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1026 WALNUT ST.PDF11111111111111 13635 1026 WALNUT ST ADDRESS: iQ�P �iil[X JLy� cS� TAX ACCOUNTIPARCEL NUMBER: 00 4 39 >? ©3 1sC Cl nn BUILDING PERMIT (NEW STRUCTURE): COVENANTS (RECORDED) FOR: CRITICAL AREAS :—J=LQ ' / rV 2 2-) DETERMINATION: ❑ Conditional Waiver ❑ Study Required Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED PERMITS (OTHER): 1 q11 ` 0 q l PLu m U) , 1q: fl 01 e l (vY��) 1 q D `6t q 5 (ADb), PLANNING DATA CHECKLIST DATED: `I / I o(4 V SCALED PLOT PLAN DATED: (o� 1 �O��I /Dt i 3/1 �� ( O SEWER LID FEE S: LID #: SHORT PLAT FILE: LOT: BLOCK: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: FOR: WATER METER TAP CARD DATED: OTHER: LATEMKDSTs\Forms\Street File Checklist.doc _LE BUILT: 1946 --- --- -- ZONE: RS-6 LARRY & CARLA PAOLZAHN LOT SIZE: 8,800 SQ. FT. 1026 WALNUT STREET LOT COVERAGE: , ts�, EDMONDS 98020 EX.GARAGE: -400 Sul. FT. EX. RES.: 1.00 .4 4:mT 425774-01721206- 291-6026 cell ADDITION: 170 30. FT. _ ,�/4j",& . FT. i.�.351, TAX No: 00434203500800 IMPERVIOUS SINCE 1977b- ��, j SQ. FT. Zoos A10%o . �e.Q c LEGAL: CITY OF EDMONDS PIP11jG, A-vp- BLK 35 D-00, LOTS 8 & 9 'D r1cl6c . S-- � Vt YV v' & W 20 FT. OF LOT 10. W�►LiJ�1 t SOT. V, h SCOPE OF PROJECT: c 6 r 470 SOFT SINGL FV00!b C�`�' &( �200 �, ADDITION. W AA + 10 51 be\oALX.. N 10 2000 i5D to+YD 5 va L901 Set clk� lRe uq is�ed 25' /w •N l=lrAu-r C&C- 5 DA?UM ii wA-rer. A • ice•' G• qQ•5� D loo. , -i°l°I -:-4 = i°I.'15 Aver aq •75' + Z6' V6 12�1•Z5'tta�x MOP. = 113.'15' Lo'f PLA'' P'L,Lk] I la'W JUN 17 2000 AWN& CJ PLANNING DATA SINGLE FAMILY RESIDENTIAL STREET FILE Name: Wo 1 �� Date: 1�®2 Site Address: ��� ��T �--�-- Plan Check #: 2467o®-7 Project Description: V �- ®ve���, Reduced Site Plan Provid . (YES NO) Zoning: Map Page: -4 1 Corner Lot: (YES / Flag Lot: (YES O Critical Areas Determination # : 1gg7 — O Z 24 ❑ Study Required Waiver SEPA Determination: Exempt ❑ Needed (for over 500 cubic yards of grading) ❑ Fee ❑ Checklist ❑ APO List with notarized form Required Setbacks Street: ® Side: e Side: .7F ® Rear: Actual Setbacks Street: ® Side: 7� Side: � �® Rear. ❑ Detached Structures: ❑ Rockeries: ❑ Fences/Trellises: ❑ Bay Windows/Projecting Modulation: ❑ Stairs/Deck: Buildin Height 'Ced G 1 n $G e'i Datum Point: -�- ���� Datum Elevation: Maximu Height Allo ed: ii� ��` ctual eight: l2e 12-.`75Other 3. Parking Required: Parking Provided: Iva, ch Lot Area: �0�� ®, ��®® Maximum Lot Coverage: 35% roposed: reb 14 adasv L'V ' Lot Coverage Calculations: q�® 22 g ADU Created: (YES C Subdivision: Legal Nonconforming Land Use Determination Issued: (YES / Comments Plan Review By: Planning Data Form 04-11-06.doc t �1 • City of Edmond3 Critical Areas The Critical Areas Checklist contained on this form is; to be filled out by any person k� preparing a0evelopment Permit Application for the City of Edmonds prior to his/her subInittal of a development permit to the City. j i The purpos� of the Checklist is to enable City staff tp 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 frbm observations of the site or data available at City' Hall (Critical Areas inventories,! maps, or soil surveys). An applicant, or his/her representative, must fill out the