20000569.pdfDATE
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME 0717
)I�r_-Af q- b � 2: W ('_1 6
MAILING ADDRESS
2-oill Ave 0,
CITY ZIP
cl)rnojo 5 sl)z,4
ADDRESS
CITY ZIP
9,4k�M4AI C6AJST1f-qcJ_1bAJ
jT1111"11E
ZIP
;TATE LICENSE NUMBER
41,4?- 1) M c >,- //I
ROPERTY TAX ACCOUNT PARCEL...
/ � z -v- 6 /( D It ') 6 o
0 NEW fg] RESIDENrIAL C3 PLUMBING t MECH
0 cl COMPLIANCE OR
ADDITION C] COMMERCIAL CHANGE OF USE
0 REMODEL APARTMENT [3 SIGN
0 IEHCE
C] REPAIR GRADING YD. , _ X FT)
DEMOLISH TANK 0 OTHER
G AIIAG E C] BRMRINYG WALL 0 RENEWAL
CAF,.RT
-ACTIVITY) EXPLAIN:
SIR
NUMBER OF .,CAL
I ....E.LuNG A EAS
OF UNITS NUMBER f1i
STORIES
DESCRIBE WORK TO BE DONE
A,;,,) 4d �'v 2 2-' -ro 6y_T-&,Jb
,yC )<I S7-t/J t, 1361blZe) 6 Os_=
6 (JEZ kr--)((s7 tAJ t, 6 A K A—&—,'
[PERMIT EXPIRES
P ERMIT
NUMBER
JOB Sul DAPTN
ADDRES& 190"
L-1)
- -
PI -AT NAMEfSUSDIVISION NO.
IOTNO
LID NO.
LIC FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
T .. P
R., U-11.
0
EXISTING — PROPOSED—
..100
SW ... Ik 9110
0
13
REQUIRED DEDICATION— FT
METER SIZE TuNE
'ZE
No. OF FIXTURES
PIV REOUIPE�
D
1E
--REMARKS
I....1--l— A1,11.NSIBLE FOR EROSION CONTROL/DSAINAGE
FIRE REVIEWED BY DATE
VARIANCE OR CLI
VA
SHORELINE OR ADD.
INSP
c] Y�
SEPA REVIEW
APLETE EXEMPT
SIGN AREA
ALLOWED PROPOSED
HEIGHT
ALLOWED PROPOSED
Eco, :i4=
Xp
X
;7-5 ,
LOT COVERAGE
REQUIRED SETBACKS (FT)
PFIOPO�SD SETBACKS (PT)
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT R CE REAR
'-F
2-51 Xp
I
15 -7&/?,y,
-
z"
PARKING
LOT AR A PLANNING REVIEWED By DATE/
RE5 PROVIDED
B
-0_,--
e �xxt t %5� ee,
ITYPEOFCON I OCCUPANT,
GROUP
-iPE CCUPANT
CAD
qq INSPECTIONS PER UBC 1081FINAL INSPFCTI
VALUATION FEE
PLAN CHECK FEE
11 LOT SLOPE I
BUILDING
6�,IEAT
PLAN CHECK NO:
erb
PLUMBIN
MECHANIC�L
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 (CURDS, SIDEWALKS. DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
STATE SURCHARGE
PERMIT APPLICATION: 1800AYS
I YE
PERMIT LIMIT.- 1 AR ' PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENO. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ON BEHALF OF HIS OR HER SPOUSE, HEHIS. A�IGNS AND SUCCESORS
ION
;APPLICANT.
N INTEREST, AGREES TO DEFEND AND HOLD HARMLESS THE CITY OF
LANDSC PING
:NDEMNIFY.
E EDMONDS. WASHINGTON. TS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANYAND
INSPECTION FEE
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
OF TH, S PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
FRO THE ISSUANCE OF THIS PERMIT, ISSUANCE
DEEMN ANY CITY ORDINANCE
EDT MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF
0
NOR LIMIT IN ANY WAY THE CITY'$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
TOTAL AMOUNT DUE
PT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPUCATtON; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
T .1pli-I � " - . w 0 �iq by th.
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
Bu",h Oljjc� I D.,I,: -cl F .- j. -d
TION; AND IN DO NG THE WORK AUTHORIZED THEREBY, N PERSON WILL BE EMPLOYED
1 0 RELATING TO
,,,,pt �. 11-wildgId 1. 10 Pf0v1d0d
'TIO
FOR INSPEC
N VIOLAT ON OF THE LABOR CODE OF THE STATE OF WASHINGTON
I
WORKMEN'S COMPENSATION INSURANCE AND RCW '82,
OFF IALS SIGNATURE DATE
(425)
-7
OAT'
IOWNE��q IGNED
0
16
_j 771-0220
RbL.A
EXT 333
ATTENTION
OR STRUCTURE UNTIL
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING 771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL FILE YELLOW
ASSESSOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER GOLD -
�198
z
0
m
Ma
0
mm
M
10
c
0 -n
n
-4
M
rn rn
0
0
0
cm
m
mo
z
--I
z
z
0
d
0
m
PLOTPLAN
CITY COPY
KEN AND JOAN ZUKOSKI
20111 80TH AVE. WEST
EDMONDS, WASHINGTON 98026
PHONE: 425-774-7160
RlECEIVEr..
