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111 OLYMPIC AVE
TAX ACCOUNT/PARCEL NUMBER: 4?D4 0 - C)40 0 2- 1 c-)006
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS:8(l Q- - blafl DETERMINATION: Conditional Waiver 0 Study Required 0 Waiver
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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 $:
LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S).#:--7&q,;L,
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER: Wr-11 - cla= - R
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APPROVE BY PLANNING
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Zone -------- P-g -�
I Comer
'Flag
Setbacks
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Actual
Front
7-0
Sides
5
Rear
15'
Other
Height
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SIREET FILE
NAME: Av,(Am DATE: 1-6 1
SITE ADDRESS: it I ol!jr-Rc- 4-,e-, —PLAN CHK#: O�-Z4S-1- 1302001, oi
PROJEC T DESCRIPTION: E-n-ZLow &r*k "1AA hu I
REDUCED SITE PLAN PROVIDED?-4;Y:e�s�/ No)
MAP PAGE: CORNER LOT: (Yes FLAG LOT: (Yes
ZONING: CRITICAL AREAS DETERMINATIONM 1952'12,9
Ll Study Required-
L3 Waiver F.4r-PA, 1 2&
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LdConditional Waiver 5 jpA -( h -ql 0,4 k§U'" - Pul N 11.M 4�ej A., 4*^,,$A
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L3 Fee
Lj Checklist
nADA H.6 —1 —f—i—A f^r—
"7z. &r";.:�
L3(Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger)
La Exempt
SETBACKS:
Required Setbacks:
Street: 2W Left Side: 5 Right Side: S' Rear: IS7
Actual Setbacks:
Street: ?-4.5' Left Side: 2-5' Right Side: Rear:
Street map checked for additional setback required? (M No / DNA)
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DETACHED STRUCTURES: ^6� 5
ROCKERIES: 1.
FENCES[TRELLISES:
BAY WINDOWS / PROJECTING MODULATION:
STAIRS / DECKS: Iq j.;", FPWj"W f4j'K, 04A prr— N h'V �A,�A ie+; A,,D (k4A f�v-
5" "0
PARKING: Required: 2- Actual:__r 11U,� P !/1 tI. A':�
LOT AREA:
-)4o
LOT COVERAUtz: 749
Calculations, A , 9 4,o
BUILDING HEIGHT:
Datum Point: pawcr pgu a Datum Elevation: lab.
Maximum Allowed: Actual Height: 2- 1. 5 L!Et� VA kw-e re 44,*
A.D.U. CREATED?: No / Yes) v
SUBDIVISION:
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: ffaLl-p-roy
173b, U.S. 1.
Plan Review By:
NewBPPIanningDataForm. DOC
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0 RECEIVED
Critical Areas Checklist .1111 0 9 1992
Site Information PERMIT COUNTER
Project Name: Permit Number.
SiteLocation: 111Z J06','J" �Og_ Property Tax Account Number 54197-QQ0-AaL
I I - - q -
Approximate Site Size (acres or square feet):
Have you filled out a Critical Areas Checklist for a project on this site before?
General Site Conditions
1. Has the site been cleared or logged? Date of most recent action:
Soils / Topography
2. In the Snohomish County Soil Survcy� what is the mapped soil type(s)?
3. Describe the general site topography. Check all that apply.
Flat: less than 5 feet elevation change over enti rie' site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10 feet over a
horizontal distance of 66 feet.)
11illy: slopes present on site of more than 15% and less than 30% a vertical rise
of 10 feet of horizontal distance.)
Steep: grades of greater than 301% present on site.
Comments
Hydrology/Vegetation
4- Site contains areas of year-round standing water
5. Site contains areas of seasonal standing water. 0() --Approx. Depth:
6. Site is in the floodway floodplain of a water course.
7. Site contains a creek or an area -re water ' flows across the grounds surface? fi—Eflows
'whe
are year-round? �J D Ylows are seasonal?
