20050875.pdfI
DATERECEIVED
C l.0j__ `j PERMIT EXPIRES 14l
CITY OF EDMONDS NUMBERi```'�
CONSTRUCTION PERMIT APPLICATION JOB UITEIAPTtt
ADDRESS �
OWNER NAMEINAME OF BUSINESS C` 1 1
PLAT NAME/SUBDIVISION NO. LOT NO LID NO.
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MAILING AD ESS LID FEE S
(jw�//1 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCPApprovod 17
O U - 1 `a 1 h - RW Permit Requited 0
Street Use Permit Requited 0
CITY ZIP TELEPHONE EXISTING PROPOSED Inspection Required O
l \ Sidewalk Requited E3
tEi(1 WDA s J•jS �1?.� o �� O -�� REQUIRED DEDICATION FT _ Underground D
Wam required 93
NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
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YESE3 NO O z
{Uu CE
t ADDRESS REMARKS w
w
cii OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE 0
Qit _. _ i II w
NAMErr CBL# f) z
q610,3
. (� ,3 j '
Yl� (� \ ENGINEERING REVIEWED BY DATE
U dy RESSI
O�`i V''Pl S ��5 V�
FIRE REVIEWED BY DATE LU
Z CITY ZIP TELEPHONE
C1 '+as yfg(0- 613
STATE I�ENSE NUMBER EXPIRATION DATE CHVARIANCE OR CU SHORELINE OR ADBp INSPECTION SEPA .
uE - 5h • Eyen�►Jrpn Gi R Q'D COMPLETED EXEMPJ
haL, 'ate S� QU�,b UJC o1 G c . IffM
�Av Aw. I8 Yes ONO
Q PROPERTY TAX ACCOUNT PARCEL NO. CAp ZONE SIGN AREA HEIGHT
0 U ,, JC WAIVER O ALLOWED PROPOSED ALLOWED PROPOSED
a.1 3 �-3 1 STUDYCI !VA N!i
NEW ❑ RESIDENTIAL ❑ PLUMBING I MECH . LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REAR
❑ ADDITION ❑ COMMERCIAL COMPLIANCE OR I ❑ CHANGE FUSE 'VAr
NA z
❑ MIXED USE PARKING LOTAREA PLANNING REVIEWED BY DATE g
❑ REMODEL 1:1 MULTIFAMILY ❑ SIGN REQ'D PROAV`IDED
FENCE /•.q �%
REPAIR ❑ GRADING CYDS ❑
( X FT.) REMARKS
DEMOLISH ❑ TANK 1:1OTHER
Z ❑GARAGE RETAININIRE
CARPORT ❑ ROCKE YG WALL 1:1 FIRE ALARM SPRINKLER
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(TYPE OF USE, BUST SS CTIVITY) EXPLAIN:
'TYP OF�ONSTRUCTION CODE OCCUPANT
N GROUP� LI �r
c NUMBER NUMBER OF
OF DWELLING I SPE AL INSPECTION CONSULTANT OCCUPANT
O STORIES UNITS LOAD
-+ 4nPQrrllntInn
UIRED D Y,ES_
DESCRIBE WORK TO BE DONE ''-
RKS O
i • �T;.c,_ ): rs :LLANED OF DEBRIS o
�Q.Y`�\1'1 1 ✓� ('tir+G+ �'�'^O�I«�� ASJ ,}ECH EPq�T
bID( SEti'JE0t MUST BE CAPPED AT1 +CTURALD 1 IC'kcjz., �_-� ^ter SUATOM ATER DIETER TO' BE REMOVED OR
HOSE BI '?�FEF I Description FEE
Plan Chok UH CKLIST ON BA(Ata@f6Ld0Dr9t;jUW
HEAT SOURCE LOT SLOPE% VESTED DATEINSPEC110N 1z Kt VL11KbM13N
Building Permit City Surcharge
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 CONSTRUCTIONON THE PUBIC Gradin
DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE g
2 SEPARATE PERMISSION,
Engr. Review
W
PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
IL PERMIT LIMIT, SEE ECDC 19.00,005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire Review Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIL ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due =CL
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.•
Recording Fee Receipt # �f� l(fGIJ
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 DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL Building Official or his/her Deputy: and Foes are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27,
OFFICIALS SIGNATURE / DATE
ATURE (OWNER O G NT 1n, DATE SIGNED (425).
