1140 3RD AVE S.PDFIIIIIIIIIIII
4914
1140 3RD AVE S
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS: 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:
SEWER LID FEE $:
SHORT PLAT
SIDE SEWER AS BUILT DATED. -
SIDE SEWER PERMIT(S) #:_
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DA'
OTHER:
LOT:
LID #:
BLOCK:
L:\TEMP\DST's\Forms\Street File Checklist.doc
CA FILE NO.
Critical Areas Checklist
--------------------------------------------------------------
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: / / �1� L? tea S.
2. Property Tax Account Number: C> Cf 6 -2o D V
3. Approximate Site Size (acres or square feet): G��. 0 O APR R � �°j'9
4. Is this site currently developed? yes; no. -4 ,6ff
If yes; how is site developed? S' /"
f.�
.V
L$Err
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: N/9 ; Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? Me _ Flows are seasonal? (What time of year? ).
10. Site is primarily: forested ; meadow ; shrubs ; mixed
urban landscaped (lawn,shrubs etc) k'
11. Obvious wetland is present on site: r 0
SCS.mapped soil type(s)?
3: .Wetland:iriveritory. or C.A. rnap:indicates wetland present on site? '
4 Critical Areas .mventory or C A map. indicates Critical Area on site?: ;J
5:. Site within designated earth sub "I nice.landsl de hazard area?::
6 S.ite designated; op the Envtrorimep ally; Sensrtiye Areas Map? t
DETERMINATION
^cs chk.doc; Rev IW03/97
The City of Edmonds
Water Service Drawing
EASEMENT NO . ............................................
NEW CONSTRUCTION 1!37 REPAIRS ❑ LID NO . .................. . ASMT. NO...................
OWNER................................................................................................ CONTRACTOR.................................................................................... PERMIT NO.20.012.5
JOB ADDRESS A.I..A .Q ........ a..R.v A� C .
....... .......:. ........ ....
04
1 C-/B 20. 5
LEGAL DESCRIPTION: LOT.NO....................................... BLOCK NO. ....................................
................................................:................................................................................................................
NAME OF ADDITION ..:..............
(Go PSI SuFft%_oN
pE rtE (!1
i' 4 2-
PWW0001.11175 (REV.11178)
Approved:
1-�...........��
DATE .v.. ��OD....... By .........
CITY.OF EDMONDS SIDE SEWER PERMIT.
�890 j9a° .. PERMIT N2 91.54
Address of Construction: AQ r'✓�'t �i ._CJ ��%�y/
Property Legal Description (Include all easements):
Owner and/or Contractor: iWit°il 6W U C�/�/Lt A/C
State License No. 9 (CN 6yw(RQ4;_ 0 & uilding Permit No, 2D105
Single Family
❑ Multi -Family (No. of Units )
❑ Commercial
❑ Public
Invasion into City Right-of-Way:XNo ❑ Yes
RW Construction Permit No.
Cross other Private Property: No ❑ Yes
Attach legal description and copy of recorded easement
1
I certify tW I have read and shall comply with all city requirements
as indicated on the back of the Permit Card.
4 00
Date
* CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
OFFICE USE ONLY
*.FOR INSPECTION .CALL 771�4 2, PUBLI RKS DEPT.
Permit Fee: •' Is ued By
_ Jo
Trunk Charge s Date Issued: S� vh 0
Assessment Fee: Receipt No.:
Lid. No.:
Partial Inspection: .P1,40e S FMnAe� 1_,6C Date, Initial."
'Comments
Reason Rejected:. Date Initial
Final Inspection Approved: Date? -/�5=00InitialJe ill tijGCoN•��(l
_p0
** PERMIT MUST•BE POSTED ON JOB SITE **
White Copy: File Green Copy: Inspector ' Bull Copy: Applicant.
Revised 3190
The City of Edmonds Side Sewer Drawing
EASEMENT NO. .............................
NEW CONSTRUCTION REPAIRS ❑ LID NO ................... ASMT. NO . ..................
OWNER.............................................. ................................................. CONTRACTOR ........... ------- * .................... PERMIT NO. AL51
... I-1.1i A.. 3 —(-(1 .... pt
... Lu - ------------ .....
