1006 CAROL WAY.PDF11111111111111
10497
1006 CAROL WAY
0
ADDRESS: 10 (0 L4md vv o-141
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):lQt� bi qqSFP-)
COVENANTS(RECORDED)FOR:
CRITICAL AREAS: DA- AT DETERMINATION: ❑ Conditional Waiver ❑ Study Required kWaiver
DISCRETIONARY PERMIT #'S: V -
DRAINAGE PLAN DA'
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS (OTHER): ���h l)lTt�t I G�U �� �y ��J-7 V C 1 (�►Itl
ro Ls)
PLANNING DATA CHECKLIST DATED:I
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID
SHORT PLAT
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #: lqt8
GEOTECH REPORT DA'
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
OTHER:
LOT: IZ BLOCK:
LATEMP\DSTs\Forms\Street File Checklist.doc
Agency Case No. PU,GET SOUND CLEAN AIR bate Rt'cervetl' -
• AGENCY
110 Union Street, Suite 500
200400625 �4' f� R'r� �� ' Seattle, WA 98101-2038 7 1004
www.pscleanair.org
NOTICE OF INTENTgenXt/j(orily CH
A. Proiect Tyne: 1. ❑ Friable Asbestos Removal 2 Friable Asbestos Removal S Demolition 3 ❑ Demolition Only
B.
Property Owner: ; .i ✓c✓ v C _ Phone: q.ZC - --7
Vlailing Address: =_:L fin' City:% �.Lf;_ % ,r;:.a State w Zi
C. Asbestos PLEASE PRLYTCLEARL}'. THIS RUL BE YOUR RETURN AMIL1NG LIBLL
Contractor: l �
Owner/CEO:
Mailing .Address: ; .7 `f itir je-(: >
Phone: `�2 s - ? 7 S - s3.:: L
Contractor
Job No.:
city: 1 '
� i ear - Gz
State:
Zi ` 3
Fax:
D. Site
Address: /� �Cev� 4�i. Ci .dS Zip:
Site
Manager:
Local Phone: 1J ( r
E. U Asbestos Survey or No. of Date of Asbestos Was Friable Asbestos Identified? WYes LJNo
❑ Mat'l Presumed Structures: Survev: too Was Nonfriable Asbestos Identified? ❑Yes PNo
AHERA Buildin Certification #: I L--c>� S �s� Attach a copy of the survey when friable asbestos
Inspector: ' l
P r t t r Ex . Date: , y has not been identified.
—ry w . ryuweu uryure uu uemulnron projects
F. Demolition Start No. of T2.
Trainin. Fire (List Fire Dept.)
Information: Date: % Ir �� Structures: ❑ Ordered Demolition attach copy of Order
Demolition Insert demolition contractor's mailing address on back. Will nonfriable asbestos be left in place during demo? U Yes No
Contractor: 1 -... i If yes, list type and
G. Friable Asbestos Work Days: M T W T„ F Sa Su
Project Information: Start Date: Completion Date: �; /za Hours:
Will all friable asbestos � Yes
Total Qty. to be Removed: - - Linear Ft. t i .-1- S uare Ft. materials be removed? ❑ No
Ll BOiler\Fumace Insulation LJ Duct Insulation ElPipe Insulation Ll Fireproofing U Paints LJ Plaster Textured Coatings
LJ Cement Board LJ Cement Pipe U Friable Flooring LJ Friable Roofing Material Other:
H. Asbestos/Demolition Project Categories:
Notification Period
Project Demolition
1. Single -Family Residence (owner -occupied):
Fee Surchart=e
A. ❑ Asbestos Removal Project Only
B.11.Demolition Project (with or without asbestos removal
A. Prior Notice
' B. 10
A. $25
project)
Days*
B. $50
*(Asbestos removal can begin upon notification; demolition must wait 10 days)
Note: If the single family residence is owned by one family who has been or will be using the residence pp� I�i it�� i ile the above boxes
lA or IB maybe checked. If this is not an owner -occupied residence, one of the categories listed belk�-0Cr�te it EQle family
residence does not include rental ro er , multi -family units, or any mixed -use buildin .
2. Ll All Other Demolitions with no Asbestos removal or Nonfriable Asbestos
10 Days JUN 3
0 ZU04 $200
only
Friable Asbestos Projects other than Single Family Residence):
Asbestos
3. >_ 10 - 259 linear feet and/or >_ 48 - 159 square feet of asbestos
Prior Notice 10 Da s
$
$100
4. L3 260 - 999 linear feet and/or 160 - 4,999 square feet of asbestos
10 Days
$200 $100
5. >1,000 linear feet and/or >5,000 s uare feet of asbestos.
1LJ
10 Days
$750 $250
6. Ll Emergency Asbestos Project or Emergency Demolition Project
Prior Notice
Twice Project Fee
(Single -Family Residences are exempt from emergency fee; however, property owners must provide a
written emergency request)
I. 1 certi at the infor anon con din this notification &supplemental data is, to the best of my knowledge, accurate &complete: Agen Us e my
Signature Re resenting O 0 Date Review d By
Puget Sound Clean Air Agency Form No.: 66-160 (Revised 1/04) TS jK IV; VL t '
PaT. P° J. (o P_
The Puget Sound Clean Air Agency requires advance notification before any person commences a friable asbestos. project
involving materials equal to or greater in. size than 10 linear feet or 48 square feet and for all demolition projects
(regardless of asbestos content) involving structures with a projected roof area greater than 120 square feet (Regulation
III, Article 4). All asbestos removal and demolition notifications must be submitted to the Agency on current Agency
forms. Asbestos removal and demolition prtiiects involving materials and structures below the notification threshold are
still subject to all other requirements of Regulation III, Article 4.
After receiving a complete notification with the appropriate project fee, the Agency will review the form and return a
copy to the asbestos and demolition contractor by mail. The returned copy will be your validated notification.
PLEASEPRIATCL6IRLY. rfII1i11LLBE)OLAREn P%'AbUU.%GLIBEL
J. Demolition I _
Contractor: v 4 C+ 2 Sot•, - ' i ! I ; -
Oxmer/CEO: f jv •f�
Mailing Address: +
2 2/z?v.{'� t�d
Phone: J _
`f ZS - 77 s / �S 3S
Contractor's
Job #:
City: `: o o
State: l
Zip: 9 26 Z `7 S
Fax: �S- 53 - 6, �
GUIDELINES FOR SUBMITTING AN ASBESTOSIDEMOLITION NOTIFICATION
Step 1. Check the appropriate project type in Box A. Friable asbestos includes popcorn ceiling material, sheet vinyl flooring, cement
asbestos board siding, and duct insulation. Nonfriable asbestos is normally found in vinyl floor tiles, window putty and most roofing
materials.
Step 2. Enter property owner information in Box B.
Step 3. Enter the asbestos contractor or property owner information, if the property owner is conducting a single-family residential
project, in Box C. Print clearly this is your return mailing label.
Step 4. Enter the site address for all notifications in Box D. For multi -structure projects, attach supplemental sheet with a site map
(include an address for each site) and a list of the type and amount of friable asbestos to be removed from each structure.
