1120 EDMONDS ST.PDFiiiiiiiiiiiiii
10942
1120 EDMONDS ST
FA
•
•
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER: DSD�%� T(JC1
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS : DETERMINATION: ❑ Conditional Waiver ❑ Study Required 4aiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (
PLANNING DATA CHECKLIST DATED: 1 05 l
SCALED PLOT PLAN DATED: (D - 27 - G 4-
SEWER LID FEE $:
SHORT PLAT FILE:
M,.M
SIDE SEWER AS BUILT DX
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DATED:
LID #:
LOT: BLOCK: y1B l t'.1 3
L:\TEMP\DSTs\Fomis\Street File Checklist.doc
.. APPLICAYI 11 & WORK PERMIT � Application No.. ... ..i/..n(/P//
.
CITY OF EDMONDS Building Department Permit Limit, One Year
APPLICATION is :Wyde for a permit to construct the following work, in accordance with the accompanying plans
and, specifications:
WORKNew/ -...__................................................. _....._ .. Ground Area ............:...................... No. Stories..
Plans Submitted _-� ...... Const. Type ........ ,, � �`-- ........... Height...`...::.. ... . ....
f/. Q — C�-�.'' ..-`�C�' //-F 1..�Fire Zone........_....._..
LOCATION —Address ................................_..........._...__....._..........._.... .jJ�J� Use Zone._
Recorded Lot-.._....._ Block._..•........-.... Add'n.114.�'r% `�` "_ �..... ..�.......... .........../:.}.
Sewerage._
OS-, i I _ r
/off � .-- /
Lot _— Width .,�1� ��-.-_ ... Min. Bldg. Setbacks, Front and Rear :. �_..._ -••-:,. Sides ...:�1.?� ... ?1..
`� �LLC/ t�•�
Plans by, ti`"n/���' _Address_.__ - -. .-- •_......_....__.........•._... Phone .._..................._.......
Bldg. by— Phone .............................
�,- AddressPhone..._..._.._............. ..
.._.._.__.._.._.�.............__.-.._.._..._._.._.._........ ....
HeatLngby _..... __ .—__.__----•--------__._ Address . .__._._...._..__... _.__..._..._ r............... Phone ................... _...........
Elect. by-.-------- -- _ _ _ _..__.._.__ ......_._. Address. .... ..... ................ ................... .................... Phone................................
The above is a correct statement and I agree to g6mply with all applicable Codes and State Laws regulating the work.
Signed: Owner/
PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the approved plans
and specifications and Building Department notations thereon.
VALUATION PEKMIT FEES
Bldg. $.....!"...................v.
�
Plbg.3
$........1............................
APPROVED: Heat .... $............... .....`...
Date... _..-........... r �......................... Elect. ..$ ........................................
BUILsiIIZG DEP,,ARTINIENT Others ...$........................................
VV��..... TOTAL FEE $...... c:a,......��.......
NOTES: No work requiring Building Department or City Engineer's inspection shall be covered before inspection and approval.
Twenty-four (24) hour notice requested. Contact the City Engineer prior to construction of all site utilities, such as
curbs, paving, driveways, sewer, water and street connections.
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RECEIVED
JUN 2 9 199k
PER.Wff COUNATER
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RECElWFp '
1eN17 MAY I
>
a CITY OF rDhtu tJ tis
PLANNING DATA
SITE ADDRESS: ��2D /%�fuS'5-. DATE:Z�z�
ZONING: e,5 - 12 PERMIT#:
PROJECT DESCRIPTION:
SETBACKS:
Required Setbacks:
Front:;�6 Left Side:1c)Right Side:/0Rear:2,5
Actual Setbacks:
Front: Z 6 Left Side:j Z-- Right Side:_? Rear: / L0(morr)
FLOOR AREA:
LOT COVERAGE:
Maximum All
BUILDING HEIGHT: J
_57-
Maximum Allowed: �7 Actual Height:
SUBDIVISION: �� yTl LDS
CRITICAL AREAS #:
SEPA DETERMINATION:
LOT AREA:
OTHER:
Plan Review By:
W
CAWE NO. ff4-12-0
Critical Areas Checklist
Site Information (soils/to
JJpography/hydrology/vegetation)
1. Site Address/L.ocation: 11,2 0 r _ S�
2. Property Tax Account Number: d 7 % - O a il)aa_2z),) a6
3. Approximate Site Size (acres or square ): L�, ®o a rdi
4. Is this site currently developed? es; no.
Air, yes; how is site developed? �#,a , f
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):
6. Site contains areas of year-round standing water: �_ ;Approx. Depth:
7. Site contains areas of seasonal standing water: IV 0 ; Approx. Depth:
What season(s) of the year?
8. Site is in the floodwayX)o floodplain A/ o of a water course.
Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? Flows are seasonal? (What time of year? ).
10. Site is primarily: forested ; meadow ; shrubs ; mixed
urban landscaped (lawn,shrubs etc) .
11. Obvious wetland is present on site:
Rcv0U0N9e
C90.194-
City of Edmonds
Critical Areas Checklist
RECEIVED
JUN - 3 1994
COMMUNITY SERVICES
The Critical Areas Checklist contained on and submit it to the City. The City will
this form is to be filled out by any person review the checklist, make a precursory site
preparing a Development Permit visit, and make a determination of the
Application for the City of Edmonds prior subsequent steps necessary to complete a
to his/her submittal of a development development permit application.
