20030773.pdfDATE RECEIVED ,e:
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
EQ NAME/NAME OF BUSINESS
ADDRESS I
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STATE LICENSE NUMBER
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PROPERTY TAX ACCOUNT PARCEL NO.
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RESIDENTIAL
DITION
COMMERCIAL
REMODEL
MULTIFAMILY
REPAIR
CYDS
DEMOLISH
TANK
ciGARAGE
o RETAJNINGWALL
CARPORT
ROCKERY
(TYPE OF USE. BUSINE"
ACTWM EXPLAIN:
NUMBER
OF
NUMBER OF
DWELLING
STORIES
UNITS
DESCRIBE WORK TO BE DONE
[PERMIT EXPIRES
USE PERMIT
ZONE NUMBERCMe—�
JOB
ADDRESS
SUITE/AF`T#
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PLAT NAMEISUBDIVISION NO.
LOT NO
LID NO.
AM, q-a i�vI
LID FEE $
PUBLIC RIGHT OF VIJAY PER OFFICIAL STREET MAP
TESCP Approved
AW Permit Required
Street use Permit Rsqd
EXISTING - PROPOSED
inspection Required
Sidewelk Required
REQUIRED DEDICATION-
FT
underground
wiring required [3
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
I
YES13 NO C3
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
LIM
REVIEWED BY DATE
I I amau -_ 2j"63 -
FIRE REVIEWED BY DATi
11 �W )I
-
VARIANCE OR CU
SHORELINE OR ADIII
INSPECTION
BOND
ION DATE
CkECKED BY
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POSTED
1$
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— ---
E3YES PAR
--'
SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWED PROPOSED
,
EXP
j
LOT COVEhAGE
REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS (Fr.)
PLUMBING/MECH
ALLOWED PROPO BED
FRONT SIDE REAR
FRONT LIR SIDE REAR
COMPLIANCE OR
2:1150/
10 6 eag;
L413 ao
CHANGE OF USE
0
PARKING
LOT AREA
PLANNING REVIEWED 13Y AATE jo/
0 SIGN
REO'D
PROVIDED
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FENCE
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REMARKS
OTHER
FIRE SPRINKLER
FIRE ALARM
CI ST ULTION
CHECKED BY
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GROUP
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CRITICAL��_
SPECIAL INSPECTION REA
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LOAD
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REQUIRED [] YES
15REMARKS
PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REMD
4 1& R. j>kW0411414
� I
GLAZING % LOT SLOPE %
PLAN CHECK NO' VESTED DATE
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURaS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: 180 DAYS
PERMIT ILIMM I YEAR - PROVIDED WORK 15 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, AWSING 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 CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT; 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
(MEN'S COWENSATION INSURANCE AND RCVV 18.27.
VALUATION
$
Description
FEE
Description
FEE
Plan Check
j2U —1
State Surcharge
Building Permit
City Surcharge
Plumbing
Mechanical
J62
Grading
Engr. Review
0
Engr. Inspection
Fire Review
Plan Chk. Deposit
Fire Inspection
Receipt #
Landscapelnsp.
Total Arnt.Due c7tl` __9
R ecording Fee
#
Receipt #
CALL
FOR INSPECTION
(425)
771-0220—t
EXT 1333
APP ICATIONAPPR011Ai"
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.
OFFICIALS SIGNATURE DATE
1 t�g J, �� 3
-Ayfu4pf BYjj'j JATE
1 (1044V
IT UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL J01101
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINA12'- FILE YELLOW - INS
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
I
my of CAMnaft W 094WD3-X
rowwl Wc. so Fowd k*C, 2'
1 01011 a arms 01sk &
Pw,^- DOW OX Do"
'2
ZONE - Ea- 12-
SETBACIK00-
RECEMED
FRONT
jr
CIT.2. r,-0
SIDE SEP 2 9 2003
REAR A5k
PERMIT COUNTER
OTHER
HEIGHT
Found WC, 2* Dram
131ok A Punch. Down as' lie, SITE
---------------------
S 89-22'37" E 363.95,
C4HWAR" Dftve
-- — — — — — — — — — — T — — — — — — — — — — — — — — — — — — — — — --
PROJECT NOTES
ote Lonzandorfor 1 1. TOTAL SITE ACREAGE - 1.21 ACRES. MAIN ST.
130 Cascada Dr. I
2. PROJECT ZONING - RS-12 0 T
2&AO WALNUT P K
3. SEMACKS SHOWN ON ARE FOR REFERENCE 21 TH
ONLY AND VEST NO. RIGHT. Uj LU
3:
4. CONDITIONS OF APPROVAL MUST BE MET AND mcuoTY mAP
CAN BE FOUND IN THE FINAL APPROVAL FOR 4,w U
THE SHORT SUBDIVISION LOCATED IN FILE LOT COVERAGE CA
CO TYK I-L S-2003-X.
