517 4TH AVE S.PDF111111111111
5077
517 4TH AVE S
APPLICATION
Th-b City of Edmonds � for
SIDE SEWER PERMIT EASEMENT NO - ------------------------------------------
NEW CONSTRUCTION REPAIRS LID NO. --ASMT. No
.......... ------------------------- ....................................... CONTRACTO ............................................ --:= ----------- ................ PERMIT NO - --------------------
OWNEP - ------ R
JOB ADDRESS ------------- ----------- LEGAL DESCRIPTION: LOT NO - -------------------------------- ...... BLOCK NO - ----------------------------
................................................................................................ ..................................... ...........
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By- - - ----------
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
Call 7,75-2525 for side sewer inspections BEFORE covering any porlion of the construction.N
Inspection will be provided within 24 hours after requst. No Sat., Sun., or holiday Inspections./
ADDRESS LOCATION OF CONSTRUCTION_...!S�D - 4',-ifl `�Cuti)_
................................................................................ .................................................................
PROPERTY LEGAL DESCRIPTION ........... ...............................
...........................
...................... ................................................... . ........................................................................ ................................................... . ..................................................
I " I I
........................................ Co.
........................ OWNER AND/OR BUILDER .... .................................................................
CONTRACTOR'S NAME & ADDRESS ...... .................................................................................................
Permission Is granted .................. .................. 19... for repair and/or connection of a side sewer to the city sanitary sewer
sy,+em in accordance with City of Edmonds ordinances.
A -li-NTION IS CALLED TO THE FOLLOWING:
NOTE No. I —The owners of the property may obtain a permit to construct sewer Inside property line. A licensed Side Sewer Contractor must be employed to construct
side sewer in street area. Do not cover any portion of sewer before it has been Inspected.
NOTE No. 2—All work performed In city right-of-way requires an Invasion of RIght-of-Way Permit obtaJrrable from the City Engineer's office.
NOTE No. 3—Obtain full Information regaxdIng Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Top of side sewer must have at least 30 Inches coverage at property line and 12 inches inside property line; minimum grade,of 2%. No bends in grade
sharper than % will be permitted.
NOTE No..5--Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to Improper
work which may develop within one year of completion.
NOTE No. 67-It Is unlawful to alter or do any other work than is provided for In the permit, or to do any work on the main sewer or Its appurtenances except to In-
sert the pipe into the wye.
DISAPPROVED
APPRO VED
Date ... By ................
-'P'7 -Y
Date ...... ..............
Date .................. By ................ Date .................................... By ................
OF ........
6.09
BY_ - - & ..... 7: ISM ........... ... . .......................................................................................
Remarks:
................
--------------- --------
---------- ----- ----- ---- -
..................................................................... . ............................................................................................................................................................................ .........
BOTH Permit Cop' MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
004, 'OpI
. ...... hereby certify that the side sewer installation constructed under this permit
1 ".5.2 **** ......... ... * ... * ............ ....
(owner of Contracting Firm Performing Construction)
w 'br.,Installed in accordance with all governing ordinances of the City of Edmonds.
Dated this .......... &D ......... day of ...................... r-5.1 ....................
V V Check BEFORE you dig for: Water Ej, Gas Ej, Telephone Ej, Power E], Sewer E], OtheIr E) V V
APPLICATION
The City of Edmonds for EASEMENT NO - --------------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION (g-- REPAIRS F� LID NO. -.7% --- ASMT. NO - ------------------
OWNER .... ----------------------------------- CONTRACTOR ... 130-L ---------- --------------------------------------- PERMIT NO - --------------------
T' JOB ADDRESS --------- ---------------------------- LEGAL DESCRIP'nON: LOT NO . ..... -------------------------------- BLOCK NO - ------------------------------------
......................................................... ................................................ .......................................................
NAMEOF ADDITION ---------------------------------- ........................................................................... ........
"Y
jipprovea:
DATE...........................
..... By ..............................
...................
11/75
10017, "J, ,
Tuming
Houses. .
