9104 OLYMPIC VIEW DR.PDF9104 OLYMPIC
VIEW DR
ADDRESS: q I o -1 OL,\ wl 1.G
TAX ACCOUNT/PARCEL NUMBER: 0 /1 i'7 GYo ,;?.o -3 1 D n
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED: I"I 0M
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER): P "1 O - 0 901S
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORT PLAT FILE:
SIDE SEWER AS BUILT DATED: I I
SIDE SEWER PERMIT(S) #: 11 1
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
OTHER: },A] 1 1 l rq<z
LID #:
LOT: BLOCK:
LATEMP\DSTs\Forms\.Street File Checklist.doc
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CITY of E D M DS 4#E SEW..E.R P1,RAIT
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For Inspection Cal'1 771-3202 �, RL PERMIT N09`�
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Address of Construction: Fi e ' i 16 F�
Property Legal Description (Include all easements): d 3
Owner and/or Builder: ?40
Contractor & License No: L:�/1�% C� / 7 MCA
Si ngl e Family Residence
Multi -Family (No. of Units )��"'
EDMONDS
r Commercial (No. of fixture Units ) TREATMENT PLANT
Invasion into City Right -of -Way: No to`-- Yes (If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No w__'Yes (If Yes, easement required,
attach legal description and county easement number.)
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PLEASE READ THE ITEMS LISTED ON THE BACK R c l,� ci c v
OCT 2 11988 _ _
I certify that I have read and shall comply PUBLIC WORKS Date
with the items listed on the back.
Permit Fee: _
Trunk Charge:
Assessment Fee:
i9
25"
'Issued By:
fDate Issued: 21 "fig
Receipt No.: 94�1(o
Partial Inspection:
Comments Date Initial
Final Inspection Approved:_
Date Initial
Rejected:
eason Date Initial
** PERMIT MUST BE POSTED ON JOB SITE **
Wh.ite Copy - File Green Copy -'Inspector Buff Copy - Applicant
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MEMO TO: Building Division
FROM: Engineering Division
SUBJECT:
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.
b) water and sewerl1 ines to be separated by 10 foot minimum.
7) Builder/owner.responsibl`e for containing all temporary runoff and
erosion on site and .may pot. 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.�im. .to 6:00 p.m. on weekends and holidays.-
9) No burning of construction refuse wi thn-u+ -;g=rnval by Fire Dept.
1hc.18913
CITY OF EDMONDS
121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771-0221
Website: wmci.edmonds.wa.us
DEVELOPMENT SERVICES DEPARTMENT .
Planning • Building • Engineering
March 7, 2005
Mr. David English
104 Olympic View Drive
Edmonds, WA 98026
GARY HAAKENSON
MAYOR
�3-7
L z
k4
RE: Construction of Retaining Walls on Olympic View Drive and Sunset Way
Dear Mr. English:
I received your letter dated February 17, 2005, but was out of the office last week, so I
was unable to respond earlier.
We have checked our records,.and the Sunset Way right-of-way width is in fact 20 feet in
front of your property. Therefore, we agree with you that your retaining wall along
Sunset Way appears to be on private property and may remain in its current location.
However, as I indicated to you on the phone earlier this week, the retaining wall along
Olympic View Drive must be removed immediately because of safety concerns and
because it is in the city right-of-way. I noticed that you have begun to remove this wall
and I appreciate your responsiveness. Please complete removal of the retaining wall by
March 11, 2005. Once the wall has been removed, the slope needs to be revegetated.
Please complete revegetation by March 31, 2005.
If you plan to reconstruct a retaining wall on your property along Olympic View Drive, I
strongly suggest that you carefully review the Retaining Wall Permit Submittal
Requirements handout previously provided to you. If you have any questions about .�
permit requirements, please feel free to contact a Development Services Permit
Coordinator at 425 771 0220.
Thank you for your cooperation.
