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7027 165TH PL SW.PDFiiiiiiiiii -� 920 7027 165TH PL SW 11 IF 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). APPLICATION The City of Edmonds, for EASEMENT NO - -------------------------------------------- SIDE SEWER PERMIT NEW CONSTRUCTION REPAIRS LID NO. - ................ ASMT. NO . ........... OWNER ------ ------- �- -------------------------------------- '�'CONTRACTOR ------ �--D 9�i PERMIT NO. JOB ADDRESS ------------- LEGAL DESCRIPTION: LOT NO - ----------- -------------------------- BLOCK NO - ------------------------------------ '0 0 NAME OF ADDITION .......... ....... �'p 7- -- -- - ............................................... Approved: DATE..................... Bya* .................................. _,;-_11 77- 7 - -- ---- .S, ;,,-SE,.W PEk-MIT. IDE �4$R M FY' %.O,'F,. ED ��l A-SEWkRDEPARTMENT' AIT 'PERM '(,,C a I P1, 175-2525 for, side sewer. 4nspectiohs, �_BEORF. :co�ering) any, portion of. 1fie .,C?n�tru I cti ?P�,N I e ctian -will' be, providedt' Within, 24 hoursjiafte`� requst. NO ­Sat., SU6.,: or'4ollday Inspections.7 DRES& LOCATION- 70 V7'"', .................................... ...................................................................... .......... .................... A, PROPERTY LEGAL;-DESCRIP n'O14,.:..J* ................. r, ... .... zi-zv ..... I .... ! ... ! ..... t� ........... . . . . ... . ... .... ........ ............................. .................................. ............................... ........... . . m ....... 7 ............................................. ......................................................... ....................................................................................... ................................ w ................... OWNER -AN,]?/OR, BUILDER -A )` C`�-)'�VAA .................................. ...... ------- 7 ....................... 7­1 ............ 7 ........... ..... V T� CONTRACTORISWMIEi: 'AMDRESS.; ... D. ........ ... ......... ................... ........... ............ .. ............. ................... n1sMon.1s:grant6d' '19 for- repair and/or,e ty�'��fi r wer� Pen ......................................... ................. onnection of a side,�se*er toi: t .systblln- in acibordali&i-with City, -of Edinonds, ordin* ances. -ATTENTTON,�§.�PAL D OTE;.No. .1�'The,.ownez t act 't '��nSt* U�j �4,bf,%the'propeity may obtain a. permit to,.cofistruA, sewer*- inside pr'oper�y�llne: A licensed',Side 'sewer' C' on r or emp pyed, o r side' iewei-.fi;"Utreelt�.area. Do not,cover any'portion, of'sewer before it has been Inspected,. �411` NQTIP No. '2—All k ' jrli*,,`�_4�'f��&In 461ty right-,6f-way requires; an Invasion. of. -RJghtr�f-Way Permit obtaJnable from the City Engineer's. office. P�` NOTE No., 3!--Obtai�n',f6'ltii�fori�atio�,,,�ejELrding Ordinance 11%1'6�030,` cl� Regulations 'govern Ing'side sewers When youl get -perTnit. . . . an l�O.TE.No,..