20030508.pdfDATE RECEIVE
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS —
MAILING ADDRESS j i
90ZO- 2,1(cp f. SW
CITY ZIP ITELEPHONE
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NAME
Denix, as tcl Y\
ADDRESS
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CITY
Vh n iroe,
NAME se'l
ADDRESS
CITY
STATE LICENSE NUMBER
4
71-P
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-19 3
TC13—L #
ZIP I TELEPHONE
PROPERTY TAX ACCOUNT PARCEL NO
OOS( I
10 0000 * 106
NEW RESIDENTIAL
ADDITION COMMERCIAL
13 REMODEL MULTIFAMILY
REPAIR 13 !M CYDS
DEMOLISH 1:1 TANK
oGARAGE [3 RETAININGWAILL
CARPORT ROCKERY
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
RE ds' f A_aL4y /-/0
NUMBER NUMBER OF
OF DWELLING
_STORI UNITS
DESCRIBE WORK TO BE DONE
I V, ffi T5 -w7 M 9 E . W Im
PERMIT EXPIRES
USE PERMIT
ZONE as--s
NUMBER
JOB —tlq
ADDRESS C1 6 1, g z I b
STUMP
PLAT NAME/SUBDIVISION NO.
LOT NO.
LID NO.
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP APPf0v6d
RW Permit Required
street use Permit Req'd
EXISTING 'PROPOSED
Inspacwn Required
Sidewalk Required
underwmm
REQUIRED DEDICATION —000 FT
Wiring (squired 13
METER SIZE
LINE SIZE
NO.,WIXTURES
PAV REQUIRED
YES13 NO X z
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
REVIEWED
FIRE REVIEWED BY DATE 1 011
VARIANCEORCU-1 SHORELINEORADB# I INSPECTION BOND
nON DATE CHECKED BY
1[3 REO'D POSTED
I
YESXNO Is — - -
SEPA REVIEW
SIGN AREA HEIGHT
COMPLETE EXEMPT
ALLOWED PROPOSED ALLOWED PROPOSED
,
EXP
LOT COVERAGE
REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT)
PLUMBING if MECH
ALLOWED PROPOSED
FRONT SIDE REAR , FRONT UR SIDE 13
COMPLIANCE OR
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PARKING LOTAREA
P NNIN REVIEWE D BY 06
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SIGN
REOD PROVIDED
FENCE
( — X—FT)
REMARKS
0 OTHER
FIRE SPRINKLER
FIRE ALARM
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CHECKED BY TYPE OF CONST4UCTION
OCCUPATq3
GROUP
CRITICA I
AREAS
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SPECIAL INSPECTION AREA OCCUPANT
NUMBE oo��_
REQUIRED [] YES
y LOAD
REMARKS
PROGRESS INSPECTIONS PE%UBC 108/FINAL INSPECTION RE01D
ev"
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a I A '1711 1 1
,H T SOURCE GLAZING % LOT SLOPE %
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PLAN CHECK NO: 0 � —11L I VESTED DATE '
THIS PEnMTT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPUCATION: ISO DAYS
PERMIT ILIMM 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. ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
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
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORREC1% AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKME���NSATICN INSURANCE AND RCW 16.27.
SIGNATI(IRE �(OWNE �R �AGENT) DATE SIGNED
�CAJ 1 10 6
I R:131 54IL4,om
—1
Description
FEE
'
Description
FEE
Plan Check
—
State Surcharge
6V
Building Permit
City Surcharge
Plumbing
Mechanical
(519
Grading
Engr. Review
Engr. Inspection
Joo
Fire Review
Plan Chk. Deposit
i nZcl
Fire Inspection
Receipt #
V H'/,
Landscapelnsp.
