20000896.pdfPERMIT EXPIR
F ES
CITY OF EDMONDS
USE PERMIT
Z.4 1�k NUMBER
ICA
CONSTRUCTION PERMIT APPLICATION
IOU NA
ADDRESS 7 -4
. SUITEIAPTN
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OWNER NAMENAME OF B�NESS
N &
LID NO.
'S CIL
PIT NA.EISII..'VISION
LID FEE S
MAILING ADDRESS
STREET MAP
TESCP AP
PUBLIC RIGHT OF WAY PER OFRCIAL
TING _19n4!— PROPOSED
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NAME P_AtvD�� fnurv_s�
METERS E LINE SIZE NO.
RENA.. A 3-7
ADDRESS
MN—ONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
NTGADT.
CITY ZIP
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TELEPHONE
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NAME S
ENGINEERING RE' 'D TE
X7,
ADDRESS
09—
FIRE REVIEWED BY DATE
CITY
08 CU SHORELINE OR ADS. INSFECT16N I BOND
STATE LICENSE NUMBER
VARIANCE
RE" 'D IPOSTED
0 Y ES 0110 1
SOU`Adb\l� C>O
SERA REVIEW AREA HEIGHT
F;R—OPEArY TAX ACCOU NTPARCELNO
�)_3 �7 03 12� C9 0
COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
EXP
NEW RESIDENTIAL CK PLUMBING I MECH
LOT COVERAGE REQUIRED SETBACK$ (M. PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR
C
OMPLIA E OR
0 Cc No
45 P, 15'
C] ADDITION COMMERCIAL RANGE OF USE
PARKING LOT AREA PLANNING REVIEW �G BY DATE
j
REMODEL [3 APARTMENT n SIGN
REGO PROVIDED 17 03b, )?� 4.*�
% != 0 FENCE
Cl REPAIR X IT)
REMARKS
0 Im.n owl lem a4lA l
DEMOLISH TANK
�GARAGE IRIETAKIN
_CAAPORT C EV WALL 0 RENEWAL
ITIPE OF USE. BUSINESS OR ACTIVITY) bXVILA
ICODE DO
By Ty E OF CON AUCTION 0 DURANT
CHECKED By R UP
c
NUMBER NUMBER OF CRITICAL
DWELLING AREAS
OF NUMBERC4 0
H—R
o STORIES
SPECI LINSPE T R AREA' OCCUPANT
REOU RE M YES 1,16'r LOAD<(O
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC IoSIFINAL INSPECTION REO'D
11
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C-0 5 7
-7n
VALUATION
FEE
PLAN CHECK FEE
cP451
HE' SOURCE GLAZIN 5. LOA% "40
BUILDING I vn ;�74q
VBSTED DATE
PLUMBING_
M CHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
L A
8 DONE ON PRIVATE PROPERTY ONLY. ANY CONST UCTIONON THE PUBLIC
E
2 DOMAIN BOB, SIDEWALKS, DRIVE AYS, MARQUEES. ETC) WILL REQUIRE
ICU W QUIRE
:I SEPARATE PEAMJSSION�
t
PERMIT APPLICATION! 180 DAYS
PERMIT LIMM i YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG, REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
SRO
P S E
'APPLICANT, 4ALF OF HIS OR HER SPOUSE, HEIRSLA SIGNS AND SUCCESORS
N SEHAL��F FUS311
Nli%ON BEHALF OF HIS OR 2 SL HARMLESS THE CITY 01
N x
ENG. INSPECTION FEE
ING
6
�HYER
D
END NG No D
�'APPLA.CA
TO IN EMNlF`)E`GEFEND ND NO
INT E� U.S G
EDMONDS I�ASHINGTON. ITS OFFICIALS, EMPLOYEES� AND AGENTS FROM MY AND
I E
ALLCLAIMj FOR DAMAGESOF WHATEVER IN ATURE� ARISING DIRECTLY ON INDIRECTLY
M ALL NOT BE
THE ISSUANCE OF THIS PERMIT, SSUANCE OF THIS PER IT SH
RED I
PLAN C ECK DEPOSIT I 44,a], fo
FROM
DEEMED 0 MODIFY. WAIVE OR REDUCE ANY REQUIREMENTOF ANY CITY ORDINANCE
UTY 0 ENFORCE ANY ORDINANCE PROVISION.
