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646 PINE ST.PDF11111111111111 12783 646 PINE ST -PROJECT REVIEW CHECKLIST PROJECT NAME: PROJECTADDRESS: PLAN CHECK #: RECEIPT DATE47 - 91012) REVIEWED BY: (Ini idl/Date) :PLAN. WATER COMMENTS FIRE BLDG. SEWFR STREET ENQ SetbacksNariance/Setback Adjustment Conditional Use Permit 2 AD13 Requirements 3 Other Zoning Requirements . ........... ........................... 4 Underground Wiring Required . . . . . . . . . . . . . ...... 5 Lot Slope 15% 6 SEPA Environmental Checklist/Hydraulics Permit . . . . . . . . . . ..... .... ............ 7.... Tree Cutting Plan .......... . . .............. 8 Plat/Subdivision Requirements ILegal Description Verification Quit Claim/Street Dedications ............ ........... W, ......... . .... ..... ........ ..... . Easements - Public/Private ...... ...... . . ... 12 Engineering Storm Drain Review Fee Engineering 2.2 Inspection Fee .. ........ ...... . . . .. ... . . . 14 Drainage Plan (On -Site) Setback - Top of Bank, Stream, Water Courses . . ........... . . ........ ........... . ............ ............. ... ........ ...... 16 Setback - Storm Drain Line . . ... . .... ..... .. ....... 17 Open Ditch - Existing 18 Culvert Required 9 Culvert Size .. 20 Shoulder Drainage/Shale Open Runoff Catch Basin Required Driveway Slope & Vehicle Access Sidewalk Required 24 Curb & Gutter Required Curb Cut For Driveway Required 26 Street Paving Required .... .. .. 27 Right -Of -Way Construction Permit Required Street Name Sign Required Other Signing Required Bond Required For Public Improvements ................ ..... . ... FEMA Map Check/Water Table ......... . . . . . 3� Side Sewer Availability 33 Calculate Sewer Connection Fee If No LID # . . . . . ............ 34 Create Street File .. . .. . .... ....... ........ .......... Existing Water Main Size . .......... Water Meter Size . . . . . . ... 37 Service Line Size 'X -X 4V 38 Water Meter Charge Required 76o . . ........... 39 Hydrant Required 40 Hydrant Size Existing -7 . ..... . .. ................. ... 41 Fire Line Charge Required Sprinkler . . . . . . . . . . . . . . 42 Street Cut 1190 Miscellaneous 1_43_ Reviewed By: FIRE PLANNING ENdjNEERIN_G P0 AI<S 00cy 9 j900 ? C) HOOLIC WORKS DEPT, R E C 0 R D OF C 0 N T A C T S 21 2 22 3 23 4 24 5 25 6 26 7 27 8 28 RW PERMIT DATE ISSUED RECEIPT I 9 29 10 30 L 4 11 31 '12 32 13 PAID $ RECEIPT DATE 33 SS PERMIT # DATE ISSUED RECEIPT 114- PAID $ RECEIPT DATE 34 35 36 '17 37 METER SIZE3/t� PAID DATEZ49/2,TRECEIPT 1 :�18 38 �19 39 �20 40 HEIGHT CALC"S 14. : I ( . 46. Z Is : lel&8 c TOTA-L, -'6'T'Z8.0 -t -Z o 113.2 Lor = 714-3.1 mp,;c - CIrt& = P.CT OA.L r_vm%, = A 6 0 �L lmpvrzv)ot)oj Arze:p',= 9411-1 -SITE PLk�,l LOT A. OF C-IT�l OF' IS-DMbKl- C-0., W&,. -N E .5T, ro-o To c. rb P&Tu ?T- RIM-173MT / Ir PLA Q 2 70 A m4l ILE)- 170— P/-\C) F) Cl E M E R,&, L ID )40 M E-5 w c "C lo� S)TE. PL,&,�,J LOT A. OF C- I T-f OF` Sr D M -0 H c 0., caply HEIGHT CALC"5 c 140 1. 