527 3RD AVE S.PDF4986
527 3RD AVE S
0
ADDRESS: z a24 P=46 Z&9z
TAX ACCOUNT/PARCEL #:
BUILDING PERMIT (NEW STRUCTURE) #:
COVENANTS (RECORDED) FOR:
CRITICAL AREAS #: DETERMINATION: El Conditional Waiver [] Study Required XWI,- aiver
CRITICAL AREAS#: DETERMINATION: Conditional Waiver E] Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORD FOR:
PERMITS (OTHER — list permit #'s):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED: 4W7 14�'�
SEWER LID FEE $:
LID#:
SHORT PLAT FILE:
LOT:
BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE/ENC ROACH M ENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
L:\TEMP\DST's\Forrns\Jana's Street File Checklist 5-14-08.doc
-0 0
PLANNING DATA
NAME:.
SITE ADDRESS: DATE:-
1
ZONING: PLAN CHK#:
PROJECT DESCRIPTION:
CORNERLOT t�o (Yesft4o)
SETBACKS:
Required Setbacks:
Front: VO Left Side: Right Side: Rear:
Actual Setbacks:
*Front: L4 Left Side: Right Side: (0 Rear:
Street map checked for additional setback required?-- "'fEb —(Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED—k-<��
—(YIN)
LOT COVERAGE:
Maximum Allowed: Actual:--Wo 4-0
BUILDING HEIGHT:
Maximum Allowed: 14- Actual Height: 1�0- 14-
DatumPoint:, HAt4-�Llc Datum Elevation: J.,e-o
SUBDIVISION:
CRITICAL AREAS #: CAD —
SEPA DETERMINATION:— N A
LOT AREA: I ?A,
OTHER:
Plan Review By:
ALLEY
62'
HEIGHT CALC'S
'A . ......
103.43
'B . ......
105.73
108.09
'D . ......
106.11
TOTAL 423.36
MEAN 105.84 (+25,00)
MAX 130.84
A.
CB#I. TYPE I-L-
GE 303.00
LE . 98.32
USE 13' 30' CMP vil 2' of 24' CMP
@ ENDS for connection to CB's
CB#I. TYPE I-L, w/restrictor-
GE 102.00
ll� 98.24
F -T
C)
LJ
x x
Lj
, V)
C)
5'
cn
JB
�'Rop,
SINGL FAMILY
SI
IF RESIkE
-0!6^1
USE 16' 3' D.I. @ 2%
()8-
00
I.E. 3' D.I. 97,92 ---7
,7�0.
5,
PROP. ROCKERY 17
PROP
- 20,
1,31.36 y 0
DRW Y 0 10�,
02 10
%6 102
10 0 6 2
6'.
(L
jupi
PER411T CoUf
PROP. ROCKERY
0
EX. REI. WALL
TOP WALL 102.82
EX. P,P-
'0,�10
30 EX. M.H.
3r-d AVENUE S
30 /
APPROVED BY PLANNINNG
-7
SCALE: 1" = 20
0
STREET FILE
HEIGHT CALC'S
'A . ......
103.43
'B . ......
105.73
108.09
'D . ......
106.11
TOTAL 423.36
MEAN 105.84(+25.00)
MAX 130.84
m.
CB#J. TYPE I-L-
GE 103.00
I.E. 98.32
USE 13, 30. CMP w/ 2' of 24' CHP
@ ENDS for connection to CB*s
CB#I. TYPE I-L. w/restrictor-
GE 102.00
I.E. 98.24
USE 16' 3' D-1. @ 2% -
98 4
411/
I.E. 3' D.I. 97.92
ALLEY
62'
3rol AVENUE S
30 /
C,
APPRovvD
v Ald
"—Ex. RET. WALL
TOP WALL 102.82
EX. P.P.
EX. M.H.
SCALE: 1" = 20
0
STORM. DRAINAGE REPORT
SITE PLAN
for
Alan &, Kathy Sparks
for
A SINGLE FAMILY RESIDENCE
located at
527 3rd Ave S., Edmonds, WA 98020
prepared by
John W. Mellor, P.E.
4
0 0
UNDEVELOPED SITE
The majority of the subject property is slightly sloped with a topographical change
from the S E corner to the, NW corner of the proposed house of 109.75' - 98.50'
11.25'. This change occurs over a distance of 145'for a slope of 7.76%. The
grass covered ground then drops down from the West property line to the back of
sidewalk along the East side of 3rd Avenue S a vertical distance of 98.50'- 97.83'
= 0.67'.
The acreage of the subject property is:
13 1' x 62' = 8.122 sg. ft. = 0. 1864 acres
43,560 43,560
DEVELOPED PROPERTY
The developed property will contain one single family residence, the new home will
have a total of 2,408 sq ft for a total of 0.05528 ac of new impervious surfaces
including roof, driveway, and sidewalk areas.
The remainder of the site, the -pervious surfaces will be lawn and landscaping
8,122 - 2,408 = 5,714 sq. ft. or 0. 1312 acres I
DETENTION REQUIREMENTS
This project will use the City of Edmonds' standard drainage system worksheet.
