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1143 C AVE S.PDFIIIIIIIIIIIIII 10492 1143CAVE S ADDRESS:__ TAX ACCOUNT/PARCEL NUMBER: 'Db rD g ?pan 6 D I 1 0 O BUILDING PERMIT (NEW STRUCTURE): 1 9& � b1 q 37'15FA COVENANTS (RECORDED) CRITICAL AREAS %! DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED PERMITS (OTHER): PLANNING DATA CHECKLIST DA SCALED PLOT PLAN DATED: SEWER LID FEE $: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver LID SHORT PLAT FILE: LOT: l BLOCK: SIDE SEWER AS BUILT DATED: `l SIDE SEWER PERMIT(S) #: -122 GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT FOR: WATER METER TAP CARD DATED: LATEMP\DSrs\Forms\Street File Checklist.doc 4. is rJ ,, \. i �C. r"/Ja •,'• M N j� ® F A ® WORK ,gyp /� r j i11 i �1'k'il •� N i �APPL.MAIN' �a� �c I>r®Rii' PERMIT APPlicatton No.,:/... CITY OF Permit Limit. One Year EDMONDS Building Department r ; ro f Y' Sr' n _ ti APPLICATION is hereby made :or a perm�j. to construct the following work, in accordance with the nccompsnying Plana and specifications: (/ ///- ` et ` 7� t P.�C / 1 ....'... `Pz ........... round Area ............ No. es j ' � Stories WORK —New/Addn. J . -•• - - 1 � iJ� Jn. £ � xtr tY i .... i .;Ci.r.....%.......`....� .�.... �.. C->.-- ..._... ....•--•-•• i 3i Height. ttedPlana Submit' e _ t{o s I ` / Use Zone.L. J. —Fire Zone:._-.... 3 .�- r ........................... // i ) .. • LOCATIOti —Address f L. 1. ..................+y /if Sewerage.•"'."rc tiF�} tii " !... 'L Block ................... Add . ..........._............................. 1 t� .Ld' r.n`r raw ` rded Lo J............ - .,. l _ • • Recc Front and Rear ..............................:: Sides............. • .. c F� 9dirw aFss+ . i ,--- Min. Bldg. Setbacks, Lot Area................................... Width---......... g• ' c r ( U l_ ...._... Addresa..�••••........... Owner. S P r r r. h J> ....._........... Phone.......-..._ ✓I£iki z� T:�f ...................... .............. r 3 k Plans by......._........._ ......................... ....L, ... Address.............................._........................................ Phone.............. .. r t . i ...... - t, t- Bldg. b3•........._................__................................................._ on .............. .. Ph e 1 • �'r ;b = Address .............:.......... 1 .. Plb b ........ ........ .......... . Phan ................ Address........._............ _. P e..:....' .............................................. a r`K � Heating by .............. .• , I:. iEE . t................................... .:.... Phone ..................... Address..... ........... . f" ._....................... ►, I ( - Remarks ...................................................... ..t' ......................a...::._._:. w a x ......................._................................_. .,A 5 J} m r.........................................---............_......... 1 .. .._:_..........___.......... - i�} - r...................................................... .. .�y5 i.._.— •- f..._..............._....-.................._............_..................._._... . .................--------- ..... .........- .-.. •. C 5g a-k 0 1 ................_.._. cry grrl g ii fJY t Y Y xr J The above is a correct statement and l agree to comply with all applicable Codes and State Laws re atin the work. a i xx'r t A i.......................................... Date' Y�fl}y 1� Signed: Ovmer/ g PERMIT for the above work Is hereby approved, subject to the above conditions, and to compliance with the approved plans, �° ���'�, y'r :c• r i and specifications and Building Department notations thereon. e c I i PER1%rlT FEES VALUATION \G ' $ Bldg. 'T/ G { 4 - Plbg. .... $...... ................. ; ynU f 1 � Heat.... $..... ....._................ t APPROI ED: Q G . / .:......._. ..... :..:. Date... a ............. _"- ........................................ Elect. ... $. . J � x1aK•"�'S "yam x Dr.PARTMENT -Others ... $................. .........._... .:;u'*,.