Back Into
Homes!
Mal a,
)OIBRUNO
for your independence
44
Superior Styling
Li
Graceful and Compact
The Electra -Ride Elite offers the finest in
streamlined, ultra -compact design. Its vertical
str-:ght rail installs to within 6 in (152 mm)
from the wall. Family members and guests
will have no problem using the stairs. The
seat height, footrest height and armrest
width are adjustable for added comfort. The
armrests can be independently flipped up, for
easy transfer from a personal mobility device,
completing the unit's package of flexible
features.
Elegance
A stairlift that reflects the taste
and sophistication of the most
elegant homes, the Electra -Ride
Elite sets the new standard for
residential accessibility. When
marvelous features complement
classic design, the result is
uncompromising quality.
Refinement
The Electra -Ride Elite
represents more than a decade
of research and engineering.
With a honeycomb rail design
for improved stability, and
visual coded diagnostics to
instantly analyze the unit's
operational status, the Elite
is the epitome of form and
function.
[1j
NO
The arms, seat and footrest
flip up, creating plenty of
space to walk up the stairs.
M1
The Elite's hidden, rack-and-
pinion drive system provides
a smooth ride, without
hesitation, when the unit
stops and starts.
Quality Craftsmanship
Safety
With a rated weight capacity of
400 lb (181 kg), and sensors that
detect any obstacles on the stairs,
the Elite moves up and down
your staircase with power and
efficiency. The new offset swivel
seat makes the entry and exit
position at the top landing safer
and easier than ever.
Reliable
Equipped with two 12-volt batteries
that are powered by a small,
unobtrusive battery charger that
plugs into any household outlet,
the Electra -Ride Elite provides
uninterrupted performance, even
during a temporary failure of
electrical service to your home.
Electra -Ride Elite Features
so
The new offset swivel seat
The footrest and carriage safety
The simple, unique design of
The two wireless call/send
makes the entry and exit
sensors safely stop you, even if
the rail hides all mechanical
controls make installation
position at the top landing
the slightest obstacle is in the
components, and installation
simple and clean with no wires
safer and easier than ever!
way while you ride!
requires no modification to
running along the wall.
your staircase.
ExcePtional Value
• Locking swivel seat at the top and
bottom of the stairway
• Two remote, wireless call/send controls
• Generous seat size — 17.75 in (451 mm)
adjustable to 21.75 in (552 mm) between
the arms
• Footrest and carriage safety sensor and
retractable seat belt
• Charging -station indicator lights at
the top and bottom of the stairway
• Onboard audio and visual diagnostics make
service easier and more precise
• Meets all ANSI - A 18.1 requirements;
CSA/C-US listed
• Bruno's Gold Warranty — Five years for
major components and two years on parts
Convenient Installation
• Rail installs to within 6 in (152 mm) of
the wall
• Can be installed on either side of the
stairway
• Standard track lengths of:
16 ft (4.9 m) — two 8 ft (2.4 m) sections
20 ft (6 m) — two 10 ft Q m) sections
(Custom lengths also available)
Smooth. Powerful Drive Svstem
• Self-locking worm gear; rack-and-pinion
drive
• Maximum rider weight of 400 lb (181 kg)
• Soft -start, soft -stop for the user's maximum
comfort
Battea-Powered Technol
* Ensures access even during power outages
Powered by two 12-volt batteries; continuously
charged by a 2-amp battery charger that plugs
into any I I 0-volt household outlet
Comfo
• Adjustable seat height for easier entry/exit
at the top and bottom of the stairway
• Adjustable footrest height for added comfort
• Flip -up arms for easy wheelchair transfers
• Adjustable armrest width
• Contoured seat for maximum comfort
Ask us about our other...
Home accessibility solutions and automotive products
OUTDOOR ELECTRA-RIDETm VERTICAL PLATFORM VEHICLE LIFTS TURNING AUTOMOTIVE
ELITE Model SRE-2010E LIFT SEATING"" (TASTM)
The , only 400 lb/ 181.8 kg capacity outdoor Model VPL-3100
stairlift... an INDUSTRY EXCLUSIVE!
