Calcs/CYG Zal SEPA? OK
3: Driveway Slope% -0n�4- Profile OK_.2
4. Truck Route Plan OK 0
5. Street Dedication? FEET
6. Easernent_&j;:!� Type___pl�
OTHER COMIVIENTS:
Corrections Required Received
1. . LS. S -z b m; t, -
2. 9YOA �� C,4c -
1_ C val,' �-j 2,0 t, C--() —
4.
5.
PWREVIEW DateSent /'LZL_Back-L/4'&'(-,—FMEREVIEW'Date Sent Back
PLANNING REVIEW TINE TOTAL DAYS *** ENG REVIEW TIME TOTAL DAYS
FIRE DEPT REVIEW TIME
TOTAL DAYS' PW REVIEW.
BUILDING DEPT REVIEW TIME: In -House —Outside.
TOTAL DAYS
TOTAL DAYS
ORDINANCE COMPLETION DATE COMPLETION DATE TOTAL REVIEW TIME DAYS
PERMIT # ISSUE DATE
*CONTACT PERSON STATEMENT*
BY SIGNING TEEIS FORM I UNDERSTAND THAT I AM THE ACKNOWLEDGED CONTACT PERSON FOR
TEOIS PROJECT- IT IS My RESPONSIBILITY TO COORDINATE ALL SUBN=ALS WrM THE CITY
AND ONLY I CAN'MAKE INQUIRIES ON THE STATUS OF THE PERM[IT. I UNDERSTAND THAT rr IS
My RESPONSIBILITY TO DETERM[INE IN ADVANCE OF PERMIT SUBM1TTAL ANY DISCRETIONARY
PERIffrS TEIAT MAY BE APPLICABLE TO THIS PROJECT. I ACKNOWLEDGE THAT TO THE BEST OF
My ABILITY I HAVE SUBM[ITTED ALL NECESSARY DOCUMENTATION IN ORDER TO MAKE A
CO ON.
/gignea Daie Mailing Address
_01 ,� d� 0,J k
Co�fact Person (Print Clearly"
377W
hone Number FAX Number
4d
-;7 I\ell Ad
Zalv_ 5;"s WA, q CO)
R0UTE1XXAJTeznp)B1dg1Fonns-5/96
4-M
0'. 777-77
alfiage/Shale Open Runoff,-,
Required
ope & Vehicle Access
MIPIZ
11
_4
. .. .......
...... .. *,.,�--"�
7 7
Iti nX,I
8 9 0 - I . c)
City--of'Edmoiids
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number.
Issue Date:
A. Address or Vicinity of Construction: lsl�o
B. Type of Work (be specific): WV J�A CWX e..It4 N�Iab
C. Contractor: 'Contact:
Mailing Address: aN\0Nb IAL,)l cl� Phone: Q0
State License #: r-0tAGrJDS #ur\ 9 bOl�- Liability Insurance: Bond: $
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. 0 Commercial EJ Subdivision El City Project [] Utility (PUD, GTE, WNG, CABLE, WATER)
Multi -Family WSingle Family Other
dr N
INSPECTOR: INSPECTOR: RvJ
F. Pavement or Concrete Cut: Yes G. Size of Cut: x H. Charge$
xNo
APPLICANT TO- READ A44GN
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the City ofEdmonds harmless from injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its departments or
employees, including or not limited to the defense ofany legalproceedings including defense costs, and attorney fees by reason ofgranting thispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, -A T WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
7'raffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
Ihave read the above statements and understand thepermit requirements and thepink copy of thepermit will be
a *1 bl all * S 0 spe i
vat a e o f ct 'on yurp S.
Signature: a:� — Date.
(Contractor or Agent)u
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
APPROVED BY: P, W
TIME AUTHORIZED: VOID AFTER
SPECIAL CONDITIONS:
COMMENTS:
pA
DATE:
FOR CITY USE ONLY
RIGHT OF WAY DEPOSIT
DAYS DISRUPTION FEE/FUND III:
RESTORATION FEE:
PERMIT FEE:
TOTAL FEE:
RECEIPT FEE:
ISSUED BY:.