c'�hecklist, sign and date it, and 0 Checklist 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. Witha' signed copy of this form, the applicant should also submit a vicinity map or plot plan for individual lots of the parcel with enoughdetail that City staff can find and identify the subject parcel(s). In addition, the applicant shall include other pertinent information (e.g. site plan, topography,map, etc.) or studies in conjunction; with this Checklist to assist staff in completing their preliminary assessment of the site. I have completed the attached Critical Area Checklist and attest that the answers provided are factual, to the best of my knowledge (fill out the appropriate column below). i Owner / A�plicant: Applicant tative: Upy Name -- ' 'Name JOZ4 vLA41r' .f7"-je Street ZIP , Oq 9lFom � -e��x City, State, ZIP Phone �1 ate' Date Street Address City, State, ZIP Signature Phone Date CA FILE NO. - ! i ! �� f Critical Areas Checklist -------- ----------- drolo'' gy/veg'etation) Site Information soilshopography-/-h-y---------------------------------- 1. Site Address/Location: /OZ 2. Property Tax Account Number:,' -4,342 03f 60 gre I Approximate Site Size (acres or square feet): Ymoo —boo 1 4-C 4. Is this site currently developed?l /***' yes; no. If yes; how is site developed? 1.4 5. Describ the general site topography. Check All at apply. mytry 97 Flat: less than 5-feet elevation change over entire site. Rolling: slopes on site generally less khan 15 % (a vertical rise of I 0-feet over a horizontal 4istance of 66-fep't). Hilly: slopes present on site of more than 15% and less than 30% ( a vertica: rise of I 0-feet over a horizontal distance of 33 to 66-feet). ,; Steep: grades of greater than 30% present on site (a vertical rise of I 0-feet over a horizontal distance of less than 33-fdet). Other (please describ6i 6. Site contains areas of year-round standing water ;Approx. Depth: 7. Site contains areas of seasonal sanding water: AZ-; Approx. Depth: What season(s) of the year? 8. Site is in the floddway floodplain of a water course. 9. Site contains a creek or an area W:here water flows across the grounds surface? Flows are �ear- round? o Flow4 are seasonal? (What time of year? 10. Site is primarily: forested meadow ;shrubs mixed! urban landscaped (lawn,shrubs etc) IL Obvious wetland is present on site: 7 Q R. -map A 4 oo sVt PT.., ....... ........ ... . . .............. g# a. .. .. ...... V -4&_chk.dm Ray tDIM/97 BUILT: 1946 �- ZONE: RS-6 STREEcl" FILE LOT SIZE: 8,800 SO. FT. ;NET IS REGPCNSIBLE FOR ?�1 1 ONfROL AND DRAINAGE LARRY & CARLA MOLZAHN 1026 WALNUT STREET LOT COVERAGE: Ac.av #6 EDMONDS 98020 EX.GARAGE: /400 S%l FT. EX. RES.: 1080 4 f7 425-774-0172 / 206- 291-6026 cell ADDITION: q-70 SQ. FT. �1 N� S �• _ �� . 3 `�o TAX No: 00434203500800 IMPERVIOUS SINCE 1977,;80j SQ. FT. 200� Arvv(-T• c� ��c� LEGAL: CITY OF EDMONDS p(Nlc iy ��D- J VIIIOvs BLK 36 D-00, LOTS 8 9 & W 20 FT. OF LOT w�►tu�rt s�. , oafffda C446- SCOPE OF PROJECT: 470 SO FT SINGLE FLOOR BY ll Nlr2lNEE9RllQ ADDITION. ALL MPOSED SURFACES TO o�rn 8E MIMED WITHIN 2 DAYS t� AA -F Ids t bGW4LK_. ��i8►� U�t� • )no �S__ 6 Corner&_Flaggg, ;tbacks Rectuired Actual Front 60 Sides Rear es) 15' Other Height OeA4, sc& n� -.,re -6 PEIAI r CAV-2: DATUM: WA-Tr--V. METE-1 A • IQo•' G• 9q.5� p, loo• �q°I =4 1.15 Avel °t9 •i5' + 26' - I24 •'I5 t•fAX PROP. = 113.