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7804 OLYMPIC VIEW DR.PDF11111111111111 12634 7804 OLYMPIC VIEW DR City of Edmonds 'kW CRITICAL AREAS CHECKLIST 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 a development permit 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). EIVE" ' JUL141997 An applicant, or his/her 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 assist staff in completing their . preliminary assessment of the site I have completed the attached Critical Areas Checklist and attest that the answers provided are factual-, to the best of my knowledge (fill out. the appropriate column below). Owner/Applicant: L a,,, l - C' Name Street Address n City State Zip 7�Z,F- %-;`33 Telephone Signature Date c:recepdonljanalcac1.doc Applicant Representative: Name Street Address City State Zip Telephone Signature Date (over) CA FILE IqO. Critical Areas Checklist -----------------------------=--------- Site Information (soils/topography/hydrology/vegetation) 1. Site Address/Location: f�,^h,�f �,�yy,,,o,'t �,'YL' U,. 2. Property Tax Account Number: 3 70 SQ— ©G 3. Approximate Site Size (acres or square feet): 4. Is this site currently developed? _ yes; no. If yes; how is site developed? 5. Describe the general site topography. Check all that apply. Flat: less than 5-feet elevation change over entire site. 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: �_ ; Approx. Depth: 7. Site contains areas of seasonal standing water: !U iJ ; Approx. Depth: What season(s) of the year? 8. Site is in the floodway_&t, floodplain of a water course. 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round? Flows are seasonal? (What time of year? ), 10. Site is primarily: forested ; meadow, ; shrubs ; mixed X urban landscaped (lawn,shrubs etc) 11. Obvious wetland is present on site: ^ca chkdoc; Rev 02/11/97 — — — — — — — — — — — J. I AfEADOWPALE _j MEADOWDALE 4. SL 7 T 47 1 fed TFN a f LAERV6 T, k. v CJ Isr o 164TH _BR 0 WIVA5i A. B-Al' SIN Sit SIM f ERIC I7%TH Sv -COUNTY. 8 .`.PARK PROPEP;�-ffi, 1 r4 -- PL < A T IN 'MM I $T �W 3w Ats ISIST Pp." >-UAWfl- it �Z < IMTH PE > SIN M UT x sw ". ; g : 2 ST : :. IDS 1 7TH -1 QA Pt SW L SW 1S1T T 1 88T zk,, q > p IN F, 0 LYNA WATERIS a. MV I PLST SW W Q T ') < : r — -f Al C3 3'.f! 19151 91S PL p l4e, zi " UZ 192N I P� SW 3: L 93!! Imp P AJ I 41H EZ� ST swH. pi 9W.. TH w 1 5TH t IN - 1 11. s s PUGET6 i x See Alop 5,1? 91 il J� , tv RECEIVE® JUL9b1997 PERMIT COUNTER cx ri ry ., ®o ice- `,h -. •. 4"_ �", �. ( �'l �1✓, \ S t 1 ;;,Op 3 -- °'• �(-j 2 ; ' ^ t I I cm �� t�� � '�_�_,�_.V �-' -.s ''•'1: 3 F��star .�I,� .. .�.=A1— i�1'q � Vie Miry Ag 40-61 'S)'1HOIdAdOJ 0 O N dL-OZM A. O p v D Pilchuck Job #106071217 30 Nov 01 Sheet 1 / 1 J. Buss National Barricade Co Notes: 1. All signs and spacing shall conform to the MUTCD and City of Edmonds,specs. 2. Work zone is 150' s/o 180 ST SW & 12' e/o c/l Olympic View DR 3. Flaggers will control alternating one-way traffic. 4. Alert residents of work, dates, times 5. Channelizing devices are 28" cones. 