23608 76TH PL SW.PDF111111111111
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23608 76TH PL SW
ADDRESS: Llb�eug
TAX ACCOUNT/PARCEL #: 0 o to 00c) C)
BUILDING PERMIT (NEW STRUCTURE)
COVENANTS (RECORDED) FOR:
CRITICAL AREAS DETERMINATION: 0 Conditional Waiver E]StudyRequir
:ed::kWaiver
CRITICAL AREAS #: DETERMINATION: F1 Conditional Waiver El Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EA.SEMENT(S) RECORD FOR:
PERMITS (OTHER — list permit #'s): Sf:(,?
PLANNING DATA CHECKLIST DATED: ��Itl ic)
SCALED PLOT PLAN DATED: /lb
SEWER LID FEE $:
LID #:
SHORT PLAT FILE:
LOT:
BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #: �pt ��
GEOTECH REPORT DATED:
STREET USE/ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DATED:
OTHER:
L:\TEMP\DST's\Forms\Jana's Street File Checklist 5-14-08.doc
Owner: Keplingerl Stone
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ADD: 23608 76b PI SIN, Edmonds, INA 98026 1 - -- I ; I I I I 1 1 1 . 1 1 7f
—1,-- LEGAL: BEHElU BLK 000 D-00 — LOT 5 T
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SUW TO ESE Crff OF EDMONDS PUD
PARCEL: 00654000000500
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-Sq Ft
Lot Size: 8,276
House Sim: 1,616 Sq Ft
Deck (Existin2): 224 Sq Ft .... ..
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Deck (Proposed): 265 Sq Ft Y
Lot Coverage: 22.7%
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Contact Name: Dave Kleven ai
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Company: Deck Pro
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Phone#: 206-786-1 /X\
Address: 16410 84' St NE #D232 >< /x\
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Lake Stevens, WA 98258
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PLANNING DATA S TREE T FIL
SINGLE FAMILY RESIDENTIAL
Name: LTo�%c-� ke-(�,r%qer
Date: alulin
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SiteAdd,ess: p2GC)S _ -
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Tax Parcel
Project Description: Co(-N-
A-"cX t._
sir"y dex-k.
Plan Check #: 9,0 1 C) - 1
Reduced Site Plan Provided: NO)
Zoning:
Map Page: 0or
Corner.Lot: (YES <9
Flag Lot: (YES /0
Critical Areas Determination #:.Q-9,Ae100001--+
El Study Required
N Waiver
SEPA Determination: ExerCA
Exempt
Needed (for over 500 cubic yards of grading)
0 Fee 0 Checklist 0 APO List with notarized form
Required Setbacks
Street:
Side:
I Side: ee)
Rear:
Actual Setbacks
Street:
(a)
Side:
6.8
Side:
El Detached Structures:
D Rockeries:
0 Fences/Trellises:
0 Bay Windows/Projecting Modulation:
&r Stairs/Deck: cle No c
1�uildihq- Height
Datum Point:
Datum Elevation:
Maximum Height Allowed:
Actual Height: c,� WA
Other
Parking Required:
Parking Provided:
Lot Area:
Maximum Lot Coverage: 35% Proposed:
!:-I E 7x 1, Co I G 'P
Lot Coverage Calculations: 3)1' cs.\, -11A -a-k grf< 1 2.-4 X
ADU Created: (YES
Subdivision: 9nelme)K; Fz\0J:&, -
Legal Nonconforming Land Use Determination Issued: (YES
Comments
STREET FILE
A- tc, I
Plan Review By: Planning Data Form 07-14-09
/000,
APPLICATION
te City of Edmonds for
SIDE SEWER PERMIT EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION REPAIRS E] LID NO - ------------------ ASMT. NO - ----------- ------
OWNER ...... >T� --- ------------------------------ CONTRACTOR ........ -------------------------------------------- PERMIT NO.
JOB ADDRESS ---- ------ \-- -4 ...... LEGAL DESCRIPTION: LOT NO - ------------- -7 --------------------- BLOCR NO - ------------------------------------
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........................................................................................... ......................................................................
NAMEOF ADDITION ....... ........................................................................................
