20050276A.pdfDATE RECEIVED
PERMIT
CITY OF EDMONDS INUMBER
PERMIT EXPIRES
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NAME
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PLAT NAMEISU ED IVI SION NO. LOT NO. LID NO,
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved
RW Permit Requited
EXISTING PROPOSED Street Use Permit Requited
Inspection Requited
Sidewalk Requited
REQUIRED DEDICATION FT Underground
Wring required
METER SIZE LINE SIZE NOIOF FIXT7 PRV REQUIRED
I 1 0 YES13 NO El
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
ENGINEERING REVIEWED BY
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STATE LICENSE NUMBER EXPIRATION DATE I CIIECKED BY
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PROPERTY TAX ACCOUNT PARCEL NO.
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NEW
RESIDENTIAL
PLUMBING / MECH
ADDITION
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COMPLIANCE OR
CHANGE OF USE
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MIXED USE
00'
Ga"'I MODEL
MULTIFAMILY
SIGN
�""/REPAIR
GRADING
CYDS
FENCE
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DEMOLISH
TANK
OTHER
GARAGE
RETAINING WALL
FIRE SPRINKLER
ALARM
CARPORT
ROCKERY
FIRE
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
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NUMBER
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NUMBER OF
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TUNITS
STORIES
ITS
DATE
DATE
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SIGN AREA
HEIGHT
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ALLOWED PROPOSED
ALLOWED PROPOSED
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LOT COVERAGE
REQUIRED SETBACKS (FT.
PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED
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REMARKS
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TYPE OFVOUCTION 112 OCCUPANT
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REQUIRED E I
REMARKS
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Description
FEE
Description
FEE
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State Surcharge
HEAT SOURCE
LOTSLOPE%
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VESTED DATE
Building Per mit
City Surcharge
PLAN CHECK NO:
Plumbing
Base Fee
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
Grading
DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
PERMIT LIMIT: SEE ECDC 19.00.005(A)(6)
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
"APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESSOR S
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Receipt #
E EDMONDS, WASHINGTON,
Fire Inspection
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
C FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
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DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANC
Landscapelnsp.
Total Amt. Due
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D NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
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Rocording Fee
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Receipt #
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
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GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
This application is not a permit until signed by the
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AN THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
D'N DOM
CALL
Building Official or hisihor Deputy: and Fees are paid. and
B ,,OF THE S
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IN VIOLATION THE LA § TATE OF WASHINGTON RELATING TO
FOR INSPECTION
receipt is acknowledged in space provided.
WORKMEN' PENSAWN INSyplj�NCE AND RCW 18:27.
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OFF 17SIGNATURE "T,
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SIGN (E (OWNER&G T):",�
DATE SIGVED
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771-0220
REL SED,13
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ATTENTIOW---
EXT. 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI-
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ORIGI - YELLOW .(NSPECTOR
FIcATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / IBC110 I IRC110.
Pl6t OWNLER GOLD - ASSESSOR
PRESS HARD - YOU ARE MAKING 4
COPIES
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Mar. 28 2005 10: 37AM P1
FROM :SCHAEFER ENGINEERING CORP FAX NO'. :4257750900
E N 0 1 N I. I N G
P. E C�
MAR .2
Much 2.8. 2005
PERM11 coUNTER
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Ms. Jej
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811ildills" Division
Cily or l."(fillolids f
121 5"' Avetwe Notilt -n
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%L,;hinglon 98020
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Re: Plan Chuck 05,476 0�
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PERMIT C;0W-.'"
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Edmoli(ls WA 98020
Out- File Number: 994001
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Dear Ms. Readwin:
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dated March 24, 2005.
This corre.spontlei ice in response to you" letter addressed to Mr. Da" Blair, -n v,
j,11e, ij;lsetticio. dinher framed wall hasa 6-foot door opening in the middle- The wall is located directly
e noorsiccl beam frorn each end r ducing. M M
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under tbe floor steel benni. The basement wall provides support to III
r ror the door opening below the steel
2-2x�, HF il I licadc
the tilist3ppoited sp�n to 6 f6eL. Contractor to provide 0
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beam,
I r y0j, 11 ve aliy qiiestiolis or eomments regarding any element of our report, please do not hesitate In
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contact me at (425) 775-5550.
Reviewed*by:
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Will Wolfcrt. Director
Ahmed M. -41cidi. Sl'.� COY
and Collision lnveAiga(ions z
Senior Structural Lngineer Property
Schaefer Engineerino Corporation
Schaefer Lnoineering Corporatiol)
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Mr. Royal D"I'lo 0 11 gas
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JEXPIRES
SKATTLE OFFICE '23109 55TH AVFNUF.WEST, MOUNILAKL TLWV�L WA 98C4J 425.17.4.5550 FAX 425.775.0900
DsrIvaIj OVFIC1E 14�1:J.S W A4TH AVFNUF, GOOLN CO t 1403 3Ci3.2/9.2768 FAX 311:1779..1007
poRILAmo OFjIcjE 82(j SE 010%1014 ri A(, F, PORTLAND OR �7202 503.736.1106 WbO3.73&105.1
CITY CLERK CONFORMED COPY
01TY OF EDMO NDS
121 STH AVEN UE NO. 200504270559 1 PG
E DMONDS,WA 93020 04-27-2005 12:52pm $19.00
SNOHOMISH COUNTY, WASHINGTON
STATEMENT ON ACCESSORY DWELLING UNITS
Property Address: flV)� Avr-_t4Ut�_ W$�
Edmonds, Washington
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Assessor's Parcel Number: 00 ('0 19 +C�p I C>C> I DD
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I have read the requirem�nts for accessory dwelling units contained in Chapter 20.21 of the
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Edmonds Community Development Code (ECDC) and understand that an accessory dwelling
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unit as defined in ECDC Section 21,05.015 is prohibited until an Accessory Dwelling Unit
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Permit is approved.
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I also understand -that an Accessory Dwellin Unit Pen -nit cannot be approved unless all the
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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
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regulations imposed on Accessory Dwelling Units.
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Property Owner Signature:
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Property Owner Name (printed): L A
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Date:
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STATE OF WASHINGTON)
COUNTY OF SNOHOMISH)
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I certify that I know or have satisfactory evidence that Dim 3ACLk r
signed this instrument and acknowledge it to be his/her free and voluntary act for the uses and
purposes mentioned in this instrument.
Notar \-;,pxqpsure seals must be smudged. Dated:
VkA 1W. Signature of
1 Notary Public
1411 /1"
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Res iding at:
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THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR.
ADUstatement
September 20, 2005
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Edmonds building Department
Jeannine Graf
Ca
121.5t' Ave N.
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Edmonds, WA 98020 . . .
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Dear Je ine Graf.
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We are requesting the final approval of occupancy.
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our plan was to only comp er floor at this time.
lete the upp
Our intention. is
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to com lete the lower level in one year.
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Sincerely,
Fn
Dan Blair
th
1010-9 Ave S
Edmonds, WA 98020
425-672-4796
206-354-6967 - cell
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall ..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
CIS
Roug h-In ...................
Commercial Final ......
HEATING:
Test ....................
P77Gas
Gas Piping ......... .......
00-
Equipment.................
Commercial Final .......
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
-t (—D(.0
?fbV',9
fIRST FLOOR FRAMING...
tw%
INSULATION ....................
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Floor Insulation .........
iy IF
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
'9 --7
SPECIAL INSPECTION ...
1-7
MISCELLANEOUS ..........
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