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20040548.pdfAliln,4a 4,t�q 3D 6yo DATE RECEIVED v54, )j CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OW R NAME/NAME OF BUSINESS. w MAILING ADDRESS ` CITY / ZIP ITELEPHONE l NAME CITY NAME ADDRESS CITY ZIP I TELEPHONE 1 /—T ZIP STATE LICENSE NUMBER C B L TELEPHONE EXPIRATION DATE CHECKED BY a PROPERTY TAX AQQOUNT PARCEL NO. ,� NEW RESIDENTIAL ❑ PLUMBING! MECH ADDITION ❑ COMMERCIAL ❑ COMPLIANCE OR CHANGE OF USE ❑ REMODEL ❑ MULTIFAMILY ❑ SIGN FENCE ❑ REPAIR �rC'� CYDS ❑ ( X FT) DEMOLISH ❑ TANK OTHER fyeGe . RETAININGGARAGE WALL FIRE SPRINKLER z ❑ CARPORT ❑ ROCKERY ❑ FIRE ALARM 0 (T'gE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: } o NUMBER 3 NUMBER OF CRITICAL I toOF DWELLING ,y/ AREAS fi)) i O STORIES UNITS 'r� NUMBEk l ) DESCRIBE WORK TO BE DONE _ A , _ _ kif19ONR8E^"' GLAZING % LOY9L'OPL"°� Pltrri;rre�x-rro: G"A- THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO t BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC 9 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC,) WILL REQUIRE 'a SEPARATE PERMISSION, w PERMIT APPLICATION: 180 DAYS a PERMIT LIMIT: 1 YEAR • PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION to •APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF 2 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 1HIS PERMIT SHALL NOT BE g DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION." 0 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 WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. SIGNATUR PW;I((a1R ,AGENTS DATE SIGNED la \.. !.. ')'tom-s!S (J%Vow 1�.. .., •'V`7�/' ' PERMIT EXPIRES " USE PERMfT ZONE' ..i� I '� NUMBER JOB SUITE/APT# ADDRESS 57 7 /10`PLAT NAME/SUBDIVISION NO. LOT NO LID NO �..,� LID FEE $ TESCP PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Pe Approved i• rmd Requaed i L% ,/1} Street We Permit Pao d EXISTING PROPOSED (Y inspectionRogwretl -- Sidewalk Reqwred REQUIRED DEDICATION �— FT Undorgrouno Wiring required METER SIZE I LINE SIZE NO. OF FIXTURES PRV REQUIRED YES ❑ NO ❑ REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE e::bu Ioks RING REVI FIRE REVIEWED BY 3/4 J4, DATE r, z FE z z a z w w LL VARIAN(Vj.I 1QR LIN OR A'8 SECTION BOND cOTI POSTED ❑YES ZNO $ SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED ;�r . -WON - --- EXP LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT �SIDE REAR FRONT LIR SIDE REAR 0 PARKING LOT AREA PLANNING REVIEWED BY DATE rig. REO'D PROVIDED f REMARKS L.I. L l it t:. 1L L. 'IIjL IL 1 r 1L, ;L ie TLJ/.r kl .tlF—I!• Ya c.'iilitr•r7' i/J ;'1)rIt_t �. !It ;rir•r!'l CHECKED BY TYPE OF CONSTRUCTION CODE OCCUPANT ;7. GROUP y oeo SPECIAL INSPECTION jA2&jjP � OCCLOAUPANT �. REQUIRED REMARKS = PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RE01D 9 _ 5 t -, VALUATION Do L Description FEE Description FEE Plan Check G State Surcharge Building Permit % City Surcharge 40) Plumbing Base Fee ) Mechanical Grading Engr. Review Engr. Inspection J�1 Fire Review Plan Chk. Deposit. " Fire Inspection Receipt 0 landscape Insp. Total