L.j''." - ,
I)EVELOPMENT SCRVICC,
CITY OF ECM061,
APPROVED BY-PLANNINP3
ImpI--RVl0uS SURFACE CALCS
Existing,building pad
(constnicted 1976) 1226 s.F.
J;Aisting driveway 572 s.f.
Existing Casentclit 1422 sf
Proposed addition 0 s.f.
HEIGHT CALC
Da(un, Point F100
Existinglauilding +123
Proposed addition +122
LOT COVERAGE
3320 S.F. (impervious) 30%
LOT AREA
10,902
TAX ACCOUNT PARCEL
19270411010000
LEGAL DECR]PTION
THE SOUTH 138 FEET OF THE NORTH
597 FEET OF THE WEST 119 FEET OF
THE SOUTHEAST QUARTER OF THE
NORTHEAST QUARTER OF SECTION 19
TOWNSHIP 27 NORTH RANGE 4 EAST
W M TOGETHER WITH A JOINT MAIN-
zi
TENANCE AGREEMENT OF RECORD OVER
i
0'
THE NORTH 25 FEET COMMONLY
KNOWN AS
n.
_4
M
0
R
I j5xiSnmt, AlKALr tASE."lF-AT2-,'
0 c"
t
z
Fjtl)pe.%� 4DIDMOAA
A6z)ve le.,%S-,tt46 C.AQA60L
0 -n-
-n
AVE
mm,
co:
I�A
m
?4r3
Z
+Io3
"T�
'Permix#:
War et Dwelling Calculati011 (roll in un-shaded cells)
- p R-Mcomponer
t-I to
4e
1.
Net roof/Ceilin area
Net Cathedral Ceilln area
3.
tikylight Area or (.15 x Floor area)
whichever is smaller
floor over unheated space
4
Framed
Vatl 10 r-2
Z
0
d
Glazing 05 x Floor area) minus Z)KY119n1b
0
ff skylight area exceeds. 15 x Floor
th— ent-1
An
A
Exam t swinging Door
9
Framed Wall (545+7+50
dgwal S"Sew a
-40
0
11.
Interior 1.-
-4 K
12.
Exterior Insulation
M rn
M Z
11
*Slab on Grade
0--1
> Z
14.
Pro
osed Dwellin Calculatlon (fill in un-shaded cells)
0 -n
-n �
Name:
Street:
-49
X m
m
Net Ceiling (type 11 61-tn
U
0
0 M
Not Ceiling (type 71
Lot
C C/)
9 in
Skylights
City:
M C)
Z
Skylights
(0 5.1
Phone:
Framed floor (over un -heated space)
*Slab on n-da
51) 1 .0
Notes:
>
Glazing
Z
Glazing
-i
T
Glazing
Cl)
Z
Glazing
0
Glazing
m
Glazing
Door
Door
Door
Exam t
t
**If the Proposed
Net wall P�e I)
UA value Is less
Net wall e 2)
than or equal to the
'r 3 Wall (use (able 1 page 1)
Below G
Target UA value, the
dwelling design
the
gp
compiles with a
.Slab on grade perimeter measured In linear feet
1997 WSEC
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing U411r7AA0.11.
wall
Pier/Porch .................
Z'
Retainirig Wall ...........
IT!
Slab Insulation ..........
PLUMBING:
Underground .........
rn.
C
rn Cy
Rough -in ...................
0
-40
0
Commercial Final
I
M'
ITI z
HEATING:
C: z
Gas Test ..........
>
Gas Piping .................
Ectuipment .................
0 -n
Commercial Final
M M
EXTERIOR SHEATHING
NAILING ....................... 00
FRAMING ;4
0 M
C co,
..................... Lk
IT 0
FIRST FLOOR FRAMING
p—
INS ULATION ...............
Floor Insulation
z
Wall Insulation ...........