Total Amt. Due
a�& 6V
Recording Fee
Receipt #
CALL
FOR INSPECTION
(425)
771-0220
APPLICATION APPROVAL
This application Is not a permit until signed by the
Building Official or his/her Deputy: and Fees are paid, and
receipt Is acknowledged In space provided,
OFFIC SIG �E DATE .0
RELWED PATE
ATTENTION L" M1 3
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- TRIC INAL - 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
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CITY COPLYL
RIECEIVer)
JUN 3 0 2063
PERMIT COUNTER
OWNER:
VjCla BOGACHOV
Mg 21�m ST SW
EDMONDS, WA 98026
(42s) 672-1683
HEIGHT CALCuLATIONS
A 97.49
B 99.75
C 98.80
D 98.75
AVEp.AGE CaADE = 98.45
AcTuAL = 123.01
MAXD" - 123.45
LOT COVFJLAGE
21755F (230/0)
LOT AREA
9511 SF
LOT SLOPE
FLAT
TAX ACCOUNT NO.
00561000001400
LEGAL DESCRIPTION
LOT 14 ROSEWOOD NO. 2 SECTION 30,
TOWNSHU? 27 NORM RANGE 4 EASTV
Cffy OF EDMONDS, SNOROWSH CTY,
WASUNGTON
APPROVED BY PLANNING
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418.7;
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Height Calculation/Grading Verification Worksheet
Address: bdo o (ul- &�w Permit
Date
A. Datum Point-0 P--eA Prf 10 4"A
B. Datum Point Elevation: (OQ�
C. Average Grade:
3. waximum Ele0ation Allowed:-' Aaverage grade) + 25'= S-
4.. Reference Point Elevation Shot to Hous�:
(datum elevation).+ C)".r-3 (9, 6010 r7FF-
L rade to transit level line shot to house)
6. Measurements from line shot -onto house to.roof ridge:
VOU'n�
S 31
Total
7. Actual Elevation: (reference point elevation) 4dtl�jmeasbrements from
Conclusion:
k;)3-,D.-3 __(zctuaQi;grka'ter/(ess7t�Q (allowed),- therefore the-hoiise.id
Is not over the height requirement per ECDC 16.20.30 requirements
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FINAL PROJECT APEBQV -FORM
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AL PRon= APPROVAL.
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RE-DISPECTED OU7STANDING ISSUES
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RECORD OF INSPECTIONS
LDATE :RECI
DATE RECEI
t7
/L'5 I FPERMIT EXPIRES
CITY OF EDMONDS
USE PERMIT
ZONE
giz—os
NUMBER
CONSTRUCTION PERMIT APPLICATION
JOB
ADDRESS W-K-1
STSU7P
OWNER NAMEINAMVF BUSINESS ..
PLAT NAME/SUBDIVISION NO. OT NO.
LID NO.
ac
7
MAILING ADDRESS
LID FEE $
CIO
IESCPZ
PU13UC RIGHT OF WAY PER OFFICIAL STREET MAP RW '. "=.
street use Permit R00
CITY ZIP TELEPHONE
EXISTING. 'PROPOSE
inspection Required
Sidewalk Required
q 2 146 2. 1 (P
Mk ?o
REQUIRED DEDICATION FT
urw M
Wking "required
..EAM
NAME
DenVx, Us(
METER SIZE LINE SIZE NO. q0FIXTURES
PRV REQUIRED
YES 13 NO JK
ADDRESS
ZS119 12.0 15
4-
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRANAGE
1
CITY ZIP
V11 y oe,
&
NAME CBL #
so�
M L
01
2
ADDRESS
MGINEERING REVIEWED BY
x _r MC67 N W-1 L_
DAT�
Lp imme,
a
CITY
STATE LICENSE NUMBER
ZIP I TELEPHONE
PROPERTY TAX �QGOUINT PARCEL NO -
oosw-000001/100
NEW RESIDENTIAL
3K ADDITION COMMERCIAL
1:3 REMODEL 11 mumi:;Amy
[] REPAIR 1:1 !M CYDS
A:] DEMOLISH ft 0 TANK
o,GA1RAGE o RETAINING WALL
CARPORT ROCKERY
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
S'Wedr-rA /4--/ A/49*16'
NUMBER NUMBER OF
OF WELLING
SToRI-- UNITS
DESCRIBE WORK TO BE DONE
A -m L I I A J% h
BY
DATE
VARIANCE OR CU �HORELINEORADBII INSPECTION. BOND
CHECKED BY, POSTED
8`EPA REVIEW SIGN AREA HEIGHT
COMPLETE , EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
JEXP
PLUMB ING / MECH
LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SETBACKS (FT.)
