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1016 GLEN ST
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RECEIVED
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IA L L-. W �`�' rEW C E- CCSPA f -f P9jC--,SS; ()R r , T&EAT�.I1 OEVELOPMENT SERVICES
- COUNTER
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City 1 Edmonds Building Department
APPROVED
r PLAN
*_ r:
()H, JOB .,
CITY OF EDMONDS
BUILDING . DEPARTMENT
WORK
ADDRESS _Y-25ll9 64ell
OWNER C,�Lic,
APPROVED DATE: 8.2
i3
BLDG. OFFICIAL
PERMIT NUMBER
-9-LD2o/3_670 l
RECEIVED ',.... • .
JUN 0 9 a995:;
PERMIT COUNTER
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PLANNING DATA
SITE ADDRESS: /19169 OL121 5'�, DATE: d S
ZONING: K5 -% PLAN CHK#: !?S —97—
PROJECT DESCRIPTION: l(�) X 2
SETBACKS:
Required Setbacks:
Front:4,0 Left Side: S Right Side:_5 Rear: IS
Actual Setbacks: ,
Front:/Left Side: Right Side: �Rear: / 5-
CORNER LOT J�f�
LEGAL NONCONFORMING LAND USE DETERMINATION, ISSUED
LOT COVERAGE:
Maximum Allowed: Z.b Actual:
BUILDING HEIGHT:
Maximum Allowed: 15 Actual Height: /2
SUBDIVISION:
CRITICAL AREAS #: "/ G
SEPA DETERMINATIO
LOT AREA: 0-I 4l -Z5
OTHER:
Plan Review By:
RECEIVED-.
Critical Areas Checklist MAY 2 2 1992
Site Information PERMIT COUNTER
Project Name: Permit Number:
Site Location: I Property Tax Account Number. ' S Go 00 2- v a 3 Q Q
Approximate Site Size (acres or square feet): 2
Have you filled out a Critical Areas Checklist for a project on this site before?
General Site Conditions
ND
1. Has the site been cleared or logged? 12 o Date of most recent action:
Soils / Topography
2. In the Snohomish County Soil Survey, what is the mapped soil type(s)? i
3. Describe the general site topography. Check all that apply. S' r t7
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 305,16 ( a vertical rise
of 10 feet of horizontal distance.)
Steep: grades of greater than 30% present on site.
Comments
Hydrology/Vegetation
4.. Site contains areas of year-round standing water: �^
5. Site contains areas of seasonal standing water. n Approx. Depth:
6. Site is in the floodway floodplain of a water course.
7. Site contains a creek or an area where water flows across the grounds surface? flows
are year-round? Flows are seasonal?
8. Site is primarily: forested ; meadow ; shrubs ; mixed
9. Obvious wetland is present on site: �
10. Wetland inventory or map indicates wetland present on site: ✓,
11. Critical Areas inventory or map indicates any Critical Area on site: fl. 0.
e9a-199
City of Edmonds
Critical Areas Checklist
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 a development -permit
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).
An applicant, or his/her 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.
Vrith a signed copy of this form, the
applicant should also submit a vicinity map
of the parcel with enough detail that City
staff can find and identify the subject
pareel(s). In addition, the applicant is
encouraged to include any other pertinent
information or studies in conjunction with
this Checklist to assist staff in completing
their preliminary assessment of the site.
I have completed the attached Critical Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant:
kZ r SIT4 1<!l
Name
Title
N
Zvi 6 6-
Street Address
City, State, ZIP
z f �.\
Phone
Applicant Representative:
Street Address /
City, State, PP \ Phone
Signature
`z
Date
Signature Date
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
14u R r S,''AR l<
MAILING ADDRESS
jut ( GLC ST n Cl i
CITY p ZIP TELEPHONE NUMBER
C6Mr��ijOS jZ'u1u-7-7y-o;Ll -i �
VAME
ADDRESS
NUMBER
NAME
NGf.JC
ADDRESS
CITY ZIP TELEPHONE NUMBER
STATE LICENSE NUMBER EXPIRATION DATE
Legal Description of Property - include all easements
7.Z
Tax Aecounl
SSGo-U v
Parcel No.