Amt. Due r J V Recording Fee c Receipt # 4jo-ov k,149ljAPPLICATION APPROVAL' l LL BuilThis application Is not a permit until signed by the ' / ding Official or hislher Deputy: and Foes are paid, and FOR I N PECTION receipt is acknowledged In space provided. OFFICIALS SIGNATURE DATE (425) 771-0220 DATE ATTENTION u EXT 1333 C14V1d IT IS UNLAWFUL 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 09103 1 1 A ►n.. •ram% 1 A r%rm a• A 1i11L6i► A 0%,^r%1a—r% ORIGINAL -FILE YELLOW - PINK • OWNER GOLD • r O n m -n vM m� -I O 0 n C mz "'I DZ r —I O� mm_ ON r CN k En Zr Z 2 z 0 n M I in 158th ST SW in20' 20' L40-iy N88'09'4JmW 212.49' ;-------- ^ I A-060949' Ro5258.80 0.•� �' VACATED 150 ST = NT44'17T � in w g I Ln 15.02 -- 1 --- . _ 1.56' a-'- —�� --*sue - — -- 20.19' f 91 N88'09'431Y 192.89' 99.2' FND R/C STAMPED 1S 9435' �^ N� 0.2'(S) OF CALC. CDR. fC1p .� (ACCEPTED) 000 ssss' ." "', 777.-7-„-7rr-. 3 6 P cl New 1 WCLA l 'AV LOT 1 I /�-i 707 I UPPER V EXISANG HOUSE 115810 ' ' -Y LEVEL 1 17'SJ' DECK V o I I \v R�5258.80' I ' Ln119,15' ---------- DUSTING LOT LINE—I`----�CKAND ------- \\ UPPER LEYEC DEC!(J ---- J1.8_ 'TOTAL Z mos 11 %I I ` \25X21 SQ. FrA \ \\ \\ \\ 1 ASNPALi I ` A\ \ \ \ \ \ �WQE R \K DII \ \\� i ORNEIVAY ' , 1 1 ►I . r,7,o suF 2 J I w \`�\ ► L-�CCS {lr� INS / 1 ;' p 1 / d `�\� $ Rock l / JI I I I 1 11 1 x Irk LEA L0'I�\2 \ \ IPED 1S :7 COR. 54.5' \ \ \\ ' S8.4? \ \ Y \\ \ \ (FENCE IS 1.2' 7CLF N88'09'4JiV 184,6J' 70CLF FENCE IS 1.5' SOUTH OF SET SOUTH OF Pt � I TBM N I IVEE I CORNER ne. �� .:-,�q,.l;I�+i � RECE 2004 LOT 3 �, $EP►C b.MAY 2 6 1 cAr7 ..... 0 20 PERMIT COUNTEF otions of all features shown are approximate. + f ure is for informational purposes only. It is intended to assist in the identification of features (2 ll SCALE IN f EEl :d in a related document. Data were compiled from sources as listed in this figure. the data do not guarantee these data are accurate or complete. There may have been updates to tht!' SITE PLAN ice the publication of this figure. This figure is a copy of a master document. The rnoster hard G EO E N G I N E E R S� stored by GeoEngineers, Inc. and will serve as the official document of record. FIGURE 2 ig enttiled "Exhibit Mop for Gil Thiry", provided by Western Engineerings, Inc., dated 1 1 / 10/03. PL ,y:!' 47 I 11 ex.-ia- a &art Pile fl- Iria;iaP JOB Gd %%'/w FILE NO. 0917-W-01 .00 BY Gii'ff DATE 3%k/,00a SHEET_ OF_(_. 1let &A QAC I,SB:A J76 JW (NOT OPEN h GeoEngineers, Inc. NOfr� % rwk. skotA *rhos. On:..�tv�H.R•k ao%na41 paltvn smnsom3 ?..t.j N1L0 udYiafwce Ao� a2 q�eh Y.MJL, GEI 08.91 JOB (^v / FILE HD. o2L2Z.Q ' BY EAfE DATE _ 3%frhouo SHEET_ OF_� of n �- . � .�� AIA w DPP m "1 � p�10 an�.n a S�;lc.n IM. �t , �4n S,�,sk.hl d�1 1 I ` ISB rA sr. SW. CAI OT OPEN h — 0 o h ` 192.d9' ( ! Toe=IIVA I08 rPENC// ORA,N 0. d'cP PVc PeR p. y 3 , ; h i I .� / �2 O ., -t Q . O V , Ir So RAH n Nvlt s,ta sWtA oms tir+oP, T/ .! �V4. %3r fJsA... Srti �,ry K.' flic Re;I pile. ' I M w K h h O y TSe i.ZLr rAWI d. I*co r' .n 'f��. _ I L, b ; .riou art Ram � aHer►rr.,.