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1007 VISTA WAY.PDF11111111111111 13604 1007 VISTA WAY APPLICATION The City of Edmonds for SIDE SEWER PERMIT EASEMENT NO. - ------------------------------------------ NEW CONSTRUCTION REPAIRS LID NO_ ------------------ - ASMT. NO OWNER ------ E!-XC>EHUA= -------------------------------------------- CONTRACTOR --- --------- PERMIT NO. JOB ADDRESS !-wu.�`��---------------------LEGAL DESCRIPTION: LOT NO. ----------- --------------- -------- BLOCK NO. ---------------------- ------------- - ----------- I ..................................................... ------------------------------------------------------------------------------------------------ NAME OF ADDITION ---- ------ ------------------------------- CITY OF EDMONDS - SIDE SEWER PERMIT WATER -SEWER DEPARTMENT PERMIT /Call 775-2525 for side sewer Inspections BEFORE covering any portion of the construction.) \Inspection will be provided within 24 hours after requst. No Sat., sun., or holiday inspections./ ADDRESS LOCATION OF CONSTRUCTION... f? :'"....C.......... r��'a:!..: J ........i:`..:!..:.1........................................................................................ PROPERTY LEGAL DESCRIPTION .....................s _....�?........ .f.....!!• !:?5.�:: r. �,: °.. _} 0.`A.... ,':r�:' ............................................................ ....................... ..........................................................................................................i...-.�.......�r.*......p�..................,...................._................................ ......................OWNER AND/OR BUILDER..... r :. . CONTRACTOR'S NAME & ADDRESS ...::...........%...._:.. .; . P- - s, a ' ' r ;'r l wi !:e: i.:... i' s nission is granted....:.:................ . 18..:y.r, for repair and/or connection of a side sewer to the city sanitary sewer a.,_ mm in accordance with City of Edmonds ordinances. k1_4;NTION IS CALLED TO THE FOLLOWING: NOTE No. 1—The owners of the property may obtain a permit to construct sewer Inside property line. A licensed Side Sewer Contractor must be employed to construct side sewer In street area. Do not cover any portion of sewer before it has been inspected. NOTE No. 2—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office. NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit. NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 inches inside property line; minimum grade of 2%. No bends in grade sharper than % will be permitted. NOTE No. 8—Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to Improper work which may develop within one year of completion. NOTE No. 6—It Is unlawful to -alter or do any other work than is provided .for in the permit, or to do any work on the madn sewer or its appurtenances except to In- sert the pipe into the wye. DISAPPROVED❑ Date..._ ........... ....................... By ................ Date..................... .......... By ................ Date .................................... By ................ APPROVED Date..... °".'...��✓.................... By............................................................ _............................. .......................................................... Remarks: ............................................................................................................................................. _ ........ ................................................................