Interpolation of Table'l indicates a required volume of 60 cy ft for a new impervious
area of 2,408 sq ft. Table 1 also indicates a required pipe length of 13'of 30" pipe
for an impervious area of 2,500 sq ft. A 13' section of 30" detention pipe with 24"
C M P ends for connection to Type 1 -L catch basins will be used for this project.
Table 2 indicates an orifice diameter size of 5/8".
At this portion of 3rd Ave S where no storm drainage collection exists all of the
neighbors use runoff through 3" diameter D.I. pipe through the sidewalk and curb
into the gutter. This means of final disposal of runoff from the detention system is
proposed for this project.
2
Table 1 — Detention Pipe Sizes
Impermeable
Required
Area Sq. Ft
Vol Cu Ft
2000
50
2500
62
3000
75
3500
87
4000
100
4500
112
5000
125
Note: Allowable Pipe Materials:
Impermeable
Area So. Ft.
2000
2500
3000
3500
4000
4500
5006
Pipe DiarAeter' '
150 180 24u 300
40 28 16.
10
50 35 20
13
60 42 24
15 Required pipe
70 49 28
18 length in feet
80 56 32
21
90 63 36
23
100 70 40
25
Reinforced Concrete
Alumi ' nized Pteel.
Aluminum
CMP Asphalt Coated
N-1 2 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
7/8
ITable 3 — Rectangular Catch Basin Requirements I
Detention
Max. size
Catch Basin
pipe diameter
knockout—
Typei
< 180
20"
Type 1, C13 15
180 to 240
260
Type IL, C13 16
24" to 368
360
Type 11, C13 19 19 (48" Basin)
368 to 420
420
Type 11, C13 19 19 (54" Basin)
*Source: Assoc. Sand
& Gravel Co. Standards
5
Revised 3/16/95
S1/2. NEI/4, NEI/4, NE1/4, & N1/2, SE 1/4, NW 1/4, SECTION 26, T. 27N., R3E., W.M.
HEIGHT CALC'S
'A . ...... 103.43
'B . ...... 105.73
'C' 108.09
'D . ...... 106.11
TOTAL 423.36
MEAN 105.84(*25.00)
MAX 130.84
10_�el?
81
CY)
CB#I, TYPE I-L—,
GE 103.00
I.E. 98.32
USE 13' 30' CHP W/ 2' of 24' CMP
ENDS for connection to CB's
CB4I. TYPE I-L. w/restrictor—,
GE 102.00
I.E. 98.24
USE 16' 3' D.I. @ 2%
98
LE, 3' D.I. 97.92
ALLEY
62'
61
"—EX. RET. WALL
TOP WALL 102.82
EX. P.P.
E x. m.H.
of-%$ - m
WAS
0
3rd AVENUE S
3 0' 19343
AL
EXPIREs 2 /24 / 97
SCALE: 1" 20'
0
0 C46LE NO, C(Co
Critical Areas Checklist
Site Information (soUs/topography/hydrology/vegetation)
1. Site Address/Location: 52�F7 �5 rd g��,f S J U -N 7 - 1996
2. Property Tax Account Number: 005--- Colo 00 PERMIT COUNTEER
3. Approximate Site Size (acres or square feet): RECEIVED
4. Is this site currently developed?,& —yes; — no.
MAY 15. iM
If yes; how is site developed?
5. Describe the general site topography. Check all that apply. KNUCOUOR
-Flat:. less than 5-feet elevation change over entire site.
0- eet ov
Rolling:' iiop�`�n "site je�erally less than 15% (a vertical rise of I f er a
horizontil distance of 66-feet).
Hilly:, dopes present on site of more than 15% and less than 30% a vertical rise
of 10-feet over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a
-f
horizontal distance of less than 33 eet).
Other (please describe):
6. Site contains areas of year-rou nd standing- water. t) G Approx. Depth:
7. Site contains areas of seasonal, standing water: Approx. Depth:
What season(s) of. the year?
8. Site is in the flood"y floodplain of a water course.
9. Site contains creek or an area where water flows peross the grounds surface? Flows are year-
round? A () _ Flows are seasonal? Mhat time of year? -- — ).
10 Site is primarily: forested meadow f�LG; shrubs mixed
urban landscaped Qawn,shrubs etc) Yl�_ Lf
11. Obvious wedand is present on site:. �� 6
.6 90-191-
'City-drEdmonds
Critical Areas
TI
"N14ii
Checklist
The Critical Areas Checklist contained on
this form is to be fined '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.
17he 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. lie
information needed to complete the
Checklist, should be easily available from
observations of the site or data available at
City Hall (Critical Areas inventories, maps,
or soil surveys).
An applicant, or his/her representative,
must fill out the checklist, sign and date it,
and submit it to the City. The City will
review the checklist� make a precursory site
visit, and make a determination of the
subsequent steps necessary to complete a
development permit application.
