18105 69TH PL W.PDF111111111111
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18105 69TH PL W
PERMIT NO: -9209
City of Edmonds
PERMIT EXPIRES, 1W 0
SIDE SEWER PERMIT
Address of Construction: & RECEIVED
LID #
Property Tax Account Parcel No. /Z -72 042 6 IS 600 1 SEP .2 0 2000
Attach copies of all access and utility easements Verified and Approved b PuBLIC WORKS DEPI
Owner and/or Contractor: ak-xr�,-r 4?2%z (fAn
Contractor License �7� e�3 4�4 F-75-0 Buildin: Permit#:
9
Single Family Invasion into City *Right -of Way: E] Y I es so
Multi -Family (No. of Units *RW Construction Permit 4
0"
Commercial (No. of Units Cross other "Private Property: El Yes RINo
Public "Attach legal description and co' y of recorded easement.
A p
Owner/Contractor J C? 0
Owner or contra r si n 4ra�ndAcrnowledgement statement: Date
By signing f, 611 certifyVat I have read the City's public handoutAbiltifled
Side Sewer Specifications, and shall comply with all City requirements outlined therein.
W CALL DIAL -A -DIG (1.-800-425-5555) BEFORE ANY EXCAVATION W
W FOR INSPECTION CALL 425-771-OM extension SZ9., W-
NOTE: IF JOB SITUS NOT READY FOR INSPECTION WHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION FEEVILL BE CHARGED..
Job Site Ready YES . NO —Date: Initial:
Partial Inspeciioh:061Y� .-Z 6c,_k g7o 0�0 V_ L_ Date: 5-,b-w Initial: _V�c
Partial Inspection: Date: Initial:
/�As-,built to Street File:
FINAL INSPECTION APPROVED: Date: .217— 0 1 Initial:
PERMIT MUSTBE POSTED ON JOB SITE '1�
White Copy: File Green Copy: -Inspector , Buff Copy: Applicant
L;temp;bldg;forms-,sspermitjlg4/00
4
The City of Edmonds
Side Sewer Drawing
EASEMENT NO . ........... ...... ......................... 0*
NEW CONSTRUCTION 19/ REPAIRS E] LID NO . ................ .. Asrvrr. NO...
OWNER................................................................. .................. CONTRACTOR ........ C��!kt, ........................................ PERMIT NO.
JOB ADDRESS .... R1.05 ............ 0 �p L, Lt) .......
..... ..... ..................... LEGAL DESCRIPTION. LOT NO. - .................................... BLOCK NO . ....................
.............................. .................................. ............... .........................................................................
NAMEOF ADDITION ........................................................................................................................
Lu
Z
PWW-0001-11/75 (REV.11/78)
L
�P_
-Z4
Ict
,73
Approved:
DATE.... ......... By ---- .............................
RECEIVED
City of Edmonds MAY 2 0 '1399
DEVELOPMENT SERVICES
CRITICAL AREAS CHECKLIST
The Critical Areas Checklist contained on this forrn 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 Cltv.
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Are are. '
as or
may be, present on t he 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 sur-veys).
An applicant, or his/her representative, must fill out
the checklist, sign and date it, -and submit it to the
Ci , The City will revie
ty w 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
locatin2 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 Aith 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:
A71210A Af, kz�' ;_4_41
Name
Street Address
city State Zip
Applicant Representative:
Name
2-
Street Address
IL---7-r 'WIA
City S tate Zip
Z-y �2
Telephone Tej� ....... ... ..... ......
Signature
Signature
Date
creception\janakad.doc
Date
(over)
CA FILE NO.
*rkical Areas Checkfi*
-------------------------------------------------- ------------
Site Information (soil s/topography/hydrolo gy/vegetation)
I . Site Address/Location:
2. Property Tax Account Number: -7 Z�7
.3. Approximate Site Size (acres or square feet): 4
4. Is this site currently developed? 4,--- yes; —no - -
.If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
Z,— Plat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of I 0-feet over a
horizontal distance of 66-feet).
4��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: )L) 0 Approx� Depth:
7. Site contains areas of seasonal standing water: /_)0 _; Approx. Depth:
What season(s) of the year?
8. Site is in- the floodway floodplain of a water course.
9. Site contains aPreek or an area where water flow oss the grounds surface?/Flows are year
round? U Flows are -seasonal? (What time of year?