-15' S1'f� �Lbfl E i Larry Molzahn 1026 Walnut Edmonds, Wa 98020 Plan Check #06-128 Impervious surface calculations C �iSh by Kt k lan AM I V,on Existing Driveway Existing Building Roof Outline Existing Covered Porch Existing Building Roof Outline Existing Patio Existing Garage Roof Outline Proposed Addition Roof Outline Proposed Deck Proposed Concrete Slab For Hot Tub t5S �Pr-4 1,200 sq. ft. %1 &sq. ft. 112 sq. ft. 131 sq. ft. 240 sq. ft. 480 sq. ft. 506 sq. ft. 80 sq. ft. 42 sq. ft. 'Pcm-- M7 I mpmv ibo5 �Ld. qce -Trq� d X vieV✓I Uv s SV � kce !3i 14 a663 Built 1946 Built 1946 Built 1946 Built 199 cj Built 1965 Built 1946 v 1 c; 2 1 .t131✓Li 0 D M N t e,Pproval Vro� shall be � u "Nothing in this pen°i'r rnlitting the ,� inttrDretiad u° allovnt►q Pe cture W A �• N 11 V- ...:�tannnce of eny mire", . ez�etm� illegal, Elommnrnrn ing Or u Ule Of Bite �,t,tlitton w►uC° `° °utride the �oFE of aPpljoLtion9 regtlydless of whether such bu lding, n,ruc�cure orCondition building, 4 ructure or site Ian or drawing. Such �ndit�on may be the subject of a separate -lent Adion.» LIY%C dt 6 U�6�ER/CON r € AC 1'0;116 Rb SPONO& L&*:- FOR EFOSSON CONLfq L AND DAMAGE S(TP P LA �J �ipi� /�GC!3R/�✓ �osG. ai�vv� E.Ovuovrpj. e-04 98o2.6 BY PLANNING AMC 946' •tZs' p ro P = a3 7S' La t PAT _,.,, Cornerj[Flag,_Q,L backs. Required Actual runt 1/QZ�-- �n Sides -- Rear s lb' Other H O t lye iMCI ADD GUTTERS/QOWNSPOUTS 5 AND SPUSRSLOCKS Y � • Larry Molzahn 1026 Walnut Edmonds, Wa 98020 Plan Check #06-128 Impervious Surface calculations Existing Driveway 1,200 sq. ft. Built 1946 Existing Building Roof Outline 862 sq. ft. Built 1946 Existing Building Roof Outline 137 sq. ft. Built 1999 Existing Covered Porch 112 sq. ft. Built 1946 Existing Patio 240 sq. ft. Built 1965 Existing Garage Roof Outline 480 sq. ft. Built 1946 Proposed Addition Roof Outline 158 sq. ft New deck covers existing concrete patio and does not add any new impervious surface. Post 1977 impervious surface 137 sq. ft. Proposed impervious surface 158 sq. ft 295 sq. ft._ R [E0 M Col MAY 0 8 200 i t UCj-N OF (�®Y.9�f�gC�b PLANNING DATA SINGLE FAMILY RESIDENTIAL STREET FILE Name: Date: �A 70s Site Address: 2 Plan Check #: cG -DR Project Description: 14ee roc' re r c1/1J 'b'd y70 Reduced Site Plan Provided: YES NO) Zonin"Flag Map Page: Corner Lot: (YES Lot: (YES NO Critical Areas Determination #: 1397 — Offal ❑ Study Required Waiver SEA Determination: Exe..,p�t AExempt ❑ Needed (for 500 cubic yards of grading or site within 200 feet of Puget Sound or Lake Ballinger) ❑ Fee ❑ Checklist ❑ APO List with notarized form Required Setbacks Street: O, Side: i Side: E Rear: Actual Setbacks ecz Street: 5 Side: si Side: E Rear S 3 Does street map require additional setbacks? (YES / NO / DNA) Detached Structures: E>cs�%(�<q� C�eA-d ew 8Cage, s cw� on e�.b* , Rockeries: Fac;s3;.,� r0i;, s can o, ❑ Fences/Trellises: No,\e_ s"wn o e�a.nS, Bay Windows/Projecting Modulation: � �:ce-P\ice on noc-�1ns�e±e e�' \base-. Stairs/Deck: Fjci6�t�n �c sec de'2le�S can on b.ns . Buildin Height Datum Point: Datum Elevation: + too. i Maximum Height Allowed: i JActualHeight: i Other Parking Required: Parking Provided: No Lot Area: 8 Maximum Allowed Lot Coverage: 5% Proposed: 2,3,7,E Lot Coverage Calculations: Res:deft� = 1020 * comr�ed pore-%-1 va � �C66 ^ . a g $'GO -z a oi3 . �o ADU Created: (YES /no Subdivision: C Legal Nonconforming Land Use Determination Issued: (YES AD Comments ReviewPlan Planning Data Form 2-7-06.doc PLANNING DATA F,-�IFT FILESINGLE FAMILY RESIDENTIAL 11 STREET FILE Name: L Date: 31/oco Site Address: e� Plan Check #: a _ Project Description: "ro a -&r e. J�rie tzw% ct'one Reduced Site Plan Provided: E5 NO) Zoning: _ Map Page:Qog Corner Lot: (YES / NO Flag Lot: (YES NO Critical Areas Determination #: • ❑ Study Required Waiver SEPA Determination: Exempt ❑ Needed (for 500 cubic yards of grading or site within 200 feet of Puget Sound or Lake Ballinger) ❑ Fee ❑ Checklist ❑ APO List with notarized form Required Setbacks Street: N O Side: 5, Side: i Rear: L i Actual Setbacks c YAc4 a Q/ ;+• Street: Side: , Side: E + Rear: S 1 .4- f gar, e, S60M on Detached Structures: Ex �Xy s OC^ on o Rockeries: �c t4jcq c-c ❑ Fences/Trellises: None a�%OL,-jn o,, e�bn%. dace Bay Windows/Projecting Modulation: Fx%*eAirj -4', cn r%OCA , IskWe oc Stairs Deck: cl" 4oczn oA se- ,,c/ deck wa.'s ��O«�W// i�e a 'd Buildin Height Datum Point: r Datum Elevation: + Maximum Height Allowed: a5 s� Actual Height: / Other Parking Required: Parking Provided: NO e- Lot Area: Maximum Lot Coverage: 35% roposed: ot3. Lot Coverage Calculations: Lx� covey e, a:?006 permA _ ADU Created: (YES NO Subdivision: Legal Nonconforming Land Use Determination Issued: (YES NO Comments (� ,1 t // 1 1 -1 iS ?et'cmAr %a A,(- cOOCNk A\ -a ' �SO(One. n 00Y AbtxT 6[ MiC . ^e T�.p� 1eOre) /t co,/ex-b _,N �GC� 4r C:a�GS oe-, ike, 4rm %C J"0 , 'a.,n -� iOn 'l�b cz-..% a.eProwe'd in aCCG Gv clev- %.-A ckeck 0 OG -tom$, JK*an iao Plan Review By: Planning Data Form 2-7-06.doc PLANNING DATA NAME: SITE ADDRESS: DATE: ZONING: /n PLAN PROJECT DESCRIPTION: CORNER LOT (Yes/No) FLAG LOT Nb (Yes/No) SETBACKS: Required Setbacks: Front:,552,0 Left Side: Right Side: S Rear: /S Actual Setbacks: Front:',7,7_Left Side:Ld Right Side: Rear:_UR Street map checked for additional setback required? A/ (Yes/No) LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED (Y/N) LOT COVERAGE: / Maximum Allowed: �I� Actual: f''f BUILDING HEIGHT: 0 Maximum Allowed: "" n�✓Actual Height: /# W41 Datum Point: �'%1 Q,y�,� �� L�( Datum Elevation: 10 A.D.U. CREATED?: SUBDIVISION: CRITICAL AREAS #: __L� SEPA DETERMINATION: N/4 LOT AREA: 92W OTHER: Plan Review cAfileApmmiOplendudoc P/2 t N 1 to vn 9 vrn I► 1 ►%o w DIVE E r /�bnl ti/yEN 1� Q / 00. o 103 C7RRFlt:Td- ioo t P19vc4 Asm^f LXISTl�t6 t{AtnE i i too t 9 W 20' Lor /o , L.or 9 ` 8 rBlk 3:5- Ass SWs Alkfl- 4N2 63s dGt j&a_M MAO eefa&*6 4S:q a 4, Srrz '44eg ig"' � - ZokxAvG O�3--Goy %oAosQgAyy - L�vEL TOLERANCES EXCEPT As NOTED REVISIONS NO DATE BY �A.P[A t DECIMAL 2 Trb.NA * �y J DRAWNer SCALE - 0I YATE1Wl ,GV 4 __,... CHECKED DATE WING KID A U t 6 R� -- APPLICATION The City of Edmonds for SIDE SEWER PERMIT NEW CONSTRUCTION C] REPAIRS El EASEMENT No . .......................................... 108-08800 OWNER............ Glen ... A.