18823 81ST AVE W.PDF11 lill 111111
7361
18823 81 ST AVE W
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS:
DISCRETIONARY PERMIT
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORT PLAT FILE:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S)
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DA
OTHER:
DETERMINATION: []Conditional Waiver E] Study Required E] Waiver
LID #:
LOT: BLOCK:
LATEMP\DSrs\Forms\Street File Checklist.doc
0 PLANNING DATA
SINGLE FAMILY RESIDENTIAL
0 1 =STREET ��]
Name:
Date:
Site Address:
Plan Check #:
Ls- >
Project Description: "'o ,a -
Reduced Site Plan Provided: S NO)
Zoning:
Map Page:
Corner Lot: (YES
Flag Lot: (YES pl!�))
Critical Areas Determination
11 Study Required
W�Vaiver
SEPA Determination:
Exempt
Needed (for over 500 cubic yards of grading)
El Fee 0 Checklist El APO List with notarized form
Required
Street:
Sil
de:
Rear:
Actual Setbacks
Street:
Side:
Year: li -7
El Detached Structures:
11 Rockeries:
El Fences/Trellises:
El Bay Windows/Projecting Modulation:
Pff'Stairs/Deck:
Pielght
Datum Point:
Datum Elevation:
Maximum Height Allowed:
Actual Height:
Other
Parking Required:
Parking Provided:
Lot Area: I L 4�.� -�
Maximum Lot Coverage: 35% Proposed:
Lot Coverage Calculations: A— — �-a 0 � - ) ?- 7,-
1 LIX-S-
ADU Created: (YES / NO)
Subdivision:
Legal Nonconforming Land Use Determination Issued: (YES / NO)
Cornments
Plan Review By: (f—
Piammig Oata form 04- [1-06.doc
V)"_
0 F EP I D M. "M I M 1
1W CITY
E WY
rRTMENT. ,
NV W� -'DE
z.,
PERMITY
5 177'
(qall 775-25M for side.,sewer. coveri�g, any. �portionof the construction,
-be proyl ed:,,withirk,:2�k-*,, �Sun �or:holld�y In sp�ctjo� S.
Inspection: ��Ill
urs afrer� requst. NO, Sat.
N XONSTRUCTIONL
:.A,DDRESS_,A;0CA1T0 OFt' ..... ksRm .................. ...... ........... ......
............
..........
....... .................... .... ........
'T,
. .........
....................................
.......................... ................ ....... ............. .................
.................. ....... '014W, .................
........... IER,��D/OWBU 'PER ... .... ........ .. ...........................
TRAr
vCTC
.................
.......................... ...... . ......... .............
................................. ...... 16-,.,7!F-i-,fo'r,irepa�ir��andVor,.,conne4dti6n lof a,91de sewer 'to the:city.- saiiitar
M y r
4n1.1A dainci_e'-xvitfil�cl�'Y. .,of.!Edii�fonds,,or�dlnan(�6s.:
-k-,"M�i P Nj IS, CA!��Io TO��HE FOLI�OWINi3:
NOTE-V6.
1�T�e owners; ol!Ahe propeity�,may 6b*tain
slde� :36werdn-street,-area. Do not cover a permit to, construct sewer Inside' -property line' A11censed Side Sewer Contractor.must be:employed, to��corrstruct
any, portibn -of se er before it ':has;been lnspcp�SA,,�..
�A,11, worli .;performed in, city fight- I of -way r . . I w - i z ' - " j
NOTE ?No. 2 equires an Invasion, of Rlght-of-W.a:y ,Permit- obtkihiLblb �from'the City Engine'
er's office.
n you -get permit.
NOTE,No. '3—Obtairi lull I' formation ieiardi�g ordinance 1.1.16.030 andi'llegulition B"w e rs�
s govern�ng side &
NOTE No.. 4 . —Top'Jof sid'e'sewir inust have at' -least 30 inches'. coverage at propert I Y. line and 12,1�che�',tn�lde property line; minimum grade of 2 No bends In grade
'sharper,thawJ/s will b6.perrhitted.
N qTE No;::& --'Trenches, L �in str�et, riiust7 �e` wa:ter; settled and- surface of street -orijinaJ condition"'doritraetors shall be responsible for failure A - ue to Improp I er
restored to I
work which. -may, �divelop,41thin one year of completion.
