546 PARADISE LN.PDF11111111111111
12713
546 PARADISE LN
The City of Edmonds Side Sewer Drawing EASEl'ylZl'%,Tr NO . ............................................
NEW CONSTRUCTION 13 REPAIRS LID NO . .................. ASIMT. NO . ..................
OWNER----- W&R—R.Ell ... T-A --- F W --------------------- ................................ CONTRACTOR ------------------------------------------------------ ----------------------------- PERMIT NO. - -----------------
JOB ADDRESS ---- 546. - - P-4R.A-D--j- S F2, -LANE ---------------------------------- LEGAL DESCRIPTION: LOT NO - ------------------------- ............ BLOCK NO . ....................................
I
4
...................................................................................................................................................... I ...........
NAMEOF ADDITION -----------------------------------------------------------------------------------------------------------------------
DYE TESTED ON SEWER
Approved:
PVNI-0001-1 1175 (REVA 1/78) DATE ............................................ 3y ...... -----------------------------------------------------
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
—L;. [a,
The Critical Areas Checklist contained on this form is to
be filled out by any person preparing a Development
Permit Application for the City of Edmonds prior to
his/her submittal of the application to the City.
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, or
may be, present on the subject property. The information
needed to complete the Checklist should be easily
available from observations of the site or data available at
City Hall (Critical areas inventories, maps, or soil
surveys).
Date Received: i — 1 Le -- 0 LA
City Receipt *:
Critical Areas File
Critical Areas Checklist Fee:
Date Mailed to ADDlicant:
A property owner, or his/her authorized representative,
must fill out the checklist, sign and date it, and submit it
to the City. The City will review the checklist, mike a
precursory site visit, and make a determination of the
subsequent steps necessary to complete a develoyment
permit application.
Please sub mit a vicinity map, along with the signed copy
of this form to assist City staff in finding and locating the
specific piece of property described on this form.. In
addition, the applicant shall include other pertinent
information (e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant. staff
in completing their prelin-Anary assessment of the site.
The undersigned applicant, and histher/its heirs, and assigns, in consideration on the processing of the application. agrees
to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including rewonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccmute. or
incomplete information fumished by the applicant� his/her/its agents or employees.
By my signature, I cer* that the information and exhibits herewith submitted are true and correct to.thebestdof my
knowledge and that I am authorized to fi s applica
tion on the behalf.of. the owner as listed. below.
DATE
SIGNATURE OF APPLICANVAGE _1��
Property Owner's Authorizadon
By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials the staff of the City of Edmonds to enter the subject property for the
purposes of inspection. d po-A.-g attendant t ation.
SIGNATURE OF OWNE DATE
owner/Applicant:
Warren LaFon
Name
546 Paradise Lane -
Street Address
F-dmonrls, WA qgn?n
city State zip
Telephone:—(-4 2 51 774-n-9sn
Email address (optional):
Critical Areas Checklist-doc/3.19.2001
Im
Applicant Representative:
T,SA Encling-(=ring, Tnr-- At-.f--n* Michael mit
Name
19400 33rd Ave, W., #200
Street Address
Lynnwood- WA 98036
city State ZIP
Telephone: (425) 775-1591
Email Address (optional):
Critical Areas Checklist CAFileNo: 04-H
Site Information (soils/ topography/ hydrology/vegetation)
1. Site Address/ Location: — 546 Paradise Lane
2. Property Tax Account Number: 2 7 o -12 5 W, 0 2 6 o n 01�0 0-0
3. Approximate Site Size (acres or square feet): 30,000 SF
4. Is Ns site currently developed? X yes; _ no.
If yes; how is site developed? 1 S F R
5. Describe the general site topography. Check all that apply.
Flat less than 5-feet elevation change over entire site.
X Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal
distance of 66-feet). Development Portion
Hilly: slopes 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).
X Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a horizontal
distanceof less than 33-feet). we s t, e r n E d g e
Other (please describe):
6. Site contains areas of year-round standing water: No Approx. Depth: N/A
7. Site conbdns areas of seasonal standing water: No N/A
Approx. Depth.
...W.hat season(s) of the ye�ar?