Step 5. Check either asbestos survey or material presumed in Box E. All demolitions require that an Asbestos Hazard Emergency
Response Act (AHERA) asbestos survey be conducted by a certified AHERA building Inspector. Attach a copy of the survey to the
notification of a demolition project when only nonfriable asbestos or no asbestos is identified on the survey.
Step 6. Enter the project information in Box F. and check the training fire or ordered demolition box if appropriate (a copy of the
official order must be attached). All asbestos must be removed prior to conducting a training fire. Additional training fire
requirements are contained in Regulation I, Section 8.08. If any nonfriable asbestos materials will be left in place during demolition,
check yes and list the type and quantity of material.
Step 7. Enter asbestos project information in Box G. List types of friable asbestos material to be removed: surfacing material such as
popcorn ceilings or plaster, sheet vinyl flooring, duct and pipe insulation, cement asbestos board siding or pipe, etc.
Step 8. For owner -occupied Single -Family Residential projects, check BOX H1A for renovation projects or BOX H1B for
demolition projects (with or without asbestos removal). Asbestos removal may be conducted after a complete notification is
received, but demolition activities can only begin on the 10`h day after the notification is received. Note: If the single family
residence is owned by oneJ'"inily who has been or will be using the residence as their domicile, boxes IA or IB may be checked A
single family residence does not include rental property, multi family units, or any mixed -use building.
For Commercial asbestos projects (or projects that do not qualify as Single Family Residential); check the project category H2 -
5 that matches t1he'ar'd6unt of friable asbestos that will be removed. If a demolition is involved, include the appropriate surcharge
(additional fee) in your payment. To file for an emergency asbestos or demolition project, check the appropriate box I - 5 and the
applicable emergency box iriiH6. All emergency requests must be accompanied by a letter from the property owner demonstrating the
need to conduct the project immediately in accordance with the requirements in Regulation III. Section 4.03 (c).
Step 9. Please certify the accuracy and completeness of the information provided by signing the notification in Box 1.
Mandatory amendments to the notification are required for changes that increase the project category, change the types of asbestos
materials to be removed and changes to start date, completion date and work schedule for asbestos projects. No fee is required for
work schedule changes if the contractor is participating in the Agency work schedule fax program. A $25.00 processing fee is
required for all amendments.
Puget Sound Clean Air Agency asbestos regulations and forms can be downloaded from the Agency web page at www.pscleanair.org.
For technical assistance call (206) 689-4058 and for administrative inquiries call (206) 689-4090.
Puget Sound Clean Air Agency Form No.: 66-160 (Revised 1/04) TS
•
:um point
p of sewer MH
00.00'
_—_--Carol Wa
PL=37.41'
EX. CB
RIM 101.75N TST
6" INV 101.08- 101.5'
FOOTING DRAINS N
TO BE TIED INT
DETENTION SYST 02.5'
ICS TYPE /-L - "'RIM 10,E 00
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CRAWLSPACE: I
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PROPOSED RESIDENCE
elevation: 106.5'
Finished floor ;
�I
elevation:112.0' I
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GARAGE:------
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WbRARY CONSTRUCTION
ENTRANCE REQUIRED
•
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HWAGEOSCIENCES INC.
19730-64th Avenue West, Suite 200
Lynnwood, WA 98036
Tel. 425-774-0106
Fax. 425-774-2714
AReport No.:
FR-001
Date (mm/dd/yy):
6/16/2005
HWA Project No.:
2005-000-10
HWA Task No.:
300-1100
Project Name
Location or Address of Project
Permit No.
Howard Anderson House
Edmonds, WA
Client
Client Representative
Weather
Howard Anderson
Howard Anderson
Sunny, 65 *F
Design Authority (engineer or architect of record)
Design Authority Representative
HWA Project Manager
Howard Anderson
Howard Anderson.
GeorCle Minassian
General Contractor
General Contractor Representative
HWA Field Representative
Abode Construction
Jim Anderson
John H. "Jack" Carlock
FIELD REPORT
SUMMARY OF FIELD TIME SPENT ON PROJECT TODAY:
First Site Visit: Start Travel: 10:00 Arrived at Site: 10:15 Departed Site: 11:30 End Travel: 11:45
ACTIVITY BEING INSPECTED: Compaction of Crushed Surfacing Base Course (CSBC) for use as driveway base.
GENERAL LOCATION: New drive construction along the southern edge of the lot at 1006 Carol Way.
DETAILED LOCATION: The specific locations and elevations tested are summarized on the attached 'Field Compaction Test Report'.
TYPE OF INSPECTION: Periodic
DETAILS OF PLACEMENT OF THIS MATERIAL: There is no information available regarding the depth of the lift(s) or the number of lift(s) placed.
Nor is there any information available regarding the compaction equipment utilized during compaction activities. Based on information provided
through visual observation, it appears that the CSBC was placed in depths varying from two inches to eight inches, depending on the location.
HWA INSPECTION ACTIVITIES RELATED TO THIS ITEM: HWA carried out visual observation and compaction testing. HWA did not observe
material placement or compaction operations prior to testing. Test results are summarized on the attached 'Field Compaction Test Report'.
CONFORMANCE OF THIS ITEM: To the best of the inspector's knowledge, the item inspected was found in conformance with approved plans,
specifications and RFIs.
MISCELLANEOUS ACTIVITIES, OBSERVATIONS AND/OR COMMENTS: Two areas were observed as being insufficiently compacted. The first
area is the eastern most 45ft of the driveway area. The CSBC material placed in this area was very thin and intermixed with moderately wet, native
soils (silty SAND). The entire area displayed significant deflection under foot and probing with a 1/2" diameter steel t-handled probe was refused at
depths between 8 inches and 12 inches. It was learned that this portion of the planned driveway/parking area had been a vegetated area for the past
several decades. HWA advised both the owner and the contractor that, in its current state, the area is not ready to be paved, and that any ACP
placed in this area would fail in very short order. HWA recommended that this area be covered with a layer of crushed rock or pea -gravel, and that a
fixed boundary be. placed between this area and the paved area of the drive (under construction) to support the shoulder of the ACP in that drive. It
is our understanding that the owner and contractor are considering these recommendations.
The second area of concern is where the new asphalt driveway (under construction) meets the edge of the thirty foot wide, exposed aggregate
concrete parking area/entrances to the garages. It was observed that the fill material, a combination of CSBC and native soils (silty SAND), placed
in the approach to the western 10 feet of the parking area/entrances pumped easily under foot so the area was probed with a 1/2" diameter steel t-
handled probe. The probe was refused at depths grading from 4-inches in the eastern portion of this area to 14-inches to the west. HWA further
advised the owner and the contractor that these materials be removed and replaced with a more suitable material (CSBC, CSTC, or gravel borrow)
and that the new fill be placed in lifts no greater then six inch thick and compacted with a "jumping jack" style compactor. HWA suggested that we
inspected the placement of the first couple of lifts to ensure that the contractor/owner are meeting with our recommendations. See included drawing
for the approximate dimensions of this area.
