17627 TALBOT RD.PDF11111111111111
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17627 TALBOT RD
ADDRESS: 1 J & X7 bot
TAX ACCOUT%ff/PARCEL NUMBER: Sq q4 oo lo o s 000 (o
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR --
CRITICAL AREAS: � q 9 9 - 0c6 7 DETERMINATION: n Conditional Waiver [-] Study Required �* aiver
DISCP,E'r[ONAP,YPEP,mrr#,s: vcwoto-cmig (m,�wgu)
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS
PLANNING DATA CHECKLIST DATED: %Islo(a
SCALED PLOT PLAN DATED: <� zo/
SEWER LID FEE LID#:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED: L-,T7 If j 63
SIDE SEWER PERMIT(S).#: oob-0jus (ozn
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
111604
WATER METER TAP CARD DATED:
*THER: 1Q2 -7- Q 1-1 00�
-,:2 7-- 7 9
LATEMP\DSrs\Fomis\Street File Checklist.doc
The City of Edmonds Side Sewer Drawing LYNNWOOD LINE EASEMENT NO - ------------------------------
NEW CONSTRUCTION REPAIRS 0 LID NO. -J-44— ASMT. NO - ------------------
OWNER ------ Al ----- K-U-tz
------------------------ _— ----------------------------- CONTRACTOR
5� q_-S-P-kS!t-.-QNV-i.",4ERMIT NO. -4035P
JOB ADDRESS ........ 191.2-9 To-16t RCk LEGAL DESCRIPTION: LOT NO - -------- 51
-- ------------------------------------------------------------------- ----- ---------------------------- .- BLOCK NO - ------------------------------------
---------------- ------------------------------------------------------------------------------------------------
NAME OF ADDITION ................................
Ae
4—
deep)
k
PWW-OWl-11175 (REV.11/78)
v- (D It P-V-C- Sick Sewer
(Sck. W:14)
,e,-4,, C-0. ( 3 jeep
+ 4je-Xvisp-Tee and to" S+u6 C bldeep)
Approved:
DATE -be.-C-271-09�i9 B,
The City of Edmonds
\^Jo-*e-v Seirvice UrcwjiK
i6ftiM& a
EASEMENT NO - -------------
NEW CONSTRUCTION 0 REPAIRS [:] LID NO - ------- ----- - ASMT. No.
OWNER � ----- At ....... Kutz ----------------------------------------------------- CONTRACTOR EdOWOK6,5-)%-�
. ------ PERMIT NO.
--------------------
JOB ADDRESS LEGAL DESCRIPTION: LOT NO - ---------- 61 --------------------- BLOCK NO - ------------------------------------
----------------- 71au.a --- P t-k --- I -------------------------------------------------------------------------------- ----------
NAME OF ADDITION
Approved:
PWW-0001-11/75 (REV.11/78) DATE ... 1). -V- C.. 2 j -
Ni9lly
.CITY OF EDMONDS-
FOR INSPECTION CAI*
PUBLIC WORKS DEP * S T Permit IH? 0800
I I SI, DE SEWER PERMIT 775-2525 Ext 2 20 Issue Date 9 //0 W I
i
rd
Z-
04
E-A
a4
2:
0
U
W
M
0
E-4
* PERMIT MUST BE POSTED ON JOB SITE *
`7 K0 Z 0
1. Address.of Construction
2. Property Legal Description (7492e all. easementsl_,)�'LOT4
TCL L.�el f ect V-
3. Single Family Residence &.X Multi -Family No. of Units
Commercial F=,11% q - -7
-nd/
4. Owner a- o-r_Bui1.der
5. Contractor & License No.
6. Invasion into City Right -of -Way: No Ll�.es (If YesURight-of-
way Construction Permit Required - Call Dial Dig (342-5344) before
excavation).
7. Cross other private pro
.perty: Yes No V Easement required -
attach legal description and county easement number.
READ THE FOLLOWING AND SIGN:
a. Property owners must obtain ewe s on
their property. A licensed side sew atMapl 11 oye to
construct side sewers in the public
b. The side sewer contractor as s p ot", ach
installation for one year.
C. Commercial establishment req re six inch (6")
side sewer line.
d. Side sewers may not be insta (30")
to any structure. SNOHOMISH OUN
e. Side sewer lines must be laid i Tni*A11j&ffl1N$41#6 %PNC�j 150)
and maximum grade of 100% (45 0 ). 0
f. No turn in side s8wer greater than 45 (1/8;bend) is 0 allowed
between cleanout. All 90 turns must be constructed of a 45'.�(1/8
bend) and wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system.
h. Pea gravel is required for bedding when installing sewer lines
:through other than granular soil.
i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 1001 along sewer 'line run.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
k.. Side sewer must be left uncovered until inspected and a . pproved
by the City.
1. Inspection during normal working hou'-r"s only. Two' (r2+- working
days notice required.
DATE:' A C)
I ��'e-rtlfy tha-t- I have read
L/0 U01- LYAmw000 PLA Lrr and shall comply with the above
PERMIT FEE: '�!;S.00 tic)
L) W
CONNECTION FEE:
V\J*ql� �_
PE IT
ITKOL ISAPPROVED BY: Date:
aj By: Date:
APPROVED By: r����Date: 12-17,-? 1 -11
0 1 0
IST BE POSTED ON JOB SITE
CITY OF EDMONDS HARVE H. HARRISON
MAYOP
CIVIC CENTEP - EDMONDS, WASHINGTON 98020 - (206) 775-2525
DF-PARTMENT OF PUBLIC WORKS
November 26, 1979
Rick Suran
Edmonds Asphalt Paving
209 4th S.
