20000492.pdfI IIIIIII
PERMIT EXPIRES *LP—_
us'
PERMIT 200492
CITY OF EDMONDS ZONE
K, NUMBER
SUITEJAPT#
ADO 0
CONSTRUCTION PERMIT APPLICATION IOBRESS
OVINERNAMEINA EOFBUSINESS
S-rr-vg- �;40*feuC Z�_WW t AJAI
PLAT NAMEISUBDIVISION
NO. LOT NO,
L
L:l NO.___
B FEE � __
m
MAILING ADDRESS
/j _5-616 —�7439b 0,�Acc
PUBLIC RIGHT OF WAY PER .11IBIAL STREET MAP
El-
EXISTING PROPOSED .
REQUIRED DEDICATION— FT
........
""ll
A 0
CITY Z
17
61mottlil WA Woo
TELEPHONE
NAME
-7WqA4
METER SIZE I LINE
11 1 1 . 7
PRV REQUIRED
YES E3 NO
t ADDRESS
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDS AINAGE I_6
Z2
CITY 11P
stb#0A14 ko 92
6g 44?e?
e
SNG[NSERING REVIEW fDA_TI
/j
ADDRESS
0
.1 3;W
FIRE REVIEWED By DATE
I- CITY
8. z Wlf 1go �3
EP NE
RIP-12V
VARIANCE OR CU
SHORELINE OR ADS�
MPEG ION
I BOND
STATE LICENSE NUMBER P.—HONDATE
9 (2 (2 3 2 7 36 1//
CHE kGY
— "T.'
OYES ONO
I F-Ta
SEPAREVIEW
COMPLETE EXEMPT
EXP
—SIGN AREA
ALLOWED PROPOSED
HEIGHT
ALLOWED PROPOSED
J27 I
PROPERTY TAX ACCOLIN PARCEL NO.
NEW RGSIOENTIAL 19 PLUMBING I MECH
LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SETBACKS JFT,)
F )NT SIDE,, REAR
PR.P.��.�ETBA.KS(FT
F�ONT �RrOE REAR
COMPLIANCE 08
ADDITION COMMERCIAL 0 CHANGE OF USE
E3 REMODEL APARTMENT 0 SIGN
/0
REGD PROVIDED
AREA MING D BY D E
C3 PENCE
0 REPAIR X FTT
E.ARKE
C] DEMOLISH TANK ED OTHER
GARAGE M RETAININGWALL [3 RENEWAL
CARPORT — ROD E Y_
ACTIVITY) EXPLAIN:
COq
f�TION
GROUP j
CT OICUPAJ(
T NUMBER
' OF
C STORIES
UM8'RO'
-W 'ELLING
M�N TS
ICA
'AREAS
NUMBER -7
smu, RED YES
OCCUPANT
REA LOAD
17+OL
DESCRIBE WORK TO BS DONE
REMARKS
PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REO
4
yopoe-vy 6.30 W 1&r6r_abC 4
VALUATION
FEE
z
0
c: m
In C3 , � I
0
80
c
:0 m
IT! m
z
0 -n
m M
0
0 Fn
C 0)
c w
MO
z
RMIT
PLAN CHECK FEE
coll
z
0
0
m
i I EA� SOC 'Ibl
n
PLAN CAECK Nob-,,
LOT[L
I ��E��L
rESTED DATE
BUILDING
PLUMBING
MECHANICAL
2
:I
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC
DOMAIN JCURBS� SIDEWALKS, DRIVE 'S, MA QUEE% ETC.) WILL REOUIRE
WAY
SEPARATE P RMISSION.
GRADINGIFILL
STATE SURCHARGE
PERMIT APPLICATION: 180 DAYS
ERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
P R LIMIT ' YEA._ PROVIDED WORK
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
END REVIEW FEES
50
ENG, INSPECTION FEE
12.
L C L 0, HE SSiGNS AND SUCCESORS
;APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, A
'=NTEREST AGREES To INDEMNIFY EF.' D HARMLESS THE CITY OF
N INTEREST. AGREES TO tNDEMNIFY.LDEFEEMNPDLOAYNEDESHOALND AGENTS FROM ANY AND
S S�
EDMONDS,WA HINGTON. ITSOFFICIALS
R G . SCIF WN TSV R NATUHE. ARISING DIRECTLY 08 INDIRECTLY
ALL CLAIMS FOS CA.A.ES.1 WHATEVER NA
SHALL NOT BE
LANDSCAPING
INSPECTION FEE
EIPT
u
L?
FRO. TH. ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PE
0 F ANY CITY ORDINANCE
PLAN CHECK DEPOSIT
Z_
vu
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REOUtREMENT
ANY ORDINANCE PROVtSION�'
PT
FORLIMI INAN WAY THE CRY'$ ABILITY TO ENFORCE
T Y
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION
APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
S RUC.
p., uMil.,, IF, IF.