It is our understanding that the CSBC placed as base for the Anderson's driveway was imported from Rinker -Everett. The most recent Proctor for -
this material that HWA has on hand was sampled and tested on June 14, 2005.
SIGNATURES:
Signed: _44 / Reviewed:
H epresentative HWA ProLeAf Engineer or Revie
SUMMARY OF UNRESOLVED ISSUES
Report# Item# Status
na na There are no outstanding issues at this time.
This report should only be reproduced in its entirety. Report is not final until signed by HWA field representative and HWA reviewer. Page 1 of 3
•
19730-64th Avenue West, Suite 200
�LT,' 'y=_,
Lynnwood, WA 98036
Tel. 425-774-0106
HWAGEOSCIENCES INC.
Fax. 425-774-2714
AReport No.:
FR-001
Date (mm/dd/yy):
6/16/2005
HWA Project No.:
2005-000-10
HWA Task No.:
300-1100
Project Name
Location or Address of Project
Permit No.
Howard Anderson House
Edmonds, WA
Client
Client Representative
Weather
Howard Anderson
Howard Anderson
Sunny, 65 *F
Design Authority (engineer or architect of record)
Design Authority Representative
HWA Project Manager
Howard Anderson
Howard Anderson
Geor a Minassian
General Contractor
General Contractor Representative
HWA Field Representative
Abode Construction
Jim Anderson
John H. "Jack" Carlock
FIELD COMPACTION TEST REPORT NUCLEAR METHOD
MATERIAL BEING PLACED: see accompanying field report
PROJECT IMPROVEMENT TESTED: see accompanying field report.
Test
No.
Detailed Test Location
Elev'n
or
Depth
B.G.'
Probe
Depth
(in)
Lab Control*
Proctor/Rice/Marshall
Field Test
Relative
Compaction
Density
Moist.
ID
#
Max.
Dens.
Opt.
Moist.
Over
Size °/
Total
pcf
Dry
pcf
Moist.
%
Field
%
Spec
%
1
Andreson's Driveway, 18ft east of
10th Ave, 1 ft right of center line.
- 2 inch
6-inch
Ag-1
142.8
7.3
10.1
141.9
135.5
4.7
95
95
2
Andreson's Driveway, 88ft east of
10th Ave, at center line.
-2 inch
6-inch
Ag-1
142.8
7.3
10.1
141.9
136.0
4.3
95
95
3
4
5
6
7
8
9
10
11
12
13
Test Method X ASTM D2922/D3017 (soil) ASTM D2950 (asphalt) Other:
Densometer. X Troxler 3440 Troxler 3430 Troxler 3411-B CPN MCI-DR-P
Serial #: 25520 Density Standard Count.: 2511 Moisture Standard Count: 645
'Lab Control: Standard Proctor X Modified Proctor
Asphalt Marshall Density Asphalt Maximum Theoretical Density (Rice)
COMMENTS: Test locations and elevations are approximate. Testing provides data only for a specific test location and to a limited depth.
Accompanying field report provides additional information. '"Depth B.G. indicates depth below grade. Grade means the design finish grade of the
current type of fill material being placed. Bolded results indicate compaction below specified value.
Completed By: John H. "Jack" Carlock
Reviewed By: George Minassian
This report should only be reproduced in its entirety. Report is not final until signed by HWA field representative and HWA reviewer. Page 2 of 3
�I O
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19730-64th Avenue West, Suite 200
Lynnwood, WA 98036
Tel. 425-774-0106
HWAGEOSCIENCES INC. Fax.425-774-2714
Od Report No.:
FR-002
Date (mm/dd/yy):
6/19/2005
HWA Project No.:
2005-000-10
HWA Task No.:
300-1100
Project Name
Location or Address of Project
Permit No.
Howard Anderson House
Edmonds, WA
Client
Client Representative
Weather
Howard Anderson
Howard Anderson
Sunn , 65 °F
Design Authority (engineer or architect of record)
Design Authority Representative
HWA Project Manager
Howard Anderson
Howard Anderson
lGeorge Minassian
General Contractor
General Contractor Representative
HWA Field Representative
Abode Construction
Jim Anderson
John H. "Jack" Carlock
FIELD REPORT
SUMMARY OF FIELD TIME SPENT ON PROJECT TODAY:
First Site Visit: Start Travel: 10:00 Arrived at Site: 10:10 Departed Site: 10:30 End Travel: 10:40
MISCELLANEOUS ACTIVITIES, OBSERVATIONS AND/OR COMMENTS:
At the request of Howard Anderson, HWA visited the Anderson House site today to inspected the placement of the CSTC fill
currently being placing in the approach to the western 10 feet of the exposed aggregate concrete parking area/ garages entrances.
At the time of our arrival, it was observed that Howard Anderson (owner) had already placed several lifts of the CSTC, so an
inspection of the exposed at depth native soil was not possible. Mr. Anderson did confirm for us that the depth of the over
excavation generally followed those given in our recommendations. The area was being backfilled in 4 inch lifts (uncompacted
thickness) and compacted with a contractor's grade jumping -jack. At the time of our visit the elevation of backfill was approximately
4 inches below grade. The area was probed with a 1/2"diameter steel t-handled probe to check for areas of soft, loose, disturbed
or otherwise unsuitable soils. One small area of unsuitable soil was found during the probing and was removed. Probing of the
CSTC was refused at 2 inches or less. Though no compaction testing was performed today, our physical evaluation indicated that
the CSTC was firm, well -compacted and unyielding.
SIGNATURES:
Signed:2-G- Reviewed:Ma
H epresentative HWA Prqj9ct Engineer or Revie r
SUMMARY OF UNRESOLVED ISSUES
Report# Item# Status
na na There are no outstanding issues at this time.
This report should only be reproduced in its entirety. Report is not final until signed by HWA field representative and HWA reviewer. Page 1 of 1
t
/_
-6TREETS�E_ �}
CITY OF EDMONDS
250 - 5TH AVE. N. • EDMONDS, WA 98020 • (206) 771-3202
COMMUNITY SERVICES:
Public Works • Planning • Parks and Recreation • Engineering
890 19y -
September 16, 1991
LARRY S. NAUGHTEN
MAYOR
PETER E. HAHN
DIRECTOR
Howard Anderson
1006 Carol Way
Edmonds, WA 98020
Dear Mr. Anderson:
I have reviewed your account and you were issued a credit in
October 26, 1990 of last year. As per City policy: Only one leak
credit will be granted in any three year period unless very
extraordinary circumstances can be demonstrated.
Should you have any additional questions, please contact Ilene Larson,
Utility Billing Clerk.
Sincerely,
Ron Holland
Water/Sewer Supervisor
RH/lk
cc: Ilene Larson
Utility Billing Clerk
#221975/TXTWATER
0 Incorporated August 11, 1890 0
f�� IV, qlu,.�e-1
tins � Z
i KQ 1.J45 Y�e►n ih 57�? �/cd .
,71
fas kI qc-4 gts �.