NEW
RESIDENTIAL
PLUMBING
ADDITION
COMMERCIAL
MECHANICAL
OREMODEL
1:1APT. BLDG.
SIGN
OREPAIR
O GRADING
O FE( NCE
CYDS.
K-FT)
El DEMOLISH
O OOOSINSERT
O SWIM POOL
TUB/SPA
GARAGE
RETAINING WALL/
CARPORT
ROCKERY
RENEWAL
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
I-
eslVLij ci
NUMBER
OF
I
NUMBER OF
DWELLING I
CRITICAL
JAREAS
C4i Z74
STORIES
UNITS
NUMBER
DESCRIBE WORV TO BE DONE IATTACH PLOT PLAN)
.
A T)otj A-" %,VJA-, w
ZONE �b PERMIT g4�S>3b
NUMBER
JOB SUITErJ
ADDRESS I C9 / L G L L- A j S(,
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCP APProved ❑
EXISTING REQUIRED DEDICATION
RW Permit Required ❑
Street Uae Permit Req'd ❑
PROPOSED
Inepeclion Required ❑
Sidewalk Required ❑
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
I
I
YES ❑ NO ❑
ENGINEERING MEMO DATED
REVIEWED BY
FIRE MEMO DATED
REVIEWED BY
w
SIGN AREA
ALLOWED PROPOSED
A
4
SEPA REVIEW
COMPLETE EXEMPT
�
E%P
AOQ� p
N (rij'
SHOR I e
VARIANCE OR
I
INN
VIEW BY
/ 0qE
FRONTSETBASIDECKS_ FEET REAR I ` J
GMT LOT
A� 5
C vE A�GEE Z
ARK
Vlw� nYpvCl,IVn nc� OCCUPANT
REQUIRED CIYES LOAD
MARKS
PROGRESS INSPECTIONS PER UBC 305
FINAL INSPECTION REQUIRED
PLAN CHECK FEE
HE SOURCE: GLAZING
BUILDING
/
A 1 FA
D/d
V
PLUMBING
Plan Check No. /7
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADING/FILL
Any construction on the public domain (curbs, sidewPiks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
r SO
Permit Application:180 Days
Permit Limit: 1 Year • Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
H
successors in interest, agrees to indemnify, defend and hold
J
harmless the City of Edmonds, Washington, its officials,
i
employees, and agents from any and all claims for damages of
=
whatever nature, arising directly or indirectly from the Issuance
of this permit. Issuance of this permit shall not be deemed t0
PLAN CHECK DEPOSIT
c
i
modify, waive or reduce any requirement of any city ordinance
nor limit in any way the City's ability to any ordinance
pD
enforce
_TOTAL AMOUNT DUE
JV2
provision."
I hereby acknowledge that I have read this application; that the
Information given is correct; and that I am the owner, or the duly
ATTENTION
APPLICATION APPROVAL
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
slate laws regulating construction; and in doing the work authoriz-
AUTHORIZES
This application is not a permit until
ed thereby, no person will be employed in violation of the Labor
ONLY THE
signed by the Building Official or his/her
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
Deputy; and fees are paid, and receipt is
do Insurance an
RC 18.27.
INSPECTION
acknowledged in space provided.
