23206 75TH AVE W.PDFlill 11111111
6004
23206 75TH AVE W
ATE MED
10 [PERMIT
EXPIRES
USE PERMIT
ZONE
A067
CITY OF EDMONDS
NUMBER
CONSTRUCTION PERMIT APPLICATION
JOB SUITEIAIT#
ADDRESS-
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Z2 5::�� 1 ,
OWNER NAME/NAME OF BUSINESS
(W
PLAT NAME18UBDIVI SION NO.
LOT NO.
LID NO.
;V
LID FEE $
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MAILING ADDRESS
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved 0
RW Permit Required 0
0
EXISTING — PROPOSED
Street Use Permn Req'd C3
Inspection Required 0
Sidewalk Required 0
CITY ZIP
ONE
�jco L)s 0 a,
7
REQUIRED DEDICATION— FT
Undeiground
Wiring required 0
NAME
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
bANIGL_ 'W 1'-2
YES 0 NO 0
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ADDRESS
10,
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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CITY ZIP
TELEPHONE
NAME
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ENGINEERING REVIEWED/DATE
ADDRESS
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FIRE REVIEWED BY DATE
CITY ZIP
TELEPHONE
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LIKN.v4c,c�o "1 181 6�)
411-11 00- C,
VARIANCE OR, CU�
SHORELINE OR ADB#
INSPEC� 'ON
RE-0 D
POBOND
TE
S D
STATE LICENSE NUMBER EXPIRATIORDATE -
CHECKED BY
\ci z Lit, 6
0 YES
SEPA REVIEW
COMPLETE EXEMPT
SIGN AREA
ALLOWED PROPOSED
HEIGHT
ALLOWED PROPOSED
PROPERTY TAX ACCOUNT PARCEL NO.
-)14
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CO
EXP.��
0 NEW C] RESIDENTIAL 0 PLUMBING MECH. - ,
LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SETBACKS (FT..)
FRONT SIDE PEAR
PROPOSED SETBACKS (FT-)
FRONT L/RSIDE REAR
G/ADDITION COMMERCIAL o' COMPLIANCE OR. .
io,
e2 t
z
CHANGE OF USE
PARKING r
LOT AREA
PLANNING REVIEWED BY DAT
REMODEL APARTMENT 0 SIGN
REJ.'D JIROVIDED
01
FENCE
REPAIR GRADING CYDS 1:1 X FT)
DEMOLISH TANK o OTH ER
GARAGE RETAINING WALL
CARPORT 0 R mR RENEWAL,
OCKr Y
z
i=
ITYPE, OF USE. BUSI�TR ACTIVITY) EXPLAIN:
CHECKED6Y TYPE
OF`CONURUCflON
E OCCUPANT
GROUP
NUMBER
OF
NUMBER OF
DWELLING
CRITICA�
AREAS
SPECIAL I NSPECTOPI,', I
4REA OCCUPANT
0
STORIES
UNITS
NUMBER
;REQUIRED
LOAD
</C)
D,G8CR(BE WOFI�< TO BE DONE
-:A7Y- 111,� .
REMARKS
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ROGRESS,INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D
5
to
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N\� 0
L) I A'�A� b,\Op�_
Ae yt-, nN--e_,k_ --L k 1 CL,� c'_0 iV(A.
VALUATION
FEE
L �At 0
PLAN CHECK FEE
HEAT SOU GLAZING % LOT SLOPE %
�t
BUILDING
I ---
HECK NO. VESTED DATE
S4:Z
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADING/FILL
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
j
t:
SEPARATE PERMISSION.
STATE SURCHARGE
M
Uj
PERMIT APPLICATION: 180 DAYS
CL
PERMIT LIMIT. 1 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
IS
ul
_j
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
LANDSCAkING
2
EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
INSPECTION FEE
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
RErPT -7
x
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT _2
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
-
_j
0
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
REC7
-7
TOTAL AMOUNT DUE
i��
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPOCATION 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 his/her Deputy: and Fees are.paid. and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION receipt is acknowledged in space provided.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
SIGNATURE DATE
SPKAIVRE (OWNER OR,�eENT) DATE SIGNED
(425)
eY V1 /CC-' j
771-0220
BY DAYE
ATTEWO'OW
EXT 333 -
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX PINK - OWNER - GOLD - ASSESSOR
5198
A
CITY OF EDMONDS.
SINGLE FAMILY ADDITION/ REMODEL COVER Ofifum
U b FILE
I 11C.
