1160 EDMONDS ST.PDF1160 EDMONDS ST
•
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TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE): �7fAJ(i(.lU�
COVENANTS (RECORDED)
CRITICAL AREAS: DETERMINATION: ❑ Conditional Waiver ❑ Study Required 4-W--'aiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS
q `1
PLANNING DATA CHECKLIST DATED: 921 110
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORT PLAT
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMITS) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
LID #: /
LOT: BLOCK: kuwo (III/
1ble,e
L:\TEMP\DSTs\Forms\Street File Checklist.doc
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7 7 L/ — L/ 7 :50 & "Nothing in this permit appro s shall be
interpreted as allowing ora=.the__
t f�l j� IiJUIJi� rO=for'ce�anY currently existing illegal, —'
Ming or unpermitted building, structure
� �.:c�. econdition which is outside the scope of the
�. C—* (-.".. ; d c bvve,. I t application, regardless of whether such i
i . building, structure or condition is shown on e
; �,r site plan or drawing. Such building, stru or
ct.... 7 condition may be the subject of a separate M
. enforcement action." I
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OWNEWCONTRACTOR IS RESPONSIBLE C
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C" 1 � � � C6
FOR EROSION AGE
CONTROL AND DR)T
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TO +CMINECT Tp EXr .
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NOTED I'"' , ItL
Zone A�?S-- 12— Comer _Fla�. `, ERING
Setbacks ReqWred Actual
Front—
Sides a,_ r ; D
Rear
Other
He,�i ►ht 25 e-REI§09" U B p "t �� ,
� FIco.�eSTREET
LIAR 0 2007
23lJiiL iNOF OHONCNCOS
APPR BZPL�ANN --- C — � � �`
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PLANNING DATA
SINGLE FAMILY RESIDENTIAL
STREET _:L:E:]l
Name: O1 S-0-n
Date: 3-7-2007
Site Address: I (� C) FOtke, py6e(s
Plan Check #: a7 to/ q
Project Description:
Reduced Site Plan Provided: (YES / NO)
Zoning: s _'
Map Page:
Corner Lot: (YES / NO)
Flag Lot: (YES / NO)
Critical Areas Determination #:
❑ Study Required
Waiver
SEPA Determination:
>-Zxempt
❑ Needed (for over 500 cubic yards of grading)
❑ Fee ❑ Checklist ❑ APO List with notarized form
Required Setbacks
Street: 2�
Side: to/
Side: to
Rear: 2-9-
Actual Setbacks
Street: 3 /
Side: I Z
Side: to /
Rear: --
Detached Structures:
Rockeries:
❑ Fences/Trellises:
❑ Bay Windows/Projecting Modulation:
❑ Stairs Deck:
Buildin Hei ht GtVG -I- (>
Datum Point: � � ✓G�
Datum Elevation: .4-1 OC /
Maximum Height Allowed: Zjr / etGV 1l'1 -� 3,/
Actual Height: I / 127
Other
Parking Required: EGi>L '5-0
Parking Provided: M9 G h
Lot Area: 12,000
Maximum Lot Coverage: 35D/o 61 Proposed:
Lot Coverage Calculations: 4 2 �I $ = 3y N
ADU Created: (YES / O)
Subdivision:
Legal Nonconforming Land Use Determination Issued: (YES / NO)
Comments
Plan Review By: ,���v1/b✓
Planning Data Form 04-11-06.doc
'
PLAN FILE NUMBER j BUILDING
Building Permit Applic®lion. App ca Heavy yes / / t, PERMIT 650062
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NUMBER
N OR NAME OF-B1iSINESS) JOB ADDRESS
- ms�T.ThG A13DRE$8 $IDE Y RD SET BACK REAR YARD
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CITY may-/ TELE HONE NUMBF:.ti U1q MAP NUMBER VACANT SITE
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\/ONE
�J ❑ YES - ❑ NO
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NAME - '- BUILDING AREA LOT AREA VARIANCE NUMBER
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ADDRESS
HEIGHT
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ALL BUILDING r„•...3ACR8 .