10. Site is primarily: forested meadow 4---; shrubs Z--- mixed
urban landscaped (lawn,shrubs etc)
1. Obvious wetland is present oil si I te:
Legal: Lot 13 Olympic View Crest Impervious Surface
R F— C E I V E D Address: /6/0.6 61T27,p4_,4). so vare feet
Assessor's Tax Pareel#: j2-72_C>*Z
J U L 2 1 2,01�-'J
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
Owner. Westar Development Co. Ise Scab: 1"=2010"
16927 30 Ave. NE
Ko.nmarp WA 4207A
&Z6D *-@�7-Z757
0 P7-
APPROVED BY PL 'IN
'01V
RL
Rff
C/Imn Ueld
Lr
->, C <�Vnlzzjr ---:3
*L*4
L
-4
IMPERVIOUS SURFA CE CALCULATIONS
Proposed Building Pad 12*00
SIF
Proposed Garage 630
was"
Proposed Patio & decks 230
SF
Proposed Walkways 78
Proposed Drive 700
SIF
SF
%W
TOTAL 2838.25
SF
OW
HEIGHT CALCULATIONS
sow on.
Original Current
Proposed
A 344.00 - 346.24
344.00
B 344.00 345.20
345.00
C 344.00 344.66
D 344.00 345.99
345.00
344.00
Average Grade 344.00 345.52
344.56
Datum = CB #1 342.70
cut / fill -1.52
0.00
Height of Structure
M Allowed
24.42
368.92
aximurn
c 369.00
PLANNING DATA
NAME: yye5F_�beflclopreleol_�
JA/
SITE ADDRESS: DATE:
ZONING: 12�_o PLANCHK#:
PROJECT DESCRIPTION:
CORNERLOT IVO —(Yes/No) FLAG LOT "0 —(Yes/No)
SETBACKS:
Required Setba
Front: Left Side: Right Side: -7 Re r:
Actual Setbacks:
Front: Left Side: Right Side:. Rear:
Street map checked for additional setback required?_'-� (Yes4g�
0>7 ot
�6ZRI
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED, _(Y/N)
191'�IFR"( IzOO
LOT COVERAGE:
Maximum Allowed: Actual: ewp-d ge- 6 _110
B UILDING HEIGHT:
Maximum Allowed: bo- 0 Actual Height: j
Datum PoInt:CA+16A 190'5710 -Datum Elevation:S q 2- - -7
A.D.U. CREATED?:
SUBDIVISION: ONY��C'
tqq j�hj�
CRITICAL AREAS re 54rep S lof es
�'e_p -3 S 0-,e7 -S 4t---
SEPA DETERMINATION:
LOT AREA:
OTHER:
Plan Review By:
cArileApermitYlplandaLdoc
Legal: Lot 13 O"pic View Crest
Impervious Surface
RECEWED Address: IS/06 6-TZVF4-,4t).
square feet
Assessor's Tax Parcel#-.
J U L 2 1 2000
DEVELOPMENT SERVICES Cin.
CITY OF EDMONDS
0"er. Westar Development Co. In e: 1"=2010"
WATER SEPVIC&w
16927 SO Ave, NE
E INSPECTIONS
lCanminirp WA 9MP.2
L*Z-S!) *1ra-7 - z,757 REQUIRED, CALL 771.
0% , ''. _7
ir -T!u .1 -r,
Fit
-*Pa Pig CC) 3034)
SC4+ 4-0
�-JPPROVED AS NOTED
lbt",c F-vo
t(4
OA
V, —
A
j
01
/C�
S/ Ltrz Mir-
31 -7o
'IMPERVIOUS SURFACE CALCULATIONS
L)
Proposed Building Pad 1200
SIF
Proposed Garage 630
Proposed Patio & decks 230
SF
Proposed Walkways 78
Proposed Drive 700
SF
SF
E
NTRAOTOR IS RESPONSIBLE FOR
E
101 NMRAIMM5
SF
L
HEIGHT CALCULATIONS
aw am aw
Original Current Proposed
A 344.00 346.24
344.00
Q
B 344.00 345.20
345.00
*4#7-24-/Aj� 7-0 k5f 7Z;
'0/7'Y-' V145W 0
C 3441-00 344.66
345.00
Z,4177
D 344.00 345.99
344.00
Average Grade 344.00 345.52
344.50
Datum = CB #1 342.70
OL\11) DIZ
cut / fill -1.52
Height of Structure
0.00
24.42
I VE,
jMa)dmum Allowed 369.00
368.92
rj.3/ lu/ zur-K-1 1 U. 4 1 44J40I 4J IV 1N=L-MU1N-�1UUVM= I I=
67D 10+-
NELSON-COUVRETTE & ASSOCIATES, INC.