l "•' ' �I 771 -0220 AS Y / DATE
_jr
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- ORIGINAL -FILE/ YELLO - INSPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED, UBC109 I IBC110 I IRC110. PINK -OWNER GOLD - ASSESSOR
10/04 PRESS HARD YOU ARE MAKING 4 COPIES
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Page 2
normal public use of the surface of the waters overlying lands subject to the act at
any stage of water level r
WAC 173-27-040 O(P):
(p) A public or private project, the primary purpose of which is to improve fish or
wildlife habitat or fish passage, when all of the following apply:
t OThe project has been approved in writing bY the department offish and
wildlife as necessary for the improvement of the habitat or passage and
appropriately designed and sited to accomplish the intended purpose;
(ii) The project has received hydraulic project approval by the department of p
fish and wildlife pursuant to chapter 75.20 RCW,• and n
(iii) The local government has determined that the project is consistent with rn
: the local shoreline master program. The local government shall make such
determination in a timely manner and provide it by letter to the project
proponent, c M.
m0
The basis for the exem
p project does not appear to meet the definition of p n
tion is that the
"development" under the Shoreline Management Act. We reach this conclusion because (1) the
project does not include grading, excavation or filling that requires a City of Edmonds grading
M z
permit, and (2) the site is to be restored to a natural state, with the only "improvement being an D z
unpaved public pathway to' allow the public improved access to the adjacent public beach. r
Although this project does not directly fall under the emption of WAC 173-27-040(2)(p), it is N
clearly consistent with this type of activity. 0 rn '
This project is consistent with the City of Edmonds Shoreline Master Program (Chapter, 23.10 rn m '
ECDC), particularly the following policies: o0 in
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23.10.060 Shoreline use element goals and policies N. I
Goal A.7. Encourage restoration of shoreline areas that have been degraded or a
i diminished in ecological value and functions as a result of past activities or
catastrophic events.
Goal A.9. Encourage increased accessibility to the shoreline for a variety of
users and activities. ►
23.10.075 Public access element goals and policies Z
Policy B.3. The city should maintain public shorelines; waterways and tidelands
in public ownership for continued public access and use, rn
Policy B.4. The city, where practicable, should acquire key shoreline parcels that
become available; such parcels are those integral to necessary expansion. of
existing prime beach areas.
Although this project is determined to be exempt from the requirement to obtain a. Shoreline
Substantial Development Permit, this determination assumes the following conditions:
1. The demolition and site work are not sufficient in scope to require a City of Edmonds
grading permit.
Snund/n�,ise „rigimuing fr,ml temporary Construction sites as a result of
Cnnstl• 16011 actinpity arc exenitu I'rcml the tl(Iiise limits of FCC Chanter.
;.30 clnlyduring file hours. „f 7:1)Oanl it) h:001)tn on weekdays and �y
=.r I0:00am and h:tl0tlnl oil Saturdays. excluding Sundays and Federal PERMIT#' rf!/ i% �J
�5�
Holidays: At all other tittles the noise orltdilatin&v from construction
;jji: & siteshlcti vitics niust Comply ply With the noise limits nfChawer 5.30, unless EXPIRES:
a vitriance has been granted tlursumif to FCC-' 5.3(1. t ?tt.
ISSUED: �• '
City. of .Edmonds
THIS ARD MUST §J POSTED ON SITE AND AVAILABLE TO THE INSPECTOR
Owner:
Site Address: x *A- ea
Project. -Owz x
II1SpeCt10I1S
Approved ate Notes
#1 ENGINEERING
MOBILIZATION AND EROSION CONTROL INSTALLATION MUST BE APPROVED PRIOR'ro COMMENCEMENT OP ITIONA WOR
(425) 771-0220 x1326 Mobilization / Erosion Control _ _ _ _ _ _
Ti htline 0
Detention tap z
Forms (sidewalls, drivewa .)_ 0
Water Service,-� - - - - - _ n
Permit # Side Sewer m
Permit # Right -of -Way wn
Js* c/g, paving)
00
Pre -Demolition NON'S6jr,,. _
#2 SITE/DEMOLITION—--------- ------ vm
Asbestos PSCAAPermit S �— - - fin
_------------- ---- c�
Sewer Ca /� - - - - - - - p n
Cleaned Site/Final
=M
#3 FOUNDATION Setbacks ________________ _ Mz
Footings ----- -- -- fJ
Foundation Wall=4. .