/ /1 NOTE: TO EAVM LINES
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CITY TELEPHONE NUMBER REMARKS
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NAME
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ADDRESS -
Encroachment Permit PERMIT NUMBER STREET GRADE CHECK
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RMulred
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YES NO
CITY �
TELEPHONE NUMBER METER SIZE I•BERVIC SIZE CLEARANCE ^HEC BY
STATE LICENSE NUMBEP, �CITY LICENSE NUMBER REMkRKS{
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LOT BLOCK TRACT
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TYPEECCONNL•'CTION VERIF1
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PERC. TEST PERFQT ER
to
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FIRE ZONE TYPE OF CONSTRUCTION STRERT IMPROVIZD
❑ YES ❑•.NO
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SPECLIL INSPE RED OCCUPANCY GROUP
--- ❑ YES O
1
PLAN CHECKED BY
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W0:4K TO BE DONE
NO. OF BLOOD. 'r Loo. TOTAL►Ra
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BUILDING --
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I VALUATION
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BUILDING PERMIT
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NUMBER OF STORIES 2 FEE
NEW DEMOLISH
PLUMBING
I 3 PERMIT 0
❑
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ADD FEE -
❑HEAT & GAS LINE
ALTRR I RESIDENTIAL NUMBER OF 4 I
PERMIT FEE
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+ DWELLING �.
REPAIR I NON-RESIDENTIAL UNITS DEMOLITION
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5 PERMIT FEE
PROPOSED U8E ���
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6 AMOUNT DUE
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I hevehy acknowledge that I have road this application; that the in.
formation
given Is correct; and that I am the owner, or the duly author- ATTENTIONAPPLICATION APPROVAL
,
• lzed
agent of the owner. I agree to comply with city and elate laws regu- THIS PERMIT
]at:ng
construction; and In doing the work authorized thereby, no person Thin application is not a permit until
AUTHORIZES
will
be employed in violation of the Labor Code of the State of Washington signed by the Director of Building In OYLY THE Ilg spec -
WORK to Workmen's Compensu.tloa Insurance. WORK NOTED tion, or '11s deputy; and fees are paid, and
I`j0TE:-',PERW%,V
LIMIT ONE YEAR receipt is acknowledged in space provided.
SI
T, (O R OR AGENT) DATE SIGNED INSPECTION DIRECTU1t S SIGNAT RE
D'-rPARTMEN ;
CITY OF
EDMONDS 1JA7r_.,a
J N C /APPROVED' Jc ' PR 6-1107
FILE
-
Sc� /'' _ �O f •
S UZahYhQ (0I501.1 S�
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50`71-04
RECEIVED
AUG 12 10-99
DEVE CAN CTR.
OF EDMONDS
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STREET PLE
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• PLANNING DATA
NAME: 0<d1E* -
SITE ADDRESS: b` DATE: 7,707
ZONING: _ �S v _ PLAN CHK#:
_qq:l
PROJECT DESCRIPTION: ►VP,{ �r (�lSW1�,(�.1��
CORNER LOT 00 (Yes/No) FLAG LOT o (Yes/No)
SETBACKS:
Required Setbacks• l _
Front: 2S Left Side: VU Right Side: / 0^ Rear: zs
Actual Setb cks:
Front: . Left Side:1��Right Side: 0 Rear:_ 31
Street map checked for additional setback required? �V �eJ (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED NO (Y/N)
LOT COVERAGE: _,o
Maximum Allowed: �eo Actual: 2'7
BUILDING HEIGHT: ,
Maximum All7v!
Actual Height:
Datum Point: Datum Elevation:
A.D.U. CREATED?: U Vi —
SUBDIVISION:
CRITICAL AREAS #:.(_ `"
SEPA DETERMINATION:
LOT AREA: I , n(Qn A�- 1
OTHER:
y S dJ a c ti , a" E ag v gti0•` •t` t •n �sr +i n r' �t 7
f �.
