20040990.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
ER NAMEWME OF BUSINESFp
MAILING ADDRESS
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GRAj.1tjG CYDS
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RETAININGWALL
CARPORT
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(TYPE OF USE, BUSINESS OR AC 2 N:
NUMBER
NUMBER OF
OF
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DESCRIBE WORK TO BE DONE
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USE PERMIT
ZONE NUMBER q q
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ADDRESS t76
PLJZ�AME/SUBDIVISION NO. LOT NO. LID NO.
LID FEE S
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ESCP Approved
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required
I Street use Permit Roq'd
EXISTING — PROPOSED Inspection Required
Sidewalk Required
Underground
REQUIRED DEDICATION FT Wiring required
METER SIZE LINE SIZE NO. OF FIX ;TTU�RES PRV REQUIRED
21 YES 13 NO 13
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/D RAIN AGE
T-
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E jl�GtNEERING REVIE
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VARIANCE OR CU
SEPA REVIEW
COMPLETE , EXEMPT
EXP
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REMARKS
DATE
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SHORELINE OR ADBI I INSPECTION I BOND
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REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT)
FRONT, 4 SID�,,,,R!q,,(j,FR(PT L?ISIDE/REAR/
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LOT AREA PLANNING REVIEWEP qy DATE :3
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CHECKED TYPE 0 PUCTION OCCUPAN
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AREAS SPECIAL INSPECTION OCCUPANT
NUMBER q REQUIRED LOAD
REMARKS z
�IPROGRESS INSPECTIONS PER UBC 108/IBC109/IRC109 FINAL INSPECTION REQ'D
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EL1140 4r1s;,le VALUATION
$
Description FEE Description, FEE
Plan Check )q/ State Surcharge
HfiAT SOURCE LAZINC3 LOT St PE %
Building Permit LIP)' City Surcharge
08
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VESTED DATE
PLAN CHECK NO: Plumbing �zlu -Z, Base Fee
L[ - q q - � Zo
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading
DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION. Engr. Review
PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION Fire Review Plan Chk. Deposit
'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 Fire Inspection Receipt #
170
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 CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION-4
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION Recording Fee Receipt # /0
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAI
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building Olficial or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided.
WORKMEN'S 5@AIV\NSATION INSURANCE AND RCW 18.27. 0 FIVLS SIGN URE DATE
Sj E." DATE SIGNED (425)
771-0220
B DfE
A il�
ATTENTION V
ITIS UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTILAFINAL
INSPECTION HAS BEEN MADE AND APPROVAL OR ACERTIFICATE OF OCCU-
PANCY HAS BEEN GRANTED. UBC109/IBC110/iRC110. PINK
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
01 P1
YELLOW /INS4ECTOR
GOLD -ASSESSOR
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LS FOLLO BY ENGIINEERING
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TH N C EAST PARALLEL VA04 SAID NORTH LINE OF TRACI 17
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24J.J' 'Irr SOUTH OF THE NORTHEAST coRNrR T"rRror.
THENC, NORTHERLY 103.36 FEET TO WE POINT OF BEGINNING.
REL 0:
ALL RMT PORTION OF TRACT 17, SKELTON'S LAKE V.4LLEER
THE PLAT THEREOF RECORDED
Nov
5 ACRE TRACTS. coRowc To
IN VOLUWC 6 OFAfCEArS, PAGE 21. RECORDS OF SNOHOMISH
OU G TON - DESCRIBED AS FOLLOWS:
co WASHiN
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INHICH 15 32J.36 FEET SOUTH OF THE NORTHEAST CORNER THEREOF.
POIN ON IHE 0 FrEl;
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CITY
COPY
PERMIT C(11
THEN
ENCE WEST PARALLEL TO THE NORTH LINF OF SAID TRACT To
THE WEST LJNE THEREOF;
THENCE NORTf ALONG SOUD WEST LINE 20 FEET:
THENCE f'
EAST TO THE POINT Or BEGINNING.
SITE= FLAN
BOTH SITUATE IN THE COUNTY OF SNOHOMISH. STATE or WASHINGTON.
S �'J!
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----------
CITY OF EDMO
N COPY
TRAFFIC IMPACT ANALYSIS
WORK SHEET
3 P% -AZ-L
'701
Name of Proposed Project:
Owner/Applicant:
Applicant ContacAerson
4S lies TV.
Ron LAM
Name f.
490
P
. Name P%
Street/M �ilmg AddWre
I
0%— —.Mft
144 /VOW"
Street/M i ling Address
9:4";4 44
.
