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23232 76TH AVE W11111111111111 15146 23232 76TH AVE W ADDRESS: 2' 0;5a ' -71Q TAX ACCOUNT/PARCEL NUMBER: 00 BUILDING PERMIT (NEW STRUCTURE): �7_CU `7 'OFD COVENANTS (RECORDED) CRITICAL AREAS: "l 2" ( ✓ DETERMINATION: ❑ Conditional Waiver ❑ Study Required Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: PERMITS (OTHER): PLANNING DATA CHECKLIST DA' SCALED PLOT PLAN DA SEWER LID FEE $: LID #: SHORT PLAT FILE:.J`--1 ' �� LOT: Z BLOCK: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: SOILS REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: FOR: WATER METER TAP CARD DATED: OTHER: LATEMMI)STsTormAStreet File Checklist.doe ShELTONS LAKE McAI_F_Fl u 5 11CF',E l-FACTS (VOL. So PG. 29) i a P �. N . EX. ASPN. ORWY. 0 — — — — — — A x ■ x x IDO I C 0 r I -7'f6" LOT 2 _ ICI PLAN a840- 00 � GAi2A�aE I 7.5' DRAiNACE EASEMENT I ( I ' 1 C'X t O' POWER ESM'T r4 A L91 EX. 15' ROAD M ! F. 0 rIR5.00 R-16.00 L_ 12.00' Zone R5 Corner Al Flag Y,(J Setbacks R uired Actual Front 7 a q « Sides �/ L-I3 _ 3d'-3 `r Rear Other Hei t aS w•uX, �( PIR D 6 PLANNING gq�s mac._ sws rrx �x . � ern ��pw »,�pw �� maduompm cie pww"im sue mvM "r sv o wwwY Dom t ry" ON GOLPM Peff IWAL eA MPM rw NOap 0 Wkwze A. Off00d a. Il0 VWQ04- 4M 9epee. �ve��ee �—wa M7 PROPOSED 20'INGRESS, EGRESS — — — — T do UT11lll' EASEMENT — — — — _— — — EX. ASPH. I CS STREET FILE fY ?N k® OCT 1,' 2004 PERMIT COUNTER 100 '0 Zone S- Corner N Flag*f. (AJPP,ROV BY PLANNING RECEIVED Setbacks Re ui ed Actual aft (`�� g/ 7 0q716re TRHFILEJUL 2 2 2004 Front ,, 1�7 30.3 j� EX. AS H. DRWY. ides l�� 7 Rear - l K _N LOT 2 0 I 8,001. S.F. ATIO �— 'NAGE —�I I— T� i I iT I=�� I. O m N —N PLAN 2g 2— I RA, E IUE `n EX. 15' ROAD — A. F. 8609,' LITY ESM'T COVE ENTR1 PERMIT COUNTER _ CCJ(_' BSBL FFL. i o3.v S z'-5" Rve+r sa f6t!t a,, U-) rek q' ' LOT GOVERA6E J (PROPOSED) EX� rnff TO REMNN RESIDENCE 6ARA6E GOV. AREAS 1,4i4 SQUARE FEET 667 SQUARE FEET 144 SQUARE FEET TOTAL 2,245 SQUARE FEET (25.6%) N 35% MAXIMUM LOT GOVERA6E N IMPERVIOUS AREAS (PROPOSED) O ED Op r- RE51DEWE (W/ OVERAHN65) .2,611 SQUARE FEET DRIVE Q WALK 546 SQUARE FEET 11 Al TOTAL 3,201 SQUARE FEET (40.0%) 100,0i O 100,0 o ` PROPOSED LO 20' INGRESS, EGRESS & UTILITY EASEMENT Pive� ----- —�' — 303.1 7 EX. ASPH. DRWY. APPROVED AS NOTED C8 LL WMEEKIN ,. i PLANNING DATA NAME: J o ,�F -rv(e DATE: T/12 0 SITE ADDRESS: M k3 k 76 ve. W. PLAN CHKX: OH - 3y 3 PROJECT DESCRIPTION: A/ SF R REDUCED SITE PLAN PROVIDED?: es NoU— MAP PAGE: 56 CORNER LOT: es No FLAG LOT: 6s / No ZONING: - CRITICAL AREAS DETERMINATION t/: q,Z - 130� ❑' Study Required: AWaiver ❑ Conditional Waiver SEPA DETERMINATION: ❑ Fee ❑ Checklist ❑ APO list w/ notarized form ❑ (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger) Exempt SETBACKS: - /Vorf ..Required Setbacks: � � r � „ ! �, Street: 7� Left Side: 7 Right Side: 7 Rear: 7l �� is It Actual Setbacks: 21 3-/6,c Stnset: X'* 1 W SCT.