6. Tapers will be 50' - 1 00'and must contain at least 6 devices. 7. All signs are 48" x 48" B/O unless otherwise specified. =o�E 8-5�! 03SO10 N1tlM301S M/8 bZ x AS WORK ZONE 36" x 24" B/VV SIDEWALK CLOSED R5-8 N O O 0 0 — W20-7A - N O O ONE LANE ROAD AHEAD W20-4 36" x 24" B/W &°EWA�CLDSEO At 76 AVE W for N o - ; M xv/b peds R5-9a CNANNEL[ZINC DEVICE SPACING (FEET) MPH TAPER TANGENT 50/70 40 BO 35/45 }p 60 25/30 20 40 n .m >, [va v •. --.- � � o.-r ear .. � d � VA MS Ild _ 0 981 Q c ai m/1�V H NN ni �a •.� arm b�i n IC$L �D uQt Nold e_SO�O„Q� i Mai 9',F� N H N• �I, i,i31 � r htL s iYe N N N L' ��• TTTT a �• t «I+ YN �N� tiC.06 LWS3.O Oeb� m saoa ws• f R hS a.bo.s s FE J1' v491 -4 �. M 2! N,66 e p Z� L961 S „ r461 awoN, 59b1 awe 3,035 „ vs p C Ssw 0� Q n96r � v 3 Ra5 .i/S 0 r 9.825. h ^ Sebi 3.E'L5.SV5 N N ,. 9eLl S3d(W 7914 n iN a MS .m � A � mac i6 m G7b� H i w � A � 9 A i � 368,• Il\leld\seE)\screw\ Lswejaw 9 Silver City Construction, Inc. P. O. Box 1417 Mukilteo, WA 98275-1417 March 11, 2002 Dave Gebert City of Edmonds Development Services 121 5`h Avenue N. Edmonds, WA 98020 Dear Sir, - y G� .s I DIVISION ENGINEVjNG 3�6- This is a letter to request an increase in my driveway slope from 14% to 20% at 7804 Olympic View Drive. My reason for requesting this is the difficulty and steepness of the site. In order to place the house on the site and create a hammerhead for turnaround, I had to dig the foundation down approximately 6 feet and export about 400 yards of dirt. The house is set back from the right of way about 55 feet and the part of the drive 16 feet in front of the garage door is between 11 and 15%: the rest is between 14 and 20%, with the first 30 feet from the road being about 18%, (as measured by Jeanie McConnell with the Smart Level). I hope that this will be adequate basis for my being granted the increase in slope. i erely, Presiders , Sily ity Construc n, Inc. - Z Co —5 01 -- s"G v CM) 1nc.189v March 20, 2002 CITY OF EDMONDS GARYHAAKENSON MAYOR 121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771.0221 DEVELOPMENT SERVICES DEPARTMENT Planning • Building • Engineering Jamie Schwartz Silver City construction, Inc. P.O. Box 1417 Mukilteo, WA 98275-1417 RE: Request for driveway slope waiver at 7804 Olympic View Dr. Dear Jamie; We have reviewed your request for a driveway slope waiver up to 20% for the above address. We understand thatfurther excavation to keep the driveway slope under 14%, as required in Section 18.80.060D, would have resulted in greater cuts in the vicinity of the adjacent slope. Although this condition should have been identified earlier, and the driveway slope waiver request submitted at that time, we will approve the subject waiver request. The driveway slope is granted up to 20%. If you have any questions please call me at 425-771-0220, ext 1324. Sincerely, i L le Chrisman Engineering Program Manager IlEdmondsfilelDATAIUSERSIchdsmanlletterslschwartz-dw slope waiver.doc • Incorporated August 11, 1890 Sister Citv - Hekinan. Japan ZAVALES DESIGN ASSOCIATES -1243 N.E. 152nd Street ' pSuite B RECEME® Seattle, WA 98155 362-2992 AUG ' 2 4 2001 MILT ZAVALES, PERMIT COUNTER LOT, rp1� GE rA_..... _..._ .. HOD%. x Ml✓MIOU5 SURA�CES otr,;; a 4F-A1 sS.... .. tv�waY . WIdL�s ToTbl.. . 