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5 N\Q--CkG"i CITY OF EDMONDS NEE CONSTRUCTION PERMIT APPLICATION ZONE NUMBER 9SQ�31_ L., ... /// a JOB �7L• / OWNER NAME NAME OF BUSINESS ADDRESS SUIT EIAPi C MAILING ADDRES. 3 oo CITY /v�V u�Vr� ZIP 3,,TELEPHO NENUMBER NAMEADDRESS- ! 9 Co o a3>'•-..rP t2Ltie hJ c_I Q CIT ZIP TELEPHONE NUMBER NAME —7 s %fit CC, 4)STh-c c7-i AD RES$ CITY ZIP TELEPHONE NUMBER o 1 _T,E LTCEI $EIJUMBER EXPIRATION DATE h Legal Description of Property - Include all easements .�- a fV3O o� w Prppcceny q - Tax Aount / ..�S Parcel Na. 00700 D EW . ''''{{�ESIDENTIAL ® PLUMBING ElADDITION El COMMERCIAL © MECHANICAL OREMODEL APT. BLDG. SIGN ElREPAIR �C7S5. ❑ FENCE %— DEMOLISH NSE TTOVE. HO TUB/SPA, GARAGE ❑ RETAINING WALL/ ❑ IQI CARPORT ROCKERY RENEWAL'; 3 (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: F ESIIJE w NUMBER NUMBER OF CRITICALOF / STORIES LIN17$LING -O E JAREAS NUMBER 'J(p DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) Con-s tic SFR�s/�lcv« 0 LEGAL DESORIPTION CHECK SUBDI VISIOry NO Lip NO Z4IRequIred PUBLIC RIGItT OF WAY PER OFFICIAL STREET MAP TESveE ❑ E %(STING REQUIRED pE01CATION� RW quired Strem PROPOSED InaPured I ReQ d ❑ -- SideiredMETER ZE LINE yfh NO. OF FIXTURES QUIRED/� NO ❑.el W'f�l . T71#WxiE .Lv s �AQ- ENGINEERING MEMODATED REV ED BY FIRE MEMO DATED HLVIEWED BY SIGN AREA-SEPA REVIEW qpB . ALLOWED PROPOSED COMPLETE EXEMPT FF SHO L EXP VARIANCE OR� CLI G BY OAT VV �� � g SETBACK F ET " ///� o HEIGLO LOT' COVE 23E CJ FRONT.''SIDE. REAR' L REMARKS ' Ov C WE ,O� TYPE OF CONSTRUCT( N CODE OCCUPANT GROIN 7 SPECIAL INSPECTOR. AREA /, .. M rQ OCCUPANT YES. REQUIRED - - rC7L.lL,J G LOAD REMARKS - PROGRESS INSPECTIONS PER.UBC 305 L9P/7?19L725e-lW2jv IvIlqU C,n E U0WAAw P. 14� FINAL INSPECTION REQUIRED /WrJlV�E 1� L Zvi - 'VALUATION FEE 4VC . /���0� ?—I �yd� U I HEAT SOURCE: GLAZING , P/p PLAN CHECK FEE BUILDINO PLUMBING f �'9 L , ' S loq Plan Check No. � MECHANICAL C! ! as F This Permit covers work to be done on private property ONLY. Any construction on the public domain (curbs, sldewolks, driveways, marquees, etc.) will require separate permission. GRADINGIFILL STATE SURCHARGE _450 Permit Application: 180 Days - Permit Limit: 1 Year - Provided Work is Started Within 180 Days "Applicant, on behalf of his or her spouse, heirs, assigns and STORM DRAINAGE FEE ENG. INSPECTION FEE SD N succossors in interest, agrees to Indemnify, defend and hold w harmless the City of Edmonds, Washington, Its officials, f employees, and agents from any and all claims for damages of 5 whatever nature, arising directly or Indirectly from the Issuance of this permit. Issuance of this permit shall not be deemed to 9 modify, waive or reduce any requirement of any city ordinance x° nor IimiI In any way the City's ability to enforce any ordinance provision." //''__����,,� V &IfIva/ PLAN CHECK DEPOSIT TOTAL AMOUNT DUE +I I +/ 7P'a� / I hereby acknowledge that I have read this application; that the information given is correct; and that I am the owner, or the duly ATTENTION APPLICATION APPROVAL authorized agent of the owner. I agree to comply with city and state laws regulating construction; and In doing the work authoriz• ed thereby, no person will be employed In violation of the Labor THIS PERMIT AUTNonlzes ONLY THE This application is not a permit until pp p signed by the Building Official or his/her Code of the State of Washington relating to Workmen's Compensa• WORK NOTED Deputy; and fees are paid, and receipt is lion Insurance and RCW 18.27. INSPECTION acknowledged in space provided. SIGNATURE