Piers_
Retaining- - Wall - - - - - - - - - - - - - - - 0 M
Slab Insulation -.- - m
Imn
t.
#4 PLUMBING Ground Work - - - - - - - - - - - - - MM
Permit# Rough In CA
Grease Fixture 0M
#5 PUBLIC WORKS Cross Connection Control C (n
Trash Enclosure
(425) 771-0235 7 / Y z .
#6 MECH/HVAC Gas Test/Pie
Permit # Equipment
#7 FRAMING Exterior Sheathing! _
Shear Nailing ---- ----- --- - -- - D
z
First Floor Framing
------------ --- - _
Framinp, N
Height Check z
#8 INSULATE CAULK Wall-- ----- - --- ----
#10 FIRE
(425) 771-0215
Floor--------------� --- - rn
Ceilin
AIL
Hydrant ----- -- ---- ------
FDC------------------- --
Fire Protection System
Extinguishers-
Addressin Visibilit
FINAL PROJECT APPROVALS
Engineering J
' Sewer Division
Water: Division
Planning
Fire
444 FINAL OCCUPANCY APPROVAL aic•
OR ANY PORTION THEREOF IS NOT TO BE OCCUPIED PER UBC 109. UNTIL ALL
..rapt ICABLE CITY DEPARTMENTS HAVE GRANTED A FINAL APPROVAL
all (425) 771=0220 x1333 for
BUILDING INSPECTIONS'
i
II1SpeCt10I1S
Approved ate Notes
#1 ENGINEERING
MOBILIZATION AND EROSION CONTROL INSTALLATION MUST BE APPROVED PRIOR'ro COMMENCEMENT OP ITIONA WOR
(425) 771-0220 x1326 Mobilization / Erosion Control _ _ _ _ _ _
Ti htline 0
Detention tap z
Forms (sidewalls, drivewa .)_ 0
Water Service,-� - - - - - _ n
Permit # Side Sewer m
Permit # Right -of -Way wn
Js* c/g, paving)
00
Pre -Demolition NON'S6jr,,. _
#2 SITE/DEMOLITION—--------- ------ vm
Asbestos PSCAAPermit S �— - - fin
_------------- ---- c�
Sewer Ca /� - - - - - - - p n
Cleaned Site/Final
=M
#3 FOUNDATION Setbacks ________________ _ Mz
Footings ----- -- -- fJ
Foundation Wall=4. .
Piers_
Retaining- - Wall - - - - - - - - - - - - - - - 0 M
Slab Insulation -.- - m
Imn
t.
#4 PLUMBING Ground Work - - - - - - - - - - - - - MM
Permit# Rough In CA
Grease Fixture 0M
#5 PUBLIC WORKS Cross Connection Control C (n
Trash Enclosure
(425) 771-0235 7 / Y z .
#6 MECH/HVAC Gas Test/Pie
Permit # Equipment
#7 FRAMING Exterior Sheathing! _
Shear Nailing ---- ----- --- - -- - D
z
First Floor Framing
------------ --- - _
Framinp, N
Height Check z
#8 INSULATE CAULK Wall-- ----- - --- ----
#10 FIRE
(425) 771-0215
Floor--------------� --- - rn
Ceilin
AIL
Hydrant ----- -- ---- ------
FDC------------------- --
Fire Protection System
Extinguishers-
Addressin Visibilit
FINAL PROJECT APPROVALS
Engineering J
' Sewer Division
Water: Division
Planning
Fire
444 FINAL OCCUPANCY APPROVAL aic•
OR ANY PORTION THEREOF IS NOT TO BE OCCUPIED PER UBC 109. UNTIL ALL
..rapt ICABLE CITY DEPARTMENTS HAVE GRANTED A FINAL APPROVAL
all (425) 771=0220 x1333 for
BUILDING INSPECTIONS'