City
State Zip
city
State Zip
Telephone:
fro,%
Ifif - 1371
Apdc- r&,?0--33S 7
Telephone:
Traffic Engineer who prepared the Traffic Impact Analysis:
Firm Name
Contact Name
7Feleplione
1. PROJECT DESCRIPTION
a. Street address (iftnown): '67 A ve.
b. Location:
(Attach a vicinity inap and siteplan.
c. Specify existing land use:
Fa4*VJ h. 42.*.0 /1446
d. Specify proposed typ nd size of developrilent:
" 04 1 40MA 0
e. When will the project begin construction and when will it be completed?
f.
g. Defi
e proposed access locations:
a
I sight distance at site egress locations:
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Five YearsAfter Openin2 L
With Project:
Without Project:
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Note any assumptions/variations to standard analysis default values and justifications:
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7. MITIGATION RECOMMENDATIONS O'�
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State recommended measures and fees required to mitigate project specific traffic impacts. Traffic impact
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Fee Rate Study Table 4 (attached) and as identified M
fee shall be calculated from the Edmonds Road Impact z
in ECDC 18.82.120, except as otherwise provided for independent fee calculations in ECDC 18.82.130. C
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SAENGRWaryd'City ProjecIMIA Guidclines\Trann3iAnalyWork 9-04.dm Page 5
12/20/2004 14:15 4258275424 AESI PAGE 07/07
w
FIELD REPORT
Associated Earth Sciences, Inc. Field Report# I — Page . of
Proj4ct Name Prooct wafter
wewthe�
911 Fifth Avenue, Suite 100 - KlrXIand,Wash!n§ton98033 z:32-34 q4;'g" AL-0— W V
426-627-7701 a FAX425-827-6424 . I Nty 81da. Permit Number
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TO: _1;qt—J %4 Engineer/Archked
410 7__ (0 h clienvowner
A;�mk.%CAAS. F-0 Z-0 SO,-'AVLAJ - I I
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ATTN: Eenhwork CqMradaftsuper1rdandent
AS REQUESTED BY:
THE FOLLOWING WAS NOTED:
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FIELD COMPACTION EQUIPMENT UTILIZED: ---
AREAS OF ADDITIONAL CONCERN:
ADDITIONAL TESTS REQUIRED: F'�YES RNO WHERE?
FIFLD REP:
cOPIES TO*
DA-tF MAILED: _4404"t'-' PROJECT MGR:
-Field Report subject to re.yieW by AES1 Project Manager A RE:CEIVED
JAN 0 1 2005
btVELOPMENT SERVICU,
CITY OF EDMONDS
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12/20/2004 14:15 4258275424 AESI PAGE 02/07
FIELD REPORT
Associated Earth Sciences, Inc. Field Re ft # 13 Page of
Date Projea rAmmG 41A project NV~
T q '51.4 A %I k��)! I
It 5/--1q I --f 1,-eo 4
6117. Y, _ wmiimer
911 Fifth Avenue, Suite 100 & Kirkland, Washington 98033 4t,4t.At,4
426-827-7701 - FAX425-827-6424 Numder
TO: S cru,,.c� Q EngimaerfArchiled
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denerm CortractoriSupon-VI-11,
ATTN:
AS REQUESTED BY: Faithwark C0r*&d5r/SWadn1enderA
THE FOLLOWING WAS NOTED:
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FIELD COMPACTION EQUIPMENT LITILlIZED,
AREAS OF ADDITIONAL CONCERN:
ADDITIONAL TESTS REQUIRED: 17YES E]NO WHERE?-
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COPIES TO: FIELD REP,
DATE MAILED! 'PROJECT MGR:
*Field Report subject to review by AESI Project Manager
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12/20/2004 14:15 4258275424 AES1 PAGE 03/07
FIELD REPORT
Associated Earth Sciences, Inc.
9 111 Fifth Avenue, Suite 100 * Kirkland, Washington 98033
425-827_7701 - FAX 425-827�5424
TO- Sat.,,J q 140A-tf-I
ATTN:
AS REQUESTED BY'
P;kap '2- of Z—
Date — - --I-
fz /15
Pro - I - WA Name
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THE FOLLOWING WAS NOTED:
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ck
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FIELD COMPACTION EQUIPMENT UTILIZED:
AREAS OF ADDITIONAL CONCERN:
ADDITIONAL TESTS REQUIRED: [—]YES [-�NO WHERE?