TOWNER OR AGENT)�,,./ GATE SIGNED DEPARTMENT CITY OF of L' S GNA URE ArE EDMONDS ATTENTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC cnu POR INSPECTION 7i1 �OLLO r EL AS DATE ' ' ORIGINAL — File YELLOW — Inspector .4Jf�t ' CITY COPY City of Edmonds Building Dept. ' f, 250 5th AVE. N. A Edmonds, Wa. 980207*�i 771-0220 P. E Gentlemen: � �. This letter is to accompany plans for Mr. and Mrs. Falk, residence to be built on `L lot 8, and south 1/2 of lot 7 block 29 Meadowdale Beach on 75th Pl. W, Edmonds. This f"� a is to notify your department that I am the lead professional as well as the architect for this project. I will be responsible for coordinating and incorporating recommendations of other design team professionals. All plans have been prepared in accordance with C,r tip fig ei y1 geo tech and structural engineers recommendations, and measures have been r�1, tij'F�'JiTA established to reduce the potential risk of injury or damage from any earth movement. r 41 f?f� hankyou, ° vF" � 9AR Ronald D. Joh son t} Architect - 19601 23rd. NW. Seattle, Wa. 98177 546-2288� c� i tiC Jj >�• r "�R . Y t't4yk5� i� a �v tar tirnm 1t�� , STRUCTURAL DESIGN ASSOCIATES, INC. CONSULTING ENGINEERS 5630. 196TH ST. S.W. P.O.SOX5366 .Cjop1��(} LYNNWOOD. WA 96046 PHONE: (206)775.74346 March 10, 1994 Debbie & Thomas Falk 16105 N. Meadowdale Road Edmonds, WA 98026 subject: Residence on Lot 8 & South Half Lot 7, Block 29, Meadowdale Beach Edmonds, Washington - DECLARATION STATEMENT - Our Ref.: Letters\90-704-1.rjh Dear Mr. & Mrs. Falk: This letter is to inform you that our office has reviewed the geotechnical report from Geotech Consultants, Inc. No. JN89482, dated February 7, 1990, and letter dated March 10, 1994. The review indicates that the lot is in an area subject to ground failure. It is impossible to guarantee future slope stability, regardless of how well it is investigated or engineered, and there are always risks associated with construction in a known hazardous area. Among these risks is the possibility of the loss or damage to your property and life, as well as the property and life of neighbors, public and private, due to soil failure. Because of the unpredictable nature and wet condition of the soils, owners must assume the responsibility for risks of building and living in this known hazardous area. The reports, recommendations, opinions, designs and specifications, associated with this project are professional opinions only, and are not to be construed as a warranty, expressed or implied, against loss or damage. DECLAR ATION STATEM .NT To the best of our knowledge and understanding, the building plans, submitted with the permit application substantially incorporate the above mentioned reports' recommendation. Careful and conscientious application of the above referenced recommendations during and after construction, "... will reduce the risk that the house will be affected by earth movement. The proposed development will not increase the potential for soil movement". Respectfully submitted, STRUCTURAL DESIGN ASSOCIATES, INC. S D. VAA, Zse WAS O yr �475 Vanden Ende, P.E. president S�ONAL KVE/ev .-....._ a a I'M" STRUCIURAL ENGINEERING DESIGN AND INVESTIGATION - . . . . • rr-.I i-711. 1"1", f r. ,._.r.. n.I, .,,. 