23705 78TH AVE W.PDF111111111111
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23705 78TH AVE W
FEE,
STATEMENT ON ACCESSORY DWELLING UNITS
GRANTOR: Ci4-t. ,�p WnIO-ndg GRANTEE-:J�!��Df/4�e�
Property
Washington
Legal Description: LC51- 4 5- 0 v�- S iAoEa- i> L-K,�-
29 - / 6 -1 (:!Np C-rt�t �c5q--
Assessor's Parcel Number: 0 1 -�2� 04 — q —. 0 0 1 — 000 (=)
I have read the requirements for accessory dwelling units contained in Chapter 20.21 of
the Edmonds Community Development Code (ECDC) and understand that an accessory
dwelling unit, including a second kitchen, as defined in ECDC Section 21.05.015 is
prohibited until an Accessory Dwelling Unit Permit is approved.
I also understand that an Accessory Dwelling Unit Permit cannot be approved unless all
the criteria in Chapter 20.21 are met, and all the necessary items are submitted,
including an affidavit of occupancy and a covenant to be filed with the Snohomish
County regarding the regulations imposed on Accessory Dwelling Units.
IV
Property Owner Signature: � =" �Q- & J,-2 t
Property Owner Name (printed):'TI4 o t-1 �-s - �, . k 't-7 c-7T— ,
Date:. 2—
STATE OF WASHINGTON)
COUNTY OF SNOHOMISH)
I certify that I know or have satisfactory evidence that ' n V" a�S R - 'B F-I--T-
signed this instrument and acknowledge it to be his/her free and voluntary act for the uses and
purposes mentioned in this instrument.
Notary's ressure seals must be smudged.
. ......... p
Signature of
Notary Publi
10 7--A,7
Residing at:.
: OJ- e �/— C9 -0,0 2-
ointmerit
L 1'�' , My App
Expires: .2e)4a3
A q 'A
THIS b0i"'C"UMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR.
14-C 7 %_9 i)
City of Edmonds � PERMIT NO: 94,96 , ,
PERMIT EXPIRES I 14-IJO I
,SIDE SEWER PERMIT I
Address of Construction: 2—'3 *705- 'm h A YG vv LIJQ #
Property Tax Account Parcel No. 3 1 Z :2 6 002
Attach copies of all access and utility easements 1V% Verified and Approved by
Owner and/of, Contractor: Tin t 1 91 L- 1-1-
Contractor License TOM %KG jj * 17-1 M%1 Building Permit -001 Of) 6
Single Family Invasion into City *Right -of Way: El Yes [M No
Multi -Family (No. of Units *RW Construction Permit 9
Commercial (No. of Units Cross other "Private Property: El Yes No
Fj Public "Attach legal description and copy of recorded easement
Owne ontrac o
Owner or contractor sig anh acknowledgement statement: Dak
By signing for this permit I certify that I have read the City's public handout entitled
ide Sewer Spleciri cations, and shall comply with all City requirements outlined therein.
�Ws
2 CALL DIAIL-A-DIG (1-800-425-5555) BEFORE ANY EXCAVATION.2
V FOR INSPECTION CALL 425-771-0220 extension 329.'V
24 HOUR NOTICE REOUTRED FOR ALL INSPECTION REQUESTS
NOTE: IF JOB SITE IS NOT READY FOR INSPECTION WHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION, FEE WILL BE CHARGED.
Job Site Ready YES NO Date: Initial:
Partial Inspection: —Date: Initial:
Partial Inspection: Date: Initial:
FINAL INSPECTION APPROVED: Date:Ldmbi Initial: As-bu . ilt to Street File:
t- PERMIT MUST BE POSTED ON JOB SITE
White Copy: File Green Copy: lnsp�qtor Buff Copy: Applicant'
L;temp;bldg;forms�sspermitjlg4/00
30'
C/o
22*
15'
45- 20'
00
441
C/o
45*
GARAGE
CITY OF EDMONDS
SIDE SEWER AS -BUILT'
ADDRESS
23705 78TH AVE W
PERMIT
NUMBER 9496
HOMEOWNER xxxxxxxxxx
CONTRACTOR B M
DATE
06/19/02
DRAWN
BY
ISMAEL ABILA
-WSI, ow
CITY CLERK
CITY OF EDMONDS
121 STH AVENUE NO.
EDMONbs, WA 98020
CONFORMED COPY
200203070004
03/07/2002 09:13 AM Snohomish
P.0001 RECORDED County
STATEMENT ON ACCESSORY DWELLING UNITS
GRANTOR: r, 4:14 5��P GRANTEE-1222�
Property Address: -T�4-A AVe- W.
