23132 76TH AVE W_1IIIIIIIIIIIIII
15142
23132 76TH AVE W
.9'
M
= °°
'
U
N
? Q
22.7'
Z
17'
w
Ir
O
(y)
;m
M
z Q
2 .2'
N
17'
7.5'
N
Dm
U_
co
22.5'
N
'a
,
2
17.5'
O
(�
t
7.5'
N
�
`
3
r
w
M
N
;Q
>
w
L,J
17.7'
m
F-
7.5'
w
Ir
Q
N
F
=m
u-
0
r
N
' Q
I
U
CL
U)
w
2'
O
a
15
0
00
4
T"
Z
w
m
O
Lo
2
LL
76th
AVE W
CITY OF EDMONDS WATERLINE
AS
-BUILT
ADDRESS.
76th AVE
W
- 23132
PERMIT
NUMBER 2004-0272
HOMEOWNER:
CONTRACTOR:
SWEAZY
DATE INSPECTED:
DRAWN BY;
DATE
DRAWN;
4/27/05
I,
ABIL4
4/29/05
I t
M � i
N 4 i
W
N ( -
'� ! 1 t Add/e55
oa 1
rJ 2 3(2!0
t 1 i 1 j ; 3 �3r3oi
' i t
i
N I Zz.
4- r 1 ! \
a
jrrp(.1�g
Zonq--- ��
2vo4_ v2.70
z vv4- d2� l
LL
t
7 (o A VE" .
t
of ED o CITY OF EDMONDS WATERLINE AS 'i BUILT
d ADDRESS HOMEOWNER
CONTRACTOR SCALE
DATE DRAWN. PERMIT 1890 L fJ
¢-7 7 _ /)4 BY l l !AlzC -L NO. Ile' 7p A5
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
employees or officers shall be liable for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
.��w... .....�.. , ,..-.. � � r��;......�v�•-�w�L:b>,v., .r •—� ,. ,. •.r � ,.t-r.�7.y��g �-r��....,;n-�, u9 �:n'Ve wr .r , .. �-N 't.,..u'.. .; y'•.. r.s�, .,� -, �II;ram^.. 1
� .?Y ,. rYvtr:..��k...w�,u'J • �iu.�.r,.�tir•,•irm'Yv4�nd'- .. - �. R .••••.. .
-;, I
RMIT NO:C1 Of d1110nds' a
1 c, SIDE SEWER PERMIT 'PERMIT EXPIRES
r.
Addresstiof�Co
Property Tax"A:
Attach copie c
Owner and/or
Contractor Lic(
Single Fait
Multi-Fam
❑ Com merci,
❑ Pudic'
,.Klr7
11,access and, utility easements Veri
#: ,z:;
r0
i90
Approved by
s
o City *Right -of Way: ekes ❑ No .
uction Permit # -'6 -17
**Private Property:. ❑ Yes No.
al description and copy of recorded asement.'".
F ',J
$a,
Owner/Contractor
O i nei or codtractor signature . -A knowledgement statement: ate
By`signing fodr this permit I certify that I have read the City's public handout entitled,
Sid06er Specifications, and shall comply with all City requirements outlined therein.
CALL DIAL -A -DIG (1-800-42.!{, 5555) BFFORE ANY EXCAVATION W
W FOR INSPECTION CALL 425-771-0220 extensionvgbg
24 HOUR NOTICE RE UIRED FOR ALL! INSPECTION RE UESTS
l
t
;. -
FOR OFFICE USE ONLY
:.
Permit Fee $ Repair Fee Issued By: r
Trunk Charge $ Date Issued
Ilu
Assessment Fee $ Receipt No:
City Permit Surcharge Fee $5.00 Total Fees'Paid $
ilyInvasion i
ly (N�o'lof Units. *RW Con,
.1 (No. of Units ).: Cross oth
**Attach 1
NOTE: IF JOB SITE IS NOT READY FOR INSPECTION WHEN,
INSPECTOR ARRIVES A $45 RE.INSPECTIION FEE WILL BE CHARGED.
Job Site Ready.YES,' NOI —Date: Initial:
Partial Inspection: 191 CZ u,V rh0le (3 COL .
Partial Inspection:
FINAL INSPECTION'APPROVED: Date: lllll . U I
r
1� PERMIT MUST BE POSTE
White Copy: File Green.Copy: Inspector
L;temp;bl dg;forms;sspermitj lg4/00
Date: dSInitial:, M
Date: Initial:
itial.-4d As -built to Street File: ❑
t ,•
DI.ON JOB SITE` -
Buff Copy: Applicant
r
i DATE RECEIVED
e
'
I • .
y
PERMIT EXPIRES
USE
PERMIT
CITY OF EDMONDS
ZONE
NUMBER
�
CONSTRUCTION PERMIT APPLICATION
JOB
suITE/Awra
ADDRESS
T ""
OWNER NAME/NAME OF BUSINESS
PLAT NAME/SUBDMSION NO.
LOT NO. LID
NO.
