6830 174TH ST SW.PDFiiiiiiii lill
1037
6830 174TH ST SW
DEVELOPMENT SERVICES
RESIDENTIAL BUILDING PERMIT
APPLICATION
121 5th Avenue N, Edmonds, WA 98020
Phone 425.771.0220 2 Fax 425.771.0221
PLE,4 SE REFER TO THE RESIDENTUL B UILDING CHECKLIST FOR S UBAffYTAL REQ UIREMENTS
PROJECT ADDRESWt?� Su�it�# City State Zi i)-
g7
3e-) I QA
J
4162L
Parcel #:
-j I Lj
(poy I AD IgS
Subdivision/Lot #:
Project Valuation: $
APPLICANT:
4'
Phone:
Fax:
Address (Street, City, State, Zip):
t. ffo m is t"IA
E-M 'I Address:
er-
PROPERTY OW R:
Phone: A, V
J__ '5
Fax:
Address (Street, City,
(, f 30 19L1 �re,,'p 15:%_,1 [J A
62 L
E-Mail Address:
LENDING A&
Phone:
Fax:
Address (Street,"City, State, Zip):
E-Mail Address:
CONTRACTOR:*
zj� I
Phone:
Fax:
Address (Street, Cit§, State, Zip):
E-Mail Address:
*Contractor must have a valid City ofEdmonds business license prior to
doing work in the City. Contact the City Clerk's Office at 425.775.252,5
WA State License #/Exp. Date:
City Business License #/Exp. Date:
DETAIL SCOPE OF WORK:
PROPOSED NEW 'SQUAMRME F
OTAGEFOR TMS PROJECT:
Basement: sq. ft.
Select Basement Type: 0 Finished 0 Unfinished
I" Floor: sq. ft.
Garage/Carport: —sq A.
F Floor: sq. ft.
Deck/Patio: sq. ft.
Retaining Wall: 0 Yes 0 No
Other: sq.ft
I declare under penalty ofperjury laws that lite information I have provided on thisforrWapplication is true, correct and
complete, and that I am the property owner or duly authorized agent of the property owner to submit a permit application to
the City of Edmonds.
Print Name: wner 0 Agent/Other (specify):
------- �' ---Date, _V1 I IZ6
�0�
:L6 --.—
FORM A LABuilding New Folder 2010\DONE & x-ferred to L-Building-New driveTorm A.doc Updated: 6/20/2013
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CITY OF EDMONDS.
121 5th AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - fax (425) 771-0221
www.edmondswa.gov
DEVELOPMENT SERVICES DEPARTMENT
January 26, 2015
SAMUELSTLIKENBERG
6830 174TH ST SW
EDMONDS, WA 98026
Re: 'Building Permit Application: BLD2013-1001
Site Address: 6830 170 ST SW.
Expiration Date: September 16', 2014
Dear Mr. Stukenberg,
DAVE EARLING
MAYOR
e-11,
,�'00
�b I
The purpose of this letter is to inform you that the above referenced permit application expired
on September 16 1h , 2014. There are no more, extensions available.
Please be advised, upon receiving this letter, the application materials and plans on file with the
City will be recycled within ten working days. Please come in during the 10 day hold period if
you wish to have your plans returned. If for some reason you cannot make it in by that date and
wish to retain your plans, please contact us.
If you wish to pursue the project in the future, a new permitapplication and new fees will be
required.
If you have any questions, please feel free to call our offices at 425-771-0220.
Sincerely,
Linda Thomquist
Senior Permit Coordinator
City of Edmonds 425-771-0220 ext 1336
Cc: file
Incorporated August 11, 1890
Sister City - Hekinan, Japan
-ij
February 17, 2014
City of Edmonds
Building Official
121 51h Avenue North
Edmonds, WA 98020
Re: Building Permit Application: BLD201*01
Site Address: 6830 174 1h St SW, Edmonds
To Whom It May Concern,
R mm' S U B
FEB 2 0 2014
WAtYA WARTIVIEW
- a
ww"OHM
The purpose of this letter is to request an extension on the above referenced permit application which is
set to expire on March 16, 2014. According to Edmonds Community Development Code Chapter
19.00.025 F Section 105.3.2 we can extend our permit for another 180 days to September 16, 2014
without any additional permit fees for a new application.
Please respond in writing to acknowledge the extension of the application referenced above.