8. Site is in the floodi,%4y 6f a' water course.
9. Site contains a creek or an ' area where water flows across the grounds surface? Flows are year-round?
No Flows. are seasonal? N/A (What time of year? N/A
10. Site is primarily: forested — ; meadow shrubs mixed x
urban landscaped (lawnshrubs etc) X
11. Obvious wetland is present on site: No
Critical Areas Checklist.doO.19.2001
/101/1.9/1994 02:43 7740580 WARREN LA FON PAGE 02
MAY-18-1999 11:04 CITY OF ED,'13NDS 4257710221 P.01,,03
Requester's
E�zU&AJL:)S0- 1/,0,4 --,'-790Z0
Requester's Phone 'Z 74 — 0 5&CD
Arm Cb&
Request Made: in Person Q�L 1�r�ltjng TodaY3 date: ��Tll
NATURE OF RNaUEST
Please be spedfle and include all inforrnatlon pertinent to your requast, i.e. address of property, file
name or nurnber (if applicable), owner of property, ate. Thank youl
is information requested to be used for cornmercht a Yes L�6'.No
(Please e�pleto sfteebwd beelamthm to Role&" reibille Roweowvdv-)�V
Signature of Persc� Miking Re
ACTION ON REQUEST FOR PUBLIC RECORDS MUST BE TAKIN VATHIN FIVE (a) SUSIHF-S$ DAYS
(Be* R.C.W. 42-17-320)
1. Action taken:
Request Granted
Acknowledgement
(Estirra*ed rnpone* date prWded.) (S*o N& 4)
Rocord Denied I .: (See Nm 5 & 6)
Record Withheld in Part (See Nos. 6 & 6)
, Continued an mvemp side.
N I
C�
01/19/1994 02:43 7740580 WARREN LA FON
MPY-19-1999 11:05 CITY OF EDMONDS
PAGE- 01
4257710221 P.33/037
L11
RATION TO RELEASE PUBLIC RECORDS
(PRINT NAME)
Having been duly sworn, deposes and says:
r
I have requested copies of the following puKic records�
f C(
2. 1 understand that Washington State law. RCVV 42.17.260(g), prohibits the
use of lists of individuals for commercial purposes.
3. 1 understand that the use for commercial purposes of said record3 may
also violate the rights of the individuals named therein and may subject me 10 liability
for such commercial use.
4. 1 understand that section 2 and 3 herein apply when I use said records lot,
commercial purposes and when others use said records or copies for same fOl'
commercial purposes, I understand that I may be liable in either C830.
S. I understand that -commercial purposGs" means that the person
requesting the record intends that the list will be used to communicate with thc!
individuals named in the record for the purpose of facilitating prafit expecting activity.
S. T'herefore, I do hereby swear and affirm on oath and under penalty of law
that I will not use said records for commerCial purposes and that further, it is mil
affirmative duty to prevent others from using said records for commercial purposes.
7. 1 do further swear and affirm on oath and under penalty of law that I will
protect and hold harmless, including the costs of defending. the agency and its agentis
and employees from which I have obtained said records from any and all claims arising
either directly or Indirectly from the commercial use of said records
Signature
TOTAL P-03
01/19/1994 02:43 7740580 WARREN LA FON PAGE' 03
MAY-18-1999 11:04 CITY -DF EDMONC15 4257710221 02/0 -1
Requat fbr Public Records Cont. — 2
2. Request forwarded to attorney for mview: 0 Yes Dais ForwaMed:
D No
3. Notification to Requester of Action Taken: Notification Date:
HRequest granW.
Need for additional tirne. How long? (So* No. 4)
Request denied. (U* Nos. Sande)
Record withhold in part. ($" No*. 5 amd 6)
4. If additional time needed, explain why:
5. If request denied or record withheld in part, name the exemption contained In Chapter
42.17 RCW which authorizes vAthholding or denial:
6. If request denied or record withheld In part, explain how the exemption applies to this
record:
T. Request recolved by: Department:
Dated:
FEES:
0 — 5 copios: --free
Standard copy charge: pages $
Other(Roler to current records Imlex & five sclwdule):
TOTAL FEES:
RECEIPT NO: DATE:-
DOCUMKNTS PROVIDED: Dates
F-1 MAILED [] PICKED UP
Request. for: * Public. �Records
4.
