20050306.pdf0
DATE RECEIVED
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CITY OF EDMONDS
CONSTRUCTION PERMIT, APPLICATION
QYiNER NAME/NAME OF BUSINESS
AILINGAPDPESS
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NAME
ADDRESS
0111110*1�
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PROPERTY TAX ACCOUNT PARCEL NO.
TELEPHONE
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TELEPHONE
EXPIRATION DATE
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PERMIT EX
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NUMBER
JOB SUITEIAPT#
ADDRESS
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PLAT NAMEISUBDIVISION NO.
40
LID NO
1; -()'3 1
7
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL S REET MAP
TESCP Approved 13
13
RW Permit Required
13
Street use Permit Required
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EXISTING PROPOSED
inspection Requited
Sidewalk Required C3
,REQUIRED DEDICATION FT
underground
W.tina ronuifed E3
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
YES 13 NOO
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REMARKS
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OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
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ENGINEERING REVIEWED BY
FIRE REVIEWED BY
DATE
DATE
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VARIANCE OR CU
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ALLOWED PROPOSED
ALLOWED PROPOSED
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MIXED USE
MULTIFAMILY
PLUMBING / MECH
COMPLIANCE OR
CHANGE OF USE
SIGN
LOT COVERAGE
ALLOWED PROPOSED
I REQUIRED SETBACKS (FT.)
FRONT SIDE REAR _I
FRONT LJRSIDE REAR
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PLANNING REVIEWED BY DATE
REPAIR
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FIRE SPRINKLER
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(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
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GROUP
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C) OF DWELLING SPECIAL INSPECTION CONSULTANT OCCUPANT
ca I LOAD
0 STORIES UNITS REQUIRED
DESCRIBE WORK TO BE DONE
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BY:
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tv) Description FEE Description FEE
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HEAT SOURCE LOTSLOPE% VESTED DATE' 00&
Building Permit 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.
2— Engr. Review
PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
W
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 SUCCESSORS Fire Review Plan Chk. Deposit
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_j IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
rc EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND. Fire Inspection Receipt #
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ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due
x 0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION AP DRDVAL
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_ CALL Building Official or his/her Deputy: and Fees are paid. and
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED receipt is acknowledged in space provided
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
OF 11 SIGNIT R DATE
SIGSNATZZNEM _4 DATE SIGNED F425)
771-0220 DATE
ATTENTION \J r7JT. 1333
-UPYJA BUILDING OR STRUCTURE UNTIL
IT IS UNLAWFUL TO USE OR OCd i10
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- ORIGINAL -FILE - YELLOW -INSPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 if IBC110 / IRC110. PINK -OWNER GOLD - ASSESSOR
10104 PRESS HARD - YOU A 6PIES
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statutory warrant� dejed recorded January 5, 1971 L
03 thence, N89*40'00 E, along the north line of sold Gc
N0016'00"E a distance of 20 feet; thence S89-40-C
or less, along the w,
.0016'00"E 101-36 feet, more
2 0 20' thereof, of a tract conveyed to Clarence ' A. Sates,
160th St SW dead recorded July 5, 1973 under auditors file nurr
151— 40 of that certain access road, 20 feet In width. desci
bars 1288464 through 1288468, inclusive; t
:2 lu file num
I SW 6 lessi albng the aouth line of said Farrel tract to th
jeoth 9
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�10.0 . I . I t 22 describ
Together with that portlim of sold Troc
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161 St S Beginning at a point on the north line of sold trov
16 P1 viesterly of the northeast corner thereof, said point
E
double 121, spruce O"N ad by Helen Gragg and Elizabeth Coghlon; thenc
Gr n ii �nd Coghlon property, 311.27 feet to the SOL
CL S (3 'g
"o W , along the south line of sold Grosig-Coghl,
S 89-40-00" 183.39' po t of
In beginning;
thence -46 7.35 feet; thence NOO'26'E .0
1 2. 2 70.97' 9040'W 12
thence S�112'E 20.0 feet to the true point of begi
SHED
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PARCEL B-,
9
That portloh of sold Tract 22 described as follows:
If Plum 0 28" pine
Beginning ot a point on the north line of said traci
8 ors
corner there(f; thence.SO1'12'E 311.27 feet to the
S89'40'00"W 10 feet; thence NOO*16'00"F- 20- feet; i
SOO*16'00"W to the true point of beginning,
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;t- Together with and, Subject to all rights easements c
13,627 sq. ft, 0;
0 sq
12,do ft. Total area 0.59 acres
LIJ OWNER: SILVER
30* coda
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ADDRESS-' PO E
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C4 MUKIL
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ZONING:* RS-12
36 cedar
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10" adr
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18" IS" hemlo 11;41. N 89-40,05" 147.57'
a or S, 70
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12" ma ran 9104.07
98
1 oldr a `-,143.65' 209.44-
82 N 89640'02" E 353.09'
pine
EDWARD R. LEWIS
GRAPHIC SCALE
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74 276 110 210 40 80
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N 89-40-
FINAL PROJECT APPROVAL FORM