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. 1994
FIELD INSPECTION NOTES
Comments:
Diaaram.:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES E] NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
ors'
Dv*-<��\zz.-���,�,,�.-�-n-,:--�)
Pour-
zz�
E
% 110,
S2o
J+�IANFL-L V�)r—A"-�
Elk
Location: 27N3E26A Scale 1:40
F"1i111h1FXU! -111 �M
City erFdmouds, Building Division
250 Sth Avenue North
rdmon" WA 98020
WITNESSM thot for and in consi . deratton of the prevnises, the above named,ownerl do
hereby dWilre and ZrnTjt to the City of Edmonds u Grants* the following restrictive co . vensAty to'
wit:
That at the time of the execution of this Covenant the Gristors have agreed to the- Ordinance
of the City of Edmonds provide that an buildi'al for multiple fAmIlY h0usin't- may be erected on
subjed property containing more tWM h4:!i.- --ja � units.
Said Cavwant shab be binding UPOD all present and future ov"e" of said rtal estate ad their heitt,
successors and aeWs. DATED this q — day of I 9-f 7
%06� , - ---
State of wio�
jameA
county af—LtL� r t./b liptd
I C*Mf� " I know or have gifisfactory evi4ace that 'e-A -/b - -
this instrument, on oath ltilted that he/she was authorized to execute the 'Wtfum"' and ,
__ (p4mg of party
acknowledged it M the (title) of
on b4aff oil whom instrument was exetuted) to be the free and voluntary act of sucn pirt� for the
uses and purposes mentions in this instrument. Subscribed and sworn to before me this
day of
'10 he,, TRAVIS L ST4
NOTARY PUBUC - Sy
MISSIOMfly
rOtS
0 1
2005 N5
PROVO, UTAH
COMEXPE.-
970 13 0 0 4 0 0)
ZJ-�O/
in and for the sot* op*Mth"n.
m, .12 C 1: PuE 0 3'5 1
Fi 0# 41) '14. , V. J � - J-
CRy e(Umeads, SuMing Division
M Sth Avenue Nertb
Vftew* WA 98020
WITNZSUTK that for and in consideration of the preM1841, She 9b*VV Named Owmr* do
bwaby dodat* and grant to the City at, Zdm*nds AS CrAn#A* the (611OW'"S r4't?Wv* cove"An" to'
Wit:
TbM at the tim of the execution, of this Covenant the Grators have agreed to the Ordit1fincl
of t6 City of Eftonds pro" that po building for multiple fonfly houOvij mly be sracted ON
evuls" property containing Moft than . 1 '2- WOMMW units.
Said Comsat sbab be binding upon jal IpMMI and 16ture ownen of sald r*61 estate and their haln,
successors wad asefPs.
DATED: this day of
ion
SUM Of WSAbi$gW PUBLIC
coww of OP
signed
11fiat- sit
I @Or* dw I INOW or hm swasts 0
tWs huftumat. an ost?i stated that be/& a was Muthorixed to azatute Ow instrument and
wim,wAodged it w the (this) Of , ("amll 4(party
od b4aw 00 w1how 11astrument was OX0000d) to be the fm and vol�njgry act of jiuch psrt� Pr the
on d no Mentigns to this lashro bveriWA and swore to before Me this /�'S C/
day "f 19
Notary
my eamwwov
and far S of w8shington.
�;100
9701300400
voL. 3261PAGE0352
io RECORDED
all= AD=S-. 97 JAN 30 PH 12: 04
City of Zdznondi�, Building Division
250 Sth Avenue North AUDITOR
14monds, WA 99020 SNOHOMISH COUNTY. WASfu�
DEPUTY--- --
DECLAMITON OF RESTRIMVE COVENANT
MMLIn-FANMY RESMENTUL
k-Z6,7
Graator(s):(�Lmes I Iserlaslan'(2)Kenneth & Lois Nilsen Additionaloupg.