Edmonds, Washington
Legal Description: L-6-1-- 4 5- 0 V-, s iAo &3- �,L-q c�-
<- ry -Y � -c!, iu-- t�- m 6 1
I WA-5-
Assessor's Parcel Number: 2�� 00 C200
I have read the requirements for accessory dwelling units contained in Chapter 20.21 of
the Edmonds Community Development Code (ECDC) and understand that an accessory
dwelling unit, including a second kitchen, as defined in ECDC Section 21.05.015 is'
prohibited until an Accessory Dwelling Unit Permit is approved.
I also understand that an Accessory Dwelling Unit Permit cannot be approved unless all
the criteria in Chapter 20.21 are met, and all the necessary items are submitted',
including an affidavit of occupancy and 'a covenant to be filed with the Snohomish
County regarding the regulations imposed on Accessory Dwelling Units.
Property Owner Si nature: N J,
9
Property Owner Name (printed):'Tj4o1,,7 IA_S
Date: 02—
STATE OF WASHINGTON)
COUNTY OF SNOHOMISH)
I certify that I know or have satisfactory evidence that
signed this instrument and acknowledge it to be his/her free and voluntary act for the uses and
purposes mentioned in this instrument.
Notary's ressure seals must be smudged.
P
Signature of
1". top "'N
Notary Public
%Stoll
Residing at:
L 1, My Appointm
oa- e -�/— cj216,0 2— -
'.A " -
e% a -,O'b A Expires:...
T1119'Di"O'"'C"UMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITO I R.
STATEMENT ON ACCESSORY DWELLING UNITS
GRANTOR: ri4-t4 2PFdk;;-10-ndS GRANTEE-.-U��-��23�e/4�,,,.�-
Property I Address: 2.,,-,L705- -79LAA AVe- LAI,
Edmonds, Washington
Legal Description: L-,C5--1 -f, 5- 0, V-
Assessor's Parcel Number: 01�� oil —. q-001 — ooc<�
I have read the requirements for accessory dwelling units contained in Chapter 20.21 of
the Edmonds Community Development Code (ECDC) and understand that an accessory
dwelling unit, including a second kitchen, as defined in ECDC Section 21.05.015 is
prohibited until an Accessory Dwelling Unit Permit is approved.
I also understand that an Accessory Dwelling Unit Permit cannot be approved unless all
the criteria in Chapter 20.21 are met, and all the necessary items are submitted,
including an affidavit of occupancy and a covenant to be filed with the Snohomish
County. regarding the regulations imposed on Accessory Dwelling Units.
VV n
Property Owner Signature: --VL,6-e-NA-4_
Property Owner Name (printed):T14oM A-S C-n—
Date:. v�)Z 4ZO 2-
STATE OF WASHINGTON)
COUNTY OF SNOHOMISH)
I certify that I know or have satisfactory evidence that -111nv"O-s R - B F-1--r-
signed this instrument and acknowledge it to be his/her free and voluntary act for the uses and
purposes mentioned in this instrument.
Notary's pressure seals must be smudged.
Signature of
Notary Public
a 0 T.J,
Residing at:
2 V,
My Appointm
Expires:
THlibb"'C"UMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY
I
AUDITOR.
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FEB 12 2001
DEVELOPMENT SERVICES CTR-
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CITY OF EDMONDS.