With a signed copy of this form, the
applicant should also submit a vicinity map
or plot plan fox-1—ndividual lots of the paree- I
with enough detail that City staff can find
and identify the subject parcel(s). In
addition, the applicant shall include
other pertinent information (e.g. Site
plan, topography map.. etc.) or sLudles
conjunction with this Checklist to assist
staff in completing their preliminary
assessment of the site.
I have completed the attached Critical Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fiU out the appropriate column below) -
Owner / Applicant-.
Applicant Representative:
Nam
Street kdress Street Address
City, State, ZIP Ity, —state, 2ZIP Phone
Si tLIre
Date Signatare Date
0
I Q ,-'
co
VN- C,
7y
Z77 - 3 r�S..'
ALLEY
62' '-plan
STREET FILE
HEIGHT CALC'S
'A . ......
103.43
'B . ......
105.73
108.09
'D . ......
106.11
TOTAL 423.36
MEAN 105.84C*25-00)
MAX 130.84
CB#I. TYPE I-L-
GE 103.00
LE . 98.32
USE 13' 30' CMP w/ 2' of 24' CMP
@ ENDS for connection to CB's
CB41. TYPE I-L. w/restrictor-
GE 102.00
I.E. 98.24
USE 16' 3' D.I. @ 2%
98
-oz
I.E. 3' D.I. 97.92
3rd AVENUE S
30/
iA
W
it, UUL!,.
V
! f JR O�VED
7f-
EX. RET. WALL
TOP WALL 102.82
EX. P.P.
E x. M.H.
SCALE: I" = 20'
Mr. A. Lyle Chrisman
City of Edmonds Engineering Division
250 5th Avenue N
Edmonds, WA 98020
RE: Grading for a Residence located on 527 3rd Ave S , Edmonds
Dear Lyle:
June 6,1996
To comply with City requirements I prepared this cover letter with calculations for
the grading activities related to the subject project.
Calculations for grading are as demonstrated on the calculation sheets and the plot
plan submitted herewith:
House excavation is based on a basement level. The volumes of this excavation
is based on the average end area method as indicated on the calculations
sheets.
House excavation volumes are based on two rectangles.
Driveway excavation volumes are based on three rectangles with a minimum cut
of 0.5'.
Total excavation is 437 cu yds. I believe this to be a somewhat conservative
estimate, please use the plot plan as an explanation to the calculations sheets.
Please call if you haVe any questions, 775-5317.
Sincerely,
John W. Mellor, P.E.
ALLEY
62'
HEIGHT CALC'S
CD
'A . ...... 103.43
X Li
'B . ...... 105.73
108.09
(,u
'D . ...... 106.11
TOTAL 423.36
MEAN 105.e4C+25.00)
MAX 130.84
5''
5'
81
6'
J'N
\
'Ll
B
11
C-
--�ROP-
S'I'N G Lt,,F A M I L Y
4 E RESID
E
CB#j, TYPE I-L—
—,1
m
IA
GE 103.00
I.E. 98.32
-0
USE 13' 30' CMP w/ 2' of 24' CMP
PROP. ROCKERY
PROP. ROCKERY
ENDS for connection to CB*s
PROP.
CB41, TYPE I-L. wlrestrictor--,
02-36
DRWY 0
0
GE 102.00
I.E. 98.24
102
-10.
1:00
100,L-62
EX.
H.
��:,—EX. RE7. WALL
TOP WALL 102.82
USE 16' 3' D.I. @ 2%
18,
E X. P.P.
8
1 gq 10 -90,>
9
3 01
I.E. 3' D.I. 97.92
Ex.
m.H.
3rd AVENUE S
30/
SCALE: 1 = 20'
105.73 � 8' /4�9, 0,9
50T —10,�,A c>F
a X CA VA —ir ot,-
e)
E - 6.
2- 3 +- 4. 34 2-6 4-Z 99
2
"6 6 - 17, 70
z
t 4-:7, 9 8 7. 70 >< 0
2-
6196 K
79
2�- >e
.40.71 43,5-,72 x 14-
2— 2.7
0
91.,* 7 Z.
9e-64 9,04
4, 5-
4- o -2o 0 0 0 %,. "D :57
-4.9 4 -�- 4, 2-
7-
>< L3�
27
ep -
43� / , 90
= 13 4-, C. o
= 4 2 - 4- 9 c u Ya5
= e4,eo
8 4- / 3
Z7
2- 4 2, 4— 9, �3 4 37. S'O (-2 u
40
The City of Edmonds Water Service Drawing EASEMENT NO . ....................... ................ —
NEW CONSTRUCTION REPAI",S C LID NO . .................. . ASMT. NO . ... ............ .
OWNER............... ............... ............. CONTRACTOR .................................................................................... PERMIT NO. lkv-rt?
JOB ADDRESS J-2 7 -.7
.............................. ........................................ LEGAL DESCRIPTION: LOT NO . ....... .............................. BLOCK NO . ..... ............... ..............
.................... ........................................................ .......... I ................................................................
NAMEOF ADDITION ....................... ..................................................................................................
In.
