20030799.pdfI
u4b
FDATE
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
9Q!4AMER
AAME OF BUSINESS
MAILING ADDRESS
NAME
ZIP
21-0
as
ZIP
LICENSE NUMBER
"P-0
ITY TAX ACCOUNT PARCEL NO, 4
.T IF z __ -.1 r_/ -_
L S I -F,, 2 2 9 2
TELEPHONE
LEPHONE
:&LIK
CBL N
,--'I
`6
TELEPHONE
W'd
Cg-'R'ESIDENTIAL
ADDITION
[j COMMERCIAL
13 REMODEL
MULTIFAMILY
REPAIR
CYDS
OLISH
TANK
V0
GARAGE
RETAJNINGWALL
C;ARPORT
ROCKERY
OWE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
NUMBER
OF
��JNUMBER
OF
DWELLING
STORIES
UNITS
DESCRIBE WORK To BE DONE
-PERMIT EXPIRES
USE
ZONE kS J� PERMIT
NUMBER
ADDRESS TqIAPT#
1100000010 Z�A Is 0j, 5T LL
PLAT NAME/SUBDIVISION NO. LOT NO. LID NO.
-4 3 LID FEE S
OFFICIAL STREET MAP
PUBLIC RIGHT OF WAY PER TESCP APProved
RW Permit Required 13
Street Use Permit Rsq'd 13
EXISTING — PROPOSED Inspection Required
Sidewati; Required -19'
REQUIRED DEDICATION— FT Underomund
wiring required )Rr
METER SIZI, LINE SIZE I NO.0 S--- ____PRV R UIRED'
7�14( 11 VNO 0 z
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
-11 ' M�Calh 0� ( .' 10k k�i
FIRE REVIEWED BY DATE 1 9
nON DATE
U
SHORELINE ORADB#
E
JE31NYSERE��ION
Q&O
S,
'��ND
TED
PA REVIEW
SIGN AREA
HEIGHT
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWED PROPOSED
EXP
201FLUMBING MECH
LOT COVERAGE
REQUIRED SETBACKS (Fr.)
PROPOSED SETBACKS (FT)
COMPLIANCE OR
ALLOWED PROPOSED
FRONT SIDE REAR
f "
FRONT LIFISIDE REAR
I
CHANGEOFUSE
2,!5100.
7.5 1.21;-'l
3 5 17-517 5 2_9'
PARKING
LOT AREA
PLAN NING REVIEWED BY 6ATE
SIGN
REaD PROVIDED
916
E3 FENCE
-
I ?�>
( X — FT)
REMARKS
600l
T7
0 0 H7E_
FIRE SPRINKLER
FIRE ALARM
CHECKED BY TYPE OWLICTION C,0t,1r-L _PCCUPAN
CRITICAL --- I I -T GROUP 7
AREAS SPECIAL INSPECTION ARE*7 OCCUFANT
NUMBER REQUIRED n YES - A ') LOAD
REMAR
::LKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'dD
I A 2-#7 W A. 17AI 1 77. , --A, I.- I
10
LLIQ.Tjp�-' Ille
VALUATION A
Description
FEE Description FEE
Plan Check
State Surcharge
H
GLAZING %
1q, T-102—
LOT SLOPE %
.
Building Permit
t9i 2
City Surcharge
PLAN CHECK NO: VESTED DATE
Plumbing
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Mechanical
BE DONE ON PRIVATE PROPERTY ONLY. ANN CONSTRUCTION ON THE PUBILIC
DOMAIN
Grading
(CURBS. SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review "!�14
PERMIT APPILICATION: ISODAYS
PERMIT IUMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE
Engr. Inspection
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
I EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS
Fire Inspection
Receipt
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
Landscapeinsp.
Total Amt. DL 3
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
-
j
Recording Fee
Receipt #
I HEREBY 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
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WFTH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
CALL
This application Is not a permit until signed by the
Building Official or his/her Deputy: and Fees are paid, and
IN VIOLATIPN OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
receipt Is acknovelodged In space provided.
WORKME NSATION INSURA
ACE AND RCW 18.27.
