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18923 OLYMPIC VIEW DR.PDFiiiiiiiiiiiiii 12595 18923 OLYMPIC VIEW DR ADDRESS: q&3 r) TAX ACCOUNT/PARCEL NUMBER: U BUILDING PERMIT (NEW STRUCTURE): COVENANTS(RECORDED)FOR: CRITICAL AREAS: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: PERMITS (OTHER): CO � 00 C 1 PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: SEWER LID FEE $: SHORT PLAT FILE: 6}t' l� l D TY- LOT: SIDE SEWER AS BUILT DATED:_ UN 3 I SIDE SEWER PERMIT(S) #: r ` GEOTECH REPORT DA' STREET USE / ENCROACHMENT PERMIT WATER METER TAP CARD DATED: v2IZ�l U7 OTHER: LID #: BLOCK: LATEMP\DSTs\Forms\Street File Checklist.doc • 0 MEMO TO: Building'Division FROM: Engineering Division SUBJECT: /8923 62Vd4 rc SEW After review of the subject building permit application, we have the following comments: 1) Connection to City water system required. 2) Connection to City sanitary sewer system required. 3). Right-of-way permit required for any work „on City property. 4) Driveway slope not to exceed 14%. 5) Back water valve required if downstairs plumbing is below elevation of upstream manhole. 6) Water and sewer lines to be separated by 10 foot minimum. 7) Builder/owner responsible for containing all temporary runoff and -erosion on site and may not impact neighboring properties in any way. 8) Construction hours from 7:00 a.m. to 10:00 p.m. on weekdays and 10:00 a.m. to 6:00 p:m. on weekends and hol' ays. v, 17 I re ., E p I... r 110.1 lil - Ao� IT, t leg P 0. AR ;; 1 'N +r G1 Y r a' 7f 4 4k 4JA rrl, I �wl 'I t) m OL.YKAPIC VIEW DRIVE U 0019' 27" E 13 2.00' 9 2.00, w �0 40' 110. N U) Ln 8 S S0*49127" S� II 2m - I Ox N ; LU n Y) M.71 N 0 O ; I l 0 f� N 10, m o m I oD I ------------ I �m IJ 2S 2S 2S' r N N N Q 0019' 27" E N W� 117.00' "q o — — — a w do j I25' f � N I 1 25' i IS Y1 M LU — / � D I � N 0 _ 7� 0 N �- ----- LI 2S' 13 2.0o' o ,' 20' x D E z m m n -i 0 Z NOTE: Approval of this short subdivision is sub- ject to the conditions found in City of Edmonds File #S-17-84. A I' " ftl>R 17FD r CITY of HANDS �DE For Inspection'Call 771-320 6TT F REET E Address of Construction: 3 cz Property Lea Description (Inc.lude all easements):, Owner and/or Builder: Contractor & License No: Single Family Residence C/ SEWER PERMIT PERMIT NO. W O 4 EDMONDS .WT_MENT PLANT 7; _'� 7(/-)'ovi Multi -Family (No. of Units ) �?•c/�V�• ^ v Commercial (No. of fixture Units PII,, Invasion into City Right -of -Way: ' No ✓ Yes (If Yes,'W%fPt.14*y Construction Permit required. Call One -Call -Center (1-800-424-5555) before any excavation.) Cross other Private Property: No I Yes (If Yes, easement required, attach legal description and county easement number.) PLEASE READ THE ITEMS LISTED ON THE BACK I certify that I have rea'dand shall comply with the items listed on the back. Permit Fee: Issued By: -DMC' Trunk Charge: �J`J • 00 Date Issued: - Assessment Fee: Receipt No.: �07 Partial - Inspection: P 1 Date Comments Date Initial Final Inspection Approved: �-1 $� , Date Initial Rejected: ason ** PERMIT MUST BE POSTED ON JOB SITE ** Wh.ite Copy - File Green Copy - Inspector Date Initial Buff Copy - Applicant z a. C LQ w at r � � o aw. z O U z w � o z a El � o o � � z z C •� ® z o 0 x w A w o � u o � w w � a z f J C O W a V w A 6 9 .N G w 25 CITY OF EDMONDS ASSET INFORMATION SHEET LJ NEW ❑ ADDITION ❑ RETIREMENT ASSET NO. 15A v 4F ADDITION TO ASSET NO. DESCRIPTION ' SERIAL NO. LOCATION DEP . NO. " PURCHASE ORDER NO. *PROJECT NUMBER PURCHASE ORDER DATE PROJECT COMPLETION DATE COST COST ST7a?