4'v.w, 1-1EIGHT CARSk4go d11JM CdQ t _ M2tt(� RECEIVED r � UG DEVELOPMENT SERVICES CTR. CITY 0 EDMONDS LEGALPF5CKl 1 , JAP OV NING -STREET FILE . o� CITE' C®PY �.o �5I L%/F.R c r .' couS'T�ZIJCTlOI _ . v ...... ............................ �WRAP - [K E. U C COWACT Edmonds Uhhhes Dnwfm FORM :......................:.................` A coordinated utility environment which maximizes joint utility opportunities to provide quality service for the citizens of Edmonds YOU WILL BE GIVEN A CONFIRMATION NUMBER BY EACH UTILITY ONCE YOU HAVE INFORMED THEM OF YOUR PROJECT. tiF ADDMM: e_ Rich Afdem — 425-670-3208 You will need to provide PUD with a site plan'and a completed New Service Questionnaire. P.UGET SOUND ENERGY � v� t Doug Usitalo — 425-356-7520 Or -New. Customer Construction �-_Departnent� 1-888-321-7779 '1 #��q Dow Brandley — 425-710-4118 You will need to provide Verizon with the location of your project, total line requirement, and the date in which service is required. A copy of your development plan may be required. AT&T wnomuii�i� Esa Patterson — 425-317-9601, ext 221 v 7:00 am — 3:30 pm �yMPIC y�fw �A6 SEWER Steve'Dunphy - 425-774-7769 For customers in Olympic View Service Area You will need to provide OVWSD with the survey map of your site and complete a development information form. THIS FORM MUST BE COMPLETED AND GIVEN TO DEVELOPMENT SERVICES STAFF AT THE TIME OF PERMIT SUBMITTAL - STANDARD DRAINAGE DETENTION SYSTEM WORKSHEET OWNER SIB �N ►.i CALL .BY: VLk'JAn ADDRESS �' PHONE:2�� DATE: *****DESIGN DATA***** IMPERVIOUS AREA PIPE DIA PIPE LG ORIFICE FINISHED RE:CEj'VE:® DETENTION PIPE LENGTH LOCKING LID (TYPICAL) ,-J-. MINIMUM Mi CO CIUBOX OR RISER OF -----TO OUTLET OUTLET CONTROL MIN. 2 5 200i JUL UPPER CATCH BASIN. aRIFICE DEVELOPMENT CONTROL CATCH BASIN CITY SERVICES CTR. OF EOM ONDS SYSTEM CROSS ' SECTION 2'X2'X6' DEEP, 4-6' SPALLS OR EOUAL FROM CONTROL CB 2'X 2'X 3' DEEP, 3/4' CRUSHED ROCK ExIST1NG GRADE / — FROM CONTROL R/PRAP OUTLET a ROCK OUTFLOW TRENCH, MIN 10' LONG. 1� PERF PIPE TO BE LEVEL PEREF PIPE W/ END CAPS PRIORHTOHPLACEMENTNOF WASHEDiDRAIN ROCK RUNOFF SPREADER.TRENCH ...................... FOOTING DRAINS SHALL NOT BE CONNECTED TO DETENTION SYSTEM NOTES. - I. Call Engineering Division (771-0220) for a tightline and detention system inspection before backfilling and for final inspections. APPROVED BY 2, Responsibility for operation and maintenance of drainage systems on private property is the 6l0 7 responsibility of the property owner. Material accumulated in the storage pipe must be flushed out and removed from the catch basins to allow proper operation. The outlet control orifice DATE must be kept ones at all times. Table 1 — Detention Pipe Sizes Impermeable Required Area Sq. Ft. Vol Cu Ft 2000 50 2500 62 3000 75 �. 