1 c:n„ r i. r . r • • � s 08/12/1996 11:22 2068810641 DODDS GEOSCIENCES �� PO$t Office Box 6966 Tellephone 206) 867-3297 RUtLD/fyf; Facsimile (206) 861-6641 AUG 2 1996 City of Edmonds Job N 256 - Sth Avenue North Augi Edmonds, WA 98020 Attention: Jeannine L. Graf Building Official Subject: Final LRUer Falk Residence 15910 - 75th Place West Edmonds, Washington Dear Ms. Graf. - In accordance with City of Edmonds requirements, this final letter summarizes our regarding the construction of the Falk Residence at 15910 - 75th Place West in Washington This office provided andifor directed the construction observation services includin pile observations, excavation monitoring, footing drain installation, and erosion conttc It is our opinion, based on observations during our periodic site visits, that the 1 constructed in accordance with the geotechnical aspects of the plans. If there are any questions concerning this letter, or if we can be of further service, pie the undersigned directly at (206) 867-3297. Sincerely: Mark K. Dodds, P.E. MKD/wd ex�� 6//?O� I. CITY CLERK i RECORDED CITY OF EDMONDS ����` /^I®�e;�� T Filed for record Z : Z � 1A A�1 505 BELL STREET 11 — 1C $ v N1�4y 22 l99 EDMONDS, Re Request WA 98020 n,= 000 TtMWILLIOER, Snohomish Co Auditor COVENANT OF NOTIFICATION AND INDEMNIFICATION/HOLD HARMLES. IQ Under the review procedures established pursuant to the S ate 1241 Building Code, incorporating amendments promulgated by the Cit y y ® of Edmonds, and as a prerequisite to the issuance of a building G� permit for the construction of a residential structure and Cq attendant facilities, the undersigned OWNERS of property do C� hereby covenant•, stipulate and promise as follows: id� I. Description, of subiect P This covenant of notification and indemnification/hold harmless relates to a tract of land at the street address of /.S c /n �P-Q bins.art street address), Edmonds, Snohomish County, Washington and legally described as: BLK 029 D-00 - LOT 7 & 8 LESS N 30 FT. LOT 7 PLUS PTN VACATED S ._ IIEADOWDALE BEACH PLAT, according to the plat thereof recorded in /' volume 5 of Plats, Page 38, records of Snohomish County, Washington TOGETHER WITH vacated street adjoining on the West as may attach ty operation of law. Situate in the County of Snohomish, State of Washington Subject to easements, covenants, restrictions and reservations of record. ?- Notification and Covenant of Notification. The above referenced site '(hereinafter "subject site") lies within an area which has been identified by the City of Edmonds as having a potential for earth subsidence or landslide hazard. The risks associated with development of the site have been* evaluated Y technical consultants and engineers engaged by the applicant as a part of the process to obtain a building permit for the subject site. The results of the consultant's reports and evaluations Of WSS52079A/0006.040.034 WSS/klt 02/08/90 —1 Gu 3 G 3 l ?G 14 9 S Quit.o�ivs FEB 9-100 • y}1 _ Gy • � T J'�^Y. fir �yd.;J arising from and out of such development. In addition, the OWNERS on behalf of themselves, their successors in interest, heirs and assigne s, do hereby promise to indemnify and hold harmless the city of Edmonds, its officers, agents and employees from any loss, claim, liability .or damage of any kind or nature to persons or property either on or off the site resulting from or out of earth subsidence or landslide hazard, arising from or out of the issuance of any permit(s) authorizing development of the site, or occurring or arising out of any false, misleading, or inaccurate information provided by the OWNERS, their employees, or professional consultants in the course of issuance of the building permit. 