-Rolton ............................................................. CONTRACTOR ................. ................................................................................ PERMIT No....--- 'ADDRESS --------- 1OZ6 ... Ulaut.-St . ......... ................................................. LEGAL DESCRIPTION: LOT No . .............................................. BLACK No . ............................................ NAME OF ADDITION • Dye Tested On Sewer 1972 Approved: DATE................................................ By ..................................... ................................ BUILT: 1946 ZONE: RS-6 LOT SIZE: 8,800 SQ. FT. LOT COVERAGE: I fit — EX.GARAGE: 483 SQ. FT. EX. RES.: qAx : 4 4:T }- o Vo6eb ADDITION: 156 SQ FT. _ I Z aQ FT.. _ (S74- LARRY & CARLA MOLZAHN 1026 WALNUT STREET EDMONDS 98020 426-774-0172 / 206- 291-6026 cell TAX No: 00434203500800 oa A-0va. bop &P LEGAL: CITY OF EDMONDS BLK 35 D-00, LOTS 8 & 9 ��. & W 20 FT. OF LOT 10. WaIV'C S'[. —' SCOPE OF PROJECT: SO FT SINGLE FLOOR ADDITION. MAY 2 � �, �� ����; �� p � _�� APPROVED BY PLANNING DEVELOPA Ni SERVIC4S CTA -Z:TT9 OE EDMONDS • &a°®6p C�V• o I�ti� o 20� 45 �RVDOWNSPOqq I . 0 r-y-. KE5IDt=WCE 0 ooy zz; — �pep� �. D EC-K 4-1' i I L - EctaT,.Wodefy L I-T E- PLL j DA-��? wA'tEtZ. METE�� . 1Do•0� A• IaD•� �• 99.5• p, toa• �4 = °t°I•�SavEI PR,oP. = 113•�5' LOT PLA-r, f Larry Molzahn 1026 Walnut Edmonds, Wa 98020 Plan Check #06-128 Impervious surface calculations d-003 Pro pC4-&i 1<t 1 V%A W t Vlb-A 1516 a b63 Existing Driveway 1,200 sq. ft. Built 1946 Existing Building Roof Outline %I Z sq. ft. Built 1946 Existing Covered Porch 112 sq. ft. Built 1946 Existing Building Roof Outline 131 sq. ft. Built 199 q Existing Patio 240 sq. ft. Built 1965 Existing Garage Roof Outline 480 sq. ft. Built 1946 Proposed Addition Roof Outline 506 sq. ft. a�f� Proposed Deck 80 sq. ft. � Proposed Concrete Slab For Hot Tub 42 sq. ft. � Tce,+- M7 I MpeA01'00S ��''_ �e 13q sf d X% e✓✓,v0s SV ekc.e /657 s aGv3 �ro�� � .._ -rofd = , �F 900(o qKopo6-ed Twi �a" vaou-s Sulfwu �o Ea,C = 86 I sf '51L CITY OF EDMONDS 250. 5TH AVE, N. - EDMONDS, WA 98020 - (206) 771-3202 COMMUNITY SERVICES: Public Works • Planning • Parks and Recreation • Engineering 890.199 CERTIFIED MAIL April 4, 1991 Glen A. Bolton 1026 Walnut St. Edmonds, WA 98020 RE: Problems with venting of your plumbing fixtures Dear Resident: LARRY S. NAUGHTEN MAYOR PETER E. HAHN DIRECTOR The City's sewer cleaning records show that the home at this address is experiencing problems with the venting of some of your plumbing fixtures when the City crew is conducting cleaning operations of the City sewer line in front of this address. The City's cleaning operation is essential for both you and your neighbors. It cleans debris in lines to prevent plugs, prevents corrosion and potential future collapse, and achieves a better flow characteristic in the public sewer lines. We need to do this often -- perhaps even 3 times a year -- in some critical areas. The City's cleaning operation typically involves the utilization of a high pressure water jet. The problem which occurs at the home is the result of a high pressure surge through your internal plumbing system. A properly constructed plumbing system is designed to