PLEASE, PRINT...�i"i.."C' EARLY
Requesters Name: A�&-AJ
Requesters Address: ��3� LA'AlIS
Requesters Phone No.:- (4Z5) ---r 7(,n ra 2
Area Code
Request Made: [3 In Person N In Writing Today's date: /. 26 - c-0
NATURE OF REQUEST
Please be. specific and include all information pertinent to your request, i.e. address of property, file
name or number (if applicable), owner of property, etc. Thank you!
0-
Is information requested to be used for commefc1all purpo Yes 21 No
(Please complete attached Declaration to Release PublivVecoulp.) . . T�-4
Signature of Person
ACTION ON REQUEST FOR PUBLIC RECORDS MUST BE TAKEN WITHIN FIVE (5) BUSINESS DAYS
(See R.C.W. 42.17.320)
1. Action taken:
21 Request Granted
r] 'Acknowledgement
(Estimated response date provided.) (See No. 4)
Record Denied (See Nos. 5 & 6)
El Record Withheld in Part (See Nos. 5 & 6)
Continued on reverse side.
Request for Public Records Cont. 2
2. Request forwarded to attorney for review: El Yes Date Forwarded:
3. Notification to Requester of Action Taken: Notification Date:
171 Request granted.
Need for additidnal time. How long?
(See No. 4)
Request denied. (see Nos. 5 and 6)
Record withheld in part. (see Nos. 5 and 6)
4. . If additional time needed, explain why:,
5. If request denied or record withheld in part, name the exemption contained in Chapter
42.17 RCW which authorizes withholding or denial:
6. If request denied or. record. withheld in part, explain how the exemption applies to this
record:
A 1-1
7. Request received by: Department:
Dated: Z*7";, . 73
-FEES:
0 — 5 copies: ---- ------- - m ---- - ------- ------- free
Standard copy charge: Zi pages @ $.15,22 $
Other (Refer to current records Index & fee schedule): --------- -------- -------- -------- $ 0
TOTAL FEES: $ 10q.
RECEIPT NO: A41 D(% DATE: "(11(00
. % I
DOCUMENTS PROVIDED: Date:- /14cro—
V -
MAILED apickED UP
1.
DECLARATION TO RELEASE PUBLIC RECORDS
1%J
(PRINT NAME)
Having been duly sworn, deposes and says: _
1 . I have requested copies of the following public records:
I understand that Washington State law RCW 42.17.260(9), prohibits the
use of lists of individuals for commercial purposes.
3. 1 understand. that the use for commercial purposes of said records may
also violate the rights of the individuals named therein and may subject me to liability
for such commercial use.
4. 1 understand that sec tion 2 and 3 herein applyw'hen I use said records for
commercial purposes and when others use said records or copi . es for same for
commercial purposes. I understand that I may be I iable in either case.
5. understand that "commercial pu I rposes" means that the person
requesting the record intends that the list will be used to communicate with the
individuals named in the record for the. purpose of facilitating profit expecting activity.
6. Therefore, I do hereby swear and affirm on oath and under penalty of law
that I will not use said records for commercial purposes and that further, it is my
affirmative duty to prevent others from using said records for commercial purposes.,
7. 1 do further swear and affirm on oath and under penalty of law that I w�ll
protect and hold harmless, including the costs of defending, the agency and its agents
and employees from which I have obtained said records from any and all claims arising
either directly or indirectly from the commercial use of said -records.
Signatur'e
iR� "W
vc�e,� Pejbll�, &3c�660),ot, l4doo btr-6v
WY
F7057F
jL7
1 Z�f
�� -1
6yk�- [diet 0
o/ Pn7
nt, rx ec, 4 CA t(li3ffa
<
6m (dav, ltkli4
1'7 4q -7
rl---7) P(q 6,zs�l Wfte q -Z Ng
I
4 11, Lee- o;�; go
L _L
-r,
5
Ll
eevi&-i
tedio-
44 R ,
J(
wev-
letc-� '/� f
6;?SeW4,i Af q
I "
Requpst-fo,:,r.::-.Pu,b.lic...Records
i*t ** . .. .. . ..
