642 ELM ST.PDF642 ELM ST
APPROVED BY PLANNING
qz-
Adoa
JUN 15 1995
PERIWITCOUNTER
ELM STREET
EXISTWO
CLL-OE-SAC
SITE PLAN
Le
A
S. (.0 Avow. 40-- f 9g.b-5"
gq.,v Ar-'W" f4r -- 11 Moobl'
+49.ir Ao-w— #+r i zq.03,
rr
Date: Octob*r_lp 1968
to: John E. Noran
Director of Public Works
From: Leif R. Larson
City Engineer
Subject: Sewer Connection Charges
Legal Description: That portion of Sec. 259 T27l R.3E W.M. described as
follows: Beg. at t�a NE cor. of E 1/20 NE 1/4, NW 1/4, SW 1/4; thencis S 1009030"W
20 ft.; thence N 88 10030" W 30 ft, to POB, thence con. N 8801813011W 150.78 ft.;
thence S 101105011 W 97 ft.; thence E 150.78 ft. less the East 75.39 ft. of said
described property.
Commonly Known as: 642 Elm Street Owner: E.G.M. Erikeson
Z.F.F. Calculation:
(66.35 ) Z.F.F. x ( $5.50 $ 364.93 Connection Fee
� .1 ) Unit x ( $25.00 )
le
$ 25.00 Trunk Charge
$ 10.00 Permit
$ 399.93 TOTAL
City Engineer
The City of Edmonds
�11F
WIN 01,
ujv,/,
.j
40000
U.
Lu
ul
cl)
APPLICATION
for
SIDE SEWER FERAM
BASEMENT No.
NEW CONSTRUCTION 0 REPAIRS Cl
CONTRACTOR'Z4/
LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . .....
NAME OF ADDITION
......... a -------------- .......................
.4
00
Approved:
DATE ... ........ By ..............
P
Date: October 1, 1968
t'lemo to: John 1, Mloran
Director of Public Works
From: Leif R. Larson
City Engineer
Subject: Sewer Connection Charges
Legal Description: That portion of See. 25, T27, R3E W.M. described as
follows: Beg. at t 8 e NE cor. of E 1/2, NE 1/4, NW 1/4, SW 1/4; thence S 100913011W
20 ft.; thence N 88 1023011 W 30 ft. to POB, thence con. N 8801813011W 150.78 ft.;
thence S 101115011 W 97 ft.; thence E 150.78 ft. less the East 75.39 ft. of said
described property.
Commonly Known as: 642 Elm Street Owner: E.G.M. Eriksson
Z.F.F. Calculation:
(66.35 ) Z.F.F. x ( $5.50 $ 364.93 Connection Fee
( 1 ) Unit x
lc
to
$25.00 $ 25.00 Trunk Charge
10.00 Permit
399.937 TOTAL
City Engineer
IC
C ''OF EDMONDS
ITY.
Can- PRospect 6-1107 when work
.CIVlC--_CENTER,-WATER-SEWER DEPARTMENT
Is ready for Inspection. (No Inspe!,
lions Saturday, Sunday or holidays.) 3133
N2
SIDE. SEWER'PERMIT
ADDRESS....... �Y�J�1.m ... S.t.r.e.e.t ............................................................................................. . ............................................................
P ............ B...q.M.4 ... Erdk;a8.Qn .......................................... CONTRACTOR ........ VQ.Q.19Y'j��..Rip
ft.j� ... �.Qvpr ................
Perixils'sioft- Is granted .......... O.c.t.o.b-er ........ 10..., 19.68.., for ........................ days. to REPArR or CONNECT a side sewer
-.'*Ith, City..Sewers In accordance with application on file and -governing ordinances.
ATTENTION ISCALLED TO THE FOLLOWING:
]�OTE, No.. 1—The, owners of the property*may obtain a permit to construct sewer inside property line A licensed Side Sewer Contra r must
:, � , - eto
be employed to construct side.sewer in street area. Do not cover any Portion of -sewer bef*ore it has been Inspected.
.—NOTE No. 2—Obtaln' full. Information regaxding Ordinance 11.16.030 and Re'gulations governing side sewers when you get permit.
0TE No. 3�Top of side'smer must have at least 30 Inches coverage at property line and 12 Inches de Property line; minimum grade of 2%.
No.bends in grade sharper than % will be permitted Insf
NOTE No. 4�Treroches in Street must be water settled and surface of street restored to orl I ginal condition. Contractors shall be responsible for
failure du6.to Improper work :which may develop within one year of completion.
NOTE No. 6�lt 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 appur-
tenances except to Insert the pipe Into the wye.
