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631 ELM PL.PDF1111111111 lill 11160 631 ELM PL ADDRESS: (.a�t e�,vn Place� TAX ACCOUNTIPARCEL #:00-7 BUILDING PERMIT (NEW STRUCTURE) #: COVENANTS (RECORDED) FOR: CRITICAL AREAS #: DETERMINATION: El Conditional Waiver E] Study Required 0 Waiver CRITICAL AREAS #: DETERMINATION: Conditional Waiver Study Required El 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: SEWER LID FEE $: LID #: SHORT PLAT FILE: LOT: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: GEOTECH REPORT DATED: STREET USE/ENCROACHMENT PERMIT FOR: WATER METER TAP CARD DATED: OTHER: L:\TEMP\DST'skForms\Jana's Street File Checklist 5-14-08.doc Pz 4QA o Aw - L QAIO ",E s E L PL R PO R- 0 r Al W !14 S W 2 S, T. 2 7A.I. Wq CIT:Y of EDMADS S *E' SEWER PERMIT For Inspection Call 771-3202 STREET ME, PERM EVIA EDMONDS W Ay T 'T L RUNK LINE, Address of Construction: Property Legal Description (Include all easements): Owner and/or Builder: 40M 0- AA)b 17'OrY7eS 1111C, Contractor & License No: 40-mc— Single Family Residence Ll� Multi -Family (No. of Units Commercial (No. of fixture Units Invasion into City Right -of -Way: No (If Yei :�' Yes s, Right -of -Way Construction Permit re'quired. Call One -Call -Center (1-800-424-55.55) before any excavation.) Cross other Private Property: No Yes (If Yes, easement required, attach legal description and county easement number.) PLEASE READ THE ITEMS LISTED ON THE BACK I certify that I have read ary&shall comply with the items listed on the back. Permit Fee: 0 0 Issued By: Trunk Charge: Date Issued: 0/ 0 / Assessment Fee: Receipt No.: 5_6 9�3 C;, / , 0 -/,/ Date Partial Inspection: 'Comments Date Initial - Final Inspection Approved: Date -Initial co Rejected: C) Reason t _e _Tn i —ti a I PERMIT MUST BE POSTED ON JOB SITE Wh-ite Copy File Green Copy - Inspector Buff Copy Appl i cant The City of Edmonds Side Sewer Drawing EASEMENT NO . ........................................ -- NEW CONSTRUCTION REPAIRS E], LID NO . ............... . AS,MT. NO - ------- --- OWNER .14MMF-LA-,Nl-D ----- 4CkM-F--'3 We . ......................... CONTRACTOR . .......................... PERMIT NO. JOB ADDRESS --- (031 ------- ..... RLANCAE ------------------- LEGAL DESCRIPTION: LOT NO. -2.3 ---------------------------- BLOCK NO. ------------------------------------------------------------------------------------------------------------------------------------------------------------------ 1,DP C0.5,6P NAME OF ADDITION ------- ---------------------------------------- Approved: PWW-0001-11/75 (REV.11178) DATE - 7.08.6 Byl,�.",, --, .. ............................... 0 0 STREET CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATI04 USE '77�ZERMIT ZPNE- —.-- 7 ff NUMBER JLS-C, PR JOB ,-- ADDRESS , � 1 Elm Place NAME (OR NAME OF BUSINESS) Homeland Homes Inc. CEGA_�_DESCRIPTION CHECKI i,91- SUBDIVISION No. LID NO. 1 -2 UJ Z 3: 0 MAILING ADDRESS 221 James St. PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. CITY TELEPHONE NUMBER Edmonds 775-2033 EXISTING D-Ig��REC)L_URED DEDICATION PROPOSE NAME Design Consultants RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED 0 STREET USE PERMIT REQUIRED 0 LU ADDRESS F-- 903 10th SEE ENGINEERING MEMO DATED CITY TELEPHONE NUMBER Mukiltio 745-6569 REMARKS NAME Homeland Homes INC. cc ADDRESS 0 221 James St. METER SIZE BUILDING SUPPLY SIZE FIXTURE UNITS Z 0 CITY Edmonds TELEPHONE NUMBER 775-2033 REMARKS 0 STATE LICENSE NUMBER HO-ME-LHI174*KE SIGN AREA ENV. REVIEW ADB NO. ALLOWED PROPOSED COMPLETE EXEMPT Z 0 Legal Description of Property - Include all easements (show below or attach four copies) SHORELINE VARIANCE OR CU PLANNING REV15W BY DAT� Lot #23, Plat of Elm Place WNEW D RESIDENTIAL El PLUMBING ADDIALTER COMMERCIAL 1:1 MECHANICAL REPAIR RETAINING WALL E] SIGN EXCAVATE DEMOLISH OR FILL PRE -MOVE INSPJ REMODEL COMPLIANCE INSP. FENCE El x —FT) swim POOL WOOD STOVEI INSERT APT. BLDG RENEWAL NUM ER OF STORIES B [NUMBER OF two DWELLING one UNITS NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN) construct single family home YARDS HEIGH� LOT COVEWGV FRONT SIDE REAR — CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT 0 0 Z cc LU W Z a Z W cc Uj 3: I I M92- -.