........................ ............ 1 1/7 5
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APPUCATION
Tl,* City of Edmonds for
SIDE SEWER PERMIT EASEMENT NO - ------------------------ -------------------
NEW CONSTRUCTION REPAIRS E] LID NO - ------------------ - ASMT. NO - ------------------
-720AIAI 131,41
OWNER ---I - - -------------------------- - ------- ----------------------------- CONTRACTOR 12'1'6WZX ------------------------ PERMIT NO.
- 7tl-
.� -Z/ 0-'-
JOB ADDRESS -3 ---- 9 ----- 0,:P /--cl
------------------------ ------------------------------------ LEGAL DESCRIPTION: LOT NO - ------------- 7 .......................... BLOCK NO - ------------------------------------
0
.................................... -------------------------------------------------- --------------------------------------------------------------------------
NAME OF ADDITION ------------------ ------------------
BY--------------------------------------------------- YiW6
NOTICE:
No warranty of accuracy.
The information shown on the attached
map(s) was compiled.for use by the City of
Edmonds, its Employees and Consultants.
The City of Edmonds does not warrant the
accuracy of anything set forth on these
map(s). Any person or entity requesting a
copy should conduct an independent
inquiry regarding the information shown on
the map(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
employee-s or officers sha-11 be lia-b-le for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
CITY.OF EDMONDS - SIDE' SEWER' PERMIT
WATER -SEWER DEPARTMENT
PERMIT N?
Call 775-2525 for side sewer inspections BEFORE; covering any portion of the constructlon.�
Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections.)
6127
DRESS LOCATION OF CONSTRUCTION .........
W . . ..... . ..........
............... .............
PERTY LEGAL DESCRIPTION .................
......... - - ------
......................................................................... .... I.
...................... . ........................... .........
.. . .......... . ........................................
............ . .................. . .............. ...................
.... .............................. .
. ............................... * ........
............. ......................... ... #7NER
CONTRACTOR'S NA31E & ADDRESS .................. . ......
. .............................. . .. . .. . ..... .......................... ......
hPermission Is granted ........... . ....... it. Cj ....... :z? . ...... 16a�-Ior repair and/or connection of a side sewer to the city sanitary sewer.
k'. system in accordance with City of Edm nds ordinances.
!y1ATTENTION IS CALLED TO THE FOLLOWING:
fl"OTE No. I—Th owners of the property may obtain a permit to construct sewer
side Inside Property line. A licensed Side Sewer Contractor must be emp 0 co
e sewer in street area. Do not cover any portion of sewer before it has been Inspected. loyed t t::
4V310TE No. 2—All work performed In city right-of-way requires an Invasion of RJght-of-Way Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtain full Information regarding Ordinance 11.16.030 a
nd Regulations governing side sewers when you get permit.
NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 Inches inside property line: minimum grade of 2 To .
"harper than % will be Permitted. No bends 'I
..NOTE No. 5--Trenches in street must be water settled ajid surface of street restored to origina.] condition.
work which may develop within one year Of completion. Contractors shall be responsible for failure due to.'116
NOTE Nm 6—It is urdawful to alter or do any other work than is Provided for In the Permit, or to do any work on the main sewer or its appurtenances except
Bert the pipe into the wye.
'ROVED 0 Date ... . ................................... By ......... ...... Date...
y..... Date ............... . ...............
VED Dat By._
............................. ...........
. . . . .............................. . ............................
Remarks: ....... . .................................. . .. . .................................. i�
BOTH Permit Copies MUST Be Signed By Owner of Firm Perforining Construction PRIOR To Request For Inspection
I...................................
.................................................... .
(pwner of Contracting Firm. PerfGrming Construction) hereby certify that the -side sewer installation constructed under this !permit"
was installed in accordance with all governing ordinances of the City of Edmonds.
Datedthis ............................ day of ..............................................
................... 1 19.:; .....
Voll diK for: Watt,r n, Glli r�. Telephone D, Power
Sewer Other —j v
0
PUBLIC WORKS DEPART,,M 04k1ST STTFR? P-1
6,mW
I - LE
B�IILDING PERMIT REVIEW -77 'VJ
(address) (date)
I C, 0
-
Street Right -of -Way Existing, 4-1
-- M. Ar
-S 4. REQD
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Access Easemmts Existing—L—W n M
a 'REQD_—N-A--
H
p4
Utility Eas'ement Existing, FT
REQD
Lot Per Subdivision Plat
Assessor
Site Plan Checked for Accuracy
Z
Underground Wiring Reqd.