TqK
aa�97s
--� SIKEET FILE �
>> CITY OF EDMONDS
250 -5TH AVE. N. • EDMONDS, WA 98020 • (206) 771-3202
COMMUNITY SERVICES:
Public Works • Planning • Parks and Recreation Engineering
f89p-19��
October 1, 1990
Howard Anderson
1006 Carol Way
Edmonds, WA 98020
Dear Mr. Anderson:
LARRY S. NAUGHTEN
MAYOR
PETER E. HAHN
DIRECTOR
I have reviewed your account and will allow a credit to your account
according to our City policy: the average consumption for the same
period during the previous year charged at normal customer rates, plus
the excess usage charged at the City's cost, plus a surcharge of 15%
applied to the excess only.
Should you have any additional questions, please contact Ilene Larson,
Utility Billing Clerk.
Sincerely,
Ron Holland
Water/Sewer Supervisor
BM/lk
cc: Ilene Larson
Utility Billing Clerk
#221975/TXTWATER
• Incorporated August 11, 1890 •
Sister Cities International — Hekinan, Japan
1006
4„
1.5' 6"
c/O
IT 4" C/O
2' �
11' FROM EDGE OF PAVEMENT
Lu
Q
O
CAROL WAY
of ED!fO
v'
CITY OF EDMONDS SIDE SEWER AS- BUILT
ADDRESS
1006 CAROL WAY
SCALE
NTS
HOMEOWNER
NDERSON
CONTRACTOR
1890
DATE
03/05/2005
DRAWN:
-BY SIBREL.
PERMIT
NO. 9953
r-t"N`�' Ky=�^�"•4r.t. _ �. v.r•....11'��•r.. ..,r..,.,;r..,,. ...-./r•+- t � N
-••1.'a.d�N'•%n:1eM0i6it;'M�Y.--�O�.,,,,Wiii,"�n .r7d'„"y. S/'Ki'V*�{Ff�'vR".'r,'.w �:� �'' •r ...SJ i+�41��`'L^tt��M,.'„'.N"7GrCar'4�'?.'nnu� �1 WS.FI�t4�iy%itiii�}'�rM'�Y-t5'fr ri"rr rt`
City of Edmonds,PERMIT NO: 9953
SIDE SEWER PERMIT .
PERMIT EXPIRES JS �
Address of Construction:10(l)(0 (AV_A7) t_ WA-4 LID #
Property Tax Account Parcel No. 191CW0
Attach copies of all access and utility easements A)jA Verified and Approved by
Owner and/or Contractor:+t�ky-D A ZAAg
Contractor License #: A EG ow Y-4 i g Permit #: Zw4 014-q
Single Family Invasion into City *Right -of Way: ❑ Yes .N-No
/❑ Multi -Family (No. of Units
❑ Commercial (No. of Units )
❑ lr
•j
*RW Construction Permit #
Cross other **Private Property: ❑ Yes . N No
**Attach legal description and copy of recorded easement.
17ni p' contractor signature and acknowledgement statement:
y,sigmng for this permit I certify that I have read the City's public handout enti ed
ide Sewer Specifications, and shall comply with•.all City requirements outlined therein.
I/4aI05'
Date
9 CALL DIAL -A -DIG (1-800-4-5555). BEFORE ANY EXCAVATION 9
V FOWINSPECTION CALL 425-771-0220 extensions"
24 HOUR NOTICE REQUIRED FOR ALL INSPECTION REQUESTS
NOTE: IF JOB SITE IS NOT READYFOR INSPECTION WHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION FEEWILL BE CHARGED.
Job Site Ready YES NO Date: Initial:
- Partial Inspection: &4'To 8Ar !CC/LL Date:l & itial .
Partial Inspection: Date: Initial:
FINAL INSPECTION APPROVED: Date: 1. Initial: I As -built 4o Street File: • , (�
1,� PERMIT MUST BE POSTED ON JOB SITE t-
White Copy: File' Green Copy: Inspector Buff Copy: Applicant
L;temp;bl dg;forms;sspermitj lg4/00
of EDP City of Edmonds
0
Development Services Department
Planning Division
Phone: 425.771.0220
rpc I gqo Fax: 425.771.0221
The Critical Areas Checklist contained on this form is to
be filled out by any person preparing a Development
Permit Application for the City of Edmonds prior to
his/her submittal of the application to the City.
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, or
may be, present on the subject property. The information
needed to complete the Checklist should be easily
available from observations of the site or data available at
City Hall (Critical areas inventories, maps, or soil
surveys). RECEIVED
The undersigned
to release,
attorney's
incomplete
,AN 3 12002
Date Received: I- 31- 02 -
City Receipt #: 9_0 27
Critical Areas File #:
Critical Areas Checklist Fee: $45.00 •
Date Mailed to ADDlicant:
A property owner, or his/her authorized representative,
must fill out the checklist, sign and date it, and submit it
to the City. The City will review the checklist, make a
precursory site visit, and make a determination of the
subsequent steps necessary to complete a development
permit application.
Please submit a vicinity map, along with the signed copy
of this form to assist City staff in finding and locating the
specific piece of property described on this form. In
addition, the applicant shall include other pertinent
information (e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant staff
in completing their preliminary assessment of the site.
rtrl vvn � a...
:applicant, an i�, s er/its heirs, and assigns, in consideration on the processing of the application agrees
iriify defend and hold the City of Edmonds harmless from any and all damages, including reasonable
arising` from any action or infraction based in whole or part upon false, misleading, inaccurate or
nation furnished by the applicant, his/her/its agents or employees.
By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I"am authorized to fiileWis ap ' ti on the behalf of the owner as listed below.
SIGNATURE OF APPLICANT/AGENT,2 _ram_ DATE
Property Owner's Authorization
By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
SIGNATURE OF OWNER�.C� DATE 2
Owner/Applicant:
Name
Street Address
City State Zip
Telephone: `i2S-- 77 cS - `s30 z
Email address (optional):
Applicant Representative:
Name
Street Address
•
City State Zip
Telephone: 0
Email Address (optional):
Critical Areas Check] ist.doc/3.19.2001
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
0.
2.
Site Address/Location:
Property Tax Account Number:
CA File No: 02-- 2-H
3. Approximate Site Size (acres or square feet): I i 3 AL.
4. Is this site currently developed? X yes; no.
If yes; how is site developed? _ >>!�jg_ 4,1", %
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.'
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a' horizontal
distance of 66-feet). '
Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise, of 10-feet
over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of 10=feet over a horizontal
distance of less than 33-feet).
R1
Other (please describe):
Site contains areas of year-round standing water: Approx. Depth:
Site contains areas of seasonal standing water:' 06 ; Approx. Depth: _
What season(s) of the year?
Site is in the floodway �110 floodplain Oo of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
�'l10 Flows are seasonal? (What time of year? ),
10. Site is primarily: forested ; meadow. ;shrubs ; mixed
urban landscaped (lawn,shrubs etc) I/
11. Obvious wetland is present on site: A)1A-
Critical Areas Checklist.doc/3.19.2001
►5
0.
0
vi
0
0
N
N
09
SCALE: 1" = 30.00'
ASSESSOR'S PARCEL NO.
00 5927 000 012 00
OWNER
HOWARD AND LEANNE ANDERSON
1006 CAROL WAY
EDMONDS, WA 98020
LOT SIZE
14,810 SQ. FT.