8. Site is pri'marily: forested meadow -shrubs mixed e- J I&A,
9. Obvious wetland is present on site:
10. Wetland inventory or map indicates wetland present on site:
11. Cn-tical Areas inventory or map indicates any Cnitical Area on site:
I/
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9
City of Edmonds
Critical Areas Checklist
The Critical Areas Checldist 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. I
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. no information needed. to
complete the Checklist should be easily
available fi-om observations of the site or
data available at City Hall (Critical Areas
inventories, maps, or soil surveys).
An applican% or his/her representative, must
fill out the checklist� sign and date it, and
submit it to the City. The City will review
the cheddist, make a precursory site visit,
and make a determination of the subsequent
steps necessary to complete a development
permit 4plication-
Mrith 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 thesubjcct
parcel(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:
Narne
Titte
Street Address
City, State, ZIP . Phone
Applicant Representative:
_�)'a 5'10 14 6. ro L9
Name
Titte
7qO:z
Street Address
K- -4, r) i U)A- 6 7,�-034
City, State, ZIP Phone
7 - 9)
Signature Date Date
S�ignature
0 0
City of Edmonds
Critical Areas Determination
Applicant: I Full Circle Design Group I Determination #: I CA-92-129 I
Project Name: I Rodig I Permit Number: I I
Site Location: 1 1112 Olympic Ave. Property Tax Acct #: 1 5489-000-019-12
Project Description:
Waiver Criteria (all criteria must be found. to apply):
xx There will be no alteration of the Critical Area or its required buffers;
xx The development proposal will not impact the Critical Area in a manner contrary to
the goals, purposes, objectives and requirements of the Critical Areas ordinance;
xx The development proposal meets the minimum standards of the Critical Areas
ordinance;
XX The above findings are based on the following conditions of approval:
1. The applicant must follow the requirements of the Building Official for
construction on steep slopes
2. The applicant must follow the requirements of the Engineering Division for
erosion control
Based on the above findings and conditions, the requirement for a Critical Areas Study
associated with this development permit is h
,qreby Waived, as authorized by Chapter
20.15B. 150 (B) of the Edmonds
S"hen F. Bullock
Name
July 16, 1992
Date
The City of Edmonds
Water Service Drawing
EASEMENT NO . ............................................
'R F- Loc--.-n o N
NEW CONSTRUCTION REPAIRS LID NO . .................. ASMT. NO . ..................
OWNER................................................................................................ CONTRACTOR .................................................................................... PERMIT NO . ....................
JOB ADDRESS ... ii.l ........ O-L. % J.Mplc ........
............ LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ....................................
NAMEOF ADDITION ............ I ...........................................................................................................
i I I OLtIMPIC AVF-.
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15
r= 9 1 ST.
3/411 P.Q.
NSW
1" 160 Psi -
Ous tA-TR./SC--Ftj"
b 0—
*-� NOR-rH-- =..- 0
Lllj P-I\ P I C- Ib"N E Approved:
L� j .9 .. / ...................
-11/75(REV.11/78) DATE A .151.5 .... By ..............
JREQ&
S
NIT of EDMOODS MAY'5 1981: 1 W., P El M" I T
Inspection Call 771-3202 PERMIT No.
PUBLIC'WORKS
struction:
Address of Con,
Property Legaa. Descriptilb�n (Inclu : de' all. easements):,, 0125,
4YOwner Builder: Awmwl
and/or
Contractor & License No: k77 -5- 12V klwt t6w_
Singie Family Residence
EDMONbDs
Mufti -Family (No. of Units
=TREATMENT
TM T P
PLANT
Commercial (No. of fixture Units
Invasion into City Right -of -Way: No Yes (If
Yes, Right -of -Way
Construction Permit required. Cal I One-Cal-1 -Center- (1 -800-424-5555)
before 'any
excavation.)
Cross other Private Property: No Yes' (If Yes,
easement required,
attach'legal description and county easement number.)
