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17039 76TH AVE W11111111111111 15066 17039 76TH AVE W TAX ACCOUNT/PARCEL NUMBER: a,31000122..0=5 BUILDING PERMIT (NEW STRUCTURE): 20aF�07)(0Q COVENANTS(RECORDED)FOR: CRITICAL AREAS:— q9 -0156 DETERMINATION: ❑ Conditional Waiver KStudy Required ❑ Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED PERMITS (OTHER): PLANNING DATA CHECKLIST DATED:T� SCALED PLOT PLAN DATED: `7 23 SEWER LID FEE LID #: SHORT PLAT FILE: 1�OL4 59 LOT: 13 BLOCK: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT WATER METER TAP CARD DATED: OTHER: L:\TEMP\DSTs\Forms\Street File Checklist.doc ... . •. . . F.ATE RECEIVED ` Q PERMIT EXPIRESP my OF EDMONDS vtc6�- Oib(D NUM CONSTRUCTION PERMIT APPLICATION JOB �O3 / i� I H ��� n . 1 1 SUITE/APT# ((VNN�1 OWNER NAMENAME OF BU INES 1 / 1! I o Vi,-1 � � Yr V J j j [/ JIC PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. , w MAILING ADDRESS O 2 H J LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP rescP APMoved O D p CITY ZIP TELEPHONE ad �A 1190 �r Zs-3't�t -�3 ?! EXISTING PROPOSED �� RW PereW Repurcad �mium P.�m aecwrw O :P�Ma aa�.od o SCewalk RnOi+reO o 'i REQUIRED DEDICATION FT �gfOind � NAj/•ryj�tE - Q�L V - -1� METER � LINE 3 r SIZE NO. FJ URES PRV REQUIRED w j+'A'J�'I T�� I i�CI VI ,Y ,GiO�11 �( Y YES �.. N0� z t ADDRESS /y� L •�7 N C'L k 1 I n L�l.! J �.J I . •�•1�,� /0 REMARKS ERICONTRACTOR OWRESPONSIBLE FOR EROSION CONTROUDRAINAGE 1, V z CITY W A/��,,,, ,^, .iy� /yZ��IP,� TELENPHONE Za /-� o w N �S 5 �/]�© / y ^J �5i GYI V�� "IA 2 J / L^ 0 7 Y NAME O �V\ e (��)��,,1 YL� Bla� C r./"- - E INEERING REV`IYEb/WED BY J DATE I ' 0 ADDRESS i CITY Z4P TELEPHONE F�RE REVIEWED BY DATE STATE LICENSE NUMBER EXPIRATION DATE CHECK 0 VARIANCE OR CU SHORELINE OR ADB# INSPECTION RED) SEPA COMPLETED Ex EMPT SQIACI�/\V r-N r l �'v YES NO I PR/O�PERTYTAX AMCCOUNTPARCEL NO. D1..7..J I IWO ��O� CA# ,/ ZONE SIGN AREA ALLOWED .PROPOSED HEIGHT 1 J `�J STUDY 'Cu �.`� ^ 1 211 �� NEW RESIDENTIAL PLUMBING/MECH LOTTCCOV'rE,'�RAGEC ALLOWED PROPOSED 1.REQUIRED SETBACKS (FT.) PROPOSED •. FRONT SIDE REAR FRONT SE TBACCKS•(FT..) NR•SIDE REAR ❑ADDITION ❑ COMMERCIAL COMPLIANCE OR ❑ 1 7 G JJ JJ 25 1 I QI G I 32 5 J I IV I S� r (a l i , CC �: MIXED USE CHANGE OF USE z ❑ REMODEL ❑ MULTIFAMILY ❑ SIGN PARKING REO'D PROVIDED LOT AREAJ I11.4 -rj;�� PLANNING REVIEWED BY DATE g 0gjzSiC`S o. ❑ REPAIR GRADING CYDS ❑ ( FENCE X _ FT.) ` Z' o REMARKS 181 ur;4,"1.040L G MDdI' j�fi ❑ DEMOLISH ❑ 7qN ❑ OTHER GARAGE RETAINING WALL FIRE SPRINKLER CARPORT ❑ ❑ ,.ROCKERY FIRE ALARM ..