Sincerely,
Cody Stukenberg
/'? C. 1 SoQ3
CITY OF EDMONDS
121 5th AVENUE NORTH * EDMONDS, WA 98020 * (425) 771-0220 - FAX (425) 771-0221
www.edmondswa.gov
DEVELOPMENT SERVICES DEPARTMENT
October 28, 2013
Samuel Stukenberg
surfaceequipmentservice@gmail.com
RE: Plan Check # BLD2013 -1001
6830 174t' St. SW, Edmonds
Dear Samuel:
DAVE EARLING
MAYOR
Please respond to the attached comments from the planning department and the building
departments regarding your building application. The City cannot continue to process
your application until you fully respond to all of the noted items. Thank you.
Sincerely;
ison
Senior Permit Coordinator
Cc: File
L\Temp\DST's\M aster Letters\PIs Respond Incorporated August 11, 1890
Sister City - Hekinan, Japan
C. I So13
I CITY OF EDMONDS
121 5th AVENUE NORTH * EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
www.edmondswa.gov
DEVELOPMENT SERVICES DEPARTMENT
[E
February 11, 2014
Samuel Stukenberg
6830 174" St. SW
Edmonds, WA 98026
Re: Building Permit Application: BLD20131001
Site Address: 6830 174h St. SW, Edmonds
Expiration Date: March 16, 2014
To Whom it May Concern:
DAVE EARLING
MAYOR
The purpose of this letter is to inform you that the above referenced permit application
will expire March 16, 2014. According to Edmonds Community Development Code
Chapter 19.00.025 F Section 105.3.2, applications are only valid for a period of 180 days.
An application may be extended for an additional 180 days. To extend the subject permit
application you must submit a request in writing to the Building Official prior to the
referenced expiration date.
Please note that if the application expires and you decide to proceed with the project in:
the future, a new application along with permit fees will be required. 'V.
If you have any questions, please feel free to call our offices at 425-771-0220.
Sincerely,
Marie Harrison
Senior Permit Coordinator
Cc: File
a
L\Temp\DST's\Master Letters\App Due to ex ire 10/21/00
Inpcorporated August 11, 1890
Sister City - Hekinan, Japan
V.
'y go - 199
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number:
EET FILE 'T
Issue Date: t
A. Address or Vicinity of Construction: 17 4 'r H 5 T- _'5 ug
B. Type of Work (be specific): 7-0 XG At-AdSS ST4CC-r
C. Contractor: C4-tAvMt39A-'5 C41ryPg4e#Vxz e-4-
MailingAddress: 5-53 AAq)�J ST FDA6U>S
State License#: 5clP 4e OCo I Q I Q At
D. Building Permit # (if applicable):
Contact: VACA—� <GAVovj04c_
Phone: 7 74-- 7144-
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. -M Commercial E] Subdivision El City Project [:] Utility (PUD, GTE, WNG, CABLE, WATER)
F� Multi-Fariffly E] SingleFamily I n Other
INSPECTOR: I INSPECTOR:
F. Pavement or Concrete Cut : El Yes KINo G. Size of Cut:
H. Charge$
APPLICANT TO READ AN,11VM'N'
e� ity of Edmo
oreseen or unforeen, that may _r
INDEMNITY. Applicant understands and by his signature to this applicati - ' I nds harm"s?"I u---ges, or
claims of any kind or description whatsoever, f �e made ago tts4rthe Ciry� of Edmonds, or any ofjQ,depaVments, ?
X-,eniploy-
1Fpe
ees, including or not limited to the defense of any legal proceedings including defense coh�� �nd a,tom� e
y fees by reason of gr4nting th" t7ni(.
THE CONTRA CTOR IS RESPONSIBLE FOR WORKMANSHIP A AD MA 7ERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECITON
AND ACCEPTANCE OF THE WORK ES77MATED RESTORA77ON FEES WILL BE HELD UN77L THE FINAL STREET PATCH'IS COMPLETED BY
C17Y 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 Departme
Work is to be inspected during progress and at completion. 771-0220
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 regfilations as required by the City Engineer.
All street cut ditches 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 undet:s/and the permit requirements and the pink copy of the permit will be available
� A
on site at a1l times 16i:_in_`s`0ection purposes.
Signature:
I
Date: 8— 2-4-- IF z_
or
CALL DIAIA-DIG PRIOR TO BEGINNING WORK
..........RECEIPT.NO:..
DATE::::-:::::.
ISSUEDZY::
NO WORK SHAIJ, BF.GIN PRIOR TO PFRMIT
Engrg. Div. 1991
17,'7r
FIELD INSPECTION NOTES
Comments:
IDiagrarn:
(Fund I I I - Route copy to Street Dept.)
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
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NOTICE:
No warranty of accuracy.
