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10609 226TH ST SW.PDF/ iiiii I iiiiiii
3528
10609 226TH ST SW
ADDRESS: /4 — a,ZVJIC 5�-6
TAX ACCOUNT/PARCEL NUMBER: V7 0 J ?_S 003 ( �V
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS(RECORDED)FOR:
CRITICAL AREAS: 65 - (1 e) DETERMINATION: ❑ Conditional Waiver ❑ Study Required,.,�aiver
DISCRETIONARY PERMIT
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS (OTHER): q-3' 0 M 622 t . &.�/Y�(,�&9D
PLANNING DATA CHECKLIST DATED: I I I O
SCALED PLOT PLAN DATED: Ul 7510 3
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S)
SOILS REPORT DA'
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
L:\TEMP\DSTs\Forms\Street File Checklist.doc
N 88*21'060 W 1.50.06',
EXISTOqG HOUSE
J_
1'2
(E) DRIVE
m.
—ITIfNTIVURCH
z0vz?
AS NOTED ,
Data: �]j,
N MIV601 150.06'
' �IERICC�''�"�ri0 � �N DRAINAGE
iR
• RECEIVED
JUN 2 5 2003
PERMIT COUNTER
ul
APPROVED BY PLANNI G
-7
�TREE"i- FILE
C t W,� : t 5-( 2- . P�r-
20 ACCESS -------- A
EASEMENT 121& -7
(17. & cl.)
7LI
2. T ) :
LAC)C.L. 226th ST. S.W. "
SITE PLAN'
SCALE: 1"= 20'-0"
Critical Areas Checklist CA File No:
Site Information (soils/ topography/ hydrology/ vegetation)
1. Site Address/ Location: I b (o O 9
2. Property Tax Account Number: Z 70'3 2- S-00 302 10 O
3. Approximate Site Size (acres or square feet): S0 iA�prn Xi
4. Is this site currently developed? yes; no.
If yes; how is site developed? e s c oQ Jy� �Q
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).
Other (please describe): j
6. Site contains areas of year-round standing water: )y C ; Approx. Depth:
7. Site contains areas of seasonal standing water: ; Approx. Depth:
What season(s) of the year?
8. Site is in the floodwayfloodplainof a water course.
9. Site contains a creek or an area where water floAvs across the grounds surface? Flows are year-round?
Up Flows are seasonal? (What time of year? ).
10. Site is primarily: forested ; meadow ; shrubs ; mixed
urban landscaped (lawn shrubs etc) \l 4rS
11. Obvious wetland is present on site: On
Critical Areas Che dist.dW3.192001
City REdmonds
Development Services Department
Planning Division
Phone: 425.771.0220
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). .
Date Received: tOl0 U—:>
City Receipt #: o
Critical Areas File #: 2-603 .6
Critical Areas Checklist Fee: -1 00' l
Date Mailed to Auulicant
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 fording 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.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information 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 file application on the behalf of the owner as listed below.
SIGNATURE OF APPLICANT/AGENT
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 a t this application.
SIGNATURE OF OWNER DATE 3
PLEASE� PRINT CLEARLY
Owner/Applicant:
1M �" L2 v-ka s
Name
Jlb(oocl 22-(o sT Sk)
Street Address
q_otko- t W 1020
City State Zip
Telephone: LfZS- -� l 2 g Ll q
Email address (optional): M (P—S pl—& Z P . Cew
Applicant Representative:
Name
Street Address
City State Zip
Telephone:
Email Address (optional):
Critical Areas Checklist.doc/3.191001
e��+d FILE.
CITY COPY
I ------------
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6110
AREA OF RAISED
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EXISTING DRIVEWAY
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-----------'-------
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SITE FLAN Z�
V-3m'-m"
"Id L)
SEE ATTACHMENT FOR LEGAL DESCRIPTION
j i c- 5 71 2....
