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1040 B AVE.PDFIIIIIIIIIIIIII 10192 1040 B AVE 4u, , 2 ................... . ....... District City of Edmonds ---Water Department TAP CARD PU.L .2 1954 P.AIDDat......................... No......---...--- ................. No......:---------------------------------- MeterTap Size........................ Size----............._....................:. Mfgrs. 0 .......... ..... ... . ................ . Style ............................................ *Y ........... For.. .... .... .... � ........ P ......... ..... .. ................................. .................................... ...................................................................................... ...... ........ ................................................................................................................. . ....... . .............. LotNo ........................................... Blk. No.---..........................................:..... Add. ............................................................... ... ..... .......... Service Location .... ... *!7�0 - --------- ......................... .......................................................................................................................................... Mo-,ter 'Location ......................... * .............................................. ; ........................ Make Tap .................................................................................................................. Pressu're .............................. lbs. Test--....-----------................... % SendBills to ........................... ..................................................... ................................. : ......................... Dateof Work ....... .. Z.// .... ........................................... ........................... Foreman ......................... .......... ................... Guar. Voucher No ............................................ $ .......................................... Remarks: .................................................................................................................. ........................................ STREET ..... FILE ..................... . .............. .......................................................................................................................................... .......................................................................................................................................... OUTGOING Index .......... Reg ....... Route Bk --------- Stencil ...... Card --- INdOMINd Index .......... Reg ...... Route Bk ......... Stencil ------ Card. ....... . M.&I Chargeable to Installation MeMl NO. SIZE DESCRIPTION RATE ATIOUNT ----- ..... .......... -Meter ......... . ..... Meter Box i_::� . . ........... ... . ... .............. 3 .. Ir .......... . ... .......... Meter Plate ............................ .............. .. . ......... .......... .............. .......... Check Valve ........... . .... . ....... .............. . . .... . .. .......... .............. ......... Pipe, Galv. Screw .................. .............. . . ......... .......... .............. .......... Nipples .................................... .............. . ......... .......... .............. .......... Bushings .................................. .............. .. . ......... .......... ............... .......... Plain Ells ................................ .............. ...................... .......... _1 .......... St. Ells ------------------------------------ -------------- -- - -------- ---------- .......... . ... .............. ......... ............... ............... - ------------- ............... .............. .......... .......... .......... ................................................................ ............................................................................... ... .... .......... .......... Tees ......................................... ...................................................... ...................................................... ...................................................... ...................................................... ....................................................... .............. .............. .............. .............. .............. .............. I .............. ...................... .... . ...... .... . ...... ............ ............ ......... . ........ ... I I ........ I --- - ---- .......... .......... .......... .......... ........... .......... Material Chargeable to Taps Connected NO. I SIZE. DESCRIPTION RATE AMOUNT ..................... Pipe, Black Screw .................. ------------- *------ --------- .............. .......... Pipe, Galv. Screw .................. .............. ............. ......... .. *-/ ..... ..... r..-. Lead Connections . .r .... ............ Curb Cocks ................ .......... Corp. Cocks ........................... ....."...... ............. .............. ............. ... * -- - ....... ...... -7— -------- .............. .......... Unions .................................... .............. ............. ........ .............. .......... Saddles ............................ * ... .............. ..... ....... .............. ......... Nimles .................................... ............... ......... . .......... ............... ......... Bushings .................................. .............. ............ .......... ............... .......... Plain Ells 7 --------------------- " --------- ----------- --- ---------- .............. .......... Street Elli ........................... ... ............ .......... .. .......... ------- ...... .......... Tees ........................................... ............... ............ .......... 7 .............. .......... Curb Boxes ............................ .............. ............. .......... .......... ... .......... S. O. Extensions .................... .............. ............ .......... ............... .......... Gates ........................................ ........... ... ....... ........... .......... -3 --------- - !Yoo' Plugs ............... ...... ............... Couplings ........................... ............. .............. ...... ..... . ----- Gate Boxes .... . ....... .... . ............... ........ . .. ......... .............. ---------- .... ------------------------------------------- _V -- -------------- . . ......... ........... .............. .............. .............. .............. ............. .......... .......... . ........ .......... .......... .......... ........................................................... ........................................................... ........................................................... ......................................................... . ........................................................... ......................................................... . ............. .......... . ............. ............. ............. . ............... ........ ............. ............ ............. .. ... ... . ........ . ........ .......... .............. ............... ............... .......... ::::. .......... .......... . ........ -f. - ........................................................... ........................................................... ........................................................... Hours Tifiiel-Day Men ........ Hours Time —Monthly Men .. ............... ............... ............... ........... ....... ............ ............ ............ ............ . ........ . .... . .. . .... . .. . L ........ .......... Hours Time —Auto ...... * .......... ..... .............. j .......... Superintendence ...................... ... .............. .......... Total .................. i .......... . ... 