8 P !e-8.0 TOTA-1-:4-128.0-H le-8.1 113.2 s IL7-A770 ^-) 0 ��Jr LOT A0LVA, 7ki43.1 MA7c.c,/rt& 11-11.1.r XCT UAL r-v V-%, 6 o X Impurzvlovoj PINE 5T, Rim- r PZ-A z I - . —M j)4ttc44lwA j4ACC a- A A A POLA NJ 2 70 5 At tic- 9644 + / Z) /3 & /19 P/1'r ) T=' I c 1= m F 7 TZ & I TI) W.n m P7"1:zl STANDARD DRAINAGE DETENTION SYSTEM WORKSHEET OWNER PI?Clr'C ADDRESS � �Ae P/ CALC PHONE DATE: zd *****DESIGN DATA***** IMPERVIOUS AREA PIPE DIA PIPE LG ORIFIC.E . I DETENTION PIPE LENGTH LOCKING LID FINISHED G XTYPICAL) pt�� I —V- MINIMUM I UPPER CATCH BASIN -2 6� MIN ffPRR0AM1CfOP OUTLET M ASUR OF CONC BOX OR RISER .OPE OUTLET CONTROL '1914 1 N. I .ORIFICE CONTROL CATCH BASIN SYSTEM CROSS SECTION 2'X2'X6* DEEP, 4-6' SPALLS OR EOUAL FROM CONTROL CB 2'X 2'X 3' DEEP,* 3/4' CRUSHED ROCK FROM CONTROL RIPRAP OUTLET I LdNG. WITH MRAF WASHED DRAiN ROCK RUNOFF SPREADER. TRENCH FOOTING DRAINS SHALL NOT BE CONNECTED TO DETENTION SYSTEM NOTES.- 1. Call Engineering Division (771-0220) for a tightline and detention system inspection before backfilling and for final inspections. APPROVED BY 2, Responsibility for operation and maintenance of drainage systems on private property is the responsibility of the property owner. Material accumulated in the. storage pipe must be flu., out and removed from the catch basins to allow proper operation. The outlet control orifice DATE 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: Pipe Diameter 1511 1811 24" 30" 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 Aluminized Steel Aluminum CMP Asphalt Coated N — 12 ADS (Not permitted on roads) f—able 2 — outlet Orifice Sizes Impermeable —Area Sq. Ft. Outlet Orifice Diameter (Inches) 2000. 5/8 2500 5/8 3000 3/4 3500 3/4 4000 7/8 45t 7/8 7 J: > Table -6 - -Rectangular Catch Basin Requirements Detention Max. size Catch Basin —pipe diameter knockout— Type ._ < 18" 2011 Type 1, CB 15 18" to 24" 2611 Type IL, CB 16 24" to 36" 3611 Type 11, CB 19 19 (48" Basin) 36" to 42" 4211 Type 11, CB 19 19 (54" Basin) *Source: Assoc. Sand & Gravel Co. Standards I Water Service Drawing The City of Edmonds EASEMENT NO . .................................... NEW CONSTRUCTION REPAIRS El LID NO . .................. . ASMT. NO . .................. OWNFR RAC.tFAC ... ............. I ............ CONTRACTOR 7BA-M---C-0NTn0F*�Q'X0k5 ................................... PERMIT NO. JOB ADDRESS .... (C.qL ..... PIA1,16 ........................ I .......................... LEGAL DESCRIPTION: LOT . NO. ..� .............. I ...................... BLOCK NO . ................................... NAME OF ADDITION ..: ...... —i 4� NOTICE NO WARRANTY 0: ACCURACY The Informp-tic, affachad me— wa: CC-r;!�,j ;,r . k #k : 11c, Q- y t tj Ey 01 !7�'OyeO�S anc! Ccnsj!'=-s Tb,, Cjt,, C I Edmonds dor� noi w_, T, - -�'j of an�',, - s. Vo c: i ap An'. per�.� ci e:,,,, 3 CCpy S 1'. u 2� n C I CV. Cn V rE t1:,:,,z r stLb F,_ i.v t, th� IM,7,i ct E mayerr,,-, rctc),,tLt ic..Zu' C�,: th, Ci,� ef Ed�-,ioinc_ nc� its c.�.-, ,� , ; Ci DML�_.s t0i tri, r-, ,'ell On this map, ncr fu ur�'or represen."cl'. pro�,jL�&d bL"-' upoli spia map PWW-0001-1 1175 (REV.11 1/78) G4G PIKC s-1 Lh Aproved: DA T F, ...... .. ..................... By 641 ............... ............ S)TE PLkNI U In LOT A. OF C-IT--e PINE 5T, r.O'- 0 TO c. rb PLyx) e 4y C�A)SVek 0,� nr�� ------ 71 WL- HE)GHT CALC'5 c 9. 8 TOTA-1-:4128.0-H le-8-i mg&w -z 113.2 M -VOSIC AJ CA A) L 2 70 b LOT A,%Vb� = 71Y4.3-13 At mp,�C. cvrl,& = 2411.15' . 160�L 41 45.0 I c 1= m fr T:z I T-) W-n m 9,-,:Zl STANDARD DRAINAGE DETENTION SYSTEM WORKSHEET OWNER PUG f 1C 1)QMJfS-TftC' CALC13Y: IMPERVIOUS AREA DATE: *****DESIGN DATA***** PIPE DIA PIPE LG FINISHED I DETENTION PIPE LENGTH .V- MINIMUM ,.G:.TL, TO I/ SLOPE r-------- LID ORIFIC.E 7/4 r " 'M'iAXNRffP1RA1N'fOP OF CONC BOX OR RISER -OUTLET CONTROL UPPER CATCH BASIN ORIFICE CONTROL CATCH BASIN SYSTEM CROSS SECTION 2'X2'X6' DEEP, 4-6' SPALLS OR EQUAL FROM CONTROL CB 2'X 2'X 3' DEEP, 3/4' CRUSHED ROCK ADE FROM CONTROL OUTLET � W I _"��CUTFLOW TRENCH Be MIN 10' LONG. ERF PIPE TO LEVEL ERF PIPE W/ END CAPS ��`P'TR E M PRJNCH SHALL BE LIN P WITH ,RIPRAP OUTLET OR TO PLACEMEN 0 WASHEODARrAIN ROCK RUNOFF SPREADER. TRENCH FOOTING DRAINS SHALL NOT BE CONNECTED YO DETENTION SYSTEM NOTES.- 1. Call Engineering Division (771-0220) for a tightline and detention system inspection before backfilling and for final inspections. APPROVED BY 2. Responsibility for operation and maintenance of drainage systems on private property is the responsibility of the property owner. Material accumulated in the- storage pipe must be flushed out and removed from the catch basins to allow proper operation. The outlet control orifice DATE Table 1 — Detention Pipe Sizes Impermeable Required Area Sq. Fto Vol Cu Ft 2000 50 2500 62 3000 75 3500 87 4000 100 4500 112 5000 125 Note: Allowable Pipe Materials: Pipe Diameter 1511 1811 2411 30" 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 Aluminized Steel Aluminum CMP Asphalt Coated N — 12 ADS (Not permitted on roads) -;Fa—ble2 — Outlet Orifice Sizes Impermeable Area Sq. Ft. Outlet Orifice Diameter (Inches) 2000. 5/8 2500 5/8 3000 3/4 3500 3/4 4000 7/8 7/8 (-7/78> T -5-- able Rectangular Catch Basin Requirements Detention Max. size Catch Basin pipe diameter knockout Type < 18" 2011 Type 1, CB 15 18" to 24" 2611 Type IL, CB 16 24" to 36" 3611 Type 11, CB 19 19 (48" Basin) 36" to 42" 4211 Type 11, CB 19 19 (54" Basin) *Source: Assoc. Sand & Gravel Co. Standards 5 �o w -Z c s..0 s, , I *.'Cto'- 0- HE)GHT CALC"5 c -Z IS. o 113.2 LOT A-ILCA, 7&14-3.1 Xe-TUA.L r-VV-�, 16OX lMP6rzv)OQS ArZS:A,= -S)TE PLktl LOT A. OF C-IT'e OF- SM.M6NID-1 N E 5T, \ . 45'.ID 40'-0 TO C, rs 17ALTV N,n. mim,173.9T I IM, I -40 CO PLA Ki 2 70 b At 170— P/-\C)F)C. EMER,&,LID 40ME-5 CITY OF EDMONDS ,9 9 0 1 4 Address of Construction: Property Legal Description (include all easements): SIDE SEWER PERMIT I . ' 11 0 PERMIT ILI 11:1nIzr. DEPI Owner and/or Contractor: State License No. .0,4a i �V,6'41 tp Building Permit No. 9 Single Family Invasion into City Right -of -Way: 0 No Yes El Multi -Family (No. of Units RW Construction Permit No. 0 Commercial Cross other Private Property: y No El Yes El Public Attach legal description and copy of recorded easement Q=4:-2A Q,, I/ /I l?'A I certify tyat I have read and shall