FRONT SIDE REAR
PROPOSED SETBACKS (FT.k.
FRONT LIR SIDE REAR
COMPLIANCE OR
i
CHANGE OF USE
c!:ZZ1%-.#Q7a
SIGN
PARKING
REO'Dj PROVIDED(t2
IA� _ —
r LOT AIR P
—
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REVIEWED BY
) -
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I fAT P
A -
IFENCE
3 ( _X—FT)
OTHER
F RE SPRINKLER
FIRE ALARM
CRITICAL\, V"' I
AREAS -"i — —"-% A^ ,
.%— __PZX Lot—ri- V_ I -*-
CHECKED BY ITYP I
SPECIAL INSPECTION JAREA
REQUIRED [] YES 1 "J15-7
REMARKS
PROGRESS INSPECTIONS
ut, 1 -.1
-J
C(17
OCCUPAT
,�3 GR
OCCUPANT
LOAD
1
108/FINAL INSPECT109 REaO
9
I A e.- n I L.,_., - - Tm.--
7 e_-x $
51�6 AMI Mnl e!)r— 77AM) LV 0-1
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9C&M - yfltrMS& F3(21 A. 6 afnlz Description FEE Description FEE
Plan Check
State Surcharge
ASKRCE G% LOT SLOPE Building Permit
,� - _A2A 7-"
city surcharge
PLAN CHECK NO: VESTED DATE Plumbing
71ja.
Mechanical
THIS PERMIT AUTHORMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONILX ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS,SID6!PK VEP Aya' MARQUEES, ETC.) WILL REQUIRE Grading
6 TE
EPM ERMISSION. Engr. Review
PERMITAPPLICATION. ISODAYS
PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS E2r. inspection
SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION
'APPUCANT, OR BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
t-Irtj HOVIOW
Plan GnK. u,eposit
IN INTEREST, AGREES TO INDEMNIFX DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
7T fz I
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Landscape Insp.
-fatal Amt. Due
DEEMED TO MODIFY WAIVE Oil REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
,
�OR.UMIT IN ANN WAY THE CffY`S ABILITY TO ENFORCE ANY ORDINANCE PRO VISION.-
am
I
Recording Fee
Receipt #
I fAEREBY ACKNOV49DGE THAT I HAVE READ THIS APPLICATION. THAT THE INFORMATION
APPLICATION
APPROVAL
GIVEN IS CORRE I AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
ruk OWNER. I AGR E M COMPLY WITH C17Y AND STATE LAWS REGULATING CONSTRUC-
CALL
This application Is not a permit until signed by the
; AND IN DOING THE WORKAUTHOPIZED THEREBY. NO PERSON WILL BE EMPLOYED
I IOLATION OF THE LABOR CODE 0 THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Building Official or his/her Deputy: and Fees are paid, and
recal s acknowledgbd In space provided.
� pt
WATION INSURAN
RKMEI$� . AND RCW 18.27.
Cj
On DATE
'At G
BIGNATL(RE (bWN9 GENT)
DATE SIGNED
42�
&1,E
771-0220
RELEASED BY PATE
ATTENTION E)ff 1333
q UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
00000", 'WAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- -FILE YELL(7V- INSPECTOR
ool.
OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER _V-ASSESSOR
PRESS HARD -YOU ARE MAKING 5 COPIES GRErN - ACco(FRTING
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