-,4;—Top-oizsi�e--sewer'r��st,li�ve,at least 30, Inches. coverage. at property Iline and: 12. inches. inside -property lifie; minirau - rn� 'rade of 2 No� bends lh;,grade: sharpe�,*th 9 an 'A�. wil0be iiermltted� NOTE 'No., 5L.Trenches-An . street must.�be: water -settled and surface of street restored, to original condition. Contractors shall be responsible for failure due i6 Improper work which, may,develop,within 'one year of completion.' NOTE'No. 6--It Is �urflawfulf to,alter or do any other, work than Is provided'forAn the permit, or t6,do any work on the roaln sewer or its 4ppurtenainces except. to, in- sert:thebipeAnto the, wyi. DISAPPROVED "Ej Date ... . ................ .......... .... 11y ................ Date;.� ........ ;V­ ...... 7 .......... . B�y� ............... D t ............... . .......... ............ APPROVED� Date ........... ..... ...................................................................... ................ . .............................. ....... -neit rks:. ...................................... ........... ............................. ....................................................... ..................................................... .... .......... . .. . ....... .......... ..................................... ........ ................... ............................... ..... 4'1_,_:' - r. t . .. -r. ............................... .......... A;6T C piesi MUST''Be'Signed. By Owner,of :Firm %Performing boths"trikibn. PRIOR To Request- For- lns� e*ction' (Owner,of, erebylcertify, thaft I �e,side!sewer -ins tallatfon constructed uhder this,.permit ,was, installed/in accordance withallgpverning.ordinances of* the City'of Edmond& U Date& -this: ............... of .............................................. ......... ........ ....... .............. Check IiE'FORE you',dig'foi: Water'E], Gas Telephorie,�3, Power.;0, Sewert.E]j,­Qther'E] VVI STREET FILE DATE: MEMO TO: Building Division Community Development Department FROM: Engineering Division ' Public Work-s Department SUBJECT: 2027-I(OF I �n 9LACirn After review of'the subject building permit application,. we have the following comments, (1) Coordination of the location of any structure with respect to utilities,,streets, property lines and driveway grades is t responsibility of the contractor. (2) The contractor is required to keep the abutting streets clean- ed of dirt and de5ris caused by the construction. _(3). A "Right -of -Way Construction Permit" is required, from the Engineering Division of Public Works, for any work within the Public_Right-of-h,ay or public easement. PIV 5/77 Driveway slope not to exceed 14%. rX ,;I 61 .K&40T b OIL", NMtjr Ric 0, ILA yli4l�'a U. I 2ral -510317 . a - Date ddress Z IStreet Right -of -Way Existing 156/A cl REQD N-A. Access Easements Existing REQD Utility Easement Existing REQD Lot pe-:� Subdivision Plat Assessor map Site Plan Checked for Accuracy . 