• B.A.R.S. ACCOUNT NO. 4�1�- UUy' Olc,� ' �'f'-S� ao' ESTIMATED LIFE INITIATED BY DATE APPROVED BY "SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST `SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT ACCOUNTING ONLY L'J DEPRECIATE MONTHLY DEPRECIATION AMOUNT _ ANNUAL DEPRECIATION AMOUNT _ a G.L. ENTRY REFERENCE b P INITIAL DATE 4Q-,) VERIFIED BY PROCESSED BATCH NO. DEPARTMENT FILE 0 a STREET FILE CITY OF EDMONDS 250 - 5th AVE N. • EDMONDS. WA 98020 • (206) 771-3202 COMMUNITY SERVICES: 1 gq C � Public Works C Planning • Parks and Recreation • Engineering - 80.1 LARRY S. NAUGHTEN MAYOR PETER E. HAHN DIRECTOR March 24, 1989 i George Marian 18903 Olympic View Drive Edmonds; WA '98020 r Dear Mr: Marian: I have reviewed your account where you replaced your water service and will give you a credit per our policy which allows one credit per billing period (12-28-89 - 2-27-89). We do appreciate your quick response to the repair. Should you have any questions, please call Ilene Larson, Utility Billing Clerk, at 771-3051. Sincerely, Bobby R. Mills Public Works Superintendent SM/lk 1 cc: Ilene Larson #235525/TXTWATER e Incorporated A1.19ust 11, 1890 • Sister Cities International — Hekinan, Japan 0 • o?35-6aS-- City of Edmonds Water Department Billing 501 Bell Street Edmonds, Washington 98020 Dear Water D@partment: March 21, 1989 I have recently repaired a serious leak on my property, and I am writing to plead for an adjustment in my bill. I was notified just prior to receiving a bill for $101.26 that my water consumption was completely out of the ordinary. Until that time, noted by your meter reader, I had no idea. That billing date ran from 12-28-88 thru. 2-27-89. I live alone and am too old to do any digging, but I immediately began to search for the problem, checking all the pipes, faucets, etc. The first plumbing company I contacted charged me $196.00 to dig three test holes, which took about 3 hours. They told me they could not find the problem. After a three day delay, the next plumber began work, finally completing the digging and installation of an entire new water line 420 feet from the meter to my house, at a cost of $1,400.00. During the time that this work was being completed my bill went up another $75.00. Can you please make an adjustment in the bills reflecting these huge amounts? I assure you I did everything I could do as quickly as it was possible. I have a small income, and frankly I am reeling from the cost of laying a new water line at a cost of $1,400.00. Thank you for your consideration in this matter. Sincerely, arian o e 18903 Olympic View Drive RETURN THIS PORTION WITH YOUR PAYMENT TEAR ALONG THIS PERFORATION-110- � 9 0 - 1 9 " - I City of Edmonds Edmonds Water Department! SERVICE ADDRESS 11.: Id ACCOUNT NUMBER: PAST DUE AFTER: AMOUNT DUE: City of Edmonds Water Department - 501 Bell Street Edmonds, IiiA 98020 771-3051 I w)r I"..11 I-j: cz T 1. 9 T 1*•,J:, Ic. I A f.-1A r-,(-I-1 1 '. - !:-J. :J !"A Message py jr It "Ir THI 01:1 Vt For 0111? 1 j:: I j.'r.: Q I.-I.:t . .!.I 1 1! 1 (1 You - V: I 1: x T 1, 1 r I t I METER READINGS/GATE CONSUMPTION • ACCOUNT NUMBER: PREVIOUS PRESENT 100 CUBIC FEET CODE AMOUNT S— f 4f I SERVICE ADDRESS KEEP THIS PORTION FOR YOUR RECORDS PAST DUE AFTER 2aE#PRINT KEY FROM-Y4 BY USER-IJI.