CONSULTING GEOTEcHNicAL ENGINEERS, GEOLOGISTS
ANo ENVIRONMENTAL SCIENTISTS
Facsimile Transmiftal r 0 Ll-
To:- LYL#- MAR 1. 0 .2000
Company: CiT-� c)f- f.DMot-JD5 ENGINEERING
Phone:
Fax: (42,g) -721
From:
Company: Nelson-Couvrette & Associates, Inc.
Phone: 425-486-1669
Fax: 426-481-2510 BUILDING
Da I te: MAR 1 6 2000
Pages Including Cover Page:,
NCA File #:
cc:
Comments:
"I "I &UUU L U. � J 4 4 �J 4 0.1. 4.J.L U
NELSON- COUVRETTE & ASSOCIATES, INC.
—11-� CONSUONI; GeorECHNic.4t. ENCINSEITS. GEOLOG'SrS
��—D ENVIRONMENTAL SCIENTISrS
I IQ
-500 -r
17311-135th Avenue NE. A Project: OLqb?\C- C�Es'
Woodinville. WA 98M
(425) 486-1669 - (425) 337-1669 Owner: tiv)
Fax (425) 481-2510 Location:
Weather:
Purpose
of Visit:
r'"Ur- UZ
FIELD REPORT
File No. 2 �- 4.19 q
Date : A/ I
Report No. I q
Page: I Of 1-4
BY: AP �'
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Attachments:
Distribution:
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71< ? PIP- " M 10 49-� MOW --� JL) F4T- I ow
03/10/2000 10: 45 4254812510 NLL�DUN-UUUVKL11L rlmtlr- UID
NELSON- COUVRETTE & ASSOCIATES, INC.
1-1-� CONSULTING GfOrECHNICAL EN(71NEERS. GEOL061STS
AND ENVIRONMENTAL SCIENTIM
17311-i351h Avenue NE,A-500 Project:
Woodinville, WA 98072 Owner:
(425) 486-1669 - (425) 337-1669
Fax (425) 481-2510 Location:
Weather:
Purpose
of Visit:
FIELD REPORT
FileNo. 21&*M. -
Date: 3/2100
Report No. 14
Page: 2 of
By: Mp k'
rY mUT>A oF T-*-- ISO -T)t G'r -";w CJ �z gt3f- A t� D 05'r 51 LA- M F-17 O-L
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Attachments: Signed: "�426Z
Distribution:
Nf a swmCoLm?E rTE & A SS XWES,
caffamumcpEonumecAL Bapinm a
m ammou �
PROJECT NAME:
OLI?MPIC Vlfld CPf-
LOCATION:
ED/Vlot4c)s
PROCTOR METHOD: — ASTM D - 698-91
TEST
DATE NO.
APPROX.
GENERAL FEETTO
LOCATION GRADE
*110C C, 7
PIA4 2
c q
c 9
c 10
1 37
IN -PLACE MOISTURE AND DENSITY TESTS
JOB NUMBER:
2 (o 419 9
REPORT NO.:
IPAGE
OF
ASTM D - 1557-91 TESTS CONDUCTED BY: P
7
PPROX.
FILL % WET DRY MAX % %
DEPTH MOIST DENSITY DENSITYI DENSITY C 0 M P. S flPEE C COMMENTS
BLOWS
PASS
OR
C
[FAIL
47
12.7
1,34,7
121
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.*�(_"�DATE RECEIVED
PERMIT EXPIRES
CITY OF EDMONDS
USE PERMIT
ZONE
NUMBER
F
JOB RESS i Ul T#
ADD
C07NSTRUCTION PERMIT APPLICATION
OWNER NA E/NAME OF BUSINE
M SS co bv
PLAT NAM E/SU BDIVI SION NO�
LOT NO.