4 H � Underground Wiring Reqd. Y 01 Check Accuracy of 1.6gal Description E51 Environmentally'Sensitive Area PC) Z Environmental Checklist Reqd. Flood Hazard Zone Shoreline Management Area. �J 0 Z 3 -Slope, Soil, Vegetatf-on 'Stream, Creek, Drainage Basin Existing Zoning Ter Code Amenities Design Board Approval Reqd. ADB # Approval Board of Adjustment Approval Reqd.. 0 OT!- Review By: F) " t;r� Date:-- r-�, IS 1-71S Existing Water Main Size C.Z Water Main Reqd. P4 Service Line Reqd. e W Hydrant Size Existing C> r- Hydran t Reqd. Per Fire Code Size Detector Check Meter Reqd. ILAO Cross Connection Inspection 4,910 Fire Department Comments Water Meter Chargg /S Reqd. -awpgR, 40 0 Review by: ;71-7 Date: �f Septic Tank Permit Reqd. Permit No. Sanitary Sewer Availability Proi. Drawing No. File No. —APi, W Side Sewer Availability 7-D �3: - W Sanitary Sewer Connection Fee Reqd. Review By: W/S Date: Open Ditch Existing_21��..._R�eqd. Culvert Reqd. /V —Size P� Catch Basin Reqd. Indicate.on Site Plan Shoulder drainage =intaixi collection an swale open 'runoff 1�1,u-ihole reqd. Indicate ai Site Plan Soil Conditions and Ground Water Field Checked -,oO' oa._ Review by Date Street Paving Req'd._AY— Curb and Cutter Reqd.' Sidewalk Reqd. -Al-a . Curb Cut for Drivewa)� Reqd.'_ jnt�: A�92�4, AUP4 100, Right -of -Way Construction Permit Reqd. r,6- e Bond Reqd. for Public Improvements M Street Nwir_ Sign Reqd.. Other Signing Reqd. I LD &)V-- �Pre Permit Site Inspection made on 51 27� ,.� -4 BY: SMER WW WATER U) STREET ENGINEE- RING. Special Requireinnants listed in mem to Connunity Development Department, Building Division BY Date o All item filled in on Building Permit Application BY Date Drawings Stamped and Notations Made BY ex Date Approved by 'Public 14orks DeparLinent Revised: lv 10-1977 \rju�KF--;;AWD OfPSF-r. Vf-f�IFY 60NDIl-IONS ON -jO5SITF-- F��T To :&w Ir. RF-CEIVF ,TIW.t (DNTIW-IZA� -KE5FOt�901-F- fOK fbL.�OW(Wl- -MAWWFAC�RE16 SEP D�WIX?AT-ON5, 50K Sf-l-�-rlKfq E.QWIFMfqT- AND 5OWfl?, -epEf-:p ?ERMIT COUNTER To A&flttVF- �\ BkMcfp �w5rfm 9-'K, AW- LWR MAT-Ff;�INI-S *�)F, Fk? .165 in Building Permit STREET FIL9 Application Information Application #.. 920792BLDG Date... 9/08/92 Site Address 7027 165th Pl SW Job Name ........ NYS. Owner Information Name ........... Steve & Kim Nys_1 Address ....... 7027 1.65th-Pl SW City/St/Zip... Edmonds, Wa Home Phone .... �742­7218 Work '.Phone... --.Contractor Information - Name .......... Address ....... City/St/Zip... Contact ....... Name .......... Address ........ City/St/Zip... Contact ......... Name .......... Address ....... City/St/Zip,.. Contact ....... Phone. . . ...Architect Information Permit... # P-920792BLDG Unit ATA# 6550 000 010 00 98.026 cdnt #... OWNER Arch #... Phone ... 776-3444 Engineer Information Engir Pho.n.e... New ...... Addition...-. Alteration..... X Repair ....... Nature -of Work.. Remodel existing garag e into den Building Type code ... SFR-VM Cost/SqFt ... $ 65.12 Building.Area Basement ......... First Story .... 412 Second Story ..... Third Story .... Over 3 Stories ... Garage ......... Decks ............ Shell Only___- N Total. Square Footage ...... 412 ......... 1,500.