CONYROL SMCTURE \ I PARCEL "A" LOT AREAzz 12,870.90 SO. FT. ooj,
Lot 13 Rolno and Mary Lluska \ 0 dgr�
t ad Dr. FT. INCLUDING HOUSE, DECK.
20130 Moplawo BUILDING SO
"a r4nct GARAGE, FRONT PORCH-.2988 SQ. FT. 0
Loutei 313.10- 01
H
14U.ID 2988/ 12.870.90= 23.2X
a
% z
%
TOTAL IMPERVIOUS AREAS BUILDING
Op
V STRUCTURE AS NOTED ABOVE=2988 SQ. FT.
0 23 % DRIVEWAY AREA=1920 SO. FT.
� 2
Parcel D TOTAL IMPERVIOUS AREA=4908 SO. FT.
25' t
,Ilt g MAX, HEIGHT CALC. PARCEL "A
NJ I
10 A=202.25'.'
ZAVE CY
12.870.2 S1
%
TV. y B=206.25'
0
oo.SXI L— —1
L. I Fn .. - \k D=202.25'
777777 -IIE-20&52 LF a P C=207.25'
145.311
&IF 89*23 12. 0 AVG.=818 4=204.5' 0
E 1 'in N '23-tt' W 151.6w
i Lot 12 MAX, HEIGHT=204.5' + 25 =229.5'
4
ACTUAL RIDGE 0 229.5'
-20�.42 or C?
MAIN FLOOR 0 206.25'
'a
5 5S2z!F%
�m I
wit GARAGE SLAB 0 205.25'
$6% X 24" ADS REOMR I j
TVP I UPP 0
4W
% P. ER FLOOR 0 216.25
I Parcel C L4 TOP PLATE 0 224.25'
13.4214 $11- % -IN
.0k
Parcel a I DRAINAG
13,41=11 St or % t. C
TIGHTLINE NEW ROOF DRAINS TO
EXIST. PLAT RETENTION SYSTEM
..Arao
.."'rao
N 218 - - - - - - -
Ne Z, 169.49' 9BAPM '.--v
IL0131 Fence Ow) - -1 r ..... X., ---- ---- LJOUL)CS",
S 89-22'53* E O-M' zqRs 330.67' LL - 49 CY
rkffrff CUT cz 49 CY
Fo�d Rebor &
LS 17979
LEE S�th Elele Hiatt PFMM CONTAM
20026 Maplewood Dr.
Lot 11 APPUCANT/OWNER/DEVVLOPER.-
Allyn and Carolyn 4111[ngs EACLEWOOD HOMES
20307 92nd Ave W. Ia6O7 OLYMPIC VIEW DR.
79 LEGEND
�44' N EDMONDS. WA 98020
0 GO Type 2 w CATV Riser 0 CB Type I ATTN. CRAIG REIMER
nu Sewer Manhole a Phone Riser -6- Fire Hydrant PHONE: (425) 771-61122
R1 W&PLANNING a Cloonout cc:io Rock Wall FAX: (425) 775-8395
FIL N 199.41 Go
rn 297.31 -o- Power Pole
FL 5 199.41 0 a Electric Motor a Shower Drain Chain Link Fence
FIL E 200.11 Go 04 Water Volvo 0 Gas Motor SM ADDRESS:
A -jbjI212A'2j * Wood Fence PARCEL me
4 M Gas Volvo 0 Mon Box —x— Wire Fence
1 20217 92NO AVE. W.
10 Deciduous :0 Coniferuous Buried Cable Rim 216.28 EDMONDS, WA 9W55
PLAT Marker. FO
T11= 1101191111IMPTICM
CH Cheff y H Hemlock P Pine
D Deciduous M Maple S Spruce
I
. Height Calculation/Grading Verification Worksheet
Address: ;� Or� Permit #:
Date: C9—
A. Datum Point: .(2-6
B. Datum Point Elevation: C) 1 -3 1
C. Average Grade: L)
3. Maximum Elevation Allowed:,�Lz)4.s + 25'=
,average grade
4. Reference Point Elevation Shot to House:
Do<�S - + .09. e)
4_ (datum elevation) (grade to transit level line shot to hous
6. Measurements from line shot onto house to roof ridge:
-7
-7 X) I
Total 3 k4
*1�(reference point elevation) -01
7. Actual ElevationoLcAp, L-36(measurements from
#6) dt9'Ci 1 )'�>
Conclusion: I SO (allowed); therefore the house is/
-2�, �. (actual) is greater a2l 50 ,
is not over the height requiremenlWACDC 16.20.30 requirements
LATEMMUILDINGWISC\Height CalculationGrading Verification Worksheet.doc
13
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FINAL PROJECM APPROVAL FORM
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DATE:
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ISSUES - GRANT FINAL PROJECT APPROVAL.
RE -INSPECTED OUTSTANDING
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
t:3
SETBACKS .....................
FOUNDATION:
Footing ......................
Y)n
Wall..........................
Pier/Porch .................
Retaining*Wall ...........
