20050865.pdfDATE RECEIVED
`A I PERMIT EXPIRES
CITY OF EDMONDS NUMBIER --C
CONSTRUCTION PERMIT APPLICATION JO DRESS , SUITEIAPT#
SER NA EINAME OF BUSINESS / < `
PLAT NAMEISUBDIVISION NO. LOT NO. LID NO
MMAILING ADDRES
LID FEE S
z<4
3
r , / C% PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved O
O I 1 �.�(, ! RW Permd Requved E3
CI Seeel lion Permit Rrgeued
n ZIP TELEPHONE EXISTING PROPOSED InspocUunRegwred��Qj
� � �On ZU % �.+ �� SidewalkRequiteduud
(J ��s / I REQUIRED DEDICATION �_ FT Underground O
WOW) requited 13
NAME METER SIZE LINE SIZE IJO. OF FIXTURES PRV REQUIRED
YES O NO O z
z
Lu
Lu
ADDRESS REMARKS w
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE 3
1 • .. . \ i. _ .. t. _ .. .. zw
r
a
��UYVi i� l tJl 1 Z) - Vfi
ENGINEERING REVIEWED BY DATE
AD' Tq,
(L oLfi LL'
Lwv&
FIRE REVIEWED BY DATE w
-
ZIP T EPHON���_
VARIANCE OR CU SHORELINE OR ADB# INSPECTION SEPA w
STATE LICENSE NUMBER EXPIRATION DATE CF BY
1) ftl 6 REQ'D COMPLETED EXEMPT
CL ce5
OYESAl NO
CA# ZONE SIGN AREA HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO.
lb
rl Q C�� / %� WAIVER O R� ALLOWED PROPOSED ALLO'N ID PROPOSED
V V LJ Wnommun� t/ STUDY O , /• �L S N I G
RESIDENTIAL LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
❑ NEW 4 ❑ PLUMBING I MECH ALLOWED PROPOSED FR_QNT r= S� E REAR FRONT LIR SIDE REAR
❑ COMMERCIAL ❑ COMPLIANCE OR 3 5 % 3 I �r NI So i`3 t •y z
ADDITION CHANGE OF USE t 4 / z
❑ MIXED USE PARKINGLOT AREA PLANNING REVIEWED BY DATE 5
❑ REMODEL ❑ IL
MULTIFAMILY ❑ SIGN REQ'0 PROVIDED
FENCE % NIC 4� VO gXrt N �
❑ REPAIR ❑ GRADING CYDS El_ ( X FT.) REMARKS y,�
❑ DEMOLISH ❑ TANK ❑ OTHER ( �e ro (et*� ��'IV �, dpi 4
❑GARAGE RETAINING WALL FIRE SPRINKLER ` I - (0 t �
CARPORT ❑ ROCKERY " ❑ FIRE ALARM
(TYPE F USE, B (NESS cW ACTIVIM EXPLAIN: �9 344, C 51
TYPE OFjCgUCTION DE I OCCUPANT
GROUP
i NUMBER NUMBER OF
OF DWELLING I SPECIAL INSPECTION CONSULTANT OCCUPANT
STORIES .
DUNITS REQUIRED 0 YES LOAD
DESCRIBE WORK TO BE DONE
REMARKS z
L �� • r r `"a GEOTECH REPORT
BY: n
STRUCTURAL DESIGN
r� BY:
tr`5 VALUATION/!
$ C.•� l
Descripti✓✓✓onn FEE Description FEE
Plan Check State Surcharge
HEAT SOURCE LOT SLOPE% VESTED DATE
Building Permit City Surcharge
O
0
M
cM
M0
O.
OC
_M
mZ
lt' �
CZ
O mn
=n
mrn
O�
r
C 0)
r Z
D
Z
2
Z
O
n
M
PLAN CHECK NO: _ Plumbing Base Fee
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO Mechanical
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
f DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC,) WILL REQUIRE Grading "
J
SEPARATE PERMISSION.
PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5) Engr. Review ./
:L PERMIT LIMIT: SEE ECDC 19.00.005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engf. Inspection
N 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire_ Review Plan Chk. Deposit
w IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
M EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # 7 '(,
sALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape InSp. Total Amt. Due
= NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.*
Recording Fee Receipt # �S
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF This application is not a permit until signed by the
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN D ING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL Building Official or hislher Deputy: and Foes aro paid. and
IN VIOLATION O E LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided.