(10 Puild-:Lng Permit. Fee.... $ 33..5U Pi. an pzeview F(se ........ 20.48 "'. ' L .1 . () 8, .0t.a.1, Vees ............ $ Heat. . - 0 STREET FILE DATE: -2 HFMO TO: BUilding Division Coli"lluniLy Development DcparLmenL FROH; Erl,�'YineerLng Division Public Works Department SUBJECT: After reviex, oF Che subject building permit application, i,,e have the following comments: ki a bz =Pant- I-e'r' 0 I PUBLIC 0 Z �-4 Z Z SPAINIALek SY5-1r-m 0 DEPARTmENT CHECKLIST Cr A IR I/ W /L-D S PE1;U1,aT REVIEW FL el 1dressP:T;T,-, te' 7q 3- Z674 Street Right -of -Way Exist' 1. Mg­�����­REQD Access Easements Existin Utility Easement Exist* ing REQD Lot Per Subdivision Plat Assessor map, Site Plan Checked for Accuracy_ Underground Wiring Reqd. Check Accuracy of Legal Description Review by Existing Water Main Size ­ Water Main Required Service Line Required Hydrant Size Existing_ Hydrant Reqd Per Fire Code W Detector Check �tter Reqd. H Cross Connection Inspecti .< I Fire Departrnmt COnrjents I Date Size —V —RE— VXC V —0 n a T)OWN TmagrT V,41 AVIOSPHSX(c I'dater Meter Charge Reqd. Review b Y4 I —I ID a t e ZAP -WIN= -3 AMe Us Septic Tank Design Approved Septic Tank Permit Reqd. Date Sanitary Sewer Availabili Dermit No.— Drawing No. Proi -------Yile No. C4 Side Sewer Availabili W Sanitary Sewer Connection Fee Reqd. Review b W ------------- Date In Open Ditch Exist' "9-��...­Reqd. x Culvert Reqd. 04 Catch Basin Reqd. — Size ------------ 0 Shoulder drainage maintain o 1 c Indicate On Site Plan on E­4 swale open runoff U) �bnhole reqd. I Soil Conditions and Ground Water Field Indicate on Site Plan Checked Review b —Date_ Z44J9-� Revised: lvlO-1977 I MIT USE N Applicant Fill ZON )__NU M13ER L ICATION lns�ide Heavy Lines "AME OF�78USINESS) AODRESS I" n LEGAL DESCRIPTION I SUBDIVISION SHORT SU13 NO. Z 0 CITY e -.1 U I U NAME M — S (� I � 0 ADDRESS I- U T CITY z 0 U �vAyr LICENSE Legal Descripti9p of Property z U In W a J W J RcDW) ELEPHONE NUMBE ELEPHONE NUMBER ONE NUMBER LICEN ;—Below or Attach Four Copies) --z -0 �\j Ik 0 v� 0' FRONT NEW 9RESICENTIAL. JAL GAS El LINE FIRE ZONE TV NON-RESIDEINIT SIGN ITY EJADD DEMOLISH RETAINING SPECIAL INSPECTOR REQUIRED ALTER EXCAVATE OR FILL WALL FENCE I — X —FT) 0 YES El r-4 o PLAN CHECKED gY REPAIR PRE -MOVE INSP. swim POOL REMARKS Z NUMS(:Ur S IUMBER OF )WELLING 1 NITS TURE OF WORK TO BE DONE M C—DkokkKJ co PLAN CHECK FEE 2 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING PROPOSED DEFICIENCY OF RIGHT OF WAY PUBLIC IMPROVEMENTS REQUIRED 11 DRA:NAGE IMPROVEMENTS REQUIRED Cl DRA NAGE PLAN REQUIRED El UNDERGROUND WIRING REQUIRED 0 CONNECTION TO SANITARY SEWER 0 SEPTIC TANK PERMIT REQ-D 0 NO. ELEVATION OF PROPERTY CORNERS El & FOOTINGS REQ'D SEE ENGINEERING MEMO DATED CHECKED BY METER SIZE I BUILDING SUPPLY SIZE SIGN AREA JCOMENV. REVIE�J- ALLOWED I PROPOSED PLETE I EXE M PT SHORE REMARKS VARIANCE OR CU PLANNING REVIEW BY DATE YARDS LOT COVERAGE SIDE REAR -r—__ PE OF CONSTRUCTION DE )HEIGHT BUILDING PLUMBING MECHANICAL FENCE SIGN "Applicant, on behalf of his or her spouse, heirs, assigns