_........................................................................................................................................................................... .......... — BOTH Permit C pies MUST Bfe Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection -- ............. .. .... hereby certify that the side sewer installation constructed under this permit (Ow of Contrac ing Firm P r crmin Construction) %—Anstalled cordance with al overning ordinances of the City of Edmonds. Datedthis ............................day of ................................................................. 19......... J J Check BEFORE you dig for: Water ❑, Gas ❑, Telephone ❑, Power ❑, Sewer ❑, Other ❑ J J The City of Edmonds ,T OWNER ----------- _ -- ----- - A17------ ----------------------------- JOB ADDRESS _-141 APPLICATION for SIDE SEWER PERMIT NEW CONSTRUCTION ❑ REPAIRS ❑ EASEMENT NO- -------------------------------------------- LID NO- ------------------ ASMT. NO. ------------- NO. ------------------- LEGAL DESCRIPTION: LOT NO. ------ /--------------------------- BLOCK NO. ----------------------------------- --------------------104 -- -- NAMEOF ADDITION -------------------------------- ------------------------------------------------------------------------------------- DATE-------------------------------------------- By -------------------- - -................. v------- " line E1428 1016 1023 1421 1031 1422 1420 1(120 1043 S 827 3 - 1418 1030 1402 b 1306 1304 P. 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DALEY ST . - 432 433 434 a31428 ni K�M W S 7 o O m O o422 '� o �1 J �421 42O 123° 19' '4120321 �'l a all to s atz et -r City of Edmonds Critical Areas Determination Applicant: Richard Cantwell Determination #: Project Name: PC # 03-449(addition to Permit Number: enclose second story deck) CA-03-52 Site Location: 1007 Vista Way Property Tax Acct #: 00649400000100 Project Description: Approx. 160 sq. ft. addition to second story of house Waiver Criteria (all criteria must be found to apply): X There will be no alteration of the Critical Area or its required buffers; X The development proposal will not impact the Critical Area in a manner contrary to the goals, purposes, objectives and requirements of the Critical Areas ordinance; X The development proposal meets the minimum standards of the Critical Areas ordinance; X The above findings are based on the following conditions of approval: Waiver is only for pending Building Permit. See attached site plan. Based on the above findings and conditions, the requirement for a Critical Areas Study associated with this development permit is hereby Waived, as authorized by Chapter 20.15B.040 (A)(2) of the Edmonds Community Development Code. Star Campbell C' Q==e-'4 Q� 11 /4/03 Name Signature I- Date ZONE E'- Y� SETBACKS: D� FRONT=s ' \ SIDE � REAR OTHER HEIGHT GUTTERS/DOWNSPOUTS TO CONNECT TO EXIST. SYST. + OWNEWCONTRACTOR IS RESPONSIBLE FOR S EROSION CONTROL AND DRAINAGE t 1 d o, B' DlrRCrROUN R&'I"VVr(UN T"IC ' V�(RSF�ED AAAlrsFTE� — Y ,/ o +' �Rl'VCWR �! ! 2Q/ossq / �P( �� `� I 4 APPROVED AS NOTED BY GWEERING .01 <104 � r 1�4 Ip I 4 3 sq Fr ; ccorl d- I W N !0�-. 64 "iorhL- Sq FT 1- - ��. _. --- - ------------ - - - - -- - - - - it A. �W I"(ATl o R. -1 is Critical Areas Checklist CA File No: Site Information (soils/topography1//hydrology/vegetation) 1. Site Address/Location: 2. Property Tax Account Number: �A q 4 Zf d con 6 -te D 3. Approximate Site Size (acres or square feet): l g. DD s� tz- 4. Is this site currently developed? -,yes; no. If yes; how is site developed? 5. Describe the general site topography. Check all that apply. AN 2 _ X Flat: less than 5-feet elevation change over entire site. PERMIT COUNTER 5_ Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal distance of 66-feet). - Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of 10-feet over a horizontal distance of 33 to 66-feet). Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over'a horizontal distance of less than 33-feet). Other (please describe): 6. Site contains areas of year-round standing water: -4V-Z2_; Approx. Depth: 7. Site contains areas of seasonal standing water: A16 ; Approx. Depth: What season(s) of the year? 8. Site is in the floodway floodphdn of a water course. 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round? =a r7 Flows are seasonal? (What time of year? ). 10. Site is primarily: forested ; meadow ;shrubs ; mixed urban landscaped (lawnshrubs etc) GfQf3A N G�71/O S��¢�p� 11. Obvious wetland is present on site: N4P7r 77fd',F For City Staff Use Only 1. Plan Check Number, if applicable? 2. Site is Zoned? 3. SCS mapped a 4. Critical Areas inventory or C.A. tap indicates Critical Area on site? S. Site within Reviewed DETERMINATION m IUI VAfl" Critical Areas Checklistdot/3.19.2001 City of Edmonds Development Services Department Planning Division Phone: 425.771.0220 Fax: 425.771.0221 The Critical Areas Checklist contained on this form is to be filled out by any person preparing a Development Permit Application for the City of Edmonds prior to his/her submittal of the application to the City. The purpose .of the Checklist is to enable City staff to determine whether any potential Critical Areas are, or may be, present on the subject property. The information needed to complete the Checklist should be easily available from observations of the site or data available at City Hall (Critical areas inventories, maps, or soil surveys). Date Received: t/24/03 City Receipt #• Z1 g-� -7 Critical Areas �File #: -2603 --00 52— Critical Areas Checklist Fee: $45.00 Date Mailed to Applicant: .r-1 ?>-0'8 A property owner, or his/her authorized representative, must fill out the checklist, sign and date it, and submit it to the City. The City will review the checklist, make a precursory site visit, and make a determination of the subsequent steps necessary to complete a development permit application. Please submit a vicinity map, along with the signed copy of this form to assist City staff in finding and locating the specific piece of property described on this form. In addition, the applicant shall include other pertinent information (e.g. site plan, topography map, etc.) or studies in conjunction with this Checklist to assistant staff in completing their preliminary assessment of the site. The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable attorneys fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or incomplete information furnished by the applicant, his/her/its agents or employees. By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my knowledge and that I am authorized to file this application on behalf of the owner as listed below. SIGNATURE OF APPLICANT/AGENT DATE Z Property Owner's Authorization By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application, and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the purposes of inspection and posting attendant to*s application. SIGNATURE OF a -ds PLEASE PRINT CLEARLY Owner/Applicant: f�i► A Street Address ,r K VIWAcity State zip Applicant Representative: Name Street Address City State Zip Telephone: 462 6- 7 %t;C=K3iL?- Telephone: Email address (optional): Va m,, 49,01, Email Address (optional): Critical Areas Checldistdoc14.43003 CITY OF EDMONDS CRITICAL AREAS DETERMINATION Site Location: 1607 Vista Way Tax Acct. Number: 6494 000 001 00 Determination: Study Required Determination #: CA-03-52 Applicant: Fred W. Boede Owner: Fred W. Boede CRITICAL AREAS DETERMINATION: STUDY REQUIRED (CA-03-52) During review and inspection of the subject site, it was found that the site may contain or is adjacent to critical areas, including a wetland and stream pursuant to Chapter 20.15E of the Edmonds Community Development