Edmonds,,'.Wa. 98020
Gentlemen.:
Subject: SIDE SEWER PERMIT 6380
. . '(17-6-27 TALBOT ROAD) -
You were issued subject permit for installation of a side
sewer. A partial inspection was accomplished on September 17,
1979 and to date we have not received a request for a final.
Please complete the installation and request a final
inspection by November 30, 1979 or I will cancel your permit.
If you have any questions regarding this matter, please
call Doug Johnson at-775-2525 ext. 220.
Yours very truly,
JAMES E. ADAMS, P.E.
City Engineer
JEA: vlw
The City of Edmonds
Side Sewer Drawing
a
EASEMENT NO. --- ----------
NEW CONSTRUCTION REPAIRS E] LID NO. � ----------------- - ASMT. NO - ------------------
OWNER
---------------------------- CONTRACTOR ---------- ---------------------- ------------- ---------------- PERMIT NO.
JOB ADDRESS --- Vr7-G2,r7 ------ ---F"-'OLL-Bo-,T ----- RI),-- LEGAL DESCRIPTION: LOT NO - ----------------- -------------------- BLOCK NO - ----------
PWW-0001-11/75 (REV. 11/78)
too
NAME OF ADDITION -----
1)':Je- -T-EZ->-T-'F--D OM Se-wC--�R,
0
Approved:
DATE- --------------------------------
F�N
IL11 E
By.......... ------------------------------- f�
�,V=C WORKS DEPART�IENTGAIST
BUILDING PERMIT REVIEW
(address) (date3
Street Right-of-14ay Existing_____f�--_,<ZD REQD
Z
H
Access Easements Existing REQD
Utility Easement Existr REQD
Lot Per Subdivision Assessor Na
jh�j_ - t p
Site Plan Checked for Accura
Z
Underground 1qiring Reqd.
H
U
Check Accuracy of Legal Description
Z
Review by Date
Existing Water Main Size
Water Main Required
Service Line Required
Hydrant Size Existing
Hydrant Reqd Per Fire Code* �Jj IN —Size
Detector Check 1-leter Reqd.
Cross Connection Inspection
-
Fire Department Conuients
Water 11--ter Ch Re d--D _')C11
Review b �hAge
Y. -7 ? 0
Septic Tank Design Approved- Date
Septic Tank Permit Reqd. —Permit No. M
Sanitary Sewer Availability Proj._ L__ 1 �,q
Drawing Nb. t-N File No.
j�a L-\ Y') ling
—
Side Sewer Availabili Z
CC51n
Sanitary Sewer ection Fee qd. t1i
Review by D . ate -7- 1-:1--7�
.Open
Ditch Existing Reqd.
�F:
Culvert Reqd. 1Z. 0 Size
P4
Catch Basin Reqd. Indicate on Site Plan
C)
Shoulder drainage maintain collection on swale'opcn runoff
�Ianhole reqd. Indicate on Site Plan
Soil Conditions and Ground Water Field Checked
Review by- x Date
0
T1
f
Revised: lvlO-1977
, �/ ),4G DIVISION
461 L D
Applicant.Fill
III
LJ S E,
PW-.
ZONE -26
PIERMUPY APPLICATION
nside Heavy Lines
JOB
'NAME (OR NAME OF BUSINESS)
ADDRESS j-7 (C) 9
LEGAL DESCRI PTION.1 SUBDIVISION SHORT SUB NO.
MAILING ADDRESS
.
3z
[)to,
o CITY NUMBER
PUBLIC RIGHT OF WAY PER OFFICIAL eTREET MAP
ITELEPHOME
EXISTING_
NAME
PROPOSED
IR oB i LA eti- P,-S
L e V
DEFICIENCY OF RIGHT OF WAY
in
U
W ADDRESS
PUBLIC IMPROVEMENTS REQUIRED
0
0
Ui
DRAINAGE IMPROVEMENTS REQUIRED
M CITY TELEPHONE N.MB.R
DRAINAGE PLAN REQUIRED U
(-�'F-A AA
UNDERGROUND WIRING REQUI RED
NAME
CONNECTION TO SANITARY SEWER (L
A
SEPTIC TANK PERMIT REQ'D 0 NO.
0 ADDRESS
ELEVATION OF PROPERTY CORNERS
U
& FOOTINGS REQ'D
CIT.Y TELEPHONE NUMBER
z
SEE ENGINEERING MEMO DATED
0
STATE LICENSE NUMBER CITY LICENSE NUMBER
CHECKE
Legal Description of Property (Show Below Or Attach Four Copies)
METER SIZE BUILDING SUPPLY SIZE
L-r-1 T 5; 1 T 4
� K
7
FL)LAI- ,
REMARK- CN U
z
2 ACCCIP, '"QC 1�
L J-21-A-7
lhekt-10--
SIGN AREA ItNV. REVIEW ADB NO.
U
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P COMPLETE EXEMPT
ALLOWED ROPOSED
L4
SHORELINE #
W
ca- i—= I
b
W
REMARKS
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I OF t[646S�21 Orklh
Mll U)M�l
VARIANCE OR CU PL.ANNING REVIEW BY IDATE
YARDS
COVERAGE
FRONT.
SIDE
t7
ILOT
M1%j
NEW
RESIDENTIAL
GAS
El L
REAR
ze
FIRE ZONE.