NOT No:'*�It`
is unlawful fo�_.Itert.br-'do-:any other work-thazi is provided for,in the lnrmit, O�.. o- qq,any wo�r� pn the main sewer or Its appurtenances except to in'
h
q- Isert Ithe pipe, into;t e.-,,WYe�
.-�`DISAPPROVED
Date .... ........... 4 ... ............. �.* .... (By .................. 'Date ',:,BY ................ Date ............. ....................... BY
................. . . ....... ..
PROVED :.',D1016 ......
Remarks: . ...............................................................................
�':BOT_H,'�Perm , smu B ner'' fFi -.P'-rf
it.,'Copie ST e Sig�,efi�-By, w o rm e ormingi,,Qns r.ucti6nPR16R To Request For Inspection
'khereby certif k,!,th;it'�.t'h6-_;s_ide',' u -,permit .
... .......
. ............... .................... sewer installation constructed nder tAis
(Own6rof Contracting Firm, PerfGrming.:Construction
-governing ordinances,o it e*,'6-i"y"-_,_' 1�d
wL�nstalied,JiA accofdance with'all h' t f on s.
.9 d tHis ........ ..... �14Y,',Of ............. 1 . ............ .......... ......
.4
'dig, for: - ' ' .'a"' � MR,T;c I T6205
GA9
-'BEFORkyqu, Wdte'*r.,,,[j,,j'�,,, I
plie, �ewcr -Other
APPLICATION
The City of Edmonds for EASEMENT NO . .......... ....................
SIDE SEWER PERMIT ............
NEW CONSTRUCTION REPAIRS LID NO. � ................. . ASMT. NO . ..................
OWNER ......
- ---------------------------------------------------------- CONTRACTOR ...................................................................... ------------- PERMIT NO.
JOB ADDRESS ----- --------------- c .1 ........
_1 ------------------- LEGAL DESCRIPTION: LOT NO - ----------------- 4 -------------- BLOCK NO - --------- / ------ ---------------
el) 51 ('141, .1 /-7z
--------------------- -------------------------------------------- ............ ------------- -------------------------------------------------------------------
NAME OF ADDITION --- ......................
...........
Approved:
DATE-------------------------------------------- By ------------------------------------------------------------
j
The City of Edmonds
APPLICATION
for
SIDE SEWER PERMIT
CONSTRUCTION E REPAIRS E]
EASEMENTNO . ............. _ ........ ..............
LID NO. _l_;�.?.__._ASMT. NO. -?l ___
�a. Aw-
=>
_rt'!
OWNER Lj
-CONTRACTOR ... T ----PERMIT -:�No
,zw ----------------------- ------------------------- ----------------------- I ........................................ . .......
JOB ADDRESSV_e�� �__ \ - 1,12 - '. . . . I
--------------- .............. I -------------- i* ------------ ...... _ LEGAL- 'DESCRIPTION: LOT NO. .� ....................... ----------- �_' BLOCK NO .. ..............
----- --------
------------- I ............................................................... -----------------------------------------------------------------------------
NAME OF ADDITION
- ------------------------------------------------------------------------------------------------------ ..........
Approved:
B y
DATE .........
ODD JOBS BY MILLS
R0813Y A. MILLS
81 -!4 , ?06'rH SW
EDMONDS. Vv,� 98026
PH(LtvE (206) �',"974
OGL;�urvl - -)9801
CUSTOMER'S ORDER NO. DEPT. DATE
NAME
ADDRESS
SA
�Dd �3 4
SOLD
C^ SH
cc
D,,I Accl.
I DS PETD.
I PAID OUT
QUAN.
DESCRIPTION
PRICE
AMOUNT
o C
2
V 4
3
4
('n �z I
a,
5
6
0(9
8:
9
io
i f
12
cd,
13
14
. .15
16
17
REC'D BY
5020
KEEP TH;S SLIP
FOR REFERENCE
0 C,.,
�,>A L.A -= 4
Clio
Zone— Comeri—J-PIA&I—)
Setback Reggired Acjg
Front 9-f5--
Sideojl� 1.5
Rear I t-.7
Other
Hei a
W
p
JUL .- 2 2009
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
20
Os cc-,
Nit- 0-01 0-�X) - Lot I -L
�'l 3
STREET RE