Code (ECDC). STUDY REQUIREMENT — WETLAND AND STREAM Based on the above finding, a Critical Areas Study is required to determine the classification and location of the stream and the wetland on the property. • Wetland/Stream Classification: A critical areas consultant shall perform the following: o Classification of the wetland and stream pursuant to the criteria established in ECDC Sections 20.15B.060A4 and A5. o Delineate the edge of the stream and the edge of the wetland on the site. o State any mitigating measures appropriate to preserving and protecting the wetland and the stream. • This part of the study shall be performed as a three party contract with the city selecting the consultant and the property owner or applicant paying the fees. When you are ready to proceed, please contact a Planner. • Wetland/Stream Delineation: After the critical areas consultant has classified the wetland and the stream and delineated the boundaries of each, a surveyor licensed by the State of Washington must perform the following: o Physically mark the edge of the wetland and the stream. o Delineate the required buffers. Refer to ECDC 20.15B.120A and 20.1513.130C for the required buffer widths. o Delineate the required building setback from the buffers. The required setback is 15 feet per ECDC 20.1513.080C. o Create a map showing the stream, the buffer and the building setback. • In order to complete this Study Requirement, this map must be submitted to the Planning Division for review and approval. DEVELOPMENT PROPOSALS ON A SITE WITH A WETLAND AND/ OR STREAM Development proposals that encroach into the buffers or building setbacks may be allowed through the approval of certain processes. The specific process depends on the individual site and development proposal but may include Buffer Averaging, a Critical Areas Variance, and/or i a Reasonable Use Exception. If you think that you have a proposal that may require one of these processes, please contact a Planner for more information. PROJECT SPECIFIC CONDITIONAL WAIVERS If the property owner wishes to apply for a specific development permit which they feel would not impact the Critical Areas located on the site, they may submit their proposal to the Planning Department for review. If the Planning Department finds that the proposed development permit will not adversely impact a Critical Area or its buffers, a conditional waiver may be issued on a project by project basis. EXEMPT DEVELOPMENT PROPOSALS Certain development proposals may be exempt from Critical Areas Requirements (ECDC 20.156.040). If you think that a specific development proposal may be exempt, contact a Planner for more information. Name Signatu Date ❑ Cited sections of the Edmonds Community Development Code (ECDC) can be found on the City of Edmonds website at www.ci.edmonds.wa.us. 2 _ . CITY OF EDMONDS ENGINEERING DEPARTME APPLICATION FOR RIGHT-OF-WAY CONSTRUCTION PERMIT (Applicant to Ccmplete A & B and Subm. t in DupZicate) A, Permit to be issued to: For work at: (address or vicinity) /1�n7J/.7, �Y Type of work to be done: (Attach Drawing I+'hen Aoplicable) yr Time Required -- Start: Finish: 9 /� Owner: �'?/GZG� � 1� G :. W r Lr— Name Mailing Address 'City State Contractor: Name Mailing Address City State 21V— ?--? ey/ Telephone Number State License :umber Telephone Number B� INTDE*1NI7Y: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from any injuries, damages or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the applicant or the City of Edmonds, or any of its departments or employees, including but not limited to the defense of any legal proceedings including defense costs, court costs, and attorney fees by reason of granting this permit. Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year following the final inspection and acceptance of the restoration by the Engineering Department. Work subject. inspection and restoration in accordance with City Code. A 24-hour noti a is required; r inspection'.by.the Engineering Department. Call''775=252 X O Signature: )ZA �'A;1'77 er r A Da a Si ned DO NOT WRITE BELOW TH I I NE (To be completed by Issuing Agency) Permit Issued, (Date) i %% Permit Number %7— �a Fee:2 • ' Bond: Time Authorized: —A D G/ Apt I / < S d DATE: 1P 7 l� i Q-) 1 1 rd ME,10 T0: Harry !-phi tcutt Buildina Official N L P FROM,: Richard H. Allen Assistant City Engineer SUBJECT: 1\,(—,,\—y Lo-T 1 w�= I E I!�J �c After revie-,1 of the subject building permit application, we have the following �' y cor gents (1) Coordination of the location of any Structure with respect to utilities, streets, property lines and driveway grades contractor. is the responsibility of the C2) The Contractor is required to keel) the abuttin streets cleaned of dirt - and debris caused by the construction. ! (3) A "Ri lit -of -Way Construction" permit is required, from the Engineering Div. of Public Works, for any work within the Public right-of-way or public easement.' r C 1 BSI' '� lfl t N =� LID, M- aom' Tp 1_ '�1(ac � D) n' Q Tv�--W) A�� e-�-ko P r,- Ly--a -TO Ea UTTD g PoNp Re011tM 14 PEAT SNovLD 8E CoMPU-YFO © P 'fAE A005G# ,f AV LoT I M P N*a PIJ,T,I,fc 1%,01T5 111TI. cfln; Lim, I p I Street Riplit-of-It:,i), Existing II Access Pascmvnts Exi-sting II Utility Easement Existing]_n PT 0 T) Lot Per Subdivi.si.on Plat Asscssor 1 TOT) C. ;itc Plan CJ,.ccl,,cd for Acctiri(-Vtr_- R RcVicl. by — )a II Existing later "I.,lin I;i,::c 1""Iter -ni.n Poquirod ff llvdr;int Si.-o Existi;,fl /lb1 Hydrant Pcouired par Fire Cocle, Size Detector (leck �'Otcr Ron fired II Firc llcrm jj,,,C;jt C(,) II --- i� Septic Tanl-, Design il__ __ i sciltic T'lill, Permi.t to A(— Ritc P�-rmit "o. it II Sanitin, Scv:cr Availal.dlity Ilroj li r Draldnin -0. z HIC No. II S4 (10 5lcv.!cr Availabi h Sanftary Serer Connection Fee 11cqui.rocl Ilovicv., !)y Date ZZ (�Icn Djtdi —2 O.W.rocl— Culvert Pectlired /V 19- Si.�e 0 IICatch llasdii Rcnuircd Indicate oil r7i I... Plan R 1) 11,111holo required Indicate on Sito Plan soil collations, Ground hrater Fi.cl(l �"r-- If-- --Z Date 9--�J " PiP.;LIC 1''OR1:S 111:PT. (?1}:C}: LIST �(. J — 311ILDI;JG P1?1>, U PT-VI]iIJ I Street I'sght-of-I ay Existing > 2> R1iQT) Access Easements Fxisting l Utility Easc�nient Existing ] RE(1D �I Lot Pcr Subdivision— Plat—� V Assessor flap H II Site Plan CJlecl:ed for nccurac T�7im 1-) mg: 1 ul• LO I I1ndCr. *round I'liring Rcnd. ca I _ Chmic Au — .tray Review by Datc i --- --V j P.xi.sti.nR 1,`atcr ?•4ain Size �f L2,1, Water "ain Pcduircd 11N•dreL;t Size Existing Hydrant Required Per Fire Codef —Size Detector (deck `icter Rewired i J �' 4� V� L i ,i Crag �nnec#bn .fr+��z��T�n �I -i.re 1!cparti, -it Co;,Llc;its 1 --=y--- r R1 eR-ctxl-Zequ ire ci W2 270 bv Septic Tank Desimi Approved _ Date_ -- I ( i Septic Tank, Permit PCouired_ Permit "o. �I � t SanitarySelrer Availability `tee j "rui Drawing No. rz,.------- Pile ?Io.�_����__— Side Sewer Availabilit- �I II Sanitary Sewer Connection Fee Pcqui.rCd Review by hate 77 I i — — II Open Pitch Existil:R /f/ Renui.rccl� I Culvert Recuired �/ Size 1 _ E: MI Patch Basin Renuirecl--- Indicate on `'ite Plan S boulder dra"Maq� ticu,V\ 01ri co Ic-alan in stL Cde /ri i o pien rct n o to F (� + Hanhole rcqulred — f3' — _ Indicate on Site Plan ---- I j` Soil Conditions F, Ground Rater Picicl Review by_ � � Date � � /-- Fi Street Paving; Required^ Curb and Glitter lRcouircd Sidcwall: Pern_ ii.recl Curb Cut for Driveway Required Right -of -Way Construction Pcimit RcquiredY /77 S