Check Accuracy of.Legal Description
Z
Review by�_ JE!��
Date
Existing Water Main Size 6,
Water Main Required
Service Line Required
Hydrant Size Existing C�-_
c4
Hydrant Reqd Per Fire Code
Size
Detector Check Meter Reqd. 1,,-)o
Cross Connection Inspection Q�o
Fire Department Conuients
T vJater Meter Charge Reqd.E,�- -290c,!Z
Review by
Date 2-10 745
Septic Tank Design Approved �VA
Date
Septic Tank Permit'Re
Permit No.
Sanitary Sewer Ava ability q.�t,
Zb a Ta
Proj . pt-Al
Drawing No.
File No. j5W
Side Sewer Availability 7-0
Sanitary Sewer Connection Fee Reqd._
�3:
Review by <7Ae��
Date
Open Ditch Existing
Culvert Reqd.
Size
Catch Basin Reqd.
Indicate on Site Plan
P4
0
Shoulder drainage maintain collection on swale open runoff
Manhole reqd. kp`
Indicate on Site Plan
Soil Conditions and Ground Water Field CheckedeAg, —&j*�Qe go,�az4
Review by
Datie-;gL—Z,�2 C,
Revised: lvlO-1977
USE PERM]
BUILDING' DEPARTMENT Applicant Fill ZONE NUMBER
Inside Heavy Lines
PERMIT APPLICATION J".
I NAME'(�ORNAME OF BUSINESS) ADDRESS
N
LEGAL'LOT
'A LOT AREA SUBDIVISION NO.
MA L.NG DDR -P
W MAILI G DDRESS YES No
Z 1
STREET R/W
CITY TELEPHO NE NUMBER ISTING STREET R/W 34- FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W !E344— FT. FT.
NAME I fREMARKS —
XDDRESS
U
M CITY
_rE7LEP.ONE
i�UMBER
NAME
A�S
0 A4 D R E S
7
U.
X CITY
P�
TELE H 0 N E -N U M B EWR
Z
T T L
L_IC.;ENSE: N
M-BER
CITY CENSE NUM'BE
Legal escrilption of Property (Show Below
or Attach Four Cdnie!
C our Co..i e
Z
0
U
In
STREET AND/OR UTILITY WORK
R/W PERMIT REQUIRED
PZT
RE010.
40 YES
NO
*YES NO
UNDERGROUND
WIRING REQ'D.
WYES 0 NO
TYPE CONNECTION
SANITARY SEWER
19YES
VERIFIED
Y
NO
SYST
�'D
ES
YES
PERMIT NUS
PERMIT NUMBER
A:PPVPT
PP C� Y CITY
BY CITY ENG.
44NO
REMARKS
METER SIZE LOfNG SUPPLY SIZE
BUI
,.;� y I
I
SIGN AREA �NV. REVIEW ADB NO.
ALLOWED I PROPOSED COMPLETE I EXEMPT I
REMARKS
VARIANCE OR CU PLANNING REVIEW BY DATE
YARDS
RESIDENTIAL GAS
1:1
FRONT
I
I V_ c—
::X SIDE REARI
OVERAGE
�kNEW
ADD
ALTER
REPAIR
ElNON-RESIDENTIAL
1:1
DEMOLISH
EXCAVATE
OR FILL
PRE -MOVE
INSP.
LINE
SIGN
RETAINING
1:1 WALL
FENCE
Ell— X—F"
swim
POOL
FIRE ZONE
TYPE
OF CONSTRUCTION
1CODE
HEIGHT
SPECIAL INSPECTOR
REQUIRED
0 YES El
AREA
OCCUPANCY
GROUP
OCCUPAI
LOAD
P N CHECKED BY
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
NUMBER OF STORIES
NUMBER OF
REMARKS
=
DWELLING
NI
U TS
FN ATURE OFA(?RK TO BE D�6fiE
Z
P L A N
PLAN CHECK
N
NO.