OF CONSTRUCTION
CODE
HEIGHT
NON-RESIDENTIAL
SIINE
GN
,
_3
ITYPE
ADD
DEMOLISH
RETAINING
WALL
SPECIAL INSPECTOR
REQUIRED
OCCUPANCY
_3
OCCUPANT
F1
ALTER EXCAVATE
FENCE
YES No
JAREA
____p
F
LOAD
F OR FILL
I— "
—' -
PLAN CHECKED BY
.1
THIS SITE
IS LOCATED IN THE CITY
PRE -MOVE
swim
OF EDMONDS. LOCAL SALES
TAX
REPAIR
INSP.
P OOL
SHOULD BE CODED 31.04.
z NUMBER OF STORI ES
NUMBER OF
DWELLING
REMARKS
0
2-
C/ DA-�LJj
UNITS
LO Ai ia--
NATUITE
02�01.
OF WORK TO BE DONE
U
In
W
PLAN CHECK FEE
VALUA TION
FEE
PLOT PLAN
&M
L
BUILDING
PLUMBING
MECHANICAL
7,�'Aj ,j
FENCE
"Applicant, on behalf of his or her spouse, heirs, assigns and SIGN
in
W successors in interest, agrees� to indemnify defend and hold harmless
-i I RETAINING WALL
Y the City of* Edmonds, Washington, its officials, employees, and
a: agents from any and all claims for damages of whatever Ball re,
< I
I arising directly or indirectly from the issuance of this permit. I'su - SWIMMING POOL
4r,
011 !w -,!' this permit shall n.,; he deenied to modity. Nvaivc or reduce
1A
L
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M.
12
m
10
9'
IL
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77�
RECEIVED
FEB 2 -8 2001
f'%Clfr-1 r%DkAr-Kl'r OrMlllf�rk I-V
CITY OF EDMONI)f
PF-
UjAll - W-PtS4 jt'51vpt�W
(p), J"
i
0
City of Edmonds
0 RECEIVED
MAR 10 1999
-"F- CRITICAL AREAS CHECKLIST PERMIT COUNTER
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
th� 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.
Please submit a vicinity map along with the signed
copy of this form to assist City staff in finding and
locating'the specific piece of property described on
this form. 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 Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column, below).
Owner/Applicant:
M - "11
Street Address
City State Zip
Telephone
Signature
Date
Applicant Representative:
Name
i_D4
Street Address
1�QOA 'k f4'V' '�-/ 8 (') 7-
City State Zip
4Z �� '7 -7 6 A-4 to C� t
Telephone
Signature
Date
c:reception\jana\cac1.doc
(over)
FILE NO.
Critical Areas Checklist
----------------- --------------------------------------------
51te'Information (soil shop o graphy/hydrol o gy/vegetation)
L. Site Address/Location: r F /k-()
2. Property Tax Account Number: _--�7 7 / '060 - U,�>l
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? yes; no.
if yes; how is site developed?
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 I 0-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 3.3 to 66-feet).
Steep: grades of greater than 3 0% present on site (a vertical rise of I 0-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: PIV )/4 Approx. Depth:
7. Site contains areas of seasonal standing water: A/ 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? 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:'
- — ----------------------------------------------------- For City. -Staff. Use: Only ------------------------ -------- --------------------
Z
.. .... 5.ite,isZ6ned?. t.� t).
I:.: SCS 7 M*Japped soil ty . p e(s.'
I Weiland inventory or C.A. map indicates wetland present on site?
4.: Critical Area's i n*ven'tory:or C.A.: map indicates Critical Area on site?
$jte:within. designated ear-th.:subsidenc,.e:laodslide.hazar.d: are4?:LLj
ske.designat d o.n.the-En
e virournentally Sensitive Areas Map?..
D:V,TtlkMINAV0N
-ce_chk.doc; Rey 10/03/97
It
C.
March 26, 1999
RGH Construction
P.O. Box 1214
Edmonds, WA 98020
01 0
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
Subject: Determination regarding Critical Areas Checklist # 99-57
0
Dear Applicant:
BARBARA FAHEY
MAYOR
Enclosed please find a copy of the Critical Areas Checklist you submitted. The "DETERMINATION" reached by the City
is located on the reverse side of the form (bottom of page).
It is very important for you to retain a copy of this Critical Areas Checklist "DETERMINATION" for your records.
....IMPORTANT INFORMATION.TO BE NOTED.
PLEASE EXAMINE THIS" DETERMINATION- FOR ADDITIONAL REQUIREMENTS. YOU MA Y NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN CKLIST OR REAS SEMY.
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
mo, You must submit a covy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL 4M
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT m- —ftOCESSED.
Permit applications include the following:
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Enc: Critical Areas Determination
* Architectural Design Board
Thank you.
Sharla Graham
Planning Secretary
C:Recept1onUanaXCRLTR.doc
Incorporated August 11, 1890
Sister Citv - Hekinan. Janan
r
IMF-
13!�'JLD,VqG DIVISION
Applicant.Fill
USE
ZONE -26, 1PAW11
PEW11 APPLICATION
inside Heavy Lines
NAME (OR NAME OF BUSINESS)
A DOI �ES�
g-1
'1, 7 T,
R,
LEGAL'D'ESCR1IPTION_ SUBDIVISION SHORT S'UB NO.