LID NO,
7 C
LID FEE$ ��I-J:�A_
W
MAILING ADDRESS
TESCP Approved E3
z
0
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MA : P
EXISTING PROPOSED
RW Permit Required ks) 0
Street Use Permit Req'd AM
Inspect on Required
SIdewa:k Required j�k)
CITY ZIP
TELEPHONE
REQUIRED DEDICATION— FT
Und rground
wiring required
NAME
METER SIZE I I
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
rz cH IV �A
Iq
In
7T1
0
YES NO 0
z
L
ADDRESS
/87,/-5 Av%,R,
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
z
z
a
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CITY ZIP
TELEPHONE
2,
NAME A,
ENGINEERING REVIEWED/ ATE
cc
0
4.
ADDRESS
L)
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FIRE REVIEWED BY DATE
uu
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CITY. ZIP
TELEPHO NE
z
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0
VARIANCE OR CU
SHORELINE OR ADB#
INSPECTION
. RE(D
BOND
POSTED
STATE LICENSE NUMBEA EXPIRATION DA E
CHECKED BY
slw.) Co Ut
I
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(
C]YES _�ro
SEPA REVIEW
COMPLETE EXEMPT
SIGN AREA
ALLOWED PROPOSED
-
Hel&,HT
ALLOWED PROPOSED
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t
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PROPERTY TAX ACCOUNT PARCEL NO.
L5
W
7
,
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EXP
NEW RESIDENTIAL PLUMBING MECH
LOT COVERAGE ,
ALLOWED PROPOSED
REQUIRED SETBACKS (FT.)
FRONT SIDE REAR
PROPOSED SETBACKS (FT.)
FRONT UR SIDE REAR
COMPLIANCE OR
ADDITION COMMERCIAL
USE
2o
/Go
i �* 5
z
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CHANGE OF
PARKING
LOT AREA
PLANNING REVIEWED BY DATE
C3 REMODEL 0 APARTMENT 0 SIGN
REO 'D R VIDED
GFIADING FENCE
REPAIR CYDS X FT)
RFMA
OTH
DEMOLISH TANK ,�TV �
z
GARAGE RETAINRING WALL RENEWAL
CARPORT ROCKE Y 0
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
FA01
CHECK4DBY
I
TYPE OF CONSTFIUCTION
Cq,QE OCCUPANT7
GROUP ;P�
9:
U
_w�
LI.,
he�-
NUMBER
OF ?.,-.
NUMBER OF
DWELLING
I
CRITICAL
AREAS'
i 79-144i
0
w
0
to
SPECIAL ANSPECTOR JAREA
REQUIRED
OCCUPANT
f-Ify, 1
LOAD
0
STORIES
UNITS
NUM13ER
YES
0 1
<
DESCRIBE WORK TO BE DONE
REMARKS
z
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D 6
TIA Cq P, al
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(71
VALUATION
FEE
PLAN CHECK FEE
HEAT URCE LOT SLOPE %
S11
BUILDING .
I
PLAN CHECK NO: VESTED DATE
I
PLU MBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
BE
GRADING/FILL 140-
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
D SEPARATE PERMISSION.
STATE SURCHARGE
PERMIT APPLICATION: 180 DAYS
ui
PERMIT LIMIT: I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
*APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
ENG. INSPECTION FEE
W IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
_j
LAIMMATING tj
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
cc ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
10
RECEIPT
PLAN CHECK DEPOSIT
OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
-i DEEMED TO MODIFY, WAIVE
NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
RECEIPT
TOTAL AMOUNT DUE
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
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
This application is not a permit until signed by the.
CALL
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
Building Official or histher Deputy: and Fees are paid. and
IN VIOLATION OF THE LABO -'QOD OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION receipt is acknowledged in space provided.
WORKMEN'S COMUM�TJQ, URANCE AND RCW 18.27.
� , _�L I
OFF 161ALS SIGNATURE,. DATE
Wil
SIGNATUhj DATE Sl NED
M;
(425)
Liz
771-0220 'RtLEASED zzl "14, .
