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10120 240TH PL SW
ADDRESS: Z" 6l'�
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS: DETERMINATION: ❑ Conditional Waiver Study Required ❑ Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE S: LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S).#:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
LATEMP\DSTs\Forms\.Street File Checklist.doc
SKETCHI&REA TABLE ADDEN&M
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Obtain Electrical Permit from � IL t
--State .Labor, &Jgd.ustri�-.. in this permit approva
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MAR 14 2007
BUILDING DEPT,
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LPAN ,
AREA
CALCULATIONS
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Subtotals
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PLANNING DATA STREET FILE
SINGLE FAMILY RESIDENTIAL
Name: 0/ Wr
Date:
Site Address: 10 120 _ �?-Yo4 Tl SVV
Plan Check #: f;1o7 -0"9
Project Descriptions
Reduced Site Plan Provided: (YES / NO) �0% SCE oning: 5 _
Map Page: QG 3
Corner Lot: (YE
Flag Lot: (YES O)
Critical Areas Determination #:�.� -4v ;x pwla.<<d
❑ Study Required /t /0 ext S-h a S�44- 4A na f - /-a
❑ Waiver V C �'t
SEPA Determination:
;Pff�" xempt
❑ Needed (for over 500 cubic yards of grading)
❑ Fee ❑ Checklist ❑ APO List with notarized form
Required Setbacks
Street: Z�
Side: S /
Side: - 1 5 /
Rear: ! s
Actual Setbacks
Street: /
Side: I
Side: MO Gh
Rear: � `o G�
PKpetached Structures: $
❑ Rockeries: f �Z(Se--
❑ Fences/Trellises: �LS /'l' " t l ) �a'o ` So 1-f
❑ Bay Windows/Projecting Modulation:
❑ Stairs Deck:
Buildin Height
Datum Point:
Datum Elevation:
Maximum Height Allowed:
Actual Height:
Other
Parking Required:
Parking Provided:
Lot Area: (%. �jG�G�L - J�l'IoCO %'eGO
Maximum Lot Coverage: 35% Proposed:
Lot Coverage Calculations:.�s
ADU Created: (YES &D
Subdivision: � O-YV 1 �G _-IOYy�� /VO Z /W,041— Q 16'
Legal Nonco forming Land Use Determination Issued: (YES / NO)
Comments
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Plan Review By: py� //, Planning Data Form 04-I1-06.doc
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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 map(s), nor for any one representation
provided based upon said map(s).