-'s BUILDLN ., w t TOTAL FEE $.......'I/>s ........... - BY W. •:{�' S}� \O'fES: No work requring Building artment or City Engi is inspection shall be covered before inspection and approval to construction of all site utill Twenty-four (!rt hour notice requested. Contact the City Engineer prior ties;••such ascurbs, paving, driveways, sewer, water and street connections. • - '•.�ytj.*.ar:a=;?� • -. � a -ilk' � f��w.; The City of Edmonds OWNER ......... c ..... HOUSE No../..!..J-1 TW-7 ..... a] w n R AMICATION for SIDE SEWER PERMIT OUTSIDE (3 INSIDE 0 REPAIRS 0 Date Approved: BACKFILL WORK ORDER ISSUED ............................................ DEPOSIT" $ :.W .................................. SEWER WORK ORDER ISSUED ................................................ DATE... ........ BY CARDNo . .......................................... EASEMENT No ............................................. q JUI: City 61 Edmonds ---Water Department TAP CARD. -Date...... t4 ._­..,.,/�K�_ Meter ........ Tap 0 ........... Size .... ... ..... ............. size................._........--. Mf9rs. No------------------------------................::---.. tyle ........... . ....... . ....... . ... For................ /Z. . .............. ............ ..... az� ......... :.; ............... M ...... .. ......... . . ............................................ . . ....... ­ - - - - -------- LotNo ........... .................... s ........ Blk. No....:. Add....................... Q ........................... m ............. . ... : ........................ . ........ ........ ServiceLocation ....... ............................................ ................... .......... ------------------- 7 ...................... ....... . . . .......................... MeterLocation * .......... " ...... . ................. a ....... . ... .. . ....... . .. ......................... z� ............ w ............................... . ....... . ............ .... . ... ...... MakeTap' ........................................ o ............................ . ....... . ...... .......... ................... : ....................... ...... . ......... .. . .................. . . ..... . ....... . .Pressure ....................... ........ lbs'. Test .... : ............................... SendBills to ........................ ......... . ................ . ....... . .. ......................................... ......... ...... ............................ ................. . ........ I Date of. Work ...... 3 ......... . ............. ............... ........................... . ...... "w .................. .............................. m ....... Foreman Guar. Voucher No .......... ................................. $ ........... . ................ . ..... Remarks: ........ . . .................................... I ........ . ............................... . ...... ......................................... . ....... ... . ................................... . . ... . .............. .......................................... . .................. ........................ . . ..... . .... ......................... ........... . . .. ........................... ......... ..... ....... . ....... . ... . . . ....... ........................................ ....... . ........... ....... . ... .............. ............ ............... : ........................ .............. ;� .................... . ....... . ....... . ..... All.. .. . .......... ............................................................................ .... . ................ . ....... . OUTGOING Index ......... Reg ..:..Route Bk .......... *Stetcil Card R—QWNQ-AJn-dex ........Reg----Apute�JCarW City of Edmonds Critical Area Notice of Decision Applicant: ��dC / `1-3 Property Owner: S oc Critical Area File #: (R� �' ®oZ L Permit Number: �LD Zd 1 3 O 2 c% Site Location: 11 � /� ,, j Parcel Number: D©S 0 Bo 01 1 o 0 Project Description: n0 �4 IeCL ❑ Conditional Waiver. No critical area report is required for the project described above. 