HomeMy WebLinkAboutPermit File 2310 35th Court T . 0„ CITY OF ANACORTES
WASHINGTON
c BUILDING DEPARTMENT
CERTIFICATE OF OCCUPANCY
This is to certify that the(Description of Building or Structure):
Single Family Residence
2310 35th Street
Located At:
- STREET&NUMBER
Village Park LLC
Owner:
Constructed By:
OWNER OR CONTRACTOR
Bldg.Permit#C0M98-0198 Date Of Issue: 9-30-98
Occ.Group: R3 Use Zone: R2
Has Been Inspected And Occupancy Is Hereby Authorized,
This 22nd Day Of ,,rrM^^a��rch 19 99 '§
AUTHORIZING OFFICIAL
SEE REVERSE SIDE FOR SPECIAL REQUIREMENTS.
0613904-2 0001 05/19/2006 002 8
Fermit Fees 006962 $167.03
1I . 6-
., City of Anacortes Permit#: BLD-2006-0270
904 6th Street Issue date: 05/19/2006
•
"w + P.O.Box 547
Expire date: 05/19/2007
sy, CO.' Anacortes, WA 98221-0547,42
Job Address: 2310 35TH CT Permit Type: Single Family Alteration/Repair Permit
ANACORTES WA 98221-4721 Project:
APN: P112544
Remarks: Extend the second floor over the existing living area per approved plans as noted.
Owner STONE FRED M Contractor: ADVANCED SERVICES I
Address: 2310 35TH CT Address: 913 S 30TH ST
ANACORTES WA 98221-4721 MOUNT VERNON WA 98274-6125
Phone: Phone: (360)848-8696
License#: ADVANS981PN
General Information: Fees:
Building Valuation 13000 Building Permit Fee 98.50
Occupancy Group it-1 Plan Review Fee 64.03
State Building Code Fee 4.50
Total Calculated: 167.03
Deposits/Receipts: 0.00
Total Due: 167.03
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED I I
HEREBY CERTIFY T. HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL
PROVISION • 1; S A • ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR
NOT, T ,,,,[[[[����'-RAN G OF ' PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER
TATE Z LOC, AW RE ULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
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Floor Joistf 2003 International Building Code(01 NDS)1 Ver:6.00.2
By: Hayden H.Watson , Northwest Datum&Design, Inc.on:04-13-2006: 12:37:34 AM
Proiect:06061 GRAVITY-Location:Jst1 -typ floor
Summary:
1.5 IN x 9.25 IN x 12.0 FT a16O.C./#2-Hem-Fir-Dry Use
Section Adequate By:45.2% Controlling Factor Section Modulus/Depth Required 8.07 In
Center Span Deflections:
Dead Load: DLD-Center= 0.07 IN
Live Load: LLD-Center= 0.19 IN=L/744
Total Load: TLD-Center= 0.27 IN=U541
Center Span Left End Reactions(Support A): I
Live Load: LL-Rxn-A= 320 LB
Dead Load: DL-Rxn-A= 120 LB
Total Load: TL-Rxn-A= 440 LB
Bearing Length Required(Beam only.support capacity not checked): BL-A= 0.72 IN
Center Span Right End Reactions(Support B):
Live Load: LL-Rxn-B= 320 LB
Dead Load: DL-Rxn-B= 120 LB
Total Load: TL-Rxn-B= 440 LB
Bearing Length Required(Beam only,support capacity not checked): BL-B= 0.72 IN
Joist Data:
Center Span Length: L2= 12.0 FT
Floor sheathing applied to top of joists-top of joists fully braced.