JOB ADDRESS E �$OV ................ LEGAL DESCRIPTION: LOT NO .................................... BLOCK NO. ....................................
NAME OF ADDITION
Approved:
PWW.0001 - 11/75 (REV. 11/78) DATE 1.1.10.0 ...................... � By , ~ ..................
Lot 4
\� 104 196 198 110 115.00' 1.12 114
cy
5c ft /' O
o
/.2327.27
KCCE55 DRIVEWAY N
0(5 . '"r
Lot 1
1109.17 ft2
II—
-----------------
i
I i Xi5tifig house
,.
08
i
I !to ,remain
1623.33 ft2 "� 5
�
j�142 3RD 5
f ROF05ED /•'
/"
5 ' NEW 5F /'
, — !
!
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EX15TING DRIVE
HOU5E
0'
---------- ,
5Elf 5ACK5 \\ 41 SET BACK5
95.34
o
Lot 3
II 26' 4" ft2
i
,,
i� LO ftz
112,
LOT 2:
-LOT 3: i
IMPE•�IOU5 5URFACE: /
IMPERVIOU5
SURFACE: I
114.,
/
2327.27 - _
1343.57 - ---_-_-_-- '
/"
941.50 _._
1623... - I— --J Lot 2
3670.84 - TOTAL
/
25 4.&3 TOTAL _ EPLOT
116' 11g 120
PLAN
NEW
CURB CUT
15'
IE (8"5
1E(8"t
W
EXISTING
CURB CUT
MM
t'J
BY PLANN
t-I(''Iclu
SCALE: 1 "=20'
r
PERMIT EXPIRES
CITY 'OF EDMONDS USE V._ PERMIT
zoNE NUMBER
CONSTRUCTION PERMIT APPLICATION JOB ///71 SUITE/APT#
ADDRESS f (rl ) 1"
OWNER NAME/NAME OF BUSINESS
-LEGAL DESCRIPTION CHECK SUBDIVISION NO. LID NO.
W MAILING ADDRESS �.+�- �►► "
z c^ __
O C72z-- 2� _2 J7 - PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved
CITY ZI
P TELEPHONE RW Permit Required
EXISTING �>/ REQUIRED DEDICATION Street Use Permit Req'd
n V)N J qq,) ) V 1 1M . Q 7-- . 9 Inspection Required y�
Ili/• �y �. �' `-�f ��+�.i [,:.}[,r 1-JI !� PROPOSED Sidewalk Required PL �
NAME METE% SIZE /LINE SIZE NO, OF FIXTURES PRV REQUIRED
.3( YES NO ❑
ADDRES REMARKS L) (; b v ,u we.
/Z�.477Z+ ' /, Z
i 12e f F :/ ( T7c? 0a w
CITY ZIP TELEPHONE
NAME 4 6
ENGINEERING MEMO DATED REVIEWED
BY
a[ ADDRESS
FIR MEAO DATED REVIEWED BY w
a
Q LL
Z
CITY ZIP TELEPHONE
U VARIANCE OR CU . ADB# SHORELINE #
STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY
SEPA REVIEW SIGN AREA HEIGHT
G COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
z0 LEGAL DESCRIPTION OF PROPERTY - INCLUDE ALL EASEMENTS I �/ 5/ r ��
n EXP
P (j`
2 LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
w ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR r,
w
a / -/
L� z
< PROPERTY TAX ACCOUNT PARCEL NO. -- Z
LOT AREA PLANNING REVIEW BY DATE a
�n NEW RESIDENTIAL
YL
I`7C`❑—..ADDITION �❑
PLUMBING / MECH
REMARRS
COMMERCIAL
❑
COMPLIANCE OR
CHANGE OF USE
❑ REMODEL
❑ APARTMENT
❑
SIGN
❑ REPAIR
GRADING
❑
FENCE
CYDS
( X
FT)
CHECKED BY
TYPE OF ONS RUCTION
CODE OCCUPANT
❑ DEMOLISH
❑ TANK
❑
OTHER
GROUP
SPECIAL INSPECTOR
',5r �,7� UPANT
GARAGE
WALL
❑
❑
RENEWAL
REQUIRED ❑ YES
iiVl�' AD
4—
z CARPORT
RRETAINING OCKERY
Oa (TYPE OF USE, BUSINESS
OR ACTIVITY) EXPLAIN:
REMARKS
L) `_ t
PROGRESS INSPE
TIONS PER UBC 108
w NUMBER
NUMBER OF
CRITICAL
O STORIES
WEL
DUNITSLING
0
NUMBER
DESCRIBE WORK TO BE DONE
FINAL INSPECTION
REQUIRED
VALUATION
FEE
PLAN CHECK FEE
HEAT SOURCE
GLAZING %
LOT SLOPE %
BUILDING
PLAN 6HECIK N
VESTED DATE
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
GRADING/FILL
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
M
DOMAIN (CURBS,SIDEWALKS, DRIVEWAYS, MARQUEES,ETC.) WILL REQUIRE
t
SEPARATE PERMISSION.