-Y-/V SPECIAL INSPECTOR REQUIRED 0 YES 0 NO AREA OCCUPANCY GROUP R,,3 OCCUPANT LOAD REMARKS n�4mw- -T/VS111- Z Ptw&m5s f1*141 PZWAfA1e-Y-,0V$P4!fT1A1V VALUATION FEE PLAN CHECK FEE BUILDING PLUMBING MECHANICAL This Permit covers work to be done on private property ONLY. GRADING/FILL Any construction on the public domain (curbs, sidewalks, STATE SURCHARGE driveways, marquees, etc.) will require separate permission. Permit Application: 180 Days Permit Limit: 1 Year - Provided Work Is Started Within 180 Days ENERGY CODE "Applicant, on behalf of his or her spouse, heirs, assigns and successors In interest, agrees to indemnify, defend and hold 'Uni harmless the City of Edmonds, Washington, Its officials, 2 employees, and agents from any and all claims for damages of < whatever nature, arising directly or Indirectly from the issuance of this permit. Issuance of. this permit shall not be deemed to PLAN CHECK DEPOSIT modify,.walve or reduce any requirement of any city ordinance TOTAL AMOUNT DUE 0 nor limit In any way the City's ability to enforce any ordinance provision." 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 authorized agent of the owner. I agree to comply with city and state laws regulating construction; and In doing the work authoriz-* THIS PERMIT AUTHORIZES ed thereby no person wl 49 employed In violation of the Labor ONLY THE Codepf th; Sre of We n on relating to Workmen's Compensa- WORK NOTED ,F) INSPECTION SIGNATVAE (op DATE SIGNED ;r/ DEPARTMENT 3/26/86 F�w CITY OF lIii" EDMONDS &.TTENTION- 771-3202 T IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE JNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR � CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC 'HAPTER 3. 02-78 EM APPLICATION APPROVAL This application Is not a permit until signed by the Building Official or his Deputy; and fees are paid, and receipt is acknowledged in space provided. OFFICIAL'S SIGNATURE DATE RELEASED BY: DATE ORIGINAL - File YELLOW - Inspector PINK - Owner GOLD - Assessor Re ewed --(initial/&te) by: PLANNING `TR/SWR W STREET ENGNRNG SnX= FAMILY/M.MTIPLE/CU4U=TAL (Circle One) BUILDING 1111117TI'17717711 11111711 SETBACKS CHECIM 11,111rIll 11111117TIM17717 MMITIONAL USE'.'P ERXIT �4 aV, r Tl/-/7-/777-/ 77 T- ADB MQUIPMENTS onfER 77TM /11/f/ 7////[/[77777T//77 ENVIRONMEWAL FEATURES 77� 77 1711111 117117777 777777777 ACCESS SLOPE & VEHICLE ACCESS ///////// 111111111,111W11 DRAINAGE PLAN (On Site) 777777 7-771111 7 STREET FILE 8 LEGAL DESCRIPTIM VMFICATION 777777 11111711 9 QUIT CLAIM/DMICATIONS 117111117 //////// 10 ////////7 7777TI77T 7T77777T FASEKWP - PUBLIC/PRIVATE IITIT17T[ CAILWTE S0*M COMMON IF NO LID# 12 111117117 77T777-77 PLAT/SURDrVISION_ REnuiRFMEtM 13 77 777777777 7TI77TI77 RTGJfP--OF-WAY CONS"UCTION PERMTT Mon 14 /T/rM7 11111171f P,ciqD Rpon Fon puyug impRowmm—,)�Io ////// ///////// SOILS 0CMITTalf9 & GROUND 111117 777777177 111771177TTITIT17' WATER HEM OfECKED 16 77187 111111177 7M77TI7 STREET PAVING . RMITREn 111/11 ///////// 17 11117-1T1T1=-1T17F1T77' CURB AND GUTTER REMIRED ////// ///////// ///////// 18 TIT177 SIDEWMLK REQUIRED 19 111117111711777 771111 -URB CUP FOR DRIVEWAY REM ///////// ///////// 20 111171111 7771-TI777 7TT177TI77 WREET NAME SIGN REQD 21 111771 1777-11-Iff 77T/77/W7 - MER SIGNING REQQ ////// ///////// 22 777771171177111 31DE SEWER AMIABILITY ////,// ///////// 23 17TI77 11171117 11117 oasTniq wrER mhm Sim ///////// //////// 24 77TI71-1-P 1111717711 - ATM MY-FER SIZE ///////// 34/" //////// 25 ;ERVICE LINE SIZE 777117177 ///////// 7777177 //////// 7117771111 - 26 1111-11117- 7//////// 1111111T 1777111117 - (IMMINT REQUIRED ///////// ///////// //////// 27 YDRANT SIZE EXISTING TTIT 7117"1-11 it 7TRI71 -ITITRTITI 28 1171111111 - T,10SS CONNECTION' INSPECTION REM 29 11117777T 7777/777 1111111-IW - ATER METER CHARGE REM //////// 30 77777771 7711171177 - FIRE LINE CHARGE REQD - SPRINJUM 31 TREET CUT 32 711711W 111117TI7 PEN DITCH EXISTING 33 711777711111111 111111T17 REOD ////// ///////// ///////// 34 /7/7117/77777-7 7777-77777 ULVERr REQD 35 SIZE 1111111117MITR7 36 771111 ATCH BASIN REQ0 171777777 77/777777- 37 77777 771717 -717- 7777TI771- INDICATM CN SITE PLAN: 38 HOULDER bRhtWW— MAIWAM -ITM //7//77/77T/7/-T7T- SHALE OPM RUNOFF 39 ISC 40