Live Load Duration Factor: Cd= 1.00 I
Live Load Deflect. Criteria: U 480
Total Load Deflect.Criteria: L/ 360
Center Span Loading:
Uniform Floor Loading:
Live Load: LL-2= 40.0 PSF
Dead Load: DL-2= 15.0 PSF
Total Load: TL-2= 55.0 PSF
Total Load Adjusted for Joist Spacing: wT-2= 73 PLF
Properties For:#2-Hem-Fir
Bending Stress: Fb= 850 PSI
Shear Stress: Fv= 150 PSI
Modulus of Elasticity: E= 1300000 PSI
Stress Perpendicular to Grain: Fc-perp= 405 PSI
Adjusted Properties
Fb'(Tension): Fb'= 1075 PSI
Adjustment Factors: Cd=1.00 Cf=1.10 Cr=1.15
Fv': Fv'= 150 PSI
Adiustment Factors: Cd=1.00
Design Requirements:
Controlling Moment: M= 1320 FT-LB
6.0 Ft from left support of span 2(Center Span)
Critical moment created by combining all dead loads and live loads on span(s)2
Controlling Shear: V= 387 LB
At a distance d from right support of span 2(Center Span)
Critical shear created by combining all dead loads and live loads on span(s)2
Comparisons With Required Sections:
Section Modulus(Moment): Sreq= 14.73 N3
S= 21.39 N3
Area(Shear): Areq= 3.87 N2
A= 13.88 N2
Moment of Inertia(Deflection): Ireq= 65.79 N4
1= 98.93 N4
Uniformly Loaded Floor Beaml 2003 International Building Code(01 NDS)1 Ver:6.00.2
• By: HaydenH.WatsonNorthwest Da
tum atson , ort t &Design, Inc.on:04-13-2006 : 09:55:47 AM
Project:06061 GRAVITY-Location:61 -existing floor beam
Summary:
5.125 IN x 12.0 IN x 11.5 FT /24F-V4-Visually Graded Western Species-Dry Use
Section Adequate By: 125.5% Controlling Factor:Section Modulus/Depth Required 8.38 In
Deflections:
Dead Load: DLD= 0.07 IN
Live Load: LLD= 0.13 IN=L/1059
Total Load: TLD= 0.20 IN=L/706
Reactions(Each End):
Live Load: LL-Rxn= 2530 LB
Dead Load: DL-Rxn= 1265 LB I
Total Load: TL-Rxn= 3795 LB
Bearing Length Required(Beam only,support capacity not checked): BL= 1.14 IN
Camber Reqd.: C= 0.10 IN
Beam Data:
Span: L= 11.5 FT
Unbraced Length-Top of Beam: Lu= 0.0 FT
Live Load Deflect. Criteria: L/ 360
Total Load Deflect. Criteria: L/ 240
Camber Adjustment Factor: CAF= 1.5 X OLD
Floor Loading:
Floor Live Load-Side One: LL1= 40.0 PSF
Floor Dead Load-Side One: DL1= 15.0 PSF
Tributary Width-Side One: TW1= 5.0 FT
Floor Live Load-Side Two: LL2= 40.0 PSF
Floor Dead Load-Side Two: DL2= 15.0 PSF
Tributary Width-Side Two: TW2= 6.0 FT
Live Load Duration Factor: Cd= 1.00
Wall Load: WALL= 40 PLF
Beam Loading:
Beam Total Live Load: wL= 440 PLF
Beam Self Weight: BSW= 15 PLF
Beam Total Dead Load: wD= 220 PLF
Total Maximum Load: wT= 660 PLF
Properties For:24F-V4-Visually Graded Western Species
Bending Stress: Fb= 2400 PS
Shear Stress: Fv= 240 PS
Modulus of Elasticity: Ex= 1800000 PS
Ey= 1600000 PS
Stress Perpendicular to Grain: Fc peril= 650 PS '
Bending Stress of Comp.Face in Tension: Fb_cpr= 1850 PS
Adjusted Properties
Fb'(Tension): Fb'= 2400 PS
Adjustment Factors:Cd=1.00
Fv': Fv'= 240 PS
Adiustment Factors:Cd=1.00
Design Requirements:
Controlling Moment: M= 10910 FT-LB
5.75 ft from left support
Critical moment created by combining all dead and live loads.
Controlling Shear: V= 3188 LB
At a distance d from support.
Critical shear created by combining all dead and live loads.
