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520 MAGNOLIA LN
PLANNING DATA
NAM E:_ P, & 1,13 /C,
SITE ADDRESS: r 7-0 �i_ Z.1.
DATE:
ZONING: PLAN CHK#: 67� -
PROJECT DESCRIPTION:
CORNERLOT Yes/No)
SETBACKS:
Required Setbacks:
Front: -�-2 Left Side: Right Side: Rear:' 1
Actual Setbacks:
.,&- Front: (. I Left Side: z10 Right Side: (0 Rear: 2 6
Street map checked for additional setback required? ^/-0 (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED— A,"' (Y/N)
LOT COVERAGE:
Maximum Allowed: 3;-ro —Actual:
BUILDING HEIGHT:
Maximum Allowed: -.Actual Height:
Datum Point: Datum Elevation:
SUBDIVISION:
CRITICAL AREAS #:
SEPA DETERMINATION:
LOT AREA: oo
OTHER:
Plan Review By: /C
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
-D F"IT Permit Number- 93 "3
STREET FIN
Issue Date:
- F ---- A. Address or Vicinity of Construction: 520 MAGNOLSA LANE
8 9 0 - 19 C� B. Type of Work (be specific): PLACE APPROX. 1 10-FT OF BURIED SERVICE WIRE
FRQM TERMINAL # 4060 TO CUSTOMER HOUSE. SEE SKETCH. 4-0
C. Contractor:GTE NORTHWEST INCORPORATED Contact: BARB 488-1642
MailingAddress: 22118 20TH AVE. SE SUITE 139hone: BARBARA TOLLEFSON, PERMIT COORDINATOR
StateLicense#: BOTHELL, WA 98021 Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. F1 Commercial []Subdivision El City Project Xg Utility (PUD, GTE, WNG, CABLE, WATER)
R Multi -Family E] Single Family [:] Other W.O.# 2100-9POOIDB 242310
INSPECTOR: IN SPECTOR:
F. Pavement or Concrete Cut : [I Yes 93No G. Size of Cut: — x — H. Chargq�_$
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees " e.�d�,,th )nds hakl4e - damages, or
�e & City ofEdmc 01
claims of any kind or description whatsoever, foreseen or unforeseen, that may be maile-dgid?ust the City of Edmonds y o�Adegp'artments or
employees, including or not limited to the defenseof any legalproceedings including defense costs, and attorney fees by reason ofgranting this permit.
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.STREFT PATCH
R'
IS COMPLETED B Y CITY FORCES, AT WHICH TIME A DF-BITORCREIJITIWILIIBF-PROCF,15,�FD FOR [SSUANOF TO MEA�PP-LICANT.
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 Cityredulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the erfld of the working day;
NO EXCEPTIONS.
Ihave read the above statements and understand thepermit requirements and thepink copyof thepermit willbe
auailableonsit at all times for inspection purposes.
Signature: 2= - Date: 8-2-93
(Contractor or Agen
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: %-A-) RIGHT 'OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFTER 0- 1 -- DAYS
SPECIAL CONDITIONS:
COMMENTS:
DATE:
DISRUPTION FEE/FUND 111:
RESTORATION FEE:
PERMIT FEE:
TOTAL FEE:
RECEIPT FEE:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. Nv. 1991
9
FIELD INSPECTION NOTES
Comments:
Diagram:
(Fund Ill - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES El NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
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TO 'T o:
F F:,-)M G T E EASTSIDE C) - 0 CI '-I F lvl
APPLICATION
for
The City of Edmonds SME SEWER PERMIT
NEW CONSTRUCTION REPAIRS 0 EASEMENT No . ..........................................
105-05900
OWNER........ Car-l-F—hotes ................................................................... CONTRACTOR .................................................................................................. PERMIT No . ......................
ADDRESS .... 52-0 ... tla-gaGl.i.a --- Lane ........................................................ LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
NAMEOF ADDITION .........................................................................................................................................
DYE TESTED 014 SEWER
JULY, 1972
Approved:
DATE................................................ By .................................................................
0
APPLIC OPY
5 F
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6ALA4e
q900
APPROVED BY PLANNING
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41
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CITY OF EDIVIONDS
USE
ZONE PERMrT
NUMBER
CONSTRUCTION PE.RMIT APPLJCATI0N
joS SUITFJAPT
ADDRESS liq ZA)
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OW#E/ .; ,
NAME NAME OF BUSINESS
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41::4 z-
RIPTION CHECKI
SUBDIVISION NO. LID NO.
