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24002 76TH AVE W.PDF111111111111 6451 24002 76TH AVE W 0 0 0 0 The City of Edmonds APPLICATION tole SEDE SOMR PERMIT Fulm. j , w....EDE 0 INSIDE: 13 REPAIRS 0 CARD No. . ....... EASEMENT No . ................. OWNE:R ... �,:OLVW4V.w3 Q .......................................... CONTRACTOR ............ ................... .................... . ......... ....PERMIT No. do STREET HOUSE 27 ............. . .. ... !n. .. kv r . ....... .... AVENUE LOT No . ................................. ........................................... � BLOCK No..._..... ............. NAMEADD ......... ........................ .... . .. . ... ... ........ . .. . APPROVED IJK - t, ( �% W% G Date Approved: BACKFEIX WORK ORDER ISSUED ... ........................................ DEPOSIT, $.. ................... . ........... .................. SEWER WOltK ORDER ISSUED .... ............................. ......... DATE .... . .. ..... '....0 ..... Byi uy, .. ... ... ............... ....... lb� STRE& i fttAreas Checklist Site Information ProjectName: Permit Number Site Location: -.=2Y/-)0?- '76 6-,,�ky, &0. Property Tax Account Number n '- "' "' 5 fll� Approximate Si��12YCag�� or s`quark;4- o,�) Is a 'r W// - 1�101f- po,�� - / 6- Have you filled out a Critical Areas Checklist for a project on this site before? /IVO General Site Conditions '7 1. Has the site. been cleared or logged? Date of most recent action: Soils / Topography 2. In the Snohomish County Soil Survey, what is the mapped soil type(s)? 3. Deson-be, the general site topography. Check all that apply. Flat- less than 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.) Ily-. slopes present on site of more than 15% and less than 300/,o ( a vertical rise of 10 feet of horizontal distance.)' Steep: grades of greAter than 30% present on site. Comments Hydrology/Vegetation 4. Site contains areas of year-round standing water: /Vo 5. Site contains areas of seasonal standing water-, 11�0 Approx. Depth: 6. Site is in the floodway floodplain A of a water course. 7. Site contains a creek or an area where water flows across the grounds surface? LLU—nows. are year-round? Flows are seasonal? 8. Site is primarily: forested meadow. _;shrubs mixcd 9. Obvious wetland is present on site: //0 Rey W27192 '690 -19q City of Edmonds Critical Areas Checklist The Critical Areas Checklist contained on this form is to be filled out by any person Preparing a Development Permit Application for the City of Edmonds prior to his/her submittal of a development permit to the City. Ile purpose of the Checklist is to enable City staff to determine whether any potential Critical Areas are or may be present on the subject property. 