6923 163RD PL SW.PDFiiiiiiiiii,
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6923 1-63RD PL SW
STREET FILE
I L
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163 Pt,
STREET FILE
:10 /1 0.
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLIC]ATION
use � PERMIT
ZONE
L NUMBER 93631 g
ADDRES a 7
OW NA VE/NAME OF BUSINES1
Wo lr,,,�
F
LEGAL Ok:5r.RIPTIUN CHECKI
SUBDIVISION NO,
LID NO,
MAILING�ADEDZESS
3 w), tat 15 tv
1
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING — AEOUIRED DEDICATION
PROPOSED
E'
T SCIP Approved 0
R� Permit Required 0
Street Use Permit RIKI'd 0
Inspection Required C3
Side.alk Required 0
CITY --T—TELEPHONE
0 ovds 9AZ6j?0&-7q2,P21�
NUMBER
NAME
t4_;O/ J,111,jNJ EINCIINEEFI.�. MWO.O�TED
REVIEWSY
4-_P.16� jlf��
METCH 51zt
JOUR, I"IJ 511"LY 51ZI!
INO.OFFIXTURES
CITY TFLEPHONE NUMBER
-77
z z_k/,jqWe-�&d _3 -P ;
REMA4S
STATE LI CENSE NUMBER EXPIRATION DATE
SIGN AREA
ALLOWED PROPOSED
SEPA REVIEW
COMPLETE I EX �M /PT
EXP-)
ADS NO.
SH7ELINEV
Legal tion of Property - Include all easements
A-�4,q(-,4ed
cc
VARIANCE OR CU
R EVIEW BY
SETBACKS —F T
/ 0
FRONT DE J��R 112�
M.,
EI?HT_
:!:, ILI
S
L( T �-W��
'j, "b
z
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Property
Tax Account C�/ 9
Parcel No. r
H1,MA8Kr,
NEW RESIDENTIAL
RADDITION COMMERCIAL MECHANICAL
0 REMODEL El APT. BLDG. SIGN
CHECKED BY
TYPE OF CONSTRUCTION
-S,47 4911_�g
CODE
1 C?/
HEIGHT
11514m
F] GRADING FENCE
El REPAIR CYOS. I x _Fn
OODSTOVE SWIMPOOL
E.OLI.. [:] WINSERT HOT TUB/SPA
EGARAGE RETAI
C 1`411413WALL/�.
ARPORT-.: .0. ROCKERY- Ej RE;NEWAL
0 (TYPE OF USE. EXPLAIN:
a
67- MY/' -_ -_ - —
NUMBER OF STORIES NUMBER OF
a EC INSPECTOR JAREA
RPOUIARLED
YES
OCCUPANCY
R.Up
OCCUPANT
LOAD
REMARK&'
PROGRESS INSPECTIONS PER USC 305
DWELL NO
UNITS
DESCRIBE WORK TO 13E DONE (ATTACH PLOT PLAN)
77,� rA I e 1,(I'k
FINAL INSPECTION
REQUIRED
VALUATION
F
FEE
E E
PLAN CHECK FEE
_7LAZING
BUILDING
HEATSOURCE:
%
PLUMBING
Plan Check No.
MECH"ANIC*AL
This Permit covers work to be done on private property ONLY,
GRADINGIFILL
Any construction on the public domain (curbs, aid= �� '!
.driveways, marquees, etc.) will require separate per
STATE SURCHARGE
5
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENO. INSPECTION FEE
In successors in interest, agrees to indemnity; defend and hold
harmless the City of Edmonds, Washington. Its Officials,
3 employees and.agents from any and all claims foridamage� qf�
h.evei n� lure, arising'directly or Indirectly from the lssuanciY'
of this permit. Issuance of this permit shall not be deemed to
77W
MAY
/:20M
3z)
PLAN CHECK DEPOSIT
modify, waive or reduce any requirement of any city ordinance
? nor limit in any way the City's ability to enforce any ordinance
provision."