+ -;-vD L4 — �'• (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAI j i U` 4 1 _ l l TYPE dF L� UCTION �QD1ij GROUP�T CNUMBER NUMBER OF V V �/J'1 p OF STORIES DWELLING UNITS SPECIALI P TION CONSULTANT OCCUPANT LOAD L DESCRIBE WORK TO BE DONE REQUIRED &YES REMARKS - p • '-Tg.. GEO7ECH REPORT m BY: -. STRUCT E 1 BY: EA �� //�� /�__��•�• _ VALUATION po d Description FEE Description FEE Plan Check I State Surcharge HEAT SOURCE i/ t r l S LOTLO % �5 VESTEDJD�TE .? F gu�liJing'Petmit . , r +t� r H. �itjr� lrch"a o 1 r' v i9PCQN CHECK NO �d ` ,r+ ltG�J, Plumbing Base Fee Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO r J BE DONE ON PRIVATE PROPERTY -ONLY. ANY CONSTRUCTION ON THE PUBIC DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading 2JD . L s SEPARATE PERMISSION. Engr. Rev w �.•__ m PERMITAPPLICATION: SEE ECDC 19.00.005(A)(5) o. PERMIT LIMIT SEE ECDC 19.00.005(A)(61 ^'lyy •' r,�SEE BACK OF PINK PERAIIIT FOR MORE INFORMATION4.' -. / _r Jt -:�[- ' APPLICANT, ON BEHALF OF HISOR`HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire Review Plan Chk. Deposit IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # -^f ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due NOR UMIT IN ANY WAY THE CITY'9 ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT; AND THAT 1 AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER AGQE,E TO COM y+Y, WITH CITY AND STATE LAWS REGULATING CONSTRUC• CALL This application is not a permit until signed by the TIONDOING THr RRED THEREBY NO-gER$ON',Mbi BE EMPLOYED. IN VIOLATION'OF THE H 11 SY11TE OF,WASHI�CTYON REUiRII{, TO TlI FOR �NSPEC' 1pN Bwlding Official a his/her Deputy: and Fees are paid, and receipt is acknowledged in space provided. WORKMEN'S C ENSl1 1pNil/SUkAN .F RCY3 CFI 'S1�+7;fA SIGMA OWN RG r i DATE SIGNED '+ TU ; D TE y 771-0220 AIENTION EXT. 1333 FTSE IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL *INSPECTION HQ S BEEN MADE AND APPROVAL OR A CERTI- FICATE,OF,OC�UBANCYFrAS.BEEN:GRANTED::UBCf09' I,IBC1t0.J;1RC110.- RIciNAL-FIL ELLOw-INSPECTOR y :•, PINK -OWN GOLD -ASSESSOR 100`RA�21) YOUARI:, MAKING 9OPIES SCALE 1" 30' I r 3 Wg A CQ C w 2 - - r L 1 A% I 24 HR. NOTICE REQ. Temporary BenchmarkL FOR INSPECTION HEIGHT CALCS " raj OTED SET PK NAIL IN ASPH I e=ios.o BY ENGINEERING try ELEV=100.06 (ASSUMED) Y�Ze_ -10 2. B23 .11 E \ RRi�te: 237.11' > AVG. GRADE=108. 43 3 / � 20%1a103.67 P , :r r +,25.0' E 1,. PCSSLE¢N l MAXIM U�r� �3 vA1GTA FOR EROSION CONTROL AND DRAINAGE %WA & E}�IMPERVIOUS SURFACE CALCS TION /11EQW PROPOSED BUILDING ROOF OUTLINE: 4,354 S.F 71_o �• • ; , / I PROPOSED PATIO/WALK: ? 