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6920 172ND ST SW.PDF1111111111 996 6920 172ND ST SW ROPREET FILE il CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS P� I tiC * "R Lit) 1 4( t+LE le- i�e� MAILING ADDRESS CITY -7 78 -b30 NUMBER NAME �!� A/A P 6wo /v/ e, TA a e - /7 oIJ ADDRESS V, 00 // 27 -7 M 7- A/e CITY TELEPHONE NUMBER Z /4,4 t hi,/ b 0 1 ki�-2 -1v 6 U STATE LICENSE NUMBER . . A F-6- C 1-77- LO Legal Description of Property - include all easements (show below or attach two copies) Vkc+ eve ans- N EW RESIDENTIAL PLUMBING ADDIALTER COMMERCIAL MECHANICAL REPAIR APT. SLOG. El SIGN EXCAVATE DEMOLISH OR FILL FENCE E] CARPORT REMODEL I- x -FT) swim GARAGE POOL WOOD STOVE/ r7 RETAINING WALL/ INSERT ROCKERY RENEWAL NUMBER OF STORIES NUMBER OF DWELLING lu NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN) VF 5 1ptlije E USE PERMIT ZONE NUMBER JOB ADDRESS 69,20 17 57shl _EGAL DESCRIPTION CHECK -U I WIVISI NO. LID 110 Z07 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP EXISTING f&77 -REQUIRED DEDICATION PROPOSED,5;t-- APPROVED BY el7h e— :5*iVe= RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED STREET USE PERMIT REQUIRED SEE ENGINEERING MEMO DATED 41 REVIEW BY C,,� A lclkltz REMARKS NG SUPPL SIGN AREA I ENV. REVIEW ALLOWED I PROPOSED COMPLETE i EXEMPT VARIANCE OR CU SETBACKS — FEET FRONT SIDE REAR BY ITYPE OF UNITS ADB NO. I SHORELINE 0 NING REVIEW BY I DATE ---T—HEIGHT I LOT COVERAGE - HEIGHT SPECIAL INSPECTOR AREA OCCUPANCY OCCU PANT RE0141RED GROUP _JLOAD r] YES [�NO REMARKS PROGRESS INSPECTIONS PER UBC 305 PLAN CHECK FEE BUILDING PLUMBING MECHANICAL This Permit covers work to be done on private property ONLY. GRADINGIFILL 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 WorN 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 harmless the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of i whatever nature, arising directly or indirectly from the issuance of this permit. Issuance of this permit shall not be d eemed to PLAN CHECK DEPOSIT modify, waive or reduce any requirement of any city ordinance TOTAL AMOUNT DUE 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 will be employed in violation of the Labor ONLY THE C.ode.gf the State of Walhington relating to Workmen's Compensa- WORK NOTED #9n Laurance. INSPECTION DEPARTMENT I TUREi (OWNER OR f DATE SI IN� 1 AAT) _ 1�; 5,/ 7 CITY OF EDMONDS VALUATION 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 0 a: 0 Z Z Z 0 Z 03 ATTENTION 771-3202 RELEASED BY: DA rE PROJECr NAME: PRWBCT APPLICATION R IPT DATE: 1-1��4 q CHI=ST , L; ADDRESS: 172 -5;7- Shl Reviewed by: (initial/date) Commmm PLANNING WTR/SWR SMM ENGNRNG FIRE BUILDnr. /77-777777777777 1111-71711 Sn4ME F=Y/MULTIME/CaMME11CIAI, - (Circle One) SETBACKS CHECKED - Plarming 7 777-7 TI-17 —7 77 717 77TTIT17 7 VARIANCE/SETBACK ADJ. ///////// //////// I F/ 7 77 7 T 7 TR T1 7 7 7TF7-7 17TFI - CONDITIONAL USE PERMIT ///////// //////// 2 777T/7—T777--7777-7 77777777'7777777777 ADB, REQUIREMENIS CHECKED ///////// //////// I 77T17T-777=7777177 O`IHER ZONING REQUIREMENTS ENVIRCNKMAT, FEATURES 5 7 7 777T/7 77/77777 77777T7 RECY ACCESS SLOPF & VEHICLE ACCESS DRAINAGE- PLAN (On Site) 777717 777777777 777777777 77777TI7 STREgr FILE ////// ///////// ///////// //////// / PIRI. I,, A LEGAL DESCRIPTION VERIFICATION 06' 11171 ///////// ///////// ///////// ///////// //////// //////// ' 9 77T77TRT 17777777 QUIT CIAIM/DFnICATIONS 10 EASEMENT - PUBLIC/PRIVATE 7777=7777777/ ///////// //////// 11 CAJ,CMATE SEWER CMNaCTION IF NO LID#. 