Grutes(s): jjjWWGdj
Legal DeaMption (abbreviated): Sec Twn—
OR City Park Addi&-igu.
Assessors Ta Parcel flWo): (1) 4096-001-018-0005
— Assessorps Tax Parcel TDO not yet aulptd
w,=pjw,Kenneth and Lois Nilsen and James and. Ester Rasband
an dw owners of the following described real estate in the City of Edmonds, to Mt;
Property Address;_ 516 4th Avenue South, Edmonds
LMW Docylpdon: Lot 18, Block 1, City Park Addition to Edmonds, according to the
plat -thereof recorded in Volume 9 of Plats -,-,Page 10, in Snohomish County. Wa hington
Assessor's Tax Panel ID 0 (s): 4096-001-018-0005
VVMMMA& the abovi awned owwo are desirous of uinposing a restrictive covenant upon
said promises In compWance with Section 19.00.040 of the Edmonds Community Devvlopment Code.
voL. 32CIPAGE0350
f.
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number: 0 92
Issue Date: -2�7
A. Address or Vicinity of Construction: - 518 4 AV S (9709033)
B. Type of Work (be specific): Install 4701 of 2"MPE IP from 36'E to
7k89 0 285'E C/L 3 AV S @ lb'S C/L Howell St., thea go south 190'
@ 181W C/L 4 AV S.
C. Contractor: -Puget Sound Engrgy Contact: Mariamne Kingsbuey
MailingAddress: 1122 75 St SW Everett Phone: 356-7500 X7596
State License #: 98203 Liability Insurance: _ Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. Commercial [-] Subdivision El City Project Q Utility (PUD, GTE, WNG, CABLE, WATER)
Multi -Family E] Single Family El Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut: ED Yes ONo G. Size of Cut: — x H. Chargq�_$_
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the City ofEdmondg harmless from injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its departments or
employees, including or not limited to the defense ofany legalproceedings including defense costs, and attorney fees by reason ofgranting thispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FMCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THEAPPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
Ihave read the above statements and understand thepermit requirements and thepink copy of thepermit will be
available on site at all times for inspection purposes.
Signature: Date:
4-15-97
(CoAiractor of Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFrER DAYS
SPECIAL CONDITIONS: is] P,
COMMENTS:
DISRUPTION FEE/FUND Ill:
RESTORATION FEE:
PERMIT FEE:
TOTAL FEE: 3o, c,()
RECEIPT FEE:
13
F17.1v I A
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. 1994
FIELD INSPECTION NOTES
Comments:
Diaaram.:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
El NO
APPLICATION
for
The City of Edmonds S11DE SEWER PERMT
EASEMENT No . ......................................
NEW CONSTRUCTION REPAIRS
OWNER .... Fah--A-V..) .... Mm, ... Jahn ...... S . .............................. CONTRACTOR ............................................................................................. .... PER141T No . ......................
ADDRESS ... 05, ........................................ ......... LEGAL DESCRIPTION: LOT No . ........... ..................................
BLOCK No . .............................................
NAMEOF, A�ITJON ............................................................... I ........................................................................
Lu
NOW=
LJL
ui
co
DVa- 7a,-5-t-e�cj 0 n W q-r'
Aj)�roved:
DATE.................... ........................... By ............ . ........... ............................................
L
USE P ERMIT
.(;I I y OF EDMONDS ZONE g-476.1-17tIUMBER 4376po"
WTI
CONSTRUCTION PERMIT APPLICATIO JOB SUITE/APT
OWNER NAME NA OF eusINESS
ir JOL M& &2" LEGAL DESCRIPTION'CHECK SUBDIVISION NO. L to NO.
w MAILING ADDfA�bb
Z :F
3: -7,1 - TESCP Approved 0
0 b� PUBLIC RIGHT OF WAY PER OFFICIAL STREET MA'O.