10' tOIER i�
SIG R XORGE�N�T) DATE SIGNED
J_
11405)
425)
OF Cl S IGNAT;Uf DATE
=11AA-AV�1 7�q
Ael-I
771-0220
- _71D�
LEksEb BY ATE
ATTENTION G" I Off 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL (A' ,
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL�- FILE YELLOW - 14SPECT6R
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - O�VNER)- GOLD - ASSESSOR
04/02
PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
to
z
0
0
M
M
C
N
C
M
M
z
0
MITI
CO)
0
Fn
C
MO
CO)
z
0
4
0
M
N541052'5-7"N 50-00' 0WINER/CONTRAC FOR 1S RE
CITY COPY I Amr nAmAQF
Pr-- Vr L 45 12 il - LOT 5 g
RECEIVED
z
7-- Of %
0 15, C, I TY 3:
�; w
SEP - 3 2003 OF ErPMON05
Jezoi)
L AATER LINE
A
/ /. 5; au
DEVELOPMENT SERVICES CTR. 141,9 A? i* I z
"t cm It
CITY OF EDMIOKS EASEMENT
210d1TH 5.yq. /*
SEWER.
WATER & a U.
INSpECTIONS REaD.
EXT. 1326
y 5 -9 Zrl /b 9�LL 425-771-0220 Lu
Lb C4
co r-
A�,&* 7— (oil 1w c?
rN L:v ia 1100
w cm co
OWNS Z Z;.:.
w
A ///V, CLi
-MID Itao,
fc LINE OF uJ
u. fF
ovERHANC75 Z
-TO'BlE 0 �
cm 0
COVERAGE 05EN1101A CONC:. :! 0
BUILDINC IVEI ,
CD
10,425 5-F. A E e&UXBwe'" MIN
LOT AREA CONC PAD
MAX. COVERA&E xx %
2,646 5.F. COVV -.4 prwp. 11
57, 1 -fl, or
BUILIAN16AREA -1 FORCH I
I ----- ---- --- -- -
k4A>c q?iI5.1721
q10. q,
,.-3
IMPERIVIOU 'BURFACE LINE .9, F J
u LLJ
�ANT L
10,425 5.F. egi-�
LOT AREA 50% /
MAX. IMpER\/Iou5 SURFACE Z Z5 //M Im
BUILDIN& AREA Lu
= 5�280 S.F. ACOEPTABLE TIGHTLINE
(INC. OVERHANC75 ts &UTTEf;Z5)
DRI\/EyjAyS is v4ALK5 = 1,002 5.F. MATERK PLAN NE OF
M2012 NT'L
TOTA IMF. ARZA 4,252 5-F. SDR 35 jr- CA
-FIREPLACE
ACTUAL FERCENTAC7E = 41.0-1% SCH 40
N - 12
LE6AL VE!50PIFTI0N F810 HANCOR
U)
LOT 5 1 .
CHAPMAN 5HORT FLAT
IN 5A 1/4 OF 5ECTION Icl, T�2-7 N., R.4 EJ KM. T u
;)F EDMONDS,
CITY C
5NOHOM15H COUNTY VqASHINGTON
APPROVED AS NOTED 1u CONC FA---
�r Ole
Y EtsIGINEERING 20, 5.5.5.L. -SIO
In 00so SU!Rf AN((, z
FMA DEVELOPMENT LLC a- m �<
IcI400 - 53P.D AVE Vii 5UITE WL
LYNNYqOOV, NA q8O36 NOOQOO'53"E BE
Date: 4.4ro' z
Z
. — — 1%
N5q 52'51"E 50-00'
SITE PLAN
15C,ALE 20-011 0 20 40 50 25.00 -------
%
UN3MWG,M4L JO A,47VM311,�M 01 3r1a 81 -U:
-91FU 10 IN31MOM SIRL cl LLON
BOLLON SINIMMI ls"V=�WM 3WVIW *30
Height Calculation/Grading Verification Worksheet
Address: 005 IS 0) Permit #: (D79 I
Date: 4-
A. Datum Point:
B. Datum Point Elevation:
C. Average Grade:
flcv re,
taverage gra
3. Maximumtievanon Allowed.
4. Reference Point Elevation Shot to House:
4( �datum elevation) +IjL!—Z (grade to transit level line shot to house.)
6. Measurements from line shot onto house to roof ridge:
0
Total: 1 " 0. 1 4V
7. Actual Elevation: (reference point elevation) -0 (leasurements from
#6)
Conclusion:
4 3 cl (actual) is great ess tha (allowed); therefore the house is/
is not over the height requir%e��r ECDC 16.20.30 requirements
LATEMBUILDINGWISC\Height CalculationGrading Verification Worksheet.doc
31
A,
z
0
1
0
m
OM
c
MO
0
80
c
-4 r.
