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17021 76TH AVE W.PDF17021 76TH AVE W CITY OF EDMONDS STREET FILE ASSET INFORMATION SHEET dN W is ADDITION ❑ RETIREMENT ASSET NO. 0-Y�o ADDITION TO ASSET NO. DESCRIPTION / SERIAL NO. LOCATION �%D DEPT. N0. �v D *PURCHASE ORDER NO. _ PURCHASE ORDER DATE COST `PROJECT NUMBER PROJECT COMPLETION DATE COST D , v B.A.R.S. ACCOUNT NO. C)OO "Di o3yv OD(� • ESTIMATED LIFE5 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 _ • G.L. ENTRY INITIAL UPl REFERENCE ii4 VERIFIED BY PROCESSED BATCH NO. DATE DEPARTMENT FILE .A t CITY OF EDMONDS SE PERMIT ONE ._ NUMBER CONSTRUCTION PERMIT APPLICATION NAME (OR NAME OF BUSINESS) .} JOB ADDRESS D160 . &P J. %t(L, j } Cf F 1 %(�Lf o t ` i % ff,' /)' LEGAL DESCRIPTION CHECK SUBDIVISION NO. LID NO. Z MAILING ADDRESS /l 7'. �� 7 G _ j CITY TELEPHONE NUMBER PUBLIC RIGHT OFWAY PER OFFICIAL STREET MAP. f % ) A��" ' I 1 Iy�/ j NAME EXISTING (a `J REQUIRED DEDICATIp M PROPOSED-7 i / U z r r: RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED CI W w ADDRESS STREET USE PERMIT REQUIRED ❑ z U ('\t) SEE � W Q CITY TELEPHONE NUMBER ENGINEERING MEMO DATED SEE PIW DEPT. REVIEW CHECK LIST DATED NAME REMARKS ADDRESS 14 METER SIZE BUILDING SUPPLY SIZE FIXTURE UNITS CITY TELEPHONE NUMBER w r 0 REMARKS U STATE LICENSE NUMBER CITY LICENSE NUMBER Legal Description of Property - include all easements SIGN AREA ENV. REVIEW ALLOWED PROPOSED COMPLETE EXEMPT ADS NO. (show below or attach four copies) SHORELINE N z 0 a VARIANCE OR CU PLANNING REVIEW BY DATE U W w 0 a YARDS LOT COVERAGE z U FRONT SIDE REAR z g © El REMAR a NEW RESIDENTIAL PLUMBING ClADDIALTER C� w NON-RESIDENTIAL MECHANICAL CJ ❑ REPAIR RETAINING WALL SIGN ❑ F] EXCAVATE E] FENCE CHECKED BY TYPE OF CONSTRUCTION COD E HEIGHT DEMOLISH OR FILL ( x FT) PRE -MOVE INSPJ SWIM COMPLIANCE SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT INSP. POOL REQUIRED GROUP LOAD SIDE SEWER WATER LINE B YES I NO REMARKS z ❑ z o 0 o a m wNUMBER OF STORIES INUMBEROF o DWELLING m 01 �`) UNITS r NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN) r VALUATION FEE PLAN CHECK FEE a BUILDING / 'j f PLUMBING l � This Permit covers work to be done on private property ONLY. MECHANICAL GRADING/FILL J 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 N successors in interest, agrees to indemnify, defend and hold W harmless the City of Edmonds, Washington, its officials, Qemployees, and agents from any and all claims for damages of GE2ALD a FOSS 20 dg�,� �O WILLIAM WF-12T WA 1712 E N 5. NICHF-LIN ; STEPHEN D. NOFZl GE 2. L O•�.. ZD ,- - I_ 429.5C -t 30 _.. IL5.97 .:.� o ..� 105.10 - 16 C 9 zo . 3 000 N0MES iT1 OIto z $ I1200o� I o} \ I C- I O I 12 OC►O o \ m - - NI 80 30' , BLDG. SET- BACK (TYP.) 105.10178.43 437. 40' 20 20 i PETER BILDCO d CAQL_ MUSZtEL D ANIEL NCCLINTICK STEEN z _ .. i SECTION ® �7eND �JT2EET SW `(NOT OPEN) 137.49 � - 1 DANIEL E 19t28+ Iv SNORT. 5 92 z DANIEL 0 o EDMNDS , p Lovell-Sane:la, > a GtXT4UT . 02VM 2sum UM Awm vt: JTT - DATE: MEMO TO: Building Division Planning Department FROM: Engineering Division Public Works De I partw,Ilt SUBJECT: After review of the subject Building Permit application, vie have the follovii I ng comments: 1. Connection to City ,_rater system required. 2. Connection to City sanitary sevier system required. 3. Right-of-viaY permit required for any' -------- ----------- work on Cit.-opo --- - ---- --- 4. Driveway Slope not to exceed 14%, 5. Backwa-ter-valve rnUiQd f downstairs Plufllbiq is below elevationof upstream ilia 6. !dater and sevier lines to be separated by 10 foot, minimum. ----------- .7. Builder/Owner res onsLqjle for containing all tewporat -------- - --- on site and May not impact neighboring nrn,-) ii IN "Ile /A,11 44t- B!) 6/82 .I PUBLIC !6JDRKS EEPAM CHECKLIST BUILDING PERMIT REVIEW lz2L (address) to 0 Street Right -of -Way Exist' 01 �QD Z Access Easements Existing �1/,I: = ;I�-�l�- — H REQD a Utility Easement Existi�REngQD w Lot Per Subdivision sf� Plat Assessor Map W Site Plan Checked for Accuracy z Z Underground Wiring Reqd. U Check Accuracy of fe al Description /G , Z Review by �r�3','r� G%�` Date Existing Water Main Size (i Water Main Required Service Line Required Hydrant Size Existing 1:41 Hydrant Reqd Per Fire Code N/,g Size w Detector Check Meter Reqd. Cross Connection Inspection Fire Department Comnents lWater Meter Charge Read . ; 3 Review byy� _ t Date j�/% ? � Septic Tank Design Approved Date Septic Tank Permit Reqd. ��� j,/,� Perrdt No. Sanitary Sewer Availability /<�i Pro 1 .i Drawing No. 1 /.,� File No. Side Sewer Availability w Sanitary Sewer Connection Fee Reqd. 3 Review by Date w Open Ditch Existing L, - X, � Regd. i Culvert Regd.PF e n PP P (>(�C(> C_ ,i� Size oc Catch Basin Regd., ` i Indicate on Site Plan Shoulder drainage maintain collection on swale open runoff H t t 1 -� I Manhole reqd. Indicate on Site Plan r 4, Soil Conditi anGround Water Field Checked Review by—Ze>-L�: l Date /�-1 C j Rey�visey�d "`1v10-1977 DATE: _ MEMO TO: Bui lU* FILE FROM: James E. Adams City Engineer SUBJECT: SEWER CONNECTION CHARGES r1702'1- _ _76 th Ave. � W . *tember 29, 1983 - ------------- (Street Address) Blueprint Homes (Legal Owner) Single Family Residence X Subdivision Plat PRD Multiple Commercial LEGAL DESCRIPTION: Lot 1 S-23-81 Z.F.F. Calculation: ( 128.486 ) z . F . F . x ( 5.50 ) _ $ 706.67 ( ) Lateral x( ) _ $ ( ) Unit (s) x ($ 25.00 ) _ $ st cc: Owner Street Address File Connection Fee Lateral Charge Equivalent Count (when applicable) Trunk Charge Permit TOTAL CITY- OF EDMONDS ~ FOR INSPECTION CALL Pdoo ' PUBLIC WORKS DEPARTMENT �������' ��/ Permit l�a _ SIDE SEWER PERMIT- 9741-z�nJ Ext. 'QQ,Z Issue Date PERMIT MUST B - V TE AWA& si 1. Address of Construction / ; i �; .e �, LY.NNMOD LINE 2. Property Legal Description (include all easements) L:-rf- I --� 3 -- !R 1 3. Single Family Residence ✓ Multi -Family No. of Units Commercial 4. Owner and/or Builder 5. 'Contractor & License No. ass J®6 ITO, A &WCP1_1 6OAit 6. Invasion into City Right -of -Way: No X Yes- (If Yes Right-of- way Construction Permit Required - Call Dial Dig (342)P50:444 before excavation). 1-800-424-5555 7. Cross other private property: Yes No Easement required - attach legal description and county easement number. READ THE FOLLOWING AND SIGN: a. Property owners must obtain a permit to install side sewers on their property. A licensed side sewer contractor must be employed to construct side sewers in the public right-of-way. b. The side sewer contractor assumes full reponsibility for each installation for one year. C. Commercial establishment requires a minimum of a six inch (6") side sewer line. d. Side sewers may not be installed closer than thirty inches (30") to any structure. e. Side sewer lines must be laid at a minimum grade, of 2% (1.15°) and maximum grade of 100% (450). f. No turn in side sewer greater than 45° (1/8 bend) is allowed between cleanout. All 90 turns must be constructed of a 450 (1/8 bend) and wye with removable cap. g. No down spouts, footing drains or floor drains can be connected to side sewer system. h. Pea gravel is required for bedding when installing sewer lines through other than granular soil. i. Cleanouts are required at 30"-60" from each plumbing exit line and at minimum intervals of 100' along sewer line run. j. Trenches within City right-of-way must be restored to original conditions. Contractors shall be responsible for -right-of-way failure due to poor compaction of fill. k.. Side sewer must be left uncovered until inspected and approved by the City. 1. Inspection during normal working hours only. Two (2) working days notice required. l DATE: I certify that I have read and shall comply with the above + PERMIT FEE: DISAPPROVED BY: Date: �w :,v; �, �e,�rr�e. ,tD0 By- Date: _ tn CONNECTION FEE: APPROVED By: Date: o * PERMIT MUST BE POSTED ON JOB SITE The City of Edmonds Side Sewer Drawing EASEMENT NO_ ------------------------------------------ - NEW CONSTRUCTION REPAIRS F] LID NO_ ------------------ - ASMT. NO. ------------------ .0 1,4s r CONTRACTOR --- OWNER A.fyv-=Rica,-rq --- GF-mE R-- oNl -------------- . _Q j< c -709-7-- ......................... PERMIT NO. JOB ADDRESS --- --------------- ------------------- LEGAL DESCRIPTION: LOT NO. ---1 ------------------------------- BLOCK NO. ---------- ��YN ...................... ................... ---------------------------------- --------------------------------------------- ... --------- N-AME7=ADl7ITI0lT -- — ----- — ----- — ----- — ------ — ------ — ----- — --- — ------ L'3NH. Ir". PL.. PWW-0001-11/75 (REV.11/78) I- tv, CA - le jo "Pw 3.5 0 PRIVATE DRIVE COMSE 2.5* DP ::,� � 1. op I r7O 2- 1 7(o Ir" Av F— W. Approved: '7' QJL is DATE .q"-,--5- 1984 By ------- ---- ----- - ------