0
STREET FILE Date: October 1. 1968
Heino to: John r— �L'Iloran
Director of Public Works
From: Leif R. Larson
City Engineer
Subject: Sewer Connection Charges
Legal Description: That portion of Sec. 25, T270 ME W.M. described as
follows; Beg. at the NE cor. of E 1/29 NE 1/4, NW 1/4, SW 1/4; thence S 100913011W
20 ft.; thence N 88'1013011 W 30 ft. to POB, thence con. N 8801813011W 150.78 ft.;
thence S 101115011 W 97 ft,; thence E-150.78 ft. less the East 75.39 ft. of said
described property.
Commonly Known as: 642 Elm Street Owner: E*G.M. Eriksaon
Z.F.F. Calculation:
(66.35 ) Z.F.F. x ( $5.50 $ 364.93 Connection Fee
Unit x $25.00 $ 25e00 Trunk Charge
10-00 Permit
$ 399-93 TOTAL
le City Engineer
e7
ZI-
-Ile
It
It
P:7PT. C.U7, LIST
L
trce t Pir Existin
MOD
Access Eascinmits Exi-�tinp
9
r5r-
Utility Eascinont Existing
RED!)
Lot Por Su�)div4sjon5— Assessor
Plat
Sitc Plan nic-c!:ed for Accuracy
u),
Uncicraround !1cod.
RON, tu., . Uv
!)atc
t;?A
L'atcr :"ain .—ircd
Hv(11-an"
.)I Z('
nctectnr ("Ice: '"C', tor P.Ccl"i"Cr!
r-jr,c ........... ..
C 'I"aill:
S,,�ptj.c Iny"it Pcouil-od
o
sidc Sm dlabi
-er Corn -Co 1,10(mirc(I
cction
Culvort Pool
0
Catch DIF�in Oufmi rod
-Ch P 1-0
v,
11,11,11,11c, required
41 ition
soil Co d1l"Op
---- lbtc
cnni
11ro.i
File '.'o.
S S
ize
n n It -i a c
111dica
;1-01111(1 1-�'ater Hold (1oc,x(I
--Rite
rn
M-
-n
m
mw
S trce I.1ving, 1"Cquircd
ftirb wid (',,i-Ltcr i i i. rc
Sida'alk Pcouired
Cur`b nut for Privc,_,av Rcquired
rcd
Pinlit-ol-Wav Construct i Oil I 11't Reold
Bond Rcquirc(l_'Si�- �11)iic Improw-,ents
T. 1 (2 Sion Rcmlircd
O'licr Si-1 iri, R nui 3 c!
'C
C,
I)rc --it Sitc Inspcction nocic oil
itc
;2i
SCwC.
U
It
Water
St-rcet
spocj�!!. PC";I;iroi-,cnts listed in me-.') to
T)ate
4 1
A-11 itc;�ls filled in oil JIC',-,,yjjt
�pnlj.CItion
P"Itc
22-1
C;
mndi ".btations
By
nat(�
r_
r_
PCIMIT)IRCIA
STREET FILE
CITY OF EDMONDS HARVE H. HARRISON
MAYOR
200 DAYTON ST. o EDMONDS, WASHINGTON 98020 * (206) 771-3202
OFFICE OF THE CITY ENGINEER
March 10, 1982
Mr. Wayne Tanaka
Ogden, Ogden & Murphy
2300 Westin Building
2001 - 6th Ave.
Seattle, Wa. 98121
Dear Wayne:
SUBJECT: PROPERTY LINE DISPUTE
638 ELM STREET
The attached letter was received last June, and it
appears that we never answered it.
Please advise.
Sincerely,
*A-'--�� , P. E�.�
i S E. AD P. E.
y V
Engineer
JEA/st
Attachment
4okd�aMaochA Dt
W
0
Ms. Mary Lou Block
Director of Planning
City of Edmonds
505 Bell Street
Edmonds, WA 98020
Dear Ms. Block:
0
638 Elm Street
Edmonds, WA 98020
May 21, 1981
L D
JUN 8 1981
Dir. Of PuWic Works
This letter regards the placement of a rockery/fence at the
east side of my property.
The properties involved are: My own, at 638 Elm Street ("638");
and that of my neighbor immediately to the east of me, at 642
Elm Street ("64211).
It is clearly visible that the rockery, which begins near the
street, veers to the west (into my yard) as it progresses
south. At a point at right angle to the front of the neigh-
bor's garage, the rockery joins the fence (cyclone). The rock-
ery and fence were place there in early 1979 by the previous
owner of 642, Mr. Blowers. Mr. Blowers and I discussed the
fact that the rockery/fence did not follow a true course south,
so he was aware of my disagreement with it as the property line.
