18223 76TH AVE W.PDF111111111111
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PLANNING
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R.ESUB
MAR 13 2012
BUILD ING DEPAR-FiMENT
CITY OFEWONDS
PLANNING DATA
SINGLE FAMILY RESIDEN17AL
I S TREE T =FILE
Name: g:
Date:
Site Address:
Tax Parcel:
00a+0200W050-
Project Description: eo,. 3/
S. rN Cie.%K-
Plan Check #: SL'0%0%?-14i%34
S' 61 IV ZZ ;�,� �--co i "qpj.�& 4 s4u*rz�
Reduced Site Plan Provided: /fE—S-2)NO)
Zoning:
Map Page:
Corner Lot: (YES AO
Flag Lot: (YES
Critical Areas Determination #: C-91%AQ,01=00
El Study Required
JU waiver
SEPA Determination:
Exempt
Needed (for over 500 cubic yards of grading)
0 Fee 0 Checklist 0 APO List with notarized form
Required Setbacks
Street:
OL5.,
Side: -X
Side:
(S of
Rear:
ActualSetbacks
Street:
Side: 10,+ it
Side: (A) to'
Rear: �E) as
El Detached Structures:
Rockeries:
Fences/Trellises:
Bay Windows/Projecting Modulation:
Stairs/Deck: IN-cipasad 4 sxu.-.cm. 0#% sAe-96-m
Q Height
Da turn Point: N
A
Datum Elevation: NIA
011
Maximum Height Allowed: e
Actual Heig ht. 9. d,' 40 c(ex-%,.
Other,
Parking Required: Sjr -Aa\
Parking Provided: h1a
Lot Area:
Maximum Lot Coverage: 35% Proposed:
Lot Coverage Calculations: Pro P 0 sed D P- yfb; I 1-f I -T*k- a S 2 --!k 0 1:2. :102 1 s Oz.'
ADU Created: (YESO
Subdivision:
Legal Nonconforming Land Use Determination Issued: (YES
Comments
P4 e U_9,FA.C-a 'CC -Of" 6*t^rd%.r7 v1F U-r-ceV% ilt:b-Serime,4.
Plan Review By:
Planning Data Form 07-14-09
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STREET FILE ENGINEERING PU8LIC,Wo'RX8
PROJECT REVIEW
CITY OF EDMONDS
CWC C160(A * IWOOM. %VASM*41ON Wn
CHECK LIST
SINGLE FAMILY IWLTIPLE COMMEMAI
PROJECT WE gxl-r 5FI;ir. CONTACT WIE TELEPHONE NUMBER
ADDRESS J,?ZZ,3 r1417,fAVe ;V.
INITIAL DATE CIMENTS
ACCESS SLOPE AND VEHICLE ACCESS
Z12-4';
i DRAINAGE PLAN
STREET FILE
LEGAL DESCRIPTION VERIFICATION
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QUIT CLAIM/DEDICATIONS
EASEMENT - PUBLIC/PRIVATE
CALCULATE SEWER CONNECTION IF NO LID f
STREET PAVING REQUIRED
CURB AND GUTTER REQUIRED
SIDEWALK REQUIRED
CURB CUT FOR DRIVEWAY.REQUIRED
RIGHT-OF-WAY CONSTRUCTION PERMIT REQUIRED
BOND REQUIRED FOR PUBLIC IMPROVEMENTS
STREET NAME SIGN REQUIRED
OTHER SIGNING REQUIRED
(ADDITIONAL CONKENTS ON BAC
EXIS71NC- WA7ER MAIN SIZE
1`5 T
WP7(R MAIN REQUIRED
SERVICE LINE REQUIPED
HYDRANT SIZE EXISTING 17�111
HYDRANT REJUIRED PER FIRE CODE SIZE
CROSS CONNECTION INSPECTICH
;73— 1
WATER HrTER CHARGE REQUIRED
DATE (AWITIONAL CC*KNTS ON BA
SANITARY SEWER OWING 100BER . FILE 10"ER
SIDE SEWER AVAILABILITY SANITARY SEWER COVIECTION FEE REQUIRED
OPEN DITCH EXIST111A REQUIRED
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DATE:
MEMO TO: Building Division
Communitv Developm'ent Department
FROM Engineering Department
SUBJECT:
After review of the subject Building Permit application, we have,:�i
the following comments:
1. Connection to City water system -required.
2. Connection to City sanitary sewer system required.
3. Rip
,ht-of-wav Permit required for any work on City property.