Founded over 20 years ago, Bruno Independent Living Aids, Inc., is a world-wide manufacturer of accessibility products designed to enhance the
lives of those challenged by limited mobility. In pursuing this goal, Bruno is proud to be the only U.S. manufacturer of indoor/outdoor stairlifts,
interior/exterior scooter, powerchair and wheelchair vehicle lifts and Turning Automotive Seating" (TAS-) products to be ISO 9001 Certified. This
is one of the most stringent,, widely -recognized quality standards in the world and your assurance that Bruno is committed to providing you with the
highest -quality, most reliable products in the industry. Ask your certified Bruno dealer for details on all Bruno independence products.
Represented by:
BRUNO INDEPENDENT LIVING AIDS, INC.
1780 Executive Drive, P.O. Box 84, Oconomowoc, W1 53066
www.bruno.com
KISO 9001:2000
KEMA CERTIFICATE
AWWbd by
ATM ANSI -PA W
ACCESSURIM EQUIPMEW Ac.W NOM
Cud WbAYI.M. M
MANUFAVURERS ASSOCIAMN 0029,
BRUNO
for vour independence
All illustrations and specifications in this brochure are based on the latest product information available at the nine of publication. Bruno Independent LivingAids, Inc. reserves
the right to make changes at any time without notice. Electra -Ride Elite Brochure 7/10- 10 Q Bruno Independent Living Aids, Inc. 2010.
Part#: MKT-SRE-2010
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CITY OF EDMONDS g�-�4,4 W
PUBLIC WORKS DEPARTd TA —
AGV%dov
RIGHT - OF - WAY CONSTRUCTION PERM
A. *Address or vicinity of Construction-
Z EckIVED mit No.
E _11�wissu e Date (11 /13 h?
JUN 4. 19 ri
0 wrier: d� A
Name (JA_tA��� oxk,-t� ucmc
44 aj�� G
Millig Addrqss
DOd-O
City, State, Zip Code
0 Contractor: t2,6) / 7-�
Name
b�jiling Address
1n� "4 Q ;-( U3 kk q 90 1
C11y3
State, Zip Code
ed I o:
n
• Work in Conne�_tion With:
0 Sub or Plat 11 Single Family
0 Comml. / Ind. )2� Apt. Condo,
• Pavement Cut: 0 Yes 0 No
C (r (Do -,� I ��- (0 t—S-9
State Ly�nse Number
CI C , 1 —4-1 �_ G�l
Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICA TO READ AND SIGN
INDEMITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any 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 it's departments or employees, including or not limited to the defense of any legal
proceedings including defense, costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - bour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this permit must be available at
Signature: ( - Z(
Owner or Agent
job site for inspection purposes at all times.
-1) ate Xyleel
THIS PERMIT MUST BE POSTED AT THEJOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By: e. uf�4a&k,
Time Authorize�: did after —days
Special Conditions:
0
Arnmendments:_
47,EET
Permit Fee: -
Security Deposit:
Receipt No.:
Fund III Fee:
Street Cut Dimensions
X —
FILEO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
41
Eng. Div. Damber 1978
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CITY OF EDMONDS W RECEIVED Wrmit No
PUBLIC WORKS DEPARTMENT AN 4 Issue Date
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. *Address oLrv�icinity of Construction 1,6111� 0 Permit Issued To:
8[ �:;
I __ I q _ _ , &R. Al
Owner: I I X-XJ X,
N am e cux—,61�� OW-�
S-1 -
WM *h Addr s
A �Jh
City, S ta te, Zip Code
Contractor: C
Name
yjiling Address
g9oll
Gty�, State, Zip Code
MAN
Type of Work to be Done:
Work in Connection With:
El Sub or Plat El Single Family
El Comml. / Ind. X Apt. Condo.