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the aa
I h 0 re
Information given Is correct; and that I am the owner, or the duly ATTENTION APPLICATION APPROVAL
I n fo rim a
u I ho"�
. :uthorized agent of the owner. I agree to comply with city and THIS PERM T
tate laws regulating construction; and In doing the work authorlz- AUTHORIZES This application Is not a permit until
. , le,
H
Le'td-th-ereby. no person will be employed in violation of the Labor ONLY T E signed by the Building Official or his/her
Code of the Stale of Washington relating to'Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is
tion Insurance INSPECTION acknowledged in space provided.
1. NA TUR I N I ERJOR AGENT) DATE SIGNED DEPARTMENT
9 CITY OF DATY
�3
EDMONDS 'Olt;
CALL FOR h(LEASEppy: DATE,
ATTENTION INSPECTION _V2
IT S UNLAWFUL TqUSE OR OCCUPY A BUILDING OR STRUCTURE
UJIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-0220 ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC
CHAPTER 3. PINK — Owner GOLD — AsseS50r
"�- - 1. - �b
Critical Areas Checklist'
Site Information
Project Name: t Permit Number
Site Location: 10 16 Property Tax Account Number.
Approximate Site Size (acres or square feet): Za 0-00r� 4
Have you filled out a Critical Arms Checklist for a project on this site b efore? —Aro
General Site Conditions
1. Has the site been cleared or logged? V-05 Date of most recent action:
f
Soils / Topography
2- In die Subhomish County Soil Survey, what is the mapped soil type(s)? ZVe-e-e ['A 11'e
CoA-*7
3. 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-)
luily: slopes present on site of more tim 15% and less thati. 3 O'Yo a vertical rise
of 10 feet of horizontal distance.)
Steep: grades of greAter than 301% present on site.
Comments
Hydrology/Vegetation.
4. Site contains areas of year-round standing water:
5. Site contains areas of seasonal standing water- �OApprox. Depth:
6. Site is in the floodway floodplain /J^() ot a water course-
7- Site contains a creek or an area where water flows across the grounds surface? A/0 flows.
are year-round? Flows are seasonal?
8. Site is primarily: forested. meadow shrubs X mixed
9. Obvious wetland is present on site: AIP
10- Wetland inventory or map indicates wetland present on site: ffO
11. Critical Areas -inventory or map indicates any Critical Area on site:
Rcv 3127192
City of Edmonds
Critical Areas
Checklist
'IhC Critical Areas Ch=Mist *
contained on
this form is to be filled out by any person
Prq)adng a Devejo
pmcntpeimit
APPlication for the city of Edmonds
prior
tO hisilicr submittal of a development permit
to the city.
111c Purpose of the Cheddist is to enable
City staff to daenxiine whether any potential
Qitical Areas are or may be present on the
subject property. The information needed to
complete the ChoMist should be easily
available fiom observations of thesite or
data available at City Hall (Critical Areas
inventories, maps. or soil surveys).
An applicant, or his/her representative.
.. must
,fill out the checildist, Siva and date k and
submit it to the City. Ihe City vn-U review
the chmMist, muke a precursory site visit,
and make a determination of the subsequent
stePs necessary to complete a development
Penmit application.
With a signed copyof this form. the
applicant should also submit a vicinity map
of the parcel with enough detail that City
staff can find and identify the subject
parcel(s). In addition, the applicant is
encouraged to include any other pertinent
information or sttidics 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:
Applicant Representative:
vJ 0 A) ( 4 (t/
Name It (�� .
Name
0,4A,,lefl—
Title -
&`70L-3
Street Address
City. State, ZI Phone
7/9 - d, 7-f ir
V- I?