Directions: Applicants are to complete the information in the WHITE BOXES ONLY (Shaded boxes are for City use only).
This cover sheet must accompany each building permit application for a single-family residential addition/remodel project.
PL AN CHECK
APPLICANT
..DATE RECEIVED e—//-00
PROJECT ADDRESS L06 24� A-V,-,- VV
PROPERTY TAX ACCOUNT PARCEL # 4-10 �00 — joq— 00q_
DESCRIPTION OF WORK
OWNER__— PHONE- 42ED - ��O - H,� 1
CONTACT PERSON PHONE 42e� - LL10. - �Cj� I
E-MAIL FAX_2Z(o - 3 8 2- - q (oE2-
MAILING ADDRESS
FAX CORRECTIONS MAIL CORRECTIONS E-MAIL CORRECTIONS
BY SIGNING THIS STATEMENT I UNDERSTAND THAT I AM THE CONTACT PERSON FOR THIS PROJECT. IT IS MY RESPONSIBILITY TO
COORDINATE ALL SUBMITTALS WITH THE CITY AND ONLY I CAN MAKE INQUIRIES ON THE STATUS OF THE APPLICATION. I
UNDERSTAND IT IS MY RESPONSIBILITY TO DETERMINE IN ADVANCE OF PERMIT SUBMITTAL ANY DISCRETIONARY PERMITS THAT
MAY BE APPLICABLE TO THIS PROJECT. I ACKNOWLEDGE THAT 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
ZONING INFORMATION
DATE
_
ZONE LOT AREA 12-, 0 1, (4
.,.-UMBE.R,.OF -DWELLING UNITS EXISTING OlVe- DEMOLISHED Mt PROPOSED ,4/,l
AL"§77 CA Determination SUBDIVISION CU
VARIANCE SHORELINE SEPA Expires OTHER
L:\temp\building\forms\Add—rvw.vsd -- 7/00
DRIVEWAY SLOPE % GRAD1N_G CY'DS EASiM_ENTS'
EXISTING IMPERVIOUS AREA CONSTRUCTED BEFORE 1977 SQ.FT
EXISTING IMPERVIOUS AREA INSTALLED 1977 OR LATER SQ.FT.
PROPOSED NEW NET IMPERVIOUS SURFACE Ad1d1,17a--- 6741_e� IrX'I S SQ.FT.
(City'Us6 OnW
SIDEWALK REQ'D' _]YESE] NO' DRAINAGE PLAN REO'D OYES ONO 'LID#
UNDERGROUND WIRING REO'D [:]YES[:]NO STREET DEDICATION FT.
STAFF COMMENTS:,.'.
j6*lJlLDJ1N[G CONSTRUCTION INFORMATION
EDITIONS
1997 UBC, UMC, UPC, WSEC, VIAO WITH AMENDMENTS
WIND SPEED 80 MPH SEISMIC ZONE 3
WIND EXPOSURE B
Floor Live Load lib Roof Snow/Live Load Balcony,Llve Load
Floor Dead Load tO Roof Dead Load Balcony Dead Loa -ill
NUMBER OF STORIES— BASEMENTS N';F FLOOD ZONE
LOT SLOPE % A, SOILS REPORT PROVIDED YES El NO
FLOOR AREA (Measured to face of exterior wall)
Existing Proposed Total
(-2-
Living Space _,CC (n
Garage
Carport
Deck/Cov. Porch
Other -
(City Use OaW
Ceiling Insulation Window U-Value
.Wall Insulation Skylight U-Valuie
Floor Insulation Glazing %
Door U-Value Slab Insulation
Energy: Prescriptive Target Systems
Whole House Ventilation System Req'd El Yes'-[3.No
Any request for modification, variance or ot her administrative deviation (herinafter "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 offical In accordance,with the
appropriate provision of city code or state law does not approve any Items not to code specification.
PERMIT ISSUANCE APPROVALS (City Use Only)
PLANNING'REVIEW.&-APPROVIi�--.-2�����
CONDITIONS OF -APPROVAL: lop,
ENdINEERING REVIEW & APPROVAL DATE
'.CONDITIONS OF APPROVAL:
Z)
BUILDING REVIEW.& APPROVAL DATE
�,j /Ct)
CONDITIONS OF APPROVAL:
i.
9,2'-D 3/8*
F
NOTEi
24" OVER14ANG
TYPICAL
NOTE:
TIE NEW ROOP DRAINS
INTO E)(ISTINdG SYSTEM
Lot Coverage Cala
EXISTWJ WOUSE 1-566 SCLIFT.