BY E
ATTATIq
EXT 333
IT IS UNLAWFUL �&USF_QA OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE YELLOW - 114SPECTbR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX PINK - OWNER GOLD -ASSESSOR
CITY OF EDMONDS
SINGLE FAMILY/DUPLEX COVER SHEET
Directions: Applicants are to complete the Information In the WHITE BOXES ONLY (Shaded boxes are for City
use only). This cover shoot must accompany each building permit application for a now single-family
residence.
PROJECT ADDRESS k 161515 RFE Ti- - (A-5 -
PROPERTY TAX ACCOUNT PARCEL III t Z160 11 B li200
DESCRIPTION OF WORK Lx�2 I ejft-Qilc� Kj
OWNER 14-:Nj, CQ PHONE 447-5, L4o-7*
CONTACTPERSON LPR2:&4 -,-�EU3:7 PHONE 41 a 6. qr6-7!Aa!5.-j
E-MAIL-- FAX J+aIL5,
MAILING ADDRESS q 0,-, ALI`4�— ME, KENH 012 r-, S
110 FAX CORRECTIONS MAIL CORRECTIONS E-MAIL CORRECTIONS
:v SIGNING THIS STATEMENT I UNDERSTAND THAT I AM THE CONTACT PERSON FOR THIS PROJECT. 17 Is my
ESPONSIBILI T T To COORDINATE ALL SUBMITTALS WITH THE CITY AND ONLY I CAN MAKE INQUIRIES ON THE
ST A TUS 0 F THE APPLICATION. I UNDERSTAND IT IS MY RESPONSIBILITY TO DETEBMINE IN ADVANCE OF PERMIT
SUBMITTAL ANY DISCRETIONARY PERMITS THAT MAY BE APPLICABLE TO THIS PROJECT. I ACKNOWLEDGE
T " AT TO THE BEST OF MY ABILITY I HAVE SUBMITTED ALL NECESSARY DOCUMENTATION IN ORDER TO MAKE A
COMPLETE APPLICATION AND No DISCRETIONARY APPROVALS ARE REQUIRED.
SIGNATURE DATE
ZONING INFORMATION
ZONE ?-.5 - q LOT AREA
NUMBER OF DWELLINGYNITS' EXISTING —V— DEMOLISHED PROPOSED
DISCRETIONARY APPROVALS CA Determination '141-ftiv-
SUBDIVIPION CU VARIANCE SHORELINE
601 pj —
SEPA e-12. Expires- OTHER,
City Use Only
LOT COVERAGE INFORMATION
EXISTING SF PROPOSED SF TOTAL SF
HEIGHT CALCULATION INFORMATION
DATUM % A C.: D
AVE MAX ACTUAL
SETBACK INFORMATION
REQUIRED FRONT SIDE SIDE' REAR
PROPOSED FRONT_ SIDE SIDE REAR
Y [-]*ES[ NO...ST.-DEDIC.[DY 613
CNIt.'LOT11-.Es[-]N0 FLAG*LOT E 110��jt:
1EQUIRED YES[] NO RECORDING If
STAFF COM11i
ENGINEERING INFORMATION
DRIVEWAY SLOPE % GRADING CYDS
EASEMENTS
EXISTING IMPERVIOUS AREA CONSTRUCTED BEFORE 1977 SO.FT
EXISTING IMPERVIOUS AREA INSTALLED 1977 OR LATER O.FT.