18_ S.F.' 4i PROPOSED GARAGE (INCLUDED IN ROOF OUTLINE) PROPOSED DRIVEWAY.11,100 S.F. PROPOSED PORCH: (INCLUDED IN ROOF OUTLINE) tv w }P I I GARAGE" .�Co. I`- I I ipati 0 Y a rF8j5 o F5 <Setbat.k_ a P pynet45.OLILS8' IqPI __ _ --- 4:x4• LOT COVERAGE: _3,561_ S.F. (21 %) /ALL POS °�{ R II s0�cto IBE C VERB WITHI Sa LOT AREA: _16,589 S.F. ���J 1 I �: ; ;149r HTL� i 18, C.O. LOT SLOPE: �% SEP 2 2 2t�u;i M�TER! 'L I - 1 ! BUILDING DEPARTMENT SDR i VARIANCE I F EDMONDS 1 GRANTED HOUSE INCL. OVE`RDIG = 3;53� 'I I SCO co I i IPER I SHORT Dena=90.00'00. 3538 S.F. x 4.1 = 8,314 r -i2 II PLAT I , • \30.00 42 HAYCOR ---_ 8;314 G.F/27 307 C.Y. �o - _ I • ✓ ri',3E A"I•D AID ADDRESS SIGN REQUIRED 00o gar—�—_I ''•{`�. h GRADING CALCS 12,847 S.F. (NET)l1�7A \�\1B" 00'00' 109.0 W9 S.F. (GOSS MA0 FFL EASEMENT _ C.O. § L#31.42 AVERAGE GRADE 108.35 LOWEST FOOTING 106.0 15'` 77L. EASEMENT AVERAGE CUT 2.35 rI L -PL0T PLAN S F I E �N p :� I SOUNDVI EW HOMEBUI LDERS 0 of 11 PLANNING DATA L�� NAME: Cj& 14-3V /5nuV14VIeW "V'Vle5DATE: p411 21 ( 7,005 SITE ADDRESS: I -'(��j -rti AnZeyj Ue, PLAN CHK#: 05 -3 415' PROJECT DESCRIPTION:�e�/ f.Z REDUCED SITE PLAN PROVIDED?: &YesNo) MAP PAGE: 4-5 0 CORNER LOT: (Yes / No) FLAG LOT: ZONING: CRITICAL AREAS DETERMINATION #: q 61 - 01 15 (a N Study Reguired: " (AVYIVIc-4�', ❑ Waiver ❑ Conditional Waiver SEPA DETERMINATION. - Fee ❑ Checklist ❑ APO list w/ notarized form ❑ (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 R. of Puget Sound or Lake Ballinger) ® Exempt 30-' Guloi, yGled-�, of grading PwPbsed - SETBACKS: 2 5' VC -Alf 5- t'b a G k- Required Setbacks: V Ldl LA C.� c( n t p I g' -I A VO M 3 l Ins,A rovu I . PP W Street: 6' Side: I O' Right Side: I O'far: 1 Actual Setbacks: I �i 1 Street 3 Z, t Side: 110 Right Side: !'I 3 l Rear: a Street reap checked for additional setback required? (Yes / No / A ❑ DETACHED STRUCTURES: N pV)2 GJ N OW V1 M 5.1 j'G p 1 o.V) ❑ ROCKERIES: N O V1G 5 V) 0WVj OYl 51 tL PI a h . ❑ FENCES/TRELLISES: NO V1-G 5410w✓i dYl 6(trz PI o V1._ El BAY WINDOWS / PROJECTING MODULATION: P OL+i'0 p f f 9 (,(V(64. Q p, 0Y) ❑ STAIRS/DECKS: NQVIPs SMV✓ I OY) 5�� Plan• J 5�de? rnfae� P'%jecfi'a� PARKING: Required.- ?'' Actual:-� LOT AREA: (D 5 g c ov-&rA 2c. - ro O f o tit+line L- I s a p, LOT COVE : 2� �' Calculations: y-I 5 8 1 tP 5' 89 O • z5 q• : 103.9 43 34 BUILDING HEIGHT: ,y. � 3 1 0 a - O 1{- Datum Point: Co l n a I I \-'� Datum Elevation: 10 0. _ (' : I I 1-:j Maximum Allowed: ZGj' (I 33. 35 Actual, Height: 7/3. 