SINGLE FAMILY/DUPLEX COVER SHEET
Directions: Applicants Mfg to Complete the Information In 'he WHITE BOXES ONLY j5haded boxes mo for City
use only). This rover shoal must accompany each building permit application lot a now single-larally
PROJECT ADDRESS kN Zh� U--)
7, t
PROPERTY TAX ACCOUNT PARCEL If 72,1 QC0<,� -
7 �,4
DESCRIPTION OF WORK CA- el
t�j� -k- 'MMCHONE —77e-4 2- �11—
CONTACT PERSON P H 0 N E
E-MAIL FAX
r
SS i�),
MAILING ADDRE Ea ma 2!;,,q sall;
P�FAX CORRECTIONS El MAIL CORRECTIONS E-MAIL CORRECTIONS
fly SIGNING THIS STATEMENT.1 UNDERSTAND THAT I AM THE CONTACT PERSON FOR THIS PROJECT. IT IS MY
RESPONSIBILITY TO COORDINATE ALL SUBMITTALS W17H 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
UBM17TAL ANY DISCRETIONARY PERMITS THAT MAY BE APPLICABLE TO This PROJECT. I ACKNOWLEDGE
S I IN ORDER TO MAKE A
THAI 70 THE BEST OF MY ABILITY I HAVE SUBMITTED ALL NECESSARY DOCUMENTA 10
COMPLETE AP RE REQUIRED.
DATE
SIGNATURE�I=ijr
ZONING INFORMATION
ZONE_ N2s- LOT AREA
NUMBER -OF DWELLING UNITS' EXISTING DEMOLISHED PROPOSED_
DISCRET16NARY APPROVALS CA If
SUBDIVISIONJ� �jljf CU VARIANCE ------9HORELINE
SEPA OTHER
AGE INFORMATIO
LOT COVER
EXISTING'SF PROPOSED SF ----fOTAL SF
HEIGHT CALCULATION INFORMATION
DATUM M,�jin k1al e n9ve-*- A,960. A
AVE 1.57 MkX '�554f, --7��
SETBACK INFORMATION
amilM2 FRONT. SIDE SIDE --7, --
SIDE SI . -n �7
EROPOSED FRONT DE. 7 ..S' -Rrw,:
NO.. FLAG LO
C] YE!S)kN0` RECORDING
ADU S.LAIEMEfiLafLQAl=
STAFF COMMENTS: -knos,4- e- -1n5
ENGINEERING INFORMATION
DRIVEWAY . SLOPE GRADING CYDS f.7 3.
EASEMENTS
EXISTING IMPERVIOUS AREA CONSTRUCTED BEFORE 1977 —SO.FT
EXISTING IMPERVIOUS AREA INSTALLED 1977 OR LATER SO.FT
PROPOSED NEW NET IMPERVIOUS SURFACE
CitX*Ufi8 Onix
SIDEWALK REQUIRED[] YES [3 N . 0 DRAINAGE PLAN REQUIRED 0 Y*ES [:]NO
UNDERGROUND WIRING REQUIRED YES [:]NO
STREET DEDICATION FT. LID#
STAFF COMMENTS:
SPECIAL INSPECTIONS REQUIRED FOR THIS PROJECT (City Use Only)
ROILS.,
13 START OF WORK
DEXCAVATION & GRADING
DSHORING INSTALLATION A MONITORING
PROOF ROLLING
PLACEMEN T OF FILL & CO MPACTION
SUBSURFACE DRAINAGE
VERIFY SOIL BEARING
PILE, PLACEMENT
EROSION CONTROL
3 GENERAL SITE MONITORING BY THE
GEOTECHNICAL ENGINEER OF RECORD
13GENERAL SITE M ONI TORING BY THE
GEOTECHNICAL ENGINEER OF RECORD
DURING WET ViEATHER CONSTRUCTION
FINAL GRADING A FIELD REPORT
1:1
13 OTHER
OPLACEMENT OF REINFORCEMENT
E]PLACEMENT OF CONCRETE
OBOLTS fNSTALLED1N CONCRETE
DSTRUCTURAL MASONRY
13STRUiCTURAL STEEL ERECTION
13HIGH STRENGTH BOLTING
DWELDING (WABO CERTIFIED ONLY)
OTHER
PLAS CHECK 0
C-�
DATE RECEIVED
BUILDING CONSTRUCTION INFORMATION