7777777777777"111111111 ////// ///////// ///////// 12 / / ff/7 7777=72////// PLAT/SUBMISTON REQUIROwlENTS 13 R1GJJT-OF-WAY CONSTRUCTION PEPMTT RFj_M TfTrl 7 ////// 7777 7TI 77 ///////// 7 7 7 7 7 " 7 ///////// *O�? / 14 ////// 7T/-/77777777777777 PIOND REQD FOR PUBLIC IMPROVEMENTS 15 SOILS CONDITIONS & GROUND 11111f 77777777T771111111 WATER FIET,D afECKED ////// ///////// ///////// MM/k 16 77T/7 77777TI7 777-= - STREET PAVING REQUIRED 17 CURB AND GUTM REQUIRED 777TTTTR7 18 771111 111117171 7T/777777' SIDEVOUX REQUIRED ////// ///////// ///////// W 19 77-77-77 7TI77TR7 aM CUT FOR DRIVEWAY REQD ///////// 20 STREET NAME SIGN REQD TIT11717T T777TITIT 7TT777717 — 21 0711ER SIGNING REM 7,777T/T/7 ///////// T17TI77TI7 — 22 SIDE SEWER AVAIIABILITY 77771-f ////// 7777=77/-= ///////// //////// 23 EXISTING MER MATN SIZE RT17 ////// JV, 1, 777M77 //////// 24 �ATER MF.TER SIZE 7M11 7777777 1117711111 — 25 SERVICE LINE SIZE 777Tff 777777T/7 11IR71117 — 26 HYDRANT REQUIRED 7TI77777T-111111111 1111111117 — 27 -ITT-177 11117777 — HYDRANT SIZE EXISTING ////// ///////// 28 CROSS C'C�TION INSPEC?ION REQD 1111177TITIT17T ////// ///////// �m 29 WATER MTP C31ARGE REQD 7T/P7 30 FIRE LINE CIMRGE REQD - SPRINKLFR 150 //////// //////// 31 STREET CUT z/V 32 OPEN DIMi EXISTING 77777TTIT17[17T711111111 33 REOD 77777/7777777777 All 34 CULVERT REM 35 1771777T1"flTf-1-r1f11111 SIZE ////// ///////// 36 CAT01 RAS IN REQD 777777'777777777 ////// ///////// 37 ITTRI INDICATED ON SITE PLAN ////// -T 38 SHOULDER DIUdiNG—E mmwmm =7777'77777 7 s 112 OPEN RUNOFF 39 MISC: 40 V E 1) i M WKS REVIEWED BY: PLANNING MGR. m-mmmmr mr.R- DATE: 671 MEMO TO: Permit Coordinator, Building Division FROM: Dan Smith, Engineering Inspector ADDRESS: s�o OWNER: After review of the subject building permit application, we have the following comments: 1) Construction hours are: WEEKDAYS 7:00am to 10:00pm WEEKENDS/HOLIDAYS 10:00am to 6:00pm 2) A Right -of -Way construction permit is required for any work on City property. 3) Connection to City water system required. 4) Connection to City sanitary sewer system required; obtain separate permit. 5) Water and sewer lines to be separated by 10 foot minimum. 6) Driveway must be paved a minimum of 20 feet back from City right-of-way; separate permit required. 7) Driveway slope not to exceed 14%. 8) Back water valve required if downstairs plumbing is below el-evation of upstream manhole. 9) Builder/Owner responsible for,containing all temporary runoff and - erosion control on site. Constructio.n may not impact neighboring properties in any way. 10) No burning of construction refuse without approval from Fire Dept-. 11) Street to be kept clean of debris, dirt, mud, and construction materials.- Contractor responsible for dust control. 12) Inspection required on drainage system, catch basin -installation, driveways, and sidewalks. A final engineering inspection is required prior to the building division granting occupancy., Lo-T 8 Luv.�ow)5 VA-r(,j NA NOTCH I t�J No (A V qrL-TNE- TO 'S TPG7E-r �o a,5'5 ET r3 60� VN cy- ol Al G NRTIU E P/7- EASEMENT A V& A6-WAL-971 14 r ram - Vk = / C) L E Y,-q .:dl co CD C I T . Y of EDIVI ON DS SIDE SEWER PERAII For Inspection Call 771-3202 PERMIT NO. 07965 ,STREET FILE Address of Construction: 5-r Property Legal Description (Include all easements): 46)7-,�3 r_,b�xl Owner and/or Builder: Contractor & License No: !�;� A R F _- / -72- L-0 Single Family Residence X, # gqo FLYNNWOOD LINE I Multi -Family (No. of Units L_ Commercial (No. of fixture Units Invasion into City Right -of -Way: No X Yes — (If Yes, Right -of -Way Construction Permit required. Call One -Call -Center (1-800-424-5555) before any excavation.) Cross other Private Property: No Yes (If Yes, easement required, attach legal description and county easement number.) PLEASEAEAD THE ITEMS&ISTED ON THE BACK I A I % - - - ; -- Ld I ��em_ W�� I -I c rtify that I ve rea6—and shall comply FEB 2 2 1989 Patel with the items 11'sted on the back. PUBLIC WORKS Permit Fee: Trunk Charge: Assessment Fee: C>v 0 L) Partial Inspection: Issued By: bate Issued: Receipt No.: Comments Date Initial Final Inspection Approved: Date 6 rnitfal Rejected: Reason . —Ta—te —I—nitial ** PERMIT MUST BE POSTED ON JOB SITE ** White Copy - File Green Copy - Inspector Buff Copy - Applicant 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). Side Sewer Drawing The City of Edmonds N EASEMENT'NO - --------------------------------- ----------- NEW CONSTRUCTION REPAIRS F� LID NO . ................. ASMT. NO - ------------------ OWNER ------------------------------------------------------- ........ ------------- -------------------- CONTRACTOR- ----------------------------- PERMIT NO. JOB ADDRESS -------- VIA. W. ------- - ----- ---- S ------------------- LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------ -------------------------------------------------- I .......................... Vo ----------- ....... !A-g;_ -t PWW-0001-11/75 NAMEOF ADDITION ----------------------------------------------------------------------------------------------------------------------- 38 0 0&0 Approved: 11/78) DATE _ -2% .......... y ... q ............... 0 D � _�WE - ----------- ------- . .......... IT 7,77 Z 0 W U 04 0 �J. CkTY OF EDMONDS STREET FILE Permit No. COMMUNITY SERVU;ES DEPARTMENT RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date 1FAFAFAFAFA_FAFAFAFAFAF5 C : r B. o Contractor A. o Owner: C �� A \-4\, ­_�� �)ALkC— Name,,-,, Ia$e ­ i::� 7-5 _,� /N\\-" " 11 . :)N -c) Mailing Address Address 1�:, , I - a =% Q10 % i City State Zip City State Zip i�lx_ C-e— %,S, 1(3;-- It '\ LA ,16 �Jxs(.,o State License Number Telephone Number C. 9 Address or Vicinity of ConsLruqiqx�, Uklat` 4'M 0 % Q k T1 t-1 z, i Type of Work to be Done:' QL4"._ QQ c_ A i . A�� -, a -V J -T D. 0 Work in Connection With: 0 Sub or Plat ED Single Family El City Projects �_w 0 Commercial 0 Multifamily Utility E. 0 Pavement Cut: El Y i N F. 0 Size of Cut: — X APPLICANT TO READ AND SIGN 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, forseen or unforseen, 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, court costs, and attorney fees by reason of granting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. Estimated restoration fees will be held until the final street patch is completed by City forces, at which time a debit or credit will be processed for issuance to the applicant. • A 24 hour notice is required for inspection; Please call Engineering: 771-3202 • Work is to be inspected during progress and at completion. • Restoration to be in accordance with City Code. • Street to be kept clean at all times. • Traffic Control to be in accordance with City regulations. • All street -cut ditches must be patched with asphalt or City approved material prior to end of working day; NO EXCEPTIONS. I understand the above and that this permit st be avalfla le at the job site for inspection purposes at all times. V I Date:— Q Signature:. Owner or)Contractor Thig-Permit Must be Posted at the Job Site For Inspection Purposes Call DIAL -A -DIG Prior to Beginning Work APPROVED BY: PERMIT FEE: �, ju. C o t ktl "J� Time Authorized: Void after-- days. Restoration Fee: Special Conditions: Receipt No.: Fund I I I Fee: Street Cut Dimensions: x RELEASED BY: Date INSPECTED BY Date NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. March 1989 FIELD INSPECTION NOTES Comments: Diagram: (Fund I I I - Route copy to Street DeM.), 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 jj� - -- r� 14 cz� �zo Q- i Cp 5-- —xmc) C-D-2 %Oto ro t) D I J, � Q I-\,i r--- CITY OF EDMONDS STREff FILE ASSET INFORMATION SHEET 12//NEW ADDITION RETIREMENT ASSET NO. ADDITION TO ASSET NO. DESCRIPTION SERIAL NO. LOCATION D6PT. NO., *PURCHASE ORDER NO. PURCHASE ORDER DATE COST B.A.R.S. ACCOUNT NO. ESTIMATED LIFE - INITIATED BY M, 1:4 *PROJECTNUMBER PROJECT COMPLETION DATE COST APPROVED BY "SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST *SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT ACCOUNTING ONLY DXD"EPRECIATE MONTHLY DEPRECIATION AMOUNT ANNUAL DEPRECIATION AMOUNT G.L. ENTRY REFERENCE DATE (yp) INITIAL DEPARTMENT FILE VERIFIED BY PROCESSED BATCH NO.-