LOT COVERAGE
3152 SQ. FT.
PERCENTAGE OF COVERAGE
21.20 %
k
i. ANDERSON RESIDENCE
1006 CAROL WAY, EDMONDS, WASHINGTON 98020
SNOHOMISH QDQNTW-, WAx �GTON
NEW BUILDING & ROOF AREA
3549 SQ. FT.
NEW WALKS AND DRIVES
1206
TOTAL NEW IMPERVIOUS AREA:
4755 SQ. FT.
EXISTING BLDG/ ROOF AREA:
2400 SQ. FT.
EXISTING WALKS / DRIVE AREA:
670 SQ. FT.
TOTAL EXISTING AREA:
3070 SQ. FT.
NET NEW IMPERVIOUS AREA:
1685 SQ. FT.
O V4NO'T 660,n
vit"i ►PA,p P-Wifts
01-16% 9110MOVSv. .
HEIGHT CALCULATIONS
DATUM PT. @ SEWER M.H. IN RD.
DATUM SET AT 100.00'
A= 108.5'
B=109.5'
C=111.0'
D=108.0'
AVERAGE HT = 109.25'
ACTUAL HEIGHT = 131.78'
MAX. HEIGHT = 134.25"
datum point
0 Top of sewer MH
z = 100.00'-
- —
z Carol
> I -- L=56.28'
O L'
cc =37.41_. 32.4g'
CL
CL
- - — — — _ 18" ROOF
I I BUILpING�fP/ _ OVERHANGS
I COVERED
I ENTRY PO}3CI
... ......-....... ...
pi
CONC ETI$ PVALKWAI Finished
, focr6e —
1120
^ ss— UTLINE OF EXISTING
r ,IiPME (B94F11rlEL — L I I
PROPOSED RESIDENCE
3 5�1"tr
o
ui W � N L7r-- -----
I D CK @ /
VO SO.IFT. / GARAGE
w [: 0 I ~ I O, : I WALnt
.......... — —
= " — I
N Cn
%Qo�g1 PROPOSEDCONCREI
I I / OVER
OVER �
I /ri EXISTING
GRAVEL DRIVE I M
I I
------K— — — — — — — — J
f ...- BUILDING SETBACK LINE
`~102'
-"` ""-104'
—106'
— ---108'
"'-110'
IV E D
Sewer MH EXISTING EXISTING GRAVEL
= 110.5'+- Alley. DRIVEWAY DEC 12 2003
cl
PERT COUNTER
PyM _ /
PLANNING DATA
-NAME:
SITE ADDI
PROJECT
REDUCED SITE PLAN PROVIDED?: Yes / No
MAP PAGE: Z CORNER LOT• e / No FLAG LOT: Yes n o
ZONING: — CRITICAL AREAS DETERMINATION #: OZ 7
❑ Study Required:
giver
❑ Conditional Waiver
CHK#: 03 -3d-7
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 3 GD Glds,
SETBACKS:
Required Setbacks: �'
Street:_Left Side:Right Side: tz-
Actual Setbacks-
;'�� �Stree
t: ��LeftSid:o t Side: Z Rear. �$
Street map checked for additio al setback required? (Yes / No / DNA)
❑ DETACHED STRUCTURES:
❑ ROCKERIES:
❑ FENCES/TRELLISES:
❑ BAY WINDOWS / PROJECTING MODULATION:
❑ STAIRS / DECKS:
PARKING:.Required: Z Actual: i
LOT AREA:-AREA:J `1 '`O
LOT COVE
Calculations: Vnaa-- /a`$
—T—
BUILDING HEIGHT:
Datum Point:
Maximum All� •{s
A.D.U. CREATED?: (No / 'es)
�-- 3S'�
Elevation: —f-119O
Height: 151 Z53
SUBDIVISION:
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: Yes No
OTHER: '
Plan Review By:
NewBPPlanningDataForrrDOC
toy
i.. ��...-.....-. -, 1_.... .:v -. -.�.....•_•.:...,L,_1..:..,..:..rr:�M"..—..::...�s.,.-,�",�..""".'`'�,j%",.,. ...,'.r."�`t�l,..�c.w„ .....+41�
City of Edmonds . Permit No: 1 70
RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date:
A. Address or Vicinity of Construction: �/® 06. -1A KQ t , 4AV .
B. Type of Work (be specific): Dig 1 V F lA /A y A P P f2 Q A C. H, i AV E 1 tZ•9,z-1 1
C. Contractor:t Jam• r / << 64 � v i0� Contact: c JS / �1.���//rJ'7 Gtv�
Mailing Address: / � /. li. f. % � �i A J. Phone: Z
State License #�: Liability Insurance:Bond: $
D. Building Permit• # (if applicable) v7� Side Sewer Permit # (if applicable):`
E. - ,� 1-Commercial ❑ Subdivision ❑. City Project ❑ EUC (PUD, VERIZON, PSE, AT& T, OVWD)
❑ Multi -Family. Single Family _ ❑ Other
INSPECTOR:
• a
F. PAVEMENT CUT: ❑:YES INO
NO G. SIZE OF CUT X
CONCRETE CUT, . []-YES
INDEMNITY: Applicant understands by his/her signature to this application he/she holds the City of Edmonds harmless from
injuries, damages" or claims of any" kind or description whatsoever,, foreseen or unforeseen, that may be, made against the City of
Edmonds or any of its departments or employees, including but not limited to the defense of any legal proceedings including defense
costs and attorney fees by reason of granting this permit.
THE CONTRACTOR I&RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOW/NG THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS .
COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT T.
♦ Traffic, control and public safety shall be in accordance with City regulation's as required by the City•Engineer. Every
flagger must be trained as. required by (WAC) 296-1,55-305 and must have certification verifying completion of the
required training in their possession. �.
♦ RestorationAs to be din accordance with City codes. All street -cut trench work shall be patched with asphalt or City -
approved material prior to the end of the workday - NO EXCEPTIONS. r .
♦ Three sets of construction drawings of. proposed work are required with thepermit application.
t
CALL. DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK.
I HAVE READ THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE
THAT I MUST MAKE THE PINK COPY OF THE PERMIT AVAILABLE ON SITE AT ALL TIMES FOR INSPECTIONS
z
SiS natu/ Date: 7' 7 CJ.
a ��
Approved by * ?
Time Authorized: Void After _
Special Conditions: r `s
FOR CITY USE ONLY
Right-of-way Fee: /faC. L!2Ph�O
Disruption Fee/Fund 111:
Total Fee: a0,- !-'' S"-
Receipt No•�l
Issued by: ,.
!i9 =mil r„ -2 f7A-....:
60 . .
UPON COMPLETION OF PERMITTED WORK,:AN ENGINEERING FINAL -
INSPECTION IS REQUIRED PER -CHAPTER 18.00 OF THE. EDMONDS -
COMMUNITY DEVELOPMENT ..CODE (Phone 425-771-0220, Ext. 1326) .
FINAL APPROVAL OF `PERMITTED WORK: JrY
nspe to �sr igttalaature . c..fit-J/C�{• L�.1
For inspection requirements see Enidneerink Inspection Information handout.
rj
.il.