�. GeoEngineers, Inc. f. t go I 10 It ....• : RE URN ADDRESS: I lip 1111111111 11111111 City •of Fdmonds, City Clerk 2C O407140507 5 PGS ' $4 21.5•tb Avenue North 07 -14 - 2004 01 : 46pm $23 , 00 i ' E rids;, W..A''98020 SNOHOMISH COUNTY. WASHINGTON .. 11 .. lee to I. Ae 0 ellm COVENANT OF NOTIFICATION AND•• "EL[NIFCATION/HOLD HARMLESS om ; Reference #: ` /�7©Jr'Y m v ' (2) Additional on pg. 0 Grantor(s)ea (1) � . ' O C Grantee(s): Citv of Edmonds I = m m Ile, ' z Legal Description (abbrevlate ft Sec_:'ir+'n��Rng_._ L�Qtr p —i let C OR Left '' Block Plat 2 � _ Assessor's Tax Parcel ID#(s): (I)_-,i �l Z�� (2) co Assessor's Tax•Parc0 ID# not yet assigned •• `• ell mm O1vDS n M CITY O>�'ED1Vl; �'• :. APPROVED FOR RECOFIDING C N mn EBY9� DATE* jWPAG ), OR r- I X le z Under the review procedures established pursuant to,.the .Stlatp''Building Code, co the C, Edmo' ds' and as a incorporating amendments promulgated by 'ty..p." ,. n j••. z prerequisite to the issuance of a building permit for the constrtgetion,of•a re$idential ' n structure and attendant facilities, the undersigned OWNERS of property•do hereby m covenant, stipulate and promise as follows: _le q I se It, It i4 [,• • ., It It ,It ,. 0.1 •`. .. . It ., . ,0 ' • r. I' leg I• 46 •♦ 'ell 11 eel I lege. III .•' go to ,,• ' • f • `• ••. APP VE FOR RECO 1N % BY DATE I PAGE OF I. 1..Des' riptIt of Subject Property. This covenant of notification and 00.: n indemnifidotionfhelit,li4rn less relates to a tract of land at the street address of M It •''�' ' - (insert street -n M� address), Edmtinds Spolaomish County, Washington and legally described as: v _ O.%rno Vogel: C �mto V =9 get IO m .... G m z C Z gog, leg ` VI • '• ••,\ O ... 16 mm 11 lop O� y' 00. � ' __... m n go �go 2. Notification and Covenant of Notification'. .,'Tice above referenced site ,......-go, ••, logo •• Steel (hereinafter "subject site") lies within an area which*h I. go n':dentified by the City y ` z of Edmonds as having a potential for earth subsiderice,or''landslide hazard, The -� risks associated wCD ith development of the site have"'l�eepr evaluatedgog by technical z go 0 It consultants and engineers engaged by the applicant as a *part ofeAhe process to -� :: ': n obtain a building permit for the subject site. The results ofi•.tht :gotisultailt's reports m and evaluations of the risks associated with development are cantain�d in'b•uilding :' permit file number (insert number) on file withgo •••"tbe` City of ..... . Department. Conditions, limitations, or prohibitions,_ on.. Edmonds Building p ; development may have been imposed in accordance with the recommethd`t'iods' of! go.�... , 0. ;• I go looll go .I' 5 1 to to If to •'♦ -to •,` APPRO ED FOR RECORDING BY DATE It PAG ,' OF r the,Jco sultah&I it! the's•course of permit issuance. 