MAILING ADDRESS
I s- 1AC E r,—:,,- -
0
I
IRI
o —,q
CITY TELEPHONE NUMBER
P. RI HAxZAY PER EET MAP
1C. G OFFICIAL eTR
Peth:!�ij bt�.qq,0111
EXISTING
NAME I
I
PROPOSED
. IR o 13 t�L K(---., /� P,
DEFICIENCY OF RIGHT OF WAY,
U _SLey
W ADDRESS
VE-
PUBLIC IMPROVEMENTS REQUIRED 0
DRAINAGE IMPROVEMENTS REQUIRED
M CITY I T-ELEP HONE NUMBER
DRAINAGE PLAN REQUIRED El
1-�"FIA-1-M e 1A A%joki
<Sze)�;-
UNDERGROUND WIRIN . G REQUIRED
NAME
CONNECTION TO SANITARY SZWER
C—A A K3 4-1-rL—
SEPTIC TANK PERMIT R . EQ'D El NO
0 ADbRESS
I-
ELEVATION OF PROPERTY CORNERS E3
U
& FOOTINGS REQ'D
0: CITY TELEPHONE NUMBER
l'-
z
SEE ENGINEERING MEMO DATED
0
U STATE LICENSE NUMBER CITY LICENSE NUMBER
CHECKEE(BY
Legal Description of Property (Show Below or Attach Four Copies)
METER SIZE BUILDING SUPPLY SIZE
L-0 T_ 5, 1 Til P;,r- I
- Phe, KI
I I
REMARKS' GK U
rt —1�)
2 Accetz AT
_1hekC,QIE-_
SIGN AREA ItNV. REVIEW ADB NO.
U - L t
ALLOWED PROPOSED COMPLETE EXEMPT
L4 tz _.,,
,
SHORELINE i5
W
W
REMARKS
9KI Q' I S 1�
10F
VARIANCE OR CU PLANNING REVIEW BY DATE
YARDS
COVERAGE
?1:3 FRONT
SIDE
t7
ILOT
M1V
NE W
RESIDENTIAL
GAS
LINE
EAR
I,,
FIRE ZONE
OF CONSTRUCTION
HEIGH
LA
NON-RESIDENTIAL
El
SIGN
_3
ITYPE
_V_
�1_1
�CODE
i ok
56� fit
F
ADD
El DEMOLISH
EIWALL
RETAINING
INSPECTOR
AREA
OCCUPANCY
OCCUPANT
ALTER EXCAVATE
FENCE
REQUIRED
0 YES
GROUP
I
LO AD
FIOR FILL
I— X—F
PLAN CHECKED BY
THIS SIT
E IS LOCATED IN THE
CITY
D
REPAIR PRE -MOVE'
INSP.
swim
POOL
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
z NUMBER OF STORIES UMBER OF
0 DWELLING
REMARKS
Ft
UNITS
Lo �,j a
LLM
a tJ
NATURE
OF WORK TO,BE DONE
U lv;5
vv e-. 5 ilp,.: 7 A / c
;D�6us
In
PLOT P N
PLAN CHECK FEE
VALUATION
FEE
UILDING
;t
PLUMBING
MECHANICAL
FENCE
"Applicant, on behalf of his or her spouse, heirs, assigns and SIGN
successors in interest, agrees to indemnify, defend and hold harmless
2 the City of Edmonds, Washington, its officials, employees, and RETAINING WALL
M *any and all claims for damages of whatever nature,
< agents from
I arisirw directIv or indirecil , v from the issuance of this permit. Issu- SWIMMING POOL
;w-c- �o* This permit sh:111 ."o, bt, j C,�Illed to waive or redu ,e
0
U
IL
M
W
3.1
0
DATE: T ___)_
14E,"10 TO: Building -Division*
Community Development Department
FROM; Engineering Division
Public Works Department
SUBJECT: r7 (Z r7
After review of the subject building permit application,' %.7e.have
the following comments:
S�.� JJA Vy'N'*_ - Y\-nxE -
I , i - A A a I . A 6 A
PUBLICUORKS DEPARI= CHEamin,
BUILDING PERMIT REVIEW
15 1-7
(address)' (dateY
Street Right -of -Way Existing
Z
Access Easements Existing___
0 WQD
r4
Utility Easement Existipg
REQD
LC5+ !7-T
Lot Per Subdivision-jj7
�������Assessor
Site Plan Checked for',Accur
Z
Underground Wiring Reqd.
Check Accuracy of Legal Descriptim
Z
Review by.
Date -7- -H�- n 5
Existing Water Main Size
-
Water Main Required
Service Line Required
Hydrant Size Existing
c4
Hydrant Reqd Per Fire Code
�jj/% Size
Detector Check Meter Reqd.
�J/161
Cross Connection Inspection.
U�A
Fire Department Comments
:3:
Water Meter aVe Re?&.-.::�,
Review by.
Date
Septic Tank Design Approved
Date tJ C�\-
Septic Tank Permit Reqd.
IJ Permit' No. t\j
Sanitary Sewer Availability
Proi
Drawing No.,
File No.
Side Sewer Availability
Sanitary SewerMection Fee Reqd. t1i
:3:
Review 'by
Date -7 - 171 -
Open Ditch Existing _ZLOZe Reqd.
Z
Culvert Reqd.
Size
r4
Catch Basin Reqd. e 5
&117 .4 7--Indicate on Site Plan
0
Shoulder drainage maintain collection on swale open runoff
Manhole reqd. '41c)
Indicate on Site Plan
Soil Conditions and Ground Water Field Checked
Review by Z2,t366 X
C71
Date_ 2 - 7R
Revised: lvlO-1977
Page 2
Street Paving Reqd. 410 A, e—
Curb and Gutter Reqd. -41 _e�:
Side�7alk Reqd. ,j,- 4C-
Curb Cut for Driveway Reqd..
P4 Right -of -Way Construction Permit Reqd.
