21409 84TH AVE W.PDF111111111111
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21409 84TH AVE W
RTSEE FILE
DEPARTMENT
Applicant Fill
USE PERMIT
ZONE NUMBER
PERMIT APPLICATION
Inside Heavy Lines
OB
ADDRESS
Ale q —
[BUILDING
E M E
NAM JOR NA OF BUSINESS)
/;17 '6; 17
LEGAL LOT
PLAT NAME
SUBDIVISION NO.
DYES NO
W
WAILING ADDRESS
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0
0
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PUBLIC RIGHT OF WAY PER ORDINANCE NO�
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W ADDRESS
U
M CITY
NAME
0 ADDRESS
U
Ir CITY
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Z
0
U
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U
VI
W
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J
W
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TELEPHONE NUMBER
EXISTING RIGHT OF WAY
7 7S—I-?,2
PROPOSED RIGHT OF WAY
DEFICIENCY OF RIGHT OF WAY
Publt±bP
�SU e P L�-
STREET/UTILITY WORK REQUIRED
YES
NO
PERMIT FOR WORK IN PUBLIC R/W
UNDERGROUND WIRING REQUIRED
YES
0 YES
NO
I NO
TELEPHONE NUMBER
CONNECTION TO SANITARY SEWER
SEPTIC TANK PERMIT REQUIRED
1:1 YES
0 Y ES
I NO
EA No
eflz""' e'-
SEPTIC TANK PERMIT NO.
SEE MEMO DATED
TELEPHONE NUMBER
REMARKS
NUMBER
CITY LICENSE NUMBER
CHECKED BY
of Property (Show Below or Attach Four Copies)
EMEIER SIZE BUILDING SUPPLY SIZE
SIGN AREA ENV. REVIEW I ADI3 NO.
ALLOWED I PROPOSED 1COMPLETE1 EXEMPT I SHORELINE
REMARKS
VARIANCE OR CU PLANNING REVIEW BY DATE
YARDS LOT COVERAGE
FRONT SIDE REARI
F�NEW RESIDENTIAL GAS FIRE ZONE TYPE OF CONSTRUCTION CODE
I LINE IHEi7wr
F-1 ADD 11 NON-RESIDENTIAL 1:1 SIGN I
ALTER
DEMOLISH
EXCAVATE
OR FILL,
RETAINING
WALL
(FMY X J& FT)
SPECIAL INSPECTOR
REQUIRED
1:1 YES 1:1
JAREA
OCCUPANCY
GROUP
1
OCCUPANT
LOAD
1
PLAN CHECKED BY
THIS SITE
IS LOCATED IN THE
CITY
REPAIR
PRE -MOVE
INSP
swim
FIPOOL
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
REMARKS
Z NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE
(r
.0
W
PLAN CHECK FEE VALUATION FEE
PROPOSED USE A I :T
i . . ABUTTING STREETS) BUILDING
u
0
W PLUMBING
0 MECHANICAL
FENCE
tn "Ap plicant, on behalf' of his or her spouse, heirs, assigns and SIGN
U)
W
J successors in interest, agrees to indemnify, defend and hold harmless
2 the City of Edmonds, Washington, its officials, employees, and 'FIETAINING WALL
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3:
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W
3:
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W
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1�
DATE:
MEMO TO: Building Division
Community Development Department
FROM: Engineering Division
Public Works Department
SUBJECT: FENCE PERIMIT APPLICATION - -�
4
After reviewing the subject Fence Permit Application, we have
the following comments to make:
(1) After a plan review and. on -site inspection in reference
to.the safety of adjoining pro erties as well as the
public right-of-way, the Engineering Division has
approved this.application.
(2) The a�pl
. ication
must be a2�roved
by
the City Planner in
accordance
with
Section (Z)
ot City
Code 12.14.OT-G-.
PW
5/77
0
Z
H
Z
W
*IC NIDRKS DEPARnnu qMnIS's IW7 Date
KiUDING PE[O= REVIW
q
0-14c, f V4*'PL�_ t�j ddress
Street,Right-of-Way Existing.. REQD
Access Easements Existing. -r�orir�_ REQD
Utility Easement Existing r-4t___ REQD
Lot per Subdivision Plat Assessor Map, '>e'
Site Plan Checked for Accuracy
Underground Wiring Reqd.
Check Accuracy of Legal Description
Environmentally Sensitive Area
Environmental Checklist Reqd.
Flood Hazard Zone
Shoreline Management Area
Slope, Soil, Vegetation
Stream, Creek, Drainage Basin
Existing Zoning Per Code
Amenities Design Board Approval Reqd. tJO ADB # Approval
Board of Adjustment Approval Reqd. QL)
Review Bv: Date: S/I S1__7AO_
Existing Water LMaIn Size
Water Main Reqd.
Service Line Reqd.
W Hydrant Size Existing
Hydrant Reqd. Per.Fire Code Size
Detector Check Meter Reqd.
Cross Connection Inspect3ion
Fire Department Ccmments
Water Meter Charge Reqo.
Review by: Date:
M JKXX 2&
beptic Tar�c Design Approved
Septic Tank Permit Reqd. Permit No.
Sanitary Sewer Availability Proj.
Drawing No. File No.
Side Sewer Availability
W Sanitary Sewer Connection Fee Reqd.
P
'evic" By: Date:
Open Ditch
Culvert Reqd. Size
CC -Itch Basin Reqd. Indicate on Site Plan
0 Shoulder drainage n-nintaiii collection ai s%�ale open runoff
rcqd. Indicate on Site Plan
Soil Conditions, and Ground. Water Field, Checked
P10"'i0T.'7 by Da te
P4
Street Paving Reqd.
Curb and Cutter Reqd.
Sidewalk Reqd.
Curb Cut . for Driveway Req'd.
Right-of-Ulay Construction Permit Reqd.
Bond Reqd. for Public Ix�)rovements
Street Nanie Sign Reqd.
Other Sipgnin,, Read.
Pre Permit Site Inspection m.de on
0
BY: SE1.1ER
U�
WATER
4
S=T
ENIGI=RING
W ME M W 1Z M&
Special ReqLdrc,-,-.',-,j-lLs listed in nieim to
Conir"niv Developmnt Departifent,
BUildifig I)i%;-iSio,'l
BY
Date
0
A 11 items filled in on Building Pernlit
Application
13Y
Date
Errawings Stap-ped and. Notations 1�1-ide
BY
D9te
Dlic 'vlorks Departrient:
Approved hy all
I'!'-'vj..-;ed: 1v 10-1977
APPLICATION
for
The City of Edmonds SIODE SEWER PERMIT EASEMENT No . ..........................................
NEW CONSTRUCTION [I REPAIRS 0
324-05800
A. M. Knutson
OWNER.................. ........................................................................................... CONTRACTOR .................................................................................................. PERMIT No . ......................
ADDRESS ........ �1409 84th Avenue W . ...............................
...............................................................
0
0
LEGAL DESCRIPTION: LOT No . ...................... : ....................... BLOCK No.
NAME OF ADDITION ..............
Dye Tested On Sewer 1972
Approved:
DATE................................................ By .......................