CODE EDITIONS 1997 UBC. UMC. UPC. WSEC, VIAG WITH AMENDMENTS
DESIGN CRITERIA WIND EXPOSURE B WIND SPEED 80 MPH SEISMIC ZONE 3
Floor Live Lood4o Roof SROWILIve Load Balcony Live Load
F1001 Roof Dead Load Balcony Dead Load tU
NU I MSER OF STORIES BASEMENTS FLOOD ZONE
[:]YES NO
LOT SLOPE % SOILS REPORT PROVIDED
FLOOR AREA (MEASURED TO EXTERIOR FACE OF EXTERIOR WALL)
Existing p(pposed Total
'At-�;O -3
Living Space
Garage 7OP& -7
Carport 9
Deck1C6V@F9d Porch
olhsr�
ENERGY CODE COMPLIANCE INFORMATION
EMELIM '10GAS, OIL 0 ELECTRIC OTHER
W
19FORCEDAiR C]HFATPUMP [:]HYDRONIC [:]OTHER
Kn PRESCRIPTIV I E: Listoptions- FOR CITY USE ONLY
LAI
TARGET UA APPROACH: Provide UA Calcustions Calling Insulation
SYSTEMS ANALYSIS: Provide Computer Analysis Wall Insulation
Floor Insulation
Door U-Valuo_--Lctl
ENERGY1VENTILATION WORKSHEETS PROVIDED
Window U-Vaiu.--Li
Skylight U-Valuo
WINDOW SCHEDULE PROVIDED
Glazing
VENTILATION CODE COMPLIANCE INFORMATION cO
KITCHEN FAN CFM 1('R) - BATHROOM FANJS) CFM it LAUNDRY FAN CIFMIOD
M EXHAUST OPTION
FRESH AIR TO BE PROVIDED TO INDOW VENTS 0)\ 1�1 WALL PORTS
EACH HABITABLE ROOM WITH: LkW
EXHAUST FA - H TO - 8 - E CONTROLLED WITH f4-HOUR TIMER kNO-SIZED-AS-FOLLOWS:
I - 2 BEDROOMS: 60 - 75 CFM 11 4 BEDROOMS: 100 - 160 CFM
313EDROOMS: 80 - 120 CFM El 5 BEDROOMS: 120-160 CFM
HVAC INTEGRATED OPTION
DE61CATED HEAT RECOVERY VENTILATION OPTION
SEPARATE PERMITS (City Use Only)
1:1 RIGHT OF WAY CONSTRUCTION PERMIT
0 ENCROACHMENT PERMIT
STATE ELECTRICAL PERMIT
FENCE PERMIT
0RESIDENTIAL FIRE SPRINKLER PERMIT
CIOTHER ' —
0MECHANICAL PERMIT
OPLUMBING PERMIT
WATER METER
aSIDE SEWER PERMIT
1:1 IRRIGATION (SPRINKLER SYSTEM)
El OTHER
Any request 109 modification, variance of other administrative deviation therinallor 'variance*)
must be specifically called out and Identified. Approval of any plot or plan containing provisions
which do not Comply with the city Code and for which a varlanco'hait 001 been specifically
identified, requested and considered by the SPpropflate City Official In accordance with the
pproplisle provision ol city Code Of state law does not approve any Items not to Code
:Pecilication.
PERMIT ISSUANCE APPROVALS
PLANNING REVIEW &APPROVAL
CONDITIONS OF APPROVAL:
(City Use Only)
DATE
4*1
ENGINEERING REVIEW & AP&VAI,
CONDITIONS OF APPROVAL:
DATE
BUILDING REVIEW AL APPROVALI��',-�-
CONDITIONS OF APPROVAL:
-,9-*--NDATZ -31k-l-al
It
RE6EIVEO
Q?ATE
ERMIT EXPIRES
USE. PERM.IT
CITY OF EDMONDS
ZONE f\ -an
VIM,& Pt4&1 —19170
CONSTRUCTIO PERMIT APPLICATION
40B SUITE/APT#
ADDRESS "75f�,Ave� W
-
OWNER NAME/NAME OF BUSINESS
..T
PLAT NAME/�UBDIVI SION NO.
