21819 82ND AVE W.PDF111111111111
7599
21819 82ND AVE W
-----7. 1 1 &.j Ab )
BUILDkNG� DEPARTMENT
11M I T
NUMBER
j
:S
PERM�T PLICATION sAREM e
_g
4
JOB 17 K
ADDRESS � CR I / � _. �A —
W
4P
NAME JOR V"VAE OF BUSINESS)
MAILING ADDRESS
LEGAL LOT
DYES - ONO
1
P LAT NAME
—7
ISION NO.
z
0
0
PUBLIC RIGHT OF WAY PER ORDINANCE
3
EXISTING RIGHT OF WAY
PROPOSED RIGHT OF WAY
CITY
_Sea)
TELEP-ONE NUMBER
NAME
U
W
t
1.
U
I'JCITY
4
DEFICIENCY OF RIGHT OF WAY
ADDRESS
STREET/UTILITY WORK REQUIRED YES NO
PERMIT FOR WORK IN PUBLIC R/W YES El No
UNDERGROUND WIRING REQUIRED (KYES 0 NO
CONNECTION TO SANITARY SEWER IQ YES El NO
SEPTIC TANK PERMIT REQUIRED D YES XN 0
0
3:
U
3
m
:3
IL
TELEPHONE NUMBER
NAME
m
SEPTIC TANK PERMIT NO.
0
U
-C
ADDRESS
SEE MEMO DATED
I Z.- I C173
CITY
TELEPHONE NUMBER
REMARKS
M
I'_
Z
0
U
STATE LICENSE NUMBER
CITY LiC ENSE NUME03E
CH ECKED
Leg . al Description of Property (Show Below Or Attach Four Copies)
WE7rE R7E ,113U[LDif4G
SUPPLYS.IZE
1
z
0
ZI) 7- Q e.) v1 A � "1
.4
4
j
0-C C-I C.) 7 6. P 7—A
RE."'ARKS'
re e: '114
-1 A
SIGN AREA
ENV. REVIEW
ADB NO.
W
W
1,
ALLOWED PROPOSED
COMPLETE EXEMP
SHORELINE #
Z rx
REMARKS
VARIANCE OR CU
PL.ANNING REVIEW BY
DATE
YARDS LOT
FRONT SIDE 16 REARI
COVERAGE
GAS
RESIDENTIAL LINE
NON-RESIDENTIAL E] SIGN
F 1 ADD
El DEMOLISH RETAINING
DWALL
EXCAVATE FENCE
ALTER OR FILL
F
EJ REPAIR PRE -MOVE swim
11 INSP. El- POOL
FIRE ZONE
TYPE OF CONSTR UCTION I
CODE,
HEIGHT
SPECIAL INSPECTOR
REQUIRED
D YES 1:1 ri
AREA
JOCCUPANCY'
GROUP
OCCUPANT
LOAD
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
REMARKS
Z
0
z
NUMBER OF STORIES
NUMB R OF
DWELLING
I-
UNITS
NATURE—OT-WORK TO BE DONE
U
W
IL
W
m
0
a
I-
W
PLAN CHECK FEE
VALUATION
FEE
PROPOSED USE
AJ
PLOT PLAN (INDICATE BUILDING SETBACKS, -
ABUTTING STREETS)
BUILDING
U
0
W
IL
0
W
>
PLUMBING
mECHANICAL
0
FENCE
SIGN
z
0
U
In
W
j
I
I
"Applicant, oil behalf of his or tier spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold hartilless
the City of Edmonds, Washington, its officials, employees, and
a'ents from any and all clainis for daniages of whatever nature,
9
arising directly or indirectly front the issuance of this permit. Issu-
RETAINING WALL
SWIMMING POOL
0
ance of this permit sliall not be decined to modify, waive (,r reduce
Zo 7L
j-e c,-o
pen
38 Pl--? 7s s
a u,6 c,*,3�; r—
� wt
all- ~,
- - — -----------
MEMO TO:
FROM:
SUBJECT:
Date ig-7 ie
Building Division
Community Development Department
Engine ' ering Division
Public Works Department
After review of the subject building permit application, we have the
following comments:
2F Coordination of the location of any structure with respect to
utilities, streets, property lines and driveway grades is the
responsibility of the contractor';
The contractor is required to keep' the abutting streets cleaned
of dirt and debris caused by the construction.