4. Ins - ranee a irement., In addition to any bonding which 1v`Jr may be required du ing the course of development, the community Services Director his/11a122=sat (strike one) specifically required the maintenance of an insurance policy for public liability- a yr� coverage in the amount and for the 3"�rG7{r'�y�fYr time set forth below in -order to provide for the financial responsibilities established the indemnification throughvi�j+, r;y" and hold harmless agreement above: t rt (insert ins ranee requirements and time ir', JR � t5r�'• -kaY< if any--ii period no insurance required, so state.] �. NO EXCISE TABREQUIRED nq F. S!ES'ERS, Suher:sh Comfy Dearer WSS52079A/0006,040.0 4 -3_-y:-;,.'^ r•nT�Fr_rxc;i�':l WSS/klt 02/08/ 0 -9i9—0 6 RJR _ t i n -7 ; � 17 +rr 6i r it to be (his/her) free and voluntary act for the purposes mentioned in this instrument. DATED this % day of 199 1 � NOTARY PUBLIC ,� i'l�x,�G��`; My commission expires- �tit STATE OF WA IN ON COUNTY I certify that I know or have satisfactory evidence �� E»tt' I�iTPlh4a•t`1 thatVVJ� Win__ ( signed this instrument and acknowledged it to be (his/her) free and voluntary act for the purposes mentioned in this instrument. DATED .this % day of NOTARY PUBLIC' My commission expires: ' STATE 'OF WASHINGTON COUNTY OF ) t Su r I certify that I know or have satisfactory evidence "r that signed this instrument, on oath ";?r stated that (he/she) was authorized to execute the instrument and acknowledged it as the (title) of (name of party on behalf of whom instrument was executed)• to be the free and voluntary act of such party for the uses and purposes mentioned in this instrument. DATED this day of 199 H .11 NOTARY PUBLIC My Commission expires: WSS/kltgA/000G.040.034 02/08/90 _5 E{ J v i PG 14 9 9 950522()3652 08-14-1996 11113AM FROM CENTER INSURANCE AGENCY TO 97' y 'AC-"R PnooUGER THIS CERTIFICATE IS ISSUED AS A MAY CENTER INSURANCE AGENCY, INC. ONLY AND OONI'MRS NO RIGHT6 UPI PO BOX 90 HOLDGR. THIS CERTIFICATE DOES NOj LYNNWOOD, WA 98046 T T E COVERAGE AF'FOR00 ISY QQW4NIESAFFORDING Ct AX ({206 672 2712 COMP 206) 77 2164 A NORTH PACIFIC INSURA INWRI� - I ]11 COMPANY A�•... RA THOMAS C. AND DEBORAH FALK B 15910 75TH FL W OOMPANV EDMONDB, WA 98026 j Cow ANY D ..�nu�t._ THIS IS •IO CERTIFY THAT THE POLICIES OF INOURANCE LIOTCD BELOW HAVE BEEN ISRUED TO THE INSUARD NAMED ABOVE T INDICATED, NOTW ITf18TANOING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH Al CEHUFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJE k CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN R- EDU� By PAID CLAIMS. I LT�j TTPEOP N7URANCE POLICYNUMBEA DTE(MIXrn �PCY DAITE IMMJDDP(Yj - POUCYErFECTrVFGENERAL LUIBIUN I I COMMERCIAL GCNCML ABILITY: ; OENERALAGGREOA Ol AIMS MADE I DCCUR' : PRODUCTS-COMPK ! PERBONAL6ADVIN- OWNER'S & CONTRACTOR'S PROT I EACH Th^CuagplvCE --' PIRE DAMAGE Arrya WEDXP :F6IITONOB4E LUBRITY i ANY AUTO I I I COMBINED.1111.0 ALL OWNED AUTOS I UGHEUULbU AUTOR I (Per pomp) I HIVED AUTOS I NON•ONRINDAUTOU i �— _ _ ..i I (ODRYINJA) - i PROPERTYOAMAGE . I GARAGE LIABILITY • 'AUTO r^ ANYAUIO I i i OI THER THAN AlIr00 EACH ACC ' AOO,X . EXSESS LIABILITY A w_ UMBRELLA IFORM I EACn OOGVr91.�HCE CIA lX OTHERTHAN UMBRELLA FORM ! _— 08-14-96; 08-14-97 ` WORKERBCOMPEISATION AND I__,I gOaTwY EMPLITTER6 LWBILfn I�i.Nrcel THE PROPRIETON i-1 i IINCI' EL EACH ACCIDENT j I PAATNER9'ENFNATiVt' OFFICERBARE: r I EL DISEASE -POLICY FXCLI I I EL OISEASE•EA EMPI OMER i A :PERSONAL IBINDFoR 266UED ON MIABILITY 08/14/96 I 1500T000 DESCRIPTION OF OPERATKINAMOCATIONGYENICLEW!SPECIAL ITEW , CERTIFICATE HOLDER IS SECURED ON INSURED'S HOMEOWNERS POLICY AS A INSURED WITH RESPECT TO CHAPTER 19.05 ECDC. 1 a1V1Ne u l P 1 �' 1pqta !1f .. f ... ....... d�[GMNtl ,�n�.