20040363.pdfE RECEIVED,�,,
CITY OF EDMONDS
CONSTRU CTION PERMIT APPLICATION
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ROCKERY FIRE ALARM
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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 (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: 180DAYS
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LL PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
(n 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
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uj IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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2 EDMONDS. WASHINGTON, ITS OFFICIAL S, EMPLOYEES, AND AGEN I S FROM ANY AND
ALI. CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTIY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODII WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY 70 ENFORCE ANY ORDINANCE PROVISION. -
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
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
W_QRMEWP COMfENSATION INSURANCE AND 1 18.27.
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PLAT NAME/SUBDIVISION NO. LOT NO. LID NO.
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Im Permit Required 13
Street Use Parrot Roq'd 13
EX19TING ___ PROPOSED inspection Required -W
sidewalk Required 13
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Wiring required C3
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Description
Plan Check
Building Permit
Plumbing
Mechanical
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Engr. Inspection
Fire Review
Fire Inspection
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Recording Fee
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CALL
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(425)
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IT IS UNLA&UL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
09/03 PRESS HARD -YOU ARE MAKING 4 CO
DATE SIGNED
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Description
State Surcharge
City Surcharge
Base Fee
FEE
Plan Chk. Deposit
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Total Amt. Due
Receipt #
APPLICATION APPROVAL
This application is not a perrnit until signed by the
Building Official or his/her Deputy: and Fees are paid, and
receipt is acknowledged in Space provided,
HI IG U E I)AT E
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ORIGINAL - FILE YELLOW - INSPECTOR
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2005072so739 1 PG
569M 00
07-28- 2005 01
st4ov,OMISH CW
CITY CLERK
CITY OF EDMONDS
121 STH AVENUE NO.
EDMONDS, WA 98020
ACCESSORY DWELLING UNIT COVENANT
Property Address: q of go
Edmonds, Washington
Assessor's Parcel Number: p.7
Legal Description: SEQ. 19 T �L4AIRVE-tv&
5 — 17-q __
1, the undersigned, have attained approval for an accessory dwelling unit (ADU) at the,
property address above, in accordance with the provisions of Chapter 20.21- (Accessory
Dwelling Units) of the Edmonds Community Development Code,
I agree and understand that'it is my responsibility to notify all future property owners or long-
term lessors of the existence of the ADU and that its existence is predicated upon the
occupancy of either the ADU or primary dwelling unit by the owner of the property,
Additionally, I will notify all prospective buyers of the limitations on use and maintenance of
the A -DU as stipulated in Chapter 20.21 (Accessory Dwelling Units) of the Edmonds
Community Oevelopment Code. An example of the limitations of the ADU per Chapter
20.21 is the property owner. is required,to reside in the, primary or ac6essory dwelling unit for
6 months out bf every year.
Finally, this covenant shall be recorded in order to notify all curTeftt and future property
owners that if any conditions of the ADU approval are violated, the property owner will be
required to remove all improvements which were added to convert the primary dwelling unit
into an ADU and restore the site to a single-family dwelling unit.
Property Owner Signature:
PrintName: L)eV�941.VOL 102 a CLe -A'
Property Owtier Signattire:
Print Name:
Date:
STATE OF WASHINGTON
COUNTY OF SNOHOMISH)
I certify that I know or have satisfactory evidence that.\&V a'_6e_ n Lt � a V�Ch)�S V N
signed this instrument and acknowledge it to be his/her, free and lunr tary act for the uses and
purposes mentioned in this instrument.
Notar I must be smudged. Dated: �2�f
.�_L%pMu"Wp
Wc
C.. 0
Signature of
Notary Public:
�o
PLJRI..�Cj
Residing at:
�A A,-
My Appointment
Expires: 1.9 — e:�,
THIS DOCUMENT MUST tE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR.
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STATEMIENT ON ACCESSORY DWELLING UNITS
Property Address: clog 0 1 lc�� Amt. W .EjM0VV�5,WA 9SQ6
Edmonds, Washington
Assessor's Parcel Number: 001,1q 3 0 000 U0 a
I have read the requirements for accessory dwelling units contained in Chapter 20.21 of
the Edmonds Community Development Code (ECDC) and understand that an accessory
dwelling unit as defined in ECDC Section 21.05.015 is prohibited until an Accessory
Dwelling Unit Permit is approved.
I also understand that an Accessory Dwelling Unit Permit cannot be approved unless all
the criteria in Chapter 20.21 are met, and all the necessary items are submitted,
including an affidavit of occupancy and a covenant to be filed with the Snohomish
County regarding the regulations imposed on Accessory Dwelling Units.