The "Right -of -Way Construction Permit" is required, from the
Engineering Division of Public Works, for any work within the
Public Right -of -Way or public easement.
Driveway slope not to exceed 14%.
Connection -to sanitary sewer required.
/-7 Septic Tank Permit required, submit design.
Fire hydrant required, submit design.
Site drainage per code # See approved plans
Sidewalk
Curb
Paving required.
1-7 Bond . required for public improvements. Submit cost estimate.
Underground wiring required.
L-7 Approved Engineering Plans required when applicable.'
1-7
ror —Fre
a F. Herzberg, P.E.
City Engineer
Department of Public Work's
Rev.. 7/78
Y I
46LIC WRKS DEPART= CHECKAR iZ- I X-I le Date
BUILDING PERMIT REVIEW
0
Z
�-A
Z
F . A
U
Z
14
ajyxCj - VZ_ 'Lq�JUV- qdress
Street Right -of -Way Existing ";C� AC) REQD
Access Easements Exi�sting 'N-�bna REQD
,Utility Easement Existing -Pe22- REQD
Lot per Subdivision Plat Assessor Map-,
Site Plan Checked for Accuracy
Underground Wiring Reqd.
CheckoAccuracy of Legal Description Y -11(
Environmentally Sensitive Area
Environmental Checklist Reqd.
Flood Hazard.Zone
Shoreline Management Area MN
Slope, Soil, Vegetation
Stream, Creek, Drainage Basin
Existing Zoning Per Code Qs - 9
Amenities Design Board Approval Reqd. !jjn ADB # Approval
Board of Adjustment Approval Reqd.
Review By: Date:
Existing Water Main Size
Water Main Reqd.
Service Line Reqd.
Hydrant Size Existing
Hydrant Reqd. Per Fire Code
Detector Check Meter Reqd..
Cross Connection Inspection
/Y
159 'fr _
AIA Size
Fire Department Comments
Water Meter Charge Reqd. 2
Review by: Date:
I- UaLe:
Septic Tank Permit Reqd. Permit No.
Sanitary Sewer Availability )ze-C.-
Proj.
Drawing No. File No.
Side Sewer Availability V&-
Sanitary Sewer Connection Fee ieqd.
Review By: Date: '7
Open Ditch Existing Reqd.
Culvert Reqd. Size
r4 Catch Basin Reqd. Indicate on Site Plan
0 0 Shoulder drainage n-�iinuiin collection on swale.open runoff
E_
0
C
C
S
u
e
t
0
v
u
c
h
e
all
reqd. Indicate on Site Plan
C
Soil Conditions and Ground Water Field Cliecked
Review b)� rx-Ite,
IgStreet Paving Reqd.
Curb and Gutter Reqd.
Sidewalk Reqd.
Curb Cut for Driveway Reqd.
P4 Righ.t-of-Way Construction Permit Reqd.
Bond Reqd. for Public Inprovemnts
H i
Street Nam, Sign Reqd. W.0�5
Other Signing Reqd.
0 � A10
:)IPre Permit Site Inspection made on
;i!:
0 0
;i!:l
BY: SEIIER
WATER
STREET
ENGINEEMING
0
0�
C14
Special Requireine-rits listed in mejTo to Comnunity Developra--nt Deparitwant,
Building Division
If
BY I I Da te
All item filled in on Buil plication
BY w
Drawings Stairped and Notations �kide
BY
Approved by Public '%,,7oi:]-,s DepaftiTo-iL
RQvised: I-V 10-1977
Date
Date