111C information needed to complete the Checklist should be easily available from observations of the site or data available at City Hall (Critical Arms inventories, maps, or soil surveys) - An applicant� or his/her representative, must fill out the ChOcIdist, sign and date, it, and submit it to the City. The City will review the cheddist, make a Precursory sitev'isit- and make a det&m3ination of the subsequent steps necessary to complete a development Permit application. With a signed copy of this form, the applicant should also submit a vicinity map of the parcel with enough detail that City staff can find and identify the subject Parccl(s). In addition, the applicant is encouraged to include any other pertinent information or sttidies in conjunction with this Checklist to assist staff in completing their Preliminary assessment of the site - I have completed the attached Critical Area Checklist and attest that the answers provided -are factual, to the best of my knowledge (fill out the appropriate column below) - Owner / Applicant: Name K Title - Street Address J" 6(1-;'7o1-7 6 City, State, ZIP Phone -7 25' 3&s-r S Yit Date Applicant Representative: Name Title Street Address City, State, ZIP Signature Phone Date CITY OF EDMONDS SINGLE FAMILY/DUPLEX COVER SHEET Dirac lions: Applicants are to complete the Information In the WHITE BOXES ONLY (Shaded boxes are for City use Or' 111. This cover shoot must accompany each building permit application for a now single-family residence. * PROJECT ADDRESS �� 2— — , ^/ V (4 � PROPERTY TAX ACCOUNT PARCEL 0 DESCRIPTION OF WORK OWNER P A 1-k PHONE 7.;?-- 7(� CONTACi PERSON e-e %�e-r'*zj PHONE.2rj6- ZZ '1- -5112- E-MAIL FAX MAILING ADDRESS )qoc) 2- 1(�"' WVe- ) FAv,,-,,,jA LA,4 '�,V'O 2- (o FAX CORRECTIONS MAIL CORRECTIONS E-MAIL CORRECTIONS By SIGNING THIS STATEMENT I UNDERSTAND THAT I AM THE CONTACT PERSON FDA THIS PROJECT. IT IS MY R ESPONSIBILITY TO COORDINATE ALL SUBMITTALS WITH THE CITY AND ONLY I CAN MAKE INQUIRIES ON THE ST A TUS OF THE APPLICATION. I UNDERSTAND IT IS MY RESPONSIBILITY TO DETERMINE IN ADVANCE OF PERMIT a USMITTAL ANY DISCRETIONARY PERMITS THAT MAY BE APPLICABLE TO THIS PROJECT. I ACKNOWLEDGE T 11 AT TO THE BEST OF MY ABILITY I HAVE SUB TED ALL NECESSARY DOCUMENTATION IN ORDER TO MAKE A COMPLETE APPL I CA710M AN 0 CRETIO Y'APPROVALS ARE REQUIRED. SIGNATURE zl DATE P-a,9-,06 ZONING INIF 0 'PRM_ATI N ZONE t4—s - LOT AREA NUMBER OF DWELLINGLINITS' EXISTING- DEMOLISHED PROPOSED DISCRETIONARY APPROVALS C A-1 -,Z-- / q Determination SUBDIVISION CU VARIANCE SHORELINE SEPA_ Expires_ OTHER City Use Only LOT COVERAGE INFORMATION EXISTING SF PROPOSED SIF TOTAL SF 1% HEIGHT CALCULATION INFORMATION DATUM A B C.: D AVE MAX ACTU�AL SETBACK INFORMATION REQUIRED FRONT SIDE_ S16E REAR PROPOSED FRONT SIDE SIDE REAR 7— . . .......... . .......... ....... 0— :0 T CNR.LOT YES NO: FLAG LOT. YES N St. ormic. YES [:]N'O��a ADU STATEMENT REQUIRED YES NO RECORDING If. STAFF COMMENTS: ENGINEERING INFORMATION DRIVEWAY SLOPE % GRADING CYDS EASEMENTS EXISTING IMPERVIOUS AREA CONSTRUCTED BEFORE 1977 SO.FT EXISTING IMPERVIOUS AREA INSTALLED 197 7 OR LATER SO.FT. PROPOSED NEW NET IMPERVIOUS SURFACE City Use Only SIDEWALK REQUIRE . D [-]YES F] NO .1 DRAINAGE PLAN REQUIRED []YES []NO UNDERGROUND WIRING REQUIRED []YES []NO STREET