I have today spoken with the present owner of 642, ('Vic')
stating my disagreement with the rockery/fence as the property
line, and told him of writing a letter to that effect to the
City of Edmonds.
Until such time that I, or the owner of 642 (which is again for
sale) choose to have an accurate survey made, I do not wish the
rockery/fence to be removed, nor to change the manner in which
our adjacent yards are being used; only to place on file with
you a formal record that I do not recognize the rockery/fence
between 638 and 642 as the true property line.
cc:Owner,642
Rainier Mortgage
Snohomish County
Very truly yours,
Clarann Lasic Ballard
4
CITY OF,EDMONDS
PUBLIC WORKS EMINEERING,
STREET
ACTION REPORT
1.929 -
SUSPENSE DATE:
Date: .5
Time: File #
PHONE:
REQUEST RECEIVED BY:
TELEPHONE
CONTACT IN OFFICE r
RECEIVED BY:
Pni]TF Tf)-
smw�M
�MMMM
sm
MM
uw����MMMM
arTTnN.
All Concerned Notified w.
Action Completed/File GFr-,
0
0ECENED
STREET FILE
CITY OF EDMONDS
CIVIC CENTER * EDMONDS, WASHINGTON 98020 - (206) 775-2525
CITY AT`TORNEY
Ms. Clarann Lasic Ballard
623 Elm Street
Edmonds, Washington 98020
Dear Ms. Ballard:
March 24, 1982
MAR 2 5 1982
Dir. Of Pbblic W00NARVE H. HARRISON
MAYOR
Re: Prcperty Tine Dispnte w.ith
642 Elm Street
After some time your letter of May 21, 1981 has wound its way
through the Planning and Public Works Department to my desk in
the City Attorney's office. Your letter describes a property line
dispute with your neighbors, the owners of 642 Elm Street.
. You very clearly state that the true property line is not rep-
resented by the rockery which veers into your yard and does not
follow the true property line.
I understand that your purpose of writing was to formally
register your belief that the rockery is misplaced and that it does
not represent that true property line. The City of Edmonds acknow-
ledges receipt of your letter, however, I would point out that
Edmonds is not entrusted with the task of keeping property lines
straight and titles clear. This is a job which has been delegated
by state law to the Snohomish County Auditor. I notice that a copy,
of your letter went to Snohomish County, however, to make your
record a permanent one you should be careful that your notice of
disagreement is filed with the County Auditor and attached to all
other documents pertaining to the property located at 642 Elm Street.,
If this.is properly done, a subsequent purchaser will have notice of
the disputed property line before he or she purchases that lot.
If you have further questions regarding the necessary steps to
preserve your rights I would advise that you consult a private
attorney.
MAE/ka
cc: Mary Lou Block,
Jim Adams, City
Very truly yours,
OFFICE OF THE CITY ATTORNEY
z ":" e��4z��
Mark A. Eames
Director of Planning
Engineer
.11. -� - I � 4.
CY 9 0 - 1 9 4 -
City of Edmonds STREET FILE
W6WX%QWAY CONSTRUCTION
j A% 2 4 1992 PERMIT
ENGINEERING
Permit Number: - oaz,..
I ssue Date:
f-
A. Address or Vicinity of Construction: - 642 Elm Street
B. Type of Work (be specific): Install NEw Service
C. Contractor: -Washington- Natural Gas Company
Mailing Address: 815 Mercer.Street,
State License #: Seattle, WA 98111
D. Building Permit # (if applicable):
Contact: Frank Swan
Phone: 224-2278
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. 'r! Commercial El Subdivision F-1 City Project FX] Utility (PUD, GTE, WNG, CABLE, WATER)
F1 Multi-Fan-ffly F] SingleFamily F� Other
JNSPECTOR: INSPECTOR: is V\J
F. Pavement or Concrete Cut [I Yes FK]No G. Size of Cut- x H. Charge$
APPLICANT TO READ SIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees t o the City of Edmonds harmlessfro4 injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeen, that may be made against the City of Edmonds, or any of its departments or employ-
ees, including or not limited to the defense of any legal proceedings including defense costs, and attorneyfees by reason of granting this permit.
THE CONTRA CTOR IS RESPONSIBLE FOR WORKMANSHIP AND MA TERIALS FOR ARERIOD OF ONE YEAR FOLLO WINP TrFIN
AL INSPEC17ON
AND ACCEPTANCE OF THE WORK ES77MATED RESTORA 77ON FEES WILL BE HELD UN77L THE FINAL STREET I rCH COMP28TEDBY
CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Department- 771-3202.