City of Edmon&,,, s t ,;, �r.'w, SFs c: �;. ;t:'k{, ' �_,., §: •�'a, a� �:
yi ,�%, ;.:,ti�'s ".:�., 'a"��t.: -� h.,'. _ �::"��: fit', °•M1 ,.
!+na,- �'- yw w } rya••• �, - ro - rr at" n src " .+: r t --,..t.. t •;
CRITI�° r E A� ,A � h H C i IST }
..-_.. .,_.......,,. _...»......,y4..4 _.. = �y._r d,.j.1^ "d �...t..�„f.:T,._ » i •+•, , r.. 4.tJ..
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:Mo` ytA>r• :.,Iti2e
The Critical Areas Checklist contained non this form is"" An =applicant, or his/her representative, must fill out.
to be filled out - b an er`son re ariri % 'a''-w },the �cheekl`st si °and' 'dates it ari'd''subrriit it to the
y_._.. y .;.P P, g
Development Permit Application for the City, of+ :,;City: ,;,, The,;,City,;,will. reytiew ._the; cheekhst, make a
Edmonds prior to his/her submittal of a developmment rprecursory stevishtiand make7a.determination of the
permit to the City. subsequent' steps' necessary to complete, a development
li t'11f' .. �'t :•;,7 �( , , 1, ij' I t7� - .rF r.I. r• tq ;J ,,r
permit applications;..,
The pur-pose-of>ther-Checklist'-is_to_enable:_Cit .Lstaff to = : Please-;submit�a-,:Ylicinity, mapg._1 the_ signed
determine whether any potential Critical-Areas7•are, or,z�i,copy of this.:form'to1assist City staff in finding and
may be, present ,on the ',subject.,,prgperty}., ,;, The ;.;.locating the specific>pece of described on
� . �,,
information needed to complete the Checklistshould:, [„this ,form ; In addition,, the applicant' shall include
be easily available from. observations of the site or other pertinentinformation (e.g., site plan, topography
data available at City Hall (Critical'Areas inventories, ''map, -etc.) or studies in conjunction with -this Checklist
maps, or soil surveys). r to assist' . staff in completing their preliminary
assessmeritl' of the •site
.... ..:t, 't: , l'`5t '��"^ �i; 1171tjii? '1 3ili' �ii''•':a lii.
I have completed the attached 'Critieal-'Areas CheckLst"'and'attest'tliaf the answers provided are factual to the
best of my knowlcc',ge (fill 'out the appropriate column bel'ow).
OwneriApplicant: Applicant Representative:
Name
Street Address Street Address-
01ond s
City State Zip City State, Zip
�a -7-7q
Telephone _ .._ ... j Telephone
Signa Signature'
Date N Date r
(over)
c:receptionjjana\cacl.doc
E:E1V®
JUN 3 0 1999
CA FILE NO. l - / a
Critical Areas Checklist
"NNm,--�-p�--------------------------------------------------------
te"Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: ��lo� Ci I/Jc S c%tr'`l?OJIds,
2. Property Tax Account Number: 71-. 000—QQ 9 000
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? _X yes;;/ no.
If yes; how is site developed? l
5. Describe the general site topography. Check all that apply`'
CM
6m e.
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
1046et ovei'a horizontaldistance 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: A,— ; Approx. Depth:
7. Site contains areas of se
asonal standing water: /f/Q ; Approx. Depth:
What season(s) of the year?
8. Site is in the floodway _,A1,0 floodplainAld of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? P _ Flows are seasonal? X9 (What time of year? )
10. Site is primarily: forested meadow ; shrubs ; mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site: —Alp
--- -- -----= ---- ---'• For: Ci S
tt ri ttl"dJse f0nly - - - -
1. Site is Zoned?---
2.
3
4
5;
6. Site tiesated on th Environto , tai11 Si ittve fleas 1N4p?
�;dtaa
^ca chk.doc; Rev 10/03/97
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CITY OF EDMONDS SIDE SEWER PERMIT
�890g9° y PERMIT N? 9191
Address of Construction:
Property Legal Description (Include all easements):
Owner and/or Contractor: It I �v
State License No. ` 9ildin
i 0
L
mit No. AJI
�gI� U�M�o .rc1 SvSo.� 01Sa
Z06 6%-2 - 6g 26
XS1ngle Family t"Invasion into City Right-of-Way„)(No ❑ Yes
❑ Multi -Family (No. of LUYAS )�-�--. RW Construction Permit No.