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MAILINd-AbORtSS
TESCP Approved 0
0
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
RW Pernut Required 0
EXISTING REOUIRED DEDICATION - Street use Pemit Req*d 13
zip
TELEPHONE NUMBER
Inspection Required 11
PROPOSE Sidewalk Required 13
a:
NAME
W
ME -TER SIZE
LINE SIZE
NO. OF FIXTURES PRV REQUIRED
YES 0 No 13
0
ADDRESS
REMARKS
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CITY ZIP
TELEPHONE NUMBER
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NAME
ADDRESS
C:� Le elo -rre-e A�5eq.,e C/--. /,0 ;Z
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ENGINEERING MEMO DATED REVIEWED BY
CC
CITY ZIP.
TELEPHONE NUMBER
FIRE MEMO DATED REVIEWEDDY.
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STATE LICENSE NUMBER EXPIRATION DATE
SIGN AREA
ALLOWED PROPOSED
SEPA REVIEW
COMPLETE EXEMPT
ADS NO.
6Z-4 Y, 7,Wc--,o.4-,t 7- IF7
Legal Dd�cription of Property - include all easements
SHORELINE I
2
EXP
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VARIANCE OR CU
PLANNING REVIEW By
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DATE
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SETBACKS — FEET.Ok'
HEIGHT
LOT COVERAGE
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FRONT �IDIE REAR
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REMARKS
property
Tax Account26-27 n2- Z-Y-,-2 I 6
Ptincel No.
5e �5 4,
NEW RESIDENT . IAL PLUNIBINGIPMECH
COMPLIANCE OR
El
ADDITION COMMERCIAL CHANGE OF USE
INA APT. BLDG.
REMODEL SIGN
CHECKED BY TYP&tQ4.Q0STRUCTION
I
1
coof-
1
OCCUPANT
GRI15M
VS
GRADING
EJ FENCE
CYDS. x
REPAIR I --- YT)
WOODSTOVE' SWIM POOL
DEMOLISH INSERT HOT TUB/SPA
SPECIAL INSPECTOR
REQUIRED
AREA
59MP:ANT
LOAD
FGARAGE RETAINING WALL/
1C El RENEWAL
REMARKS
Z
0-
ROCKERY
PROGRESS INSPECTIONS PER UBC 108
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
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In
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11V50L, &-v--Ll
NUMBEFf
NUMBER OF
CRITICAL
0
OF
DWELLING
AREAS
INUMBER
0
STORIES
UNITS
0
D RISE W 0 BE DONE (ATTACH PLAN)
FINAL INSPECTION REOUIRED
7PT
_71— —
�ALU�TION
FEE
PLAN CHECK FEE
BUILDING
HEAT SOURC:E�',
GLAZING
0/0-
PLUMBING
Pla n Check No-
MECHANICAL
GRADINGIFILL
This Permit covers work to be 'done on private property ONLY.
Any construction on the puollc domain (curts, sidewalks,
driveway , S, marquees, etc.) W , 1 11 require separate permission.
STATE SURCHARGE
Penydt Appil"on: 180 Days
Permit Limit: I Year - Provided Work Is Started VAthln 180 Days
STORM DRAINAGE FEE
ENM INSPECTION FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
employees, and agents from jiny and all claims for damages of
PLAN CHECK DEPOSIT
whatever nature, arising direct ly or indirectly from the issuance
of this permit. Issuance of tlil'ii permit shall not be deemed to
0
0
i modify. wa ive or reduce any.' quirement of any city ordinance
1
T
nor limit in any way the City', ability to enforce any ordinance
TOTAL AMOUNT DUE
7 12A-
provision."
y�j
1 hereby acknowledge that I a read this application; that the ATTENTION APPLICATION APPROVAL
information given is correct; athat I am the owner, or the duly
authorized agent of the owner,��l agree to comply.:.With city and THIS PERMIT This application is not a permit until
state laws regulating constructl#n; and in doing the woik.authoriz- AUTHORIZES
ed thereby, no person will be elIhployed in violation of the Labor ONLY THE signed by the Building Official or histher
Code of the State of Washington,relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is
tion Insurance and RCW 18.27. INSPECTION acknowledged in space provided.
SIGN �URE (OWNER OR AGE�N�T) ATE SIGNED DEPARTMENT
OFFICIA SIG URE E
CITY OF
.11--7
ik-Ud o, EDMONDS
FRUELEA 0 E
CALL FOR
ATTENTION INSPECTION 71 �/q
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-0220 ORIGINAL — File YFI'LOW Z Insilector U
A CERTIFICATE OF OCCUPANCY. HAS BEEN GRANTED. UBC t
SECTION1109 PINK — Owner GOLD — Assessor