(j�) I(V',3�,(� Left .Side: Right Side: �` Rear: Street map checked for additional setbackrequired? es / No NA w` jU//Y`dK ❑. DETACHED STRUCTURES: ` ❑ ROCKERIES: l'b P�U aI e v ❑ FENCES/TRELLISES: Q. BAY WINDOWS / PROJECTING MODULATION: O lAn/4"� S = f O ❑ STAIRS / DECKS: - 1D ? PARKING: Required: )- Actual: J LOT AREA: LOT_ COVERAGEa, �6 soo = a 7 Calculations: . BUILDING HEIGHT: Point: S5/'Atf %1 too / F4lcf I Datum Datum Elevation: Maximum Allowed:_ Actual Height: a li / 'I Sao-( A.D.U. CREATED? No Yes SUBDIVISION: LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: es No OTHER: Plan Review Bv, S) (?eC L ` V NeAPPlanningDataFornLDOC 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). fnC. 1 g9'J CityOf Edmonds PERMIT NO: 9191 SIDE SEWER PERMIT PERMIT EXPIRES ArlArPec of rnnctnirtinn t / �9�VP"�✓ LID # Property Tax Account Parcel No. s I G I — 1!� a 017 — o 6 Attach copies of all access and utility easementt_' Verified and Approved by Owner and/or Contractor: S o �f1�Vl PU) wto_ U r, e,;p —1kic - Contractor License #: 55U+r j1 V kDO fO !111k) Building Permit #: a -O(g D Single Family ❑ Multi -Family (No. of Units ❑ Commercial (No. of Units ) Invasion into City *Right -of Way: ❑ Yes No *RW Construction Permit # Cross other **Private Property: ❑ Yes �j No v ❑ Public **Attach legal description -and copy of recorded easement. add Owner/Contractor 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. 9 CALL DIAL -A -DIG (1-800-42 '5555) BEFORE ANY EXCAVATION 2 9 FOR INSPECTION CALL 425-771-0220 extensionx3es 24 HOUR NOTICE REQUIRED FOR ALL INSPECTION REQUESTS NOTE: IF JOB SITE IS NOT READY FOR INSPECTION WHEN INSPECTOR ARRIVES A $45 RE-INSPECTIOEE WIL42BJE CHARGED. Job Site Ready YES : p �INS Date: Initial:11 Partial Partial Date:lb '0 164 Initial:I ij Date: Initial: FINAL INSPECTION APPROVED: Date: Initial:__f�As-built to Street File: ❑ 1� PERMIT MUST BE POSTED ON JOB SITE ` - i White Copy: File. Green Copy: Inspector Buff Copy: Applicant L;temp;bl dg;forms;ssperm itj lg4/00 10 ED 0 1 � 76 AVE W CITY OF EDMONDS SIDE SEWER AS- BUILT ADDRESS 23232 - 76 AVE W H❑ME❑WNER CONTRACTOR SCALE SOUNDVIEW HOMES NTS DATE DRAWN PERMIT 12-09-2004 BY SIBREL N❑. 