Pavement Cut: El Yes El No
C (n 00 -1� I S- GS-9
State Li�,ense Number
q S —1 —�p --3- (10
Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ AND SIGN
INDEMITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any 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 it's departments or employees, including or not limited to the defense of any legal
proceedings including defense, costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this permit must be available atAe job site for inspection purposes at all times.
Signature:
Owner or Agent
� W/
THIS PERMIT MUST BE POSTED AT THEJOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By: / ". v") t, ack,
Time Authorized: '4d-after Q days
Special Conditions:
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Ammendments:
U
Permit Fee: ma"
Security Deposit:
Receipt No.:
Fund III Fee:
Street Cut Dimensions
i'IEET
REP WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
..BUILDING DIVISIOM Applicant Fill
USE -11 T
Z014E _�11-1 E R
Inside Heavy Lines
PERMIT APPLICATION
JOB
ADI)RFSS
NAMK (OR NAME OF BUSINESS)
LEGAL DESCRIPTION.
SUBDIVISION SHORT
SUB NO.
W
MAILING ADURESS
0
—7
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
CITY
EPHONE NUMBER
EXISTING
PF40POSED
NAME
U
DEFICIENCY OF RIGHT OF WAY
W
ADDRESS
PUBLIC IMPROVEMENTS REQUIRED 0
x
U
DRAINAGE IMPROVEMENTS REQUIRED 0
0
3:
CITY
HONE NUMBER
M
DRAINAGE PLAN REQUIRED
U
UNDERGROUND WIRING REQUIRED
CONNECTION TO SANITARY SEWER
M
NAME
It
�fwj-�"L
SEPTIC TANK PERMIT RECI'D NO.
ADDRESS
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ELEVATION OF PROPERTY CORNERS
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& FOOTINGS REQ*D
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CITY
TELEPHONE NUMBER
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SEE ENGINEERING MEMO DATED
01
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ST AT r LICENSE NUMBER
CITY LICENSE NUMBER""
CHECKED 13Y
Legal Description of Property (Show 6elow or Attach Four Copies)
METER SIZE
UILDING SUPPLY SIZE
W
REMARKS
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SIGN AREA
ENV. REVIEW
ADB NO.
ALLOWED PROPOSED
COMPLETE EXEMPT
SHORELINE #
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REMARKS
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VARIANCE OR CU
PLANNING REVIEW BY
DATE
YARDS
LOT COVERAGE
GAS
NEW RESIDENTIAL
FRONT SIDE REAR
FIRE ZONE
TYPE OF CONSTRUCTION
HEIGHT
LINE
MON-RESIDENTIAL SIGN
ICODE
ADD
RETAINING
DEMOLISH WALL
SPECIAL INSPECTOiiAJAREA
REQUIRED
OCCUPANT
GROUP
ALTER EXCAVATE FENCE
D YES 0
JOCCUPANCY
LOAD
I
OR FILL I— X—T)
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
-SHOULD BE CODED 31.04.
REPAIR PRE -MOVE swim
INSP. POOL
Z
NUMOER OF STORIiEFSi
—7
NUMBER OF
REMARKS
0
DWELLING
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U U NITS
W
NATURE OF WORK TO BE DONE
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PLAN CHECK FEE
VALUATION
FEE
PLOT PLAN
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BUILDING
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ST_-_i_)EET FILE
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PLUMBING
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MECHANICAL
FENCE
SIGN
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"Applicant, on behalf of his or her spouse, heirs, assigns and
III
successors in interest, agrees to indemnify, defend and hold harmless
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the City of Edmonds, Washington, its officials, employees, and
RETAINING WALL
agents from any and all claims for damages of whatever nature,
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arising directly or indirectly from the issuance of this permit. Issil-
SWIMMING POOL
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ance of this permit shall not be deemed to modify, waive or reduce
any requirement of any city ordinance nor limit in any way the
DATE:
llr,mo TO: Building Division
C0111"WiliLy Devejo'pmenC -Dcpartmellt
FROM; Engineering Division
Public Works Department
SUBJECT:
4
After review of the SUbject building permit application, wL have
the following comments:
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PUB�IC WORKS DEPARMIMU CHEa(LIST
BUILDING PER,= REVIEW ,5-1 -7 J-
(addres-s-T (date)
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Street Right -of -Way Exist'
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Access Easements Exist'
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Utility Easement Exist"
Lot Per Subdivision Plat
Assessor Map
Site Plan Checked for Accur
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Underground Wiring Reqd.