3500 87 4000 100 4500 112 5000 125 Note: Allowable Pipe Materials: Impermeable Area So. Ft. 2000 2500 3000 3500 4000 4500 5000 Pipe Diameter 15" 18" 24' 30" 40 28 16 10 50 35 20 13 60 42 24 15 Required pipe 70 49 (::k8D 18 length in feet 80 56 32 21 90 63 36 23 100 70 40 25 Reinforced Concrete Aluminized Steel Aluminum CMP Asphalt Coated —12 ADS of permitted on roads) Table 2 — Outlet Orifice Sizes Outlet Orifice Diameter (Inches) 5/8 5/8 3/4 3/4 7/8 7/8 7/8 Table 3 — Rectangular Catch Basin Requirements Detention Max. size Catch Basin pipe diameter knockout Type < 18" 20" Type I, CB 15 18" to 24" 26" Type IL, CB 16 24" to 36" 36" Type II, CB 19 19 (48" Basin) 36" to 42" 42" Type II, CB 19 19 (54" Basin) *Source: Assoc. Sand & Gravel Co. Standards GW Revised 3/16/95 sk'Q ru�-m a k to c ONSIBLGE R a-s-� GTOR IS RESP �ry a, AND DAAINA 41 07 AREA 141 ��� 2 2o 8 2 ZoB�(4ce3 = 1 ��g�o 1 W1-- KV l 0U'3- � U K FAGE S o t� EA1JEFS 250� , r Ut2�V�waY Wa>rKs '(oo sr Torrd>_ 3 $oo SF -31coIN-wo - a 4% . RIGHT -OF WAY,'CONSTRUCTION P M J SftXS b DMV15-V-.a-, y WiQ•� '�16tt1ot L11�.D TU z . cv, V A C.8 0- Z = -N Pei c� s 3. ple rENr = 7$' 4 :k4" N -I Z w l v, 7-41, luvr% fX. d nAwms 110 %- LEI I C• RPrNC- d LID Lk. pVtr c vla Va s � \ p9,P")vaz c�, S1 Ds; S � i co cnkT- rGL-'t 1?c►-�- Zvi ?_0a cJ cu- c� D rz-\v 5, TEMPORARY' ,&rrw-,I-IVEt-> APPROVED AS NOTED FIRE AND AID ADDR SIN REQUIRED WATER & SEWER BY ENGINEERING INSPECTIONS REQ'D PLA CALL.,425-771-0220 EXT.1326 ��1-� 1 • ?;o 1 C Date: 2 oi� C l TT CD?J9T P) r. T 1 nL 1.. Critical Areas Checklist CA File No: Site Information (soils/to o by/hydrology/vegetation) 1. Site Address/Location: �� d� Vv\, 1-, V-\Z-j 2. Property Tax Account Number: '�J"i0 1�s 00 i — 00 1 OL 3. Approximate Site Size (acres or square feet): f 0 CIO 1 4. Is this site currently developed?1_ yes; _ no. If yes; how is site developed? 5. Describe the general site topography. Check all that apply. Flat: less than 5-feet elevation change over entire site. 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: 4 ; Approx. Depth: 7. Site contains areas of seasonal standing water: ; Approx. Depth: What season(s) of the year? 8. Site is in the floodway floodplain of a water course. 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round? Flows are seasonal? (What time of year? ). 10. Site is primarily: forested ;meadow ;shrubs ; mixed) urban landscaped (lawn,shrubs etc) 11. Obvious wetland is present on site: For Csty Sta 1. Plan Check Number, if applicable? z � k 2: • Site is -Zoned?` " ' Rs"{`• _ " 3. 5Mmappedsoiltype(s)? s A � WtioD 4. Critical Aieas iriveii 5: Site within desi�iat Use Only t r ory or C.A. map uidicates' Critical Area'"on'site? 6• d earth subsideiic'e iarid 77 C"T•.T T7HV' flflf %T T Critical Areas Checklist.doc/3.19.2001 �-�°FfrD City of Edmonds Development t Services Department Planning Division Phone: 425.771.0220 1 gqo 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: 5-1g -0 1 City Receipt #: I._I("( 1 Critical Areas File M Critical Areas" Checklist Fee: $45.00 Date.Mailed to Applicant: 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 attorney's 