PLEASE READ THEITEMS LISTED ON THE BACK
-1
certify that I haveread and shall comply
Date
with the items listed on the.back.
.:dl
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C)
a)
Of
Permit Fee: 30- 00 Issued By:
.Trunk Charqe: 2-5:00 Date Issued: 40LJO-7
Assessment Fee: Receipt No.:
Partial Inspection: Comments ---Ua—te Initial
Final Inspeciion Approved:
.Date. Initial
v
Reaton N(D-F A�VrtF-r'e:)
PERMIT MUST BE POSTED ON JOB SITE
Wh-ite Copy - File Green Copy -7—Inspector
Rejected:
Da�tb t
Buff Copy - Applicant
The City of Edmonds Side Sewer Drawing EASEMENT NO - ----------------------------------------- 4-
A
NEW CONSTRUCTION F-1 REPAIRS R-,-' LID NO - ------------------ - ASMT. NO - ------------------
I
OWNER------------------------------------------------------------------------------------------------ CONTRACTOR ------------------------------------------------------------------------------------ PERMIT NO.(Q-� ._(,o_q_l
JOB ADDRESS --- ------ ................ LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO - ------------------------------------
PWW-0001-11/75 (REV.11/78)
NAMEOF ADDITION -----------------------------------------------------------------------------------------------------------------------
Approved:
DATEJ
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EW00ND
TREATMENT PLANT
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............ By ------------------------------------------------------------
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CITY OF EDMONDS %041 9 U U 6— LL= 8 U U It_ &M Permit No'.
, X C, g
COMMUNITY SERINCES, DEPARTMENT Issue Date 1'4'- 9 1
RIGHT - OF - WAY CONSTRUCTION "PERMIT ,A Al 4 All"
A. *,Owner: W. W. Thomson ENW'Fonntractor: 01c3r-;.*01vmnJe-1_ Tnc,
Name Name
1 1010 Olympic Ave. P.O. Box 180
MailiaAddress Mailing Address
E onds., WA 98020 Lvnnwood. WA 99046
City State Zip City State Zip
OLDSO 317BO (206)778-31;4
State License Number Telephone Number
9 Address or Vicinity of Construction: 111 01yrn-pic Ave., Edmonds. WA
Type of Work to be Done: Asphalt Paving.
Work in Connection With: El Sub or Plat 9 Single Family 0 City Projects
El Commercial 0 Multifamily El utility
Pavement Cut: 0 Y E N
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to 'hold the City of Edmonds
harmless from any injuries, damages, or claims of any kind or description whatsoever, forseen or unforseen, that may
be made against the City of Edmonds, or any of its departments or employees, including or not limited to the defense
of any legal,,proceedings including defense costs, court costs, and attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE
YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK.
Funds held from the Security Deposit (estimated' restoration fee) 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.
• A 24 hour notice is required for inspection; Please call Public Works: 771-3202
• Work is to be inspected during progress and at completion.
• Restoration to be in accordance with City Code.
• Street to be kept clean at all times.
*Traffic Control to be in accordance with City regulations.
o All street -cut ditches must be patched with asphalt or City approved material prior to end of working day;
no exceptions.
I understand the
Signature:
that this permit must be available at the job site for inspection purposes at all times.
Date: 5-13-91
Owner or Contractor
Permit Must Be Posted at the Job Site For Inspection Purposes
Call DIAL -DIG Prior To Beginning Work
ISSUED BY: 45-o'-"10 4 C.
Time Authorized: Void after *3 0 —days.
Special Conditions: 9,P I' a 66 el49e
Amendments:
PERMIT FEE:
Security Deposit:
Receipt No.: f40-76_
Fund I I I Fee:
Street Cut Dimensions: �J� A
X
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. July 1985
FIELD INSPECTION. NOTES
(Fund I I I Route copy to Street Dept.)