4. Driveway slope not to exceed--14'10.*
5. Backwater valve required if downstai,rs plumbinBis I)elow
elevation of upstream manhole.
6. Water and sewer lines to be -separated by 10 foot minimum.
7. Builder/Owner responsible for containing all'temporcIry run-
off and erosion on site and mav not impact neighboring
properties in any way.
Signature
SE
U USE PERMIT
CITY OF EbMONDS
ZONE
ZONE NUMBER
CONSTRUCTION PERMIT
APPLICATIOU
JOB
JOB
NAME (OR NAME OF BUSINESS)
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LEGAL DESCRIP CHECKI
SU BDIVISION NO.
LID NO.
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CITY
TELEPHONE NUMBER
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
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REQUIRED DEDICATION
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RIGHT OF WAY CONSTRUCTION PERMIT REO IRED
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STRE ET USE PERMIT REQUIRED 0
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SEE ENGINEERING MEMO DATED
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TELEPHONE NUMBER
SEE PIW DEPT. REVIEW CHECK LIST DATED
REMARKS
NAME
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CITY LICENSE NUMBER
SIGN AREA
ENV. REVIEW
AD8 70.
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Legal Description of Property - Include all easements
ALLOWED
PROPOSED
COMPLETE
EXEMPT
(show below or attach four copies)
SHORELINE#
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NEW
RESIDENTIAL
PLUMBING
ADD/ALTER
NON-RESIDENTIAL
El MECHANICAL
ElREPAIR
RETAINING WALL
SIGN
EXCAVATE
E] DEMOLISH
FENCE
CHECKED BY
TYPE OF CONSTRUCTION
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]CODE
HEIGHT
OR FILL
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PRE -MOVE INSPJ
COMPLIANCE INSP.
SpW001M.
SPECIAL INSPECTOR
AREA
OCCUPANCY
OCCUPANT
REQUIRED
GROUP
LOAD
SIDE SEWER WATER
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REMARKS
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NUMBER OF STORIE9 NUMBERO
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VALUATION FEE
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY. GRADING/FILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
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Fermit Application: 180 Days
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Permit Limit: 1 Year - Provided Work is Started Within 180 Days
"Applicant, on behalf of his or her spouse, h eirs, assigns and
successors in interest, agrees to indemnify, defend and hold
i
harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
DATE: March q 0 1982
I
10 TO: Btillding Official
Building Department
FROM:
SUBJECT:
City Engineer
Engineering Department
SEWER CONNECTION CHARGES
76th Ave. W.
kbtreet Address)7
Wayne Meyer
(L
Single Family Residence x Subdivision Plat
PRD Multiple Commercial
LEGAL DESCRIPTION: Lot 4 of Snohomish County Su'bdivision of
Lot 5, Block 3, Admiralty Acres, Section 18, T27N, R4E.
Z.F.F. Calculation:
Minimum Charge
$ 300.00 Assessme'nt
Lateral x( $ Lateral Charge'''
f $ Equivalent Count
(when applicable)
Units(s)x( $25.00) $ -?S-.00 Trunk Charge
$ %70.00 Permit
$ 3,5-S--00 TOTAL
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CC: Owner
Street address file
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FILE
CITY OF EDMONDS: ASSET INFORMATION SHEET
[De'NEW ASSET NO. 9)L-2
ADDITION ADDITION TO ASSET NO.
RETIREMENT
DESCRIPTION
SERIAL NO.