DEDICATION FT. LID# STAFF COMMENTS: SPECIAL INSPECTIONS REQUIRED FOR THIS PROJECT (City Use Only) SOILS, STRUCTURAL, DSTART OF WORK E]PLACEMENT OF REINFORCEMENT DEXCAVATION A GRADING C]PLACEMENT OF CONCRETE DSHORING INSTALLATION & MONITORING []BOLTS INSTALLED IN CONCRETE OPROOF ROLLING 0STRUCTURAL MASONRY OPLACEMEN . f OF FILL & COMPACTION 0STRUCTURAL STEEL ERECTION 0SUBSURFACE DRAINAGE DHIGH STRENGTH BOLTING EIVERIFY SOIL BEARING DWELDING (WABO CERTIFIED ONLY) 13 PILE. PLACEMENT DOTHER DEROSION CONTROL IGENERAL SITE MONITORING BY THE GE OT E CHNICAL ENGINEER OF RECORD GENERAL SITE MONI TORING BY T14E GEOTECHNICAL ENGINEER OF RECORD DURING WET WEATHER CONSTRUCTION 0 FINAL GRADING & FIELD REPORT EDOTHER "PLICANT PLAN CHECK er-j DATE RECEIVED a14L(1-0- BUILDING CONSTRUCTION INFORMATION p CODE EDITIONS 1997 UBC. UMC. UPC. WSEC, VIAO WITH AMENDMENTS DESIGN CRITERIA WIND EXPOSURE 8 WIND SPEED 90 MPH SEISMIC ZONE 3 Floor Live Load Roof Snow/Live Load Balcony Live Load Floor Dead Load_ Roof Dead Load Balcony Dead Load_ NUMBER OF STORIES BASEIMENTS_ FLOOD ZONE— _ LOT SLOPE % SOILS REPORT PROVIDED 0 YES [:] NO FLOOR AREA (MEASURED TO EXTERIOR FACE OF EXTERIOR WALL) Existing Proposed Total Living Space Garage Carport Deck/Covered Porch I Other — ENERGY CODE COMPLIANCE INFORMATION FUEL TYPE GAS, OIL C] ELECTRIC 11 OTHER FORCEDAIR [:]HEATPUMP OHYDRONIC C]OTHER ENERGY CODE METHOD OF COMPLIANCE E] PRESCRIPTIVE: List Option 13 TARGET UA APPROACH: Provide UA Calcuations 13 SYSTEMS ANALYSIS: Provide Computer Analysis 13 ENIERGY/VENTILATION WORKSHEETS PROVIDED E] WINDOW SCHEDULE PROVIDED VENTILATION CODE COMPLIANCE INFORMATION FOR CITY USE ONLY Calling Insulation Wall Insulation Floor Insulation Door U-Valuo Window U-Value Skylight U-Value Glazing %_ KITCHEN FAN CFM BATHROOM FAN(S) CFM LAUNDRY FAN CFM WHOLE HOUSE VENTILATION SYSTEM EXHAUST OPTION FRESH AIR TO BE PROVIDED TO WINDOW VENTS WALL PORTS EACH HABITABLE ROOM WITH: EXHAUST FAN TO BE CONTROLLED WITH 24 HOUR TIMER AND SIZED AS FOLLOWS: 1 - 2 BEDROOMS: 50 - 75 CFM 0 4 BEDROOMS: 100 - 150 CFM 3 BEDROOMS: 60 - 120 CFM 5 BEDROOMS: 120-180 CFM HVAC INTEGRATED OPTION DEDICATED MEAT RECOVERY VENTILATION OPTION SEPARATE PERMITS (City Use Only) 1:1 RIGHT OF WAY CONSTRUCTION PERMIT 1:1 ENCROACHMENT PERMIT 0 STATE ELECTRICAL PERMIT 0 FENCE PERMIT EIRESIDENTIAL FIR I E SPRINKLER PERMIT 0OTHER 0 MECHANICAL PERMIT 0 PLUMBING PERMIT 0 WATER METER 0 SIDE SEWER PERMIT 0 IRRIGAT16N (SPRINKLER SYSTEM) OOTHER Any request for modification. variance or other administrative deviation (herinatter 'variance") must be Spec Ifically 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 ollicial In accordance with the appropriate provision of city code or state low does not approve any Items not to code specification. PERMIT ISSUANCE AP OV LS (91 PLANNING REViEW & APPROV A L=� CONDITIONS OF APPROVAL: t Use Only).,, DATE ENGINEERING REVIEW & APPROVAL CONDITIONS OF APPROVAL: DATE A BUILDING REVIEW & APPROV k"Ifft 00�l% 7*�P CONDITIONS OF APPROVAL: AAd'jKAT9 WX