1.The conditions, limitations, or ,.. fee` i ;ulre iongoing maintenance on the part of any owner or lessee or prohibitions mar, req may re�ife Ipadilications to the structures and earth stabilization matters in order too, to address'•.futare•'.or anticipated changes in soil or other site conditions. The cotechnical en ineer, statements an4 conditionle,s prepbsed by the OWNERS' g g geologist, architfe"6cLa ud/ar' stru.Etural engineer are hereby incorporated by reference from the contents or tho•file a$ fully as if herein set forth. Any future purchaser, lessee, lender or any other.per. do acquiIt 11.0rink.or seeking to acquire an interest in the is put on notice of th1.1 e.ekistell ince.o't�the content of the file and the City urges property p review of its contents. The fle may' be review.d:during normal business hours or copies obtained at the Building Department, pity' :of of Edmonds, 121 Sth Avenue North, Edmonds, Washington 980208eel -to Is 3. Indemnification and Hold Harmless.•'' The, undersigned OWNERS 11 hereby waive any and all liability associated intlile 16 ''development, stating that they have fully informed themselves of all risks 'nssotia�ted with. development of the ive and relinquish aily and,all. causes of action against property and do therefore wa the City of Edmonds, its officers, agents and employees..a n3jntg' from and out of such development. In addition, the OWNERS on behalf of themselves;'theiit successors in interest, heirs and assignees, do hereby promise to indemni`y andI. .l�dld harmless the IN I to I'll �t..110, , tY City of Edmonds, its officers, agents and employees from any•foss,•cl'aith, li bili or either;on or'�of`f t e site damage of any kind or nature to persons or property 4 resulting from or out of earth subsidence or landslide hazard, arising :froaw.or•o'iif -of the issuance of any permits) authorizing development of the site, or occur ri►tg•' or' . N I •%u I, too too 0 1. 1 1 4, off ,, , 1. Y • O M =-� 9 0) -i cm M --1 O O C' owl K =M m Z A 'i D Z` r —1 i ,u •`. I 1 ••,, '• to .19 all AITRQVEQ YOR RECORDING I , W, DATE 7 Q OF PAG 1 rr $lo ,n•• ••'••..•,.•• ••,.,, ..••• arisipg'' out of: and false, misleading, or inaccurate information provided by the Z` �• _,. 0 OW�1F>;RS,•their�eriipl'Q;yecs, or professional consultants in the course of issuance of rn IIIto ., , the buil`c#ing Pelariit.,. ', ••. i _ 'Ile so as too It to an bonding which may be I o M 4. Insurance Rec fuiremeat:'Jn addition y C 0 m required durin/C`�' the '•course It of "development, the Community Services Director .� on v 4,,,,••• O C:. has/has not (strike one) specifit:alikorequired the maintenance of an insurance policy = m •w••,. , m Z for public liability cover60,00 age..61 i 3 thg amount •and for the time set forth below in order p D z to provide for the financial•res�otisibiiities'established through the indemnification r-. _ Cn and hold harmless agreemeikabovc: '' "I too.rbe t� ' ,. ,•. o Net 0 r' C M 01.0.1 ;r. N E m Z� IOWA 5. Covenant to Touch and Concern the Land: ,,This covenant of $ notification and indemnification/hold harmless••touchesr arid' ;concerns the subject _ D tract and shall run with the land, binding, obligahrig and/ot, nAring to the benefit of Z e owners heirs, successors and interests or ••any ,other•: person or entity future : •• 07 acquiring an interest in property, as their interest may appear,,• This,.provision shall o '' 1. 