20050028.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEMAME OF BUSINESS
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MAILING ADDRESS
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CITY ZIP TELEPHONE
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NAME
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USE PERMIT
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ADDRESS
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PLAT NAME/SUBDIVISION NO.
LOT NO.
LID NO.
LID FEE $
7EScP Appmovod Q
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
RW Permit Required E3
Street Use Permit Req'd E3
EXISTING - PROPOSED
inspection Required 13
Sidewalk Required E3
REQUIRED DEDICATION- IFT
Underground
Wiring required E3
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
YES 13 NO 13
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REMARKS
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OWNEWCONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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NAME C L ft
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STATE LICENSE NUMBER EXPIRATIO' Y VARIANCE OR CU SHORELINE ORADBO INSPECTION BOND
REqD,. POSTED
EIYES &NO
IM 1M+*2WQ1 SEPA REVIEW SIGN AREA HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
5 Al (o pcom 17DQ EXP x.
LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.)
NEW _A-�RESIDENTIAL PLUMBING/ MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR
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ADDITION COMMERCIAL COMPLIANCE OR
CHANGE OF USE
PARKING LOT AREA. NNING WVIEO Y DATE
REMODEL MULTIFAMILY SIGN REO'D I PROVIDED CL
GRADING FENCE
REPAIR CYDS X FT) REMARKS
1:1 DEMOLISH C:] TANK OTHER
GARAGE RETAINING WALL FIRE SPRINKLER
CARPORT ROCKERY FIRE ALARM
(TYPE OF USE, BUSINESS OR ACTIVITY) EX I
CHECKED BY ITYPE OCCUPANT
LICTION ICODE
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NUMBER NUMBER OF CRITICAL
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OF. DWELLING AREAS SPECIALINSP CTION AREA
7, 1 NUMBER YES LOAD
0 STORIES UNITS REQUIRED
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC 108/ ISC109/ IRC109 FINAL INSPECTION RECI-D
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A*-:.AtJ ILAA Description FEE Description FEE
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HEAT SOURCE GLAZING % LOT SLOPE % -71' city surcharge
Building Permit
IPL AN CHECK NO: VESTED DATE Plumbing Base Fee
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
I: 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 Llli YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
U) 'APPLICANT, ON BEHALF OF HI S OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review PI anChk.Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
M EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
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41 ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY Oil INDIRECTLY
x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
!3 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.0
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 TIIE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
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 Official or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE I_ABQA-,cPDE OF THE STATE OF WASHINGTON . RELATING TO FOR INSPECTION receipt Is acknowledged in space provided
WORKMEN'S COMPENSAT19K INSUFMNCE AND RCW 18.27.
OFFICIALSIAGNATME DATE
iE (OW ER OR �GE DAT . E SIGNED (425)
10 JS7/04 771-0220 RELEASED BY
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ATTENTION E)ff 1333 W
IT IS UNLAWFULTO USE OR OCCUPYA BUILDING OR STRUCTURE UNTILA FINAL &,L6 / —
INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU- ORIGINALULE YELLOW
PANCY HAS BEEN GRANTED. UBC109/IBC110/IRC110. PINK -OWNER GOLD -ASSESSOR
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
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NOTICE: IF THE DOCUMENT IN THIS FRAME ISLESS CLEAR THAN THIS NOTICE
IT IS DUE TO. THE QUALITY OF THE DOCUMENT.
Geotechnical Engineers, Geologists
Group Northwest, Ine. & Environmental Scientists
September 13, 2004 Project No. G - 1892
"'OPY
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Mr. Joe Gretsch
Infinity Homes
3841 1561 Ave. SE R ECE IV E. D
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Bellevue, Washington 98006
OCT 1 5 2004
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Subject: Soils Investigation PERMIT COUNTER
Damage Investigation
21916 - 93rd Place W
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Edmonds, Washington
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Dear Mr. Gretsch:
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site on 8/30/04 nd conducted a soils investigation as requested.
Wevisited the subject a
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to investigate the cause for the house to be sinkingon the north side of the house.
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SITE GEOLOGY
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According to the local geologic map the subjectsite consists of Quaternary age till from
the Frazier Glaciation. Frazier till generally consists of a compact mixture of silt, sand,
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and, gravel in varying amounts deposited and compacted by overriding glacial ice. The
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unit is commonly referred to as 'hardpan.
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SUBSURFACE CONDITIONS
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We conducted a subsurface in vestigation consisting of one hand auger boring ocated
30-feet west of the NE corner of the garage. The boring was angled back underneath
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the house slab from 1 -foot off the north wall. The table below gives a summary.of the
subsurface conditions encountered.
)EPTH (ft)
SOIL DESCRIPTION
COMMENTS
-1.5
Crushed rock and plaster waste (fill)
Very dense, dry
1 .5 - 2.3
Gray s Ity-SAN D with gravel (till fill)
Very dense, moist
.3 - 3.5
Red/brown SAND with silt and burnt
wood waste
Medium dense, wet
3.5-.5.0
Void Space with. wood waste above
and very wet SAND below .
Loose soils,
sloughing soils
5.0-6.0
Dark brown organic silt with, sand and
wood waste
Very loose, wet
�.O - 7.0
Red/brown fine SAND with silt
IMediurn dense, wet
V.0 - 7.2
Gray silty -SAND with gravel (WIT
rVery Dense, moist
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