1. There will be. no alteration of a Critical Area or its required buffer. 2. The proposal is an allowed activity pursuant to ECDC 23.40.220, 23.50.220, and/or 23.80.040. 3. The proposal is exempt pursuant to ECDC 23.40.230. -Erosion Hazard. Project is within erosion hazard area. Applicant must prepare an erosion and sediment control plan in compliance with ECDC 18.30. ❑ Critical Area Report Required: The proposed project is within a critical area and/or a critical area buffer and a critical area report is required. A critical area report has been submitted and evaluated for compliance with the following criteria pursuant to ECDC 23.40.160: 1. The proposal minimizes the impact on critical areas in accordance with ECDC 23.40:120, Mitigation sequencing; 2. The proposal does not pose an unreasonable threat to the public health, safety, or welfare on or off the development proposal site; 3. The proposal is consistent with the general purposes of this title and the public interest; 4.. Any alterations permitted to the critical area are mitigated in accordance with ECDC 23.40.110, Mitigation requirements. 5. The proposal protects the critical area functions and values consistent with the best available science and results in no net loss of critical functions and values; and 6. The proposal is consistent with other applicable regulations and standards. ❑ Unfavorable Critical Area Decision. The proposed project is not exempt or does not adequately mitigate its impacts on critical areas and/or does not comply with the criteria in ECDC 23.40.1.60 and the provisions of the City of Edmonds critical area regulations. See attached findings, of noncompliance. [�r-favorable Critical Area Decision. The proposed project as described above and as shown on the attached site plan meets or is exempt from the criteria in ECDC 23.40.160, Review Criteria, and complies with the applicable provisions of the City of Edmonds critical area regulations. Any subsequent changes to the proposal shall void this decision pending re -review of the proposal. ❑ Conditions. Critical Area specific condition(s) have been applied to the permit number referenced above. See referenced permit number for specific condition(s). Reviewer Signature 3 zl I /( --� Date Appeals: Any decision to approve, condition, or deny a development proposal or other activity based on the requirements of critical area regulations may be appealed according to, and as part of, the appeal procedure, if any, for the permit or approval involved. ' Revised 12/16/2010 PLANNING DATA SINGLE FAMILY RESIDENTIAL STREET FILE Name: o G� Neck S-o= Dos 6 r 30000/o o\ Site Address: U C Date: 3 t Plan Check # L9_ �7 Project Description:. i Reduced Site Plan Provided: NO) (rZoning: Map Page: Corner Lot: (YES /(NJ' Flag Lot: (YES / NO Critical Areas Determination r*: Z 14' Study Required ❑ Waiver SEPA Determination:. Exempt ❑ Needed (for over 500 cubic yards of grading) ❑ Fee ❑ Checklist ❑ APO List with notarized form Required Setbacks Street: Z� Side: u Side: - l Rear- ZO Actual Setbacks Street: �S Side_ Side: + Rear: ❑ Detached Structures: l ❑ Rockeries: ❑ Fences/Trellises: ❑ Bay Windows/Projecting Modulation: Stairs/ ec - 8uildin Height Datum Point: Datum Elevation: Maximum Height Allowed: Z's- Actual Height: X 13 Other Parking Required: Parking<Provided: Lot Area: 1 Z 6 3 2— Maximum Lot Coverage: 35% Proposed- Lot Coverage Calculations: /r�(/Sl?" dg, l f,lf ADU Created: (YES). Subdivision: Lo pL-�( S (/l Legal Nonconforming Land Use Determination Issued: (YES / NO) Comments 1 Plan Review By. 3 2 1 P1ann09-Data form Oa •11,06.doc 9,0 RECEIVED i �IF9 i`#"----- S l6 Corner FlyST FILE 'DEVELOPMENT SERVICES Zone .Actual COUNTER _ �e aired Seth s . _-�-5 Frontw r---"'" �07 Sides ' IS Other ENGINEERING DMSICft----- ----- APPROV D NOT; EP _I�t=GwY PI �NPIING Date: S �3 . ------- Ap— - f!!C�'.�CONTRAGT®R IS RSpt�1t;,w F__-FQR _...... _.. El 10SION CONTROL AND DRA. SAGE - ---- -- ----- -I - ---- y-j�'� ►--I ' -- 3 , oa i