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16223 76TH AVE W.PDFi 1111111111111115060i 16223 76TH AVE W PU�'J'ILIC WORKS DEPART= CHECKLIST . l �' - r"el-iDate .' UILDING PERMIT REVIEW , I'll NOress Street Right -of -Way Existing REQD Access Easements Existing READ Utility Easement Existing V '> ` REQD -- Lot per Subdivision Plat Assessor Ma Z Site Plan Checked for Accurac �•Lr�r�T`:�r�� "� Z y •�z��:� � Underground Wiring Reqd. a Check Accuracy of Legal. Description w Environmentally Sensitive Area w Environmental Checklist Regd. D Z Flood Hazard Zone 7� U Shoreline Management Area Z Slope, Soil, Vegetation w Stream, Creek, Drainage Basin y ; Existing Zoning Per Code Amenities Design Board Approval Reqd. ADB # Approval Board of Adjustment Approval' /Reqd. X/O Review By: !%J.�l Date: x w H Existing Water Main .Size �� [ ,- Water Main Reqd. Service Line Reqd. Hydrant Size Existing Hydrant Reqd. Per Fire Code Size Detector Check Meter Reqd. Cross Connection Inspection Fire Department Con Water Meter.ChaY*a-6 Review by Septic Tank Permit Reqd. Sanitary Sewer Availability ck Permit No. Proj . Drawing No. File No. Side Sewer Availability L� ' U 1�YZy]D• L{ n„) Sanitary Sewer ct' F e Reqd. Review By: Date:2V4 ]G17v �' ��_ USE PHRMIT �.. L BUILDING DEPARTMENT Pplicant Fill ZONE NUM PERMIT APPLICATION side Heavy Lines ;oB , A ADDRESS h�%t / ° { �� • NAME OR NAME OF BUSINESS) . �( d �l •�eO BoM`.0�%S//�' f�CC 09 r, LEGAL LOT PLAT NAME SUBD IVISION NO. + MAILING ADDRESS ❑YES NO W Po , y. 509: PUBLIC RIGHT OF WAV PER ORDINANC Ill A++- r. 0 CITY . NUMBER EXISTING RIGHT OF WAY (��w©0 E-EPHONE � "?,zCf 7-IS- ��GQ� /'" AME PROPOSED RIGHT OF WAY Sr`'IP2t ssi'oll �ES(6 Iv DEFICIENCY OF RIGHT OF WAY lJ '. 0 Y lid ytft U W ADDRESS , STREET/UTILITY WORK,REQUIRED ®YES ONO . S0., U 'Y �1 rT� PERMIT FOR WORK IN PUBLIC R/W %YES ONO U C CITU 1'�f✓ FF J J TELEPHONE NUMBER UNDERGROUND WIRING REQUIRED Y ES ❑ N O U J .��. 32tx0 CONNECTION TO SANITARY SEWER .YES NO m N SEPTIC TANK PERMIT REQUIRED OYES Did NO d NAME SEPTIC TANK PERMIT NO. �• 0 F ADDRESS , SEE MEMO DATED �, ^�/ -� y Gv P_.O �x 30C 'R Q H CITU TELEPHONE NUMBER REMARKS o %.v-L"C) -779 -93R3 U STATE LICENSE NUMBER CITY LICENSE NUMBER CHECKED BV 2.73 -01 - 80-(i9-Rc- 736 S 4 8 -.0 81% SIZE Legal Description of Property (Show Below or Attach Four Copies) METER SIZE METSSIZE tl BUILDING SUPPLY M W IP - - - 1 101 REMARKS Q 0 L{/ EY / I0AI (//IF mo SIGNAREA ENV. REVIEW ADB NO. d ALLOWED PROPOSED COMPLETE EXEMPT C U N i SHORELINE — W 0 J REMARKS . Q V W J VARIANCE OR CU PLANNING REVIEW BY DATE YARDS ' / LOT COVERAGE FI `FRONT / 0 SIDE A,REAR .1. S O'` NEW RESIDENTIAL: LINE FIRE ZONE TYPE OF �CpONSTRUCTION CODE / HEI^G HTp�' ❑ NON-RESIDENTIALEl SIGN � V ` W t617 � 30'Al rc• ❑ ADD ❑❑ RETAINING DEMOLISH SPECIAL INSPECTOR REQUIRED AREA n OCCUPANCY ,A -t GROUP 1`" GROUP OCCUPANT LOAD WALL ❑ YES NO _I �-� ALTER EXCAVATE FENCE OR FILL PLAN CHECK D By THIS SITE IS LOCATED IN THE CITY N❑ OF EDMONDS. LOCAL SALES TAX REPAIR PRE -MOVE SWIM INSP. a POOL SHOULD BE CODED 31.04. REMARKS F Z NUMBER OF STORIES NUMBER G DWELLING rQ�PL ,t 50/ TT O" TZ�N .`-i? - c+ tV t-/'� h' t'G1` (� �J Z W 0 / / - UNITS f a NATURE OF WORK TO BE DONE T �\ {� L� /� f� (� [L Lo ` ✓ N1W A&E �1_ 01ZD - ( T H NNc� W W 0 0 co O PLAN CHECK FEE VALUATION FEE - F- -' PROPOSED USE ! ; 10 W B PLOT PLAN INDICATE BUILDING SETBACKS, ABUTTING STREETS) BUILDING BUILDING �J �d 5 L L 0 N q 7-r19C 1.1"eP , /] / �7 PLUMBING I J W 0 rQ W 0 m - MECHANICAL Q 0 FENCE F Z SIGN f N "Applicant, on behalf of his or her spouse, heirs, assigns and W in interest, agrees to indemnify, defend and hold harmless f J f successors the City of Edmonds, Washington, its officials, employees, and g RETAINING WALL 0 U rc agents from any and all claims for damages of whatever nature, CSWIMMING I arising directly or indirectly from the issuance of this permit. Issu- POOL o ance of this permit shall not be deemed to modify, waive or reduce limit in way the 300 ;Illy rer)uironlcnt of any city ordinance nor any