S' erely,
UANE V. BOWMAN
Development Services Director
Cc: Dave Gebert, City Engineer
Jeannine Graf, Building Official
Rob Chave, Planning Manager
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Bowman, Duane
From: DS Car Wash [ds.carwash@verizon.net] i
Sent: Friday, March 25, 2005 8:36 AM
To: Bowman, Duane
Subject: RE: construction wall olympic view dr sunset way
Duane,The block wall install by others has been. removed and the slope restoration has been
completed. Thank you for your patience. Thanks Dave English
-----Original Message -----
From: Bowman, Duane[mailto:Bowman@ci.edmonds.wa.us]
Sent: Thursday, March 10, 2005 7:31 AM
To: 'DS Car Wash'
Cc: Gebert, David
Subject: RE: construction wall olympic view dr sunset way
Dave,
Thanks for your prompt response to this situation. I appreciate it.
Duane Bowman
Development Services Director
City of Edmonds
(425) 771-0220 FAX (425) 771-0221
-----Original Message -----
From: DS Car Wash [mailto:ds.carwash@verizon.net]
Sent: Thursday, March'10, 2005 7:25 AM
To: Bowman@ci.edmonds.wa.us
Subject: construction wall olympic view dr sunset way
Mr. Bowman. I received your letter dated March 7, 2005. Thank you for you response. The
walls I had constructed on Olympic View Dr. have been removed. Any remaining walls or
barricades in the right of way on Olympic View Drive were constructed by others prior to
us purchasing our home in June of 2000. I am meeting with the landscaper today about
revegatating the slope. I will be submitting info to the city on Friday (3/11/05) for
comment. Thanks Dave English 9104 Olympic View Drive Edmonds, WA. 98026 425-774-7610
fnc.18°)0
March 16, 2005
0 S?kEET
CITY OF EDMONDS
121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771-0221
Website: wwwdedmonds.wa.us
DEVELOPMENT SERVICES DEPARTMENT
Planning • Building • Engineering
Mr. David English
9104 Olympic View Drive
Edmonds, Washington 98026
RE: Construction of Retaining Walls on Olympic View Drive and Sunset Way
Dear Mr. English:
FILE
GARY HAAKENSON
MAYOR
The purpose of this letter is to follow-up on the letter written by the Development Services
Director on March 7, 2005 and the conversation you had with City Planning and Engineering
staff at City Hall on March 14, 2005:
• Regarding Critical Areas: Rob Chave, Planning Manager has determined that a
geotechnical report will not be required to stabilize the slope. However, you are still
required to revegetate the slope by the previously established deadline of March 31, 2005
and contact the City when the work is complete.
• Regarding the Retaining Wall: After speaking with staff about your progress in
removing portions of the retaining wall from Olympic View Drive right-of-way; the City
Engineer, Dave Gebert, P.E., has determined that all portions of the wall (regardless if
the wall was pre-existing to your purchasing of the property) must be removed from City
right-of-way. This work must also be complete by the March 31, 2005 deadline, -please
contact the City when the work is complete.
If you have any questions about these decisions please refer to the appropriate Manager as noted
above. If I can be of further assistance you may reach me at 425-771-0220 extension 1226
during City business hours.
Sincerely,
aw��
Jeannine L. GKf
Building Official
Cc: Duane Bowman, Director Development Services
Dave Gebert, P.E., City Engineer
Rob Chave, Planning Manager
• Incorporated August 11, 1890 •
Sister Citv - Hekinan. Japan
4•
loc. 18 W3
CITY OF EDMONDS
121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771-0221
Website: wwwdedmonds.wa.us
DEVELOPMENT SERVICES DEPARTMENT
Planning • Building • Engineering
March 7, 2005
Mr. David English
9104 Olympic View Drive
Edmonds, WA 98026
GARY HAAKENSON
MAYOR
RE: Construction of Retaining Walls on Olympic View Drive and Sunset Way
Dear Mr. English:
I received your letter dated February 17, 2005, but was out of the office last week, so I
was unable to respond earlier.
We have checked our records, and the Sunset Way right-of-way width is in fact 20 feet in
front of your property. Therefore, we agree with you that your retaining wall along
Sunset Way appears to be on private property and may remain in its current location.
However, as I indicated to you on the phone earlier this week, the retaining wall along
Olympic View Drive must be removed immediately because of safety concerns and
because it is in the city right-of-way. I noticed that you have begun to remove this wall
and I appreciate your responsiveness. Please complete removal of the retaining wall by
March 11, 2005. Once the wall has been removed, the slope needs to be revegetated.
Please complete revegetation by March 31, 2005.