Comparisons With Required Sections:
Section Modulus(Moment): Sreq= 54.55 N3
S= 123.00 N3
Area(Shear): Area= 19.92 N2
A= 61.50 N2
Moment of Inertia(Deflection): Irea= 250.90 N4
1= 738.00 N4
I
. Multi-Loaded Beamf 2003 International Building Code(01 NDS)1 Ver:6.00.2
• Bv: Hayden H.Watson, Northwest Datum&Design, Inc.on:04-13-2006 : 12:37:10 AM
Project:06061 GRAVITY-Location: B2-Stair header beam
Summary:
3.5 IN x 9.25 IN x 9.0 FT /Select Structural-Hem-Fir-Dry Use
Section Adequate By:92.0% Controlling Factor:Section Modulus/Depth Required 6.68 In
Center Span Deflections:
Dead Load: DLD-Center= 0.07 IN
Live Load: LLD-Center= 0.07 IN=L/1557
Total Load: TLD-Center= 0.14 IN=L/761
Center Span Left End Reactions(Support A):
Live Load: LL-Rxn-A= 878 LB
Dead Load: DL-Rxn-A= 742 LB I
Total Load: TL-Rxn-A= 1621 LB
Bearing Length Required(Beam only,support capacity not checked): BL-A= 1.14 IN
Center Span Right End Reactions(Support B):
Live Load: LL-Rxn-B= 558 LB
Dead Load: DL-Rxn-B= 729 LB
Total Load: TL-Rxn-B= 1287 LB
Bearing Length Required(Beam only,support capacity not checked): BL-B= 0.91 IN
Beam Data: I
Center Span Length: L2= 9.0 FT
Center Span Unbraced Length-Top of Beam: Lug-Top= 0.0 FT
Center Span Unbraced Length-Bottom of Beam: Lu2-Bottom= 9.0 FT
Live Load Duration Factor: Cd= 1.00
Live Load Deflect. Criteria: L/ 360
Total Load Deflect.Criteria: L/ 240
Center Span Loading:
Uniform Load:
Live Load: wL-2= 53 PLF
Dead Load: wD-2= 80 PLF
Beam Self Weight: BSW= 8 PLF
Total Load: wT-2= 141 PLF
Point Load 1 I
Live Load: PL1-2= 0 LB
Dead Load: PD1-2= 320 LB
Location(From left end of span): X1-2= 6.0 FT
Trapezoidal Load 1
Left Live Load: TRL-Left-1-2= 160 PLF
Left Dead Load: TRD-Left-1-2= 60 PLF ,
Right Live Load: TRL-Riqht-1-2= 160 PLF ,
Right Dead Load: TRD-Right-1-2= 60 PLF
Load Start: A-1-2= 0.0 FT
Load End: B-1-2= 6.0 FT
Load Length: C-1-2= 6.0 FT
Properties For:Select Structural-Hem-Fir
Bending Stress: Fb= 1400 PSI
Shear Stress: Fv= 150 PSI
Modulus of Elasticity: E= 1600000 PSI
Stress Perpendicular to Grain: Fc_perp= 405 PSI
Adjusted Properties
Fb'(Tension): Fb'= 1680 PSI
Adjustment Factors:Cd=1.00 Cf=1.20
Fv': Fv'= 150 PSI
Adjustment Factors:Cd=1.00
Design Requirements:
Controlling Moment: M= 3639 FT-LB
4.5 Ft from left support of span 2(Center Span)
Critical moment created by combining all dead loads and live loads on span(s)2
Controlling Shear: V= 1361 LB
At a distance d from left support of span 2(Center Span) —
Critical shear created by combining all dead loads and live loads on span(s)2
Comparisons With Required Sections:
Section Modulus(Moment): Sreq= 25.99 N3
S= 49.91 N3
Area(Shear): Area= 13.61 N2
A= 32.38 N2
Moment of Inertia(Deflection): Ireg= 72.77 N4 j
1= 230.84 N4
• Multi-Loaded Beam(2003 International Building Code(01 NDS)1 Ver:6.00.2
Bv: Hayden H.Watson , Northwest Datum& Design, Inc.on:04-13-2006 : 12:36:58 AM
Project:06061 GRAVITY-Location:B3-Trasfer beam
Summary: I
3.5 IN x 9.25 IN x 12.0 FT /Versa-Lam 3080 Fb DF-Boise Cascade
Section Adequate By: 79.7% Controlling Factor:Moment of Inertia/Depth Required 7.61 In
Center Span Deflections:
Dead Load: DLD-Center= 0.13 IN
Live Load: LLD-Center= 0.20 IN=L/718
