17901 69TH AVE W.PDF111111111111
5301
17901 69TH AVE W
ADDRESS: 17ql)
TAX ACCOUNTIPARCEL NUMBER: no -,10,3 7,0 0 o o 0 4,/�
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: 610'? DETE"PMINATfON: 0 Conditional Waiver E] Study Required /GyWaiver
DISCRETIONARY PERMIT ff'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID tEE LID #:
S�2 25
SHORT PLAT
SIDE SEWER AS BUILT DATED.
SIDE SEWER PERMIT(S).#:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
LOT:
BLOCK:
LATEMP\DS'Vs\Fomis\Street File Checklist.doc
-C. I b7-
Is #.P20
City. of Edmohds
Development Services Department
Planming Division
Phon * e: 425.771.0220
Fax: 425.771.0221
'Me 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 the application to the City.
The purpose of the Che cklist 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 e asily
avail - able from observations of the' site or -data available at
City Hill (Critical, areas inventories maps, or s
S) oil
s
. urveysi-
Date Received: - 7/Qc� lry,-
City Receipt#: / . i /'_
Critical Areas File #:_,�2
Critical Areas Checklist Fe 135.00.
Date Mailed to Aimlicant:
A property owner, or his/her authorized 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
pernift application.
Please submit a vicinity map� along with the s
I igned copy
of this form to assist City staff in finding and locating the
specific piece of property described on this fom. -it
.addition, the applicant. shall include , other pertinent
infbrmation...(�.g. site plan, topography map, etc.) or
studies in copjunction with this Checklist to assistant staff
in completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns, �in consideration on' the processing of the application. agrees
to release, indemnify, defend and hold the City.of Edmonds harmless from any and alldamages, including reasonable
attorney's fees, iihsing from any action 'or -infraction , based , in whole or part. upon false mislead* miaccurate or
incomplete informition furnished by the applicant, his/her/its agents or employees.
By. my signature, I certify that the information and exhibits herewith submitted . are true and 'correct to the best of my
knowledge and that lam authorized to file this application on the behalf of the * listed below.
I owner as
SIGNATURE OF APiLICANT/AGE* DAM- `-77 /Z,5 /06
Property Owner's Authorization,t
By MY signature.1 ter* that I have authorized the above Applicant/Agent to apply for the s I ubject land use applic- ation,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subiectnmnPrtu fn,, tik-
Owner/Applicant:
Name
t V\
kck
Street Address
"9b
%.P,3 0-t
city State Zip
Telephone: 44'Z5 —1 Ll -1 4-x_
Email address (optional):
Applicant Representative:
mc,
Name,
7
Street Address
lb zoci
City State Zip
Telephone: C4-L5)
Email Address (optional): �al M - 0h
#P20
CA File No: C, P-A - IMP -
Critical Areas Checklist. 01 C) 9
Site Information (soils/ topography/ hydrology/vegetation)
1 Site Address/ Location: FXOM 6c� Npw G
2. Property Tax Account. Number:
3. Approxninate Site Size (acres or square feet): .7-S 1A L 9_G5
4. Is this site currently developed? V yes; no.
If yes; how is site developed?. VN00SE
5. Describe the general site topography. Check all that apply.
V� Flat less than 5-f.eet ielevation change over entire site.
Rolling: slopes oi-i. site generally less than 15% (a vertical rise of.10-feet over a horizontal
distance -of66-feet).
Hilly: site of more than 15% and less than 30% (a vertical rise of 10-feet
over. a:horiz6nW 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 escr:ibe):
6. Sftec6ntAinsareA§ of year-ioilndsitandifi" * waten' rx6 ;'Appiox. Depth:
7. Site conta:in§. areas of seasonal standing water: nO Approx. Depth:
What season(s) of the year?
8. Site is in the floo'dway floodplain V\n ..'of
�w
_,ater course.
9. Site contains a creek or an area where water flows across the grounds'surface? Flows are year-round?
n t,*) Flows are seasonal? (What time of 'year?