If you plan to reconstruct a retaining wall on your property along Olympic View Drive, I
strongly suggest that you carefully review the Retaining Wall Permit Submittal
Requirements handout previously provided to you. If you have any questions about
permit requirements, please feel free to contact a Development Services Permit
Coordinator at 425 771 0220.
Thank you for your cooperation.
SLerely,
V. BOWMAN
Development Services Director
Cc: Dave Gebert, City Engineer
Jeannine Graf, Building Official
Rob Chave, Planning Manager
Street file
0 Incorporated August 11, 1890 •
RECEIVED
FEB 2 8 2005
ENGINEERING DIVISION
February 17, 2005
MR. Duane V. Bowman
City of Edmonds
Development Services Director
121 5t' Avenue North
Edmonds, WA. 98020
Ref: Construction of Retaining Wall on Olympic View Drive
Dear Mr. Bowman;
FEB 2 1 225
DEVELOPMENT SERVICES
Tao-e ,�Zz
NZWE2101-1001,
I received your letter dated February 14, 2005 concerning the retaining wall on Olympic
View Drive and the retaining wall on Sunset Way. We will be taking action to correct the
Olympic View Drive retaining wall issue as described in the first paragraph of your letter.
The fourth paragraph of your letter indicated there was a possible issue that the retaining
wall on Sunset Way was in the right of way. I met with Don Fiene today to discuss the
wall issue. Don checked the plat for right of way width (20'), I provided a photo of the
wall showing the relation of the wall to the roadway (approx 5" from the edge of the
roadway), roadway width (approx 19' 8"), the conclusion was the wall was likely not in
the right of way. This should satisfy the issue in the fourth paragraph of your letter.
I am requesting an extension of the March 1, 2005 correction deadline to allow me time
to notify my wall contractor, collect the required documents and plans to submit to the
city for review, permitting and completion of our project. I hope to have a projected
schedule for you by the end of next week.
Sincerely,
David A. English
9102 Olympic View Drive
Edmonds, WA. 98026
425-774-7610
ds. carwash@verizon.net
U
IBC. 18913
CITY OF EDMONDS
121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771-0221
Website: www dedmonds.wa.us
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
February 14,12005
David & Sheryle English
9104 Olympic View Drive
Edmonds, WA 98026
RE: Construction of Retaining Wall on Olympic View Drive
Dear Mr. & Mrs. English,
GARY HAAKENSON
MAYOR
It has been brought to the attention of the City of Edmonds that you are constructing a multi -tiered
modular block retaining wall on the Olympic View Drive side of your house. Based on a field
investigation, it appears the wall is being constructed within the City right-of-way and on a steep
embankment. In addition, we noted the wall appears to be constructed of different block type; there are
wide gaps between the blocks; no drainage rock or drain pipe was evident; the wall was erected up to a
tree stump; and there appears to have been undermining and failure of wood hill holders.
Retaining structures are not permitted to be constructed within the City right-of-way and must remain on
private property. Please contact Lyle Chrisman, Engineering Program Manager, at 425-771-0220,
Ext. 1324, regarding the location of the wall in relation to the City right-of-way. To determine the exact
location of the edge of the right-of-way, it will be necessary for you to have it located by a licensed
surveyor. Please remove the block wall from the City right-of-way and restore and vegetate the slope to
City Standards. If you have questions on slope restoration, contact Don Fiene, Assistant City Engineer, at
425-771-022, Ext. 1323.
In addition, the block wall constructed along the front of your property also appears to be in the City
right-of-way and must be relocated onto private property.
Enclosed for your information is a City of Edmonds Retaining Wall handout. Please review this handout
for permitting requirements and design criteria.
Please take the necessary action to correct these issues by March 1, 2005. Failure to remove the retaining
walls from the City right-of-way will necessitate a Notice to Correct and, if not corrected, lead to a Notice
of Violation which carries a $100 per day fine until the work is corrected. Finally, should a failure of the
retaining wall impact or damage the City right-of-way or harm the public traveling on the City right-of-
way, �Pe City's position is that you will be liable for such impacts and responsible for their costs.
SinJely,
G�Gur'�
V.