TOTAL 1,3r.& so".
LOT AR=A 13034 eGLFT.
PERCENTAGE 0.100
Leo Dewr�Dthn
LOT 4, 5LOCK 4, LA)M BALLING.ER LAND COMPANY
61.1190MOION 1, 5LOC4 004-P-01 TWAT PORTION OF;
LOT 4, DAF- AEG AT NE COR OF 80 LOT 4 T14 503451'30*10
ALG E LN OF: GD LOT 412132 FT TH N34ci36'151*10 156.14 FT
TO INTER WITH 6 LN OP N 81 PT OP SP LOT 4 TW NSSd 45'40*W
ALG 80 6 LN 113AI PT TO INTER WITW E LN OF W 10"0 FT OP 80
LOT 4 TW 1400.04�30"Iff ALG 50 E LN S4 FT TO NMR WITM N LN
OF 80 LOT 4 TH Sftd4S'30"E AUS SO N LN 153bll� FT TO POS
Zor" RB-e
Plot Plan
SCALE, 1".20'-0'
A
41'-10 lAb'
Bdstirg Howe
-11 11 [1
EXISTIW�
PAVED
DRIVEWAY
REc:E:JV
AUS
DEVELOPMENT SERVICLS CTR.
C17-Y cF -..
FILE
SS' .2 WW,"
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--------------
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City of Echnon&
REE I E.
TRfGL I
'OF -WAY CONSTRUCTION
HT
PERMIT Permit Number—
Wue Date:—//- 17 �13
A. Address or Vicinity of Construction: 23206 75 Av W (9402576)
Q)
9 0 B. Type of Work (be specific): Tnstall New Saryinp
C. Contractor: Washington Natural- Gas company- Contact: Rrank Syj;aa
Mailing Address: 815 Mercer St, Seattle, WA Phone: 224-2278
State License #: Liability Insurance: Bond: $
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. E] Commercial E] Subdivision City Project 2 Utility (PUD, GTE, WNG, CABLE, WATER)
Multi -Family 0 Single Family F1 Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut: 0 Yes RNo G. S i ze o f Cu:t -�el, Gx H. Chargq�,$
S
APPLICANT TO READ N
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that maybe made against the City of Edmonds, or any or its departments or
employees, including or not limited to the defense of any legal proceedings including defense costs, and attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIPAND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FO R ISSUANCE TOTHE APPLICANT.
'Construction drawing of proposed work required'with permit application.
A 24 hour notice is required for inspection; Please" call the Engineering Division, 711-0220.
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 City 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.
Ihave read the above statements and understand thepermitrequirements and thepink copy of thepermit will be
available on site at all time§Jar inspection purposes.
Signature: — .00, �/, _1 Date: November 16, 1993
rMn't"M c to r -o r Age n t)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: W�jtA RIGHT OF WAY DEPOSIT, -
TIME AUTHORIZED*: VOID AFTER I Y F10— DAYS
SPECIAL CONDITIONS: 0 &
COMMENTS:
1114N64A
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng�g. Div. 1991
�*N - A
FIELD INSPECTION NOTES
Comments:
I Diagram.:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
i�- I . -
Addendum to City of Edmonds
Right of Way .
logiv-M 4 + I if-Afiftn
Submitted b Guyla Connors
Engineering Aide
Washington Natural Gas
521-5248
- - I-N A --% f-- ---I / -
Qjc
25
--N./A r�
MIA
k-- V".p Au".Lal
-w- wai-mc,sayuj�-cint.
0 water valve
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815 M=cr St. (P.O. Box 1869). ScAttk. WA 98111 (206) 622-6767
CITY OF EDMON"Tflk-�ET ME
ASSET INFORMATION SHEET
E NEW
E] ADDITION
1:1 RETIREMENT
ASSET NO. /7 0
ADDITION TO ASSET NO.
DESCRIPTION
-5)f 12 u I c- 't /f
SERIAL NO.
LOCATION
DEPT. NO.
4 L(6
"PURCHASE ORDER NO. -
PURCHASE ORDER DATE
COST
*PROJECT NUMBER L—) 3 ZJ I:e ? 6-
PROJECT COMPLETION DATE
COST 161, yy
,-- C,- (.3
B.A.R.S. ACCOUNT NO. city - 3y-t-.p
ESTIMATED LIFE 2 --b
INITIATED BY DATE APPROVED BY
**SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT -
0 G.L. ENTRY
REFERENCE
DATE
VERIFIED BY
PROCESSED
BATCH NO. -
INITIAL
&p)
DEPARTMENT FILE
CITY OFEDMONDS
' k FOR INSPECTION CALL
kilh'LIC 'WORKS' DEPART1114T 40 Permit
AN, 775-25=0
SIDE SEWER. PERMIT Issue Date.