The information shown on the attached map(s)
was compiled for use by the City of Edmonds,
its Employees and Consultants. The City of
Edmonds does not warrant the accuracy of
anything set forth on these map(s). Any person
or entity requesting a copy should conduct an
independent inquiry regarding the information
shown on the map(s), including, but not limited
to, the location of any sewer stub shown. Such
sewer stubs may or may not exist and may or
may not exist at the location shown. Neither
the City of Edmonds nor its employees or
officers shall be liable for the information given
on map(s), nor for any one representation
provided based upon said map(s).
The City of Edmonds S-TFEEX FIMNEW
APPLICATION
for
SME SEWER PE
CONSTRUCTION �-�FREPAIRS
j
IA� g7 4A
EASEMENT No . ..........................................
OWNER ....... ................................ CONTRACTOR .... ...... 15 !6�72 . ................. PERMIT N :� .. 19
ADDRESS ... 4;�� .......... .................................... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
NAMEOF ADDITION ........... ....................................................... ...........................
0
11
Ole,
N
Approved:
DATE..j!!!� .......... f ....... 7� .......... B ... 4 ... 70"nn-��
APPLICATION
for
The City of Edmonds SIDE SEWER PERrMT
NEW CONSTRUCTION �� REPAIRS EASEMENT No . ...........................................
OVVNER --- ...... C-1-11altle .. 4--:7-ju .............................. CONTRACTOR ......................... PERblIT No . ......................
ADDRESS ... C..:RS.0 ....... -1*'02'-�1-...,S.lJ ......................................... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No..... ........................................
NA.WM OF ADDITION .........................................................................................................................................
Al, Corr,
eF
,(r7- 71-1 16 73
'
-7-z/
117 /1", 2-1V Y,
Approved:
DATE................................................ By .....
CITY W EDMONDS
WATER -SEWER DEPARTMENT
CENTER
-SIDE SEWER PERMIT
CaJl PRospect 6-1107 when work
is ready for inspection. (No inspec-
tions Saturday, Sunday or holidays.)
N2 3596.
ADDRESS.................... 0.00V.0110 ...................... 6.a30 .... ... 17.4th..�Straet ... S....W .........................................................................
OWNER.- .......... James ... C-hambars ............................................ CONTRACTOR ...... Western..-Sew.ex .......................................
Permission is granted ........... MArph ... 9 ------ .......... 19 ... 7.Q., for ........................ days to REPAYR or CONNECT a side sewer
.. .. .... .. ..
-with City Sewers in accordance with application on file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. I —The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must
be employed to construct side sewer In street area. Do not cover any portion of sewer before it has been Inspected.,
NOTE No. 2—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 3—Top of side sewer must have at least 30 inches coverage at property line and 12 Inches inside property line; minimum grade of 2%.
No bends In grade sharper than % will be permitted.
NOTE No. 4—Trenches In street must be water settled and surface of street restored to original condition. Contractors shall be responsible for
failure due to improper work which may develop within one year of completion.
NOTE No. 5—It is unlawful to a3ter 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.
CITY OF E.DMONDS
PUBLIC WORKS DEPARTMENTj ENGINEERINGif
CAT 101'
9
FILE
THIS PERMIT MUST BE AVAILABLE AT THE JOB SITE FOR INSPECTION PURPOSES
Applicant to Complete Parts A and B
9
Permit to be issued t o
For
Work at :(address or vicinity)
Type of Work to be done: ,;41,00LI211c 1--f;7E9
(attach drawing when applicable) Or
Time Required -- Start: Finish:
Owner:— -z;�,=
M-n—
Mailing Address
.City State Zip Telephone Number
Contractor: le�lolwlllu I-elo--oxZ a,
Name
-z1r1qz--0:r- Z'9
Mailing Address
City State Zip
—3-76— H-9
State.License Number
-vr�
e!5' - Z
Telephone Number
�q 0 WORK TO BEGIN PRIOR TO PERMTT ISSUANCE **'
B. INDEMNITY: Applicant understands and by his signature to this application, agrees
to hold the City of Edmonds harmless from any injuries, damages, or claims of any
kind or description whatsoever, foreseen or unforeseen, that may be made against
tile applicant or 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, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and
materials for a period of one year following the final inspection and acceptance'
of tile restoration by tile Engineering Division.
CF,_uids held from the Security Deposit (estimated restoration fee) will be held until
ti e final street patch is completed, at which time a debit or credit will be
pr ocesse'd for issuance to the applicant.
Work is subject to inspection and restoration in accordance with City Code. A
24-hour notice is required for inspection by Engineering. Call 775-2525, ext. 220.