Total Load: TLD-Center- 0.33 IN =L/431
Center Span Left End Reactions(Support A):
Live Load: LL-Rxn-A= 1503 LB
Dead Load: DL-Rxn-A= 902 LB
Total Load: TL-Rxn-A= 2405 LB
Bearing Length Required(Beam only,support capacity not checked): BL-A= 0.76 IN I
Center Span Right End Reactions(Support B):
Live Load: LL-Rxn-B= 731 LB
Dead Load: DL-Rxn-B= 473 LB
Total Load: TL-Rxn-B= 1204 LB
Bearing Length Required(Beam only,support capacity not checked): BL-B= 0.38 IN
Beam Data:
Center Span Length: L2= 12.0 FT
Center Span Unbraced Length-Top of Beam: Lu2-Top= 0.0 FT
Center Span Unbraced Length-Bottom of Beam: Lu2-Bottom= 12.0 FT
Live Load Duration Factor: Cd= 1.00 I
Live Load Deflect.Criteria: L/ 360
Total Load Deflect. Criteria: L/ 240
Center Span Loading:
Uniform Load:
Live Load: wL-2= 53 PLF
Dead Load: wD-2= 20 PLF
Beam Self Weight: BSW= 10 PLF
Total Load: wT-2= 83 PLF
Point Load 1
Live Load: PL1-2= 878 LB
Dead Load: PD1-2= 742 LB
Location(From left end of span): X1-2= 4.0 FT
Trapezoidal Load 1
Left Live Load: TRL-Left-1-2= 180 PLF
Left Dead Load: TRD-Left-1-2= 68 PLF
Right Live Load: TRL-Right-1-2= 180 PLF
Right Dead Load: TRD-Right-1-2= 68 PLF
Load Start: A-1-2= 0.0 FT
Load End: B-1-2= 4.0 FT
Load Length: C-1-2= 4.0 FT
Properties For:Versa-Lam 3080 Fb DF-Boise Cascade
Bending Stress: Fb= 3080 PSI
Shear Stress: Fv= 285 PSI
Modulus of Elasticity: E= 2000000 PSI
Stress Perpendicular to Grain: Fc_perp= 900 PSI
Adjusted Properties
Fb'(Tension): Fb'= 3170 PSI
Adjustment Factors:Cd=1.00 Cf=1.03
Fv': Fv'= 285 PSI
Adjustment Factors:Cd=1.00
Design Requirements:
Controlling Moment: M= 6929 FT-LB
3.96 Ft from left support of span 2(Center Span) '
Critical moment created by combining all dead loads and live loads on span(s)2
Controlling Shear: V= 2167 LB
At a distanced from left support of span 2(Center Span) —
Critical shear created by combining all dead loads and live loads on span(s)2
Comparisons With Required Sections:
Section Modulus(Moment): Sreg= 26.23 N3
S= 49.91 N3 '
Area(Shear): Area= 11.41 N2
A= 32.38 N2
Moment of Inertia(Deflection): Ireg= 128.45 N4
1= 230.84 N4
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NORTH W EST o SHEET DESCRIPTION:
W/ SCALE: not to scale
DATUM & DESIGN (4 ,z Stone Residence Remodel
DRAWN BY: HIM
CIVIL ENGINEERING AND SURVEYING SOLUTIONS
Anacortes, WA JOB NO. 06061
1128 E.FAIRHAVEN AVE am A
BURLINGTON.WASHINGTON 98233 SECTION
PH:1360)755.0434 FAX.(360)7550404 000aW L 005W1aa Pt.P.U. DATE: 4/13/06
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Y SCALE: not ID stole
DATUM & DESIGN ,liter = Stone Residence Remodel DRAWN 8V: HHW
CIVIL ENGINEERING AND SURVEYING SOLUTIONS 9t Anacortes, WA JOB NO, 06061
1138 N,WASHING �"► �.. SECTION
BURLINOTON,3 RHAVEN AVEAV 90333
PH:(360)7554434 FAX:(360)75504EN MUCUS L BCMRD LL.Pte. DATE: 4/13/06
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COMBINATION PERMIT
CITY OF ANACORTES PERMIT NO. : COM98-0198
P.O. BOX 547 APPLIED: 09/30/98
ANACORTES, WA 98221 ISSUED: 09/30/98
(206) 293-1901 EXPIRES : 09/30/99
SITE ADDRESS : 2310 35TH CT
ASSESSOR' S PARCEL NO. : 4702-000-009-0000
PROJECT DESCRIPTION: Construct new single family residence per approved
plans as noted.