10. Site is primarily:. forested 'meadow shrubs nuxed
urban landscaped (lawn, shrubs etc).,
11 Obvious we'dan"d'is'present on site:',
For City Staff Use 0 nly
1. Plan Check Number, if a . Pplicable? ND"f-' given
2. Site is Z6rfed?,!.
3. SCS mapped soil type(s)?, C(l ctc"( VV0 0 d 9 ra V e I I Lj 5 a n dLj 10 a M 16 -,Z15 S1 . OPC5)
& C, -r— e,
7--6-1- top
4. Critical'Areas inv entory or C.A. map indicates Critical Area on site? C; .9, a C+
pyvV-wty 10LAi- tVLA'12 f'1PL_1--
5. Site within designated earth, subsidence landslide hazard area? _N 0 -
DETERMINATION
STUDY REQUIRED -WAIVER
Reviewedby- CliVla,, G1)G(,ia--- —Date:
OWNER/CONTRACTOR IS RESPONSISFOR
EROSION CONTROL A% DRAIN)TEE
X
(E) 5'CHAIN LINK
FENCE
�4rli
Lqg!gred —A=ol
�ront VJ N ol
'o
S'des W 115-- 2 - _5 to 11b
Other ------
1-5- N 0,
0, t
(N) PORCH 21.73 SF
(B)
+T.55 +104. 15
ALL EXPOI
BE COVEFED,,VJiTHIN,,2,, DAYS.",
4/1,
a U FIT 6,wwouw -ION/
170 CONN 10T TO PM SYS7,
.�.,AiQ20SF/ X
C/o
Helah
*7 '
c�
I-R.
NE
SOR 35 w7v f
_iCH 40
'.12
v MAN **ESIDENCE
1,105SF
GARAGE
151611
3 7SF
H C
(D) (N)COVERED POIRCI /0
+lQI.2( I 240SF 151r8l'
R
0
F__=l I TI(A) I i
(E) CONC WALK& PORCH,,T(5-lr +102 85
BE REMOVED
"Nothing irk tw 4m t appro
interpreted as alloo . or W"!n
p g
mailitemee of any currefltIy e 11-1
nolmdorming Or Impermitted b
uff=_
n .6, owe iffilli Of
app hL W.-V
Ikatiorvr, ()f wbet
Itz 1 3 dmm on the
site plan or dmwh'*. Such building structure ot
9@9dition or be e subject of a separate
0
OWNERS:
EDMONDSON WMI, M. & KATHRINE M.
17901 69TH AVE W
EDMONDS, WA 98026
TAX NUMBER:
60408700000400
IMPERVIOUS SURFACE CALCS:
EXIST BLDG ROOF OUTLINE: 1,708.32SF
EXIST COVERED PORCH:
OSF
EXIST DRIVEWAY:
413.29SF
EXISTING PATIO:
OSF
PROPOSED ADDITION:
1,020SF
PROPOSED GARAGE:
OSF
PROPOSED PORCH:
21.73SF
PROPOSED(COVERED)DECK
240SF
TOTAL IMPERVIOUS AREA:
3,566.64SF
HEIGHT CALCULATIONS:
A= 102.85
B= 104.35
C= 105.55
D= 105.20
AVEREAGE GRADE: 104.48
ACTUAL: 114.75
MAXIMUM: 129.48
LOT COVERAGE: APPROVED AS NOTED
3,566.64SF (29.7n.) 8Y ENGINEERING
LOTAREA:
r
12,OOOSF
bate: zc;zo&
�
1XI �.l I
7_�l
CRITICAL AREA WAIVER:
2006-0109
APPROVED BY PLANNING
ZONE: RS8
MfiWw I D I rp / ioo( a
SET BACKS:
FRONT: 25'
SIDE: 7 1/2'
REAR: 15'
(E) SIDE SEWER PER AS -BUILT PERMIT
NUMBER 9423. SIDE SEWER WILL BE
RECONSTRUCTED PER ECDC CHAP. 18.10
AND 18.20 AND UPC CURRENT EDITION
AND DEPENDING ON CURRENT
UNEARTHED CONDITIONS
69TH AVE W (E)MANHOLE
0 COVER 100
0 10, 20'
SCALE: 1" = 20'-0"
STAR CUSTOM DESIGN SHEET' SITE PLAN
DRAFTING AND DESIGN SERVICES RESUB
WLLIAM & KATHRINE EDMONDSON
(425) 466-2686 PROJECT' 17901 69TH AVE W
LYNNWOOD, WA 98036 OCT 12 2006 EDMONDS, WA98026
WVWV.LJSINNOT_r.COM V'k A=PLrr DATE: OCTOBER 11, 2006
0 PLANNING DATA
0 11 S TR E E T F=ILE I
Name: W(11i0jVV1 A V-4-hie4-mt, 64movidso-n
Date: 1C).0S.-Z-00(,
SiteAddress: (091-H *VeW
Plan Check #: BLD-2006- 10 S 7-
Project Description: rcid 1000igpi 4 VtW roof- VItw ta,,4vo-bm L
0 C1 0 -F IV IF f tTA4 C 4 VV 0
Reduced Site Plan Provided: NO) J
Zoning: P- e) —'a
Map Page: +0 +
Corner Lot: (YES /&
I Flag Lot: (YES /(9
Critical Areas Determination #: C'p-A-2,C)D(P. olog
El Study Required
K Waiver
SEPA Determination:
RE Exempt /- c5C) �-y CA fi, t3 V-&l 6LAA�!�
El Needed (Requires: (1) Fee, (2) Environmental Checklist, and (3) APO List with notarized form).