•'P
NO WORK SHALL 131?GIN PIZIUIZ TO PI?IZMIT ISSUANCE..
RECEIVED
617.
PERMIT EXPIRES
CITY OF EDMONDS
ZONE SE PERMIT
jP u e R
CONSTRUCTION PERMIT APPLICATION
JD SUITE/APT
ADDRESS
OWNER NAME/NAME OF BUSINESS
PLAT NAME/SUBDMSION NO.
LOT NO.
LID
n�
GI
S N
!
LID FEE S
LING ADORESS�
,%,%� ��
(/V W— •
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING PROPOSE
REQUIRED DEDICATION F7
RW P Approved
RW Pbrmll Repulred
Strew Use Permit Rep'd
Skleralk Required
UndwW—W
VAMP required
CITY ZIP r
v� "��
ofm
TELEPHONE �j
A S % ? �3o(i�
V L vvv
NAME
METER SIZE
LINE SIZE1
NO. OF IXTURES
PRV REQUIRED
YES P( NO 0
r7
0
C
V
�d
ADD ESS
I (p
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
=
t,7
CITY ZIP
TELEPHONE
NAME
W C�J �•.
CBL N
,i 1
QINEERINO REVIEW BY DATE
Ix
c
ADDRESS
Y.. DATE
IRE REVIEWED 4,
\
W
M
p
U
CITY ZI
TELEPHONE
VARIANCE OR CU
:SHORELINE OR ADBY#, `? INSPECTION
"P REO'D
BOND
POSTED
Z
s
STATE LICENSE NUMBER EXPIRATION DATE`
CHECKED BY
SEPA REVIEW
COMPLETE EX E T
EXP G e
SIGN AREA y
ALLOWED, ' PROPOSED
�ti`
HEIGHT
„ALLOWED PROPOSED
Ham.53
9
PROPERTY TAX ACCOUNT, PARCEL NO.
r
`�"•'
NEW RESIDENTIAL PLUMBING/MECH
COMPLIANCE OR
❑ ADDITION �❑ COMMERCIAL ❑ CHANGE OF USE
ry"' ❑ ❑ SIGN
❑REMODEL , `,`tr MULTIFAMILY
FENCE
❑ REPAIR CYDS ❑ ( X. . FT)
❑ DEMOLISH TANK ❑ OTHER
GARAGE RETAINING WALL { FIRE SPRINKLER
CARPORT ❑i.ROCKERY , ;; ❑ FIRE ALARM'
LOT COVERAGE ZqF1r
ALLOWED PROPOSED
O
0 �� 0
AlffidififfSETBACKS (FT.•);
FRONT SIDE ,REAR
:. ..(' %V
(�
.PROPOSED SETBACKS (FT.)
FRONT L/RSIDE REAR
�f� " /l/
i r ) i0 2 ,4
P RKING
REO'D PROVIDED
LOT AREA I PLANNING REVIEWED,BY DAT
REM R S
��- •"
c `
C
1�O
m
O
(TYPE OF USE, BUSINE A EXPLAIN ;
NUMBER NUMBEp OF CRITICAL
OF DWELLING AREAS
STORIES UNITS >'.`. NUMBE
CHE
`
TYPE:OF C ION * �` r
,°�
�'
,C E.
� , ;
OCCUPA
GROUP
SPECIAL INSPECTION
REOUIRED.0, YES
AREA w n�` ' i
d°: ,'
OCCUPANT
LOAD
DESCRIBE WORK TO BE DONE
r
REMARKS {
PROCa "too 'INSPECTIONS'PER'UBC"'1t18/FINAL INSPECTION REG'D
9
sa
m
Y A Ie e►1 �'1 I 11I \� `�f'dl/ / .fi,L� �'
- - . 1 _ _ -
Description
FEE
Description
FEE
Plan Check "�{
State Surcharge
t�b
y
+%�a
e
•
OPp %HEAT SO RCE LAZING % aLOT-
Building,�`erm
City Surcharge_
PLAN CHEC N VESTED DATE
•� D
Plumbing. A
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t BE DONE ON PRIVATE PROPERTY ONLY ANY CONSTRUCTION ON THE PUBLIC
Grading
7 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
. �
Engr. Review
PERMIT APPLICATION: 180 DAYS
d PERYIT LIMIT. i 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 Inspection
Receipt It
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
2
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
LandSCa IrIS
Pe p•
Total Amt. Due
= NOR LIMIT W ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
Recording Fee
Receipt #
I HEREBY GWEN IS CORRECT: AND THAT I AM THE OWNER, ORWLEDGE THAT I HAVE READ THIS THEAPPLICATION;
AUTTHo AUT
HORIZED AGEENTTIOF
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 Otticial 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 acknovAedged In space provided.
WORKMEMS SgMLENSATION INSURANCE AND RCW 18.27.
SIGNATUR ENT) DATE SIG ED
OFFIC IQNA DATE
A�%//
Azaj D
J142/�5)
7 1 -0220
lT
NW&W)R
e
EL ED BY ATE
ENTION
XW
EJ(T 1333
h
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
a�
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PIRf
NK • OWNER GOLD - ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN -ACCOUNTING
DATE RECEIVED
.
3 PERMIT EXPIRES
CITY OF EDMONDS
USE PERMIT
ZONE/S -
NUMBER
CONSTRUCTION PERMIT APPLICATION
JOB surrE/APT
ADDRESS
OWNE NAME/NAME OF BUSINESS
PLAT NAME/SUBDIV ION NO.
LOT NO.
UD N
LID $
I
LING ADDRESS
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
RW Pe Approved
Rermll Required
D/�
O
EXISTING PROPOSED
Street 4ee Petmq Req'd
nRegQ �
CITY ZIP
TELEPHONE
REQUIRED DEDICATION FT
a
underground
1 wiring required 0
NAME
METER SIZE LINE
SIZE
NO. OF FIXTURES
PRV REQUIRED
YES 1 NO 1:1
I
3
C
ADDRE S
REMARKS
=
V
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
zZ
W W
CITY ZIP
�// �.
TELEPHONE
NAME
jCBL#
ENGINEERING REVIEWED BY DATE
ADDRESS
Q
v
FlRE• .,REVIEWED BY DATE
W
CITY ZIP
TELEPHONE
tt
O
OVAt
,
% i
<
;.
VARIANCE OR CU
SHORELINE OR ADB# <'
:INSPECTION
REO'D
BOND
POSTED
STATE LICENSE NUMBER EXPIRATION DATE
CHECKED BY
w
]YES (]NO
,.
$
SEPA REVIEW
COMPLETE EXEMPT
814N AREA
ALLOWED - •PROPOSED
HEIGHT
ALLOWED PROPOSED
PROPFIM TAX ACCOUNT, PARCEL NO.
r <'.
❑ NEW 1/I�RESIDENTIAL, ;; ❑; PLUMBING/MECH
_. LOT COVERAGE
REQUIRED SETBACKS (FT),,
PROPOSED SETBACKS (FT.)
gLLOWED p,pOPOSED
;SIDE'''•REAR
FRONT UR SIDE REAR
O
COMPLIANCE OR
❑ ADDITION ❑ COMMERCIAL O
_
_
CHANGE OF USE ,
PARKING ;.