Development Services Director
c: David Gebert, City Engineer
Jeannine Graf, Building Official
Rob Chave, Planning Manager
Street File
S:\ENGR\PRrVATE DEV&LOMENT PROJECTS\CORRESPONDENCE\9104 OVD Retaining Wall.dce
• Incorporated August 11, 1890 0
I-4c.18o/0
CITY OF EDMONDS
121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771-0221
Website: www.ci.edmonds.wa.us
DEVELOPMENT SERVICES DEPARTMENT
Planning • Building • Engineering
February 14, 2005
David_& Sheryle English
\9104 Olympic View Drive
Edmonds, WA 98026 "
RE: Construction of Retaining Wall on Olympic View Drive
Dear Mr. & Mrs. English,
GARY HAAKENSON
MAYOR
It has been brought to the attention of the City of Edmonds that you are constructing a multi -tiered
modular block retaining wall on the Olympic View Drive side of your house. Based on a field
investigation, it appears the wall is being constructed within the City right-of-way and on a steep
embankment. In addition, we noted the wall appears to be constructed of different block type; there are
wide gaps between the blocks; no drainage rock or drain pipe was evident; the wall was erected up to a
tree stump; and there appears to have been undermining and failure of wood hill holders.
Retaining structures are not permitted to be constructed within the City right-of-way and must remain on
private property. Please contact Lyle Chrisman, Engineering Program Manager, at 425-771-0220,
Ext. 1324, regarding the location of the wall in relation to the City right-of-way. To determine the exact
location of the edge of the right-of-way, it will be necessary for you to have it located by a licensed
surveyor. Please remove the block wall from the City right-of-way and restore and vegetate the slope to
City Standards. If you have questions on slope restoration, contact Don Fiene, Assistant City Engineer, at
425-771-022, Ext. 1323.
In addition, the block wall constructed along the front of your property also appears to be in the City
right-of-way and must be relocated onto private property.
Enclosed for your information is a City of Edmonds Retaining Wall handout. Please review this handout
for permitting requirements and design criteria.
Please take the necessary action to correct these issues by March 1, 2005. Failure to remove the retaining
walls from the City right-of-way will necessitate a Notice to Correct and, if not corrected, lead to a Notice
of Violation which carries a $100 per day fine until the work is corrected. Finally, should a failure of the
retaining wall impact or damage the City right-of-way or harm the public traveling on the City right-of-
way, tlhe City's position is that you will be liable for such impacts and responsible for their costs.
Sincerely, '
7` E
DVANE V. BOWMAN
Development Services Director
c: David Gebert, City Engineer
Jeannine Graf, Building Official
Rob Chave, Planning Manager
Street File
SAENGR\PRIVATE DEVELOMENT PROJECTS\CORRESPONDENCE\9104 OVD Retaining Wall.doc
• Incorporated August 11, 1890 0
VI-i�-L3 of- I�,�
CITY OF EDMONDS
L(d NEW
❑ ADDITION
❑ RETIREMENT
ASSET INFORMATION SHEET
STREET FILE
ASSET NO.
ADDITION TO ASSET NO.
DESCRIPTION /
SERIAL NO.
LOCATION T
O 401/ / l � ✓ill ✓ -
DEP . NO.
-.
* * PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
u
* PROJECT NUMBER '�61d J%50 %il
PROJECT COMPLETION DATE �/
COST • Sl�F
B.A.R.S. ACCOUNT NO.
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
U DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
0 G.L. ENTR
REFERENCE DATE
VERIFIED BY
PROCESSED
BATCH NO. -
b P INITIA
DEPARTMENT FILE
STREET FILE FINAL PROJECT APPROVAL FORM
TO: M6
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM:
IRE DEPARTMENT DATE
PLEASE SIGN
DATE: 3--4? 2_-Q5 "
ENGINEERING DIVISION DATE
PLEASE SIGN -
PLANNING DIVISION DATE 31-2
PL SIGN
PROJECTi✓��S /� �^ I���J%g�a'✓ D� /� !�V .S�D.�?G.