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION 11 YES 0 NO
Partial Work Inspection by P. W.:
m
Work Disapproved By: —
FINAL APPROVAL BY:
Date:
Date:
Eng. ijiv. July ms.')
.6016'204th;SIK.
Ift M. D Ly,
pwaRg7oc Fie.
0
M PIC HEMNa OILS
14-'7
ARK-2 --w- W
�'S.'GO-Q-2 4 _'�!`�,; ASPHALT'PAVING
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F410
'�.Thoms
PHON
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ADDRESS
'Edm
10 10 Olympic Ave..
2 1" Olympic:- 0
CITY STATE ZIP
ADDRESS
Edmonds, WA -98020
NER
Fine grade-.4kisting crushed-rock.,ba.se,!ro
compact, soil sterilize and pave w-ith two (2),
.Lnches of Class "B" Modified asphalt mat�: 351.76
_L
The above pt4ce ii for a 101x101
apron w.L flares.
It is customers responsibility to se'cure a permit
L
and check how far back from Olympic AVe. the
apron must be paved. This bid is for 10 feet.
-.Tlease sign white copy and return in order to
be placed on our work schedule.
PAYMENT DUE UPON RECEIPT OF
INVOICE ALL PRICES PLUS TAX
NOTICE TO CUSTOMER: This contractor is registered with the State. of. Washington,
':';-Permits,, if required, will be the owner's responsibility.
registration No. OLDSO**317BO, as a general/ specialty contractor and has posted with
. We shall not be liable for damage to or breakage of,septic tanks, underground. pipes,
the State a bond or cash deposit of $6,000/$4,000 for the purpose. of satisfying claims
and or condtift not visible fmm the surface of the ground nor for any damage to approaches
against the contractor for negligent or improper work or breach of contract in the conduct
(including sidewalks) from the Street to the property line�
of the contractor's business.
We cannot be responsible for sub grade failures or!��ng of subgrade mato
eft which
This bond or cash deposit may not be sufficient to cover a claim which might arise
was not. installed under the above agreement
from the work done under your contract. If any supplier of materials used in your construction
Sail sterilization (weed killer), if included in contract, will be applied at rates Specified
project or any employee of the contractor or subcontractor is not paid by the comractorz
by manufacturer. Olds Olympic. Inc.. will not be responsible for any subsequent growths
or subcontractor on your job, your property may be liened to force payment. If you wish
of horsetail weed, morning glory, deep rooted ferns, or perennials, which have not reached.
additional protection, you may request the contractor to provide you with original "lien
maturity prior to application..
release" documents from each supplier or subcontractor on your project. The contractor-
All material- is guaranteed as specified. All work to be- completed in a workman -I Ike
is required to provide you with further information about lien release documents if you
manner according to standard practices.
request ft. General information is also available from the Department of Labor and Industries.
I.. Olds Olympic Inc. a=pts- no responsibifty for any work other than thatispeciffcal�l
A late payment charge may be made on any past due balance, which the law calls
described above. Any additions to or alterations of the above work.will. be executed only�
a "FINANCE CHARGE", and it is computed at a monthly rate of,11h% (annual percentage
upon written orders and may become. an - additional charge.'.
rate of eighteen percent). It is agreed that in case suit is insfiluted to collect amount due
AN agreements are contingent on shikes,,accidents, delays of -carriers; and -other delays
on this contract or any portion thereof, reasonable attorneys fees and court costs may
unavoidable or beyond our control.
be added to this contram
PROPOSAL MAY BEL WITHDRAWN BY US IF NOT ACCEPTED
.-AN AUTHORIZED SIGNAWRE ON ONECOPY, RETURNED TO M WILL MAKE THIS
'A LEGAL.CONTRACT PENDING ACCEPIABLE CREDIT APPROVAL AND WILL BEREQUIRED
WITHI 30 DAYS
FOR'SCHEDULING OF WORK
J"t
X
OLDS OLYMPIC INC. DATE
AUTHORIZED SIGNATURE� DATE
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