-250 03/23/89 2. 3 4 5 6 7 7 3/23/89 CITY OF EDMONDS LJB201. 11 L 12 10 1.24657:31 PM In':LUir-e Cuz-;T-A�mc:-?r Ms-ory DEIWIE 13 121 Customer- Key - i 13 cusi omenNo* 235525 GEORGE MARI U 14 Old No 207:1.0800 Le is Ty- a n Desc r i p t i on/ Tr- a n 19 16 Da A- e Gvv Date Read i ng Typa, Rate C t) Tis Seq I yl.) e Amount fia 1. a nc e 21 17 02/2(3/B9 02/2*7/89 000865 2---1 0001. 106 000 1 20o00 1274-08 22 Fls- -02/28/89 02/2*7/09 000865 1-2 0001. 100 000 1 So02 1.07008 19 04/-:0/07 VVVtJC)D I — J. VV(JJ. I v US vvkl I V J. # Zt) za 01/05/89 p 36o14 21 12/29/88 12/28/88 000757 2--1 0001 9 000 1 ,. 2000 316414 -4 2 22 12/29/(38 12/28/88 00 .7 1. ---2 0001 -78 z)-o-o------f 08 3 l c2 3 1.2/29/88 12/28/818 000*757 1.--1 0001 8 000 1 1.5.26 15*26 3 4 P 36+14- 31 3 1 3 10/31 81 1us07 1 0001 -6-000 1 0 20 00 3 * 6 I 2V 3 31 10/31/80 3.0/26/88 000749 1-2 0001 a 000 1 #88 16ol4 3 3 10/31/68 .1.0/26/88 000*749 1--1 0001 8 1 15*26' ,, 1526, 3 3 3 3 097197(m P-3 3 9 Elue Date To ta I. cur-ren-t- 2 3 3 30 3/24/89 1.27*08 4.00 J. 27 08 .00 000 3 4 31 Cmd2--D-t L/Sum Fi Lf in r eq u i red in-foTy--m-7a- -6--nand-press enter C-M-a Rec 41 32 Cm64--Cst Sry He L p 2 CONTINUE' 7 END 2 CmdS---Src Add Cf'ndS-Notes 4 31 -- ---------- V a 1501 9 sl H43 44 4 ------------ ISM 6 • 7tr,;;1 .r4 ,ntT`yKr.g kl'rKJ"hM.+i�M"..4 . �hN'N^u-. ., .r�.•�,..K ,.q 7} � •4. f•N� .. �nr�./f .T°1'•....�- ^�'•...:,+�1. (» ;�....;4.r..•„ir �•lv. r�J4- f,�^•._. .�.. .f Cicy ` VE,dmonf j RIGHT-OF-WAY CONSTRUCTION PERMIT Permit Number. `i Issue Date: A. Address or Vicinity of Construction: 18923 Olympic View Drive GTE to place opera a an ma n0ta na ur a service B. Type of Work (be specific): wi re f rom ext sti ng pore 0 752 1 ocated at 18921 Ol ympi c V1 18 90 - 19 o View Dr. then east to a residence at ym View r. o ow 02', push 2 driveways and push no road. Please see attac ches sketch. 0.6.G1. 80'. Mar lyn Holmgren C. Contractor: GTE Northwest I ncorpooatod asino Koad Mailing Address: Everett, WA 982004440 State License #: D. , Building Permit # (if applicable): E. ❑ Commercial ❑ Subdivision ❑ Multi -Family ❑ Single Family INSPECTOR: , Contact: Dennis Alexander 7WI -9036 mobile 388-058 Phone: Marilyn 206/710-0786 or 488-1628. Liability Insurance: Bond: $ Side Sewer Permit # (if applicable): ❑ City Project �]X Utility (PUD, GT WNG, CABLE, WATER) ❑ Other GTE LU.O. 0 2100-9P001DB 242310 INSPECTOR: F. Pavement or Concrete Cut : ® Yes ❑No G. Size 'Girt: 2 x 5 H. Charge $ Please see. attached -sketc APPLICANT TO READ AND SIGN w INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the city of Edmonds harmless from injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds,,.or any of its departments or employees, including or not limited to the defense of any legal proceedings including ae/ensecpsts, and attorney fees 6reaaonlof'granting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. Construction drawing of proposed work required with permit application. A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220. Work and material is to be inspected during progress and at completion. Restoration is to be in accordance with City Codes. Street shall be kept clean at all times. Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer. All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day; NO EXCEPTIONS. !have read the above statements and understand the permit requirements and the pink copy of thepermit will be available on site at all times spection purposes. Signature: ve Squires Date: 2/24/97 o ractor or ent) ec Mgr -Access Design . John st®wart CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR CITY'USE ONLY APPROVED BY. ° - RIGHT OF WAY DEPOSIT" TIME AUTHORIZED: VOID AFTER ? MA? _6 DAYS DISRUPTION FEE/FUND Ill: SPECIAL CONDITIONS:RESTORATION FEE:; LOW PERMIT FEE COMMENTS: TOTAL FEE: RECEIPT FEE: DATE: ISSUED B : NO WORK SHALL BEGIN PRIOR TO PERMIT .ISSUANCE Eng. Div. 1994 FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.) Comments I Diagram CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO Partial Work Inspection by P.W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: ££t £OOd IHd6b:Z0 L6-v3-z* A I w U� wu T N Y W ~ Z � U So IA 0- LLJ 6o�U m W J W NWt7�ah+ O _j d W W O O> p U daaco--3 C) w H m 1 !J V W 0. ? n 0 0 w 1 1 1 1 Vl £099 SI8*ON Z0:91 2S/bZ/Z0 Inc. (49) CITY OF EDMONDS BARBARA FAHEY 121 5TH AVENUE NORTH EDMONDS, WA 98020 • (425) 771-0220 •FAX (425) 771-0221 MAYOR COMMUNITY SERVICES DEPARTMENT Public Works • Planning/Building • Parks and Recreation Y Engineering • Wastewater Treatment Plant October 31, 1997 Mr. Jeff Adberg Robert Maloney Architects 1107 First Avenue, Suite 901 Seattle, WA 98101 Dear Mr. Adberg: This letter is in response to your letter dated October 28, 1997, regarding Mike Shimizu's property at 18923 Olympic View Drive and the setbacks for that lot. This lot has its access via an easement which serves itself and two other lots. Adjacent to this easement is an easement to the north, which also serves three lots. After reviewing the description of the easement for 18923 Olympic View Drive in Edmond's short subdivision file S- 17-84 it is clear that the easement and all the lots the easement serves are entirely on Tract 77, and do not include any portion of tract 76 to the north. A field visit confirmed that these two easements have been developed separately, and due to the topography and rock walls between them, it is unlikely that they will ever be combined to form a street. Your letter also confirmed' that the current owner purchased the property in 1986 (when the short subdivision was recorded) and that the owner confirmed that there have been no changes to the property description with regard to any prevailing easements since that time. The Planning Division's Interpretation File No. 97-2 states that "Flag lots which are accessed by an access easement or private access tract serving three lots or fewer ... shall be required to provide side yard building setbacks from all property lines...." The Division has treated the line along the easement as the lot line, so the north setback should be taken from the edge of the easement. As this lot qualifies as a flag lot, we. will require side setbacks from the access easement edge and all other property lines. If you have any questions, please call me at (425) 771-0220. Sincerely, Meg Vruwell Planner cc: Mike Shimizu Street File o Incorporated August 11, 1890 • Sister Cities International — Hekinan, Japan �kYr� s.CbF p i' B i•'J b. � ?„{�: •rf. i% � TYJG.+ .` f ; r ��r7 � �/ �ir� rs•� ',� _ .4tt:FF.u'r�u�-n _.._ i•',}`'."�� �r!!""�`�t�.