Bond Reqd. forPublic Iuproven-enfs
Street Nam Sign Reqd.- 4Z 0
Other Signing Reqd. Al a 41
Pre Permit Site inspection made on
z
0
BY: SEWER
WATER
P4
En
Z STREET
ENGINEERING
Special Requirements listed in memo to Conumity Development Department,
Building Division
BY Date
o All items filled in an Building PermLt Application
P4 BY Date
P4 Drawings Stanped and Notations Made
BY Date
,.Approved'by.Public Works Department
Revised: 1v 10-1977
BUILDING DIVISION
Applicant Fill
PERMIT APPLICATIONir
Inside Heavy Lines
MAMIE JOR NAME OF BUSINESS)
MAILING AOOREST-
z ';7,Cj
3: <
0 -7 kt
CITY
L�:d
ELEPHONE NUMBER
_7 _71— S-17 01
NAME
u Ak 0, e- f 0 C yx GE
t�
L0 ADDREIFS
I-
x
Poll
, -Z
it CIT'y
V rv�
TELEPHONE NUMBER
NAME
e,
0 ADDRESS
U
CITY
TELEPHONE NUMBER
z
0
U STATE LICENSE NUMBER
CITY LICENSE NUMBER'
Legal Description of Property (Show i3elow or Attach Four Copies)
L 0 �- S_ / /_ /407L PAY4
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2
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W
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ZONE ER_..
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JOB
ADDRUSS
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LEGAL DESCRIPTION SUBDIVISION SHORT SUS Md-.-
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING fl-C
PR 0 POS E 0 11�0
DEFICIENCY OF RIGHT OF WAY
PUBLIC IMPROVEME14TS REQUIRED El
DRAINAGE IMPROVEMENTS REQUIRED D
DRAINAGE PLAN REQUIRED F-1
UNDERGROUND WIRING REQUIRED El
CONNECTION TO SANITARY SEWER
SEPTIC TANK PERMIT RE.'- 0 NO.
ELEVATION OF PROPERTY CORNERS
& FOOTINGS REQ'D
SEE ENGINEERING MEMO DATED -sc?
CHECKED BY
METER SIZE I BUILDING SUPPLY 9fZE
SIGN AREA ENV. REVIEW
ALLOWED I PROPOSED 1COMPLETF4 EXEMPT
REMARKS
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VARIANCE OR CU
VARDS
El
FRONT
NEW
RESIDENTIAL
GAS
LINE
FIRE ZONE
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NON-RESIDENTIAL
SIGN
ADD
DEMOLISH RETAINING
WALL
SPECIAL INSPECTOR
REQUIRED
E3ALTER EXCAVATE FENCE
OR FILL Ell—
0 YES C1 N 0
PLAN CHECKED BY
REPAIR PRE -MOVE r" swim
1:1
INSP. POOL
Z NUMBER OF STORIES
INUMBER Of
R ARKS
2
OWE LLING
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UNITS
t NATURE OF WORK TO BE DONE
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PLAN CHECK FEE
PLOT PLAN
BUILDING
PLUMBING
MECHANICAL
FENCE
SIGN
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"Applicant, on behalf of his or her spouse, heirs, assigns and
III
successors in interest, agrees to indemnify, defend and hold harmless
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the City of Edmonds, Washington, its officials, employees. and
RETAINING WALL
agents from any and all claims for damages of whatever nature,
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arising directly or indirectly from the issuance of this permit. Issu-
SWIMMING POOL
0
ance of this permit shall not be deemed to modify, waive or reduce
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Inv remdrement of any city ordinance nor limit in any way the
SHO
PLANNING REVIEW BY DATE
SIDE RE A R] L T COVERAGE
OF CONSTRUCTION ICODE 1HEIGHT
1k OCCUPANCY OCCUPANT
I GROUP ILOAD
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
VALUATION 'j-1 FEE
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PUBLIC WORKS DEPART� 1ENT CHECKLIST
I
BUILDING PER41T REVIEW
,,�,address) (date)
AL Ici 7 -7 1 — q- W-
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Street Right -of -Way Exist
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Access Easements Exist
cd
Utility Easement Exist
Lot Per Subdivision Plat 22&?=K Assessor Mhp_,gg2a__7
Site Plan Checked for Accuracy.
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Underground Wiring Reqd.
Check Accuracy of Legal Description
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Review b
Date —SV
Existing Water Main Size
Water Main Required
Service Line Required
Hydrant Size Existing
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Hydrant Reqd Per Fire Code
Size
Detector Check Meter Reqd.
Cross Connection Inspecti
PROVILD V�4CVUM
Fire Department ConTrients-
A HOSE el gr S .
Water Meter Charge Reqd.
Review by, CC 9- 1 —7 ir
3 Date r.
Septic Tank Design Approved
Date
Septic Tank Permit Reqd.
Permit No.
Sanitary Sewer Availability,
Proj
Drawing No.
File No.
Side Sewer Availability
94
94
Sanitary Sewer Connection Fee Reqd.
:3:
Review by.
Date
Open Ditch Existing
Culvert Reqd.
Size
94
Catch Basin Reqd.
Indicate on Site Plan
0
Shoulder drainage maintain collection on
swale open runoff
H
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Mm-ihole reqd.
Indicate on Site Plan
Soil Conditions and Ground Water Field Checked —
Review by.
Date
Revised: lv10-1977
Page 2
Street Paving Reqd.
Curb and Gutter Reqd.
Sidewalk Reqd.
Curb Cut for Driveway Reqd.
p4 Right -of -Way Construction Permit Reqd.
Bond Reqd. for Public Inprovements
Street Name Sign Reqd.
10ther Signing Reqd.