Boncl Required for Public Improvements5 b,/a d IC-5 Street Name Sign Required. CC Other Si<ging Rwuircd Pre Pemit Site Inspection made on BY: Scwer Water Street Fngineerinp ISpecial Requirements listed in memo to Building IN-pirtment Date_ All items filled in on Building Pcrmit Application By-- _, Date- 0 nrawin;;s Stamped and ; rotations "Iadc c By_ gate i a Approved by Public 1.1orhs Department s O /� 2 c+ r? h2 i .v CO �h r� h7 L n /i i i► 5 BUILDING DEPARTMENT USE PERMIT Applicant Fill ZONE NUMBER PERMIT APPLICATION Inside Heavy Lines JOB O O� NAME (OR NAME OF BUSINESS) ADDRESS Si VARIANCE OR COND. USE NO. ADB NO. yEj MAILING ADDRESS Z 1?10 CITY / elmC / TELEPHONE NUMBER'.1 �-^ ARDS FRONT /D SIDE ['� �a REAR LOT COVERAGE SIGN AREA ENVIRONMENTAL REVIEW ALLOWED PROPOSED Z ❑ COMPLETE ❑ EXEMPT Z NAME U /` REMARKS < W f a ADDRESS PLANNING DEPT. APPROVAL DATE _ U CITY LEPHONE NUMBER X a C LEGAL LOT LOT AREA SUBDIVISION NO. 19 VES El NO NAME STREET R/W E EXISTING STREET R/W (7 FT. DEFICIENCY THIS PROPERTY ADDRESS 0 I. COMP, PLAN ST. R/W SO FT. O FT. U Q E CITY TELEPHONE NUMBER REMARKS Driveway slope not to exceed those F z indicated on Standard DRawin #103. 0 CHECKED BY U STATE LICENSE NUMBER CITY LICENSE NUMBER Legal Description of Property (Show Below or Attach Four Copies) STREET AND/OR UTILITY WORK REQ'D. ❑ YES PNO R/W PERMIT REQUIRED 12 VES ❑ NO UNDERGROUND WIRING REQ'D. DYES NO ' TYPE CONNECTION ® YES SANITARY SEWER ❑ NO VERIF MOBY I v SEPTIC SYSTEM ❑ YES APPVD BY CITY ENG. ® NO PERMIT NUMBER ' REMARKS METER SIZE SERVICE SIZE CLEARANCE CHECKED BY RE ARKS NEW ADD ❑❑ RESIDENTIAL NON-RESIDENTIAL ❑ GAS LINE ❑ SIGN FIRE ZONE TYPE OF CONSTRUCTION CODE m W F Q e LiRETAINING ❑ ALTER DEMOLISH EXCAVATE OR FILL ❑ WALL FENCE ( x_.FTI SPECIAL INSPE CTOR REQUIRED ❑ YES ❑ NO AREA JOCCUPANCY GROUP OCCUPANT LOAD I 1= PLAN CHECKED BY THIS SITE IS,LOCATED IN THE CITY w EJPRE REPAIR -MOVE INSP. ❑ SWIM POOL OF EDMONDS. LOCAL SALES TAX SHOULD BE CODED 31 Z REMARKS NUMBER OF STORIES NUMBER OF DWELLING J UNITS 7 m NATURE OF WORK TO BE DONE SE PLAN CHECK NO. VALUATION FEE ( INDICATE BUILDING SETBACKS, ABUTTING STREETS) ' BUILDING I I tI I i PLUMBING HEAT & GAS LINE FENCE _ SIGN RETAINING WALL SWIMMING POOL p W��ZZ io v ISM 4' GARAGE 9� DOORS PE. rl- o 10' WM 0 O�koy CITY OF EDMONDS WATERLINE AS -BUILT �.l ADDRESS HOMEOWNER p v' 1007 Vista Way XXXXXXXXX CONTRACTOR SCALE XXXXXXXXXX NTS at 1890 DATE 6-28-2001 DRAWN BY K• Haney WATERLINE NO XXXXXXX E a N 0' a 3 =AWAY CITY OF EDMONDS WATER SERVICE AS -BUILT ADDRESS 1007 VISTA WAY PERMIT NUMBER XXXXXXX HOMEOWNER XXXXXXX CONTRACTOR XXXXXXX DATE 06/28/01 DRAWN BY I. ABILA w .+. FRED and TANYA BOEDE 1007 VISTA WAY EDMONDS, WA. 98020 Tel. 425 774-8342 Contact Person: Fred Boede Tax No: 00649400000100 Lot Coverage Zoning: 12,000 Sq. Ft. Lot Size: 19,254 Sq. Ft Existing House: 1759.25 Sq. Ft. Proposed Addition: 154 Sq. Ft. Percentage of Coverage (9.91/o) Impervious Surface Area Square Footage of Impervious surface prior to 1977: 0 Sq. Ft. Square Footage of Impervious surface as of 1977: Existing house 1759.25 Sq. Ft. plus 2619 Sq. Ft. of exposed aggregate concrete driveway and lower level patio. Proposed addition will cover only concrete patio on lower level. NO additional impervious surface will be added as part of this remodel project (0 Sq. Ft.) Prior to 1977 no buildings existed on this property. All construction was done in 1977. Height Calculations A = 101+ B = 101+ C = 105+ D = 105+ Average Grade = 103 Ft. Maximum Grade = 128 Ft. Lot Slope �p 7 V t S T'A- �t1 A--Y ZONE --S — z Y Y SETBACKS: !7 N o ��5�i�P O Z� FRONTS SIDE io ' REARS-' \ OTHER 1 HEIGHTS-� \ GUTTERS/DOWNSPOUTS TO CONNECT TO EXIST. SYST. t ,I CC -ALE' 1 'I a' �2 CL QZ W k4 I I t t t' 1 i FT- -+- 6 4 3 -TT FT �9 S 4 ToTA-L- I � s sue/ k 5fi o `� Wl � N TJ 2'l � V Cam! R• � NERICONTRACTOR IS RESPOiGEBLE O8 oW EROSION CONTROL AND D APPROVED AV PLAN D I - iUfiUO 0 c� �.l P cotA ?AD X p scwE,2 ESQ-sE�-tE�rT j � ' i moo �4 APPROVED AS NOTED BY N 1NG Oat®: /o AMPI ,4�wzvw-'d t\` yo SEWe7p Cove t2003 �-=-'WCF.S Vl - _c.