?
STATE SURCHARGE
PERMIT APPLICATION: 180 DAYS
2
w
n
PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
STORM DRAINAGE FEES
so
to
w
"APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
ENG. INSPECTION FEE
'j
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
cc
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
a
x
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
PLAN CHECK DEPOSIT
o
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
0
DEEMEDTO MODIFY, WAIVEOR REDUCEANY REQUIREMENT OF ANY CITY ORDINANCE
x
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 AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
This application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Building Official or his/her Deputy: and Fees are paid, and
WO EN'S COMPENSATION INSURANCE AND RCW 18.27.
receipt is acknowledged in space provided.
r)
NATURE
TE SIGNED
OFF S SIG RD
%(
-0220777
ION
IT AIS UNLAWFUL
7 O USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI / ORIGINAL - FILE • YELLOWS- INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER • GOLD - ASSESSOR
MAIL BOXES
5
n RIP RAP
SEE DETAIL (C-2)
CB I
TYPE 1
LOCKIN
TOP 8 . 0'
INV. 6.05'
03
MAINTAIN MINIMUM OF
24" COVER IN ROADWAY
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----- ----- -- CB #3--------
TYPE
- - TOP 103.44'
INV 99.85' -6" (E)
�1 10.57' -6"PVC @ I % INV. 99.75' -6" (W)
shed
\15' ESMT \
\ \ 58.22' -6"PVC @
\ 10' ESMT Lot 4
CB#2 \ 02
03 \ \
TYPE I \ 47.13' -�-6"PVC @8%
LOCKING GRATE _ CB 4 �\
TOP 102.08' TO 102.2 V \ SEE PLAN TO RIGHT
INV. 98.55'-�-1�2" (N) IN 100.50'�-�6" (N \ \ FOR CONTINUATION
INV. 98.65 �-6 (E) IN . 100.40 -�-6 (S \ \
5\00' 10 90 10811 812 �114 cuaBcur
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2327.27f Sq {c .�
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ADS
DRAINAGE SYSTEM OVERVIEW
SCALE: 1 " = 40.00'
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1138 3RD AVE S
(2328.7 SQ. FT.)
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Lot 4
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t�. ELEV.: 119. 4' Lot 1
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JI 110 LN FT 1 p0 /emain
I 124" ADS / 1 1 /I 42 3RD S
I / EXISTING DRIVE
HISS 0R
F.F.��[ EV.-J16.87'
cr Lot 3 i 1 3. �7 ft2
N1WPO FED
TO
/ / HOUSE
\ �� � /S � .*-✓� � TOP IOir,O ✓ I
TOTAL AREA: .48 ACRES
NEW IMPERVIOUS: .18 ACRES
DETENTION: 190 LN FT 24" ADS
1 T6 1'18 1'20
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Lot 2 /�
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GRADING: S-99-168
IMPORT 320 YARDS
L S H 0 CUT 140 YARDS 1 1-15-99
TOTAL 460 YARDS REVISIONS:
SCALE: 1 " = 20.00'
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130i--------r--------r--------
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INV. 10
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50
100
150
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S-99-168
1 1-15-99
ZEVISIONS:
12.13.99
1 /3/2000
I $ AND TEMPORARY EROSION CONTROL PLAN
17405
Q� FCIy^rERE �w
�SSONAL IC-2
�G
EXPIRES.. �L�
GENERAL NOTES
1. All work and materials shall be in accordance with City of Edmonds Standards
and Specifications, and Washington State Department of Transportation 1991 Standard
Specifications for road, bridge and municipal construction.