— OWNER — CONTRACTOR — LENDER
VILLAGE PARK VILLAGE PARK LLC
2301 35TH COURT 16625 REDMOND W , SUITE M404
ANACORTES WA 98221 REDMOND WA 98052
360.293.9426 425-868-5663
VILLAPL033Q5
— FEES
TYPE OF WORK -NEW AREA (sf) VALU...S: 140000 Code Amount---- By- Date---- Receipt
TYPE OF USE •SF LOT • 7674 REQUIRED SETBACKS---- ESPL $ -100.00 EF 09/30/98 9067
CENSUS CATEGORY •101 1ST FLR • 1209 FRONT • 20 ft PLCN $ 346.45 EF 09/30/98 9067
ZONING 2ND FLR • 935 SIDE(1)..: 10 ft PRMT $ 533.00 EF 09/30/98 9067
:R2, RES. LOW. : BASEMENT 0 SIDE(2)..: 5 ft PMEC $ 69.00 RP 09/30/98 9067
OCCUPANCY GROUP GAR/CARPORT...: 440 REAR • 20 ft Pam $ 132.00 EF 09/30/98 9067
:R3 :U1 :? •? OTHER 0 REQUIRED PARKING-- STEC $ 4.50 EF 09/30/98 9067
TYPE OF CONSTRUCTION TOTAL • 2 SEMI $ 3483.00 EF 09/30/98 9067
:5N :5N :? :? NUMBER OF UNITS • 1 ACCESSIBLE.: 0 Iam?x $ 400.00 EF 09/30/98 9067
OCCUPANT LOAD STORIES • 2 COMPACT • 0 STEM $ 1126.00 EF 09/30/98 9067
. 0: 0: 0: 0: BUILDING HEIGHT.: 28 ft IMPRV SURF.: 0 sf INSP $ 50.00 EF 09/30/98 9067
RISC $ 1000.00 EF 09/30/98 9067
FUEL TYPES BOILERS/COMPRESSORS- DOMES. INCIN •0
:/GAS/ / /: 0-3 HP • 0 COMML. INCIN •0
FURN < 100K BTU: 1 3-15 HP • 0 RELOC/REPAIR...: 0 TOTAL $ 7043.95
FURN >=100K BTU: 0 15-30 HP • 0 CLOTHES DRYERS.: 1
FURN - FLOOR...: 0 30-50 HP • 0 GAS WTR HEATERS: 1 — NOTES
UNIT HEATERS...: 0 50+ HP • 0 STOVE, APPLI...: 0
VENT FANS • 5 AIR HANDLING UNITS-- FIRE LOG/LITE..: 1
VENT SYSTEMS...: 0 <= 10000 cfm.: 0 WOODSTOVES • 0
VENT W/O APPLI.: 0 > 10000 cfm.: 0 OTHER UNITS • 0
EVAP COOLERS...: 0 GAS OUTLETS • 4
HOODS • 0
WATER CLOSETS...: 3 WASHING MACHINES: 1 FLOOR DRAINS • 0
BATH TUBS • 1 ELEC WTR HEATERS: 0 WTR PIPING/TREAT: 1
SHOWERS • 1 LAUNDRY TRAYS...: 0 HOSE BIBBS • 3
DISHWASHERS • 1 URINALS • 0 GREASE TRAPS • 0
LAVATORIES • 4 WASTE INTERCEPT.: 0 ADD'L FIXTURES..: 0
KIT SINKS W/DISP: 1 DRINKING FOUNT..: 0
I
I hereby acknowledge that I have read this permit and state that the above information is correct, and agree to comply with all
ordinances and laws regulating activities covered by this permit.
e.-- ---Ce--- -
Issued App cant Ow r Signature
24 Hour Notice R quire For All In pe tions
com_prmt, Rev: 11/04/93 ---- --_
1
Residential Building Permit Application
Building Department
P.O. Box 547 Anacortes, WA 98221
Phone No.: 360-293-1901 FAX: 360.293.1938
SITE ADDRESS: 2,310 NC, •
:��;�'- <r. ": : '��� '} i '.:: � C� ® S. 86J -is<J.1.0 bm",-'_'W
Name Ali ltt-te15,D Ge-Q-U CALS
k'DD -cc:
tAA�Z a tom' t s�
Address 113 to 7i0 13a- /�
City/State/Zip Mr \kD44o131 *Pr 1t'3274
Phone:U:O '70I•$t3b FAX
State License#ANA-Ne9KGr I P74 Exp 10 jI 0(o
City of Anacortes License
..13..: 4., l; .t,'..a .,.,.;.= :'Y. it t0!. ;._......... _._.1010i;;�:;.. . . ..,si:
Name rtir✓D `." Di ONNI er6146.