Property Owner Signature: I& uakm
Property Owner Name (printed):
Date: Lan jo 4
0
.0
I Pus
STATE OF WASHINGTON
0 F \N PS
COUNTY OF SNOHOMISH)
I certify that I know or have satisfactory evidence that
signed this instrument and acknowledge it to be his/her free and voluntary act for the uses and
purposes mentioned in this instrument.
Notary's pressure seals must be smudged. Dated:
Signature of
Notary Public:
Residing at:
My Appointment
Expires: 1r7
THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMSH COUNTY AUDITOR.
13
ADUstatement
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CONFORMED COPY
200507110903 1 PG
07-11-2005 04:29pm $19.00
SNOHOMISH COUNTY, WASHINGTON
CITY CLERK
Cilry OF EDMONDS
12l 5TH AVENUE NO.
EDMONDS, WA 98020
STATEMENT ON ACCESSORY nAXT'MT T
Property Address: ap90 1.
Edmonds, N
6
Legal Descri-otion:
P. 3 ?
Assessor's Parcel Number: 0L6—(-X 51
I have read the requirements for acce,-'---- 21 of the
Edmonds Community Development ry dwelling
unit as defined in ECDC Section 21.0 ng Unit
Permit is approved.
I also understand that an Accessory Dwelling Unit Pen -nit cannot be approved unless all the
criteria in Chapter 20.21 are met, and all the necessary items are submitted, including an
affidavit of occupancy and a covenant to be filed with the Snohomish County regarding the
regulations imposed on Accessory'D-vXelling Units. A
Property Owner Signature:
Property Owner Name (printed):
Date: -7 1-1 Qq
STATE OF WASHINGTON
COUNTY OF SNOHOMISH)
I certify that I know or have satisfactory evidence that
signed this instrument and acknowledge it to be his/her free and voluntary act for the uses and
purposes mentioned in this instrument.
Notary's pressure seals must be smudged, Dated:
*1� Signature of
HUDA' E OLSEN
0 �Jjy 3] Notary Public:
IC
PUBLIC
7N NGT N
T
STATE OF WASHINGTON
PI S Residing at: Q
COMMISSION EXPIRES
Y 1 006 My Appointment
FEBRUARY 1, 2006
Expires:
THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR.
ADUstatement
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CONFORMED COPY
200507110903 1 PG
07-11-2005 04:29pm $19.00
SNOHOMISH COUNTY3 �VASHINGTON
CITY CLERK
CITY OF EDMONDS
121 5rH AVENUE NO-
EDMONDS, WA 98020
STATEMENT ON ACCESSORY DWELLING UNNITS
Property Address: apgo 1 20,2:- Le. W
Edmonds, Washington
Legal Description: C1,JP-,,_< �),oj 1 RM Aec) r) - na — Lo 90 F+
A3?
Assessor's Parcel Number: Ob 6 t �1 3 0 o o 6 a LDo^t
0- -O-AWDe.' 6RVF_&_ 0,e41V77:_"E_ L B4,Vel-P_
I have read the requirements for accessory dwelling units contained in Chapter 20.21 of the
Edmonds Community Development Code (ECDC) and understand that an accessory dwelling
unit as defined in ECDC Section 21.05.015 is prohibited until an Accessory Dwelling Unit
Pen -nit is approved.
I also understand that an Accessory Dwelling Unit Permit cannot be approved unless all the
criteria in Chapter 20.21 are met, and all the necessary items are submitted, including an
affidavit of occupancy and a covenant to be filed with the Snohomish County regarding the
regulations imposed on Accessory'DN elling Units.
�4
Proper-ty Owner Signature: ) k W -_ 644"ZI
Property Owner Name (printed): Pejer 1�. j��,qt4 e
Date: -7 1-1 1 Qq
I I
STATE OF WASHINGTON)
COUNTY OF SNOHOMISH)
I certify that I know or have satisfactory evidence that Ua� �A.
signed this instrument and acknowledge it to be his/her free and voluntary act for the uses and
purposes mentioned in this instrument.
Notary's pressure seals must be smudged. Dated:
Signature of
HIJIDA E. OLSEN Notary Public: Lek
D
N R UBLIC
T
FOTA P
y
0
STATE OF WASHINGTON
XPI S Residing at: ls� QP,
COMMISSION EXPIRES
FEBRUARY 1, 2006 My Appointment
Expires:
THIS DOCUMENT MUST BE RECORDED WITH THE STNTOHOMISH COUNTY AUDITOR.
ADUstatement
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CITY OF EDMONDS MAYOR
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building Engineering
Peter Bauer
7419 201s' St. SW
Lynnwood, WA 98036
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Re: Building Permit: 2004-0363
Site Address: 2090t 80"' Ave W.