�Ei ,�.. CTR. CIiY OF Li-,L i aS -� -,;z5 STREET FILE i� TEIZ�I t Ems! i`'i, AX o R. A C:nJ 2CO3 1111ELC,TY OF EDh 0 Gi?S CTR. STleft REET FILE DATE RECEIVED PERMIT EXPIRES as CITY OF EDMONDS SE PER ZONE NU" CONSTRUCTION PERMIT APPLICATION JOB � UITE/APTII ADDRESS ZtV7 -d OWNER NAME/NAME OF BUSINESS PLAT NAME/SUBDIVISION NO. —^` LOT NO. LID N .110 nE.� 5 MAILING ADDRESS wei!O PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP -7 EXISTING l PROPOSED REQUIRED DEDICATION �� �Fr TIECP RW Pe approved Permit Required Street Use Permit Req'd Ine�VOn�"� O Sidewalk Requtred Q W` iring � Q CITY q®O 7 , ZIP C.V TELEPHONE i /� "l' NAME METER SIZE LINE SIZE NO. OF FIXTURES WEQUIRED YENO ❑ W �u C U ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE Z CITY ZIP TELEPHONE NAME CBL pl :..., cc U % C Q z �(/ ` ( ENGINEERING REVIEWED BY All D TE _ Y70AIi FIRE:. REVIEWED BY ;f� w5 DATE W CITY ZIP Cp x TELEPHONE VARIANCE OR CU - SHOREUNE'OR ADB#,. ai INSPECTION REQ'D BOND POSTED STATE LICENSE NUMBER XPIRATION DATE CH CKED B -15Wf_ A-_ SEPA REVIEW COMPLETE, EXEMPT EXP -SIGN AREA, ALLOWED PROPOSED > HEIGHT 'ALLOWED PROPOSED c ' PROPERTY TAX ACCOUNT, PARCEL NO. ❑ NEW RESIDENTIAL ❑ PLUMBING / MECH COMPLIANCE OR, ADDITION Z~ COMMERCIAL - ❑ ❑ CHANG OF USE REMODEL MULTIFAMILY ❑ ❑ SIGN LOT COVIIRAGE ALLOWED pR0 — "� p ..A ,.� REQUIRED SETBACKS (FT.) , -PROPOSED FFRnRONT SIDE REAR d� r�l t SETBACKS (Fr.) FRONT UR SIDE REAR t7 i d PARKING REOD PROVIDED LOT AREA PLANNING REVIEWED BY DATI ( GRADING ❑ REPAIR ❑ CYDS ❑ FENCE, -. :X FT) • . REMARKS ❑ DEMOLISH ❑ TANK ❑ OTHER .• - z Q V nNUMBER toOF ❑CARPORT O ROCKERYG.W� ❑ FIRE SALARM PRINKLER (TYPE OF USE, BUSINESS NTTY) EXPLAIN: CHECKED BY `TYPE �w T U ION CO OCCUPANT GROUP STORIES NUMBER OF CRITICAL DWELLING AREAS UNITS.NUMBERD V SPECIAL INSPECTION' ; REQUIRED Q q JAREi [ / OCCUPANT LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS°INSPECTIONS'PEWUBC 108/FINAL INSPECTION REGeD z 9 c �1,6 PEA VALUATION 57 Description FEE Description FEE Plan Check If y {' State Surcharge . S� HW SOURCE GLAZING % "-y PLOT-�% t l .. Building,Permit City Surcharge PLAN CHECK VESTED DATE Plumbi'ng,.' .- Mechanical THIS PERMIT AULY THE WORK NOTED. THIS PERMIT COVERS WORK TO t BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC 7 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading SEPARATE PERMISSION. Engr. Review PERMITAPPLICATION: ISO DAYS d PERMIT UMrP 1 YEAR - PROVIDED WORK IS STARTED WITHIN ISO DAYS Engr. Inspection top SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit 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 # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE 9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape insp. Total Amt. Due = NOR LIMIT IN ANY WAY THE Cn Y'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION ' Recording Fee Receipt # •7 HERESY PETUYTRDATIOFGIVNIS CORRECT; AND THAT I AM THE READ THIS ORD�OZEGEENNTAPPLICATION APPROVAL THE OWNER. 1 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 LABOR CODE OF.THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided. WORKMEN'S ON INSURANCE AND RCW 18.27. OFFICIALS SI NATURE DATE SIGNATU (OWNER R ENT) DATE SIGNED (42/�5) .. �% •'`� I3 /J �' Q 771 ^220 R Y / ✓J ATTENTION M 1333 . (4/17W W-,fA A J A IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL. FILE YELLOW • INSPE oR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN -ACCOUNTING