20030019.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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MAILING ADDRESS
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TELEPHONE
NAME
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CITY ZIP
STATE LICENSE NUMBER
PROPERTY TAX ACCOUNT PARCEL NO.
NEW C91"9ESIDENTIAL r] PLUMBIN H a jb
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NUMBER NUMBER OF CRITICAL
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DESCRIBE WORK TO BE DONE
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ERMIT EXPIRES ;Uq o_�3*
USE PERMIT
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�05- aolq
NUMBER
JOB SUITE/APT#
ADDRESS :Z �a
PLAT NAMEISUBDIVISION NO.
LOT NO.
LID NO.
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved
RW Perrrdt Required
Street Use Permit R*q'd
EXISTING - PROPOSED
Inspection Requited 93
Sidewalk Required 13
REQUIRED DEDICATION- FT
UnderWound
Wiring required 13
METER SIZE
LINE SIZE I
NO. OF FIXTURES
PRV REQUIRED
0
1
YESE3 NO 13
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1
5
REMARKS
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OWNER/CONTRACTOR RESPONSIBLE FOR -EROSION CONTROL/DRAINAGE
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JAW-Hirl 30 D)qY-5
ENGINEERING REvIEWED BY DATE
DATE I -.
rL
VA ORC RELINEORADBO I INSPECTION BOND
REO'D POSTED
SE WA 113YEs 13NO 1$
REVIEW SIGN AREA HEIGHT
COMPLETE , EXEMPT I ALLOWED , PROPOSED I ALLOWED , PROPOSED
EXP
T T CO IRED SETBACKS (Fr.) I PROPOSED SETBACKS (FT.)
I
ALL D RO S FRONT SIDE REAR FRONT L/RSIDE REAR
0'
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A�RK_ LO AREA-1 PLANNING REVIEWED BY DATF_
CHECKED BY '—E OF CO OCCUPANT"__nP
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SPECIAL INSPECTI6N_ I fAEA OCCUPANT
REQUIRED [3 YES LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC 18111MINAL INSPECTION REO'D
VALUATION
$
Description FEE Description
Plan Check State Surcharge
FEE
1
HEAT SOURCE GLAZING % LOT SLOPE %
I
Building Permit
City Surcharge
PLAN CHECK NO: VESTED DATE
Plumbing
Mechanical
THIS PERurr AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
2 DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
3
SEPARATE PERMISSION.
It:
Engr. Review
PERMIT APPUCATION: 180DAYS
PERMIT UUM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
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 MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapelnsp.
Total Amt. Due
NOR LIMIT IN ANY WAY THE C17YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
Recording Fee
Receipt # LZI
I HERE13Y ACKNOWLEDGE THAT I HUE PPAD THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT; AND TIWT Tfill OWNER. OR THE DULY AUTHORIZED AGENT OF
I E
THE OWNER. I AGREE To P H CRY AND STATE LAWS REGULATING CONSTRUC
CALL
This application Is not a permit until signed by the
TION; A�ND N DOING THE VrRr�AU LRIZED THEREBY, NO PERSON WILL BE EMPLOYED
OF THE LAPO C F THE STATE OF WASHINGTON RELATING TO
IN VlOk�
FOR INSPECTION
Building Olfficial or his/her Deputy: and Fees are paid, and
FOCelpt Is acknowledged in spacu provided.
'ON
WORK EySC&A"ATPN S RCW 18.27.
OFFICIALS16IGNA7URE
SIGN E WNE DATE SIGNED
(425)
?,
&
771-0220
,
RELEASED BY b0E
ATTENteON
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK -OWNER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES
GREEN - ACCOUNTING
0003
CLERK
OF EDMONDS, I NON �l ill I I I
V STH AVENUE NO.
.6
..,,"AIDLIONDS. WA 9M
01-14-2003 08:415am $19.00
SNOHOMISH COUNTY. WASHINGTON
S NT ON ACCESSORY DWELLING UN]ITS
GRAN-K,6it I GRANTEEAAf WAIRMdl
Property 76P
Ed.mofids Washington
0 /Y 9,2- (V�< �aAJ
Legal Descriptlin: -
Assessor's Parcel NuniSej. I)LIxa- M.57 Qa
I have read the requiremifttaLr *eiqd*ory.dweIIIug units contained In Chapter 20.21 of
the Edmonds Community D0016jni6t,jC;de (ECDC) and understand that an accessory
dwelling unit, including a sec6nd'kitelfin, as deflns4 In ECDC Section 21.05.015 Is
prohibited until an Accessory "Phing Unit Pqr6itt ks approved.
I also understand that an Accessory Dwel6g lunliperi'mit cannot be approved unless all
the criteria in Chapter 20.21 are metjuid s#fhe qecesiary items am submitted,
Including an affldavlt of occupancy aiio a 66vejuk�t tq'6e filed with the Snohomish
County regarding the regulations Impoied o**n*'Accdsory Dwelling Units.
Property Owner Siguato
re:_
Property Owner Name (printed): L jj
Date: ZO
STATE OF WASHINGTON
COUNTY OF SNOHOMISH)
I certify that I know or have satisfactory evidence that 4kr;'r&4: t:
signed this huftment and acknowledge it to be his/be—rfive and ;�l tct f4-the uses and
Purposes mentioned in this instrument.