'SABI T
R CEIPT
0 NOR LIMI T IN ANY WAY THE CITY
TOTAL AMOUNT DUE 0
IHERE' Y ACKNOWLEDGE THAT I HAVE AD THIS APPLICATION. THAT THE INFORM TI.N
G THE ORLY 'UTNI AGENT OF
AND THAT I AM THE C)TWYNAENR6
AP OVAL
APPLICATION FIR
T .,RIw� 1� - � F—il t,' R'�
GIVEN UR RRECT,
IS
THE OWN DO I AGREE TO COMPLY WITH Cl STATE LAWS REGULATING CONSTRUC-
CALL Jg Offi—I .1 W D.PUIT -Pd F .,. d. ..d
BUI
TION D N DOING TH KAUTH RIZED THEREBY, NO PERSON WILL BE EMPLOYED
LAUD CODEOOF THE STATE OF WASHINGTON R LATINGTO
FOR INSPECTIO o,pj I, a�kwlldood in SPaCO !LOVIXOd
N
IN VI ION
WOR M �S DO EN AIR N INSURANCE AND RCW 18.27.
OFF IALS SIG ATURE DATE
(425) ., 11
SIGN T 0 NE It ENT)
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771-0220 LEASED 6Y E
EXT1333
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING 08 STRUCTURE UNTIL
771-0221
INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
B.INAL-111-1 YE —'INSPECTOR
A FINAL
OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109
FAX PINK - OWNER GOLD . ASSESSOR
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122.11',
WATE
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ONE FINISHED FLOOR
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- - - - - - - - - - - - - - - - - - - - - -
CONCRETE
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SIDEWALK
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D IV'- A.
DRIVEWAY
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.......... ........ ...
- - - - - - - - - - - - - L - - - - - - - - -
. ........... . .
122.11'
60- WIDE LEVE! AREA NO
MORE THAN 6�i- BELOW LE El
ONE FINISHED FLOOR (S,�; MR PERIMETER)
A
2d SLOPE
ol
F"
API OVE6
7
to-s-15
3,6 7q
loq
RECEIVF—D
SEP 2 7 2000
Ifilp,r
f-(
BuILDING D EFT,
d
STANDARD DRAINAGEDETENTION SYSTEM
WORKSHEET
OWNM 'bj'.S ;SQA CALC BY:. Rn
AD,,Ms PHONE- 42,S- ITf - III.
. ..... DATR: cy-
'""DESIGN DATA****'
IMPERVIOUS AREA PIPE DIA PIPE LG ORIFICE
-qL
DETENTION PIPE LENGTH LOCKING LID
FINISHED G MINIMUM IT1111ALI
50 —E- WTU"REVRO40P Or
YIG.TLI E .5% TO IV. SLOPE CONC BOX OR RISER
S; too jj1JTLET
27 a
TL I CONTROL
REICEIVED
UPPER CATCH BASIN ORIFICE
CONTROL CATCH BASIN SEP 2 7 2000
BUILDING DEPT.
SYSTEM CROSS SECTION
2'X2'X6%DtCP, 4-6' SPALLS OR EOUAL
FROM CONTROL CB e'X VX 3- DEEP, 3/4- CRUSHED ROCK EXI ING OR DE
FROM CONTROL OUTLET ASHED ROCK
T 0 TRENC
11 MIN 10' LdNG.
F P TO R EVEL
Rr Pip W/ END CAP'
IR LL
PRJI
0$HT31ALAC15EL.?5P VA'SNEVWAIN ROCK
RIPJUP OUTLEr
RUNOFF SPREADER -TRENCH
FOOTING DMINS SLTAU NOT BE CONNECTED 70 DETENTION SYSTEM
NOTES.
1. Call Engineering Division (771-0220) for a tightline and detention system inspection
PROYED BY
before backfilling and for final inspections. AP
2, Responsibility for operation and matintenar- of drainage systems on private property is the
I, a ed in the storage pipe must be Rushed
responsibility of the property owner. Material aw"m I t
out and removed from the Catch basins to allow Proper Operation. The outlet control orifice DATE
must be kept.open at all times. 6
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able i Detention Pipe Sizes
impermeable
Required
Pipe Diameter
15" 18" 24" 30".—
Area Sq; Ft.
Vol Cu Ft
2000
50
62
40 28 16 10
50 35 20 13
2500
75
60 24 15 Required pipe
&) 28 18 length in feet
da
SO
70
100
80 _§L_ 12 21
4500
112
:125
63 36 23
90 70 40 26
100
5000
Note: Allowabl a Pipe Materials:
Reinforced Concrete
Aluminized Steel
Aluminum
CMP As halt Coate
s)
N —12 _a mitted on road -
(Not p
if! a SIZ
ab a 2 — outlet Orifice Sizes
impermeable
outlet Orifice Diameter (Inches)
OeArea'S4. Ft.