comply with all city requirements Date as indicated on the back of the Permit Card. * CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION * OFFICE USE ONLY FOR INSPECTION CALL 7444M, PUBLIC WORKS DEPT. 7-21-qA05 Permit Fee: — , ") 0 Issued By -,Y) Trunk Charge: '5� 5-. oo Date Issued: Assessment Fee: Receipt No.: Lid No.: Partial Inspection: Date —Initial — Comments Reason Rejected: Date —Initial — Final Inspection Approved: Date initial ** PERMIT MUST BE POSTED ON JOB SITE ** White Copy: File Green Copy: Inspector Buff Copy: Applicant Revised 3 90 Side Sewer Drawing The City of Edmonds EASEMENT NO . ...... ........ I ......... NEW CONSTRUCTION j2/ REPAIRS LID NO . ...... ........... ASMT. NO.- .... .......... OWNER ------------------------------------------------------------------------------------------------ CONTRACTOR ...... :5*- a .... R AN.;! r V\ ............... ...................... PERMIT NO. JOB ADDRESS ....... ..... ................................... LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . .................................... ............................................................................................................. .................................. ................. NAMEOF ADDITION ....................................................................................................... 11 ............. 4io )::'q 0 N I I ' sq, tA IVA ED:MONDS TREATM�E:N'T PLAN4jT Approved: PWW-0001-1 1/75 (REVA 1/78) DATE ....... ........... City of Edmonds RIGHT-OF-WAY CONSTRUCTION PERMIT Permit Number. Lssue Date: // M.1 IFIP A. Address or Vicinity of Construction:- (Q4-10 _k>(1qL 1!�;T C) QJ B. Type of Work (be specific): C. C. Contractor: LAL-2-- �ontact: "_� e_1 r, 4 C' A =- — N) Mailing Address: 4b_ Bc�k (7-a—a- Phone: 4-as (DA-0 Leos* State License #: Liability Insurance: Bond: $ D. Building Permit # (if applicable): Side Sewer Permit #(if applicable): 891at5 E. [_1 Commercial [J Subdivision E] City Project [:] Utility (PUD, GTE, WNG, CABLE, WATER) EJ Multi -Family Cg Single Family n Other INSPECTOR: OptTCLr77— INSPECTOR: F. Pavement or Concrete Cut : 0 Yes DNo G. Size of Cut: — x — H. ChargAt�_$ APPLICANT TO READ AND SIGN INDEMNITY: Applicant understands and by his signature to this application to hold the City of Edmonds harmlessfrom injuries, damages, or claims ofany 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 not limited to the defense of any legal proceedings including defense costs and attorneyfees by reason of granting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC- TION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREETPATCHIS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT Two sets of construction drawings of proposed work required with permit application. A 24 hour notice is required for inspection. Please call the Engineering Division, 771-0220. Work and material is to be inspected during progress and at completion. Restoration is to be in accordance with City Codes. Street shall be kept clean at all times. Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer. All street cut trench work shall be patched with 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 inspqction purposes. ��'A CA Signatu A. Date: h L.-O r'��(Contractor S)Aogent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Di� 1997 FIELD INSPECTION NOTES Comments: Diaaram (Fund 111 - Route copy to Street Dept.) CONTRACTOR CALLED FOR INSPECTION El YES 11 NO Partial Work Inspection by P.W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: PLANNING DATA NAME: SITE ADDRE-A- PUW <�. —DATE: ZONING: L4 PLAN CHK#: PROJECT DESCRIPTION: CORNERLO (Yes/No) SETBACKS: FLAG LOT 4h .(Yes/No) Required Setbacks: Front: ZO' Left Side: Right Side: Rear: Actual Setbacks: Front: 2_0' Left Side: Right Sid I e: Rear: Street map checked for additional setback requlre��(Yes/No) LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED & _(Y/N) LOT COVERAGE: "225 01A _� Maximum Allowed:- —Actual: BUILDING HEIGHT: A Maximum Allowed:— —Actual Height: Datum Polnt:(&� Datum Elevation:- F-1 I N 9 Usk W4 q* "I # "D 19 SUBDIVISION: 5e6j W qz-1 CRITICAL AREAS #: SEPA DETERMINATION: LOT AREA: OTHER: 5)TE PLL LOT A. OF c-s-r-i OF- smm6wo-ts . .... -S mo 1-140 m I t H c 0 -, Wb% - w HEIGHT CALC'5 x : 1(.(..Z 15 : c TOTA.t, -4 21, 0 113.2 L.O.r Avcx = 7*141.1 p4p.-A,cvrt4. = I%P-TUA.L CVV-%, = mpwrzvloo.) 41110 v 5T, - - . - . - - - . - V-% . . V� 4 % -k %,A f- C'- I , /'A ®rTlAn Y 6A 11.4 i A I- kX AfOC-- I 170 f bo CITY OF EDMONDS Address of Construction: Property Legal Description (Include all easements): Owner and/or Contractor: I - State License No. Ag,^- / rf-1-1 eq Single Family C3 Multi -Family (No. of Units-) Commercial Public SIDE SEWER PERMIT PERMIT N 2, 8985 Building Permit No. Invasion into City Right -of -Way: 11 No Yes RW Construction Permit No. Cross other Private Property: No C1 Yes Attach legal description and copy of recorded easement tt It I certify tyat I have read and shall comply with all city requirements Date as indicated on the back of the Permit Card. CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION 0FIFICE.WE"O" FOR INSPECTION CALL 744.&M, PUBLIC WORKS DEPT. 771-cqa06 Permit Fee- 6o , () 0 - Issued By Trunk Charge: 4;R 15- 00 Date Issued: Assessment Fee: Receipt No - Lid No.: Partial Inspection: Date -Initial Comments Reason Rejected: Date -Initial Final Inspection Approved: Date -Initial ** PERMIT MUST BE POSTED ON JOB SITE ** White Copy: File Green Copy: Inspector Buff Copy: Applicant Revised 310 The City of Edmonds -Side Sewer Drawing EASEMENT NO . ............................................ NEW CONSTRUCTION REPAIRS F-1 LID NO . .................. . ASMT. NO . ............... OWNEP . ........ (Wy.(p ......... ...... S. _r ............................ ----------- CONTRACTOR ........ L ........... q ..... c-P.4-5 ......................................... PERMIT NO. .. ....... . ... ... .... ... .... .. ... .. JOBADDRESS -------------------------------------------------------------------------------------- LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . .................................... NAMEOF ADDITION ---------- ----------------------------------------------------------------------------------------------- ------------ ?