IM, Pre Permit Site Inspection made an
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PA
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44 ENGINEERING
Special- Req ements-, Tist6d,11h mem-. to Community Development Department,
Building Divisi6iil
BY Date
o All items.filled in on Building Permit Application.,
P4 BY Date
Drawings Stamped and Notations Made
BY Date
.Approved.by Public Works Department
Revised: lv
-10-1977
ro: m I
CommunilLy Developi-joilL
Division
Depirtment
SUP, J ECT:
or Hic subjOct: building
colmilellf
WWAWTIC�WMPXW.�.r"
WWIIK,�r
4( 11,111111 Jill 11111,
��jfw4wffipiiijjji��Ijl
R-ECETVED
"JM 1'2'80
CITY OF EOM01yaS
PLANNING OEpj-
LL�-]
7500H
(:-: - C) F � > 0
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I CIO ,gt JUN 12 1980
Dir. of Public \NOrks
FECEIVED
JUN 12'80
CITY OF EDMONDS
PLANNING DEPT.
Puget Sound Pools
GUINTE - VINYL - POOL CONTRACTING
22918 HWY. 99 - EDMONDS, WASHINGTON 98020 - PHONE 778-5049
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RECEIVED
JUN 12 1980
N. L�- - - - "!'j
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AP.
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Uty of Edmon#
RIGHT-OF-WAY �CONSTRUCTION
PVRMIT Permit Nwnber.
Lssue Date: -7hl /9 -7
A. Addre_�s or Vicinity of Construction: ##$Wf 17627.TAIBOT ROAD
GTE to place, operate, ano mainfain a Duried seFVice
n qr r IV 11 . fk- 'IF�e -4 e. frnm S flower ot-located at 17627 Talbot Road
.1squ . YF-� %J W. r_
t? C. then east to a resMei � at 116V iaffi-i R�H. uIE w plow 70 Teet and push no
driveway or road. R.O.W. 06otage 5 feet.
GTE Northwest Incorporated
C. Contractor: Marilyn Holmgren, Permit Coordina O�Contact: . Joe Wilson . 286/771-903.6 mobile 388- . 1358
Mailing Address: 2312C W. Casino Rd Phone:
Fiveimett, 13A 9-8-2-04-1440 Marilyn 421;/710-0786 nr 488-1628
State License #: Liability Insurance: - __ Bond: $
D. Building Permit iff (if applicable): Side Sewer Permit # (if applicable):
E.
Commercial -[J Subdivision El City Project P Utility (PUD, GTE, WNG, CABLE, WATER)
Multi -Family I El Single Family Other -9POOlDB 642310
GTE W.O. 2100
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut D Yes DdNo G. Size x H. Charge
Please see atta011ed.sketch.
APPLICANT TOREADAND' SIGN
INDEMNITY: Applicant understands and by his signature to this application. to hold the City of Edmonds harmlessftom injuries, damages, or claims ofany
kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its departments o—r—
�jyployees, including or not limited to the defense of any legal proceedings including defense costs and afforney,fees by reason of granting this permit.
THE CONTRACTOR IS REsP6NS1BLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC-
TION AND ACCEPTANCE OF THE WORK. ESTIAIA TED RESTORATION FEES 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
Two sets of construction drawings of proposed work required with permit application.
A 24 hour notice is required for inspection. Please call the Engineering Division, 771-0220.
Work'and material is to be inspected during progress and at compieflon.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All'stree't cut trench work shall be patched with asphalt or City approved material prior to the end of the work-Ing day;
NO EXCEPTIONS.
I have read the above sta emenlls�,n�und 'tand the permit requirements and the pink copy of the permit will be
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available on site at alltides for urJ2Q.F0-&%
Signature: /Vtz avid Squires Date: 07/07/97
(ContrPelor — FAggnt) Section Manager -Access Design
CALT 1 1, 1 A IZAA -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: W�.
TIME AUTHORIZED: VOID AFTER DAYS
SPECIAL CONDITIONS:
RIGHT OF WAY FEE:
DISRUPTION FEE/FUND I 11:
RESTORATION FEE: -
".TOTAL FEE:
. ... .... RECEIPT NO..:
,ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div 1997
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.)
Comments:
I 'Jjia�r�� '-
CONTRACTOR CALLED FOR INSPECTION El YES El NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
LEGEND
PERMIT SUBMITTED BY
GTE
-70
PEDS CD
POLES 0
ROAD BORES
OVERHEAD LINES
I.D. UTILITY POTHOLE C-)
UG TRENCHINC ----UCT-
R. 0. w.
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CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMIT
Emit No.
Issue Date M tl&-, —7 1 Ci PC I
6 1 , —
A. eAddress or vicinity of Construction a Permit Issued To: -?4,1 "e'l i C C
: J73 1 b ot ieoa
7
• Owner: '41 n A i i./ t Type of Work to beDone:
t-1
Name
(�:n 4a e n ' Q_ Workin Connection With:
N&illng A ddress 0 Sub or Plat K'single Fam' ly
El Comml. / Ind. 0 Apt. Corkpo.
City, S ta te, Zip Code 0 Pavement Cut: 0 Yes V No
• Contractor:-
N a"m� e.
P0. pl^;i4 IR lr�
Mailing Address §iat—e Licen-se &umber
tA (A iogelej, agc)-� (0
City'r) State, Zip Code Telephone Number
* NO WORK TO BEGIN PRIOR TO PERMIT I SSUSIM*�*.