Address ,27)10 _34 14" Ale.
City/State/Zip 404 A4.a2c es, INA 1'2-24 ES OT VSLVI71.TLQ$
Phone FAX 4 /17.600
Number of Dwelling Units
E-Mail Address Number of Stories
Building Area:
ifDk "di"f S"t'.D4 .4 Siiii4r l ;4E41120 Is'Floor s.f. 2nd Floor I el s.f.
Name tJoflili@Sf 'Gem NA. 1,tenc n{ 3'Floor s.f. Basement s.f.
Address 1122 Pila,f2mAtieki Ada, Garage_ s.f. Carport s.f.
City/State/Zip Pit)p.LUJiyCbr9 up. 16/33 Deck s.f. Lot Area s.f.
Phone 40` 7 9 6+34 FAX 3& V-
E-mail Address
" � y LENDER INFORMATION MUST BE PROVIDED FOR PROJECTS OVER$5,000
Name JOG W v'GCM,k IN VALUATION PER RCW.
Address iL 3 SRcIrtk
/� '! Name 1�Pc�City/State/Zip VaLt-10 +S WA (4Th4 Address
Phone (,i) le$ $(o% FAX City/State/Zip
E-mail Address/hp~r its .0%.400, hone No. _
CONTINUED ON THE BACK
�GP • eaP,20 lep,Z.0 -5 iP
Residential Mechanical Fixtures
Fuel Type
0 Natural Gas 0 Electric 0 Wood 0 Propane Gas 0 Other
Type of Equipment Number of Type of Equipment Number of
Fixtures Fixtures
Furnace<=100K BTU Clothes Dryer
Boilers/AC/Heat Pump Gas Water Heater
Gas Outlets Gas Fireplace
Ventilation Fans Fireplace Insert
Stove,Appliance Other Units
Range Hood
Residential Plumbing Fixtures
Type of Fixture Number of Type of Fixture Number of
Fixtures Fixtures
Toilet Clothes Washer
Bathtub Electric Water Heater
Shower Utility Sink
Dishwasher Hose Bibb
Hand Sink Water Piping
Kitchen Sink w/Disposal Additional Fixtures •
I HEREBY ACKNOWLEDGE IF HAVE READ THIS PERMIT APPLICANT AND STATE THE INFORMATION IS CORRECT,AND AGREE TO COMPLY
WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING ACITIVIES COVERED BY THIS PERMIT APPLICATION. WITH THIS PERMIT ALL
CONTRACTORS AND S ' ONTRACTORS SHALL HAVE A CURRENT WASHINGTON STATE CONTRACTORS LICENSE AND A CITY BUSINESS
LIC LASE. S 4 W W. ORDERS WILL BE ISSUED ON JOB SITES WHERE CONTRACTORS/SUBCONTRACTORS ARE WORKING WITHOUT
P t;Ei
PP 3 r1i� DATE
(-) ED
U T `:: :: >. IO ACE ;: D E ' N CT •YE. N IL GI,
..:....:......
....: .. :. ...:RESIDENs.TL,GRECKL
(This form is to be completed prior to issuing the building permit)
Site Address: 3-310 3 s ;t. G s Date: 9-s--r) '
Owner: V;Li n E= P,a>e,e Lc<-
Assessors No.y7 o arm co q-c ' Lot 9 Block Addition V:Li.:c.,, Ow R.,c
OK NA OK NA
0- ❑ Fire Department Access e"., 0 Fire Hydrant Located within 250 feet
❑ E]® Fire Flow Required 0 ❑C,Covenant Not to Oppose Future LID
❑ ,n- Water Extension 0 Li'" Sewer Extension
❑ Cam" General Road Improvements 0 _.0.----Shoreline or Wetlands
❑ Er Drainage Plan Approved R 0 Site Plan
❑ o""- Variance Required 0 0- Covenant Approval
❑ t -Plat Facts and Findings Compliance 0 Er Regulated Slopes
❑ Cr Fill on Site 0 0 Survey in File
Zoning: it,-a-_
Lot Size: '7I-1 ti S
Coverage Allowed: D.-L95- s. :.
Actual Coverage: 11`i 1 S.r- = .)-3 `°
I
Plans Examiner: 12 0 Date: i- 3-- /
(Signature)
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