LOT NO.
LID NO.
tor 5
LID FEE $
w
MAILING ADDRESS
14
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved. 0
RW Permit Required 0
Req�d
0
f -
.
Street Use Pernift C3
CITY ZIP TELEPHONE
EXISTING OPOSED
Inspection Required 0
Sidewalk Required 0
7
REQUIRED DEDICATION FT
_F
Underground
Wiring required
NAME
METER SIZE
LINE SIZE I
NO. OF FIXTURES
PRV REQUIRED
a
t;E IG c) K)
P
-34
YE NO 0
S .0
A
3
3
ADDRESS
I
REMARKS
OWNER/CONTRACTOR RESPONSIBLEFOR EROSION CONTROUDRAINAGE .
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CITY ZIP
TELEPHONE
1-4
M U KI L-C-To 79-475-
9-4-q7-745�
�Pfieafij og::� �3)
NAME
ENGINEERING REVIEWED DATE
C
ADDRESS
9
c) 3L
FIRE. REVIEWED BY DATE
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CITY ZIP
TELEPHONE
LL
;7
Z6
STATE LICENSE NUMBER EX RATION DATE
CHECKED BY .
VARIANCE OR CU
SHORELINE OR ADB#
INSPECTION
REO'D
BOND
POSTED
.1
Tol< I kl� 9
)eES [3 NO
HEIGHT
SEPA REVIEW
SIGN AREA
PROPERTY TAX ACCOUNT PARCEL NO.
COMPLETE
EXEMPT
ALLOWED
PROPOSED
ALLOWED
PROPOSED
O.S
w
*> o 4 , 4 -001
EXP
LED
aP
g
NEW
RESIDENTIAL
'LUM BING/MECH
LOT COVERAGE
ALLOWED 'PROPOSED
REQUIRED SETBACKS'(FT.)
FRONT. SIDE f#E#A-
PROPOSED SETBACKS (Ft)
FRONT UPSIDE
0 ADDITION
COMMERCIAL
COMP IANCE OR
/
5'
ripimn
A.
z
CHANGE OF
PARKING
LOTAREA
PLAANING REVIEWED BY
C-] REMODEL
0 APARTMENT
SIGN
REO'D
I PROVIDED
=WIN FENCE
0 REPAIR CYDS X FT)
R�MARKS
DEMOLISH TANK 'aTtIsp
4 ed- it;P-j -70�_
GARAGE - ROETAINRING WA�L 0 .,RENEWAL
0A
CARPORT* R CKE
1A
L"j
(TYPE BUSINESS OR ACT4Wt,*_�&X�LAJN:
CS1\4vt\(t�e
9HECKEDBY'
TYPEOFCONSTRVC N
DID OCCUPANT
r0l)
C.�'k VA',
Cyl GROUP
Cj�
w
0
NUMBER
I
NUMBg.R OF
DWELCI-NG .:n JkAREAS
RITICAL
SPECIAL INSPECTOR AREA
f OCCUPANT'
(h
M
o
'OF
UNITS
NUMBER
REQUIRED [- YE
I . LOAD..
"o
-STORIES
DESCRIBE WORK TO BE'DONE
REMARKS
z
PROGRESS INSPECTIONS PER UBC 1.981FINAL INSPECTION REO'D
a
S W cr) tv VrIZ Ua t 6.. .
VMCA.Lk (a ol
XAL-4 L wt� w AIM
296 St C6,k
VALUATION
FEE
PLAN CHECK FEE
HEAT SOURCE
GLAZING %
LOT SLOPE %
BUILDING
2,
PLM CHECKINO:.
VESTED DATE
PLUMBING . .
-7w)
0 HIS—
MECHANICAL
n—
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORWTO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADING/FILL
Z
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
mj
I=
SEPARATE PERMISSION.
STATE SURCHARGE
uj
PERMIT APPLICATION: 180 DAYS
a.
PERMIT LIMIT- I YEAR - PROVIDED WORK IS STAR TED WITHIN'480 0 AYS
- .,ENG. REVIEW FEES
:
SEE eACKOF PINK PERMIT FDA MORE INFORMATION
ON BEHALF OF HIS� OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
ENG. INSPECTION FEE,
Lu
N INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
*
:;APPLICANT.
EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
FEE 1!��
Ln, A 1 -1
ALLCLAIMSF R DAMAGES OF WHATEVERNAtURE, ARISING DIRECTLY OR INDIRECTLY
REC W
*
FROM THE ISSUANCE OFTHIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
Inc,( 0
1
0
DEEMEDTO MODIFY, WAIVEOR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
1 214a
I
0
x
NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO TFORCE ANY ORDINANCEPROVISION.'
I � . I
.
RECE12
.
TOTAL AMOUNT D UE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPRUVAL
GIVEN IS CORRECT;AND THAT I AM . OR THE DULY AUTHORIZED AGENT OF
1JSTATE
THE OWNER. I AGREE TO COMPLY WI LAWS REGI)LATING CONSTRUC-
CALL
This application is not a permit until signed by the
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 ST�TF_OF WASHINGTON' RELATING TO
18.27.
FOR INSPECTION
receipt is acknowledged in space provided.
WORKMEN'S COMPENSATION INSURANCE AND RC
-(425)
OFFIC LS S DATE
OFF14C '1 1 GNATURE
E LOW
L
DATJ'SIGNEDI
,�ENT)
_NLOJ�aA
I�N,A,TU
771,0220
q,
-RELEASED
BY.77 DATE
ATTENTION
EXT/333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771 -0221
4 j
A FINAL INSPECTION -HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE - YELLOW. INSPliCTOR'
CATE OF OCCUPANCY HAS BEEN'GRANTED. UBC SECTION 109
FAX PINK - OWNER - GOLD - ASSESSOR
5/98
ar_ PL-AT' 99-IS'.%
C-IT%e Or-' RECEIV9P
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3 c. a -DEVELOPMENT SERVICES PTR.
kCITYOF EDMONDS
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APPROVEQ BY PLANNING
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FIREIND AID ADDRESS SIGN REQUIIRED
WATER SERVICE INSPECTIONS
REQUIRED. CALL 771-0W=-v &Ar/-zm9��
RECEIvED
.-MIA VA-W.-T
Ff -EB 12 2001
DEVELOPMENT SERVICES CTR.
6"9 CITY OF EDMONDS
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FEB 12 2001
AT S* -771") KvC� ',V DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
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Critical Areas Checklist
--------------------------------------------------------------
Site Information (soils/topography/hydrology 6getation)
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Site,.Addr-essfL.Ocation: 3
ax
2. PF.operty T Accoun't' Number: 44- 001 00
3. Approximate Site Size (acres orsquare feet):
4. Is this site currently developed? yes; no.
if yes; how is site developed?
5. Describe the general site topography. Check all that alp ly.
Flat: less th an 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a
horizontal distance of 66-feet).
Hilly: slopes present on site of more than 15% and less than 30% ( a vertical 'rise of
10-feet over a horizontal distance of 33 to 66-feet).' '
Steep grades of greater than 3 0% present on site (a vertical rise of I 0-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
..8. Site is in the floodway floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? Flows are. seasonal? _ (What time of year?
10. Site is primarily: forested shrubs mixed
_; meadow
urban landscaped (lawn,shrubs , etc)
11. Obvious wetland is present on site:,,
L ILL,
K
CITY OF EDMONDS
SINGLE FAMILY/DUPLEX COVER SHEET
14r: 10" In the WHITE BOXES ONLY (Shaded boxes we lot CRY
Directions: Applicants are to complete the Information
use only). This cover ithost must accompany each building permit application 101 A now SiII919-1401111
residence. ===%, A
-Y
PROJECT. ADDRESS 6wc::-5
PROPERTY TAX ACCOUNT PARCEL I
DESCRIPTION OF WORK _& if CA
OWNEFt���
CONTACT PERSON-
E-MAIL___
MAILING ADDRESS
PHONE
FAX 4trz,,57- 7? 4 - 2-09 j=
F:r4 a_j )" -A d, ? 9 0.