NOTE: THE HOUSE PLACEMENT ON THE
SITE IS NOT BASED ON A LICENSED
SURVEY BUT APIPROXIMENT PLAGEMENT
ON THE SITE
DISK No
DRAWN BY
RLE No
-
ADS
ANTHONY D. SHAPIRO, AIA ARCHITECT
A D SF f I
DATE:
CHECKED BY-
07/02/93
-
10609 226TH SW, EDMONDS, WA 98026
(206) 778-1530 FAX (206) 774-7803
REVISION No.-
PROJECT No
0 •
PLANNING DATA
NAME: G[S DATE: I 1 O
SITE ADDRESS: D D — 2 S PLAN CHK#: ©3 —
PROJECT DESCRIPTION:
REDUCED SITE PLAN PROVIDED? Ye No
MAP PAGE: CORNER LOT: es o FLAG LOT-4 Ces No
ZONING: PS " CRITICAL AREAS DETERMINATION
❑ Study Required:
Waiver
❑ Conditional Waiver
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
SETBACKS:
Required Setbacks: /
Street: Left Side: Right Side: ! Rear: 10
Actual Setbacks:
Street: Left Side: Right Side: Rear:
Street map checked for additional setback required? (Yes / No / DNA)
❑ DETACHED STRUCTURES:
❑ ROCKERIES:
❑ FENCES/TRELLISES:
❑ BAY WINDOWS / PROJECTING MODULATION:
❑ STAIRS / DECKS:
PARKING:. Required: Actual:
LOT AREA: sD 6 2
LOT COVE
BUILDING HEIGHT: ���' �,k6'v►o!� ,-� /p-f— /5f"R/ 2 Sf��'
Datum Point: Datum Elevation:
Maximum Allowed:_ 2�r' � .>� , (>(p Actual Height:_ 75
A.D.U. CREATED?: No / Yes
SUBDIVISION:
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: Yes / No
OTHER:
Plan Review By:
NewBPPlanningDataForm.DOC
CITY OF EDMONDS
us E PERMIT
zoNE NUMBER 93039t
CONSTRUCTION PERMIT APPLICATION
Oa ,..r/ UITE,A
ADDRESS OW D �'� 4/ �W
V
OWNER NAMEINAME OF BUSINESS
LEGAL DESCRIPTION CHECK
SUBDIVISION NO. LID
NO
�
MAILINGADDRESS
10601 2.2L �
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP
AWPermit
EXISTING REOUIRED DEDICATION Street
Approved ❑
Required ❑
Use Permit Req'0 ❑
CITY ZIP
�}�, S
TELEPHONE NUMBER
��•���
PROPOSED Inspection
Required ❑
Required ❑
NAME Q
Sidewalk
REMARKS
u ADDRESS
C .
)
CITY ZIP
TELEPHONE NUMBER
/'� -(— r—
1< U= n [I11 l "C''"-� 11 I7 tl li
NAME
E \l�
ENGINEERING MEMO DATED J - '
0 U UL�L_ i
REVIEW SY
I--
ADDRESS
METER SIZE -
BUILDING SUPPLY SIZE
SOMEONE
NO. OF FIXTURES
�
CITY ZIP
TELEPHONE NUMBER
3
REMARKS
STATE LICENSE NUMBER " " EXPIRATION DATE
SIGN AREA
ALLOWED PROPOSED,
SEPA REVIEW
COMPLETE EXEMPT
ADS NO.
Legal Description of Property - include all easements
'
+,
EXP
=L.
VARIANCE OR CU
PLANNING REVIEW BY
DATE
L
r
i
SETBACK$ '.FEET j." "'
J ! ,mod
FRONT' SIDE REAR,,.''
-• HEIGHT
LOT COVERAGE
u Property _.
-.
MARK
Tar o�i /� r1 Q — i'1/1
Parcelel No.. (,. i fr W
1.
NEW RESIDENTIAL �. PLUMBING
ADDITION COMMERCIAL MECHANICAL
VREMODEL 13 APT. BLDG. LJ SIGN �• •�
GRADING' FENCE
-. O CYOS. L-J..tTK_Fj1
REPAIR
CHECKED BY
TYP=3TRUCTION
CODE
HEIGHT /
DEMOLISH O INSERT TOVE r`I� 71 HOY TU4a°/SPA y
REECIAL OURED SDECJOR
AR � GROU
Y/Tw
LOCCU
ADPANT
GARAGE O WALU, j ; +„
a
, YES
KS
ARKS
, RENEWAL
CARPORT ROOKERY
1! (TYPE OFJISF BUSINESS oRACTIVITY) EXPLAIN: -s -•
PROGRESS INSPECTIONS PER USC 305
.
NU ER
O OF
toSTORIES. O
NUMBER OF
DWELLING
UNIT$ N
CRITICAL
AREAS /1/�
NUMBER
'
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
Z Z
FINAL INSPECTION REQUIRED
v
VALUATION
/�
GGJn'/ L ((aA Z�
PLAN CHECK FEE
BUILDING
MEAT SOURCE::
a1 60
GLAZING
A/0 eft IN)
PLUMBING -
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sldewPlks,
driveways, marquees, etc.) will require Separate permission.
GRADINGIFILL
STATE SURCHARGE
Permit Application:180 Days
Permit Limit: I Year - Prodded Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors In Interest, agrees to indemnify, defend and hold
v harmless the City of Edmonds, Washington, its officials,
a employees, and agents from any and all claims for damages of
h t I I I I I d l I f th I
ENG. INSPECTION FEE
w a ever nature, ar s ng d rec► y or n rect y rom a esuance
i
0 of this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirement of any city ordinance
FLAN CHECK DEPOSIT
.��'n