I ELAWSPEDULATH CON
T EOWNER.IAGREETOCOMFLYWITICIT ANDSTAT I G
WILL BE EMP OYED
CALL
d, I puI,:.AdFP.1dl
B
TION AND IN DOING THE WORK AUTH RIZEO THEREBY. NO PERSON
WASHINGTON RELATING TO
FOR INSPECTION
.pt i� n—M1,190d 11 RR- P,Illdld,
IN VIOLATION OF THE LA80A CODEOOF THE STATE OF
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.2T
OFFI tALS SIGNATURE
DATE SIGNED
(425)
771-0220
R
ATTENTION
EXT 333
C)C)
IT IS UNLAWFUL 0 SEOROC UPY A BUILDING OR STRUCTURE UNTIL
C
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
'ILE YELLOW APECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109
FAX
PINK OWNER GOLD - ASSESSOR
5.8
T clopy
V SCliWtNN SIDENCE
10506 - 243"' PLACE SW
U)MONDS,WA 98020
RECEIvE
MR( 2. 4.2000
LA
DEVELoPMENT SEAVjC8� CTR
CITY,OFEDMONDS.
<
1A
-Ink
Wgr
LOT
"ERVIOUS SURFACE CAMS
Existing Building Pad: 1,344 sE (constructed circa 1950
Existing Covered Porch: 16 sf. (constructed circa 1990)
Exii ing Driveway: 580 sf (constructed circa 1950s)
Proposed Addition: 630 sf
HEIGHT CALCS LOT AREA: 10, 160 sf
A= 101 LOT CO11FRAQE: 2,454 sf�24-/.,
H = 102
C=101 LOT SLOPE; Approx I %
1j D= 104
N
AVG. GRADE = 102
ACTUAL = 115.5
MAXWUM
A IED-BY �KXN IN
LEGAL
DESCRIPTION,
LOT. 15, 13LOOK 5, HRONROFADEWS'REPLAt OFFORt9T.CLENN,
ACCORDINO To YHE PLATIQ RECORDED IN-VO.L'U14e. 15. OF,PLAT
RECO DIREOF
PAGES 26 AND.26, OF. SNOHOMISH COUN.T.Y,'WASHINGTON.
SUEIXCT TO* EASEMENTS, RemmidiNs AD RESER�ATIO S
OF RECORD.
I
Ey
Z,
0,
01,
M.
m
00Q
3
-4
0
m
C
0
M m
0
0
C
m 0.
Z
z
z
M,
FINAL PROJECT APPMVAL F
TO:
DATE�
MEMO TO: PE I RNUT COORDINATOR, BUILDING DIVISION
FROM: ----FIRE DEPARTMENT DATE—
DIVISION DATE L2-
z
GINEERING —Li —10�
PLANNING DIVISION DATE—
M
PROJECT—
V5
M
SITE ADDRESS 16 56 0 4 M�
0
80
PERMIT INSPECTE
C
M
M z
e
DESCRIPTION OF WORK TO BE INSPECTED —
z
co
A field inspection was conducted to determine compliance with approved plans. Final approval denotes that
0 -n
-n
there are no objections from the above signed Department to the granting of
m
__$_—Final approval of the described work
0
rmance Bonds associated with the project may be released
m
C co
9 Cn
M 0
z �
_�—GRANT FINAL PROJECT APPROVAL
X
z
PROJECT APPROVAL WITH CONDITIONS NOTED
_GRANT,FINAL
z
1.
_____3AILED FINAL INSPECTION - OUTSTANDING ISSUES
rn
I
2.
3.
____RE-INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
ocaprvi.doc.l:ternp:bldg:forms6/98
�Lt)
r
PERMIT EXPIRES
U 'E
S'
PERMIT 200492,-�
ZON E 9S, NUMBER
CITY OF EDMONDS
0. SUITFJAPTN
CONSTRUCTION PERMIT AP PLICATION
�s— 6) "-J G�j
OWNER NAMEIAMI 01 BUSINESS
SIZ14 W I Aj Al
FLAT NAMEISUBDIVISION NO,
LID FEE $
C MAILING ADDRESS
—
—.2 q s oeb �,Acg� Sw
PUBLIC RIGHT OF WAY PER OFFIC
P,
/6 jo
EXISTING �� 'R.'CS.G_
o
CITY Zipat) TELEPHONE
4/A 9 6o
REQUIRED DEDICATION FT
Ik
NAME
PRV REQUIRED
YES 0 NO
-7'�fc 14 VAA 1'q 6 'j
ADDRESS
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
g
Z
CITY ZIP
sd),#o Al Isit, &14 62
r
NAME
00
i544--S 000X-Alz--7-10,,1
'C�'
ENGINEERING REVIEW ICATE
'57 �X
S
ADDRESS
Vr— Xl�
FIRE REVIEWED BY DATE
CITY ZIP
"t
LEPR NE
/a
BOND
m
IA
��
"V FIANCE OR CU SHORELINE 08 ADBI!