P�F AX CORRECTIONS 1:1 MAIL CORRECTIONS E-MAIL CORRECTIONS
Y smmmo THIS STATEMENT) UNDERSTAND THAT I AM THE CONTACT PERSON FOR THIS PROJECT. 17 16 MY
RESPONSIBILITY TO COORDINATE ALL SUBMITTALII WITH THE CITY AND ONLY I CAN MAKE INQUIRIES ON THE
STATUS OF THE APPLICATION. I UNDERSTAND 11 IS MY RESPONSIBILITY TO DETERMINE IN ADVANCE OF PERMIT
suamiTTAL ANY DISCRETIONARY PERMITS THAT MAY BE APPLICABLE To THIS PROJECT. I ACKNOWLEDGE
THAT TO THE BEST OF MY ABILITY I HAVE SUBMITTED ALL NECESSARY DOCUM ENTATIO IN ORDER TO MAKE A
COMPLETE APPLIFAYION AND NO RE REQUIRED.
DATE az e)-L—
SIGNATURE VIC=
ZONING INFORMATION
ZON LOT AREA
NUM13ER-OF DWELLING UNITS EXISTING DEMOLISHED PROPOSED
DISCRETIONARY APPROVALS CA Determination
SUBDWISION��J-IIVCU VARIANCE -----5HORELIHE
SEPA Expires_W===__ OTHER.
City UELDAU_;-� 1?,q�_
reV P.Wotik. `7 qt,,
ERAGE 11-1
LOT COV
EXISTING SF PROPOSED SF a&� -----T—OTAL SF
HEIGHT CALCULATION INFORMATION
DATUM MA12kjaje ev-e-r-Q 12-Alke-A YA, &,tj Y, 6 15r.
-�t�'3q '7Z
AVE
SZTBACK INFORMATION
SIDE 5 -ReAlf,
IMA11=2 FRONT /SIDE
EROPQSEA FRONT f SIDE ..S—f SIDE I S' —OtW 07
Ei []NO I'LiG"LOT [3 Y04 0. - ST__DFOIC_ E] YES r.:
0 Yg!S19[N,0' RECORDING
STAFF COMMENTS: Aln ki :�i, kn.' 0. Sr� k�e_ '4�1) gpe,�
4
ENGINEERING INFORMATION -73, .
DRIVEWAY SLOPE % z GRADING CYDs
EASEMENTS'
EXISTING IMPERVIOUS AREA CONSTRUCTED BEFORE 1977 SO.FT
EXISTING* IMPERVIOUS AREA INSTALLED 1977 OR LATER SO.FT.
PRO L POSED NEW NET IMPERVIOUS SURFACE
C111,11fie Onix
SIDEWALK REQUiRE1.) [:]YES [:] NO .. DRAINAGE PLAN REQUIRED [:]YES [:]NO
UNDERGROUND WIRING REQUIRED 0yes [—]NO
STREET DEDICATION FT. LID#
STAFF COMMENTS:
SPECIAL INSPECTIONS REQUIRED FOR THIS PROJECT (City Use Only)
ID START OF WORK
1:1 EXCAVATION & GRADING
OSHORING INSTALLATION & MONITORING
E]PROOF ROLLIN G
OPLACEMEN ' i OF FILL & CO . MPACTION
SUBSURFACE DRAINAGE.