LOCATION DEP?O
a V
"PURCHASE ORDER NO. —
PURCHASE ORDER DATE
COST
B. A. R. S. ACCO U N T N 0.
ESTIMATED LIFE
*PROJECTNUMBER
PROJECT COMPLETION DATE
COST
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
R/DEPRECIATE-
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
0 G.L. ENTRY
REFERENCE
DATE
VERIFIED BY
PROCESSED
BATCH NO.
INITIAL
(vp)
DEPARTMENT FILE
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City,' 'of! Edmonds
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PERMIT
Permit Number.
Issue Date:
Lnity of Construction: 18223 - 76TH AVE WEST
Type of Work (be specific): GTE TO TRENCH 60-FT & PUSH 37-FT ACkOS
TO PLACE PVC. PLEASE SEE ATTACHED PRINT.
C. �Contractor: -GTE NORTHWEST INCORPORATED — Contact: BARBARA TOLLEFSON, PERMIT COORDINATOR
Mailing Address: 22118 20TH AVE. SE SUITE 13(lhone: BARB 488-1642
State License #: BOTHELL. WA 98021 Liability Insurance: _ Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. n Commercial 0 Subdivision [:3 City Project U Utility (PUD, GTE, WNG, CABLE, WATER)
0 Multi-Farnily E] Single Family 0 Other W.O.# 2100-5POOIAV-02 242310
INSPECTOR: INSPECTOR: 1A Ik i b�dm
F. Pavement or Concrete Cut F0 Yes ONo G. Size of Cut: I x 4 H. Chargq�,$
APPLICANT TO READ AN�D 1, IN
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City
INDEMNITY. Applicant understands and by his signature to this application, agrees to h e ofEdmonds harmless frorh injuri�fs, damages, or
clairiis of any")Vi"ordescr-iptioln'��ts66'verlf6r6,aen-orunforeseen, that may be made against the City of E�monds, or any of its departments or
crnp�io�ees,4rieludi7g or not limited t4? ) 'cost�. and attorney fees by ri�ason of granting this permit.
-,-!he NelrAe of. any legalproceedings including defen8 e
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THE co c�bi? AIRESPONSIBLE FOILWORKMANSHIP AND MATERIALS FOR PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTIONAND ACCEPTANCE OF THE WOj?'W"E9'T'1MATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE, TOTHEAPPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour noiice is required for inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with Ci&-regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
Ihaue read the aboue statements and understand thepe�mit requirements and thepink copy of thepermit will be
auailable on site at all es7Zo;r �'pe 1 npucse
Signature: Date: 1-11-94
4�_�Contractor o6JY F L
ne%Y1wAn,6
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY:
TIME AUTHORIZED: VOID AFTER 2.1DAYS
SPECIAL CONDITIONS:
Q0:71L C--ITX UATF-IL IrNLEI&L AS tied
COMMENTS: c1thl
Z4 VA0vVL5 I #40\1 ANCZ -1-11 - 07.15
DATE:
RIGHT OF WAY DEPOSIT
DISRUPTION FEE/FUND Ift:
RESTORATION FEE:
-,NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE . Engrg. Mv. 1991
j
FIELD INSPECTION NOTES
Comments:
Diagram.:
(Fund f 11 - Route: cqpy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION
Partial Work Inspection by P.W.:
Work Disapproved By:
FINAL APPROVAL BY:
El. YES
Date:
Daf6:
NO
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CABLE & COUNT
BEFORE
AFTER
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PERMI
DETAIL
E N 0 SECTION
MAX BRIDGE TAp 46991
A M L A L R
I M I T 1500
0 F F I C E L 0 0 P L
APPROVED BY DATE
X
GTE PED
USE FOR ROUTINE ONLY
PRIORITY 00 ECAS G112
IN SVC 03/12/ 4
DRIVER
El DOR
0 PMO/TRANS/SAFETY
11 HICAP/SPAN
0 OPUS
El PUBLIC REQUIREMENTS
11 PLANT RELIEF/CABLE- CONG.
0 PLT. EXT/COMM. DEV./RCTA
IN SERVICE DATE 0-2-12-94
PERMITS
CONSTRUCTION
0 BLANKET
0 DIA L. A DIG
0 STATE
0 FLAGGING
�D COUNTY
El BRUSHING
0 CITY
0 NONE
SPECIAL CIRCUITS 0
CAUTION
POWER BUG 0 AE
CUTS REQUIRED
OTHER 11 UG 0 AE
11 YES IM NO
TELCO IN UG 0 AE
JOINT POLE
JOINT TRENCH
0 PUD
11 PUD
0 PSP&L
El PSP&L
0. CATV
EI.CATV.