M rn
m
z
(j)
0 -n
n
m M
a
0
0 rn
C
M 0
Z
7-1
M
z
z
9
0
m
RE-INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date si
ocaprvl.doc.l:tenip:bldg:forrmIO/OI
M
WaterMctcrSzlzc
Amountpaw—
DateParchased
ROW
Amount Piad $...P-WJPt
ED1.6e
I
2DA:TE :RECEn VO
UAA 7) PERMIT EXPIRES
PERMIT 0
ZONE )qqql i
CITY OF EDMONDS S NUMBER
CONSTRUCTION PERMIT APPLICATION JOB
ADDRESS Z4
OWN E OF BUSINESS ((S— +� I (
PLAT NAME/SUBDIVISION NO. LOT NO. LID
MAILING ADDRESS 45-0? -4 3 LID
'V Ap=,
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
Street Use Parmh Wd
CIT)f ZIP ITELEPHONE EXISTING — PROPOSED Impocon f1eqLaIred .
S1dsWa*R@qtJ1nW
REQUIRED DEDICATION— FT Urldergrourld
^14LI(weez WjMg required
NAME METER SIZE LINE SIZE PRV RED
it I I( YES NO 13 z
ff�tff r
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY 211 P ITELEPHONE
4 K
NAME r'V aT CBL#
It!
MA 1�f 61 gil, I '35o,�, GMEERM"G"REVIEWED 5*-- 1. ' :R V
bA, S
ADDRESS
I &Za I
FIRE REVIEWED BY DATE W
ZIP TELEPHONE
SHOFIEUNE OR ADB# INSPECTION BOND
EXPIRATION DAT L-ICR POSTED
JE _L'M&fWED REA
— �.'[ :.YE. 0 $
$EPA REVIEW SIGN AREA HEIGHT
PFJOPERTY TAX ACCOUNT PARCEL NO.Xore. ' Z7 COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED ROPOSED
EXP
LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.)
0y'91ESIDENTIAL. a-PLUMBING/MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR
I '1 ;5" 1-5/75
ADDITION COMMERCIAL COMPLIANCE OR 7-5 7-5-
CHANGE OF USE
IE�
P-ARKING L T AREA PLANNING REVIEWED BY DATE
REMODEL MUL11FAMILY SIGN RECYD I PROVIDED
o F NCE -2, 25 10'(/?
REPAIR CYDS ( X_ FT) REMARKS
[:] VD MOLISH TANK OTHER
GARAGE [3 RETAINING WALL o FIRE SPRINKLER
CARPORT ROCKERY FIRE ALARM
M?E OF USE, BUSINESS OR ACTIVITY) EXPLAIN: OCCUPA
CHECKED BY ITYPE OF CQWTiUCTION GROUP 3ULA
NUMBER NUMBER OF CRITICAL '1W I
OF DWELLING AREAS SPECIAL INSPECTION JAR5Pj OCCUPANT
STORIES UNITS NUMBER REQUIRED [] YES I -
DESCRIBE WORK TO BE DONE REMARKS ��ftj
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECT102N RECVD
E 9
_T_
OC- %.-.- A A
Description FEE Descripillon FEE
z
go
Plan Check 16 _46 State Surch go
HEAT SOURCE GLAZING % LOT SLOPE % 0
Building Permit City Surcharge /A_ M
L= Z5 -.L-
_C�_
-
PLAN CHECK NO:
IA-00—
VESTED DATE
Plumbing
&,04
—
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NO - THIS PERUrr COVERS WORK TO
TED
lz
BE DONE ON PPJVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
2
3
DOLWN (CURBS, SIDEWALKS, DFINEVAYS. MARQUEES. ETC.) WILL REQUIRE
t:
SEPARATE PERMISSION.
Engr. Review
PERmiTAPPILIcAiiam. ieoDAys
PERMIT LIMM I YEAR - PROVIDED WORK 16 STARTED WITHIN 180 DAYS
Engr. InspecHon
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER, SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
Fire Review
PlanChk.Deposit
IN INTEREST AGREES TO INDEMNIFX DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS. WASHINGTON, ITS OFIFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
ALL CLAI MS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
NOT BE
FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY OR13INANCE
Landscapeinsp.
Total Amt. Due
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
RecordinjFee
Receipt #
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION
APPROVAL
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-
CALL
This application is not e perffdl until signed IV litte
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATIPN OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Building Ofklal or hlsftw Deputy: and Fees are'ltald, and
receipt Is acknowledged in space proMed.
Wo��,NSATION INSUR%CE AND RCW 18,27.
OMC S IGNATU DATE-t -
SIG R OR NI)
DATE SIGNED
1425)
771-0220
RELE41215 BY /DATE
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 YE V-'4qPECT6
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
SSO
PINK-O�VN90-- GOLD-ASSESSO
IG
GREEN - ACCOUNTING
04102 PRESS HARD -YOU ARE MAKING 5 COPIES
L J