Zr
QA
lz
Approved:
PWW-0001 -11175 (REV. 11/78)
DATEJ;�4-1 ................... By .47.1 ............
CITY OF EDMONDS
SIDE SEWER PERMIT
PERMIT N2
.-3 -060 W,
Address of Construction:
Property Legal Description (Include all easements):
Owner and/or Contractor:
k
State License No. 0(,1_4� Building Permit No. —,, 1& 052 7%
Ix Single Family
El Multi -Family (No. of Units—)
El Commercial
0 Public
VL�� — d '
I certify that I have(/ad and
as indicated on the back of t
3820
Invasion into City Right-of-Way:yNo El Yes
RW Construction Permit No.
Cross other Private Property: WO No El Yes
Attach legal description and copy of recorded easement
comply with all city requirements
�rmit Card.
Date
CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
OFFICE USE ONLY
FOR INSPECTION CALLJZ4.-SM, PUBLIC WORKS DEPT.
Permit Fee: Issued By
Trunk Charge- Date Issued:
Assessment Fee: Recei pt No.:
Lid No.:
.Partial Inspection: Date —Initial —
Comments
Reason Rejected: Date --Initial—
Final Inspection Approved: Dat Initia
PERMIT MUST BE POSTED ON JOB SITE
White Copy: File Green Copy: Inspector Buff Copy: Applicant
Revised 3190
Side Sewer Drawing
The City of Edmonds EASEMENT NO . ..................................
NEW CONSTRUCTION REPAIRS LID NO . ........... : ....... ASMT. NO . ..................
OWNER................................................................................................ CONTRACTOR .............................. ;z 0
--------- ............................................ PERMIT NO.
JOB ADDRESS .... . .. �Vz - -�, -
........ ........................ LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ................................
M
PWW-0001-1 1175 (REVA 1/78)
........... .............................................................. — .....................................................................................
NAME OF ADDITION
[TRIT iLRT
3
0
L;
St 1pr--vJSLK
IZD Aup. Approved. 5,
DATE .... ........ By .......
APPLICATION
for
The City of Edmonds S13DE SEWER PERMT EASEMENT No . ..........................................
NEW CONSTRUCTION E] REPAIRS [3
OWNER..... 01SO.n., .... Mrs...bal.aA ..... ................................ CONTRACTOR ........... ....................................................................... .............. PERMIT No . ......................
ADDRESS ----------------------------------------------- LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . .............................................
NAMEOF ADDITION ................................................................................................ ........................................
,5TK'
V4, Tq,,5-11-d on: ��wq-r
Approved:
DATE................................................ By .... .................................................................
i 12C. lsoci
N 0 T I C E
TO PERMITTEE AND/OR OWNER
F-1 PARTIAL APPROVAL
Co VIOLATION
Lj CORRECTIONS ]REQUIRED
Permit Number Owner
Job Address 52-9 -3po 4Vf- 6.
F--i No PERMIT -STOP WORK -REMOVE CONSTRUCTION OR OBTAIN PERMIT AND MAKE WORK COMPLY
WITH ALL APPLICABLE CITY CODES.
F-1 CONSTRUCTION Is NOT IN ACCORDANCE WITH APPROVED PLANS AND PERMIT - STOP WORK.
MAKE WORK COMPLY WITH APPROVED PLANS AND PERMIT OR REMOVE.
F-1 STOP WORK - UNTIL AUTHORIZED To CONTINUE By CITY INSPECTOR.
F�;_l CORRECTIONS LISTED BELOW MUST BE MADE: BEFORE WORK CAN BE APPROVED AND/OR THE
I.W NEXT PHASE IS STARTED; To AVOID POSTING OF A STOP WORK ORDER, ORDER To
CORRECT, OR ABATEMENT PROCESS.
F__j JOB CARD MUST BE POSTED ON SITE AND BE VISIBLE FROM STREET.
F-1 APPROVED PLANS MUST BE AVAILABLE To INSPECTOR ON SITE.
F-1 WORK DESCRIBED BELOW HAS BEEN INSPECTED AND Is APPROVED.
F-1 CONTACT INSPECTOR AND ARRANGE FOR APPOINTMENT.
F-1 RECALL FOR INSPECTION.
11FC_iCVC0 4 e_�omPLAIIV-f W641ZOIN67 7Ha Pu�--ietN47 OF
r_9H0!f4-T /,flX /9 7-ke- -flfr (ftllfoc) ALLEr 9,�VoftP
),'o' L/ tz f4atfr_ Tua Is, oFrzF_ovs1ve_ ANP Noz Rg ALLo",�eo.
PZ_ C-,4 3 F_ /JeMOL-f TPF- U,+r4Xj4(_ FtZoA-f 7-#,f Pu8(Jc- el6yT
-OF-wAY AIVO efAL(_ AtC_ lf;tf- A TEt--tfk,1 OF You/C cc_p1,J
v(9 ACZ(ot-. W11-e- fliF9U6-57 T/4,f7 77,1E 1q4-7';flel,4(_, 9F_
?�moueFo AU4 --30A -
THE ACTIONS OR CORRECTIONS INDICATED ABOVE ARE REQUIRED WITHIN
DAYS OR PENALTIES MAY BE APPLIED. FOR INSPECTIONS CALL 771-0220.