easily vent this additional pressure without any visible impact at your residence. An undersized venting pipe (or not having enough vents) cannot handle the pressure surge, and the only release that's available is then through your toilet (or another fixture). The Uniform Plumbing Code typically requires a 2" vent, and further requires a separate vent for each plumbing fixture which is connected to the sewer (a toilet, a sink, a shower). Your home clearly does not have an adequate venting system (you either have a 1-1/4" vent, or not enough of them), and you therefore may continue to experience the pressure surges. The City does not have a choice as far as discharging its responsibility in cleaning the public sewer line. It is therefore up to you to take corrective measures as to how to properly vent your own plumbing system. The City has come up with two options that will remedy your problem: Option 1: Upgrade stack vents for toilets and other fixtures which are experiencing problems to required sizes. e Incorp-noted August 11, 18y,) • Sister Cities International — Hekinan, Japan Page 2 Option 2: Install a clean -out outside of house per attached specifications. Enclose box so it can vent properly when excess pressure is put on house lines. This option would be the cheapest and simplest way of correcting this problem. At the same time, it would allow access to sanitary sewer lines if stoppage should occur. This vent clean -out would allow a place for backup in lines to go before entering your house and causing costly damage. The City would appreciate your expeditious cooperation in this matter. The City must continue proper maintenance of its sewer lines, but we obviously do not wish to see continued problems occurring on your property because of poorly designed vents. It is your responsibility to correct these deficiencies. We cannot keep notifying you each time we come out to clean the line. It's up to you to have a plumbing system that conforms to code. Option 2 is a relatively simple one to construct. Should you have any questions on these options, please call Everett Akau, Scott Highland or myself at 771-3202, extension 317 or 318. Sincerely, �L11,64X Ron Holland Water/Sewer Supervisor Enclosure SEWERVEN/TXTSEWER ZT s,,g f ste-J MA4-*,-�vt1 s : (I) x Life rNc- (a)x 4" Pvc. y5° ao-o i x splyot It" Plbq C"np pvc of J l' , �z,j ";i �>-.. �-.4'.r, C.R�02vccJP F„/C/ 'NJ L i'e R c�.rw.1e.1 ems- 3 c x 4- l -: $0 n1c40— e %�C.DX \14 4" CO*Jc p,pR rkc"L;, 00ti.;7 3/L8/qI Puc p\vg �L� p • t o ►moo , ooCY0 o A, D,;P 1/y'* vemt rxcM Air u is • r .' ,- +• _... �k,�=.,.���:fi;�.,.��}�11'}�'�K�-&�'1 �j�ii TYi.� 'j�lV�nY'`t j�ir;'tt'�F'r�,C-a�1�rY�..�r....y��a-.,.a,,.j.se l•.+...,,•ot �t�"T" fi K,',�,.�.� ,x fro 4 CITY: OF EDMONDS• USE PERMIT ZONE' NUMBER '" �C� 57 CONSTRUCTION PERMIT APPLICATION JOB sUITE/APTa ADDRESS OW R NAME/ AME OF SINES LEGAL DESCRIPTION CHECK SUBDIVISION NO. LID NO. w MAILING ADDRESS Z O }` d�f Imo• / ' TESCP Approved ❑ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. CITY ZIP TELEPHONE NUMBER RW Permit Required ❑ 4s vow -Qt7 � EXISTING REQUIRED DEDICATION Street Use Permit Req'd ❑ Inspection Required ❑ _lo (j/� PROPOSED Sidewalk Required ❑ NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED . w YES ❑ NO ❑ 3 C7 ADDRESS F _ REMARKS ? U ¢ Z CITY ZIP TELEPHONE NUMBER 0 z w NAM�E7 T (/ / o e T ADDRESS ENGINEERING MEMO DATED REVIEWED BY ¢ p H U CITY ZIP TELEPHONE NUMBER ¢ FIRE MEMO DATED REVIEWED BY w Z O U ¢ U. STATE LICENSE NUMBER EXPIRATION DATE VARIANCE OR CU ADB B SHORELINE 0 Legal Descri tion of Property - includerall easements �"" '... t SEPA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED 0 Q IL EXP ✓ - �✓ QQ T / U -, VOW T LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) wo ALLOWED PROPOS D FRONT SIDE REAR UR SIDE REAR � .. �FRONT I (� 17�4/ `r z a Property/► Tax Account A Ci 4 L 4)69 T WING REVIEW DA E Parcel. Na n �" REMARKS NEW 1+ RESIDENTIAL PLUMBINGIMECH rVI COMPLIANCE OR W ADDITION' COMMERCIAL CHANGE OF USE APT. BLDG. REMODEL SIGN CHECKED BY TYPE OF CONSTRUCTION CODE OCCUPANT GRADING ❑ FENCE REPAIR CYDS.' (x_FT► DEMOLISH WOODSTOVE SWIM POOL INSERT HOT TUB/SPA SPECIAL INSPECTOR AREA OCCUPANT REQUIRED 11 YES �, LOAD GARAGE RETAINING WALL/ RENEWAL REMARKS CARPORT ROCKERY. O (TYPE OFUSE uswEss oR ACTIVITY) EXPLAIN:PROGRESS INSPECTIONS PER'UBC 108 z 0 m ¢ U W NUMBER NUMBER OF CRITICAL O 0 OF DWELLING AREAS STORIES UYVITS NUMBER DESCRIBE WORK TO BE DONE TTACH PLOT PLAN) FINAL INSPECTION REQUIRED VALUATION FEE PLAN CHECK FEE BUILDING HEAT SOURCE: 16 GL.lrG �% PLUMBING ///��� Plan Check O. c y MECHANICAL This Permit covers work to be done on pritate property ONLY. GRADINGIFILL Any Construction on the public,domain (curbs, sidewalks, driveways,,Tnarquees, etc.) will/re/Wre separate permission. STATE SURCHARGE Permit Application:180 Days ` Permit Limit: 1 Year Provided Work is Started Within 180 Days STORM DRAINAGE FEE ENG. INSPECTION FEE "Applicant, oh 6ehalflof his or her spouse, hbi 'SO.ignS and Successors in 7infer-est�agrees to indemnifx„d and hold y u, Jharmless _f the City of Edmonds, Washingto iofficials, s employees, and agents from any and all claim-y for damages of Ix whatever nature, arising directly or indirectly from the Issuance = of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT ,r o modify, waive or reduce any requirement of any city ordinance ` = nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE provision." I hereby acknowledge that I have read this application; that'the ATTENTION APPLICATION APPROVAL information given is correct; and that I am the owner, or the duly authorized agent of the owner. I agree to comply with city and THIS PERMIT This application is not a permit until state laws regulating construction; and in doing the work authoriz- AUTHORIZES signed by the Building Official or his/her ed thereby, no person will be employed in violation of the Labor ONLY THE Code of the State of Washington relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is tion Insurance aria RCW 18.27. INSPECTION acknowledged in space provided. SIG E (OWNER ORR'''��]AGENT) D,Ai�T SIGNED .DEPARTMENT V � -dait .CITY OF OFFI &IN _ ATE • o EDMONDS CALL FOR R LEASED BY: DAT ATTENTION INSPECTION i y q� IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE ��� O11wwo UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW — Inspector A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK —Owner GOLD —Assessor