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Check Accuracy of Legal Description
Z
Review by
Existing Water Main Size
Water Main Required
Service Idne Required
Hydrant Size Existi
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Hydrant Reqd Per Fire Code
Size
Detector Check Meter Reqd.
,4C � S&
pRgSS, V
Cross Connection Inspection
J�#VA141^C-
WAD.
Fire Department Conments
~UAWP -PE'sr —e401�r CAAW,
Water �tter Charge Reqd.
Review by
Date
Septic Tank Design Approved
Date
Septic Tank Permit Reqd.
Permit No.
Sanitary Sewer Availability
Pro,
j
Drawing No.
File No.
Side Sewer Availability -
Sanitary Sewer Connection Fee Reqd.
:3:
Review by.
Date
W
Open Ditch
Culvert Reqd.
Size
c4
Catch Basin Reqd.
Indicate on Site Plan
0
Shoulder drainage maintain collection
on swale open runoff
E-4
Manhole reqd.
Indicate on' Site Plan
Soil Conditions and Ground Water Field Checked
Review by
SwOrIPFA-S
Q- I ces-1
"-80
Revised: lvlO-1977
Page 2 0 0 1- 1
Street Paving Reqd.
Curb and Cutter Reqd.
Sidewalk Reqd.
Curb Cut for Driveway Reqd.
cd Right -of -Way Construction Permit Reqd.
Bond Reqd. for Public Inprovements
Street Name Sign Reqd.
Other Signing Reqd.
P, , Pre Pennit Site Inspection made an
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WATER
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ENGINEERING
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Special Requirements listed in meno to Commmity Development Department,
Building Division
BY- Date
All item filled in on Building Permit Application
BY
Date
Drawings Stanped and Notations Made
BY Date
by Public Works Department
Fevised: 1v 10-1977
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7—%a
'Nothing in this permit I
i�terpreted as allowing c
maintenance of any =-r
nonconforming or r
or site condition whi i
Dermit applicati011, rep
building structure or cc
site lwan or drawing. SIL
coattiorL maibe the st
enforcement U01LO
wn ag4
I�k,
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val pro shall be,
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nitting K K,
Cture
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be
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F
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Lilding, structure or
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PARKVIEW
A CONOOMINJUM
IN SECTION 26. T.27 N, k3E.. W.M.
CITY OF EDMONDS, SNOHOMISH COUNTY, WASHINGTON
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PLANNING DATA 11 STREET FILEJJ
New Commercial / Multi -Family Projects
Name: 9�&_ evv 60)V�s
Date:
Site Address:o 1 -7 eq cl q-* 4ve- S
Plan Check #: BLD -
A,1:�."CIV
Project Description:
Use(s) Proposed:
Allowed Us(__(Y�ES NO)
CUP File Number:
To Allow What Uses:
Legal Nonconforming Land Use Determination Issued: (YES / NO)
Reduced Site Plan Provided: (YES I NO)
Zoning:
Map Page:
/572-
Comp Plan Designation:
ace-ri—f P V 411e-vy
Corner Lot: (YES e ely%_,
0 aes As ,.
Flag Lot: (YE6K:
YAn- 15 RL-4-
ADB File Number (date waived):
Lot Area:
Plans Match ADB Approved: (YES / NO)
Shoreline Required: (YES NO)
Critical Areas Determination #:
Study Required A4'f �E,e
Waiver
SEPA Determination:
>kExempt
El 'Needed (for sites with 500 cubic yards of grading or within 200 feet of Puget Sound or Lake
Ballinger. Requires: (1) Fee, (2) Environmental Checklist, and (3) APO List with notarized form).