SITE ADDRESS
PERMIT # �v� ADB# /✓/Q DATE INSPECTED 31ZZe
DESCRIPTION OF WORK TO BE INSPECTED /1 C'�i'Pel�7'"C%✓
A field inspection ,was conducted to determine compliance .with -approved plans.: Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of :
.V. /
•mil / cJ ��la G,/•g/1
w �u ' rr ✓ A -lee _ ul,e-gie A7 104 X.Ie..now
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED � Cl%�J��iyi✓�f✓ ��
❑ Copy of CONDITIONS given to owner/contractor by inspector AO,
10G /1G .-11e0feA#
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
❑ Copy of CORRECTION NOTICE given to owner/contractor by inpector
I.
Ipc_ 1891,
March 16, 2005
CITY OF EDMONDS
121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771.0221
Website: www.d.edmonds.wa.us
DEVELOPMENT SERVICES DEPARTMENT
Planning • Building • Engineering
Mr. David English
9104 Olympic View Drive
Edmonds, Washington 98026
RE: Construction of Retaining Walls on Olympic View Drive and Sunset Way
Dear Mr. English:
GARY HAAKENSON
MAYOR
The purpose of this letter is to follow-up on the letter written by the Development Services
Director on March 7, 2005 and the conversation you had with City Planning and Engineering
staff at City Hall on March 14, 2005:
• Regarding Critical Areas: Rob Chave, Planning Manager has determined that a
geotechnical report will not be required to stabilize the slope. However, you are still
required to revegetate the slope by the previously established deadline of March 31, 2005
and contact the City when the work is complete.
• Regarding the Retaining Wall: After speaking with staff about your progress in
removing portions of the retaining wall from Olympic View Drive right-of-way; the City
Engineer, Dave Gebert, P.E., has determined that all portions of the wall (regardless if
the wall was pre-existing to your purchasing of the property) must be removed from City
right-of-way. This work must also be complete by the March 31, 2005 deadline, please
contact the City when the work is complete.
If you have any questions about these decisions please refer to the appropriate Manager as noted
above. If I can be of further assistance you may reach meat 425-771-0220,extension 1226
during City business hours.
Sincerely,
aA*0�
Jeannine L. GKf
Building Official
Cc: Duane Bowman, Director Development Services
Dave Gebert, P.E., City Engineer . STREET FILE
Rob Chave, Planning Manager
• Incorporated August 11, 1890 •
Sister Citv - Hekinan, Japan
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CITY OF EDMONDS'. Permit No. g 'R '3 %
COMMUNITY SERVICES DEPARTMENT STH"EET
���� .Issue Date
RIGHT-OF-WAY CONSTRUCTION PERMIT
A. • Owner:. • Washington Natural Gas
NaW65-156 AV NE
Mailing Address
Re11ey a WA 98007
B. • Contractor: S amm
Name
Mailing Address
City State Zip . City State Zip
447-0700
State License Number Telephone Number.
• Address or Vicinity of Construction: --9104 Olvmraic View DR
Type of Work to be Done: gas service: installation .
f 't.
Work in Connection With: ❑ Sub or Plat ❑ Single Family ❑ City Projects
E. ❑ Commercial ❑ Multifamily iXUfility .
.z Pavement Cut: ❑, Y ❑ N
4
U
APPLICANT TO READ AND SIGN
a
INDEMNITY: 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, forseen or unforseen,'thatmay
be made against the City of. Edmonds, or any of its departments or employees, including or not limited to the defense
wof any legal proceedings including defense costs, court costs, and attorney fees by reason of granting this permit.
H
a THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE
YEAR FOLLOWING,.THE FINAL INSPECTION AND -ACCEPTANCE OF THE WORK..
i,
U Funds held from the Security Depo9iV(estimated restoration fee) will be held until the final street patch is completed
W by City forces, at which time a debtor credit, will be processed for issuance to the applicant.
s�
r % .
s A 24 hour notice is required for inspection; -:Please call Public Works: 771-3202
• Work is to be inspected�dufing progress and at- completion.
W Restoration to be in accordance with City Code.
• Street to be kept clean at all times.
• Traffic.Control to be in accordance with City regulations.
O
W
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All .street -cut ditches must be patched with asphalt or. City approved material" prior to end of working "day;
no excebtions..
I understand the above and that this permit must be available at the job site for inspection purposes at all times.
Signature:
Date: 09-=02-88
Owner or Contractor
This Permit Must Be Posted at the Job Site For Inspection Purposes
Call DIAL -DIG Prior To Beginning Work
ISSUED BY: �/ n
Time Authorized: Void after n days.