Date
4191-
Title
Street Address
�t !III"vWC1d "U"';�L 7 71,9
4 , 'Ity, State, ZIP Phone
Date
Signature
City of Edmonds
Critical: Areas Determination
Applicant: William Wong Determination #: CA-93-131
Project Name: I . Permit Number: F- -1
Site Location: 6923 163rd Place SW Property Tax Acct #: 7412-000-019-00
Project Description:
Satalite dish
Waiver Criteria (all criteria must be found to apply):
xx There will be no alteration of the Critical Area or its required buffers;
XX The development proposal will not impact the Critical Area in a manner contrary to
the goals, purposes, objectives and requirements of the Critical Areas ordinance;
xx The development proposal meets the minimum standards of the Critical Areas
ordinance;
xx The above'findings are based on the following conditions of approval:
1. The applicant must comply with any requirements the Building Official
might call for due to construction on steep slopes (ECDC title 19.05, 19.00-
UBC chapter 70).
2. The applicant must follow the requirements of the Engineering Division for
erosion control (ECDC title 18).
Based on the above findings and conditions, the requirement for a Critical Areas Study
associated with this development permit is hereby Waived, as authorized by Chapter
20.15B. 150 (B) of the Edmonds Comm:unity,DeyveII,.,pment Code.
Stephen F. Bullock
Name Signature . Date
C I T Y of EDMON DS S I D E S E W E R P E R M I T
1FR JE02 14 AY 9 0 1987 PERMIT NO. 07700
For T
G REET,
IBLIG WORKS
Address of Cons truction: —6 '?10- //.,g _�? 11—`9 Pz -5- /v
Property Legal Description (Include all easements):
Lo-7 / 9 *Odbu_dafe_-� 4e-'IciK�5
Owner and/or Builder:
_:7-We_- -
Contractor & License No: I 98&1V 7-
V
# 0z
Single Family Residence tll� b I
Multi -Family (No. of Units
Commercial (No. of fixture Units
Invasion into City Right -of -Way: No P--" 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.)
PLEASE I::; L STED ON THE BACK
I certify that I have reacV,,fnd shall comply Da-tV
with the items listed on the back.
3000 -bA4C-
Permit Fee: Issued By:
Trunk Charge: Z 50-0 tate Issued: (ci -E-7
Assessment Fee: Receipt No.: b C1,50
Partial Inspection:
Comments Date Initial
Final Inspection Approved:
Date Initial
00
Rejected:
CD Reason InitiaT
Ln
PERMIT MUST BE POSTED ON JOB SITE
W
White Copy File Green Copy - Inspector Buff Copy - Applicant
The City of Edmonds Side Sewer Drawing EASEMENT NO. � ........................................... 4
NEW CONSTRUCTION REPAIRS E]
LID NO. - ................
AsmT. NO . ....... ..........
OWNER ------------------------------------------------------------------------------------------------ CONTRACTOR
--------
:Z.�9A-:n -----------
PERMIT NO. 0
JOB ADDRESS --------------- -------
Lk q
V-Q-,ARS
LEGAL DESCRIPTION: LOT NO. --------------------------- BLOCK NO - ------------------------------------
----------- ----------- ------------------------- --------- ................................ I --------- I ........................
NAME OF ADDITION ----------------------
Approved:
.......................................................... - 44
FWW-0001-11175 (REV.11/78)
DATEtO ......... �'L- - ----------------
------------------------------------------
CITY OF EDMONDS SIRFET FILE ASSET INFORMATION SHEET
1P/NEW
ADDITION
RETIREMENT
ASSET NO,
ADDITION TO ASSET NO. -
6�2'10
DESCRIPTION ZIA
SERIAL NO.
LOCATION DOT. NG).
4x-S-y-
PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
0
wp)
B.A.R.S. ACCOUNT NO.
ESTIMATED LIFE
PROJECT NUMBER O�z�_;:� 0 -
PROJECT COMPLETION DATE
COST
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
2 ZDEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
G.L. ENTR
m
. VERIFIED BY
PROCESSED
BATCH NO.-
REFERENCE DATE
INITIAL j
DEPARTMENT FILE
0; CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
&n S-
MAILING ADDRESS
7'A
-Z5—,O 7 - 16 V1
�),VLIL (�o
ADDRESS
FELEPHONE NUMBER
3�� -oy-?