L]BuiIding Division F—lPlanning Department L21 Engineering Department Ll Fire Department
CITY OF EDMONDS
z 1) 14,4i �6yH Inspector 1'7'7,0 Date
PERMIT APPLICATION REQUIREMENTS
To: Applicant
From: Lyle Chrisman,,Engincerins taspector
Owncr. M Cat A 4 3gavk 5
Plan Check No.--U --� �9
Address:— 5,21 Date:
Aftrx review of the subject permit application. the following requirements must be met:
I. Construction hours are:
WEEKDAYS — 7:00 A.IVL-10: . 00 PhLWEEKENDS1HOLIDAYS — 10:00 A.M.-6:00 P.M.
1. A separate RIGHT-O&WAy CONSTRUCrION pERWr is required for al I work on p ublic property. (ECDC 1&60)
Truck haul route plan must be submitted and approved prior to permit
1. Buildedowner is responsible for containing all temporary runoff and erosion control on site.
(EMC 18.30.030d)
i- NO WORK SHALL BE DONE vmrm is FEET OF STREAM OR 10 FEET FROM ANY CLOSED DRAINAGE'
FACILITY. BUELDER/OWNER IS RESPONSIBLE FOR IDENTWMG CONDITIONS ON THE DRAWING. (ECDC
18J0.50G)
MTER FABRIC FENCE SHALL BE INSTALLED AND INSPECTED PRIOR TO CLEARING AND CONSTRUCTION.
(ECDC 1830)
INSPECTIONS ARE REQUIRED ON STORM DRAINAGE SYSTEM -nGHTLINES AND CATCH BASIN
INSrALLA1101% INSPDMONS ARE REQUIRED PRIOR TO BACKFUAMG. (ECDC 1 &30)
RcWw or replace all defective exjs&g =k gutterwo sldewa& adp*=d to dw p"crty. if=10tersectionis'
mayberequired. Co ' lnvolved� a handicap ramp
(FCM 1&90). meet with the CitY FAgbwc&g stiffto detmine dw e3aent of
Np* Prior to Issuance ofthe permit.
DdvcwW slope shall not exceed 14% without a waim. Evety allcmpt should be ma& to keep the slope below 14% waim granted to
r- 14' K (ECDC I&M0601))
0. Driveways must be paved fivm pro" [in to City RIGHT-OF-WAY. A sepwatC permit is requhv& (EcDC IU0.060C)
I' INSPECnONS ARE REQUIRED ON DRIVEWAYS AND SIDEWAUM PR IORTO AND AFTER poURIKM (ECDC 1&30)
2- NO burning OfcOnstruc.tion afixtse without a pamk fmm the pt*m Departnea
3. Connection to City Water, quent is mq*a hew is & separatecharpfordiewawmew.
(ECDC7.20)
4. A back water valve Is required ifdownstairs plumbing is below die elevation Of W*eam manhole.. (ECDC 7.20)
S. WAW and sewer main lines should be separatedby 10 fed mhftum. (ECDC 1&10)
L Connection to th ' 0 city =nkuY "stem is mquhv& A sepade permit Is mqaW&
LW#6 " — Few P&W Yes . No . curze-6-0 � * oDmc may
11U�otmdiiiiiring is required an all new construction, and foraddidon36 W[teradons, and fePaks that aweed 50% ofthe total assessed
value Of the sh=tum 1� 1"
A FWAL ENGINEERING INSPEMON IS REQMRED PRIOR To TIM BU , ILDING DWISION GRANTING OCCUPANCY.
OF TEM BUELDING OR STRUCTuRL gDCDC 1&90)
Wwww— C) IZ5
9 0 - 19
Y?, -ft WP 17
7
-7 0
City of Edmonct
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit'Number-
Lssuel)ate:
A. Address or Vicinity of Construction: SZ-7 3"' Av. 5
B. Type of Work (be specific): R E P t-kc-C 1PQ k- G_ SrA k_%_
A t4 tb 'S G "r 'S E
C. Contractor: 'S No. C6, F. 0. b. Contact: 90 R KA� VS. A LC I
Mailing Address: 2 10 ( 9 kujq Phone: 4-70 -3ZI'l
StateLicense#: Wk Qqo2(. Liability Insurance: Bond: $
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. E] Commercial []Subdivision F1 City Project. E] Utility (PUD, GTE, WNG, CABLE, WATER)
Multi -Family Single Family Other
INSPECTOR: INSPECTOR: Lj�.AwkA
F. Pavement or Concrete Cut Yes ANo G. Size of Cut: x H.' Chargq�
4�
APPLICANT TO READ AND ig
JAVEMNITY. 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 hot limited to the defense ofany legalproceedings including defense costs, and attorney fCea 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 B YCITY FORCEJ, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
'Construction drawiW of proposed work required with permit applica ' tion. '
0 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 Cityregulatio sa9 required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved materiall "or to the end of the working day;
le-11,
NO EXCEPTIONS. .............