9891 Aw u—) / Zone �S Corner Al Flag YPR V BY PLANNING Setbacks Required Actual 8 f 7 V RECEIVED Front ' 7 �� �; P� Ex. ASPH. DRwY. JUL 2 2 2004 a �a Sides . a CITY T Rear 74 17 — — — — — PERMIT COUNTER _ L Other = ,� = — x x x x 100 x x x N89'29 03 E _ -IN _ �- LOT (. � I L 2 �'- FF C'� �a� N B BL 0 _I 8,001 S.F. BSBL �- i a3,c� woio'IeC LQrqt 2_w LOT O 44 Za � 1 W ✓ �� � u� (PROP05ED) �4 J RESIDENCE 1,4iq SQUARE FEET a �L A N 2 g TREE To RerwN GARAGE bbi SQUARE FEET COV• AREAS 14q SQUARE FEET W 7 _ TOTAL 2,2115 SQUARE FEET (28.6%) 35% MAXIMUM N I I N p LOT COVERAGE IMPERVIOUS AREAS d t� .. (PROPOSED) O I \ I O RESIDENCE 2,61I SQUARE FEET GO�/E ED p (W/ OVERAHNG5) ` t ENTR ( U) DRIVE 6 WALK 5qb SQUARE FEET WAGE -- �-- R E TOTAL 3,201 SQUARE FEET (ao.o%) T N�; � o s �h, 10010, W9' 1 T I = �� «o� - �� I g I G-a o PROPOSED �jkW►Q� 20' INGRESS, EGRESS_ m -IN F-,IVE O. 9 %� & UTILITY EASEMENT7r�a_ __q en Auvo-erl� T -:7-T I'Vl�rl�t- 1 M-9-5 303.1 '/ 1n EX. 15' ROAD- ILITY ESM'T EX. ASPH. DRWY. PPRQMED AS NOTED .F. 8609 �91 .9 CB BY ENGINEERING n 9 a3nz Ib� Apt\VJ 100 SKELTONS LAKE McALF_F_{; 1 EX. ASPH. DRWY. LOT 2 b„ _.... — ——8.0013`A — F3L_ r�.asmnn. M II i 282� a I PLAN i r cove e1VTR am a � 6Ai2A�E PROVED B CANNING co��.Q Zone Corner Al Flag t S Setbacks Required Actual Front 171T Sides ? �� �L- Lf Rear Other Height twi nve e,�raae_ V e�ci"ai{'�w''� awe aa. rr• ix • «s ea �. wrN. ax emwe ra► raaea� a iww sewer rmr enGONE rwr �� W4GOLMMFM tGVL 37el�V(irase Ef li re 5 Dw MO eeaoers aee eerwe ow �ver�ee arose• a W000WS + tea+ a" s YV" yea edaw pw TWAL Am saws MweeaAw 0c 7.5' DRAiNACE L EASEMENT Q I PROPOSED 1 C'X 10' POWER ESM T i `I I v� I I 20' INGRESS, EGRESS dt !liAW EASEMENT — '0r L 87. , 17 u! . H canon r rr F SAIT IX. ASPH. ORWY rIR 15.00 Rw16.00 12.00' RfCe['VED OCT 1 V2004 PERMIT COUN T k R ItPATE RECEIVED 64 PERMIT EXPIRESSE PERMIT ""TT CITY OF EDMONDS ZONE KS' $ NUMBER CONSTRUCTION PERMIT APPLICATION ASUITE/APT# DDflESS i -�� ..•-�/�I � •� OWNER NAME NAME OF BUSIN SS �''_ ' 45 .Jt O t t1 V QIa�'�`r� PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. a M�LING ADDRESS w i LID FEE $ = T♦t( r' TESCP Approved O 3 0 L. 1 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP pW permit Required [o' O Street Use Permit Asq'd CITY ZIP TELEPHONE EXISTING "" PROPOSED Inspection Required p T J Sidewalk Required (� �. V11DV1�� l) �� ram✓ �X� � 19 -� / REQUIRED DEDICATION FT �T Underground equired E3 NAME 614METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED u L\ �.J O (V_1'7tAd NWr�tT 3 'Y / I G. YE NO ❑ W ADDRESS REMARKS z �;fill/ OW ER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE i llf I{CC W CIT1( ZIP TEL ON / I l -T tl CI 4 t �% • LS G/.I i,.\�c� ��o?3; :, la`s-� 117 �, , N s� p �: K 'NfY/ C d< y: s,OLE t NAMES r. CBL # i,�Q�% ! 