PLEAVE,.P� ARLY
DEC
Requester's Name: xlAgIZEN
DEVELCU111; Of EDMONDS
Requester's Address:
Requester's Phone No.: (40;5) —1-74 — Cx5i,�Q
. Area CcKle
Request Made: In Person El In Writing. Today's date:
NATURE OF REQUEST
Please be specific and include all information pertinent to your request, i.e. address of property, file
name or number (if applicable), owner of property, etc. Thank you!
6171y or &VAXONr5 , L—,�77251e--
I
P1+-nF.r>
Is information requested to be used for co merciall Yes [M,,No
(Please complete attached Declaration to Relea �C, t-t�- S.!S
0 j I c ^,ssrtis-)
ignature of Pers§n Making Rouest
ACTION ON REQUEST FOR PUBLIC RECORDS MUST BE TAKEN WITHIN FIVE (5) BUSINESS DAYS
(See R.C.W. 42.17.320)
A"critaken:
X Request Granted .
Lj Acknowledgement
(Estmated response date provided.) (See No. 4)
F1 Record Denied (See Nos. 5 & 6)
E] Record Withheld in Part (See Nos. 5 & 6)
Continued on reverse side.
Request for Public Records Cont. 2
2.
3.
4.
5.
6.
Request forwarded to attorney for review:
Notification to Requester of Action Taken:
Yes Date Forwarded:
No
Notification Date:
[] Request granted.
F-1 Need for additional time. How long? (See No. 4-)
Lj Request denied. (See Nos. 5 and 6)
R Record withheld in part. (See Nos. 5 and 6)
If additional time needed, explain why:
If request denied or record withheld in part, name the exemption contained in Chapter
42.17 RCW which authorizes withholding or denial:
If request denied or record withheld in part, explain how the exemption applies to this
record:
7. Request receive Departme nt: UD( k)&
b
Dated: '7 ()n
FEES:
0 — 5 copies: ---- ------- ------- ------- ------- -------- free
Standard copy charge: pages @ $.is $
Other (Refer to current records Index & fee schedule): --------- -------- -------- -------- $
TOTALFEES: $
RECEIPT NO: DATE:
DOCUMENTS PROVIDED: Date: t-;?- �-7 �00_
MAILED PICKED UP
XX .
6 4
DECLARATION TO RELEASE PUBLIC RECORDS
(PRINT NAME)
Having been duly sworn, deposes and says: _
I.have requested copies I of the following public records:
2. 1 understand that Washington State law, RCW 42.17-260(9), prohibits the
use of lists of individuals for commercial purposes.
1 understand that the use for commercial purposes of said records may
also violate the rights of the individual . s na med therein and may subject me to liability
for such commercial use.
4. 1 understand that section 2 and 3 herein apply when I use said records for
commercial purposes and when others use said records or copies for same for
commercial purposes. I understand that I may be liable in either case.
5. understand that "Commercial purposes". means that the person
request ing the record intends that the list will be used to communicate with tho
individuals named in the record for the purpose of facilitating profit expecting activ . ity.
6. Therefore, I do hereby swear and affirm on oath and under penalty of law
that I will not use said records for commercial purposes and that further, it 'is My
affirmative duty to prevent others from using said records for commercial purposes.
7. 1 do further swear and affirm on oath and under penalty of law that I will
protect and hold harmless, including the costs of defending, the agency and its agents
and employees from which I have obtained said records from any and all claims arising
either directly or indirectly from the commercial use of said records.
Signature
Requesters Name:
Requip#-..' lic-Records
PLEASE PRtN.T-vX*tEARLY
KIV C lc—;>^ S-1
Requesters Address: a s-
Requesters Phone No.:
Area Co&
Request Made: 91-n-P-e—rso'n E] In Writing Today's . date:-, Is
RECEIVED
NATURE OF REQUEST
Please be specific and include all information pertinent to your request, i.e. address of property, file
,.name or number (if applicable), owner of property, etc. Thank you!
r�t C--k� N
Is information requested to be used fo!_p,6mmerAfa1 p
(Please complete attached Declaration tqA0eaSzi;A"jc R046or0*.)---
Making Request
Ek No
ACTION ON REQUEST FOR PUBLIC RECORDS MUST BE TAKEN WITHIN FIVE (5) BUSINESS DAYS
(See R.C.W. 42.17.320)
1. Action taken:
Request Granted
E] Acknowledgement
(EsUrnated response date provided.) (See No. 4)
,E] Record Denied (See Nos. 5 & 6)
El Record Withheld in Part (See Nos. 5 & 6)
Continued on reverse side.