23 t Ito 1 • CJ J5 D '. I p �. �. IDS' AA-U- CREATED?: No Yes oele, IGj t- em .5hown AYeru (7Ydr�ei SUBDIVISION: 5'• 200 t-}'- 5 8 ?j 10t' -+0 29 --(D-rH A V'C. W) '� Nc, Goo V- Y— M LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: (Yes / No I y�3 305 OTHER: hen g v►-e Plan Review By: NewBPPlanningDataForm_DOC ..,,...'-";'`z1Nv-%J'�iAwi'+Vs� ..+ r+.,'-.\k�Y.-.ww"n�r� t-Y,..��`v'.✓*'^`"''°'°�t"7„-r".'v�v, - ..•. ," .. -., ....-.. . ., �.. ,ry r, .,.� .... v.. 1�:..,n,11• ,r•Yti-.n ,_v.. >�(i� Yr+�+--;'• w 0c, PERMIT NO: 10078C1 of Edmonds PERMIT EXPIRES U) VIiIAAq 9SIDE SEWER PERMIT Address of Construction: 1-1()3qAV V" LID # Property Tax Account Parcel No. 66 -1 2, 1 bao I Z Z 05 Attach copies of all access and utility easements Verified and Approved by Owner and/or Contractor: Contractor License #: 1- O\)Y 10 V " j Single Family �❑ Multi -Family (No.' of Units ❑ Commercial (No. of Units ) ❑ Public /' \ J Building Permit #:(� Invasion into City *Right -of Way: ❑ Yes PINo *RW Construction Permit # Cross other **Private Property: ❑,Yes VfNo **Attach legal description and copy of recorded easement. - Owner/ ontractor Owner or contractor signature and acknowledgement statement: Date By signing for this permit I certify that I have read the City's public handout entitled �ide Sewer Specifications, and shall comply with all City requirements outlined therein. CALL DIAL -A -DIG (1-800-425555) BEFORE ANY EXCAVATION 9 9 FOR INSPECTION CALL 425-771-0220 extension' 13db 9 7. 24 HOUR NOTICE REQUIRED FOR ALL. INSPECTION REQUESTS ....::...... .. }.:.. ' FOR OFFICE USE ONLY Permit Fee $ Re e $ Issued By: Trunk Charge $ t Date Issued: '� bA t 22 Assessment Fee $ Receipt No: City Permit Surcharge Fee 15.00 _ „Total Fees Paid $00. i r - . 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`: /1 Date: Initial: Partial lnspection:OX Im IIACIm Ix- At&6.0s C. %•: .rt��inl�.Date: o Initial '' r T� Partial Inspection: Date: Initial: FINAL INSPECTION APPROVED: Date: 16111 nitial: As -built to Street File: ❑ 1,�' PERMIT MUST BE, POSTED ON JOB. SITE t White Copy: File Green Copy. Inspector Buff Copy. Applicant L;temp;bl d g; forms; ssperm it j l g4/00 ° F E.D* CITY OF EDMONDS SIDE SEWER AS-BUILTI ADDRESS: 17039 76TH AVE W PERMIT NO: 10076 CONTRACTOR: HOMEOWNER: Soundview Hms Bldr lSoundview Hms Bldr DATE DRAWN SCALE: DRAWN: 10/21 /05 BY: I. ABILA NTS nT- j ro 0 /.2, .11 ZO 9. 5 H 4' 1' 40 1 20' I-10' —� �18'J I 24' 6.5' 18' 1" 200psi Poly w/ Tracer Wire 2.5' Deep Storm M/H �� of ED 0 CITY OF EDMONDS WATERLINE AS— BUIL I ADDRESS 17039 76TH AVE W HOMEOWNER CONTRACTOR SCALE Soundview Hms Bldr Soundview Hms Bldr NTS DATE DRAWN PERMIT At 1890 10/21 /05 BY. I. ABILA NO. 2005-0860