WORKMEN'M ATION INSURANCE AND RCW 18:27,
FFICIALS SIGNAT E 0 TE
GN%AT�U (OWNER A)GE ►. w� I ATE Si �1
ED U� (425) `
r✓-.:�`'\ Z 771 m0220 R .li l TE lJ
ATTENTION EXT. 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI-GIN L - FILE Y L OW -INSPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 I IBC110 I IRC110, I' - OWNER D - ASSESSOR
10104 PRESS HARD = YOU ARE MAKING 4 COPIES
��.IA Jeb. - I I coavv:2 rrl N N f�r�.,U �.vl '!.7
tniv 5.1 5c%t-loacP;.( I to')•
APPROVED BY PLANi�l►��u t� �dve•oil 1/7'4w
0
m�X dt'�tancc.
i5 3*41
EA6T IN.lbl'
6a,3I'
Zone• P_I—. CornerNnFlag I\1 d I I6TI
Actual ea �r. ./
Setbacks Rdquired — EicAS 6 a uvl
I AS 625 6fiFT
�
Front
Sides
15 I
Rear STM 6= Wax I I z
Other
Bei t - $$ I I n
m
_-
��yy� soar VAN OWK 4 m
c
m
m z
Ij :a1eTlri��slpEwcE; , � I I r4 -a .
noM worwerr ut TO 1060 60. fT. EMST McKHRY D z
I roopow two ovq o=ac I � ;
cn
ADD GU 7Ei�S`/DOWNSPOUTS _ I - — - — - - J
I ��
r, r ,
ANq SPLASHBLOCKS
'
lU I -� r m m
106' DLDb TO NL l /, '. ; , I LI6' WWII TO Is& \\
4Wd)' 0 IMi81' rt*Y CLEAM PA. DY J 1091 I t m 0
Div
I'
Z�
ALLEY
BARBARA SHINN
r -t
710 SPRUCE STREET
EDMONDS WASHINGTON
m 5 to 4O 40 z
N 00484500500200 _
- I TAX ACCOUNT
LOT COVERAC� �}- o
I�o81 SQ. FT. (230) SII E FLAN
LOT AREA: I" =20'-0" m
I '102(o SQ.
FT.
I IMPERVIOUS SERFACE CALC'S l SOLID SURFACES)
EXIST, BUILDING OUTLINE (INCL. EAVES.):
4
11261.61 SQ, FT. (CONSTRUCTED IN 1913)
EXIST.' DETACHED GARAGE: 396 50. FT. (CONST. IN 1913 7) ;
EXIST. SIDEWALKS: III SQ. FT. (CONST. IN 199'1 �) f
I EXIST, DECK: 231 SQ. FT. (CONST. IN 1990)
I
PROPOSED ROOF OVER DECK: 194.92 SQ. FT. ; !
• DOES NOT INCLUDE AREA IN
COMMON WITH CONEARGE ®`�' NVLA) IIMfeI`N (t S
KELLOGG PLAT EDMONDS
INDEPENDENT DRAFTING SERVICES BLOCK 0050-00 LOT 5 OF SP.. (8-g-83)
159 �o8 arr';,,u°'°oi o
RECORDED AS NO. 8307260335
BEING PART OF LOTS 1 t 2
1 OF 2 BLOCK 5 EXIST. PLAT
�1
1�IW unU�� i�L�i�l� LLr
Memo
REIj;
CIVIL & STRUCTURAI..GNo O C:LTES
d)II-Z121uSpREE1
too.12S
( )sW. GpNEERINa
J.1 O.FFICE MONDS, 9b016
b J9,� W FAX (a ts} 77S A,
�. (.
- aXal
Ma116d I z t
Oil to
110 toll
GL e: Ci I .
C
u �.
��171
',,;, n►
'e�,;
Date;
ton
Res
' Dew S � � FIL �
6� sy , v fG Two I C I v rn
Vol G=- DSI p,ci rn OI till too. `
ell M.
ot Not poll
l� Woom
V,400 r t S r Y. z
mumm, to 40soo? CO)
loom 1 111,11, 11111 1
toot
do
ar
0004 X' too
�t000tl root.
it ch
10
5P piltoot rootM
z i
toot
O
_ m
toolooto
to
A/1 r� ,
fiv o t
*JAN 3 �. ,� ,
It 4
�u
• DEVELOPMENT" F ICES CTR. i
,CITY OFS�4ONDS i