Required Setbacks
Street:
Side: /L
21
Side:
Rear: /.g
ActualSetbacks
Street:
S i �d.
Me
Sioei
C,41
Rear:
Lot Coverage/FAR Required:
Lot Coverage/FA�Jprovided:
Lot Coverage/FAR Calculations:
B"ilding Height
Datum Point:
Datum Elevation:
Maximum Height:
ctual . t:
Subdivision: 777�
Lot Aggregation Required:
Landscaping
Landscaping Mat s ADB Approved:
LandscapiK91 Bid Provided: (YES / NO)
Bond Amount (100% Bid):
Plan Review By:
PLANNING DATA STREETE��]
New Commercial / Multi -Family Projects
Multi -Family Pa*�W Anal is
# Bedrooms per Dwelling Unit
Parking Ratio
# Units
Required
Parking
Studio
1.2/D.U.
I Bedroom
1.5/D.U.
2 Bedrooms
1.81D.U.
3 + Bedrooms
2.0/D.U.
Total Parking Required.
Total Parking Pro vided
Other
Plan Review By:
EET FILE
CITY of EDMONDS --- PUBLIC WORKS DEPARTMENT
Routing of Building Permit Applications
Proposed Property Address of Application: 519 - 4th Ave. South
-DEPARTMENT
COMMENTS
i 7 INWIPPAr
51FOR
N 0 T E S
BUILDING
DEPARTMENT COMMENTS
I I I 111'�
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5
USE
P ERMIT
BUILDING DEPARiOW
Applicant Fill
ZONE
NUMBER MAY
+
PERMIT APPLICATION
Inside Heavy Lines
JOB
ADDRESS
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Avc eublic<oro
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NAME (OR NAME Of BU'S-NESS)
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YES N 0
X
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0
SUBDIVISION NO.
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ADD N 09'
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CITY
TELEPHONE NUMBER
Z
-7*?
PROPOSED YARDS
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FRONT 10
SIDE
NAME
ALLOWABLE
ROPOSED
SIGN A. EA
SIGN AREA
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ADDRESS
OTHER
REQUIREMEIAT
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m CITY
TELEPHONE NUMBER
PLANNING APPI�OVAL DATE
NAME
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EXISTING STREET R/W6.9/t FT. DEFICIENCY THIS PROPERTY
0
ADDRESS
COMP. PLAN ST. R/W(f")/!
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MARKS
Driveway
slopes not to exc eed ili6se
TELEPHONE UMBER
CITY
indicated on Standard Dwcl. No. 103
W
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0
U ENSE NUMBER
CHECKED BY
W
CITY LICENSE NUMBER
Legal Description of Property (Show Below or Attach Four Copies)
STREET AND/OR UTILITY YES
Z
W
WORK REQ'D
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UNDERGROUND
YES
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0
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j
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THIS SITE IS LOCATED IN THE CITY
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El El
swim
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U
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REMARKS
NUMBER OF STOR
UMBER
OF
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NATURE OF WORK TO BE DONE
VALUATION
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0 "7^
NAME (OR NAME OF BUSINE
ADD
;
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0
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Z
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ADS NO.
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NAME
FRONT
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X CITY
REQUIREMENTS
TELEPHONE NUMBER
PLANNING DEPT. APPROVAL
NAME
DATE
TREET R/W
0 ADDRESS
F-
EXISTING STREET R/W,
FT. D EFICIENCY THIS PROPERTY
U
COMP. PLAN ST. R/W
FT.
CITY
FT.
TELEPHONE NUMBER
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0
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CITY LICENSE NUMBER
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APPVO By CITY ENG.
REMARKS
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METER SIZE
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TYPE OF CONSTRUCTION
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CODE
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LOAD
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PLAN lrl�CKED BY --f-HISSITE
IS LOCATED IN THE
CITY
L
III
SWI
INSP. PO L
OF EDMONDS. LOCAL SALES TAX
NUMBER OF STORIES
NUMBER . OF
REMARKS
SHOULD BE CODED 1 0
DWELLING
UNITS
NATURE OF WORK TO BE DONE
J
PROPOSED US
Z
0
PLAN CHECK'
VALUATION FEE
cL PLOT PLAN INDICATE BUIL115111TIZ 1 19: 1 C KS,
NO.