Request for Public Records Cont.
2
2. Request forwarded to attorney for review: 0 Yes Date Forwarded:
0 No
Notificationjo Requester of Action Taken: Notification Date:
g,
*[D�'Req 6ranted.
additional time. How long? (See No. 4)
Request denied. (see Nos. 5 and 6)
1i'EhRbb6`r& held , in part. (See Nos. 5 and 6)
4. If additional time needed, explain why:
5. If request denied or record withheld in part, name the exemption contained in Cha . pter
42.17 RCW which authorizes.withholding or denial:
.6., If request denied or record withheld in part, explain how the exemption applies to this
record:
7., ..Request received by: Department:
Dated:
FEES:
5 copies! ---- ------- --- ----- — ------- ------- free
Standard copycharge: pages @ $.15
Other(.Refer to current records index & fee schedule): --------- ----------------- --
JOTAL FEE&
RECEIPT NO: DATE:
DOCUMENTS PROVIDED: Date:
- M MAILED
[—] PICKED UP
DECLARATION, TO RELEASE PUB . LIC RECORDS
(PRINT NAME)
Having been duly.sworn, deposes and says:
have requested 'copies of the following public records:
2. 1 understand that Washington State law, RCW 42.17.260(9), prohibits the
use of lists of individuals for commercial purposes.
1 understand that the use for commercial purposes of said r ecords may
also violate the rights of the individuals named therein and may subject me to liability
for such commercial use.
4. 1 understand that section 2 and 3 herein apply when I use said records for
commercial purposes and when others. use said records or copies- for same for
commercial purposes.. I understand that I may be liable in either case.
5. 1 understand that. "commercial p*urposes" means that the person
requesting the record intends that the list will be used to communicate with the
individuals named in the record for the purpose of facilitating profit expecting activity.
6. Therefore,'I. do hereby swear and affirm on oath and under penalty of law
that I will not use said records for commercial purposes and that further, it is m . y
affirmative duty to prevent others from using said records for commercial purposes.
1 do further swear and affirm on oath and under penalty of law that I will
protect and hold harmless, including -the costs of defending, the agency and its agents
and employees from which I have obtained said records from any and all claims arising
either directly or indirectly from the commercial use of said records.
Signature
15598
CITY OF EDMONDS
MENT SERVICES
DEVELOP
DATE:
Received of:
Address'.
Project Location'.
Check No.
Size:
Water Meter
Water Connection Fee
Street Cut/ReStoration Fee (620 Fund)
JRepair
jewer Perff,,,,,e ir
Trunk Charge
Sewer Connection/LID Fe . eL -------
R1W ' onstu -tion Permit Fee
Street Disru -1 n Fee (i 11 Fund)
;=nc�ineefjng inspection Fee
Engi ieen Ilans Fee
Engin ering ;pecs , F
Storm Drainage Fee
Street Use Permit
Building Perm,t,-ee - , ype
Plan Check Fee 4
State Surcharge (622 Fund)
Zoning Application Fee - Type,._.
Landscape Inspection Fee
Shorelin�. Permit Fee
o�o,nrffina Fee -------
on Feve
-Traffic Mlit�igati
Sidewalk Co itributio"
Total R!� ��ived
Permit No
Received b
CITY OF EDmoNbs
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
0 1 0' 0
01
CITY TELEPHONENUMBER
qAME
U) t�dzeffg W-0
ADDRESS a_ If
ZIP TELEPHONE NUMBER
I -1-74-64,_661
USE
ZONE PERMIT
Py NUMBER
SUITE/APT #
ADDRESS
.EGAL DESCRIPTION CHECKI SUBDIVISION NO. LID NO
I'L 0/0, '1 A
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved -/es Ea-
RW Permit Required yfJ3 9�
EXISTING 10 REQUIRED DEDICATION Street Use Permit Req*d 0
10 Inspection Required YZ 9-
Sidewalk RequiredE'�P(6. 13 cr
- W
METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
YES
NOD
REMARKSVC, UjI1awC4.iee:8p,b- Id5F)6CT?01J3 12-eG2 . -0
cc
@eP.051t,tj c�,rJJUL. 9:9) DRAIIJA&C
PfAAV_/,4J4 ST72,1PI-IJ6 (0 P I IV Z
w
NAME
ADDRESS
ENGINEERI G MEMO DATED REVIEWED BY
CITY zip
TELEPHONE NUMBER
IR MEMO DATE9 ED By
1,b
STATE LICENSE NUMBER EXPIRATION DATE
VARIANdt OR cu
ADB#
SHORELINE #
Legal Description of Property - include all easements
EVIEW-'q%k, SIGN AREA
c �TE EXEMP ALLOWED I PROPOSED
E
HEIGHT
ALLOWED 1PROPOSED
0 rT -
15-/U
TAOT COVERAGE
ALL NED
3
X.