INSPEC, ION
STATE LICENSE NUMBER PIRATION GAT
EN
15, &
0 YES 0 NO
0
Q
SERA P1111W SIGN AREA
HEIGHT
PRO GEED
PROPERTY TAX ACCOUNT PARCEL NO.
EXEMPT AL OWED PROPOSED
ALLOWED
'Xp
LOT COVERAGE REQUIRED SETBACKS tF7.1
PROPOSED SETBACKS (FT)
NEW
PLU..IN.l..CR
REAR
ALLOWED PROPOSED FRONT IDE,
FRONT �R 0 REAR
I z1f
a m
ADDITION
G..ENC'A
�EEMENTIALL
ci COMPLIANCE OR
CHANGE OF USE
'�FT
'Z
D BY
m 0
0
PARKING
LOT AREA
ING IT
El RSM?DEL
APARTMENT
0
0 SIGN
R
���
c
[3 REPAIR
F NICE
GRADING CYDS E] CE— X FT�
m
0 DEMOLISH 0 TANK o OTHER
z
GARAGE RETAINING WALL RENEWAL
f-1 Do,
0 CARPORT �IISRY
t
vs
(TYPE OF —U!SUS OR ACTIVITY) EXPLAIN;
CHECK ITYPE
OF CoVqION
C OCCURA
GROUP
0 -n
-n
r
NUMBER
NUMBER OF
DWELLING
CRITICAL
AREAS
SPECIAL 1NSPE CTOR
JAIIA OCCUPANT
Iq -fq LOAD
M
I STORIES
OF
U, I
NUMBER
REQUIRE, C3 YES
t'5t
ncopz�
rn
DESCRIBE WORK TO BE DONE
REMARKS ECTION REO'D 3.
PROGRESS INSPECTIONS PER UBC 1081FINAL INSP
0
o Fn
ci 4 19q-5 VIA
C co
A Pp 4"'y ('30 pj(�'Labc '4
-136D tZ. a,14 /rV>'
VVIM �smm I law
VALUATION FEE
z t
PLAN CHECK FEE
co
LOT 1-01��
OF
z
So�C'
PLAN CHECK
2
VESTED ATE
m
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADINGIFILL
DOMAIN (CURB$. WAYS, MARQUEES, ETC.) WILL REQUIRE
SIDEWALKS, DRIVE
SEPARATE PERMISSION.
STATE SURCHARGE
PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT. I YEAR PROVIDED W RK IS STARTED WITHIN 180 DAYS
O� PINK PERMITOFOR MORE INFORMATION
END. REVIEW FEES
u 0
SEE BACK
BEHALF OF HIS,GS HER SPOUSE. H 1AS,ASSIG I AND SUCCE ORS
ENO. INSPECTION FEE
�APPLICANT, ON
IN Fy. DEFEND AN HOLD HARMl,VpS TH , ITY OF
AGREES TO INDEM
LANDSCAPING
EGINTEREST.
". EM'L ES AND ADEN FRO YAND
MONDE, WASHINGTO . ITS . FF IN Y
ALLCLAiMEFORDAMAG F HATEVER NATUR ARISING DIRE TLY R I DIRECTLY
E'
*HALL T BE
INSPECTION FEE
RECEIPT
FROM THE ISSUANCE OF THIS PERMIT. ISSU AND OFITHIS P IT N
NY ITY ROINAN E
PLAN OF CKOEPOSIT
EEMED To MODIFY. WAIVE lqlIIUOEANYlIEOUREMENTOF
D TOE
IN ANY WAYTHE CITY�S ABILITY NFORCEANYOR INAN EPROVISION
BAUILIly !Ut
RECEIPT
0 N OR LIMIT
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
PPLICATION A�!PRO AL
GIVEN CO RECT, A D THAT I AM THE OWNER
6 OTR�TT E E I I UrLy�A U T H OT2, 1�1.1 0 A G E N T . I
IS
COMPLY WITH CITY A, LAW EGLI, CONSTRUC.
E,,,T.ppI,caI—i-,A P-
CALL dimo omdw or hwh" Depuly PII
T"
I 0
THEOWNER. AGREE
TION: AND IN DOING THE WORK AD HOSIZED THEREBY No PERSON WILL BE EMPLOYED
RELATING TO
ipt I, cknowfodg.d m �p— P'. d d.
-- INSPECTION
FOR
1. 11OLATION 01 THE LABOR DE OF THE STATE OF WASHINGTON
COT
,WORKMEN'S COMPENSATION INSURANCE AND HOW 18.27.
111 OFFI IALS SIGNATURE E
—f.ATE
SIGNED
(425)
DATE
�2
771-0220
ATTENTION
EXT 333 () 0
TO USE OR OCCUPY A BUILDIN G OR STRUCTURE UNTIL
771-0221
IT IS UNLAWFUL
A FINAL INSPECTION HAS BEEN MADE AND AP PROVAL OR A CERTI
F I-ORIGINAL - FILE YELLOW - 14PECTOR
ASSESSOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
5198
FAX PINK - OWNER GOLD -