REO'D I PROVIDED
-,LOT Affk
PLANNING'REVIEWED BY DATE
❑ REMODEL <# ❑ MULTIFAMILY ❑ SIGN
❑ REPAIR ❑ GRADING ❑ PENCE
REMARKS
CYDS X
DEMOLISH ❑ TANK ❑ OTHER
GARAGE RETAINING WALL FIRE SPRINKLER
CARPORT ❑ ROCKERY ❑ FIRE ALARM
=
O
(TYPE OF USE, BUSINESS O ACTIVITY) EXPLAIN:
/
CHECKED BY
TYPE CONSTRUCTION
CO
OCCUPA
rrc
`
GROUP
NUMBER
NUMBER OF
CRITICAL
n
SPECIAL INSPECTION
OCCUPANT
m
OF
DWELLING
AREAS
O
STORIES
UNITS
NUMBER
REQUIRED ❑YES
JAREA
LOAD
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS'INSPECTIONS'PER 08C 108/FINAL INSPECTION READ
9
m
VALUATION
$
A _,
Description
_FEE
Description
FEE
Plan Check s
State Surcharge
HEAT SOURCE GLAZING % '-:. C, ''LOT,SLOPE %
,,
Building•Permit`•''tf City Surcharge.
¢;
PLAN CHEC O• VESTED DATE
.i ,�
Plumbing j
"f
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
2
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
W PERMIT APPUCATION: 180 DAYS
of PERMIT UMrC 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
WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Flf@ Inspection Receipt #
aEDMONDS,
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMTL ISSUANCE OF THIS PERMIT SHALL NOT BE
-1
9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscape Insp. Total Amt- Due
i NOR UMff IN ANY WAY THE CITY S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
Recording Fee Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE D THISTHE
GIVEN IS CORRECT AND THAT I AM THE OWNER, ORPTHE DU YTHAT AUTHORIZED AGENTTION 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 recelpt Is acknowledged In space proAded.
WORKMEN'S 9MWSATION INSURANCE AND RCW 18.27.
OF IALS SIG TUBE DATE
SIGNATU (OWNFR'�P AGENT) DATE SIG ED
(425)
771-0220
REL Y D E
ENTION
Off 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
04/02
PINK - OWNER GOLD -ASSESSOR
PRESS HARD -YOU ARE MAKING 5 COPIES GREEN. ACCOUNTING
ars(od:,
co ar��
SCALE: 1"'= 20.00
ANDERSON RESIDENCE
1006 CAROL WAY, EDMONDS, WASHINGTON 98020
SNOHOMISH COUNTY, WASHINGTON
ASSESSOR'S: PARCEL NO.
00 5927 000 012 00
OWNER
HOWARD AND LEANNE ANDERSON
1006 CAROL WAY
EDMONDS, WA 98020
LOT SIZE
14,810 SQ. FT.
LOT COVERAGE
3152 S Q . FT. --
PERCENTAGE OF COVERAGE
21.20 %
datum point
Top of sewer MH
= 100.00'
- -- - -- - _.. Carob Wa
PL=37.41 ,
EX. CB
RIM 101.75- TST
6" INV 101.08- 101.5'
PL=56.28,
o PL`32 •
FOOTING DRAINS N 1 — 4g 102'
TO BE TIED INT ,, o N
DETENTION SYST 02.5' ® _
RIM 10 .00 L
_ Mu 18� ROOF WIRES /c70/
` BUILDING gETSA-OVERHANGSI8' INV 101.4t
CB TYP£ l-L -- -- CK-LIN
RIM 1O5.00 _
I W/RESTRICTOR O _ X ��
r J~ 70'--18" SD 4'0.'5-r - —v -- co
- q1_
_.......__.._. TST111
6" INV 101.25 7
OWNER SHE ILL CONTACT
EDMONDS BUC WORKS rf CON , AL I j
® 425-771 0235 TO — —
VERIFY EXIS NG SIDE SEWER
STUB IS SU TA LE FO USE _ G I I
" C/O GJ/Go�1 t.ink tLrq 0 roof of existing home 1
- / —�_ I1
outline of existing home to CRAWLSPACE:
i I be demolished. Lowest footing I II j
r i i I PROPOSED RESIDENCE elevation: 106.5' I I FF
I - - 1- I -
Finished floor I 11 i o
elevation: 112.0' i 9 1
' o `n
SCE STABILIZED CON57RUC770N ENTRANCE. SEE ESD E1.2 CD
I `f �G II j j j j I CU � I L_I L-_
O R7L7ER FABRIC fXTRA77ON SYS7FM. SEE £SD El.I I �--------- - - - - - - I 1
C--��'--- r; I GARAGE: ---
LEG ra
PRESERVE EXIS77NG VEGETA77ON �' FF 1 Lowest footing I J
� �• rockery PS / � I elevation: 107.0' I I
TST TEMPORARY SEDIMENT TRAP FOR CATCH BASINS. SEE ESE E1.3 ¢ IZ
I fr. .��, top=111' MU �I Finished slab
PS PERMANENT SEEDING. _ I� bbtt -108' elevation: 108.75'
MU MULCH. I N / I -P V000
I I e� 7RENCHDRAIN
BY CUZ CoNCRE
I I VEG rockery
2'try W PROPOSED WATER & SEWER /
INSPECTIONS R 'I a CONCRETE
O N
DRIVEWAY I c�
CONSTRUCTION SEOU�NCE CAL 425-771-0220 SC£ o° 00000°°C°o°0°o
BUILDING SETBACK LINE �o o��°o o°0 '0 J
1. PRIOR TO ANY CONSTRUC710N ACTIVITY, THE CON77ZACTOR SHA I 0' Q° °o°o°o°o°o°o°o°o° X
SCHEDULE AND ATTEND A PRE -CONSTRUCTION CONFERENCE WITH IF - PL=100.00'
CITY OF EDMONDS.
IMPERVIOUS SURFACE AREA
HOUSE + DWY +WALK = 4813 SQ. FT.
DRAINAGE NOTES.•
1. 77E ROOF DRAINS & DRI WWA Y TO
SUBSURFACE DE7FN770N SYSTEM.
2. CA TCH BASINS (CB) SHALL HA ZE
LOCKING GRA7FS.
-102'
04'
-----• �06'
_ 11�08'
6•0
M
F;
c M
W
mr
A m
X
m 0
m
M to
m
vo
�L Cn
rockery z
0-2'tall ^� rn
v C0
cn< O
2. CLEAR FOR AND CONSTRUCT THE STABILIZED CONSTRUCnON
CE
Sewer MH'
s 109.75'+-
AI ley EXISTING GRAVEL
DRIVEWAY
TE ORARY CONSTRUCTION
ENTRANCE ROAD STABILIZA77ON TO GRADE.