Notary's pressure seals must be smudged. Dated:
Signature of
Notary Public: ......... .
9 ,CARLA RAYM
U L"'.
es
NOTARY PUELIC iding at: 444
STATE OF WASHM" y Appointment
WWI
I M XV
ONEKI
oom xpires;
00"R
AP 13
o
THIS DOCUMENT MUST BE RECORDED WITH TIOCE STqOROM[ISH COUNTY A
Re: Demo permit #2003-0019
This letter is to inform you that the demolition permit issued to you on 1-8-03
has expired on 2 -9-03. The City understands that you are intending to demolish
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13
DATE RECEIVED , 03 0 LPERMIT EXPIRES 21q r o_�3
a .21 1 1
USE PERMIT W,3_
ZONE
CITY OF EDMONDS NUMBER
JOB SUITE/APT#
CONSTRUCTION PERMIT APPLICATION ADDRESS -7 b 1-4- 4 ve- (AJ
OWINIER#AMM&ME OF BUSINESS
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PLAT NAME/SUBDIVISION NO.
LOT NO.
I
LID NO.
MAILING ADDRESS V
LID FEE S
115
I
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
7ESCP Approved
RW permit Required
Reqd
EXISTING — PROPOSED
Street Use Parmh
Inspectlon Required
SidwalkRequired
C
ZIP
TELEPHONE
.,A, � q%.
02
'iD
1
4 2so Z7 /fq
REQUIRED DEDICATION— FT
Underground
Widngroquired ___ 13
NAME
ADDRESS
CITY ZIP
NAME
METER SIZE LINE'��NO,
OF FIXTURES
PRV REQUIRED a
YES 13 NO C3 M
REMARKS
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PWNER/CONTAACTOR RESPONSIBLE FOR - EROSION CONTROL1DRAINAGE
AIL Laget
hoo,
TELEPH04
Y-5
CBLN
I-P NG REVIEWED BY
DATE
ADDRESS
CITY ZIP PHONE
STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY
PROPERTY TAX ACCOUNT PARCEL NO.
NEW
QrRESIDENTIAL
ADDITION
rl COMMERCIAL
REMODEL
MutTiFAM/Iss
REPAIR
GRADINI C
El DEMOLISH
ANK
7REAIN"'.
GARAGE
T
0
CARPO
OCKERY
(ME OF USE, BUSINESS OR ACTIV"
NUMBER
NUMBER OF
OF
DWELLING
STORIES
UNITS
DESCRIBE WORK TO BE DONE
0 0 PLUM
U
:OMPBL'ING' R
C
1:1 C EOF E
si
[ 0:i WEN FT)
CRITICAL
AREAS
NUMBER
FIRE REVIEWED BY
DATE
IE6
ANCE OR CU SHORELINE OR ADB# INSPECTION BOND
REQ'D POSTED
[:]YES 0 NO
tA HEIGHT
P FT_ I ALLOWED - PROPOSED
711EPAPREVAPT I ALLOW6EINAePROPOSED
BY I&PE OF
,to -
dow It
ffy
!VALUAnwigj %I,
)rpETtACKS (Fr.) PROPOSED SETBACKS (Fr.)
OF, [DO REAR FRONT LIR SIDE REAR
PLANNING REVIEWED BY DATE
OCCUPANT
GROUP
PANT
LOAD
INSPECTION RECVD
FEE Deacriptlon FEE
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0
M
M
MN
0 C
3� C
ITI
10
2
9�
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03�
M M
Fn
0
0)
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Plan Check
State Surcharge
HEAT SOURCE
GLAZING %
1
LOT SLOPE %
Building Permit
City Surcharge
4,
0
—
IT11
PLAN CHECK NO:
VESTED DATE
Plumbing
I __
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
1= BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC
Grading
2
3 DOMAIN (CUFM, SIDEWALKS, DRIMEWAYS. MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
t: .
Engr. Review
PERMIT APPUCATION: 180 DAYS
PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WffHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
I
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Landscapelnsp.
Total Amt. Due
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CffY`S ABILITY TO ENFORCE ANY ORDINA14CE PROVISION."
Receipt N
0.0�
Recording Foe
HERE13Y ACKNOWLEDGE THAT HAVE AAD THIS APPLICATION; THAT THE INFORMATION
I
APPLICATION
APPROVAI
GIVEN IS CORRECT; AND 11 E OWNER, OR THE DULY AUTHORIZED AGENT OF
R E AND T' E OW'
1 To 1, C,
THE OWNER. I AGREE TO H CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
This application Is not a permit until signed by the
TION; ANUI DOING THE FRI AU C�RIZEID THEREBY. NO PERSON WILL BE EMPLOYED
D T E
I
0 THE STATE OF WASHINGTON RELATING TO
Cj C F TH
IN VIW710N OF TH 0 C
ffS
FOR INSPECTION
Building ottictai or his/her Deputy: and Fees are paid, and
receipt Is acknovAeftod In space provided.
JEF
WOR"W 8 N RCW 10,27.
OFFICIALS/ SIGN�TURE ATE
BIG E WNE R
DATE SIGNED
IA03
%42.5)
771-0220
RELEASED BY -OATE
ATTENTION
M 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK - OWNER GOLD -ASSESSOR
04/02
PRESS HARD -YOU ARE MAKING 5 COPIES
GREEN - ACCOUNTING
U