CITY z I TLLt:FHuNE NUMBER I TIN' 60 REQUIRED DEDICATION RW Permit Required 0
EX S G Street Use Permit Req'd 0
V(Pwo, �& I )z PROPOSED inspection Required
NAME Sidewalk Required cc
ui
-IX PRV REQUIRED
Aj A`TA METFJ3 SIZft LINE )If NO. OF FI _WRIES <
YE NO 13
ADDRE 0
Z
z1f ITELEPHONE NUMBER
a: 44 W
CITY k, ow" Z
qI9101 tZ 2-15% 6 V� 0
&A Sjjp �Ujpl, alp JA It,/
Cl ADDRESS
GINEERING MEMO DATED REVIEWED BY
VZO-7
oto �a 9 1
CC IT -zip TELEPHONE NUMBER
RE MEMO DATED REVIEWED BY W
Z s-re 1(Z cQ,3,2y, /7-t 1-41 cc
S-JAjE,LId.ENSE NUMBER PIR TI DATE
SIGN AREA SEPA REVIEW ADB NO.
ALLOWED PROPOSED COMPLETE PT
Legal Description of Property - include all aseme JEXEM
Zn yqq SHORELINE#
y
EXP
VARIANCE OR CU PLANNING REVIEW BY DATE
Er
Wil,w4j;
ui I �rl�� I I Z-/&,11_
0 FEET 0
S,�TBACKS HEIGHT LOT C VERAGE
Z
W Fli6NT 15' SIDE 10 REAR 7-ai- 4,a—z
Property
Tax Accoun REMARKS.,
Parcel No. t 00 -o e (z. 0_�r-
141 iy- R 95-177
NEW RESIDENTIAL PLUMBINGIMECH
014AXX COMPLIANCE OR
EIAD D I'T' CHANGE OF USE
ION COMMERCIAL
REMODEL APT. BLDG. SIGN
I XGnb CHECKED BY TYPE OF CONSTRUCTION CODE OCCUPANT
REPAIR FENCE x_FT) _V_0r GROe
F CYDS. /to >
I rN—:>
WOODSTOVE j SWIM POOL SPECIAL INSPECTOR CUPANT
ETEMOLISH INSERT HOT TUB/SPA REQUIRED 04/.20- -,t�,ffligAD
RETAINING WALL/ E3 YES jW�2!::,jQn1
ROCKERY RENEWAL
Z PROGRESS INSPECTIONS PER UBC 108 Z
0 (Trj'OF USE. BU INE S OR �CTIVI Y) EXPLAIN: . a
let _j
E 7,3 :3
i-E
MCI 2
71b"-AL Ae� 415- k/!Sl&C 4:f- V1 4a
W NUMBER NUMBER OF Z CRITIC
0 OF 3WELLING AREAS
,m STORIES UNITS I N 4BER
7 D SCRIBE WORK 70 BE DONE �(&Qr N) Ae*60�0'15Y-7;
AO"-4lyr��A sj /7 INAL INSPECTION REQUIRED
VALUATION FEE
PLAN CHECK FEE
BUILDING
T SOLT&&: GLAZING
-t-orcle- At r z? PLUMBING
Plan Check No. 011, 7,,d/ MECHANICAL 4? 21
'Av— 6--Tw
This Permit covers work to be done on private property ONLY. GRADING/FILL
Any construction on the public domain (curts, sidewpiks,
driveways, marquees, etc.) will require separate permission. STATE SURCHARGE
Permit Application: 180 Days STORM DRAINAGE FEE 3-0
Permit Limit: I Year - Provided Work Is Started Within 180 Days .