VERIFY SOIL BEARING
PILE PLACEMENT
EROSION CONTROL
]GENERAL SITE MONITORING BY THE
GEOTECHNiCAL ENGINEER. OF RECORD
EIGENERAL SITE MONITORING BY TN E
GEOTECHNICAL ENGINEER OF RECORD
-DURING wET ViEATkER CONSTRUCTION
F14AL GRADING 4 FIELD A.EPORT a
OTHER
IDPLAC,EMENT OF REINFORCEMENT
C]PLACEMENT OF CONCRETE
13 BOLTS INSTALLED IN CONCRETE
13S T.RUCTURAL MASONRY
0STRUCTURAL STEEL ERECTION
EIHIGH STRENGTH BOLTING
WELDING (WASO CERTIFIED ONLY)
130THER
PLAN CNNCK fj
APPLICANIf DATS RECRIVED
BUILDING CONSTRUCTION INFORMATION
CODE EDITIONS 1991 UBC. UMC, UPC. WSEC. VIAG WiTH AMENDMENTS
DESIGN CRITERIA WIND EXPOSURE 6 WIND SPEED 60 MPH SEISMIC ZONE 3
Floor L RootSaowJ Balcony Live Load
Ive Lood4f) 'Live Load
Floor Dead Load -a Root Dead Load Balcony Dead Load=e
NUMBER OF STORIE!T. ,� BASEMENTS FLOOD ZONE
LOT SLOPE 'I_ SOILS REPORT PROVIDED [] YES NO
FLOOR AREA (MEASURED TO EXTERIOR FACE OF EXTERIOR WALL)
Existing ptoposed T IS
Living SPACO
7 `1
Garage
Carport CT—
Dockicovered Parch
Other
ENERGY CODE COMPLIANCE INFORMATION
Fur-L TYPE GAS. OIL 0 ELECTRIC 0 OTHER
rv*.ORCEDAIR OHEATPUMP OhYDRONIC OOTHER
Liy
FNFRGY CODE METHOD OF COMPLIANCE
IM PRESCRIPTIVE: List Option 0, FOR CITY USF ONLY
Lai TARGET UA APPROACH: Provide UA Calcustions Coiling Insulation
0 SYSTEMS ANALYSIS: Provide . Computer Analysis Wall Insulation
Floor Insulation
Door U-Valuo 40
Window U-Valm
MENERGYIWENTILATION WORKSHEETS PROVIDED Skylight U-Valu
WINDOW SCHEDULE PROVIDED I Glazing L
VENTILATION CODE COMPLIANCE INFORMATION C:,j:7
KITCHEN FAN CFM
_IQI),_ BATHROOM FAN(S) CFM jb LAUNDRY FAN CFM
WHOLF HOIIQF VENTILATION SYSTEM
qEXHAUST OPTION
9 FRESH AIR TO BE PROVIDED TO INDOW VENTS 4)\ fn WALL PORTS
EACH HABITABLE ROOM WITH:
7
r FAN To BE CONTROLLED WITH 24 HOUR TIWER AND SIZED `AS FOLLOWS:-
0 1 - 2 BEDROOMS: 60 - 75 CFM 0 4 BEDROOMS: 100 - 150 CFM
P3 BEDROOMS: 80 - 120 CFM 0 5 BEDROOMS: 120-180 CF M
HVAC INTEGRATED OPTION
DEDICATED HEAT RECOVERY VENTILATION OPTION
SEPARATE PERMITS (City Use Only)
ORIGHT OF WAY CONSTRUCTION PERMIT 0 MECHANICAL PERMIT
OENCROAChMENT,PERMIT OPLUMBING PERMIT
STATE ELECTRICAL PERMIT 9WATER METER
FFgCF PERMIT WIDE SEWER PERMIT
0 RESIDENTIAL FIRE SPRINKLER PERMIT 0 IRRIGATION (SPRINKLER SYSTEM)
OOTHER' OOTHER
Any (64119111 101 m9d . Ificallon. variance of other administrative deviation (befinallar 'varians**)
must be specifically called out and Identified. Approval of Any PISt Of Plan Containing PIDW11119011
which do not Comply With the City Code and 'Or Which & Va"Sn" has no' been specifically
identified, requested and Considered by the appropriate city official In accordance With the
ppeopriate provision of city code of state law does not approve any Items not to code
:Pecilicstion.
PERMIT ISSUANCE APPROVALS
PLANNING REVISW III APPROVAL
C01401TIONS OF APPROVAL: 49:;11
LA,nde,g��-PO4 r-h-7527TE Lmll--ce-Ae-gle
(City Use Only)
DAT9j_
:r- 19
1'_� - I y ?31
9NGIN9ERING RZV19W & AFFV0VA�_4"j%j(Ar44d�-
CONDITIONS C_
DATII.��al
BUILDING RXV19W & APPROVAL(ZZ, LI.&:14 A�f
CONDITIONS OF APPROVAL:
_9-*-_-�,DAT2
I(