Ihave read the above statements and undeistandthepe'rmit requirements and thepink copy of thepermit will be
available on site at all times for inspection purposes.
J
Signature: Da 1/0 — 2.1. -
00. te:
(JContractog�gent) �21
A
CAUDIA -A-DIG PRIOR TO BEGINNING WORK
)*VOR CITY USE ONL
APPROVED BY: RIGHT, Y, DEPOSIT
'TIME AUTHORIZED: VOID/AFTER PAC' 10411 -DAYS DISRUPTION FEE/FUND. 11-1:
/RESTORAITON:FEE-
SPECIAL CONDITIONS:
ge (ZfAAOVf D t5Y, Pf-C... 10T14'.'
PERMITFEE:--
I AM T9 A� _N156i;OCIP-
TOTAL FEE:
COMMENTS: Jkl -LAO -R I ECEIPT FEE:
DATE- ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMITvISSUANCE
Eng. Div. 1994
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.)
Comments:
I Diagram.:
CONTRACTOR CALLED FOR INSPECTION El YES 0 NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
ImmCC30NTY
PUB.: UMITY DIST141171 NO.'
s1w M - ISH COUNTY PUBLjC UnLrTY DM-m I
CTO.
LOCKnON Z-7 3 R' Av - S AR
POLE # NIF1/4 SZ(,,T27R,3
DATE 1012 194
W.O. #
2- 0 3Z
REASDNFORWORK RE!pLAC_,h4G br-p. pot_E W/4S' POLE,
ENGINEER j1eA14AL9Ey
DWG. #
117 50 5'
T- "S -r A, LL I t.J G <,IF--C , Rk SEP, , Q T->
DRAFTER
U.G. #
SEC , PEI> FoR Rtr-K-LOR ::CjC., �CAS PkE- 6a�)
SCALE
DATE WORK COMPLETED
FOREMAN
FEES REQUIRED:
ENVIRONMENTAL ANALYSIS
0 YES Q NO
M EXEMPT 0 NOT EXEMPT
PARA. 18 ITEM C
PROMY OVERHEAD
O.H. U.G. COND. KV
Ll RESIDENTIAL 0 COMMERCIAL
ADD CKT. FT. —PH
LE0#_
REM CKT. Fr. PH
I@$—/=
NET CKT. Fr.
SECONDARY OVER
O.H. U.G. COND. KV
BASIC
r
ADD CKT. FT. PH
10$ 1 $
REM — CKT. FT. PH
NET _CKT. Fr.
METER/COpy. I�dLE s
PERMITS (DATE GRANTED)
PRIMARY N RGROUND
U fW_SID U COMMERCIAL
U TREE TRIM
BASIC FEE $
LEU#
U STATE
U COUNTY
$
a CITY
1@ $
EASEMENTS
1B REQUIRED U NOT REQUIRED
/@$-/= $
SECONDARY UNDERGROUND
BASIC FEE $ E0 0
UNDERGROUND PLAT
DATE RELEASED
BASIC FEE $
em. @ $
FOREIGN CONTACTS
0 GTNW JPN #
STREET LIGHTING
8 CATV JPN #
$
0 JOINT TRENCH GTNW & CATV
U JOINT BORE GTNW & CATV
WORK IN RIGHT-OF-WAY
• PWMARY
0
• SEDONDARY
POLE STENCILING
tA. @ $—' = $
FROM —TO
TAKE OFF POLE
MISCELLANEOUS FEES
VAULT $ -
PRE-CONSTR. REQUIREMENTS
F-n—o— 30
.5 PERMIT $
U TREE TRIM 0 PUD LOCATOR
$
0 BACKHOE 6 FLAGGING
$
It ONE CALL DATE
TOTAL DUE: $ 530-
DAXEPAID- q.12G.12t, —
INDEX
I POLES
PLAT
LOGS
U-MAP
RECEIPT# 2 8!S7 0
XFMR
C-MAP
NeW SVC APPLIC. # Z 14 6 7
LOCATION MAP PAGE 4T4 4-
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'7 _0
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Location: 27N3E26A Scale 1:60
PUBLIC WORKS REVIEW ROUTING
SITE ADDRESS:
TYPE: BUILDING PERMIT (CHECK ONE)
��SINGLE FAMILY
MULTIPLE
76L-11�'Yffl�
COMMERCIAL
ch
FENCE
GRADING
M
DEMOLITION
rn
RELOCATION
rn
IN
CITY ENGINEER
EET DRAINAGE ENGINEER
WATER/SEWER DIVISION
STREET DIVISION
P.W. RECEPTIONIST
WORK ORDER COORDINATOR
UTILITY BILLING
DIRECTOR/ADM1NISTRATOR
RECORDS (FILE.)
OTHER:
COMMENTS:
SIDE SEWER PERMIT
RIGHT-OF-WAY PERMIT
STREET USE PERMIT
STREET TREE PERMIT
SEPTIC TANK DESIGN PERMIT
NEW METERMATER SERVICE
E.I.S.