"Applicant, on behalf of -hip or her spouse, heirs, assigns and ENG. INSPECTION FEE 30
SU'ccessors in interest, agrees to indemnify, defend and hold
20 harmless the City of Edmonds, Washington, its officials,
M employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance
DEPOSIT
of this permit. Issuance of this permit shall not be deemed to PLAN CHECK —/0 4 'Z
0
modify, waive or reduce any requirement of any city ordinance
0 too
2: nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE
provision."
I hereby acknowledge that I have read this application; that the
information given is correct; and that I am the owner, or th " a duly ATTENTION APPLICATION y- APPROVAL
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
ed thereby, no person will be employed In violation of the Labo . r ONLY THE signed by the Building Official or his/her
Code of the State of Washington relating to Workmen's Compensa. WORK NOTED Deputy; and fees are paid, and receipt is
tion Insurance and �27. INSPECTION acknowledged in space provided.
SIGN R jOWNER 0 GEN DEPARTMENT OFXFICIIG DATE
CITY OF
EDMONDS
w
CALL FOR RELVASkO BY: rIATE
ATTENTION INSPECTION -3 0
IT IS Uj4LAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-0220 ORIGINAL — File YEI 16N Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC
SECTION 109 PINK — Owner GOLD — Assessor
10247
SNOHONHSH COUNTY PUBLIC UnLnY DISTRICT' NO. I
D
1476 Rev. 12/94
AREA
LOCATION 9 bc)_,\:nl�
POLE # UP,1/4 s2_QT-27R '�> DATE 1-2.7-9�o w.o.# -tSa
REASON F(W WORK -,SiF_' C� ENGINEER 12, �khrt5r.MDWG. #
DRAFTER U.G. #
SCALE
DATE WORKCOMPLETED FOREMAN
A000f%UCn nAT= pmm=n
FEES RBOUIRED:
ENVIRONMENTAL ANALYSIS
0 YES 13NO
0 EXEMPT 0 NOT EXEMPT
PAPA 18 ITEM C
PRIMARWOVERHEAD
O.H. U.G. COND. KV
U RESIDEIIITIAL 0 COMMERCIAL
ADD CKT. Fr. -PH
LEO
REM CKT. Fr. PH
$
NET -CKT. FT.
SECOND&RY OVERHEAD
O.H. U.G. COND. KV
BASIC FEE $
ADD CKT. FT. PH
$
REM CKT. Fr. PH
NET _CKT. FT.
METER/CONV. POLE s
PERMITS (DATE GRANTED)
PRIMARF UNDERGROUND
DRESIDEffrIAL: U COMMERCIAL
q TREE TRIM
BASIC FEE $
U STATE
LEU #
C1 COUNTY
$
U CITY
$
u
EASEMENTS.
$
U REQUIRED �NOT REQUIRED
SECONDARY UNDERGROUND
BASIC FEE $
-90 $_/ = $
UNDERGROUND PLAT
DATE RELEASED
BASIC FEE $
FOREIGN CONTACTS
U GTNW JPN
U CATV JPN #
STREET-FJGHTING
$
0 JOINT TRENCH GTNW & CATV
U JOINT BORE GTNW & CATV
WORK WRIGHT-OF-WAY
• PRIMARF
u
POLE STENCILING
• SECOISMRY
$
FROM -TO
TAKE OFF POLE
MISCELLANEOUS FEES
PRE-CONSTR. REQUIREMENTS
VAULT $
PERMIT $
0 TREE TRIM U PUD LOCATOR
$
0 BACKHOE U FLAGGING
$
U ONE CALL DATE
WTAL DUE: $
INDEX
POLES
PLAT
DATE P�I[D
LOGS
U-MAP
XFMR
C-MAP
RECEIPT*
NEWSVC*PPLIC.#
LOCATION MAP PAGE
SUBSTATION
CIRCUIT NO. PHASE
i Location: 27N3E26A scale 1:50
T *%Tot-
L Vs: The City of Edmonds
I
Field locate all utilities.
Call 1-800-424-
5555
24 hours before:digging.