0• ADDRESS: I �h_ TAX ACCOUNT/PARCEL NUMBER: BUILDING PERMIT (NEW STRUCTURE): COVENANTS (RECORDED) CRITICAL AREAS v/ 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: NQ lb&b SEWER LID FEE SHORT PLAT LID #: LOT: BLOCK: SIDE SEWER AS BUILT DATED: I,>t AJ.., k5l q 1_ 1 SIDE SEWER PERMIT(S) #: co GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT WATER METER TAP CARD DATED: OTHER: L:\TEMP\DSTs\Forms\Street File Checklist.doc CITY OF EDMONDS f -� �LIC WORKS DEPARTMF� R INSPECTION CALL�e SIDE SEWER PERMIT 7-7�5-2'52=5, Ext. 2=2-' Issue Date / 71 PER"IIT MUST BE POSTED ON JOB SITE * f �DMolvt75 1. Address of Construction Ic(4O r�0C .r Fo� TREATMENT, PLANT 2. Property rLegal Description (include all easements) Vim i IL Y <<.r 3. Single Family Residence. Multi -Family No. of Units Commercial 4. Owner and/or(' -Builder) 5. Contractor & License No. -7 6. Invasion into City Right -of -Way: No Yes (If Yes Right -- way Construction Permit Required - Call Dial Dig (342,40144) bef excavation) . 1-800-454-5555 d E4 7. Cross other private property: Yes No ><, Easement required m attach legal description and county easement number. H w READ THE FOLLOWING AND SIGN: a. Property owners must obtain a permit to install side sewers their property. A licensed side sewer contractor must be employed to construct side sewers in the public right-of-way. w b. The side sewer contractor assumes full reponsibility for each H installation for one year. aC.Commercial establishment requires a minimum of a six inch (6") :4 side sewer line. o d. Side sewers may not be installed closer than thirty inches (30") to any structure. e. Side sewer lines must be laid at a minimum grade. of 2% (1.150) 0 andmaximum grade of 100% (450) . 0 H f. No turn in side sewer greater than 45 (1/8;bend) is0allowed between cleanout. All 90 turns must be constructed of a 45 (1/8 bend) and wye with removable cap. g. No down spouts, footing drains or floor drains can be connected to side sewer system. h. Pea gravel is required for bedding when installing sewer lines through other than granular soil. i. Cleanouts are required at 30"-60" from each plumbing.exit line and at minimum intervals of 100' along sewer'line run. j. 'Trenches within City right-of-way must be restored to original conditions. Contractors shall be responsible for right-of-way failure due to poor compaction of fill. k.. Side sewer must be left uncovered until inspected and approved by the City. 1. Inspection during normal working hours only. Two (2) working days notice required. DATE: i I ? I g7 <;Ld -- I certify teat I have read and shall comply with the above i PERMIT FEE: �?[�' DISAPPROVED By: Date: w �.-;�i.:;:�.. B Date: o CONNECTION FEE: APPROVED By Date: -2 8 w * PERMIT MUST BE POSTED ON JOB SITE Side Newer Drawing The City of Edmonds EASEMENT NO. ------------------------------------------- NEW CONSTRUCTION ❑ REPAIRS ® LID NO- ------------------ ASMT. NO. ----______----_ OWNER----------------------------------------------------------------------------------------------- CONTRACTOR --- ------- ------------------- PERMIT NO. ,SOB ADDRESS -�� Q--------B.---AVF-------------------------------- LEGAL DESCRIPTION: LOT NO. -------------------------------------- BLOCK NO. --------------- -------------------- w -tom EDMc NID TREATMENT PLANT NAME OF ADDITION --l------------------------- - I 1,040 B-o vF-. 1 NOR-r-44 9, 1111 to ALLe%;f Approved: pp DA11.4-1�,. �1--191------- 1, pww-ooa�-��n� ta�v.»r�s� ,�C i APPLICATION for The City of Edmonds SIDE SEWER PERMIT EASEMENT No-.......................................... NEW CONSTRUCTION ❑ REPAIRS 107-05600 OWNER--------- Jack ... Jamison --------------------------------------------------------------------- CONTRACTOR........----------.......------.............----.....------.....------------...................... PERMIT No. ........... .......... ADDRESS ...... 1•Q...B..•S'.-r-ee-t........................................................... ------ LEGAL DESCRIPTION: LOT No. .............................................. BLOCK No. ........ -.................................... 0 W J L'L F- W W H Ca NAME OF ADDITION ........... DYE TESTED ON SEWER JULY, 1972 Approved: DATE................................................ By......-----.....................--------------••--......