PERMIT MUST BE POSTED ON JOB SITE
�%wAr3wqwrAw2w,2w3Mv3��ANWI�A�A�� YIA BALLINGER
1. Address of.Construction 727?6 -: bd
, (, 7,�4t, &IC - I IFT STATION.
2. Property Legal Descriptio n (include all, easements)
,Ai4r, 1pa,� A -Lid :�'- W3 0_,�a / q
3. Single(Flamily Residence./"' Multi -Family No. of Units
Commercial
4. Owner and/or Builder A"vp
5. Contractor & License No.
6. Invasion into City Right -of -Way: No / Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (342-5344) before
excavation).
7. Cross oth.er private property: Yes No-,.,/ Easement required -
attach legal description and county easement number.
READ THE FOLLOWT,NG AND SIGN:
P4
a. Property owners must obtain a permit to install side sewers on
1 >4 their property. A licensed side sewer contractor must be'employed to
9Q construct side sewers in the public' right-of-way.
Q
W b. The side sewer contractor assumes full reponsibility for each
E-4 installation for one year.
N
.�_4 C. Commercial establishment requires a minimum of a six inch (6")
P4
X side sewer line.
0 d. Side sewers may not be installed closer than thirty inches (30")
U to any structure.
W 0
M e. Side sewer lines must be laid at a minimum grade of 2% (1.15
0 and maximum grade of 100% (450)'. 0
f. No turn in side s8wer greater than 45 (1/8,bend) is 0 allowed
between cleanout. 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 sewermust be left uncovered until inspected and approved
by the City.
1. Inspection during normal working hours only. Two (2) working
days notice required.
DATE: 'Afl-61
I—certTifyT—tEat I have rbad
All''omply With the above
and sA-a c
PERMIT FEE: -:�(),O()
DISAPPROVED BY:
Date:
4?,S, o 0 By-
Date:
CONNECTION FEE:
APPROVED By: 'r.WW1512Z___p"
T% - 4- - 1�
0
PERMIT MUST BE POSTED ON JOB SITE
*
'Side Sewer'Drawing
The City of Edmonds EASEMENT Nd.
.......................................
NEW CONSTRUCTION
REPAIRS E] LID NO . .................. . ASMT. NO . .......
...................... PERMIT NO.
OWNER LUE Fl?, I M7 r ... 0. I.V.vEis .. . .....
CONTRACTOR
-r�4
LEGAL DESCRiPTION: LOT NO - ----------- - ---
jo B. ADDRESS I-O.G ----------- 7.75 --------- w
..................... - --------------------------- -------
7 1
'NIA BALLING'E
. . ............................. .. ................................... ........... ..........................................
---- Mr-STATI
NAME OF ADDI]ION .......................... . % --------------------------------------
. ................................
75T.
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W.
5. 7
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2'3*207- 7C.'"
LOG-140uSC
3V
Approved:
DATE B, i aw ------------- *
- -----------
STREET KE
APR 111983
ZONE
SETEBACKS-
FR,r%-,INT
SIDIE
REAR
OTHER ------
/Z'7,
75'Avenue W
Up
-2-'�t-2h A)&
44-,,j�36'24 4) 1,
LOT*2 ''
Blueprint. Hmes, Inc.
City of 8dmomets
Scale 20 o"
----I - -9 - Me
/.AL
Inn
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CITY OF EDMONDS
t too
PUBLIC WORKS DEPARTME N EET F11.0c"
U
U§T
I
RIGHT - OF - WAY CONSTR I BERMIT
A. eAddress or vicinity of Construction
23=1946711AV 14 Z-3ZOS -76"' AV W
o Owner: OWEFRI
Name
-&-5koLq
Mailing Address
C, MO NOS W A
City, I State, Zip Code
Contractor: T' k-h
Name
- 2 1 E-,) �Avqj 99
Mailing Address I
�--yNNWOCO WA 9%054
City, State, Zip Code
Permit No.
Issue Date
9 Permit Issued To: 9- ao,
9 Type of Work to be Done7TIREN)oi =2w
I "e -TA(,L C(�CCN��IC L
9 Work n Connection With:
El Sub or Plat �&single Family
El Comml. / Ind. El Apt. Condo.