NAME
CITY I TELEPHONE NUMBER
STATE LICENSE NUMBER
ption of Property - Include all easements
or attach four copies)
RESIDENTIAL
ADDIALTER
COMMERCIAL_
E] REPAIR
RETAINING WALL
EXCAVATE
DEMOLISH OR FILL
PRE- OVE INSPJ
C
REMODEL E] CONIMPLIANCE INS
WOOD STOVE/ []
INS APT.BLDG
i NUMBER OF STORIES NUMBEROF
DWELLING
2- 1UNITS
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
7-/
PLUMBING
MECHANICAL
SIGN
FENCE
I x -FT)
swim
1:1 RENEWAL
F11- �2-3 16 3rd JAZ.5k1
USE "-�PERMIT
ZONE '-ZG ,
2,0 NUMBER
JOB 4MI
ADDRESS //�6 ��
TA- f —, �'
-EGAL DESCRIP N CHECKI SUBDIVISION NO. LID NO.
L 7- Iq /P, ?-
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING -- 310 REQUIRED DEDICATION
PROPOSED -
RIGHT OF WAY CONSTRUCTION PERMIT'REQUIREQV
STREET USE PERMIT REQUIRED 0
SEE ENGINEERING MEMO DATED
Y SIZE IFIXTURE UNITS
SIGN AREA
PROPOSED
ENV. REVIEW
COMPLETE EXEMPT
V tr-�+
IM-64- I
ADB NO.
SHORELINE 0
VARIANCE OR CU
PLANNING REVIEW BY
—
D A T I/,.
YARDS
FROle' SIDE REAR
HEIGH�
ILOT VERAFe,
REMARKS
CIVVMLUE�t
Mky
CHECKED BY
jwfi
ITYPE OF CONSTRUCTION
7 - N)
,:I
CODtEe
t
HEIGHT
zsq
SPECIAL INSPECTOR
REQUIRE D
0 YES
AREA
OCCUPANCY
GROUP
OCCUPANT
LOAD
REMARKS
kv
"C, 3,DS
VALUATION
FEE
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private p*roperty ON - LY.
GRADING/FILL
Any construction on the public domain (curbs, sidewalks,
STATE SURCHARGE
driveways, marquess, etc.) will require separate permission.
Perinii Application: 186 Days
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
ENERGY CODE
'Applicant, on behalf of his or her ipouse, heirs*, asilg�ns inck
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
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
nor limit In any way the City's ability to enforce any ordinance
provision."
I hereby acknowle;ge 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
a
Cod f the State of Washington relating to Workmen's Compensa-
WORK NOTED
1Z MnsT rance.
INSPECTION
DEPARTMENT
SIGNA (OWNER OR ��ENT
OAT S11 NED
].UR
7
CITY OF
EDMONDS
r
107-01
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
Z
rc
Uj
Uj
Z
0
Z
11,
cc
Z
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(L
ATTENT10K 771-3202
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
102-78
RELEASED BY:
DATE
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
PpDJECT- REVIEW Cfff=S`T-:-,
-"PhaJECT ADORES
PROJECT S 72
12i
0,
Y - CaMMENTS
PLANNING
Reviewed
WTRISWR
by: (initial/c
STREET .1 ENGMG.-,'
... .. . FIRE
BUILDING
7
SINGIZ i�ku/ /661%�IAL — (C`i�cl",�. One),
SETBACKS,CHECKED Plannihg t,
17777771
"MARIANCE/SETRACK. ADJ.