OTHER:
SUBDIVISION REVIEW
PLAT/PRD REVIEW
DRAINAGE PLAN
. OUT
Reviewed By: Date Reviewed:
(See Comments)
2/3/81
N U-1 Nit -*`(,�N'S
DATE 19
TO FROM
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GA-1
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USE
CITY OF EDMMIDS ZONE WER
-BUILDING
PERMIT APPLICATION
JOB
N A (OR NAME OF BUSINESS) ADDRESS 41&
5
LEGAL DESCRIPTION SUBDIVISION SUB NO.
W
Z
ISHORT
M A
I
5e 4 U)
3:
IL�27
0
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
CITY N E N um BER
EXISTING
3to 414
PROPOSED
NAM,& W
I..
DEFICIENCY OF RIGHT OF WAY Z
W
I-
ADDRESS CHECKED BY U
Z
TS., ENGINEERING MEMO DATED
U
M
REMARKS
CITY TELEPHONE NUMBER
\N C Il'2- )MAIVA6,c
NAME
C 4.41 6�_ 0, Pbtz- T"t-AtJ
0
B
ADDRESS METER SIZE UILDING SUPPLY SIZE FIXTURE UNITS
I-
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M
W
1,14Z �, k
4
M
CH y TELEPHONE NUMBER REMARKS
zo
U119 2- &6
STATE LICENSE NUMBER CITY LICENSE NUMBER SIGN AREA ENV. REVIEW ADS NO.
ALLOWED PROPOSED COMPLETE EXEMPT I,—
'2_33-0,41
I IHI #
Legal Description of Property (Sho�v Below or Attach Four Copies) �>tNE
/0 _"S VARIANCE OR PLANNING
0
CU REVIEW BY DATE
YARDS ILOT COVERAGE
�z
FRONT SIDE RE R
3 fbw
REMARKS Z
_j
CiTy (,C�D& -;�Gc— Zo
W
J
4o 9 6
ExNEW RESIDENTIAL PLUMBING CHECKED By TYPE OF CONSTRUCTION I C H E 1.2 IjT
NON-RESIDENT..Ll
I -� - Q i �� '&A
ADD 1:1 MECHANICAL
DEMOLISH SIGN SPECIAL INSPECTOR JAREA OCCUPANCY OCCUPANT
El REQUIRED GROUP LOAD
I
EXCAVATE FENCE 0 YES NO
F� ALTER OR FILL 1:1 I_ X FT)
REMARKS
REPAIR PRE-MOVECINSP./P. swim LOT D (4 Ak Q AG_'& j:1GrL C)V_Q i7jdr
1:1
COMPLIAN E INS POOL
Z
NUMBER OF STOR7��"U M BER OF
DWELLING
UNITS
641�E IV101416
NATURE OF WORK TO BE DONE (ATTACH PLOT P)qN)
2
EucT X 3d l'?IF—
M
84, J_ L) ['v(, T-0
PLAN CHECK FEE VALUATION FEE
egs
BUILDING
-:�;Goo
PLUMBING
V'h MECHANICA
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways, FENCE
marquees, etc.) will require separate permission,
SIGN
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 120 Days RETAINING WALL
In "Applicant, on behalf of his or her spouse, heirs, assigns and
0 SWIMMING POOL
W successors in interest, agrees to indemnify, defend and hold harmless
.I
2 the City of Edmonds, Washington, its officials, employees, and
(r agents from any and all claims for damages of whatever nature
i ( arising directly or indirectly from the issuance of this permit. Issu'
a ance of this permit shall not be deemed to modify, waive or reduce TOTAL AMOUNT DUE
$21
0 any requirement of any city ordinance nor limit in any way the
APPLICATION APPROVAL
I . City's ability to enforce any ordinance provision." ATTENTION
I hereby acknowledge that I have read this application; that the in-
formation given is correct; and that I am the owner, or the duly author- THIS PERMIT
This application is not a permit
ized agent of the owner. I agree to comply with city and state laws regu- AUTHORIZES
until signed by the Building Official or
lating construction, and in doing the work authorized thereby, no person ONLY THE
his Deputy; and fees are paid, and
will be employed in violation of the Labor Code of the State of Washington WORK NOTED
receipt is acknowledged in space pro-
relating,4o Work men�s.�Com pensa tion Insurance.
vided.
INSPECTION
S I
J;E (0 W R OR AGENT) DAT DEPARTMENT
DIREqTOR'S SIGNATURE
LGN
CITY OF
EDMONDS
THIS SITE IS LOCATED IN THE CITY 775-2'525
OF EDMONDS. LOCAL SALES TAX
DATE
41i
SHOULD BE CODED 31.04.
ATTENTION
ORIGINAL — File YELLOW Inspector
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
r2
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR MAR 2
RIM-
PINK — Owner GOLD Assessor
A CERTIFICATE OF OCCUPANCY HAS BEEN- GRAN , TED.UBC304,306.