1 C` 1 r�G��lr✓\e�) t V0 S - s�I�r�l I N L t E INEERING REVIEWED BY DATE ADDRESS f IRE REVIEWED BY DATE Lu CITY ZIP TELEPHONE STATE LICENSE N MBER EXPIRATION DATE Y VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND RE 'D POSTED SOi/(1 V %-^O• YES NO $ SEPA REVIEW SIGN AREA HEIGHT PROP TY ACCOUNT PARCEL NO. COMPLETE EXEM T ALLOWED PROPOSED ALLLOCWED PROPpSED P.� ' " -a0�-o —O EXP aV 6 11 LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) NEW RESIDENTIAL PLUMBING I MECH i ALLOWED PROPOSED FRONT SIDE REAP °9nNT� _ UR�gIDE REAR COMPLIANCE OR G / A / /! I,) fr /• V e" ? ❑ ADDITION ❑' COMMERCIAL ❑ CHANGE OF USE 3 5 t� cj7 90 7 76 7v� �T 3.. d 3 1 ❑ REMODEL ❑ MULTIFAMILY ❑ PARKING LOT AREA P NING REVIEWED BY DATE g ' SIGN RE� I PRQyIDED ❑ FENCE S I �e& � 710 ❑ REPAIR 9AIDwIN� CYDS ( X FT) REMARKS ❑ DEMOLISH ❑ TANK ❑ OTHER GARAGE RETAINING WALL FIRE SPRINKLER _ CARPORT ❑ ROCKERY ❑ FIRE ALARM. O (TYPE OF USE, BUSINESS OR ACT•Nw r 5 L CHEC D BY TYPE OF =NSTRUCTION CO OCCUPANT ze rJ r GROUP u� NUMBER NUMBER OF�aV`�' CRITICAL O OF DWELLING?o:A AREAS; SP CIALINSPECTION AREA OCCUPANT O STORIES UNITS NUMBER Z— 2,REQUIRED LOAD DESCRIBE WORK TO BE DONE ❑ YES `- REMARKS O Z PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D 9 T�f �` - :- ' S L� C J j% VALUATION �" Q — {, (p� (� Description FEE Description FET�ES.-�� YQ .Y P•, tin �C�i L-I -7 Plan Check ­7 State Surcharge L1 T..� HEAT SOURCE GLAZING % LOT SL i O �Q . Building Permit City Surcharge PLAN CHECK NO., T L a VESTED DATE Plumbing r � Y Base Fee Mechanical �) THI&PERMIT AUTHORIZES•ONLY THE WORK NOT,F,D. THIS PERMIT COVq WORK TO t At_ DONE ON PRILATE 0AC PERTY ONLY ANY CONSTRUCTION ON THE PUBLIC a DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading SEPARATE PERMISSION. s Engr. Review W PERMIT APPLICATION: 180 DAYS 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 ¢ EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire If1SpeC110n Receipt # 2- Q ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY S FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE 9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape lnsp. Total Amt. Dug 7,11 V = NOR LIMIT IN ANYWAY THE C17Y'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF 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 C RMekNSATION INSURANCE -AND RCW 18.27. OFFICI LS SION RE DATE SIGNAT R ( OR AGE DATE SIGNED ' (425) �.. jJ ''7--oq--o / 771 -0220 RELEAS BY/ dAT ± ATTENTION EXT 1333 1,t:? IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL, OR A CERTIFI oRICINAL • FIL YELLOW - INSP� CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PwK:owNER GOLD - ASS' os/os PRESS HARD -YOU ARE MAKING 4 COPIES '"