REQUIRED SE BACKS (Fr.)
IPROPOS FRONT SIDE REAR
I 0 C)
PROPOSED SETBACKS (FT.)
FRONT UR SIDE REAR
N4
Property
Tax Aci unt 4006
'o --<Z
Parcel W. 6-1
A95A*-
L1
10 000
PLANNING RE =IEW BY
:�_
�22Y�
JC V.751 I 15—AT E
I C)..", I /,
NEW El RESIDENTIAL El PLUM CH
REMAMKS
405 0-e1.t,hr3,1d IAI.4.( 6q,
P
PLI OR
ADDITION OM MERCIAL I G E
REMODEL J(APT IGN
REPAIR GRA G FENCE
AV (_X
a
HECRWB§
E OF C TRUCTION
CODE
OC UPAN
GR UP
OSTOV IM POOL
DEMOLISH IN FIT T TUB/SPA
GARAGE R NEN 11 WAL r
CA?&efg- ROC R
C
(TY U S I N( S( O� A eCj Y) EXPLAIN:
us
L
E M V— X
Prr.-- PECTOR
EQUIRED
XYES
Ir 04 -
. . q
OOCUPA14T
LOAD
i
MARKS
PROGRESS INSPECTIONS PER UBC 108
14,elU41f / h V 46d IS414e.44 A� *A 6'9 b
1
u NUMBER
5 OF
STORIES fV
NUMBER OF
DWELLING
UNITS
C I 4/
ZT
AR IS
N I
IrEl
-71 10a4fiM Pr -;A'
1V;VjIV_Xr AJL 117 LQSS—�-' V4 t*
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
I I
FINAL INSPECTION REOUIRED
0 Y9 L17CZ
itt IX it7- P 0_-58
VALUATION
PLAN CHECK FEE
BUILDING
HEAT SOURCE,
GLAZING
T %
PLUMBING
Plan Check No.
MECHANICAL
GRADING/FILL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewolks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
J
Permit Limit: I Year - Provided Work Is Started Within 180 Days
ENG. INSPECTION FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
2" harmless . the City of Edmonds, Washington, its officials,
2 employees, and agents from any and all claims for damages of
cc
whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirement of any city ordinance
0
:r nor limit in any way the City's ability to enforce any ordinance
provision."
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
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
I
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
I a plication is not a permit until
state laws regulating construction; and in doing the work authoriz-
AUTHORIZES
s=gned y the Building Official or his/her
Ed thereby, no person will be employed in violation of the Labor
ONLY THE
WORK NOTED
Deputy; and flies are paid, and receipt is
Code of the State of Washington relating to Workmen's Compensa-
acknowledged in space provided.
tion Insura ar.&"a RCW 18.27.
INSPECTION
S IGNATU (OWNE R A GEN;r) DATE-SI NED
DEPARTMENT
OFFICIAL'S SIGNATURE DATE
CITY OF
EDMONDS
CALL FOR
RELEASED By DATE
ATTENTION
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OF;
771-0220
ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
SECTION 109
PINK — Owner GOLD — Assessor
a
Z
to
102-87
CITY OF EDMONDS
USE
ZONE PERMIT
CONSTRUCTION PERMIT APPLICATION
— NUMBER
JOB SUITE/APT W
ADDRESS c5t&r—,
W
Z
0
OWNER NAME/NAME OF BUSINESS
IRIELUZI,j E�aMu \�j LLQ
LEGAL DIESCRIPTIO C E K
..dL
SUBDIVISION NO.