COPIES TO: FIELD REP: -:Tim
DATE "LED: r4o *PROJECT IVIGR,
'Field Repod subject to review by AES1 Project Manager
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12/20/20134 14:15 425B275424 AESI PAGE 04/07
FIELD REPORT
Associated Earth Sciences, Inc. Field Report# Z_
project Name
Page — I of
tFumber
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911 Fifth Avonue, SUjJq 100 a Kirkland, WashiNton 98033
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Bldg. Parmirl Numtmr
TO: U4.) A-00—ts Engineef/ArchRed
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AS REQUESTED BY:
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COPIES TO: FIELD REP'
DATE MAILED: -PROJECT MGR:
AF!eld Report subject to review by AESI Project Manager
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12/20/2004 14:15 425827542d AESI PAGE 05/07
FIELD REPORT
As . sociate d Earth Sciences, Inc. Field Report# pffle T_ olf 3
Name Pr9W.N,=_+A
911 Fifth Avenue, Suite 100 - Kirkland, Washington 98033 an %meamer -
425.8274701 - FAX 425-827-5424 MUNCIPBRY a1do. PermR Numbef
TO: F-ngin ed z
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FIELD COMPACTION EQUIPMENT UTILIZED: —
AREAS OF ADDITIONAL CONCERN:
ADDITIONAL TESTS REQUIRED: OyES FJNO WHERE? ---------
FIELD REP* —To
COPIES TO:
DATEMAILED: -PROJECT MGR'.
-Field Report subject to review by AIESI Project Manager
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12/20/2004 14:15 4258275424 AESI PAGE 01/07
FIELD REPORT
Associated Earth Sciences, Inc.
0 N R N a
911 Fifth Avenue, Suite 100 o Kkkiand, Washington 98033
425-827-7701 9 FAX 425-B27-S424
TO: AI VAOA-143
ao 7_ 6,4�1
S
ATTN: 2"A 'i.An M.--c
AS REQUESTED BY:
—!-IA r% —".all
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P(Oject Name
Pral;w. t Numb6f
1=01,
Ll �V"Arvc-
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C_Lz!:� -
Municipality
Bicig, Permit Nurnbtr
En"gineer/Architect
ClienvOwner
General Contractor/Superintandent
Earlilwork ContractorlSuperiniOndeml
L_
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THE FOLLOWING WAS NOTED:
ar, ev(,�e +0
H cf 41"t 4,Ou
61, T LaLL 4-C 1`1��Ie
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C4-i A4, 4L�j 41-_ I
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FIELD coMPACTION EQUIPMENT UTILIZED:
AREAS OF ADDITIONAL CONCERN:
ADDITIONAL TESTS REQUIRED: FIYES [_1NO WHERE.?
to. 5,
COPIES TO: FIELD REP!
DATE MAILED! 'PROJECT MGR:
-Field Report subject to review by AESI Project Manager
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5. xeterence romt ruevauon snot to mouse:
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lbo. (datum elevation) + (grade to transit level line shot to house) i,
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6. Measurements from line shot onto house to roof ridge:
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7. Actual Elevation: 101,. (reference point elevation� + -2—L,,*q (measurements
from #6) 1 �5,4
Conclusion:
�LS q_ (actual) is greater /(�han I (allowed); therefore the house is/
is not over the height requirement per ECDC 16.20.30 requirements
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUIILDING DIVISION
FROM: PLEASE SIGN FIRE DEPARTMENT DATE z
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PLANNING DIVISION DATE 71
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED Cn
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
El Copy or CORRECTION NOTICE given to owner/contractor by inpector
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL 13ROJECT APPROVAL
Date Signature
1:(emp:b1dg:fbrnis:ocaprv1 3/25/04
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DEPARTMENT OF BUILDINGS
PER INTERNATIONAL RESIDENTIAL CODE SECTION R110
AT: 2323476 th Ave W Bullding�Permit #: 2004-0990
Occupancy established by this certificate: R3 Dwelling Units:
No. Stories:— 2 Basemen . t: N/A Type of Construction: VB
Owner of building: S & S Joint Ventur'di
The Single Family Residence at 23234 76 th Ave W ha9.:bebn,.In6pedted and approved complying with the requirements of the
2003 edition of the International Residential Code as adopted by the City1or the group and division of occupancy and the use for wh,ich
the proposed occupancy is classified.
Issued this 5 h day of July 2005
Chief Building Official
By:.
Any change of occupancy or use requires a building permit and a new Certificate of Occupancy issued by the City of Edmonds Building Official.
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall .......................... e5 < If -a 0 Of
k44.,Lr- ?'t"o v-
Pier/Porch .................
Retaining Wall ...........
Slab insulation ..........
PLUMBING: .
05
Underground .............
M_r
3 k4--
Rough -In ...................
-o-!S-
Commercial Final ......
HEATING:
O's
Gas Test ....................
MT
Gas Piping .................
Equipment .................
Commercial Final .......
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING...
INSULATION ...................
0
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
--7t— =r
L
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MIT
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
P(C,-A e- S e� 11 �
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The Initials N/IT are Milton
,pilollipsoll, ,I temporary contract
inspector rol. tile City.
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