�x .j is s-r P�W-0001 -11/75 (REV. 11/78) Approved: DATE ..... 2-7.Z-27-957 .............. B . ..... & .. QNW A .... P ............................... The City of Edmonds Side Sewer Drawing EASEMENT NO - ----- NEW CONSTRUCTION Zr/ REPAIRS P/ LID NO . ................ .. ASMT. NO . ............ OWNER................................................................................................ CONTRACTOR ...... :5.;a .............. I ......................... PERMIT NO. JOB ADDRESS ....... ...... P)Yke—.5+n ...... ........................... LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . .................................... ............................................................................................................................................... NAMEOF ADDITION ........ ..................................................................................... ......................... V t, I N 7A 4.14 it> do V.41 t4.15. 0 u 5,C —le�xl 7, �,a arL-Aft Px - T% Q 6 tA I V4 Approved: IEDMONDS TTREA11VIENT PLANT -- --'. - — — --] PWW-000 1 - 11/75 (REV. 11/78) DATE ....... ............ By 117c. Isori r40 T I C TO PERMITTEE AND/OR OWNER D PARTIAL APPROVAL F-1 VIOLATION a) CORRECTIONS ]REQUIRED Permit Number >eo a -L15 Owner kf_LLf_1LA tJ Job Address /, -q �, pit-je- -5-cmerr� 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 COMYLY WITH APPROVED PLANS AND PERMIT OR REMOVE. F-1 STOP WORK - UNTIL AUTHORIZED To CONTINUE By CIT Y INSPECTOR. 5A CORRECTIONS LISTED BELOW MUST BE MADE: BEFORE WORK CAN BE APPROVED AND/OR THE 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 F'ROM STREET. F-1 APPROVED PLANS MUST BE AVAILABLE To INSPECTOR ON SITE. F-1 WORK DESCRIBED BELOW HAS BEEN INSPECTED AND Is APPROVED. F__j CONTACT INSPECTOR AND ARRANGE FOR APPOINTMENT. F-1 RECALL FOR INSPECTION. It'a"o-r- AtAo j2ajk�CF_ e-owc., C..-A-6 Akio 6qVtTe(t_ vies-T,6p j>'Zwf .A; Ke\)kUK4_'( 9 \ y'f_-r_-C me:> &"'r eLt-r-C F_?4clkweErl, THE ACTIONS OR CORRECTIONS INDICATED ABOVE ARE REQUIRED WITHIN DAYS OR PENALTIES MAY BE APPLIED.- FOR INSPECTIONS CALL 771-0220. FIBuilding Division ED Planning Department a] Engineering Department D Fire Department CITY OF EDMONDS &Q�j \,� L,'. +-t— Inspector MXI? A-*-L- -A -t Date CITY OF EDMONDS USE ZONE PERMIT NUMBER CONSTRUCTION PERMIT APPLICATION JOB ADDRESS (0 SUITE/APT # QWNER NAME/NAh4E,.0F BUSINESS ES LEGA� DESCRIPTION!,[HECKJ SU�B!VISION NO., LID NO. -74 MAICING ADDRESS Z M11 _0 0 M1 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. EXISTING REQUIRED DEDICATION-- TESCP Approved GI__ RW Permit Required Street Use Permit Req'gVj�0 CITY TELEPHONE NUMBER T�oRD-t,ws 14,gS PROPOSED Inspection Required O� Sidewalk Required �Q�' a: NAME METEI� SIZE LINEIIZE,, NO. OF FIXTURES PRV REQUIRED YES �/NO 0 W < 'Ujj ADD_RESS RE? Xcc C. 4�� e It I W W Z CITY TELEPHONE NUMBER < 14�ZIF I Z NAME VAo V6_A�;s iw\c, F-y_,&Aamo te, PV6- t? 4,� -D ADDRESS cr 01 jpg ENGINEERING MEMO DATED REVIEWECLBY :51 CITY ZIP I TELEPHONE