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 convect to the best of my knowledge and that I am authorized to file this applRition on the behalf of the owner as listed below. SIGNATURE OF APPLICANT/AGENT DATE 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 this application. SIGNATURE OF OWNER -fir/Applicant: Name Street Address City State Zip Telephone: 1)tPz� 2�d T7^713 Critical Areas Checklist.doc/3.19.2001 DATE 19 — 01 Applicant Representative: v`-7p�m Ile Name. Street Address City State Zip Telephone: Email Address (optional): .1 0 F EDllr_ ti PORCH WALK DRIVE V POLY, 180 PS WATER SERVICE 2' DEEP ANY M PIC VIEW DR STREET FILE 5' CITY SEWER EASEMENT WITH 8' CONC. MAIN WATER SERVICE 2' FROM PROPERTY LINE CITY OF EDMONDS WATERLINE AS —BUILT ADDRESS: PERMIT 7804 OLYMPIC VIEW DR N❑' BLD2001-0761 Fs NTRACT❑R: H❑ME❑WNER SCALE: ILVER CITY CONSTN XXXXX NTS DATE INSPECTED1 INSPECTED BY: DATE DRAWN1 DRAWN BY; 00-00-00 XX 06-29-07 J.TRIEU aM UT REEF FIDE • PERMIT..NO: 95.6 ity of Edmonds SIDE SEWER PERMIT PERMIT EXPIRES Address of Construction: —6 ' `NN v L LID # � /� Property Tax Account Parcel No. /1/9 37 Attach copies of all access and utility easements Verified and Approved by Owner and/or Contractor: Contractor License #:\1.�1��.C,act .�� Building Permit #: Q A�U Single Family Invasion into City Right -of Way: 0 Yes Rvio . ❑ Multi -Family (No. of Units _� *RW.Construction Permit # Commercial o. of Units Cross other **Private Property: ❑ � ) ..: El Yes : -ANo ❑ Public **Attach legal description and copy of recorded, easement. Owne /Contractor Owne ,or ntr r signa r an acknowledgement statement.. Date . By signing for this permit I rtify that I have read1the City's public handout entitled *ide*Sewer Specifications, and shall comply with allti,City requirements outlined therein. CALL DIAL -A -DIG (1-800-42�415555) BEFORE ANY EXC Iff FOR INSPECTION CALL 425-771-0220 extensionl3arw 24 HOUR NOTICE REOUIRED FOR ALL INSPECTION REOUES NtKMI I MUb I tat PU51 tU 'UN. JUb 51 I t,U' White Copy: File Green Copy: Inspector Buff Copy: Applicant VATIONV L;temp;bl dg;forins;ssperm itj lg4/00 r WE 4' 13' 5' CITY SEWER EASEMENT WITH 8' CONC. MAIN PORCH WALK �.0_ 11'4' 16'CO DRIVE 00M PIC VIEW DR �� of Eq CITY OF EDMONDS SIDE SEWER AS— BUILT ADDRESS, PERMIT f 7804 OLYMPIC VIEW DR NO, 9561 ` C❑NTRACT❑R1 HOMEOWNER: SCALE: SILVER CITY CONSTN XXXXXXXX NTS DATE INSPECTED: INSPECTED BYi DATE DRAWN: DRAWN BY; .&t.1890 XX-XX-20OX XXXXXX 06-29-07 J.TRIEU Ch' ' m m m :33 � A 0 m T -i �m ■ • co 4DATE RECEIVED i T ZL. D PERMIT EXPIRES •� USE PERMIT CITY OF EQMONDS ZONE V _• �'� NUMBER,--qX/ e� 7o6 CONSTRUCTION PERMIT. APPLICATION i IOB ADDRESS SUITE/APT# IER NAMEMAIyE OF BUSINESS 9%0t. . C\ \ (� )o �� + j PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. 1 � .ING ADDRESS \ ` -1. 