Work 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 SaWy —shal'10e in accordance with City regulations as required by4he City Engineer.
All street cut ditches shall be patcIM117with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and understand the permit requirements and the pink copy of the permit will be available
on site at all timesfor inspection purposes.
Signature: M
1514A&OAA Date: January 20, 1992
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
0
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. Div. 1991
FIELD INSPECTION NOTES (F und I I I - Route copy to Street Dept.)
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. July 1985
1. , W
WashlngtLn
Natural s'
AVMI-gton5-WG-X-TV
04-z eLm si-
WNG to window
Water main depth
unknown
12- 11 gas main---
Addendum to City of Edmonds
Right of Way
Permit Application
Submitted by: Kerry Walsh
Engineering Aide
Washington Natural Gas
622-6767 x2761
pager 969-1686
N
�jo ct�- TS
Key:
121-�
�NA
-w- water
-g- gas
-ss- sewer
water hydrant
815 Mercer St. (P.O. Box 1869), Seattle, WA 98111 (206) 622-6767
DESCRIPTIONz
That portion of the East half of the Northeast quarter of the Northwest quarter of the
Southwest quarter of Section P-3, Township P-7 Northq Range 3 East, W.M., in Snohomish
County, Washington, described as followst
Beginning at the Nor * theast corner of the East half of the Northeast quarter of the
Northwest quarter o ' f the Southwest quarter;
THENCE South 1009130" West for 20 feetl
THENCE North*881018130" West 30 feet to a point of beginning-,
THENCE continue North 88018130" West 150-76 feet;
THENCE South101115011 West 97 feeti
THENCE East 150,'78 feet to a point which bears South 1009130" West from the true
point of beginning;
THENCE North 1009130"East to the true pointof beginning; EXCEPT the East 73-36 feet
thereof; AND EXCEPT the North 10 feet conveyed to City of Edmonds under Auditor's File -
No. 2027837.
Situate in the County of SNOHOMISH, State of Washington.
0
CA FILE NO._E4 - / 3'8
Critical Areas Checklist
RECOVED
Site Informaflon (soils/topography/hydrology/vegetation) JUN 0 9 1995
1. Site Address/Location: &42 ELI-i !STMT
2. Property Tax Account Number: 25'Z70�1-3-001-0-0o4- JUN 2 7 1994
3. Approximate Site Size (acres or square feet): &657to 4SIFi PER
4. Is this site currently developed? -K yes; — no. "T COUNTER
If yes; how is site develODed? PLE'SIDEP'nAL - ttOUSE + 42-646—
S. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a
horizontal distance of 66-feet).
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).
Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: Approx. Depth:
7. Site contains areas of seasonal standing water: t%10 Approx. Depth:
What season(s) of the year?
8. Site is in the floodway 00 floodplain 0 0 of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? I*A 0 Flows are seasonal? f4O (What time of year?
10. Site is primarily: forested ; meadow _; shrubs mixed
urban landscaped (lawn,shrubs etc) ><
11. Obvious wetland is present on site:
RcY011M4
9
City of Edmonds
Critical Areas Checklist
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 Edmondsprior
to his/her submittal of a development
permit 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).
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 for individual lots of the parcel
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 studies in
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 (fill out the appropriate column below).
Owner / Applicant:
-SAL-u� -Yo Me-609-r-LiE
Name
642- ELrl S-ra&-T
Street Address
E�DH040sf WA- C5AO'ZO -7
City, State, ZIP Phone
Applicant Representative:
Name
&4z.. ari --�:-,TeaEr
Street Address
'60"00!6 VA.1919026 -779-3c,0(o
City, State, ZIP Phone
4Signatdr-eZZ �'//V* .--VatWe Signature
Date
CA FILE NO.-,74 — / 3 6
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: &42 ELm, -sTmT
2. Property Tax Account Number: 2.G a10-; - 3 - 00-) - 0 Oo4- JUN 2 7 1994
3. Approximate Site Size (acres or square feet): - &66-4.0 "S-Fi PERNiq
4. Isthis site currently developed? --K yes; —no. COUNTER
If yes; how is site developed? PLESIDERT1AL - ttOLKE
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a
horizontal distance of 66-feet).
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).
Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: Approx. Depth:
7. Site contains areas of seasonal standing water: PO Approx. Depth:
What season(s) of the yearl
8. Site is in the floodway floodplain W 0 of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? �A 0 Flows are seasonal? 1�1 0 (What time of year?
10. Site is primarily: forested ;meadow _;shrubs mixed
urban landscaped (lawn,shrubs etc) ><
11. Obvious wetland is present on site:
Rev0~4
&90 -199-
City of Edmon&
Critical Areas Checklist
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 Edmondsprior
to his/her submittal of a development
permit 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).