2000,
5/8
5/8
2500
3/4
3000
3500
QZI?
4000
7/8
4500
7/8
5000
able 3 1:'eotangulai atch Basin wiquirements
Detention
max. size
knockout
Catch Basin
Type
pipe diameter
< Is"
20-
26"
'0
T el CB15
T elL,CB1
18" to 24"
36"
Type "I CB19 19(48"Bas'tn)
24- to 36"
42"
Type I,, CB 19 19 (54"Basin)
361- to 42"
*SotArce: Assoc. Sand & Gravel Co.
Standards
5
Revised 3/16/95
C, . ...... ... .. . ... ....... .
J—
HEIGHT CHECK VERIFICATION FORM
MAXIMUM ELEVATION ALLOWED
ACTUAL RIDGE ELEVATION
SECOND FLOOR PLATE ELEVATION
PREPARED BY
Name Title
Date
DATUM POINT ELEVATION- VERIFIED BY CITY BUILDING INSPECTOR
L-.ktampNbuildingkhandout\sffiFietdHtCk.vsd 8100 Name
Date
Project Review Checklist
Plan Check# :Tb7q2S
T roject' Narn.:
Project Address: Afki��
Aw ReceiptPate: .91&L710z�
Underground Wiring.Required
Receiv
Hy*anlics Permit
OCIT 0 2 2600
Plat/Subdivision Requirements
PUBLIC woffi��
Street Dedications
i3asements-Tublic/Private
Engineen*ng,Storm Drain Review Feel
E nee� 2.2 Ins!ection Fee:
ngi g
Drainag Plan (0. site)
Setback - Storm Drain Line
Open Ditch- ads ting
Culvert Required
dulvat Siie
�,.Shoulderbraiinagd§halc Open Runoff
ditchI3�asinitequired
a 10 Vehicle Access
w yRZqM
Drive
d walk
e
Curb'& Gutter Req*ed.
C ur6�6�t for Driveway Required
Street Pavmig Required
Right-of-Wity Construction Permit Required
BondRequired for Public Improvements
F EMA Map CheckMater TabI e
ity
Side,Semwei Avaflabili
Calculate Sewer Fee ifNo LID#
Water Meter Size
Nyafer Meter Charge Required
Hydrant, Required
Street Cut
Miscellaneous
� :,;RWPermit# --0(
Receipt # t�,,-5(00
Date Issued �)O
SS Permit #
Date Issued 4 -71 OC!,
Receipt # —Uek�
Meter Size Paid$ Date aw-42
Receipt #
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
4
SETBACKS .....................
FOUNDATION:
yvI$
Footing ..............
Wall .... ...........
Pier/Porch .................
Retaining Wall
ow,
...........
Slab Insulation ..........
Its,( PQC,
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PLUMBING:
PAPtr YAV- r?C-1Ai,.41j
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Underground ............
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Rough -in ...................
Commercial Final
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Gas Test ..........
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Gas Piping .................
Equipment .................
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Commercial Final
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EXT ERIOR SHEATHING
NAILING . . ..................
IT! R1
FRAMING ..................
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FIRST FLOOR FRAMING...
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Car
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INSULATION ............
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Floor Insulation
Wall Insulation
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Ceiling insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY .................
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PATE RECEI ED
PERMIT EXPIRES
.. PERMIT
CITY OF EDMONDS ZONE NUMBER c(D
I
CONSTRUCTION PERMIT tAPPLICATION JOB BE 111TEIAPTI
ADORE 7 "C'
BE
OWNER N Pl-AT NAMEISUBDIVISION NO. LOT NO. LID NO.
'�E;AM�F BUSINESS
J e,4%ToL-�
AILING ADDRESS
q c), -2 6 -5 —
ITY ZIP ITEL11HONE
r,f)nl oA)D,-, clso'?&
CITY
sex
NAME
sou K) u le
a ADDRESS
9� 2-
CITY TELEPHONE
ZIP
q,- - 6?(, 3 5-2
S STAT U.EN� E;H-ONGA�TE ON
E �
EDDY
TATE, LICENSE NUMBER,
PROPERTYTAXA COUNTFARCELNO.
�2-3 -7 7 03L/ 122-06
RESIDENTIAL, CK PLUMBING I MECH
R
COMPLIANCE OR
Cj ADDITION 0 COMMERCIAL o CHANGE OF USE
t 0 REMODEL .-0 APARTMENT SIGN
ENCE
I
REPAIR Y.. 0 X ITI
0 DEMOLISH C] TANIT
kGARAGE f C3 RE NINGWALL NEWAL
CARPORT B FRY 0.