PROPOSED NEW NET IMPERVIOUS SURFACE
City Use Only
SIDEWALK REQUIRED []YES []NO DRAINAGE PLAN REQUIRED [:]YES ONO
UNDERGROUND WIRING REOUIRED []YES [-]NO
STREET DEDICATION FT. LID#
STAFF COMMENTS:
SPECIAL INSPECTIONS REOUIRED FOR THIS PROJECT (City Use Only)
SOILS, STRUCTURAL,
E]START OF WORK E]PLACEMENT OF REINFORCEMENT
OEXCAVATION & GRADING E]PLACEMENT OF CONCRETE
0SHORING INSTALLATION & MONITORING [_]BOLTS INSTALLED IN CONCRETE
OPROOF ROLLING EIS . TRUCTURAL MASONRY
[]PLACEMENT OF FILL . & CO . MPACTION [3STRU'CTURAL STEEL ERECTION
DSUBSURFACE DRAINAGE DHIGH STRENGTH BOLTING
VERIFY SOIL BEARING EDWELDING (WABO CERTIFIED ONLY)
E]PILE PLACEMENT 0OTHER—
DEROSION CONTROL
E GENERAL SITE MONITORING BY THE
] GEOTECHNICAL ENGINEER OF RECORD
0 GENERAL SITE MONITORING BY THE
GEOTECHNICAL ENGINEER OF RECORD
'DURING WET WEATHER CONSTRUCTION
CIFINIAL GRADING A FIELD REPORT
DOTHER*
APPLICANT LO(�IT-5T19 PLAN C HECK 0
DATE RECEIVED
BUILDING CONSTRUCTION INFORMATION
CODE EDITIONS 1997 UBC,.UMC. UPC. WSEC. VIAG WITH AMENDMENTS
DESIGN CRITERIA WIND EXPOSURE 0 WIND SPEED 80 MPH SEISMIC ZONE 3
Floor Live Load a40 Sn:wlLlve Load4 ::::::y Live Lood=
Floor Dead Load_jn :::11 Do If Load I n I Dead Lo
NUMBER OF STORIES .1 BASEMENTS 0 FLOOD ZONE
�1- SOILS REPORT PROVIDED [] YES NO
LOT SLOPE Ej
FLOOR AREA (MEASURED To EXTERIOR FACE OF EXTERIOR WALL)
Existing sod Total
Living Spec@ Ttr 15 24145
Garage
Carport
D k1C aced Porch
OC
ENERGY CODE COMPLIANCE INFORMATION
Fur, TYPE GAS. OIL [] ELECTRIC [] OTHER
FORCED AIR []HEATPUMP [-]HYDRONIC []OTHER
ENERGY CODE METHOD OF COMPLIANCE
0 PRESCRIPTIVE: List Option @--
0 TARGET UA APPROACH: Provide UA C..luations
0 SYSTEMS ANALYSIS: Provide Computer Analysis
ENERGYIVENTILATION WORKSHEETS PROVIDED
WINDOW SCHEDULE PROVIDED
VENTILATION CODE COMPLIANCE INFORMATION
FOR CITY USE ONLY
calling insulation E-3
Wall Insulation
Flo*, Insulation
Door U-Valuo
Window U.Vslue
Skylight U-Value
Glazing %��_j
KITCHEN FAN CFM BATHROOM FAN(S) CFM 05J2
LAUNDRY FAN CFM_Ep_
WHOLE HOUSE VENTILATION SYSTEM
EXHAUST OPTION
FRESH AIR TO BE PROVIDED TO WINDOW VENTS WALL PORTS
EACH HABITABLE ROOM WITH:
EXHAUST FAN TO BE CONTROLLED WITH 24 HOUR TIMER AND SIZED AS FOLLOWS:
1 - 2 BEDRO011s: 50 - 75 CFM 4 BEDROOMS: 100 - 150 CFM
3 BEDROOMS: 80 - 120 CFM S BEDROOMS: 120-IBOCFM
1RHVAC INTEGRATED OPTION
DEDICATED HEAT RECOVERY VENTILATION OPTION
SEPARATE PERMITS (City Use Only)
0 RIGHT OF WAY CONSTRUCTION PERMIT 0MECHANICAL PERMIT
0ENCROACHMENT PERMIT 0PLUMBING PERMIT
BSTATE ELECTRICAL PERMIT OWATER METER
13FENCE PERMIT CISIDE SEWER PERMIT
ORESIDENTIAL FIRE SPRINKLER PERMIT OIRRIGATION (SPRINKLER SYSTEM)
0OTHER E]OTHER
Any request for modification, variance of other administrative deviation (herinalter "variance')
must be specifically called out and Identified. Approval of any plat or plan containing provisions
which do not Comply with the City code and for which a variance has not been specifically
identified, requested and considered by the appropriate city official In accordance with the
appropriate provision 01 City Code Of slots law does not approve any Items not to code
specification.
PERMIT ISSUANCE APPROVALS
PLANNING REVIEW & APPROVAL
CONDITIONS OF APPROVAL:
(City Use Only)
DATE
ENGINEERING REVIEW & APPROVAL
CONDITIONS OF APPROVAL:
DATE
BUILDING REVIEW & APPROVAL
CONDITIONS OF APPROVAL:
DATE