Sfab Insulation ..........
PLUMBING:
Underground ............. .
Rough -In ........
Commercial Final .......
...HEATING::
Gas Test .... I ..........
Ga6,Plping .................
Equipment .................
Commercial Final .......
EXTERIOR SHEATHING
NAILING ..........................
lfttepumbnsed
Amount Paid
/Wwt
I r
01
-DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
i EMNEB NAMEINME Or BUSINESS
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f
MAILINO ADDRESS
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CITY ZP
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ADDRESS��-
CITY ZIP
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ADj?REft I
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STATE LICENSE NUMBER
M
PROPERTY TAX ACCQUNT PARCEL NO.
7
40,049
NE W
RESiDENTIAL
A DITION
COMMERCIAL
-0 REMODEL
MULTIFAMILY
REPAIR
qYDS
.0 DEMOLISH
TANK
[i GARAGE
o RETAINING WALL
CARPORT
ROCKERY
UWE OF USE, BUISINEqj�QR
ACTWM EXPLAIN:
NUMBER
NUMUER OF
OF
STORIES
DWELLING
UNITS
DESCRIBE WORK TO BE
DONE
CBL N
-5 � 0
PERMIT EXPIRES A W/
USE PERMIT
ZONE NUMBERc:��,!!�
JOB SUITE/APT#
ADDRESS 7 z&$f,
PLAT NAME/SUBDIVISION NO. LOT NO LID NO.
dft, LID FEE S
7ESCP Approved
PUBLIC RIGHT OF WAY PER OFFICIAL STRdT MAP AW Pamul newired
Street Use Permit RoqV
EXISTING — PROPOSED inspection Required R
Sidewalk Required
REQUIRED DEDICATION— FT Underwout-4
Wirlagcoquired
METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED
I YES 13 NO 13
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
D.-4011% 1(t f!.V,i,- 1.10 I(SN-HI
ENGINEERING REVIE
. ;L - 61
FIRE REVIEWED BY
DATE
DATE
F I
VARIANCE OR CU
SHORELINE OR ADBO INSPECTION BOND
rION DATE CLWCKED BY
By
I
REO" POSTED
I
[3YES _, 0 1$
S _V�p
SEPA REVIEW
SIGN AREA HEIGHT
COMPLETE EXEMPT
ALLOWED PROPOSED ALLOWED PROPOSED
j,,7
,
E
EXP
41KED
LOT COVEhAGE
MECH
REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.)
13 PLUMBING
ALLOWED -, PROPOSED
.. FRONT . SIDE BEAR FRONT. L18 SIDE REAR
COMPLIANCE OR
4413
11 CHANGEOFUSE
ING AATE
PARK LOT AREA LANNING REVIEWED BY
06
SIGN
REQ`D PROVIDtD
ACV'
FENCE
FT)
RE MARKS
OTHER
tj
I 6kf
F RE SPRINKLER
I —
FIRE ALARM
CHECKED BY
ST UCTION
JTYP�oGQ
V
GROUU
CRITICA�LZ/7
AR
liv
'SPECIAL INS�PECTION
Occu0ANT f
LOA D
NU
REQUIRED YES
JAREA
I
EMARKS
R M 8
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQD
r
lit
Description FEE Description FEE
Plan Check StateSurcharge
GLAZING % LOT SLOPE % Building Permit City Surcharge
VESTED DATE .01
PLAN CHECK NO, Plumbing
Mechanical
THIS PERGArr AU`FHORIZIES ONLY THE WCiK NOTED. THIS PERMIT COVERS WORK TO OL19
t: BE DONE ON PRIVATE PROPERTY ONLZ ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRMVAYS, MARQUEES, ETC.) WILL REQUIRE Grading
SEPARATE PEMISSION.
t: PERMIT APPUCATIOW 180 DAYS Engr. Review z0f
PERMIT ILIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 100 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE IN -FORMATION
'Plan Chk. Deposit
AN CE S Fi
'AP LJCANT ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS D'SUC SOR ie Review
IN J�TEREjT.
. 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 ORDINANCE PROVISION.'
Recording Fee Receipt III
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CGFIRECI' AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION API IMEL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC This application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED CALL Building Official or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODEOF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided.
0 RAN OFFICIALS SIGNATURE DATE
ENS COZENSATI N INSU CE AND RCW iS.27.
22! 1 - 1A01112%
81 AGENT) DATE SIGN4
771-0220-t R BY PTE
Ayd3313 f I
U!MN 1
IT UL TO EO OR STRUCTURE UNTIL mk
, %WFUL US R OQCUPY A BUILDING
L
A 1W CTION HAS ItEfflkill ND APPROVAL OR A CERTIFI- ORIGINAC. FILE - YELLOW - INSPE4OR/
PANCY HAS BEEN'q� T D. UBC SECTION 109 PINK - OWNER - GOLD - ASSESSOR
-asmcsss�ATE OFO M
$ 1/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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