=
ENTRANCE REQUIRED
- - -- -RIGHT-Ol 'WAY CONSTRU
J. INSTALL 'ALL FILTER FABRIC FENCE. FF
--- -
ANL INSPECTION R Q
ED
4. PRESERVE EXIS77NG VEGETATION. I/EG
I
1 ST 20' OF EXISTING
ALLEY TO,.5E PAVED FROM-
_
�y
112'
5. CLEAR, GRUB, AND GRADE FOR HOUSE, DRIVEWAY & UTILITIES.
_--
EXISTING EDGE OF PAVEMENT.
CONSTRUCT BUILDING & UT7U77ES
_.--„ ._- - - - "'
(PER ECDC 18.80.060C)
6. INSTALL TEMPORARY SEDIMENT TRAP FOR CATCH BASINS. QiST i
7. UPON COMPLETION OF THE PROJECT, ALL DISTURBED AREAS N T
BE STABILIZED TO THE S477SFAC770N OF THE CITY INSPECTOR. MU
APPROVED AS NOTED
BY. ENGIN 1NG
.no_
Date:..,,.Z
Receiver)
FEB - 6 2004
PERMIT COUNTER
2/5/2004 3:45:51 PM
�OA
RECEIVED
FEB 6 2004
PERMIT COUNTER
STREET FILE
''. A
radi q - d D ai - • -Plan
SCALE: 1" = 20.00'
ANDERSON RESIDENCE
1006 CAROL WAY, EDMONDS, WASHINGTON 98020
SNOHOMISH COUNTY, WASHINGTON
ASSESSOR'S PARCEL NO.
00 5927 000 012 00
OWNER
HOWARD AND LEANNE ANDERSON
1006 CAROL WAY
EDMONDS, WA 98020
LOT SIZE
14,810 SQ. FT.
LOT COVERAGE
3152 SQ. FT.
PERCENTAGE OF COVERAGE
21.20 %
IMPERVIOUS SURFACE AREA
HOUSE + DWY +WALK - 4813 SQ. FT.
DRAINAGE NOTES-
1. 77E ROOF DRAINS & DRI VEWA Y TO
SUBSURFACE DE7FN77CN SYSTEM.
2. CA TCH BASINS (CB) SHALL HA VF
LOCKING GRATES.-
datum point
Top of sewer MH
= 100.00'
CarobI -- - --. _ W aY
PL=37.41'
EX. CS
RIM 101.75- TST
6" INV 101.08- 101.5'
PL=56.28'
PL=32,46,
FOOT NG DRAINS NOT o N ` `— �- __ 102'
- TO BE TIED INTO 1 o2.s'
DET NTION SYSTEM vEc PS vEG CB I—L
RIM 1011.00
'U
_ 18" ROOF W/RES ICTOI
__ S
BUILp�NG - __�OVERHANGSI8' /NV f01.£i
I CS' TYPE /-LIFF _ _ . ETBACK tw - _ \
RIM 105.00 ,
I W/RESTRICTOR FF _- X L
18' /NV 101.25 TS r 70-18 0."51g`_.__ _ _._.. _ .._,. _. 13T - ti.__ , _ --
I 6" INV 101.25 �' I — ��
OWNER SHALL coNTAcrI FF
EDMONDS BUC WORKS J CON AL
® 425-771 0235 TO — —
VERIFY EXIS NG SIDE SEWER
STUB IS SUITABLE FOR USE G I j
C - e roof of existing home 1
(0" C,/o t0%LOCIC11-46,
�------- -------------------
- - - C�aOY�Iw✓ l------------
outline I
of existing home to CRAWLSPACE: j it 1
O I I I be demolished. Lowest footing I II j
I PROPOSED RESIDENCE elevation: 106.5' i 1 FF
Finished floor
I ; I elevation: 112.0' i I
c I I ► II _ W.
- _102'
_ --, -104'
SCE STABILIZED CONS7RUCTTON EN7RANCEE, SEE ESD E1.2 I CD !+ VEG III L II G- I II I �
O FX7FR FABRIC fJL7RA77ON SYSTEM. SEE ESD El. I /' Z@q
------------' ------ I I c:)
C f GARAGE: M z
VEG PRESERVE EXIS77NG VEGETA77ON CD �' FF I Lowest footing
84 S FIT PS �� elevation: 107.0' I 0 0
TST 7EYPORARY SEDIMENT 7RAP FOR CATCH BASINS. SEE ESD E1.3 T �• I rockery Q 1CL
PS PERMANENT SEEDING. -_ _ _„_ I ,.r ��� r .��, top=111' MU � I Finished slab I I
- _.. h / bbtt 108' elevation: 108.75'
MU MULCH. I N _ _ 1-t; C
CO 1 rockery d••�
I I el 1RENCHDRA/N 0-2' tall
BY CUZ CONCRE Ln 1�
/ VEG rockeI �I PROPOSED
0-2'toI w a CONCRETE
a M
I FF I I DRIVEWAY I c� i --
wATER & SEWER ,
0 00
I
S REO'D, I SCE o0 0°0 0 0°0 0�o I z
INSPECT ��� L--------------- 0 Q0 0 0 0 000 0 _� t�
c°-o°-o0' oOa
1. PRIOR TO ANY CONS7RUC770N AC77VllY, li�E CONT7Z4CTOR SHALL �4 o FX7 132� o BUILDING SETBACK LINE ooco000000ooco00000 X
CALL. 425-771- ...1 0 Q 0 00 0 0 0
IF
CITY OF EDMONDS. SCHEDULE ANDATTEND A PRE-CONS7RUCTION CONFERENCE WITH THE �MINION
t��ld�ALpG��A��PL-100.00'
2. CLEAR FOR AND CONSTRUCT THE STABILIZED CONSTRUC770N SCE Sewer MH" OF- STFA-JCtg i`tNt� E3t�tML TEMPORARY CONSTRUCTION
ENTRANCE ROAD STABILIZA77ON TO GRADE. s =-109.75'+- ND REO AY ENTRANCE REQUIRED
3. INSTALL ALL FILTER FABRIC FENCE. FF - -- `w' I
4. PRESERVE EXIS77NG VEGETA770N. VFG I I -'—IST 20' OF EXISTING
-
ALLEY_TOJ3E EAVED FROM_ -�..�- _ _ _ ___ __ _ _ ___ __._.-. _ 112'
5. CLEAR, GRUB, AND GRADE FOR HOUSE, DRIVEWAY & URLIRE5 - • - - -` -` EXISTING EDGE OF PAVEMENT,
CONSTRUCT BUILDING & UT7LlT/ES. __ ,_.-- - ---.. .-` ._I (PER ECDC 18.80.060C)
6. INSTALL 7FMPORARY SEDIMENT TRAP FOR CATCH BASINS. 7ST
7. UPON COUPLE77ON OF THE PROJECT, ALL DIST DRBED AREAS MUST
BE STABIUZED TO rhE S477SFAC77ON OF THE' CITY INSPECTOR. pS MU
APPROVED AS NOTED
le
� ENGIN RING ,
Date: Zf !! �D
R'E:CE7VED
FEB - 6 2004
PERMIT COUNTER
2/5/2004 3:45:51 PM
03-507
look */rvIWaLJ-
Recel
FEB
PERMIT COUNTER
T Y 0 p y