1' v 111 �w 1.' W LID FEE $ / TESCP PUBLIC RIGHT OF VJAY.PER OFFICIAL ST EET MAP Permit Required ry RW at Use PermitR Street Use Permit R 'd CITY `l`J NAME �v ADDRESS CITY is ZIP „ TELEPHONE a ZIP TELEPHONE NAME j - Al�►r6Q_ C V N ADDRESS CITY ZIP TELEPHONE U17�'1 STATE LICENSE NUMBER S) uJEG C Oq� � � txr• %- PRO EF�jY (COUNT P(P�C�I,N1 V o NEW RESIDENTIAL ❑ ADDITION, ❑ COMMERCIAL ❑ REMODEL ❑ APARTMENT, ❑ REPAIR GRADING CYDS ❑ ❑ TANK !!DEMOLISH `/GARAGE RETAINING WALL ❑ LL CARPORT ."11.v PE OF USE, BU$gyESS OR ACTIVITY) EXPLAIN NUMBER NUMBER OF OF DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE EXISTING pROPO ED Impaction Required Sidewalk Required REQUIRED DEDI FT underground .. , aa'. ... A.+ Wiring required METER E LIN EI' °' WOF FIXTURES PRV REQUIRED . 90 YES IV NO ❑ z REMARKS W Z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE 1 1� .I. 'i .' 9W A W CHECKED BY PLUMBING / MECH ❑COMPLIANCE OR CHANGE OF USE ❑ SIGN ❑FENCE ( X FT) OTHER ENGINEERING REVIEWED/D TE 7 O/ FIRE REVIEWED BY DATE W 2 LL VARIANCE OR CU SHORELINE OR ADBk INSPECTION BOND !' REO'D POSTED ❑ YES ❑ NO SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXE PT ALLOWED PROPOSED ALLOWED PRRO�POOSED EXP I LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED7oPOS FRONT SIDE REAR 2.51 IpI 26 U FRONT R$IDE REAR �1/t5' 29 Z . PARKAG LOT AREA PLA I REVI ED ATE 5 REO'D I PROVIDED �av ❑ RENEWAL a..•,,.•,,.,,. t� i�^.++�.aG.� � F�7�.t"1�/e`a 1 �/ CHECKED BY TYPE OF CONSTRUCTION OCCUPAN GROUP CRITICAL AREAS D JPROGRESS SPECIAL INSPECTOR AREA 15rr•I��� OCCUPANT NUMBER REQUIRED ElYES 'ILOAD REMARKS INSPECTIONS PER UBC 108/1FINAL INSPECTII VALUATION FEE cs 3N REO*D c J V IAA m PLAN CHECK FEE _ HEAT SOURCE 1 ZIN� *y LOT SLOPE % �a BUILDING 1 ILAI �L•//�� 7_ PLAN CHECK Nfr�; VESTED DATE PLUMBING f U MECHANICAL O �� THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO r- BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC 19F1s191W�Phtl "')O ++ DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE J SEPARATE PERMISSION. t% STATE SURCHARGE i w PERMIT APPLICATION: 180 DAYS s — a PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED.WITHIN 180 DAYS ENG. REVIEW FEES ('7 SEE BACK OF PINK PERMIT FOR MORE INFORMATION y 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS; ASSIGNS AND SUCCESORS ENG. INSPECTION FEE ..: 'I , 4 V W W IN INTEREST, AGREES 74 IbiKMNIFY, PEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING jj EDMONDS.WASHING70N,:FFICIALS,EMPLOYEES,ANDAGENTSFROM ANY AND INSPECTION FEE 4 .. ALLCLAIMS FOR DAMAF,E $.9F WHATEVER NATURE ARISING DIRECTLY OR INDIRECTLY a = FROM THE ISSUANCE O AERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT RECEIP G DEEMED TO MODIFY, WAIVE EDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE J = NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' TOTAL AMOUNT DUE RECEIPTo ,,// �� 1 HEREBY ACKNOWLEDGE THAi�FP• IAQE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT; AND THggT��I �A THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL THE OWNER. I AGREE TO COFAeE ,PITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application is not a permit until signed by the TION: AND IN DOING THE WOFjK. UTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and IN VIOLATION OF THE LABOWPOOE OF THE.STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided. WORKMEN'S COMPENSATION! SURANCE AND RCW 18.27. IG/ UR (OWN GENT) DATE SIGNED (425) OFF ALS SIGNATURE DATE 771-0220 ;+ A ENTI N EXT 1333 RELEASED BY DATE IT IS UNLAWFUL TO USE OR OCCUPYBUILDING OR STRUCTURE UNTIL' - • .A 771-0221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- " -,.., ORIGINAL- FILE YELLOW - INSPE OR r CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 -OWNER GOLD - ASSESSOR . _.'