•. _J���a .dam _ y {.S` �-. R O B E R T M A L O N E Y October 28, 1997 Meg Gruwell City of Edmonds Planning Division 121 5`h Ave. N. Edmonds, WA 98020 Dear Meg, s' "' G.j t 1•eF' A R C H I T E C T S This letter is written on behalf of Mike Shimizu regarding his residence at 18923 Olympic View Drive. The legal description is Lot 2 of Snohomish County short plat number _ 8603170279. We are planning a remodel project for this residence and want to ascertain the regulating setbacks. The current owner purchased the property in 1986 and there have been no changes to the property description with regard to any prevailing easements. As per our discussion, you indicated that this property constituted a "flag lot" with minimum 10' setbacks at all sides. Please issue a letter of authorization stating that this "flag lot" designation with 10' setbacks does apply to this property. Please contact us if there is any need for supplementary information. Thank you for your attention to this matter and for your ongoing assistance with this project. Sincerely, ?f aol� Jeff Adberg CC: Mike Shimizu 1 1 0 7 F i r s t A v e a u e S u i t e 9 0 1 S e a t t I e, W A 9 8 1 0 1 2 0 6• 6 2 3• 8 2 9 0 I -30- ` - 30.00 - W N O � IO o N O M Z Ld Q W a U Q- 7- J O ►: i 30.00 ' ——— r--———— — — — - -, 06 FND. MON. IN CONC, W/PUNCH IN Ld. ' TK IS GONE DWN. 0.5s O O ci to Lo -30- MONUMENT S CAP #8566 00 ��� OF PROP , .E�52' FND. MON. IN CASE W/PLUG DWN. I.Ot 1 A,J614 rq 0 o MZ s m z� N w P3 93427 r- BASIS OF BEARINGS PLAT OF " EOUOUOS SEA VIEW TRACTS " �► Af�� DDIT10J\l BLAKE PLACE �J1\1pI A rr LEGAL DESCRIPTION TRACT 77, F=000tJ0S SEA VIEW TRACTS, AGGORDIKJG TO THE FLAT THEREOF REGORDF-0 IIJ VOLUkAE 3 OF PLATS,OJJ PAGE 70, RECO 2DS OF SJJOHOU ISH COU►JTY, WASHlQ&TOtJ. (2EF : EOUOIJOS SHORT SUl30IVISIOIJ IJO. G-1-7-54) RECORDING CERTIFICATE FILED FOR RECORD BY I.I.J. LOVELL THIS —DAY OF1 S%uNE _ 19 a A.D.. AT MINUTES PASTO'CLOCK-n M: AND RECORDED IN VOLUME OF SURVEYS ON PAGE RECORDS OF SQOHOU ISH COUNT. W/AS Ili`, l Gj ONc t� OEAQ V. WILLIAUS 4UDIT012 DEPUTY AL101TO2 IA) �nnnn' E 0 0 1 30' 0 m 0 m .V GJ I IJ C-.J V\/ �o o S.E. GORIJER OF G0VP_P_QUEIJT LOT 3 -- (EX. GAGED UOJUUF::JT) LEGEND = SET IROQ PII.J WITH PLASTIG GAP JJO'O. 9891 SURVEYORS CERTIFICATE THIS MAP CORRECTLY REPRESENTS A SURVEY MADE BY ME OR UNDER MY DIRECTION IN CONFORMANCE WITH THE REQUIREMENTS OF THE SURVEY RECORDING ACT, AT THE REQUEST OF F2AKJK. LEIFER THIS IG+h DAY OF bEGE1..1�Ei2 19 'aG L.S. NO. 9e9 1 GEJ2ALO W. LOVELL 18 CmZw_A�WlwJ H J 41r, J D Copy OaIML 01A4 FIDE THE PLAT OF SURVEY FOR FRANK LEIFER IN NE %4 SE!/4 , SECTION 13,T.27 N.,R.3 E.,W.M. -SNOHOMISH COUNTY, WASHINGTON e, MMT11T DATE s /80 T U5"Z_m _7 lS psiY-K ,mhc 0 1 71­1' "T"' mroNAL usF 110MIT RWITMEMS aPIOW :rrmw 2CN7NG gmllI ltlaq-s -jti'�JI=cv--wrn mmws 2 7T 7TT,711'TTF /7 ND�M SWPf, VEHICLE AM.', t_we �pq,,,t 4,L: r DRAINAM PrPN (On situ) FIRE 7, r f A, A TM/DFU CWPTCHS 11"fli t "'o, �TL-711 CYH1WTPN IF INK) 1,114 PLAT/; tWIVISIOU 111'GHT-OP-WAY CYUMIK`F()N PEVJ�-Pf' RO-Ij T_ bX)m pa-D FT)R ji-111114,11,C T1.1PUM"'Mr11I'll c 'IDTIUCCo ij� 1.'!, J !'A`MR F-1131) CI!W.Kkl) MUM FAVTN(-, RKVIRM) --l-71"_" /7 ii T-771 r, d i CTW, ACTSCAMTR MXk!TIZW If I I III I lot i P J3 TrTiII, yTDWLK PWJIRED T (IM CUT FOR DRIVEWAY aM v� FPMT NAME SIC-d RFOD "i IV I 1-17TO /Ijil.1111"If"i, !/Ooi ,TPHMi SMITING 1:B§()D 74'/ S,1DM SEWER AIJAMMILITY r f,1XTSTDK WM MAIN SIM-. !;"//"y lv)wwl 4 _T SIZE F 7_1 !CF LTW SIM m_r2�,T i ?