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 for individual lots of the parcel
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 studies in
coWunction 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 (fill out the appropriate column below).
Owner / Applicant:
-SAL-L.%< 'Yo Me-6op-LI-LE
Name
642- F- L" S-rUET
Street Address
Applicant Representative:
Name
&4 -7, F-Lri --c-,TwEr
Street Address
V:DH0t4K3S1WA-0)A0'*Z0 -7 QAUo0!AW4.q13Q26 -779-3c,6Xo
City, State, ZIP Phone City, State, ZIP Phone
��� Xii7g—n—
Signatdr-e I'// bate ature Date
CITY OF EDMONDS
USE PERMIT
ZONE 11 — � NUMBER
CONSTRUCTION PERMIT APPLICATION
OB SUITE,APT a
ADDRESS <_
OWNER NAME NAME OF BUSINESS
1�� 4 L L. All e
LEGAL DESCRIPTION CHECKI
SUBDIVISION NO LID
NO
MAILING ADORESS
Z
0
L I -A
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved 0
AW Permit Required 0
CITY ZIP
TELEPHONE NUMBER
.7
EXISTING —REQUIRED DEDICATION —
Street Use Permit ReQ'd 0
/v
Inspection
ROPOSED
Required 0
Sidewalk Required 0
NAME
't) L
W
METER SIZE
LINE SIZE
NO. OF FIXTURES
PFIV REQUIRED
<
YES 0 NO 0
ADDRESS
ULJ)
j.
REMARKS
cc
<
W
W
Z
CITY zip
TELEPHONE NUMBER
Z
NAME
-rq L L,`c-
L1,71 L
ADDRESS
ENGINEERING MEMO DATED
0
REVIEWED BY
Cr
CITY zip
TELEPHONE NUMBER
FIRE MEMO DATED REVIEWED BY
W
Z
7"1 7 5
0
LJ 4��' �
cc
STATE LICENSE NUMBER EXPIRATION DATE
SIGN AREA
ALLOWED
SEPA RE IEW
COMPLETE
ADB )4Q
(///1-
Legal Description of Property - include all easements
Z
S3
4�FIOPOSED
JEXEMPT
7
S H 0 VFot WE 0
EXP,, ,
VARIANCE U
N I BY
'D
a:
4nEW
AN�
0
�Alj
e
b
7-
SETBACKS FEET
HEipHT
11.0�
Lu
V)
FROf T DIE REAR
�7
Z
Z
Property
REMARKS
Tax Account 7- 1. 61 4�
Parcel No.
NEW RESIDENTIAL PLUMBING
tuh, ,nn Ls
ADDITION COMMERCIAL MECHANICAL
MREMODEL El APT. BLDG.
N=
I
SIGN
CHECKED BY
TYPE OF CONSTRUCTION
CODE
OCCUPANT
GRO , P
GRADING FENCE
EIREPAIR
CYDS. x _FT)
71
WOODSTOVE SWIM POOL
E] DEMOLISH El INSERT E] HOT TUB/SPA
SPECIAL INSPECTOR-
AREA
OCCUPANT
REQUIRED C3
LOAD
GARAGE RETAINING WALL/
RENEWAL
REMARKS
CARPORT ROCKERY
0
PROGRESS INSPECTIONS PER UBC 305
Z
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
NUMBER
OF
1 NUMBER OF
DWELLING
CRITICAL
AREAS
INUMBER Vi'/ - 3,5
W
0
STORIES
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
FINAL INSPE CTION REQUIRED
-11
4,14
VALUATION
FEE
PLAN CHECK FEE
-FAZING
BUILDING
7&1&0
HEAT SOURCE:
PLUMBING
Plan Check No.
MECHANICAL
GRADING/FILL
This Permit covers work to be done on private property ONL
Any construction on the public domain (curbs, sidewpiks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: 1 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 I n interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
M
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, waive or reduce any requirement of any city ordinance
0
:r
nor.limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
-Ij
?p �7[1 /?a
provision."
I hereby acknowledge that I have read this application; that the
ATTENTION APPLICATION APPROVAL
Information glven is correct; and that I am the owner, or the duly
authorized agent of the owner. I agree to comply with city and THIS PERMIT
T his 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
ion Insurance and RCW 18.27. INSPECTION acknowledged in space provided.
IGNATURE (OWNER 0 AGENT) Nto. DEPARTMENT
DATE
IAL" NAIIe
CITY OF
6h EDMONDS
CALL Fw' 0
.1!
ATTENTION INSPECTION 1 16'
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 YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3. PINK — Owner GOLD — Assessor