102-78
cj
CITY OF EDMONDS
ubt PERMIT
ZONE NUMBER 9 COO 5 9 -5
CONSTRUCTION PERMIT APPLICATION
joe SUITE/APT #
ADDRESS
04=
OWNER NAME/NAME OF,BUSINESS
PULA, r� 4 112 MIA q S P Ka
LEGAL DESCRIPTION CHECK
SUBDIVISION NO.
LID NO.
61l
di
Z
MAILING ADDRESS
fkv
TESCP Approved 0.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
Permit 0
CITY ZIP
AIN 0 1
TELEPHONE NUMBER
EXISTING 16 0 REQUIRED DEDICATI ON'
RW Required
Street U3e Permit Req'd 0
Inspection Required M/
PROPOSED 6 0
Sidewalk Required 0
o
U
NAME
METE9 SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
w
YE NO 13
Six
ESS
2
REMARKS
cc
00
9
LU
CITY ZIP .
TELEPHONE NUMBER
�j
45
MI(A-kil—
2
It
NAME irf
Rotkea")
AdDRESS
Ac 4(-)
AI/oo I/ 6,� -
cc
0
ENGgErING7EMO DATED REVIEWED BY
I --I ^I
1 9
0
1C
ITY ZIP
TELEPHONE �UMBER
71- 1 A -W -f
FIRE MEMO DATED REVIEWED BY
6
C
C.)
STATUICENSE NUMBER VPIRATIPN DATE
f<1Le*H1_P_r)j0A4J#0 7/t7
0
SIGN AREA
SEPA REVIEW
AD8 NO.
I
ALLOWED PROPOSED
COM:PLIETE
Legal Description of Property - include all easements
Z
FT
SHORELINE I
0
EXP
ci, 94 te, PvA vi-3 E—Av\6�V->
FE
('L
VARIANCE.OR CU
16
PLANNING REVIEW BY
DATq
11,71:7
F� LA �iXAC
L-o—r 5
C0 k
_j
SETBACKS — FEET
HEIGHT
L6T C 4
FRONT SIDE REAR
Lu
_j
Property
Tax Account
4oq �o - 0(3 1 - o05- a=
REMARKS
Pamel No.
R71
NEW RESIDENTIAL PLUMBING
ADDITION COMMERCIAL MECHANICAL
APT. BLDG. El SIGN
0
REMODEL
G�M FENCE
CYDS. x
CHECKED BY
TYPE OF CONSTRU�TION
CODE
9
OCCUPANT
GRqUP
,�, - 0?
REPAIR _FT)
1
WOODSTOVE SWIM POOL
DEMOLISH INSERT HOT TUB/SPA
SPECIAL INSPECTOR
REQUIRED 1
OCCUPANT.
OAD
13
I
'i)),. .
J63/1 ,
GARAGE F_� RETAINING WALL]
GAIRS04T ROCKERY. RENEWAL
REMARKS _"'ff W�A'5
L S4'0
NSPE6 OS PER UBC'205
PROGRESS I N S
0
E
JYP�,OFIUSE. BUSINESS OR ACTIVITY) EXPLAIN: f
.
cc
ZJin&�=JFwy-1'1\-\I
t
NUMBER
NUMBER 0
CRIT ICAL
0
co
OF
STORIES :�—
DWELLING
1 UNITS
AREAS
NUMBE 5
15 g,-
0
DESC191BE WORK TO BE DONE (ATTACH PLOT PLAN)
`2 13 Y C1. 11 UTIQ It
FINAL INSPECTION REQUIRED
VALUATION
FEE
PLAN CHECK FEE
lylfwyr Xes )O�vu
BUILDING
" �Z
HEAT SOURCE:
GLAZING
Z)_ %
�19
PLUMBING
Ian Check No.
P //C/
MECHANICAL
4647
GRADINGIFILL
&5
This,,,Permit covers work to be done on private property ONLY.
Any construction on the public domain (curts, sidewalks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Pennit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
ENG. 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 any and all Plaims for damages of
PLAN CHECK DEPOSIT
cc
4
whatever nature, arising directly or indirectly from the Issuance
of this permit. issuance of this permit shall not be deemed to
0
m odify, waive or reduce any requirement o f any city ordinanc
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
I hereby acknowl;dge that I have read this application; that the ATTENTION APPLICATION APPROVAL
information given is correct; and that I am the owner, or1hp duly
authorized agent of the owner. I agree to comply With city and THIS PERMIT
This application is not a permit until
state laws regulating construction; and in doing the Work authoriz- AUTHORIZES
THE signed by the Building Official or his/her
ed thereby, no person will be employed in violation of the Labor ONLY
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.
SIGNATURE JOWNER OR AGENT) DATE SIGNED DEPARTMENT
AL'S T
4 OFFICI 'S /bATE
CITY OF L
i
EDMONDS
N .6 DOE*
CALL FOR RE�EASE By--I/�/
ATTENTION INSPECTION Ij
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDINO OR STRUCTURE -
FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-0220 ORIGINAL — File YELLOW — Inspector
UNTIL A
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3. PINK Owner GOLD — Assessor
_j
441