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BUILDING
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W
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HEAT GAS LINE'
FENCE
SIGN
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I hereby. acknowledge that I have read this application; that tho In-
formation given, IS Correct: and that I am the owner n, fh�
TOTAL AMOUNT DUE
1.)
SC7,, �',
u c�EET -FILE
CITY of EDMONDS --- PUBLIC WORKS DEPARTMENT
Routing of Building Permit Applications
Proposed Property Address of Application: _ -517 - 4th Avenue South ': >'e 0 - C,?/, " (�, 0
DEPARTMENT
COMMENTS
DATE
W A T E R
5
S T R E E T
4,
J�
S E W E R
N 0 T E S
BUILDING
DEPARTMENT COMMENTS
BUILDING DEPARTMENW
_.-
- Applicant Fill
IUSE PERMIT
ZONE NUMBER
PERMIT APPLICATION
Inside Heavy Lines
I t
JOB J4
ADDRESS i----ja
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NAME (OR NAME OF BUSINESS)
W
Z
3:
0
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LOT
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LOT AREA
SUBDIVroft WOCKS ijjjjj.�
MAILING ADDRESS
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CITY TELEPHONE NUMBER
VARIANCE OR
COND.USE NO.
ADI3 NO.
0
PROPOSED YARDS
SIDE
FRONT REAR
HEIGHT
Z
-C
U
W
U
M
NAME
ALLOWABLE PROPOSED
SIGN AREA SIGN
AREA
J
IL
ADDRESS
OTHER
REQUIREMENTS
CITY
ONE NUMBER
PLANNING DEPT. APPROVAL DATE
0:
0
U
Z
01
NAME
STREET R/W
EXISTING STREET R/W(,o&o FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W60&,D FT. FT.
ADDRESS
CITY
TELEPHONE NUMBER
REMARKS
Driveway slopes not to exceed those
indicated on Standard Dwq No. 1 3
az
W
LICENSE NUMBER
CITY LICENSE NUMBER
CHECKED BY
W
ISTATE
Legal Description of Property (Show Below or Attach Four Copies)
STREET AND/OR UTILITY YES
Z
W
WORK REQ'D El N 0
UNDERGROUND *ES
Z
WIRING REQ'D N 0
TYPE CONNECTION
VERIFIED BY
U
W
SEPTIC SYSTEM El YES JPFRMIT
APPVD -BY CITY ENG.
NO
NUMBER
ILI
In
REMARKS
W
METER SIZE
SERVICE SIZE
CHECKED 137
ICLEARANCE
W
REMARKS
W E�RESIDENT'IAL GAS
LINE
NON-RESIDENTIAL SIGN
ADD
r-1 RETAINING
DEMOLISH WALL
F1ALTER EXCAVATE FENCE
F� OR FILL (_ X_ FT
r-1 REPAIR PRE -MOVE swim
INSP. POOL
0-
FIRE
er
TYPE. . ONsTRUCTION CODE
17 (jar
Lr—1q7_3
SPECIAL INSPECTOR JAREA
REQUIRED
YES
OCCUPAN
GROUP f
I
z F1 1
OCCUPANT
LOAD
1.
PLAN CHNCKED BY THIS SITE IS LOCATED IE CITY
M10 OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31,04.
Fa
REMARKS
Z
J
NUMBER OF STORIES71UMIBER
OF
_ WELLING
LINITS
U
NATURE OF WORK TO BE DONE
C, j-,
Z
2
PLAN CHECK bF41-
NO.
VALUATION
FEE
PROPOSED USE
S:F 00
PLOT PLAN (INDICATE BUILDING SETBACKS.
ABUTTING STREETS)
BUILDING
U
0
W
PLUMBING
HEAT & GAS LINE
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