Special Conditions: % `r
Amendments:
PERMIT FEE: 4 ' rj-
Security Deposit:
Receipt -No.:
Fund III Fee:
Street Cut Dimensions:
x
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. July 1985
FIELD INSPECTION NO S (Fund I I I - Route copy to Street Dept.)
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY:. Date:
Eng. Div. Jul
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;EIVED
91988
(e WORKS
REVIEWED BY:
PLANNING'. F UTEERM
i ,;,
USE PERMIT
CITY OF EDMONDS zDNE Z NUMBER
CONSTRUCTION PERMIT APPLICATION doa
NAME (OR�
NAME OF BUSINESS) ADDRESS �&a y ��
�A2� �E
E � ( r_A1_� PC. i F 1 c 4o hC� S LEGAL DESCRIPTION C7ECKSUBDIVISION NO. LID NO.
MAILING ADDRESS 3� 2 7-8 /5'/
Ll 5 3 v 13151- , S TESCP
CITY TELEPHONE NUMBER PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. APPROVED BY
t^ h U.J 064 -) y ; ,�9 � C., EXISTING �o REQUIRED DEDICATION
NAME PROPOSED_
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED
ADDRESS STREET USE PERMIT REQUIRED
Z-') SEE ENGINEERING MEMO DATED O �(�/ REVIEW BY
CITY TELEPHONE NUMBER115vQ d`
REMAR
NAME
49�C-4F ,
ADDRESS
METER SI E BUILDING SUPPLY SIZE FIXTURE
CITY TELEPHONE NUMBER
REMARKS
STATE LICENSE NUMBER n
�'v f �l Z A/� // / C SION AREA ENV. REVIEW ADS NO.
Legal Description of Property - Include all easements ALLOWED PROPOSED COMPLETE EXEMPT
(show below Or attach four copies) SHORELINE#
VARIANCE OR CU PLANNING REVIEW BY IDATE
5 e OLw• e t 7�
U NEW
A RESIDENTIAL
Li PLUMBI
ADD/ALTER
1:1COMMERCIAL
MECHAI
REPAIR
RETAINING WALL
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❑ PRE -MOVE INSPJ
SWIM
REMODEL
COMPLIANCE INSP.
POOL
WOOD
NSERTVEI a APT. BLDG
RENEWA
NUMBER OF STORIES I NUMBER OF
J' DWELLING
(r{J 11'% •iS6 ]tw.J.. i UNITS
v'
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
CoTuS;2u T- Lj ew St �e
w, \C s I d,
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: 1 Year- Provided Work is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
y
successors in interest, agrees to indemnify, defend and hold
J
harmless the City of Edmonds, Washington, its officials,
s
employees, and agents from any and all claims for damages of
cr
whatever nature, arising directly or indirectly from the issuance
0
of this permit. Issuance of. this permit shall not be deemed to
o
modify,. waive or reduce any requirement of any city ordinance
x
nor limit in any way the City's ability to enforce any ordinance
provision."
I hereby acknowledge that I have read this application; that the
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
state laws regulating construction; and in doing the work authoriz-
ed thereby, no plIrson will be employed in violation of the Labor
Code of the State of Washington relating to Workmen's Compensa-
tion Insurance.,
SIG TURF AG T)
DATE SIGNED
VNIR
T ILOT COVERAGE
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E7YER6Y CODE
VALUATION
PLAN CHECK FEE
BUILDING
PLUMBING
3 91
MECHANICAL
GRADING/FILL
STATE SURCHARGE
3.S">7
ENERGY CODE
PLAN CHECK DEPOSIT
a & /3
TOTAL AMOUNT DUE
,3o
ATTENTION
APPLICATION APPROVAL
THIS PERMIT
This application is not a permit until
AUTHORIZES
ONLY THE
signed by the Building Official or his
WORK NOTED
Deputy; and fees are paid, and receipt is
acknowledged in space provided.
INSPECTION
DEPARTMENT
OFFICIAL'S S E DATE
CITY OF
EDMOND
771�
ATT E I O N
ASED B : DATE
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3. PIN! .7 Owner GOLD -- Assessor
i i ALF ZIFILL.
7 /:50
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