B. APPLICANT TO READ AND SIGN 1:��T FILiE
INDEMITY: 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 wVMS"@uizL,. foreseen or unforeseen, that may be made
mp,oy 1 `rvmQ4mited to the defense of any legal
against the City of Edmonds, or any of it's departments or e� , ec�, includin,75
proceedings including defense, costs, court costs, and attorney fees I reaso ntin&hi
Upon issuance of this permit, the contractor is responsible for(liworkm i d at iapslka. f on year
following the final inspection and acceptance of the restoration by he En ng D' 48 houlls
Funds held from the Security Deposit (estimated restoration fee n is omp red, at
which time a debit or credit will be processed for issuance to th a
Work is to be inspected. Restoration to be in accordance with 1 Ic C dance w h Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice i ring. Call
775-2525, extension 220. PA
co
I understand that this permit -must be available at the job site for inspection purposes at all times.
ate 1v I A Ru�
Signatur D
wrier or Agent
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By: (Z.
Time Authorized: NOold afte-r —days
Special Conditions:
Ammendments:
Permit Fee:- &
Security Deposit:
Receipt No.: 7_2_1
Fund 11IFee:
Street Cut Dimensions
� X
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
FIELD INSPECTION
'S (Fund 111 -9-ou
cony to Street Dent.)j
Comments:
Diagram:
Contractor called for inspection_ Yes (iR)
Work Disapproved By: Date: Bv: Date:
5P
Work Approved Bv:
--Da+-e:
Inspector:
Ena. Div. December ln78
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CIT,Y OF EDMONDS Wrmit No.
PUBLIC WORKS DEPARTMENT Issue Date
RIGHT - OF - WAY CONSTRUCTION PERMIT 311A 13MUS
A. oAddress or vicinity of Construction o Permit Issued To: e
71*%i,-_A�,7
Owner: -.6' 1-1;2 A'. 7— E 0 Type of Work to be Done:
Name
Work in Connection With:
Mailing Address 0 Sub or Plat Single Family
0 Comml. / Ind. 0 Apt. Condo.
City, State, Zip Code Pavement Cut: El Yes El No
Contractor:— ;7�1111 7)
Name
V/6
t_ v!—
Mailing Address State License Number
All-"J. 1j,11y 9_, �0_36,
City, �tate, Zip Code Teleph`on� Number
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
B. APPLICANT TO READ AND SIGN
INDEMITY: 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, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's 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.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in, accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this permit must be availa
Signature: —
Owner or Agent
at the job site for inspe I ction purposes at all times.
Date
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By: J_.
Time Auih61zcd:' Vold after —days
Special Conditions:
Ammendments:
Permit Fee:-- ___.A�
Security Deposit:
Receipt No.:
Fund Ill Fee:
Street Cut Dimensions
X —
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. Dccember 1978
Eng. Div. December 1978
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CITY OF EDMONDS.
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. *Add I cinit of ConsWu Ct . n
11 -,r C�
in t _ 11
Owner: A(.
Name
/ 76 A7 ,6 <iD 't'
Mailine Address
e,.j e,902-0
City, State, Zip Code
0 Contractor: 1C
Name
Mailing Address
A4;o� ZAIA,�
City, State, Zip Code
Wermit No.
Date
* Permit Issued To:
A3
* Type of Work to be Done: -5/4246 C-4
Work in Connection With-
• Sub or Plat VSIngle Family
• Comml. / Ind. El Apt. Condo.
0 Pavement Cut: El Yes 0 No
;0, 1-n 0 - Af 4 - 1-�'2 2, 0-0 0
State License Number
0 -7 / - 4 1.) 0
Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ AND SIGN
INDEMITY: 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, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's 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.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant,
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this permit m s be available at job site for inspection purposes at all times.
Signature: Date 9-
0 net (or Agent
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By: 92��Mjcs
Time Authorized: Void after —days
Special Conditions:
Ammendments:
Permit Fee:
Security Deposit:
Receipt No.:
Fund I I I Fee:
Street Cut Dimensions
I - X —
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
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CITY OF EDMONDS 1W
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. *Address or vicinity of Construction
9 Owner: ------
Name'
-2 61
Mahing Aadress
City, State, Zip Code
0 Contractor:
Ka,m-,e,
Mailing Address
6ty, State, Zip Code
IW6t No. --I ' ---A -.. k 17-17
Issue Date 7 —1
1. . 4, 1 -
19 1 P e r m I t ls(� u o Fd/t-.,,
0 Type of Work to be Done:
0
Work in Connection With-
D Sub or Plat 7 Single Family
El Comml. / Ind. 0 Apt. Condo.
Pavement Cut: 0 Yes El No
-o-- 2 n - Af I'--'
State License Number
n -7 1 - c / I ' I ^
Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ AND SIGN
INDEMITY: 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, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's 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.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this permit
I
Signature:
be available atthle job site for inspection purposes at all times.
or Agent
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
Time Authorized: Vold after days
Special Conditions:
Ammendments:
Permit Fee:
Security Deposit:
Receipt No.:
Fund 111 Fee:
Street Cut Dimensions
X
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
—Rr=GE1VE2
Nov
13
Eng. Div. December 1978
FIELD INSPECTIONI ES
(Fund 111 - 97ute cony to Street Dept.
Comments:
Diagram:
Contractor called for inspection
T
.A7ork Disapproved By:
Work Approved BY:
Inspector:
Yes No
Date: Bv:
—Date:
Date:
Encr. Div. December 1978
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VED
CLAIM FOR DAMAGES NOV 17 1983
NOTICE Nav 1 Y".3 Eamonds City Clerk
Claim MUST e-priseii�_d_to the City Council and filed with the City Clerk within 120 days
from the date of Accident or Accrual of Damages.