IT GTE
0 'GTE
In. NONE
FEES REO'S
0 GOP El LEC
POINT OF
0 SPEC. CONST.,------CtKACT
P1 NONE
ENGIN R Carl Samuelson
�a "IS'
PHO E NO. (206) 488-162(0-,-""
M BULK El ROUTINE
MATERIAL
CODE DESCRIPTION
EST
ACT
2806625 AK-17:25-26
50�
242";
74�"
PLACING HOURS 32
SPLCING HOURS 18 L4
FXCHANCE COUNrY
Halls Lake Snohomish
TITLETELT PLAT-4 LOTS N)
6
a 183RD ST.S.W. & 76TH AVE. W.
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T.27N R. 4E SEC. 18A OF I
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�ICITY
OF EDMONDS
Fga INSPECTION CALL &L�K
76PUBLIC WORKS DEPAR Permit 11 �O
1/ 0 -
.SIDE
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FILE !'2 �O Issue Date < 1 4
SEWER aw
PERMIT MUST BE POSTED ON JOB SITE
1.
Address of onstruction ILYNNWOOQ LINE
=
2.
Property,Legal Descriptio n (include all, easements) 4
Lo+ f PUBLIC WORKS
3.
Single Family Residence M�lti-Family No. of Units
Commercial
4.
Owner and/or Builder 4104 4J 5 /� E-L r
5.
Contractor & License No.
6.
Invasion i-nto City Right -of -Way: No Yes (If Yes Right-of-
way Construct�ion Permit Required - Call Dial Dig (A412-!5-'A4/4) before
1-800-424-SSSS
excavation).
E-1
7.
Cross other private property: Yes No Easement required -
attach legal description and county easement number.
READ
THE FOLLOWT,NG 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 repo.nsibility 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. 0
e. Side sewer lines must be laid at a minimum grade of 2% (1.15
and maximum grade of 100% (450). 0
f. No turn,in-side s8wer greater than 45 (1/8,bend) is 0 allowed
between cleano!�,t. All 90 turns must be constructed of a 45 (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.
DATE: 2 3
-.-I certify 'that Ihave read
and shall comply with the above
Date:
PERMIT FEE: �,-30-oc DISAPPROVED BY:
B Date:
0 -,Qo / 4 4
CONNECTION FEE:,��-_()Dno APPROVED By Date: 8-23- 84-
0
44
PERMIT MUST BE POSTED ON JOB SITE fAP14--
0
The City of Edmonds Side Sewer Drawing EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION REPAIRS E] LID NO - ------ ------- - ASMT. NO - ------------------
OWNER .7T7174-0
.ft
. . ..... E; ------- I: E-L.1 ------------------------------- CONTRACTOR
JOB ADDRESS .... 1$22,3 ...... ---- ------------- PERMIT NO.
vF — ----- W ----------- LEGAL DESCRIPTION: LOT NO - ----- 4
-- -------------------------- ... BLOCK NO - -------------------------
---------------------------------------------------------------------- I-- ---------------------
NAME OF ADDITION -------- I
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Approved:
lip
Sewer Drawing
The City
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Side
EASEMENTNO . ....................................
NEW CONSTRUCTION REPAIRS [j
LID NO . ......... ...... . ASMT. NO
OWNER ......
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A. P-P.R-O.A. ... te�.-�Z.M:q CONTRACTOR� .....................................................................................
PERMIT NO - ----------
JOB ADDRESS .............. ........................................................................
. LEGAL DESCRIPTION: LOT NO - ---------------- -----------------------
BLOCK NO . .............. .................
...............................
----------------- - -----
NAME OF ADDITION .... ........... .........................
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