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Expiration Date: May 17, 2005
The purpose of this letter is to inform you that the last remaining inspection on your
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project is a final inspection(s). The final inspection(s) determines that there are no
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outstanding life -safety issues and approval allows the City to close Your pcn-nit file.
The City considers the final inspection to be one of the most important inspections
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conducted on a project. In order to grant final approval the following must be corn
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smoke detectors, house numbers, guardrails, handrails, self -close doors between garage
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and residence, egress from sleeping rooms, safety glazing, weather-stripping, any
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Engineering department requirements etc. Of course not all of these things may
specifically apply to your project but it does give you an idea about the kinds of things
that must be complete as well as some items that do not need to be installed such as:
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paint, carpet, moldings, wallpaper, etc. Please be advised permits expire one year from
the date of issuance. If you will need more tirne to complete the work, permits can be
renewed prior to expiration for one half fees. If the permit expires without a final
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approval granted by the Building Inspector, full fees are required in order to renew the
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permit. This can be very costly to you and we strongly encourage You to check your
permit expiration date and call for the required final inspection(s). Note: If more than
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one department is required to final your project, this is noted on your Job Card.
Please feel free to contact me at 425-771-0220 if you have any questions.
'
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my RcOdrVio
qermitCOordiDut0r �.
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° Incorporated August ll. 1890
Sister Cihv'lfakinan. Japan
05/27/2004 17:16 14254812510 NELSON GEOTECHNICAL PAGE 02/04
FIELD REPORT
NELSON Project: Foundation.Evaluation File No.; 395504
GwTEcmicAL Owner: Pete Bauer Date: ' 5/27/04
AsSOCIATES, INC Location: 20901- 80"' Avc W, Edmonds Report No: I
17all 135THAve.NENA-500 Weather: Raining, 50's Page I of.Sr47
WoWinville, WA 98072 Purpose of Visit: Construction Monitoring By: ADJ
(425)486-1669 PAX 481-2510
We visited the site today at the request of Pete Bauer, the owner, for the purpose of evaluating the
footing subgrade for the planned addition to the existing residence located at 20901- 80b" Avenue West
in Edmonds, Washington.
Upon arrival, we met with Pete, He informed us that the footing lines had been excavated down to the
plaxmod elevation within the addition area along the west and north side of the existing building (see site
plan).
MM09VISU:
Northern-F-o-oft Lm:e
The footing line along the north side of the existing residence was part of the daylight basement
foundation (see site plan, page 2). The footing line subgrade consisted of gray�-brown, silty fine to
medium sand with gravel. We evaluated the subgrade by probing with a Yz-inch steel diameter probe
rod, under moderate pressure, and found that it penetrated V2 to I Y2 inches. We interpreted this material
to be medium dense to dense native soil.
Wgg= Footing !;me
The footing line subgrade, along the westan side of the existing residence, exposed brown, silty fine to
coarse sand with gravel and trace organics (see site plan, page 2). We evaluated the subgrade by
probing and found that it penetrated 6 to 18 inches. We interpreted this to be very loose fill material.
We recommended to Pete to remove the loose fill material down to medium dense or better native soil to
reduce the potential for settlement. He agreed and informed us that he would just extend the footings
down to the new subgrade.
AUTEENDON VISM.
Upon arrival, we met with Pete. He informed us that they had found bricks in the upper brown material,
He also informed us that they bad over -excavated approximately two to three feet below the planned
footing subgrade elevation to expose the native soil, in the southern end of the footing line (see site Plan,
page 3). We observed the over -excavation subgrade exposed brown -gray, silty fine to medium sand
with gravel. We evaluated the subgrade by probing and found that it penetrated I to 2 inches. We
interpreted this material to be medium dense to dense native soil.
Based on our observations, it is our opinion that the exposed native subgrade should provide adequate
support for the planned loads. Any ponding water or surficial water -loosened material that might
develop due the weather or changing site conditions should be, removed from the excavation prior to
pouring concrete.
Attachment: Site Plans Signed:
Distribution: C; V E 0
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05/14/2004 13:31 253-536-8488 F.S.&GS. SERVICES PAGE 02
TABLE OF CONTENTS
SECTION I STATE ACCREDITED CONTRACTOR
State License and Registration
Labor and Industries Contractors Registration
Labor and Industries Asbestos Certification
SECTION 2 ACCREDITED ASBESTOS SUPERVISO
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SECTION 5 NT ACTIVITIES
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05/14/2004 13:31 253-536-8488 F.S.&GS. SERVICES PAGE 03
SECTION I STATE ACCRtDITED CONTRACTOR
State License and Registration
Labor and Industries Contractors Registration
Labor and Industries Asbestos Certification
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