and successors in interest. agrees to indemnify, defend and hold harmless J 2 tile City of Edmonds, Washington, its officials, employees, and M agents from any and all claims for darliages of whatever naturc, < arising directly or indirectly front the issuance of this permit. Issu- ancc of this permit shall not be (teemed to modify, waive or reduce 1;-,;# in nnv w-iv the RETAINING WALL SWIMMING POOL A OCCUPANCY OCCUPANT IGROUP I LOAD THIS SITE IS LOCATED IN THE CITY OF EDMONDS. LOCAL SALES TAX SHOULD BE CODED 31.04. VALUATION I FEE Ity a 71' B4&ESS LICENSE APPLICATION DA LICENSE NO. CITY of EDMONDS 4 LW_ Civic Center - Edmonds, Washington ANNUAL FEES City Clerk Phone 775-2525 9`0 PENALTY AFTER FEB. 15 STREET FILE -A HOME OCCUPATION' INSTRUCTIONS: • All items must be completed or application will not be ac- cepted. • Sign and return application with fee. Renewals received $10.00 (A) ADDITIONAL $5.00 0 0 SMALL BUSINESS $15.00 (B) ADDITIONAL $7.50 0 0 Business with 10 or more employees ADDITIONAL $25.00 0 $50.00 (C) after February 15 must pay .9 NEW APPLICATION (LA) penalty in addition to fee. El RENEWAL (L B) NEW BUSINESSES AFTER 0 CHANGE (LC) JULY 31, 1/2 FEE. (PLEASE MAKE ANY NECESSARY CHANGES) 0 DELETE (LD) NAME OF FIRM BUSINESS PHONE NO. OF EMPLOYEES t,!\, k. ) . -MAILING. ADDRESS -7 NATUREj?F. BUSINESS J, <1 DATE OF B EMERGENCY NOTIFICATION: (PLEASE LIST TWO) INDIVIDUAL = (S) HOME ADUR-ESS 70��] /6-15*1"AR PLAP_E OF BIRTH (1) NAME & TELEPHONE C., (2) NAME & TELEPHONE .1-L) WASHINGTON STATETAX NO. e' . (70� APPLICANT'S SIGNATURE t7 a, e"S PARTNERSHIP T) SOCIAI CORPORATION P ow, t- ,URITY.NUMBER ( ),) '_,� I DO NOT WRITE BELOW THIS LINE STAFF REVIEW: FILL IN LAND USE CODE, UFIR NUMBERS, ZONI�b, ETC. CHECK APPROVAL OR DISAPPROVAL, DATE, AND SIGN. IF DISAPPROVAL, PLEASE COMPLETE "COMMENT" SECTION. ROUTE TO. NEXT DEPARTMENT ON LIST. PLANNING DEPARTMENT DATE LAN.,D USE COD E ZONING CODE ffAPPROVE El DISAPPROVE SIGNATURE'Y) E d-Ajz_�6-u I S k 1 r2 CONDITIONAL USE PERMIT COMMENTS e C�CC B�XLDING DEPARTMENT DATE 16 - K) . APPROVE 0 DISAPPROVE SIGNATURE Ik.A COMMENTS: ' . - CAPACITY: .(NO. UNITS, APTS., OFFICES,' SEATS, BEDS, STUDENTS) F113E DEPARTMENT DATE r��rAPOROVE C1. DISAPPROVE S IG NATU R E;�� COMMENTS: PO�XE DEPARTMENT DATE APPROVE 0 DISAPPIRbV'E' SIGNAtURE COMMENTS: PUBLIC WORKS. DEPARTMENT .,,.DATE 7!� 0 DISAPPROVE d"- SIGNATURE Building El Hotel/Motel (L) Permit.- '0 -Apt. Bldg. (A) I I I I Ll 1 13 Office Bldg. (0) Occup?n'cy, 0 Restaurant (R) Group-""" 0 Hosp/Nurs Home (H) Irin- El -school (S) COMMENTS: USE B 13U I LDING DIV ISIOPW'��" Applicant Fill ZONE f2 <� u L Inside Heavy Lines FERMIT APPLICATION P E! 1. Joe SS NAME JOR NAME OF BUSINESS) ADORE LEGAL DESCRIPTIOf IBDI ON SHORT SUB -NO. Ir . sk� MAILING ADDRESS — 1 1 W z � _WY1 �t4, — ­�� 0, �Sw - 0 PUE]LIC RIGHT OF WAY PER OFFICIAL, STREET MAP CITY ELEPHONE NUMBER LA EXISTING PROPOSED NAME I- DEFICIENCY OF RIGHT OF WAY U W ADDRESS t PUBLIC IMPROVEMENTS REQUIRED 0 z U DRAINAGE IMPROVEMENTS REQUIRED M CITY TELEPHONE NUMBER