NUMBER WTE LICENSE NUMBER ^- J� EXPIRATION DATE VARI� CU SH7ARINE # VNU r— G Q!W Legal Description of Property - include alFEAsernbrits 'AR Z 649 ?INS S-1 SEPA SEVIEW COMPLETE 1 7PT EXP SIGIN AREA ALLOWEd OPOSED JHEIIII HT ALLOWED 1PROPOSED 26 7:3q' 2: cc LOT COVERAGE _ ALLOWED I PROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE REAR PROPOSED SETBACKS (FT.) FRONT UR SIDE REAR W zu, Z Z uj _j Prope rily Tax Account _j T E 47'r � E N�NGfEVIEW BY DATE Parcel No. :NEW RESIDENTIAL PLUMBINGtMECH REMARKS COMPLIANCE OR ADDITION El COMMERCIAL CHANGE OF USE APT. BLDG. REMODEL SIGN G FENCE x_ EIREPAIR CYDS. El FT) BY TYPE OF CONSTRUCTION CODE OCCUPANT. GROUMI DEMOLISH I WOODSTOVE SWIM POOL 1:1 INSERT HOT TUB/SPA 9PECIAL INSPECTOR EAe M OCCUOANT &RAGE RETAINING WALL/ EJ RENEWAL REQUIRED OYES LOA REMARKS CARPORT ROCKERY (TYPE'OF USE. BUSINESS 09 ACTIVITY) EXPLAIN: PROGRESS INSPECTIONS PER UBC 108 Z D 00 Lu NUMBER NUMBER OF* REITICA ICR AS 0 OF DWELLING A 00 STORIES UNITS N ib�h I �QA vt5itir 0 DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) FINAL INSPECTION Ria'61iiIED PLAN CHECK FEE VALUATION FEE q55 4 Olin. BUILDING HEAT SOURCg;_ Aafd GLAZING 010 6ks toex_�,-_q PLUMBING MECHANICAL GRADINGIFILL S-23 iI�4) Plan Check No. gg , -7, V -f- This Permit covers work to be done on private property ONLY. Any construction on thq public domain (curbs, sidewL%Iks, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE STORM DRAINAGE FEE Permit Application: 180 Days Permit Limit: I Year - Provided Work Is Started Within 180 Days ENG. INSPECTION FEE "Applica Tit, 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 whatever nature, arising directly or indirectly from the issuance of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT or reduce any requirement of an, city ordinance _j modify, waive 0 1 nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE provision." I hereby acknowledge that),have read this application; that the ATTENTION APPLICATION APPROVAL information -given is correct; and that I am the owner, or the duly authorized agent of the owner. I agree to comply with city and au h 0 r d an,, iz ag THIS PERMIT This application is not a permit until S state laws regulating construction; and In doing the work authoriz- I ate I a W s re g ua AUTHORIZES THE signed by the Building Official orhis/her ed thereby, no person will be employed in violation of the Labor ed t he reb, , n 0 p Code of the State of Washington relating to Workmen's Compensa- ONLY WORK NOTED Deputy; and fees are paid, and4ceipt is V ion Insurance ancl RCW 18.27. t i I INSPECTION acknowledged in space provided. Lle SIGNATURE (OWNER OR AG NT) DATE SIGN ED DEPARTMENT CITY OF OFF�9!A S ;GNATp�.E EDMONDS ,.!—DATE CALL FOR .4AI., RELEAgEd ErY:" E ATTENTION INSPECTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING -OR -STRUCTURE -'AND APPRO�*LOR UNTIL A FINAL INSPECTION HAS BEEN MADE . 771-0220 ORIGINAL — File YELLOW — Inspector A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC - 11 1 GOLD A§5@s5pr BEGTION 109 /) , I �,- , , �, -,� I-D ilt PINK � Q-4rigr � in�.0 il I . �,