-•--.......... City of Edmonds Site Classification Worksheet Page 1 of 2 The project's Site Classification will dictate the specific stormwater management requirements applicable to your site. Completing this worksheet will help determine the amount of regulated impervious surface and whether your project falls into the classification of a Small Site (Category 1 or Category 2), or a Minor Site. Please reference the Glossary (pp. 10-11), Figures D and Epp. 8-9), and Examples (pp. 11-12), to assist with completion of this worksheet. 1) Is Permeable Pavement' Proposed For Use on this Site? ❑ Yes ❑ No Refer to Stormwater Supplement Chapter 5.1 If YES, the subject area is to be considered impervious for initial site classification purposes. Include total permeable pavement area in the calculation of Non -Regulated, Replaced and/or New impervious surface areas in the table below. 2) Determine the Amount and Type of Existing & Proposed Impervious Surface for the Site Refer to Stormwater Supplement Chapter 2 and Fig. C Line 1: Identify the Non -Regulated Impervious Surface Area. . Line 2: Identify the Replaced Impervious Surface Area, dividing the total between Exempt and Regulated; either or both may be zero. Note: For project classification purposes, Replaced Impervious may only be considered exempt under certain conditions. Refer to the Glossary and Figure D. . Line 3: Identify the New. Impervious Surface Area for your project. All impervious areas created post -July 7, 1977 or after the date of annexation into the City are regulated & should be included in this total unless they can be categorized separately as a Replaced -Regulated area. Line 4: Enter the sum of the total Replaced -Regulated plus the total New impervious areas. Line 5: Identify the total area currently mitigated by an existing city -approved stormwater management system. Line 6: Enter the sum of the value in Line 4 less the value in Line 5 to identify the total Regulated area in which stormwater controls have not yet been applied. Line 7: Identify the total area proposed to be mitigated through the use of Low Impact Development Techniques. Line 8: Identify the total area proposed to be mitigated through conventional Stormwater Management Techniques. ** Provide a copy of the following table on the drainage plan sheet for the proposed project ** Line Type Area (square feet) 1. Non -Regulated x Exempt Regulated 2. Replaced �a 7, . 3. New (Post 1977) 44 4 4 4� -i � � + T� d`� i�g: swwsww.+sewwwwwwawwwwwwwwwwwswwwwww✓wwww.wwwwwwwwwwswwswwwwwv 4. Total Regulated Impervious Area _ _ a h -�6,11 Mitigation required i in excess of 2000s '?. _. ,? ,1 5. Total Area Mitigated by Existing Stormwater Management System(s) -. vwwwww 6. owe--------------s----- v®noso. �ncoio----------------- -- Regulated Area Not Yet Mitigated 7. Area Proposed to be Mitigated by Low Impact Development Techniques 8. Area Proposed to be Mitigated through Conventional SWM Techniques = IIWO t (e.g. porous asphalt, porous concrete, paver blocks; concrete open celled paving grids, or plastic lattices filled with turf or stone). Revised on 310512012 E72-SWM _Erosion_Control-03.05.12.doc P.RDf -P24 2013 PREET FILE DEVELOPMENT SERVICES CTR. CITY OF EDMONDS City of Edmonds °�E°M Site Classification Worksheet _ Page 2 of 2 3) Determine the Total Area of Land Disturbing Activity sf Refer to Stormwater Supplement Chapter 8 4) Determine the Quantity of Grading, Fill and/or Excavation to cy 5) Will the project convert 3/ Acre.or More of Native Vegetation to Lawn or ❑ yes © No. Landscaped Area? 6) Identify the Watershed the Existing Site Runoff Discharges to Refer to Stormwater Supplement Chapter 2.3 Based on Site Location and Watershed Map — Figure-C. Check all that apply. r A. ❑ Direct Discharge B. ❑ Creek or Lake Basin ❑ Edmonds Way Basin ❑ Puget Sound Basin ❑ Puget Sound Piped Basin DETERMINE PROJECT CLASSIFICATION USING THE INFORMATION ABOVE AND THE PROJECT CLASSIFICATION CHART (Figure B, pg 4) O� Small Site - Category 1 ❑ Small Site - Category 2 ❑ Minor Site Stormwater Supplement Stormwater Supplement Stormwater Supplement Chapter 5 Chapter 5 Chapter 6 Revised on 310512012 E72-SWM _Erosion_Control-03:05.12.doc Page 6 of 12 PLANNING DATA SINGLE FAMILY RESIDENTIAL STREET FILE Name: b w- So Date: Site Address: l IDLt 0 J 2 Tax Parcel DO C 1� q D C7 9 D D 1-) D Project Description: s �� c� �� 0 V,- Plan Check #: Reduced Site Plan Provided: QYE/ NO) Zoning: T-C>_ L Map Page: Corner Lot: (YES CNDO Flag Lot: (YES Critical Areas Determination ❑ Study Required Waiver SEPA Determination: Exempt ❑ Needed (for over 500 cubic yards of grading) ❑ Fee ❑ Checklist ❑ APO List with notarized form Required Setbacks Street: a Side: Side: Rear: r 5� Actual Setbacks Street: Side: Side: Rear: v ek,s ❑ Detached Structures: ❑ Rockeries: ❑ Fences/Trellises: ❑ Bay Windows/Projecting Modulation: Stairs Deck: Bui/din Height Datum Point: wa f Datum Elevation: tD U Maximum Height Allowed: Actual Height: Other .Parking Required: Parking Provided: Lot Area: Maximum Lot Coverage: 35% Proposed: Lot Coverage Calculations: g �- ADU Created: (YES / Subdivision: Legal Nonconforming Land Use Determination Issued: (YES / Comments Plan Review By: Planning Data Forth W-14-09.doc PLANNING DATA STREET FILE Plan Review By: Planning Data Form 07-14-09.d« r t- 2. N0710E: NO WARRANTY OF ACCURACY. The in shown on the aftached map was compiled for use by the City of Edmonds, its errp!cyees and consultants. The City of Edmonds does not warrant the of anything set forth on the map. Any person or entity reques,;;?rg a cc,jy should conduct an independent Inquiryregarding the Infori•m2ion shop^,:; cn the neap, including, but. not limited to, the location of any seu^ r stub shok^rri. Such sevier stubs may or may not east and may or m_y net e;,kt Lt the location shown, Neither the City of Edmonds nor its empjoyacs or. ofhcc."s shall be liable for the information given on this map, nor for €ny orc.i representation provided based upon said map 'IAJ O d td L ' Z C n O z � r R •} tj �7 � S3''•,{tY jj Jy ��y t :�!t e3;d:$'6.3:':1�, r - 1 tS /w.z,� r . - . x�. if ,...�. P7'�y >r', ^`. iv.�rin `"' ; r +, A -r - -F- �� 7 Y { fF,r•�r St"Sbyd. ' �+;�-.!° ' :e' .i � C t r... ` Faf"+(4 FTta.1.R�W15.a('.� 'S.i �i, 9?-��3i•Yfi.t't � n � �� y, �,,.:Qx`. .� t•c�i. ..$) ^.•a.=��4 •c` 'y { t• i -�i ri0•�� :'-�'4'iY^. - .�'+l ..�'.`i�'s�t {�7F�' ::.'!� �.{3'Q •�-3'�!+i� %.�t,�. t �`}.�.. .7 t �.t� - - OWNER/CONTRACTOR IS RESPONSIBLE FOR EROSION CONTROL AND DRAINAGE t 2>~I •D� I 77 a a � 41� � �C � irES • ;p acoil � w � '�' •o � x. .L DIZIV t mil' �A-ru M T 5�5g Ci$�I/ w IOD•b� Zee A" rL1 0 Applicant shall repok/replace all damage to utilities or frontage Improvements in City right-ol-way per City standards that is caused or occurs during the permlited project. PROJECT ADDRESS: 1040 B AVENUE EDMONDS 98020 OWNERS: MARK THOMPSON JULIE WEST 21303 52ND AVE W MOUNTLAKE TERR. 98043 206-661-2605 mark justin@comcast.net TAX NO: 0061 9400 400401 LEGAL: YOST'S 1ST ADD TO EDMONDS PLAT OF BLK 004, D-01 N V2 OF LOT 4. PROJECT: ADD 240.5 SQ FT TO LOWER LEVEL FAMILY ROOM EXTENTION WITH FLAT ROOF. ADD SMALL CONC PATIO OUTSIDE ADDITION. (61 SQ FT) REPLACE REAR GRAVEL AREA WITH GRASS (480 SQ FT). LOT SIZE: 60' x 125' = 7,500 SQ FT. ZONE: RS-6 HEIGHT CALCS: DATUM: WATER METER LID 100.0' A. 97.' B. 98' C. 89' D. 90' 374 4 = 93.5 FT AVERAGE 93.5' + 25' = 118.5' MAX PROPOSED. 98.5' IMPERVIOUS: PRE-1977 : RESIDENCE/GARAGE, DRIVE, FRONT PATIO —WALKS; : 3,741.5 SQ FT 49.8 % POST- 1977: LOWER ADDITION: 241.5 SQ FT CONC PATIO 61. SQ FT + 301.5 SQ FT 4,034, SQ FT 53.9% REMOVE 480 SQ FT GRAVEL to GRASS: REMAINING: 3,554 SQ FT. 47,4% GRADING: 10 CU YDS. CONTACT DURING PERMIT PHASE: HANSON DESIGN KRISTIN HANSON 652 ALDER STREET EDMONDS 98020 425-774-7129 hansondesign@hotmail.com Zone R5- b Corner.Lf-Flamm% Seta .backs &g, lured Ac,_ �w Front n 0 Sides N 15l o ho Rear 1 �_ Other IieiWt a� CONTRACTOR: SEAN HELLEREN THE WAY Co. SEAN HELLEREN CONSTR. 15008 43RD RD NE M.ARYSVILLE WA 98271 425-239-6211 ptrwnc(cr�,hotm ai l . com LIC: WAYCOWC 888P2 exp. 10-22-2014 STRUCTURAL ENGINEER: ALEX MOROSEOS, PE CUSTOM DESIGN & ENGINEERING, INC 11006 60TH AVE W MUKILTEO 98275 425-343-7517 alexm@cdengr.com P OVEI) B PLANNINO NmOWrjUS in ai 8�g a�o ' lt�l rP f an unuy exwn* iliegel, U(ffio snare o or unpemutted building, structure nonconforming or site condition which is outside of whethe on�tlue hermit application, cogs, building, stnrchm or condidon is sh or site plan or dra %j � f a rate condition may th e�memee►t action. 7 0 APP72F17/ ERIN% u/3 R.