�' �:. ' `-�: b' `Ji./-'�-'.. Tl. �i' t'r>Y•1�{`.Y�...nn..N�.�,vvN�:r•.+-J`J�. u"�"...... ..rJ �♦ ! '. .".�.-v .i` f.^ ..T v ` �/// � e. City of Edmonds L Permit No: 2001 M75 F. RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date: If d A. Address or Vicinity of constfuction: CPv ! B. Type of Work (be'specific): �f J��1d < )\ CamG 5�20 U r p t o (nr) 7 f 1-7 C. ' Contractor:. PSc_ ( t (2-O v-\4 Contact: 1� �>1C� \CIS �Gu c, �.� , • tc:•' �', Mailing Address: .) .)"n Q &JPhone:: (o L I I 3 9 R'( 33 State License #: Liability Insurance: Bond: $ ' J L C i-I L .S- I ca 'I V:� O Z- c- 7- D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): E. ❑ Commercial ❑ Subdivision . ❑ City Project ❑ EUC.(PUD; GTE, PSE, CHAMBERS, OVWD) ❑ Multi -Family Single Family- ❑ Other INSPECTOR. `F. PAVEMENT: ❑ YES ❑ NO G. SIZE OF CUT X H. Charge: $ ., ONCRETE CUT: ❑ YES ❑ NO tf' ��. -'`• APPLICANT TO READ AND SIGN IDEMNITY.• Applicant understands by his/her signature to this application he/she.liolds 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 but not 'limited to the defense of any legal" proceedings including defense costs and attorney fees by reason ofgranting 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. ♦ Traffic control and public safety shall be in accordance with City regulations as required by the City. Engineer. Every flagger must be trained " required by (WAC) 296-155-305 'and must have certification .verifying completion of the required training in their dossession. ♦ Restoration is to be in accordance with City codes. 'All street -cut trench work shall be patched with asphalt or City - approved material prior to the end of the workday — NO EXCEPTIONS. ♦ Three sets'of construction drawings of proposed work are required with the permit application. I HAVE READ THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE THAT I MUST MAKE THE PINK COPY OF THE PERMIT AVAILABLE ON SITE AT ALL TIMES FOR INSPECTIONS Signature: Date: ' I � (Contractor or Agent) CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK. �`"'FOR•CI-TY USE ONLY Approved byte ,_Mn n4k 4 Right-of-way Fee: T1me,Authorized:- ,Void After /' / - G 2 .-Disruption Fee/Fund 111. Special, Conditions: 1 NT, $ I IV �. 3� till✓ 'Restoration Fee: dr- Vim(:- #t I-L fi V jn Total Fee: _t �1•fnt2S .1l1I Receipt No: � � .�_ . ,'Issued. by:,-, Ir UPON COMPLETION OF PERMITTED WORK, AN ENGINEERING FINAL INSPECTION IS REQUIRED PER CHAPTER 18.00 OF. THE EDMONDS COMMUNITY DEVELOPMENT C DE. FINAL APPROVAL OF PERMITTED WORK: INSPECTOR SIGNATURE DAtt For inspection requirements see Engineering Information Hando