SIG TU IOWNER O
A E TI 1_ DATE Si NED
DEPARTMENT
LA„J.an
-a Ok,,, 7,
CITY OF
OTURE DATE F C l' SIG A
EDMONDS
-�
ATTENTION
CALL FOR
INSPECTION
DATE
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
l
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
_ 0220
�� l
ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
PINK — Ov.,er GOLD — Assessor
Q.11-rY OF EDv*,,',--,'NL--%13
9ZI-1 77 7Z WSEC 1994 BUlLDlf,',,!-,.J',
EFFECTIVE WORK
may h/j.✓dow
4-ml-94
•
ADDRES-0 ZO-I&
6 "A
m
cz�
ZONE
SETBACKS:
FRONT
SIDE
BEAR
OTHER THE
HEICHT
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
K(-"R7- STA(2
MAILING ADDRESS
fo�c� G6,
CITY n ZIP TELEPHONE NUMBER
NAME
ADDRESS 1 -
3 3 I (, ,`..C_ I �.
CITY ZIP TELEPHONE NUMBER
� c? Syrs.
NAMEO
CITY
STATE LICENSE NUMBER EXPIRATION DATE
ascription of Property - include all Basements
T- 3. 13(.cle "I ilI 1—y P—k
Property
Tax Account ��LU'UCJ�-UGr3 0c)o-1
Parcel No.
O
NEW ® RESIDENTIAL
PLUMBING
ADDITION COMMERCIAL
O
MECHANICAL
OREMODEL APT. BLDG.
El
SIGN
O GRADING
❑
FENCE
REPAIR CYDS.
x__FT)
DEMOLISH ❑ WOODSIN TOVE
❑
SWIMPOOL
HOT TUB/SPA
GARAGE r7 WALL/
CARPORT ROCKERYG
❑
RENEWAL
(TYPE O fF . BLZSINESIVITY&Aft
NUMBER OF STORIES
NUMBER OF
DWELUNG
'
UNITS
DESCRIBEWORK TO BE DONE (ATTACHPLOT PLAN)
C(1 U •'�16--� � )7G r Co ..Tc �o i.....
r�'�
r
USEPERMIT
/ Q
ZONE /_ NUMBER�Q�J�.I
JOB �b��
ADDRESS G
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved ❑
RW Permit Required -❑
EXISTING REQUIRED DEDICATION Street Use Permit Read ❑
PROPOSED Inspection Required ❑
Sidewalk Required ❑
REVIEW BY
BUILDING SUPPLY SIZE
ALLOWED PROPOSED COMPLETE JEXEMPT
_SHORELINE a
EXP
VARIANCE OR CU I /P INNING REVIEW BY DATE
�171 IQ
C
SETBACKS —FEET HE
LOT'77C,�OlV�ERAGE
FRONT SIDE ✓ I PEA S / p�
REMARKS
CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT
88 zl�s
SPECIAL INSPECTOR [AREAk I OCCUPANCY OCCUPANT
REQUIRED ❑ 7 GROUP 2 LOAD
VES 7 J
'91EMARKS
PROGRESS INSPECTIONS PER UBC 305
FINAL INSPECTION REQUIRED
PLAN CHECK FEE
BUILDING
HEAT SOURCE:
U �`. ILL U t a e. (
GLAZING
%
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADING/FILL
Any construction on the public domain (curbs, sidewPlks,
STATE SURCHARGE
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: i Year • Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
;'Applicant, on behalf Of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
successors in interest, agrees;t0-indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
employees, and agents from any-endall claims for damages of
PLAN CHECK DEPOSIT
awhetever-mllm, arising directly or indirectly from the Issuance
of this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirement of any city ordinance
nor limit in any way the City's ability to enforce any ordinance
provision."
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the
information given is correct; and that I am the owner, or the duly
ATTENTION
authorized agent of the owner. I agree to comply with city and
state laws regulating construction; and in doing the work authoriz-
ed thereby, no person will be employed in violation of the Labor
Code of the State of•Washington relating to Workmen's Compensa-
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
II n Insuiance. 11 I
INSPECTION
SIG ATU [OWNER OR IGEN
DATE SIGNED
DEPARTMENT
CITY OF
EDMONDS
AT ENTION
CALL FOR
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220
U
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his/her
Deputy; and fees are paid, and receipt is
acknowledged in space provided.