j
Ceiling Insulation
610
Z
SNEETROCK NAILING
0
SPECIAL INSPECTION
IT
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
Z'ocs(o
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OW�rRN�VNA
:E 07INESS,
J� Z (�4 J,_ (d 5 J_
A AJ
MA LING ADDRESS
Z6 III �-0,4ik
CITY ZIP 11,1�IPIINE
-716
ADDRESS
CITY
NAME
0,4�
ADDRESS
m
(6 Als-re-q C7-/bkf
ZIP
J;E,
EXPIRATION 0111
NEW RESIDENTIAL PLUMBING I MECH
I COMPLIANCE OR
ADDITION COMMERCIAL 0 CHANGE OF USE
,TM Tj
REMODEL 'APARTMENT! SIGN
GRADING �YGS F NOE
13 (_X FT)
[D DEMOLISH 0 TANK o OTHER
Z-r
ED GARAGE C] RETAINI�NYG WALL 0 RENEWAL
CARPORT lor
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPI.A,IN:
'Nu
IICAL
D
41
GTo IES
UK
R II!IJ
I)Es�CRIBE WORK TO BE DONE
T_
�01) 413 9 ' v 2 2-," -r e) f y
c XIS_rtdt� 13el-'V2e)6tylS (
0 UF f? 6�_- 4 1 S7- tjt,, 6,4,?-A
HEAT SOURCE
L
el �� c. )CO gc�b
PLAN CHECK NO: VESTED DATE
THIM.IEFI.1; -UTPR0,RIZTEES ONLY THE Wollit NOTED. THIS PERMIT COVERS WORK To
EGON ON VA NLY. ANY CONSTRUCTION ON THE P BLIC
PROPERTY 0 U
DOMAIN (CURBS. SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQ ISE
SEPARATE PERMISSION.
PE MIT APPLICATION: 180 DAYS
PERMIT LIMIT.- I YEAR - PROVIDED WORK IS -STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. A 'IONS AND SUCCESORS
SS
HARMLESS THE
IN NTEAF.ST. AGREES TO INDEMNIFY. DEFEND AND HOLD WAND
12 EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES� AND AGENTS FROM AN
ALL CLAIMS FOR DAMAGES FWHATEVERNATURE.ARISING DIRECTLY OR INDIRECTLY
FRO THE ISSUA CE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT E
Y I
DEEMED TO MODIFY, WAIVE 0 REDUCE ANY REQUIREME.TOF AN CTIOFIDINANBE
NOR LIMIT IN ANY WAYTHE CITY'S ABlUTITO ENFORCE ANY ORDINANCE PROVISION.-
PERMIT EXPIRES
USE PERMIT
ZONE NUMBER
JOB
ADDRES,�;�ol I Rcr L, A,,
PLAT NAME'SUBDIvisioN NO.
LOT NO,
LID NO,
I
LID FEE S
TESCPAPPI-0
0
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
P P,
P1111 "I I
0
cl
EXISTING — PROPOSE.
0
0
REQUIRED DEDICATION_ FT —
wN.. 1-1-
M�TEF SIZE
LINE SIZE
NO, 0:��TURES
P1.1 RECUI.11�
I
YES N
REMARKS
--l—T-1— P-P-18LE FOR EROSION CONTROIJDRAINAGE
FIRE REVIEWED BY
DATE
%FARIANCEORCU
SHORELINE OR AD80
INSPECPON
RED G
I '800M.
0 YES �010
SERA REVIEW
SIGN AREA
HEIGHT
C 0 M P�LE7 E M PT
Al_L0!:4;7
ALLOWE,
�EEX
�F
25 1 �7[i
LOT COVERAGE
REQUIRED SETBACKS IF-0
PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT UR SIDE REAR
PA KING
R P_ 1,
PR_
LOT AREA PLllNMNGRE,!IEV4ED
BY OAT,),
�qddli-ll ae�e_ wt I I
Lax(-,elel
CHRM ITYPEOFCON
�;ffig�RN 'I ooUPA
CIJE I o CLI NTO
GR P
SPECIAL INSPEET05 TAREA
REQUIRED (3 YE
RE 5
OCCUPANT
LOAD
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D 2
L!REMA�KS
C 14 Q 1140
VALUATION
FEE
PL N CHECK F55
BUILDING
PLUMBING
MECHANICAL
GRADINGIFILL
STATE SURCHARGE
ENG. REVIEW FEES
10
LANDSCAPING
PLAN CHECK DEPOSIT
I lk,
TOTAL AMOUNT DUE
1HETREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLIC ION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
LAWS REGU fINGCONSTRUC
I CALL
Till. IPPI11.1-11 11 P-11 %1"F".. IF
=' 2.
THEOWNER. I AGREE TO COMPLY WITH CITY AND STATE
T,ION; AND,IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE LEMPLOYTED
WASHINGTON RE ATING 0
FOR INSPECTION
Id.
Blljdl�q OM-1-1 �, _, D.pwy _ _ .1. . —
111,pt m 1-111ldg d m 10 pl,ldld.
N VICLAT ON OF THE LABOR CODE OF THE STATE OF
WORKMEN'S COMPENSATION INSURANCEAND RCW 16.27.
1.
I.-NER AGENT)
0 F SIGNED
(425)
!r,.RE
JR
('0
771-0220
A17ENTION
EXT 333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
I
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFF
ORIGINAL - FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER - GOLD - ASSESSOR
z
q
0
m
rn 0 ,
0
80
c
m m
z
0 -n
n
-4
MITI
a 5; . I
0 r-
001 . i : .
c
m 0)
M 0
z
z
z
0
m