$
MAILING ADDRESS
LID
FEE $
4C /Y
PUBLIC RIGHT OF WAY
TESCP
PER OFFICIAL STREET MAP Rw
Approved
Permq Required
e....
CITY ZIP
TELEPHONE
EXISTING
Street
PROPOSED Inspection
Sidewalk
use Parrott Rev'd
Required p
Required 13
REQUIRED DEDICATION FT Wiring
p
NAME
METER SIZE
LINE SIZE
NO. OF 1 RES
PRV REQUIRED
O
rI
a�
it/
YES NO 0
W
ADDRESS
REMARKS
Z
=
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
/
I� /A I `� •
W
CITY ZIP
TELEPHONE
66=&421
9Wv
040 - =hr"
NAME
...,/. -
CBL #
/C
//
ENGINEERING REVI ED
BY DA E
a
ADDRESS _5
"
� r
�
01 ,.
/7 �—/4 Ae ..1 1 /
CITY Z1
TELEPHONE
FIRE . R ED BY
�--�'--
s DATE
w., �! i �p
r, r ' --il
rL
s/ a
;'r ,vZ 7
6� . t3
Zoe - 2zf- G os
STATE LICENSE NUMBER ti.R EXPIRATION DATE
CKED BY,
VARIANCE OR CU
SHORELINE OR ADBq
'j INSPECTION
BOND
���/�/� /` ` 1 ZP-
W.-
. 1 �
�p
V�7 1 a(6 !
SEQONO
$ 1(0 1 17
" " —""
SEPA-REVIEW ,
'EXEMPT
SIGN AREA
ALLOWED PROPOSEDALLOW
HEIGHT
PROPOSED
PROPERTY TAX ACCOUNT, PARCEL
C�O `ETE'
`D
O
•''
EXP
NEW
ti❑ RESIDENTIAL
PLUMBING / MECH
LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SETBACKS (FT.)�
FRONj SIDE REAR
?PROPOSED SETBACKS (FT.)
FRQNT U DE REAR
!❑
///"" COMPLIANCE OR
UTKO (
1
' 1� �.�
1 r a'Q ti
U I�
z
❑ ADDITION
COMMERCIAL
❑ CHANGE OF USE
1 _ TO'.
/1� i #
z
❑?
REMODEL
MULTIFAMILY
❑ SIGN
PARKING; '
READ PROVIDED
LOT AREA
PLANN EVIEWED�BY "- DATE
g
IL
^
GRADI G FENCE
❑ REPAIR Yr ❑ ( X FT)
RE
A
❑ DEMOLISH ❑ TANK ❑ OTHER
a
W t
GARAGE RETAINING WALL FIRE SPRINKLER
'. ❑
❑ 'ROCKERY
CARPORT :,', FIRE ALARM
t
(TYPE OF IME BUSINESS OR ACTV EXPLAIN:
A /e J D OM
CHECKED BY
TYPE OF CONSTRUCTION
CODE, OCCUPANT
41 GROUP
O
O
NUMBER
OF
NUMB R OF
DWELLING Iy
CRITICAL
AREAS
--'I/�.
SPECIAL INSP CTION
AR��] �!' J OCCUPANT
' !
STORIES
UNITS':.z."- ._ f/`' -
NUMBER
REQUIRED;
:YES;
''V e'r > �/ .. LOAD
-?.
DESCRIBE WORK TO BE DONE '
REMARKS'
Z
PROGRESS "INSPECTIONS "PER "UBC 108/FINAL INSPECTION REO'D
9
y
VAUJATION",
-
_
$tAx 78�i v
Description
-,FEE
Description
FEE .
A
9 '1 Y
Plan Check
v� �'
State Surcharge
H T SOURCE!1
GLAZING %
LOT.jq�OP
y( Yi
Building`P�ermit`
N
City Surcharge
4
0
PLAN CHEC �� j
VESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t
BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC
Grading
7
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
�
Engr. Review
W
PERMIT APPLICATION: ISODAYS
d
PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
•APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
L
Q
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
3
Q
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
S
9
FROM THE ISSUANCE. OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscape Insp.
Total Amt. Due
=
NOR LIMIT IN ANYWAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
01101
Recording Fee
Receipt #
ON
GIVEN.BY IS ACKNOWLEDGE THAT I HAVE CORRECT; AND THAT I AM THEEEO ER, OR THE HIS TDU Y AUTHORIZED ION; THAT THE FAGENTTIOF
APPLICATION
APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING 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 STATE OF WASHINGTON RELATING TO
FOR INSPECTION
receipt is acknowledged in space provided.
WORKMEN'S CO SATION INSURANCE AND RCW 18.27.
11
ATU DATE
O�VW86_-'J
SIGNATUR N AGE DATE
SIGNED
(425)
!
771-0220
i
DATE
ATTENTION
M 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORIGINAL -FILE YELLOW -INSPECTOR
PINK -OWNER GOLD -ASSESSOR
04i02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN -ACCOUNTING