0
IL PLOT PLAN (INDICATE BUI DIN SETBAC
m ABUTTING STREE S)
U
B U 'L
BUILDING
0
W
P L U E
PLUMBING
M
'I E A T
HEAT & GAS LINE
0
FENCE
FEN C
SIGN
RETAI 'NING WALL
POOL
SWIMMING
VALUATION I FEE
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CITY of EDMONDS BUS110S LICENSE APPLICATION E LICENSE NO.
DAT
Civic Center - Edmonds, Washington 98020
Cit- Clerk Dk . 77r—'01r,Jr, I=CT 9:11 F
ain TYPE OF BUSINESS ANNUALFEE AFTER FEEL*V
CLASSIYEARI LIC. EFFEC. DATE REASG. LIC. NO.jSPEC,j ;K(A) HOME OCCUPATION $15.00 S X22..
0
L
INSTRUCTIONS: qI 9
_ I I I i I I I I I I C] (B) BUSINESSWITH $20.00 $ .00
All items must be completeo RECEIPT NO. D E PAID - A- 1 TO 3 EMPLOYEES
or application will not be ac- PRINT 'X' BUSINESSWITH $22.00 3' 00
,!go L5-1810 IN SPEC. BOX C1 (C) 4 TO 9 EMPLOYEES
.cepted. __j / 16, lcql FOR ISSUE OF
FEE PA D PENALTY, PAID CORRECTED 0 (D) BUSINESS WITH 10 $75.00 $112.5
Sign and return application 7 LICENSE WITH OR MORE EMPLOYEES
with fee. Renewals received I LC'ACTION. ;4 NEWAPPLICATION (LA)
after February 15 must pay
penalty in addition to fee. 0 RENEWAL (LB)
NEW BUSINESSES AFTER 0 CHANGE R EQEd)V ED
JULY 31, 1/2 FEE. (PLEASE MAKE ANY NECESSARY CHANGES) 0 DELETE (LD)
J 0
NAMEOFFIRM A46�j-vllv, f-16sOc- BUSINESS PHONE NO.OF 5%- P- L- 0 Y e- - E!�,
AMON09- FIRE DEPT.
MAILING ADDRESS NATURE OF BUSINESS
BUSINESS ADDRESS INDVIDUAL PARTNERSHIP CORPORATION
-7 r to
7 _V] (S) (C)
F (P)
OWNERS NAME HOME ADDRESS
ioi-
HOMEPHONE DATE OF BIRIH PLACE OF BIRTH SOCIAL SECURITY NUMBER
-11 -1 k - --5n 0 �UW W1, l(l si6s-
EMERGENCY NOTIFICATION (1) NAME&TELEPHONE L4
(PLEASE LIST TWO) (2) NAME& TELEPHONE iJL mow
0.4 oe!N
WASHINGTON STATE TAX NO. APPLICANT'S SIGNATURE\����
DO NOT WRITE BELOW THIS LWE
STAFF REVIEW: FILL IN LAND USE CODE, UFIR NUMBERS, Z i ONING, ETC. CHECK APPROVAL OR DISAPPROVAL, DATE, AND
SIGN. IF DISAPPROVAL, PLEASE COMPLETE "COMMENT" SECTION. ROUTE TO NEXT DEPARTMENT ON LIST.
PLANNING DEPARTMENT DAT 7, 7- LAND USE CODE ZONING CODE
�9, APPROVE 0 DISAPPROVE
lell
SIGNATURE ". I I I I I 1?C1 I &I
01�
CONDITIONAL USE PERMIT
COMMENTS
G DEPARTMENT DATE Building 0 Hotel/Motel (L)
OV
:�`APPR E 0 DISAPPROVE SIGNATURE 1ZeZV5 Permit 0 Apt. Bldg. (A)
M I I 1 0 Office Bldg. (0)
Occupancy 0 Restaurant (R)
COMMENTS: Group 0 Hosp/Nurs Home (H)
CAPACITY: (NO. UNITS, APTS. OFFICES, SEATS, BEDS, STUDENTS) EES[M- 0 School (S)
FIRE DEPARTMENT DATE 0- f?Z- U.F.I.R.