I understand that this permit must be available a t the job site' for inspection
purposes at all times. Z
Signature: �4, - Date:
Owner AC&Len-t) V
TO BE COMPLETED BY ISSUING AGENCY:
Date Issued : // IM76�Z'K Permit No. F e e Z, -
Security Bond:
Time Authorized:
APPROVED BY��
Da t e
0 6
71
Cit of Edmonds
y
cE1V1t#IGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number:
.I.s....S.—TREET FILE Issue Date: 1�2_ 0-7
A. Address or Vicinity of Construction: 487o 174Tti 5-r zw
B. Type of Work (be specific): l#4-S'rAL.,L U4, 075-') "�"AJQ. N 510F_
78,90 _Iol��
4 A 7 4'rg 'n Ho 1/3 6 'rc) / LO-UM zd IAB
cAtweeA-V
C. Contractor: _1&12ACAeM 44,44X - ,C0A4dW4T 60 4CC-ontact:
Mailing Address: ;7j "A-iW S r' A9wsWj)S Phone: 774- 5-f-f e
State License#: XUPACA CC. 10 1 Q A Liability Insurance: Bond:$
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. El Commercial El Subdivision El City Project LeUtility (PUD, GTE, CABU, W TER)
n Multi -Family E] Single Family E] Other
INSPECTOR: INSPECTOR: f1c;,e Vq ,A % T C_ujj7T
F. Pavement or Concrete Cut El Yes IZ'N"o G. Size of Cut: — x — H. Charge$
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmlessftom injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeen, that.th'ay b niad4 against the City of Edmonds, or any of its departments or employ-
ees, including or not limited to the defense of any legal proceedings incti ing e ense costs, and attorney ftes by reason of granting this permit.
RIALS N
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AV FC) AI�WODII ONE YEAR FOLLOWING THE FINAL I, SPEC77ON
AND ACCEPTANCE OF THE WORK ES77MA7ED RESTOR,477ONFEES'IWLL BE HELD UN77L THE FINAL STREET PATCH IS COMPLETED BY
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 Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS. r
I have read the apo've Vt4tements and undelind the
on site �(..alll tim�sfor 'n �PectiJnurposes.
e
Signatur
requirements and the pink copy of the permit will be available
Date: k
...........
.......... ....... ..... 11 ............
.. ........... ...................... .. . . I ............. ..... . . . . . ......
..... ................ . ..... ... . ...............
........ . .. .... . .......
'OMMEN ...... ....... ........ ......
TS. IZECEW.Nor: rrr
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................
............. . .......... r r r r r ...... . r ..... . ...... r.... ....... .. r.
..... ...... ............. r r ........ r-r-1111 rr,r,.r.r.�r,r,r,�rr,,rrrrr,�,r,,�,,',I ...... r
:.:DA7M: ISSUED:BY::
k2
IN PRIOR TO PERMIT ISSUAN
Engrg. Div. 1991
FIELD INSPECTION NOTES (Fund. I 11, - Route copy to Street. De t.)
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
F—X I S77 PEQ
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6830'
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ECEIVLro City of Edmonds
1 691 RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number:
ftiy(3
Issue Date:
............
A. Address or Vicinity of Construction: 4,87n 17411" s-r _sW
0,
B. Type of Work (be specific): JNS7'ALj je- ror') A!=gAlrm k !910r,
0 1 Ag-D I 74'rg In H 0 L-36 ?'J ACLUDC ZJ "deB
C. Contractor: SgCe-
CA 6LX - Qmaw&c 6M46--ontact:
Mailing Address: !Q1 "A_1,,PJ S r A0,,rWp r Phone: 77,d. _rLf4
State License #: AuAr-4 CC- 1c) I QA Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
W
E. R Commercial E] Subdivision El City Project PAtility (PUD, GTE, WNG CABLE WATER)
[-] Multi -Family E] Single Family F1 Other Q��
INSPECTOR: INSPECTOR: flCkZ 5 \N�.A%T 7T
F. Pavement or Concrete Cut : 0 Yes
G. Size of Cut: — x — H. Charge$
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmlessftont injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeen, that ma3r'tre ) 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 4�fense costs, and attorneyfees by reason of granting this permit.
161Z
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP At�<RIALSFOR A PEklb,610F ONE YEAR FOLLOWING THE FINAL INSPEC77ON
AND ACCEPTANCE OF 771E WORK ES77MAYED RESTORA77ONFEES-IWLL BE HELD UN77L THE FINAL STREET PATCH IS COMPLETED BY
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 Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS. ?'.
I have read the a�oVi_jtd i tements and underh4nd the permit requirements and the pink copy of the permit will be available
on site �g\alll t.me.,vfor�nfpectic�l�purposes.
Sig re. Date:
natu
(con&actor"or A: genF) \1
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
J&.AdARe-.W Ba DAYS . ..... I
. .— , ......... . ..
.... I.- - I - ........ ... ......... 11
DATE:::: � —ASSUED, BY
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. Div. 1991
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