ElCc� �--� Y, \ Cross other Private Property: ko ❑ Yes
❑ Public Attach legal description and copy of recorded easement
I certify that I have read and shall comply with all city requirements
r
Date 1
as indicated on the back of the Permit Card.
EDMONDS
TREATMENT. PLANT
].
* CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATIO --*--
OFFICE, USE ONLY
* FOR INSPECTION CALL 771--SH2 PLIE
LIZ)
Permit Fee t --'�"�' �S Issued By
Trunk Charge: — Date Issued:
Assessment Fee:
Lid No.:
Receipt No.:
Partial Inspection: Date Initial
Comments
Reason Rejected: Date Initial
Final Inspection Approved: Date
Initial
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File. , , Green Copy: Inspector Buff Copy: Applicant
Revised 3190
The City of Edmonds Side Sewer Drawing EASEMENT NO ............................................
NEW CONSTRUCTION ❑ REPAIRS LID NO ................... ASMT. NO. ..
OWNER................... .................................................... ---------------- .. CONTRACTOR.......-•-------•------•---------------...........---................---..........-- PERMIT NO.
JOB ADDRESS .�1.(Ga.. ....... %Y1f7�1.0 ......�. .... LEGAL DESCRIPTION: LOT NO ....................................... BLOCK NO. --------............ ..............
PWW-0001-11175 (REV.11/78)
NAMEOF ADDITION.---•----•--...----•------•----•---------------------------------------------------------------------------------------
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Li x T, T
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Approved:
DATE .n. 13/0(0....................... By ..... J.lA^...y'.: ---------------------------------------
The City of Edmonds
APPLICATION
for
SIDE SEWER PERMIT
OUTSIDE [-] INSIDE E] REPAIRS ❑
CARDNo. ......................................
EASEMENT No . ......................................
0/1
OWNER
....... ------ ---- - - ------- ......
..........
r-
CONTRACTOR .. ............................................... .. ......... ................... PERMIT No.
STREET ,
............. ..................
HOUSE No. .......... ......................................... r ...... AVENUE LOT No. ............ ------ .............................................. BLOCK
NAME ADD. ............. . ......................
..................... '-; . .............................
Lu
LL
&Aj
Lu
Cf.)
APPROVED
JUL 28 1965
...........................
Date Approved:
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ .............................................
SEWER WORK ORDER ISSUED .......................................... DATE .......
:Y a
By .... .. . ... . . .....
-4 ................
CITY OF EDMONDS
Call PRospect 8-1107 when work
CIVIC CENTER — WATER -SEWER DEPARTMENT Is ready for inspection. (No inspee-
tions Saturday. Sunday or holidays.)
SIDE SEWER PERMIT
N2 1262
ADDRESS--------------------------------- 11(10... EdmmdS ... t=-Ct---.......------.........--------------.....----------------------------------
OWNER ................ Gar -don ... Henrikson----------------------------------- CONTRACTOR....---- Lee Wooley------------------------------------------
Permission is granted ..-_ ..............dilly-- 2S-------- , 19.65.-, for ................... E
days, to REPAIR or CONNCT S. side sewer
with- City Sewers in accordance with application on file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
j -NOTE No. 1—The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must
ed to construct side sewer In s
be employstre
et area. Do not cover any portion of sewer before It has been inspected.
No. 2—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOIE ,No. 3—Top
pbof side
ewer must
at have
than least
wi30 Inches
coverage at property line and 12 inches inside property line; min imum grade of 2
No %.
ll be responsible for
NOTE No. 4—Trenches In street
t be water work which settled
tl Y develop surface
of street one yeaestor ofred t completion.
condition. Contractors sha
-allure duetimproper
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 maln sewer or its ap-
purtenances except to insert the pipe Into the wye.