Pavement Cut: 0 Yes No
State License Number
774- -Z I 17
Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of its departments or employees, including or not limited to the defense of any legal
proceedings including defense costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering.
Call 775-2525, extens;iofr---an.QZ7
I understand that this permit must be available at the job site for inspection purposes at all times.
Signature: Date-,.
.Owner or lcie�it
THIS PERMIT MUST BE POSTED AT THE JOB SITE FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
Time Authorized: Void after days
Special Conditions:
Ammendments:
Permit Feei
F0 00
L
Security Deposit:
Receipt No.:
Fund I 11 Fee:
Street Cut Dimensions
x
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. Deamber 1978
FIELD INSPECTION NOTES
(Fund 111 - Route cony to Street -De'pi"'
Comments:
Diagram:
Contractor called for inspection Yes No
I Disapproved By:
.Alork Date: By: Date:
Work Approved By: Date: 7
Inspector:
Enq. Div. December 1978
L Snohomish Cou
1018 1 of nty 20
REV� 5/81 ..;Fve IC UTILITY.DISTR . re
AV
IiAll 7 DA _;�53 S I
W. 0. NO,
L OCATION Av vV* Z3'L0!Qo 735, TE Z
NO.
'�4 TT nn)l q8
POLE NO 77 -REVISION JOB
r
:�JE'ASON F6R,WoRK
E'NGINEER G� FILE NO..
r A I t: .
E)L�QEPELN T'l4C'J"`ES DRAF I ER-
APPROV4 S"
L ..... N v �fv
PERMIT REOUIRED E,�4MENT ENVIRONME NAL ANALYSIS
TYPE UREC) I UIRED :.ONOT REOUIRED .(3TREE TRIMMING :C:IWAT. 499'EMPT ONOT EXEMPT
'OSEWER
Air" -7V" A\J 24 NIA.- �WAL MG. ' FARA ' I*TEM
DATE GRANTED LOCATOR EIGAS
-"jjj'p-U' - p� 0: H. .,U G.- CON D..�_K V.
DATE RELEASE.D BACK HOE
ADD C K T: * F"T. P
FEES REOUIRIED YESC, NOO FORE IGN_CONTA:CTlS P,OLE STENC11LING
RE M V. �CKT, FT.�PH.
TYPE G T-N W NO. ROM T 0 NET C K T. FT.
DATE AMOUNT (adoso-
. ..... CATV_' NO. A -TAKE OFF POLE LOGS POSTED : Gj. C.E.
SUBSTA�TibN CIRCUIT,NO. TRANISF CARDS UwMAPS
DATE:\�PRK COMPLETED.-_. BY FOREMAN POLE DEOT CIRC'.
DATE ORINTED
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USE PERMIT
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CONSTRUCTION PERMITeARR
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NAME [0 ME OF BUMSINNE 1
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EGAL DESCRIPTION CHIC11 SUBDIVISION NO. L I D 17NO.
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RIGHT OF WAY CONSTRUCTION PERMIT REOUIRE�1,
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STREET USE PERMIT REQUIRED 11
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SEE ENGINEERING MEMO DATED—
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CITY TELEPHONE NUMBER
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SEE PIW DEPT. REVIEW CHECK DATED
NAME
REMARKS
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ADDRESS
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METER SIZE BUILDING SUPPLY SIZE FIXTURE UNITS
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CITY TELEPHONE NUMBER
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REMARKS
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STATE LICENSE NUMBER CITY LICENSE NUMBER
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Legal Description of Property - include all easements
SIGN AREA ENV. REVIEW ADB NO..
ALLOWED PROPOSED COMPLETE EXEMPT
(show below or attach four copies)
SHORELINE #
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VARIANCE OR CU PLAN FIEVIEW BY DATE
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YARDS LOT COVER
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FRONT SIDE REARI
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NEW RESIDENTIAL PLUMBING
REMARKS
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NON-RESIDENTIA_L MECHANICAL
REPAIR RE'TAINING WALL SIGN
EXCAVATE FENCE
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CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT
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DEMOLISH OR FILL [_ x FT)
PRE -MOVE INSP.1 swim
SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT
COMPLIANCE INSP. POOL
REQUIRED 77GROUP LOAD
SEWER
11YE
REMARKS
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NUMBER OF STORIES N UMBER OF
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NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
VALUATION FEE
PLAN CHECK FEE
BUILDING
PLUMBING
This Permit covers work to be done on private property ONLY.