'Ile'' -I not be interpreted to require a mortgagor or lender to inde1nnifyIthe Cify.except to m the extent of their loss nor to obligate such persons to maintafiaythe'igsuran�e,above required. , ` ;~... so • ., Me I be .1.110 ., I ell, !. •� •• •,,• ,li• !,, ,... , too •,,• •so .010'sw % ( I. �' ,,••so, ,, •',,. es,•be•, be to _ 1 i r ss ,,, ,, . 0 did 16 Be 9 so set be 06 Go so do do ,:..be debt ' do. , *11 to , •16• .. Id .16,APPR ED OR RECO BY DATE I % PAG-S_____ OF I u -'d. y z DOMEa#><is' r •: _day of 0 do OWNER(S) y , do de + I � -� By• I _ Me to y r, rn my so 1691 bell do 11.10 so.do be I I �0 90 m do Z: I debt $y.: A do do do be z• •,. �� r'' 0 son STATE OF WASHINGTON ) _ s�it •• m m do I do COUNTY OF ON%. r •. 0 n m do U I certify that I know or have satisfaetorx•ev deni=e, that K � i ol leg, sI eed:this instrument and I ...i r acknowledged it to be (his/her) free and voiudtaty...act;.4or'die purposes mentioned in � -4 ...., _ et I this instrument. ;� D so DATED this day of ob — _ Cn O 0 coAo: !M`jVj �� 4 O NOTARY PUBL do I.• rn "V IAq; k P'j 1. l,2 06 5 WAS��� I: \TEMMUILDING\MEADOWNCOVENANT My commission expire:'' ,. 14, Ile ,.- ',. ' ,. 1 • se :1• . Is, •, so 1 do .. do I blood ... , old 16 .,. do l FINAL ROJECT APPROVAL FOR 1 TO: DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: PROJEC SITE AI: FIRE DEPARTMENT DATE Sm ,kJ740xxM ler / ENGINEERING DIVISION DATE . PLEASE slcN PLANNING DMSION DATE PLEASE SIGN • i-� // �� . ,,, , . aril il� 7J 41L PERMIT #2f2,l%)4 — (6 1Ic63 ADB# DATE INSPECTED SZ017 &a`) DESCRIPTION OF WORK TO BE INSPECTED BUY? A Geld inspection was conducted to determine final compliance with approved plans. Final approval denotes that there are no objections from the above signed Department to the release of PERFORMANCE BONDS and the granting of GRANT FINAL PROJECT APPROVAL GRANT PROJECT APPROVAL WITH CONDITIONS NOTED ❑ Copy of CONDITIONS given to owner/contractor by inspector FAILED FINAL INSPECTION - OUTSTANDING ISSUES ❑ Copy of CORRECTION NOTICE given to owner/contractor by inspector 1. 2. 3. ZE-INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL date Sign Icaprvl.doc.l:temp:bldg:fon ns l0/O 1 z O r, n rn crn' v M0 0C mz p -1 DZ r -1 in OM mm -00 C CO 9 C/, rn Z 71 D I Z' 4 z 0 0 rn RECORD OF INSPECTIONS INSPECTOR DATE APPROVED �14c.1C V.) v SETBACKS ....... , FOUNDATION.'t'yft;t. Footing ........ (v Wall 7_ t`s•-ail Pier/Porch �11 Retaining Wall ..........: Z 0 Slab Insulation .......... n m PLUMBING: Underground t/ Rough -In .... ' 0 O Crn 44" m Commercial Final O C HEATING: _ mm Gas Test ....... Z 10 C Z Gas Piping ................. > —1 Equipment CO) O M Commercial Final ....... '71 EXTERIOR SHEATHING 'nA %rJ'= m NAILING V r IJ m FRAMING f I p m C CD FIRST FLOOR FRAMING.., CD Z r. INSULATION Floor Insulation S Wall Insulation ........... D Z Ceiling Insulation ....... _ SHEETROCK NAILING ... Z O SPECIAL INSPECTION ... 0 M MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY ..................