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,
With a signed copy of this form, the
applicant should also submit a vicinity map
or plot plan for individual lots of the parcel
with enough detail that City staff can find
and identify the subject parcel(s). In
addition, the applicant shall include
other pertinent information (e.g. site
plan, topography map, etc.) 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: Applicant Representative:
Ac `W6,xrr/7ti Cd
Name Name
//2- 0 So. L (/ ✓V,
Street Address
A/e , *L2- G
City, State, ZIP Phone
Signature
Date
Street Address
L'-Vzzewer '�V& & -�y-a 2 G
City, State, ZIP Phone
Signature Date
CAE NO. �4
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/1.ocation: l /ao eIJf`,00ib5 S;,- M&PL)Bg
2. Property Tax Account Number: 67o 7/ — Doo •— ®07-- p0 vor,
3. Approximate Site Size (acres or square feet): Za 90 �S,�/.�vTo�oic) ,
4. Is this site currently developed? yes; no.
If yes; how is site developed?s
5. Describe the general site topography. Check all that apply.
yriFlat: 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):
6. Site contains areas of year-round standing water: ; Approx. Depth:
7. Site contains areas of seasonal standing water: /lid • ; Approx. Depth:
What season(s) of the year?
8. Site is in the floodway A[#, floodpiain & of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? No • Flows are seasonal? k to - (What time of year? — ).
10. Site is primarily: forested ; meadow ; shrubs ; mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site: AV2
Rev OlAW94
690 •;94-
„ ,,,, �Py ®
MAR
9
9
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.
With a signed copy of this form, the
applicant should also submit a vicinity map
or plot plan for individual lots of the parcel
with enough detail that City staff can find
and identify the subject parcel(s). In
addition, the applicant shall include
other pertinent information (e.g. site
plan, topography map, etc.) 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:
�h,9 5 P s (�UXJaQ
Name
IIUD 9D-1M 2n S s-i
Street Address
Applicant Representative: --
Name
Street Address
2MV 774-��
City, State, ZIP T Phone City, State, ZIP l' Phone
(-:,:,2:�) -0- 1 �_� , qY
Signature Date Signature Date
h
CITY OF E ®pe w O V ®S HARVE H. HARRISON
200 DAYTON ST. - EDMONDS, WASHINGTON 98020 - (206) 775-2525 MAYOR
DEPARTMENT OF PUBLIC WORKS
j
November 13, 1980
9
STRLE-f I IL A.. Account 'No. 220-00150
Mr. Burgund G. Church
1120 Edmonds Street
Edmonds, Washington 98020
Dear Mr. Church:
SUBJECT: CROSS CONNECTION/IRRIGATION SYSTEMS
An irrigation system located on your property may be in
violation. of State of Washington and City of Edmonds ordinances
related to backflow prevention. To protect the potable, or
drinking water supply,an approved backflow device is mandatory
on all irrigation.systems.
Please call the Water Department Cross Connection Inspector,
Lee Willeiksen, at 775-2525, extension 226, for information or
an appointment for inspection of your irrigation system.
Requirements to meet State and City Codes need to be com-
pleted within thirty days from receipt of this notification.
Si_ncyrel.y,
LEE WILLEIKSEN
Cross'Connect-ion Inspector
Water/Sewer Division
LEW/amm
0
in
The City of Edmonds
HOUSE No.
0
APPLICATION
for
SIDE SEWER PRILBUT
OUTSIDE El INSIDE E] REPAIRS 0
CARD No. ......... ------------
EASEMENT No- ----------------------- ..............
. ... ..... ....
. ..... !X ............................
PERMIT No.
..... ---
STREET
IlOTl1No . .......... 7
AVEN ye ...............................
AVENUE ......................... BLOCK No. ....................
NAME ADD. A/.� ... ........... ----------------- --- ZG6�st -g -;Ken
------ ------------------- - - -----------------------------------------
LL
Date Approved:
BACKFILL WORK ORDER ISSUED ----- ............................. DEPOSIT, $ ------------------------------- w .- I I
.............
SEWER WORK ORDER ISSUED ---------- ------------------------------- DATE ... ----- 13Y --- -- ---------------- --------- - - — --" -------- --------
7.
lz�
CITY OF EDMONDS
CIVIC CENTER — WATER -SEWER DEPARTMENT Call PROSPect 6-1107 when work
Is ready for inspection. (No Inspe"�
SIDE SEWER PERMIT ti— Saturday, Sunday or hoiidayq) N
s9 1021
ADDRESS ............. 4O Edmonds Street
................................................................... ...............................................................................................................
OWNER.-...- H.enri.qk.son. Construction
.. .. . ... .. .... ....... .. ........................................................ CONTRACTOR .......
Permission is granted .____APrii-aa .................. t 19-64, for ...................... days, to REPAIR or CONNECT a side sewer
with City Sewers in accordance with application on file and governing ordinances.
ATTENTION IS CALLED To THE FOLLOWING:
NOTE No. 1—The owners of the Property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor Must
be employed to construct side sewer In street area. Do not cover any Portion of sewer. before It has been inspected.
"�j No. 2—Obtain full Information regarding Ordinance 11-16.030 and Regulations governing side . sewers when you get permit.
NuTE No. 3—TOP of side sewer must have at least 30 Inches coverage at property line and 12 Inches Inside Property line; minimum grade of 2%.
No bends in grade sharper than % will be Permitted.
NOTE No. 4—Trenches In street must be water settled and surface of street restored to original condition. Contractors sball be responsible for
failure due to improper work which may develop within one year of Completion.
NOTE No. 5--It Is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the main sewer or Its ap-
purtenances except to insert the Pipe into the wye.