! � � yqe —
ELEAS DIY: DATE
ORIGINAL — File YELLOW — Inspector
PINK — Owrer GOLD — Assessor
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
rozd7
City of Edmonds S"M-iEET R L E
RIORATM WAY CONSTRUCTION
J A N 2 4 1992ERMITo. 0<ti n ' /' Permit Number: —o /
ENGINEERING %P ti,�� I pM" ,A' Issue Date:
A. Address or Vicinity of Construction: 1016 Glen Street
B. Type of Work (be specific): Install New Service
C. Contractor: Washington Natural Gas Company
Mailing Address: 815 Mercer Street,
State License #: Seattle, WA 98111
D. Building Permit # (if applicable):
Contact: Frank Swan
Phone: 224-2278
Liability Insurance: pond: $
Side Sewer Permit # (if applicable):
E. T❑ Commercial ❑ Subdivision ❑ City Project IM Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other
INSPECTOR: INSPECTOR: + � i� V J
F. Pavement or Concrete Cut : ® Yes []No (2) G. Size of Cut: 2 x 4 H. Charge $
1 @ Water ,1 To Crops_
APPLICANT TO READ AND SIGN- k - � Z
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeen, tharmay be made agai%srthezCity`Iq%Edmonds, or any of its departments or employ-
ees, including or not limited to the defense of any legal proceedings includin dejeiue costs, and attorneyfees by reason of granting this permit.
X I a p
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MA RtA FORA PERIOD OF O YEAR FOLLOWING THE FINAL /NSPECTTON
AND ACCEPTANCE OF THE WORK. ES77MA7ED RESTORATION FEES WILL.BE HELD UN77L THE FINAL STREET PATCH IS COMPLETED BY
CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO TH APPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Department- 771-3-202.
Work is to be inspected duffing progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and understand,the permit requirements and the pink copy of the permit will be available
on site at all times for inspection purposes.
Signature: Date: January 15, 1992
(Contractor o/ Agent y
CALL DIAI,A-DIG PRIOR TO BEGINNING WORK
IN PRIOR
Engrg. Div. 1991
FIELD INSPECTION NOTES (Fund III - Route copy to Street Dey.) r
`Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO
Partial Work Inspection by P. W.:
Work Disapproved By: \ Date:
FINAL APPROVAL BY: Date:
Eng. Div. July 1983
`e
Washington
Natural Gas
A VVWvKjtcn 5-W G-pany
� Mco C l,W e�-
IIIIVJTJ
Wa
un
Addendum to City of Edmonds
Right of Way
Permit Application
Submitted by: Kerry Walsh
Engineering Aide
Washington Natural Gas
622-6767 x2761
pager 969-1686
zD
I ju
P 0A- /� ��
815 Mercer St. (P.O. Box 1869), Seattle, WA 98111 (206) 622-6767
Side Sewer Drawing
The city Of EYimondB EASEMENT NO. -_-.--_..__------------------------------
z18-n4,1s0
NEW CONSTRUCTION [IREPAIRS ❑ LID NO- ------------------ ASMT. NO. ------------------
OWNER------- ED--- PARSONS ------------------------------------------------------------ CONTRACTOR-----------------------------------------------------------------------•-•-------- PERMIT NO. ----•---•-----------
JOB ADDRESS------1.0-1.6---GLEN---STREET-------------------------- LEGAL DESCRIPTION: LOT NO. ----------- -------------------------- BLOCK NO. ...... .---------------------------
uj
.j
LL.
i�
uj
..................I......................................... ----------------------------------------------------------------------------------- -------------------
NAMEOF ADDITION-----------------------------------------------------------------------------------------------------------------------
DYE TESTED ON SEWER
Approved:
PW4Ml-»ns (REV.tiuia) DATE -------------------------------------------- BY•-----------------------------------------------------------
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