_m i!l Will Vil; I/ !111i 0`!, 1 r,.MMf?J1 I,T`eE Exi.,rriNg lih /* VIM T,711,10P 1: -(M REQ0 - �T,FA 1 It y:XOW 'DT7" EXISTING /f J pi r.13TVERr FW_D 7- cxnm nAsrN RELn �l T,­ 'j2MTCATM CV SIT& ?LAN SHMFR 011UNACC mAfiTKF..,.,..._ -- emu 01_?;N re'"OTIP Y 1,o IM BY; I •Alk USE ER NUMBER 777Y OF ED'M' NDS v NSTRU"CTION PERMIT APPLICATION A DRESS lg 3 ��y�p/G [:LAME OF BUSINESS) ///��� �/ ,� l L P/ P�" S' r LEGAL DESCRIPTION CHECK SUBDIV =• ` d /De LOT�#Z NG'ADDRESS Q7 - • / e PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TELEPHONE NUMBER EXIS � S [%1J oING—���/DEDICATION � !-It LV%i�"� � 7 7neen �vu.1v ^� C. Z. e e r .es �o sue' o TELEPHONE NUMBER - Irk,, o 3S 1 r',e _ ^ /1 / ///�t TELEPHONE N(((UVVVMMBBER_ LICENSE NUMBER CITY LICENSE NUMBER 7�'t:2,9 R 033 N below or attach foUrr copinclude all easements RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED ❑ STREET USE PERMIT REQUIRED ❑ SEE ENGINEERING MEMO DATED SEE PIW DEPT. REVIEW CHECK LIST DATED G5-) SIZE BUILDING SUPPLY SIZE FIXTURE UNITS 1� w 3 REMARKS SIGN AREA ENV. REVIEW ALLOWED I PROPOSED COMPLETE I EXEMPT 7 N VARIANCE OR CU e o V� 7L7 C�S YARDS FRONT �✓C REMARKS RESIDENTIAL PLUMBING NEW ❑ ADDiALTER ❑ NON-RESIDENTIAL ❑ MECHANICAL REPAIR RETAINING WALL ❑ SIGN , CHECKED BY EXCAVATE FENCE �—x--�I OR FILL a DEMOLISH ❑ PRE -MOVE INSPJ SWIM POOL 1 SPECIAL INSPEC REQUIRED .. - CAMP ANCE INSP. ❑ YES QREMARKS SEWER leJ WATER LINE SIDE ,,o oEl NUMBERUF D' NUMBER OF STORIES WtLUNU BE SIDE TYPE OF CC ;TOR A ❑ NO PLAN CHECK FEE BUILDING PLUMBING MECHANICAL � MUM This Permit covers work to be done on private property ONLY. GRADING/FILL Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. iPermit 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 to indemnify, defend and hold successors In interest, agrees harmless the City of Edmonds, Washington, its officials, from any and all claims for damages of employees, and agents whatever nature, arising directly or indirectly from the issuance . shall not be deemed to �a oS r of this permit. Issuance of. this permit bilty to enforce any ordinance ordinance dlimit inive or reduce any way the City s requirement TOTAL AMOUNT DUE nor provision." I hereby acknowledge that I have read this application; that the that I am the owner, or the duly ATTENTION information given is correct; and authorized agent of the owner. I agree to comply with city and and in doing the work authoriz• THIS PERMIT AUTHORIZES state laws regulating construction; thereby, no person will be employed In violation of the Labor ONLY THE WORK NOTED ed Code of the State of Washington relating to Workmen's Compensa• INSPECTION ti n insur nc PATE SIGNED 'SIGNATURE (OWNER OR AGEN ' _ DEPARTMENT CITY OF EDMONDS 771.3202 NO. WING REVIEW BY I DATE WI LOT COVERAGE REAR N CODE HEIZGHT / OCCUPANCY ( L OCCUP GROUP 17 LOAD VALUA 0 z z Z 5 4 APPLICATION APPROVAL This application is not a permit until signed by the Building Official or his Deputy; and fees are paid, and receipt is acknowledged in space provided. OFFICIAL'S SIGNATURE DATE ATTENTION OR OCCUPY A BUILDING OR STRUCTURE IT IS UNLAWFUL TO USE AND APPROVAL � D ®ORIGINAL — File YELLOW — Inspector UNTIL A FINAL INSPECTION HAS BEEN MADE BC A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC ® PINK —Owner GOLD —Assessor -. _.��� � .. ,Manrnn pnnpnp Epmanm. WA I)59a