DRAINAGE PLAN REQUIRED 0 UNDERGROUND WIRING REQUIRED El NAME < 3 r-- CONNECTION TO SANITARY SEWER C3 13 SEPTIC TANK PERMIT REQ'D* NO. 0 ADDRESS I- ELEVATION OF PROPERTY CORNERS 0 U FOOTINGS REQ'D CITY TELEPHONE NUMBER Z SEE ENGINEERING MEMO DATED 0 U STATE LICENSEE NUM13ER CITY LICENSE NUMBEW_ CHECKED 13Y Legal Descripti of Property (Show Below or Attach Four Copies) 1; . METER SIZE. BUILDING SUPPLY SIZE Lry-�_ 1 () �A(.) rP_ 1 -7-0 �) k 0 r-c- X -3/4 1 1 1 - Z 0 I - IL M U 'n W a _j pixl�,T'IKU 49GUIce SIGN AREA ENV. REVIEW ADB NE ALLOWED PROPOSED COMPLETE EXEMPT SHORELIN REMARKS VARIANCE OR CU IPLANNING REVIEW BY I DATE YARDS FRONT m 1 4 SIDE .,.JLOT COVERAGE NEW RESID ENTIAL GAS LINE FIRE ZONE T'W ADD JLJ El NON-RESIOENTIA SIGN F DEMOLISH RETAINING SPECIAL INSPE ALTER XCAVATE WALL FENCE REQUIRED 0 YES El r-j 0 OR FILL I— X—FT) PLAN CHECKED BY REPAIR PRE -MOVE WIM INSP. [:]SPOOL Z NUM8.7 OF STORIES OF REMARKS 0 194UME31ER DWELLING UNITS NATURE OF WORK TO BE DONE U 0 - W a M PLAN CHECK FEE I-11ECE11. BUILDING APR 3 0 PLUMBING MECHANICAL vilorks FENCE "Applicant, on behalf of his or her spouse, heirs, assigns and SIGN W _j successors in interest, agrees to indemnify, defend and hold harmless 2 the City of Edmonds, Washington, its officials, employees, and RETAINING WALL agents from any and all claims for damages of whatever nature, i arising directly or indirectly from the issuance of this permit. Issu- SWIMMING POOL ol ance of this permit shall not be deemed to modify, waive or reduce 0 any requirement of any city ordinance nor limit in any way the X City's ability to enforce any ordinance provision." I hereby acknowledge that I have'read this application; that the in- TOTAL AMOUNT DUE formation given is correct;. and that I am the owner,'or the duly author- ized agent of the owner. I agree to comply with city and state laws regu- lating construction; and in doing the work'authorized thereby, no person ATTENTION will be employed in violation of the Labor Code of., the State of Washington relating to Workmen's Compensation Insurance. * THIS PERMIT NOTE: Permit Limit One Yeor(Except DEMOLITIONS and FILL AUTHORIZES 014LY PERMITS without conditional use permit, which shall be completed in 90. THE WORK NOTED days; MOVED -IN BUILDINGS shall be completed in six months.) SIGNPRE JOWNER Oil AG NT ATE SIGNED INSPECTION DEPARTMENT AX j 79 CITY OF EDMONDS This Permit covers work to be done on private property ONLY. 775-2525 Any construction on the public domain (curbs, sidewalks, driveways, marquess, etc.) will require separate permission. ATTENTION 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 304,306. 102-78 F CONSTRUCTION I CODE HEIGHI I q'7 G AREA OCCUPANCY OCCUPA — IGROUP rL - _� LOAD THIS SITE IS LOCATED IN THE CITY OF EDMONDS. LOCAL SALES TAX SHOULD BE CODED 31.04. VALUATION I FEE 00 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 -pro- vided. RECTOR'S SIGNATURE 10— 5- -7cl ORIGINAL - File YELLOW -1 - nspector PINK - Owner GOLD - Assessor 0 3: U M W 3: I- z W z 0 W 0 U