1�<APPROVE 0 DISAPPROVE SIGNATURE
COMMENTS:
A 41
'NPOLI E DEPARTMENT DATE SIGNATURE
PI�PROVE 0 DISAPPROVE 0
COMMENTS:
PUALIC WORKS DEPARTMENT
frAPPROVE 0 DISAPPROVE DATE 9- SIGNATURE
COMMENTS:
ST REET FILE
INSPECTION RECORD
CITY OF EDMONDS, PUBLIC WORKS DEPARTNI'ENT
DATE: PROJECT: i;��
�Y:
1 / 7 t'�) I%,
-zs;
DATE :
tTtpFr-T FILE
T.11NISPEC111,1011i RECORD
CITY OF ED"11ONDS, PUBLIC �-!ORK�S DE-PARTMENT
p R OJ I "C'r:
en
10
*STREET. FILE
DATE: ';�L I 10 1.-�a
MEMO TO: Building Division
Community Development Department
FROM: Engineering Division
Public Works Department
SUBJECT:
After review of the subject building permit application, we have
the following comments:
(1) Coordination of the location of any structure with respect to
utilities, streets, propertv lines and driveway grades is tF—e
responsibility of the contractor.
The contractor is required to keep the abutting streets clean-
ed of dirt and debris caused by the construction.
(3) A"Right-of-Way Construction Permit" is required, from the
Engineering Division of Public Works, for any work within
the Public Right-of-Ilay or public easement..
__(4) Driveway slope not to exceed 14%.
4"NtC� - A -N
V,
AA Pro-
.. .02
PW 5/77
-0 ISS09 P=M1
'nowr
ass
PUBLIC WRKS DEPAR� GWIST
AUILDING PMUT 107IEW
-7 tgh P 1' 10 HR
ess) (be)
0
Street Right -of -Way Exist ing
V
V
REQD
Z
Access Easements Existing.
�-4
g
Utility Easement Existing, 1!0 FT. s2zQ�
NA
W
Lot Per Subdivision Plat
Assessor
Site Plan Checked for Accuracy.,_�
F-ug)
Z
Underground Wiring Reqd.
F4
U
Check Accuracy of Legal Description'�-
410
Z
Review by
:Date
Existing Water Main Size
Water Main Required
Service Line Required
Hydrant Size Existing
P4
Hydrant Reqd Per Fire Code
Size
Detector Check Meter Reqd. 1,00
Cross Connection Inspection Q�O
Fire Department Comments
Water Meter Charge Reqd.
Review by.
Date /0/7-95
Septic Tank Design Approved V A
Date
Septic Tank Permit Reqd.. V A
Permit -No.
Sanitary Sewer Availability 4,e-t.
Pro
'j.
Dr"ing No. Z
File No..
Side Sewer Availability 7-0 P,9,0AOA?�
Z-,,L vo
Sanitary Sewer Connection Fee Reqd. /J&zjjt,01
:3:
Review by. ICA-V
Date 2-AO/Za
Open Ditch Existing_
Reqd.
Culvert Reqd.
Size
P4
Catch Basin Reqd.
Indicate -on Site Plan
0
Shoulder drainage maintain collection on
swale open r un o f f
Manhole reqd.
Indicate on Site Plan
Soil Conditions.and Ground Water Field Checked -4&4q
Review
Da t,-e'
Revised: 1vlO-1977
PaLre 2
Street Paving Reqd.
Curb and Gutter Reqd.
Sidewalk Reqd.
Curb Cut for Driveway Reqd.
P4 Right -of -Way Construction Permit Reqd.
Bond Reqd. for Public Improvements
Street Nam Sign Reqd. A AR
Other Signing PP-qd.
Pre Permit Site Inspection made on
z
0
BY: SEWER
WATER
z STREET_
ENGINEERING
Special Requirenmts listed in memo to Commmity Development Department,
Building Division
BY Date
All items filled in on. Building Pern-r,Lt.,Application
C4 BY Date Ito I
P' Drawings Starrped,and Notations Made
P4 BY Date
Approved by Public Works DepartmEnt
Revised: 1v 10-1977