2) Survey is not re'
quired
_T_ I r_= — I"
>
3) Maintain a mini
mum of 5
horizo
ntal and 3,
vertical
clearance from all city
utilities and app urtenances.
P IF
4) Cuts i n aving ate show n aso
5) cuts in paving anticipated.
t -c,
EHE L L
W
4^1ZEIP"
3P'I`�\
7-
7
I q
C1 I Z - LJIDS
--elf
[No.
DESCRIPTION
DATE
B Y
A P FP-'D
REVISIONS.
AS BUILT INFORMATION
FIT T ER OR CON TRAC TOR:
COORDINATOR:
F
DATE COMPLETED:
PERCENT COMPLETED:
TEST
INSTALLATION / RETIREMENT
SUMMARY
E
TYPE OF TEST:
SURE:
L
D
DATE ON:
DATE OFF:_ E OFF:
ITIM
I I R
MAIN SIZE
W.TF.qIAL
TOT,*-!.,'C-3tA(_
TYPt OF PIPE:
PIPE MANUFACTUREA:
TESTED BY:
WasWgion
NaturM Gas,'-
:PRCOPOSED MAIN FOOTAGE
F WTEMAL f TOTAL FOOTAGE
OP MAP:
rLAI MAP: 16-4- 6eS
114 SEC: KJ G
WORKAREA:
EMERGENCY SEC.
DESIGN PRESSURE: PS10
D
E
c,
SYSTEM MAOP: PSIG PSIG
PERMITS: F_EDMC)�_JC�Y�-
S
G
N
P F_ P MA I H F_ K-F.
R \/ tH
4 AV
DRA
C"ECKED:
ArrRovEjj.
IN:___6(J�� ILAA 30
OnAWING 1`10.
7 0 C)
L
Notes: The City of Edmonds
1 Field locate all utilities.
Call 1-800-424-5555
24 hours before digging.
2) Survey is not required
3) Maintain a minimum of 5'
horizontal and 3' vertical
clearance from all city
utilities and appurtenances.
MR F-- P
4) Cuts in paving are shown as (a
5) antic,ipated.
HOW ELL- 6�5 -T
p
4-
T,
1- ?) an
7—
9 IZ- - LAIDS
'Co
No.
DESCRIPTION
DAT E
13Y
PEP D
REVISIONS
AS BUILT INFORMATION
FITTER OR CONTRACTOR:
COORDINATOR:
F
DATE COMPLETED:
PERCENT COMPLETED:
E
TEST
INSTALLATION / RETIREmr=NT
SUMMARY'
TYPE OF TEST: PRESSURE:
L
D
DATE ON: I -TIME C:---
DAI E OFF: ITIME OFF:
IfR
MAINSIZE
W.TFRLAL
T0!,'1,-C-0TA(-'
TYPt OF PIPE:
PIPE MANUFACTURER: -
I
IT ESTED BY:
F1
I
I
Vfthdnglon
Nattwal Gas
OP MAP: I C,
PLATMAP:
I14SEC:K3GZ4--, 2,q
WORKAREA:
PROPOSED MAIN FOOTAGE
EMERGENCY SEC. No.:
MATERIAL
TOTALFOOTAGE
DESIGN PRESSURE: Psia
D
KA PC--
4-7- (D
SYSTEM MAOP: - P
PSX3
E
PERMITS:
S
N
MPF IP MAI �A F�� X-F.
B� 4 AV
DRAWN:
Oil
J06NO.
CHECKED: I I
Arrpovu):
DRAWINO NO.
(c,
4-
7—
(0
Notes: The City of Edmonds
1 Field locate all utilities.
Call 1-800-424-8565
24 hours before,digging.
2) Survey is not required
3) Maintain a mini mum of 5'
01
horizontal and 3. vertical
clearance from all city
utilities and appurtenances.
4) Cuts in paving are shown as (a
5) _',cuts: in'pa�ving anticipated.