To THE CITY COUNCIL OF THE CITY OF EDMONDS: 4
PLEASE TAKE NOTICE, THAT
(if —ried, give husbanAla ruame)
-7 r
WHO NOW RESIDES AT /74 6 L�? :2��� 161- J6YAL611, US
Ts—tate present actual address by.street, number and city)
AND WHO FOR SIX MONTHS PRIOR TO DATE OF ACCIDENT HAS RESIDED AT '9/oq�l
(Give residence by street, number and city)
CLAIMS DAMAGES OF AND FTW THE CITY OF EDMONDS IN THE SUM OF 8 7;7
arising out of the following circumstances:
Describe Claim, giving
DATE and TIYX injury or
damage occurred, PLACE
and full particulars.
Accurately locate and
describe defects caus-
ing injury or damage
and all acts of negli-
gence claimed.
Accurately descr-.*Lbe
injuries or A— e
State items of Aamq e
claimed. Itemize all
expenses and losses.
(Claim must be sworn to by claimant)
2
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of Claimant)
SU&VA= AND SW9PN -4:57"t
before me this I(::, EL _day of 42"'X.' 119afteL.
ga* 6'15,ubPc 'inand Tor Pie 4f-ate of )Ur.0*10,
Washington, residing a t,_ f 'N 061 eA-
X
.3109 165th P1, S. F.
JOB INVOICE
. - 0 1 1:! V,77 I k-,: I'! �i CL.; I
821-010i 774-lia4
CUSYUMERS 5ROUR NO.--
0 DERED'
/I �- / Y3
ORDER TAKEN BY
DATEf?RqLj1,;�D X"
0 P.M.
BILL TO
ADDRESS 17(,, -2.
MECHANIC
1�
CITY
HELPER
jOB NAME AND LOCATION
YZAY WORK
0 CONTRACT
,DESCFOP'TION OF WORK
C-�
-77:t PL-7�
F QUANT.
DESCRIPTION OF MATERIAIJUSED
I
PRICE
AMOUNT
7 A;
31V
It
V,
T-
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F -1
3
HOURS
LABOR
AMOUNT
TOTAL
MATERIALS
MECHANICS @
HELPERS @
TOTAL
LABOR
I hereby acknowledge the satisfactory
completion of jhe above described �2rk�,e
TOTAL LABOR
SIGNATUR��
tPL
�ATE COh ET�3
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STREET FILE
PLANNING DATA
40 F=ILE I
Name: Pf,+ty Y-viowlt471 P7avio a v-4 Vv Li ot*
Date: 08-0EV.2.0o(,
SiteAddress: T&!((oo+ P-VA,'X,
Plan Check #: BLD-2006- ()8 (P
Project Description: vvid crmyd ad&Olovi tD
+Dr �WWIVL3 'C71U6"O
Reduced Site Plan Provided:()& NO)
Zoning: JZ.�5-2_0
Map Page: + UT
I Corner Lot: (YES /8)
Flag Lot: (YES
Critical Areas Determination #:
El Study Required
U Waiver
SEPA Determination:
Exempt I'VI
El Needed (for sites with 500 cubic yards of grading or within 200 feet of Puget Sound or Lake
Ballinger. Requires: (1) Fee, (2) Environmental Checklist, and (3) APO List with notarized form).
Required. Setbacks
St et:
Side:
1,95tvtml lot"iAl
Side:
!�?qrho
Rear:
2- 5r /571 i f- (Coo
Actual Setbacks (mo (Aawl v2e)
Street:
Side: __�_Oe:
"'Or
Rear:
Detached Structures:
El Rockeries:
El Fences/Trellises:
El Bay Windows/Projecting Modulation:
Ctili�@eck: Y" -Ftw cAA" A, f Dvw A a m!%z a c Leo-,r D Y-- lo!l H
Parking Required:
Parking Provided:
Lot Area: . 951 0J G -X. I OF LP)
Lot Coverage: C/
Lot Coverage Calculations: N (,Coop Lf 14 0
Buildin Height
Datum Point: 8 aira ge. c7 i a
Datum Elevation: 152.'
Maximum Height: I
Actual Height:
ADU Created: (YES & 1,1 0-t- am A-D(A a av k "I+ +VVUA9C-
Subdivision: Lo+ 151 1411pot Pavy—
Legal Nonconforming Land Use Determination Issued: (YES
Other
4 1 -� + Avc,"
P 16:5 MAy eAeAM_ff
PlanReviewBy: gie�w 6,?a�
u D V1 -eA,� V1 +, Va VI'a ri C
W1
C�f fi -e . LJ C C4 4;,
'VI Aoi.
AVERAGE GRADE/MM HEIGW . PLOT PLAN GARAGE ADDITION
AVERAGE GRADE 134.25
MAMMUM GRADE 149:25- 1!53, r
. >C> ( M WYATT-KNOWLES RESIDENCE
TWO ADAPTED MOM SURVEYBY afy m�rc-i W1,N 17627 TALBOT ROAD
CHADWCK . & NNMRS. 8-8-00 varcqmcl� RE -SUB EDMONDS, WA
A-132 C-136 AUG 14 20+06 LOT .51 @ TALBOT PARK
B-137 D-132 ,ULDYING DEPAMUENT APN 005C14400005100
70TAL=537 537/4-134.25 C11 OF EDMONDS
0-
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REET FILE
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othing in this permit approval process shall be
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site condition whieh is outwide the scope of the
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ty be the subject of a separate
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,AUG --21 1'2006
BUILDING DEPARTMENT
CITY OF EDMONDS BUILDING DEPARTMENT
CITY OF EDMONDS
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