2. Temporary erosion/sedimentation control measures sliall be implemented prior to any grading
or extensive land clearing. These facilities sliall be satisfactorily maintained until construction
is completed and the potential for erosion is minimal.
3. All pipe shall be placed on stable earth, or if in the opinion of the City Engineer, the existing
foundation is unsatisfactory, then the unsuitable material shall be excavated and the void
backfilled with a free draining granular material, free of debris and clay.
STORM SYSTEM
4. All grates (inlet and catch basin) sliall be depressed 0.1 foot below pavement grade.
All catch basins to be type I unless otherwise noted.
The contractor shall be responsible for adjusting all manhole, inlet, and catch basin frames
and grates to grade just prior to pouring of curbs and paving. All catch basins with a
depth over 5 feet to the flowline shall be a Type II CB. All structures located outside of the
right-of-way shall have locking lids.
Catch basin frame and grate shall be Olympic Foundry part No. SM 50G, Herringbone
pattern; part No. SM 52, thru-curb inlet; part No. Sin 44, rolled curb type; or other
approved equal; or as otherwise called for on the plans.
5. Stormwater retention/detention facilities must be constructed and maintained in
accordance with City of Edmonds requirements.
6. All road fills shall be compacted to a minimum of 95% of maximum density when tested
using the modified Proctor test. Compaction shall be accomplished in accordance with
Section 2-03.3(I 4)C, Method B or C.
7. If cut and fill slopes exceed a maximum of one foot horizontal to two feet vertical,
a rock or concrete retaining wall will be required.
8. Approximate locations of existing utilities have been obtained from available records
and are shown for convenience. The contractor shall be responsible for verifying the location
of all existing utilities whether shown or not. The contractor shall call the Utility Locator
Service, 1-800-424-5555, two working days prior to any construction.
9. The contractor shall take all necessary precautions for the safety of employees on the
project and shall comply with all applicable provisions of Federal, State, and Municipal safety
laws and building codes. He shall erect and properly maintain, at all times, as required by the
conditions and progress of the work, all necessary safeguards for protection of workmen and
the public; shall post danger signs warning against known or unusual hazards; and he shall
designate a responsible member of his organization on the construction site whose duty shall be
the prevention of accidents.
10. The contractor shall be responsible for maintaining and repairing asphalt and gravel surfaces
disturbed as a result of this construction until they are accepted by the Public Works Department
of the city.
TEMPORARY EROSION/SEDIMENTATION CONTROL NOTES
1. Maintain natural vegetation for silt control where possible.
2. Temporary erosion sedimentation control facilities shall be constructed by placing siltation
control filters around swales (natural or manmade) and shall be maintained in a satisfactory
condition until such tinie that land clearing and/or construction of permanent drainage facilities - are completed and operational. Facilities shall then be removed and the site restored to the original
or final design condition.
3. As construction progresses and expected seasonal conditions dictate, more siltation control
facilities may be required to insure complete siltation control of this property. Therefore, during the
course of construction, it shall be the obligation of the contractor to address any new conditions that
may be created by his activities and to provide additional facilities, as may be needed.
E5C Minimum Requirement - 5tablization of Exposed Areas. All soils exposed by land disturbing
activities shall be staliblized by suitable application of BMFo, including, but not limited to, sod
hydroseeding, or other vegetation, plasitic covering, or mulching. All BMFs shall be selected,
designed and maintained in accordance with the Manual. The exposed moils shall be stabilized
according to an approved timetalbe. (Typically, no Soils shall remain exposed for more than two (2)
days from October 1 through April 30 and no more than seven (7) days from May 1 through
September 30)
CONSTRUCTION SEQUENCE
I. PRE -CONSTRUCTION MEETING
2. TEMPORARY EROSION CONTROL INSTALLED
3. TEMPORARY ROAD/APPROACH
4. EXCAVATION
5. DRAINAGE SYSTEM & SANITARY SEWER INSTALLED
6. FOUNDATION
7. DRIVEWAY
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