No.
DESCRIPTION
DATE
13Y
APP*D
REVISIONS
AS BUILT INFORMATION
FITTER OR CONTRACTOR:
COORDINATOR:
F
DATE COMPLETED:
PERCENT COMPLETED:
E
TEST
INSTALLATION I RETIREMENT
SUMMARY
TYPE OF TEST: IPRESSURE:
L
D
DATE ON: ITIMF C!..-
DATE OFF: ITIME OFF:
1111
WINSVE
WTEMAL
TOT,'-','C-OTAr--
TYPt OF PIPE:
PIPE MANUFACTUREA:
I
ITESTED BY:
Natux-al Gas
0 P MAP:
P LA T MA P: 16— 4- 6, S
114 SEC: K3 P-- Zf, 2��
WORKAREA:
PROPOSED MAIN FOOTAGE
EMERGENCY SEC. No.:
MATERML
TOTAL FOOTAGE
DESIGN PRESSURE: PS10
KA PC=—
C)
SYSTEM MAOP: PSIG
PSIG
PERMITS:
S
G
N
:2" MPF— IP MAIM U-7-XT.
70
S 4 AV
DRAWN:
I , cl-7 JOB No. C) S)
CHECKED: I DRAWING NO.
Arr,,?ovr-(i: C) C-D� F —71
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17"IN 4, a4rW
Jo 10
CITY PARK ADDITION
TO EDMONDS
VOL.9, PG. 10
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CITY PARK 'ADDITION
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VOL.91 PG. 10
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1119PA I
FIR ST
I
—SS- SAN I TARY. SEWER L I NE
I
—SS- SAN I TARY. SEWER L I NE
M
%*ATtR METER
A
FIRt HYDRANT
$4
WATER VALVE
OASIVALVE
POWER VAULT
-0-
UTI�ITY POLE
UTILITY ANCHOR
12
TELgPHONE RISER
YARD LIGHT
BLOW OFF
MAIL Box
JUNCTION BOX
JL
STR�ET SION
OTREET LIGHT
1 '114
1�u
191
70z�_elp. Jw
4 17 lh'=490 101WO AV 0
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AF-slo.0 Mina 4.*
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1 of
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CONTOUR INTERVAL 2'
20 n 12n i AA
J6 HIM
W IN S Z, Wr N F_
5 16 BASIS OF BEARINGS: RECORD OF SURVEY VOLUME 9. PAGE 110,
RECORDS OF SNOHOMISH COUIll WASHINGTON
DATUM, CITY OF EDMONDS
BENCHL INVERT SANITARY SEWER MANHOLE 'INTERSECTION
4TH AVE. S. AND HOWELL WAY
JELEV.= 55.10
LE96L QESCRIPTION
10
THE EAST 71 FEET OF LOTS 19 AND 20 BLOCK 1, CITY PARK ADDITIONS;
TO EDMONDS, ACCORDING TO THE PLAT THEREOF RECORDED IN VOLUME 9 OF
PLATS, PAGE 10, RECORDS OF SNOHOMIS COUNTY.-WASHINGTON.
1458 W4 cn
N, eg F4 r w, ?78. 58' a4z c. 4m, f, e a, 4 r LOT 6RE RECEIVED
8783 SO. FT., z
ERSEN DRIVE DE-C 0 It 2000
J1091 I)EVELOPMENT SERVICES CTR.
CITY OF EDIIAOND3
Ngg 54 4 u fea a.?,* i z im a eso. oa, a A r
41W
0
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L=4)70N C4W PhR-
WIM4SS MOr IN ZkAg
A as. AOL 9, Pa. /a
44W 0. S' IN CASC PINE STREET
E-4
4-S-8.9
AUG 15 2000
nx I vr I
FlUDWEs Ao\"-4007\N=0.]1V6UA&MF0\V1\AVj
UPDAMI 15 1"9 0001#43. JOB NO: 99-4007
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