MECHANICAL
GRADINGIFILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
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successors In interest, agrees to indemnify, defend and hold
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harmless the City of Edmonds, Washington, its officials,
2
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employees, and agents from any and all claims for damages of
__ _-__ — - , - — - . .. .
A - A
GERALD W. LOVELL, P.L.S.
JURGEN P. SAUERLAND. P.L.S.
LOUIS F. CAVIEZEL. P.E.-
L T. vell-Sauerland &Associates, Inc.
S S
"i Engineers * Surveyors * Development Consullents 0 Planners
April 22, 1983
LSA File No. 83-980
STORM DRAINAGE CALCULATIONS
FOR
BLUEPRINT HOMES, INC.
LOT 1
Impervious Surface: Roofs and Paving - 2455 sf.
Percolation Rate:.. 6.7 Minutes per inch @ 2411 - 27"
Pesign Rate: 8 Minutes per inch
Lineal Feet of Trench Required per King Co. Chart Attached:
78 Lineal feet (156 sf. bottom area)
Install 1 -,3611 wide lateral,,52 ft. in length.
1=e7vel
Impervious Surface: Roofs and Paving - 2730 sf.
Percilation Rate: 1.5 Minutes per inch @ 2411 - 2611
Design Rate: 5 Minutes per inch
Lineal Feet of Trench Required per King Co. Chart Attached:
64 Lineal frt (128 sf. bottom area)
Install 1 - A611 wide lateral, V feet in length.
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LOT 3
Impervious Surface: Roofs and Paving - 2660 sf.
Percolation Rate: 1.3 Minutes per inch @ 2011 - 2611
Design Rate: 5 Minutes per inch
Lineal Feet of Trench Required for King Co. Chart Attached:
62 Lineal feet (124 sf. bottom area)
Install 1 —36-- wide lateral —4� feet in length.
Notes: 1. Maintenance of the system to be by the property
owner.
2. All work subject to inspection by the engineer.
3. Call for pre-backfill inspection.
4. Location of trench(p3) to be approved by the
I
BUIMING PERUT REVI:EW
75;�A7�,2�, -
Z- 5 " -7 �) / �� _ j
(address) (dat/e)
Street Right -of -Way Exist'
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Access Easements Existing TEQD
Utility Easement Existing
Lot Per Subdivision Plat Assessor 11ap
Site Plan Checked for Accuracy -r�7 A-
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Underground Wiring Reqd.
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Check Accuracy of LegaMperipnti;7 e7
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Review by_ Date
Existing Water Main Size 611
Water Main Required A14
Service Line Required
Hydrant Size Existirg- 5
Hydrant Reqd Per Fire Code Size -
Detector Check Meter Reqd.
Cross Connection Inspection
Fire Department Comnents
.4ater Meter Char Reqd
Review by _Pate
Septic Tank Design Approved Date
Septic Tank Permit Reqd. Permit No.
Sanitary Sewer Availability Proj.
DrM,7ing No. 2-/ 1) &),� file No.
Side Sewer Availability
Sanitary Sewer Comectio F4/Reqd.
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7:
Review by Date 5-
W
Open Ditch Existing__LIL Reqd.
:C
Culvert Reqd. 1>�Z 7�uc Size
94
Catch Basin Reqd. Indicate on Site Plan
0
Shoulder drainage maintain collection on swale open runoff
Manhole reqd. Indicate on Site Plan
Soil Conditions. and Ground Water Field Checked
RL,view b Dat
Revised: IvIO-1977
14% ;i-
DATE
MEMO TO: Building Division
Planning Department
FROM: Engineering Division
Public Works Department
r .
SUBJECT: 71w 6-
T
After review of the subject Building Permit application, we have the following
comments:
1. Connection to City water system required.
2. -Connection to -City sanitary sevier system required.
3. Right-of-way permit required for any work on City property.
4 -acruggD.F5 F.IfftrAVC-MY d_KIlA%..;,
EV,e'W7aYMI-_,%X6—P, - , � �,�--,e_—e_
5. Backwater valve required if downstairs plum��ing is below elevation of
up�_ —
tream �nanhole.
6. Water and sewer lines to be separated by 10 foot minimum.
7. Builde,r/Owner responsible for containing all temporary runoff and erosion
7
on site and ifla
not impact_fl�hborinq i)rODer
BD 6/82
I
APR 1983
ROO
ZONE
SET C,
Ac
As..
F 0 rt NIT
SIDII
o- H E
75 7w Avenue W
— -------------------
4mes, Loc.
City of Edmo"ds
Scale /'v = 20 01
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