BUSINESS 08 ACTIVITY) EXPLAI
r (TYPE OF N: 14
F
0
tli NUMBER NUMBER PEAS
a OF I Sl DWELLIN 'A
STORIES .... FRof
TS
IN UNi 7��
DESCRIBE WORK TO BE DONE
7 ve lx�
a
4 s,-
OiA ttt e-, C W—R
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HEAT SOURCE %
G-6 s
PLAN CHECKNO: DATE
THIS PERMI AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Y CONSTRUCTION ON THE PUBL C
BE DONE ON PRIVATE PROPERTY ONLY. AN IE�
DOMAIN ICURBS, SIDEWALKS, DRIVEWAYS, MARQUEE!L ETC.) WILL REQUI�
SEPARATE PERMISSION
"..""T."'L.-ATIO.' '.. DAYS
" - P .11 ... WORK IS STARTED W T"'. '" DAY
PER.IT L�M-T- '. -F R K EFIlHT 'OR MORE INFORMATION
...A.K. PH P
;APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCSSOFG
N INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY F
2 EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALLCLAIMS FOROAMAGBSOFWHATEVER NATURE� ARISING DIRE CTLYORINDJRECTLY
FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE
05EMED TO MODIFY. WAIVE OR REDUCE ANY AEOUIREMENTOF ANYCH'Y ORDINANCE
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING PROPOSED
REQUIRED DEDICATION�
WE
MET
LINE SIZE
�FT—
N.�
NO..6
6
PAY REQUIREd
YRSCE I,
�ZE
,I
jTURES
YES)4 NO 0
REMX . R's I v
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
er-m? 0/az6/aJ 04 774krel,�10-
k 7EWr, "Ia '�o %C,04 1:M--A t7-11R,
-'vr"��( /'V-.�;-- X
ENGINEERING D TE
-A
FIRE REVIEWED BY DATE
VARIANCE OR
0
0 8
10
L
SIGN AREA HEIGHT
'N REA
ALLOWED PROPOSED ALLOWED PROPOSED
LLOW P't-POE--
COMPLETE EXEMPT
EXP V,
MPROPOSED
REQUIRED SETBACKS (FT,
FRONT SIDE REAR
PROPOSED By
FRONT U , g�k All
ALLOWED
4—c; 3o, L,7("
I r? 15 It,;'
PARKING
LOT AREA
PLANNING REVIEWED By DATE
REO'D
PROVIDED
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REMAHZI,
lze�
VJ41
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CHECKIOBY ITYPEOFCONSTRUCTI
N
'T 'ON
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ODE OCCUPANT
SOUP
SPECIAL INSPECTOR
HE D IA;A,
REQUI C] YES I
LOOCCURANT
AD<(O
' '. .: I
4
REMARKS ICT,
PROGRESS INSPECTIONS PER UBC 11081FINAL INSPECTIONN REO'D
7
VALUATION
FEE
PLAN CHECK FEE
'2 L4,51
I�DING I .
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PL M81NO
qqo—
MECHANICAL
90—
GRADINGIFILL
'2
STATE SURCHARGE
ENO. REVIEW FEES
t
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ENG. INSPECTION FEE
6
T
RECEI
116
1.0
NOR LIMIT IN ANY WAYTHE CITY'S ABILITY TO ENFORCE ANYONGNAAll — -1--
TOTAL. AMOUNT DUE
G 'b" -
I �� - tl c)
I
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INIO MATION
APPLICATION
APPROVAL
GIVEN CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
IS
Thl, IPPIfIlt'l- I' - I P11111 - U.Ig Id by th,
THE OWNER, I AGREE TO COMPLY WIT. CITY AND STATE LAWS REGULATING CONSTRUC -
BE EMPLOYED
CALL
B'-', ah-'.' Dowl A F- - P"IT c-
TION; rD IN DOING THE WORK AU HORIZCD THEREBY. NO PERSON WILL
SO ODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
'Id
01-docT
IN VI CE AND NOW 1827.
wo INSURAN
OFFrJALS SIGNATURE GAT
RV�TP�j
MO'AE.�LTAI
4�
AT
D E
S7'lD
(421
ow-ua A/1w.
771-0220
FelEAlS. By 7
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ATTENTION �1- 1 100 1
IT IS UNLAWFUL TO USE 08 OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 1
E AND APPROVAL OR A CERTIFI- ORIGINAL - FIL YELLO - INSPECTOR
A FINAL INSPECTION HAS BEEN MAD PINK - OWNE GOLD - ASSESSOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX
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