LID NO,
MAILING ADDRESS I
-PO &�nx (0 co T
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING — REOUIRED DEDICATION
PROPOSED
TESCP Approved 0
RW Permit Required 0
Street use Permit Req-d 13
Inspection Required 0
Sidewalk Required 13
cc
C1
[�TY ZIP
Z 4?�
IT Pr NUMBER
V,EJ3! _F
NAME
LW)
METER SIZT
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
YES NO
W
ADDRESS
L)
X
REMARKS
Z
W
W
CITY
TELEPHONE NUMBER
9
0
NAME
JLL_ P7Lr,1,(t2kj rowsaduvlz
S
cc
0
cc
Z
0 U,
ENGINEERING MEMO DATED REVIEWED BY
tITY ZIP
ELEPHONE NUMBO
FIRE MEMO DATED REVIEWED BY
I
U,
U.
STATE LICENSE NUMBER EXPIRATION DATE
VARIANCE OR CU
ADB#
SHORELINE #
Legal Description of Property - include all easements
SEPA REVIEW
COMPLETE EXEMPT
SIGN AREA
ALLOWED PROPOSED
HEIGHT
ALLOWED
Z
G 151T6 PL-ak)
CL
cr,
njProperty
V�a_k� o'A 6+ a A-11 'LOA 11
EXP
I
1PROPOSED
LOT COVERAGE
ALLOWED � PROPOSED
REQUIRED SETBACKS (Fr.)
FRONT SIDE REAR
PROPOSED SETBACKS (FT.)
FRONT UR SIDE REAR
Z
Z
&A_ io NO—+ ci� �awjl&s
Tax Acco'rt 43 k/ V - 6 C& - Qr_6 -QM
Parcel No.
LOT AREA
PLANNING REVIEW BY
DATE
(L
NEW RESIDENTIAL PLUMBINGIMECH
REMARKS
COMPIUANCE OR
E]
ADDITION COMMERCIAL CHANG.E OF USE
I
REMODEL APT. BLDG. SIGN
CHECKED BY
TYPE OF CONSTRUCTION
I
CODE
I
OCCUPANT
GROUP
11771 GRADING FENCE
REPAIR CYDS. x —FT)
X_
DEMOLISH WOODSTOVE SWIM POOL
INSERT 17 HOT TUB/SPA
GARAGE RETAINING WALL/
SPECIAL INSPECTOR
REQUIRED
13 YES
AREA
OCCUPANT
LOAD
GhAPGAZ ROCKERY RENEWAL
AEMARKS
Y
rL
PROGRESS INSPECTIONS PER UBC 108
Z
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
W
N\
NUMBER _TNUMBER OF CRITICALVJ�L_LU IL
0
G
c 0
OF DWELLING AREAS
UNITS NUMBERCJ'�,' 3
S T 0 R I E 9211 1 1
DESCRIBE WORK TO BE DONE (ATTA0 EPOT LAN)
FINAL INSPECTION REQUIRED
Niyr)A 4
VALUATION
FEE
PLAN CHECK FEE
BUILDING
HEAT SOURCE:
GLAZING
PLUMBING
ck No. 4r6, zsi)
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curts, sidewelks,
STATE SURCHARGE
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: I 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
,n
successors in interest, agrees to indemnify, defend and hold
26
harmless the City of Edmonds, Washington, its officials,
1
employees, and agents from any and all claims for damages of
PLAN CHECK DEPOSIT
<
9
0
Y
whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirement of any city ordinance
nor I.imit in any way the City's ability to enforce any ordinance
provision."
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the
information given is correct; and that I am the owner, or the duly ATTENTION APPLICATION 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 Labor ONLY THE signed by the Building Official or his/her
Code of the_$1.a4eof Washington relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is
tion Insura6ce ari4 RCW 1817. INSPECTION acknowledged in space provided.
SIGNATU% ( Nzfl;'�AGENTI DATE SIGNED DEPARTMENT
OFFICIAL S SIGNATURE DATE
I %
Y_ CITY OF
L L!
P� EDMONDS
CALL FOR RELEASED BY: DATE
ATTE TION V INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC 771-0220 Ll
SECTION 109 PINK — Owner GOLD — Assessor
10247