�x:DilH �RtlFiY .." .. .!C' Uil IIIRtl '�fl. ink- �w^'T'T:dUM CITY OF EDMONDS BROULD ANY OF THE ABOVE DEBORIEED POUCIW BE 250 5TH AVE NORTH EXPIRATION DATE THEREOF, THE 100111110 COMPANY EDMONDS, WA 98020 14— DAYS WRITTEN NOTICE 707HE CETRIFlOA NO BUT FAILURE TO MALL BUCK NOTICE B 1 E No OF ANY KIND UPON TME COMP AUTHORMID REPAENNTAIVE , �.•• /N, :t"1fiMt i ri'iultilmom". ak Bf1jEEi. .. Hy+x A u'ivi xeut e ....,.L.H'9,t1 l ,. ...... lS.t�Yrv. 1 r+a7:.t l• v .J r.o ..._.. ... , I, 1 / 1 CITY COPY February 19, 1994 City of Edmonds Building Dept. The following describes an Owner Landslide Hcknowledgment Declaration: We warrant the accuracy of all permit submittal information and relieve the City and it's staff from any liability associated with reliance on such permit application submittals. The application may reference the reports of prior public consultants to the City, but all conclusions shall be those of ours and our design professionals. We understand and accept the risk of developing in an area with potential unstable soils and that we will advise, in writing, any pros- pectiue purchasers of the site, or any prospective lessees of structures or portions of structures on the site, of the slide potential of the area. Sincerely, Thomas C. Falk Deborall Falk Proposed single family residence located at 15910 75th Pl. W. "40 w � f City of Edmonds zt Building Dept. 250 5th AVE. N. Edmonds, Wa. 98020 771-0220 n f ( 4 Gentlemen: DECLARATION STATEMENT: I have reviewed the geotechnical report, d understand it's reccomendations, and have explained to the owner the design reccomendations of the report, and established measures to reduce the potential risk4�; of injury or damage that might be caused by any earth movement predicted in the�tAt report. o6j h li ky� an ou, Ronald D. Jo nsona'"� tA�4.4 Architect T,& � 19601 23rd. NW. x Seattle, Wa. 98177 546-2288 N�� 1 SVti ffuep/ed 7� tkZ ]�YhjJJ� �J, a a t `3 h,...p ... ram.. �...��._r .+.+.. �,. _.... .�� w-.. , �1,,���. .A�- ✓.� �.- TO: Permit Coordinator, Building Division FROM: FIRE DEPARTMENT ENGINEERING DIVISION PLANNING DIVISION OWNERS ADDRESS PERMIT# 95'/%273 ADS# INSPECTED ON j�Gj A field inspection was conducted to determine compliance with approved plans. Final approval denotes there are no objections to the granting of: L Occupancy for the building Performance Bonds may be released Maintenance Bonds may be released Landscaping is approved Other inspected PASSED FIRST INSPECTION - CONDITIONS NOTED 1. 2. FAILED INSPECTION - OUTSTANDING REQUIREMENTS - RECALL FOR INSPECTION 1. 2. 3. 4. OCCUPANCY APPROVAL FAILED FIRST INSPECTION RE -INSPECTED - APPROVED RE -INSPECTED - FAILED RE -INSPECTED APPROVED OCCAPRVL/TXTRECEP/OctobAr 13, 1993 DATE17— ug'- BYAG�--- DATE_ BY DATE BY DATE BY DATE FEES__ RECEIPT# RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ................... FOUNDATION: JGi Footing..................../�_`- S vi g �! Wall ....................... D� i<✓ i k ti l: y Pier/Porch................ Retaining Well............ Slab Insulation............ PLUMBING: Underground ............. Rough -In '—'7"' • [� -rJ'G Commercial Final ........ HEATING: Gas Test ................. Gas Piping ................ Equipment ................ Commerclal Final......... EXTERIOR SHEATHING NAILING..................K -- - �(�_ �Z ' %�_, FRAMING ..................... T-0 �jfsicrrl yii",+ia INSULATION:. .rho Floor Insulation .......... Wellinsulatlon .......fir Ceiling Insulation......... SHEETROCKNAILING _.... SPECIAL INSPECTION ... RADON MONITOR AT SITE. FINAL APPROVAL •G�� �� q FOROCCUPANCY....