-/177r/-/--/
ly7777T
-777777777
.771771/-777
777
7
CONDITIONAL USE PERMIT
T77177
ADB R=JiREMENTS CHECKED� -1: ;'T
OTHER Zc�m 'RE'Q'U'IRBMM
4
DmRoNmE"rAL Fr ATum
�5
7TT[=
777777-777
7777777
ACCESS SLOPE & VEHICLE ACCESS
/////////
-///////
3 !- P
DRAINAGE'PLAN (On teY.�Nma6VIXIAC
T717717
1
T
STRIEr FILE
11111T
18
777777TI7711111111
T/T7777
LEGAL DESCRIPTION VERIFICATION
e111111
'9
777777
TITR7777
7T7T7777T
T1771111
QUIT CLAIM/DEDICATIONS -
10
7
7 TTTR 7 7 T
7 T/T/ 7 77
EASEMENT PUBLIC/PRIVATE
77
CALCULATE SBIER CONNECTION IF 9) LID#
7
77TT[T177771717777771
12
T1 77-7
1
PIAT/SUBDIVISICN REQ-)UIRFMENTS
13
RIGHT-OF-WAY CONSTRUCTION PERMIT'REm-
T17TIT
77TF=
7Tf7Trl7f
14'
7TIllUll
77777777
BOND REM FOR P[JBL IC IMPROVEMMTS
5
-CONDITIalf, & GROUND
111117
TITT1777T77711111
'j6
WATER FIEID ClfECKED
STREET PAVING REQUIRED
17
777
777777777
CURB AND GbTTER: Rl�)UIRED'l- �k 4:
18
SIDE$QaX'REQUi RED'
7 T1 T/7
7 TTTTT9 7
7TTTfTF T
19
/77
-1177T
77U/////
rl
777/777777
7
CURB CUT FOR DRIVEWAY REQD
20
STREET NAME SIGN REQD CIO,—
21
1 3,kr, - .
a
a
07MM SIGNING RECD �& - A\
7=
7777TITIT
7777T"ll
7 7 TT17TR7
22
SIDE SEWER:AVAILABILITY
77777777
77777TIT.
2j
I W,
OP
711711
77777777T-
7777/77
EXISTING WATER MAIN SIZE .,m%�eg - '
24
—
'UV-
WATER METER SIZE, ..c
77T/77777
25
7—
SERVICE LINE SIZE
7TIT/7
7TITT7TIT
7717117777777777
-717TIT
HYDRANT.- R�l RED
7TIPITIT7717TTIT71
27
7.7777 7777717
HYDRANT'SIZE EXISTING
28
TTIT
29
cl
WATER METER V�R6E REGO, 11
11111?V111
30
FIRE LINE CHARGE
1IT77TI7
77777777.777777-777
31
sTREericur-
1�1111VIII
32
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J,
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IJX
33
33
77/77
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t
35
-SIZi
36
CATCH. BASIN'REQO�
7 7 7T17
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MICATED ON -SITE, PLAN.*
38
SHOULDER DRAINAGE � MAINTAIN. j
SHALE OPEN MNOFF
T/777
7TTF1177T
7
39
40
REVIEWED -BY:
PLANNING MGR. ENGINEERING MGR.
4,
7
A p;-t t-.!,k
N®R kvl' 4�1-
PUBBIC WORKS MGR.
0
MEMO TO: Building Division
FROM: Engineering Division
SUBJECT: z5ge
After review of the subject building permit application, we have the
following comments:
1) Connection to City water system required.
2) Connection to City sanitary sewer system required.
3) Right-of-way permit required for any work.on City property.
4) Driveway slope not to exceed 14%.
5) Back water valve required if downstairs plumbing is below
elevation of upstream manhole.
6) Water and sewer lines to be separated by 10 foot minimum.
7) Builder/owner responsible for containing all temporary runoff ' and
erosion on site and may not impact neighboring properties in any
way.
8) Construction hours from 7:00 a.m. to 10:00 p.m. on weekdays and
10:00 a.m. to 6:00 P.m. on weekends and holidays.
-)/'w 66'0 60'
EX. MO/U/CA5F-
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SHEET 2 OF 2