e d Setbacks
t et:
re
LW)
ide:
Side:
ear:
Actual Setbacks N C-W
Street:
Side: Side: 'J
Rear:
El Detached Structures: novia C-Mowyl
El Rockeries:
W Fences/Trellises: e-;c.. fclAc.4,� GV1 0WvJ g I C,1A 6"V\ LA'v\
El Bay Windows/Projecting Modulation: via V1,-- C. Vio \,V Y)
E] Stairs/Deck:
Parking Required:
Parking Provided:
LotArea: 17,, 000 47 ( c7Vw\Ao1V1)
LotCoverage:
Lot Coverage e�K - Sf-P-- I 10 5 ACW Ad A 1. L 0 710
Calculations: L301v-c4cje- nr-,w P 0 V-CA -- 1,4o
BuildingHeight
DatumPoint: M0jv*1k,,oU. WVVY
Datum Elevation:
MaximumHeight: ,JE;1
Actual Height: I ID - 'k(o I-,;
ADU Created: (YES
Subdivision: --*
Legal Nonconforming Land Use Determination Issued: (YES
Other
A c;
61 ei + 4 L+
+
Plan Review By: ge;w Co,�
0,61.40t mol� 4�4,tvvjtovl
PERMIT- NO: 9412.
Cigilly -of Eii!�JhObds
PERM T EXPIRES
1)c SIDE SEWER PERMIT
Address' of Construction:
Property Tax Account Parcei No. _.1940Y_
Attach copies of all access and utility easements Verified and Approved b ..........
Owner and/o(C�ontracto
B uil ding Permit
Contractor L WIN601111-1E
[�PSingle Family Invasion into City *.Right -of Way:, E] Yes. E]�No,'
F1 Multi -Family (No. of Units, ARW Construction Permit
ETCommercial (No. of Units' Cross, other "Private Property: El Yes %
e e
F] Public "Attach legal description and copy of ricord 'd eas6mie'nt.,':, r,
6
SZ) 6
OwnerA/ ��ontr7act4 /�141 I
Date"
&Ae(or'contractor signature. and acknowledgement statement:
0y signing for this permit I certify that I have -read the City.'s public handout entitled,
ide Sewer Specifications, and shall comply with all City requirements outlined therein.
.9 CALL DIAL -A -DIG (1 800-425-5555) BEFORE ANY EXCAVAT�qN,,
9 FOR INSPECTION CALL 425-771'0220 extension;329 V'
24 HOUR NOTICE REOUIRED FOR ALL INSPECTION REOUEST
S
.. . ....... . ... .. ...... a ........... .. ..............
FOR OFFICE USE ONLY . ...... . ..
Permit Fee $ Repair Fee $ Issued By
Trunk Charge $ Date Issued:
Receipt N
Assessment Fee $ ID
City Permit Surcharge Fee $5.00 'Total Fees Paid $,
0
NOTE: IFJOB,SITE IS,N'Ot READY F R]NSPECTION WHEN
INSPECTORARRIVES A $45 RE',INSPECTION FEE WILL MCHARGEDS'
Job* Site Ready YES. No Date: Initial:
'Parbal Inspection* Date: Initial:
s
pection:
Partial In Date' Initial:
n i I s-built to Street File: El
FINAL INSPECTION APPROVED: Date:� 1 it'a A'
'M PERMIT MUST BE-POSTED,ON JOB SITE
White Copy: File 'Green Copy: Inspector Buff.copy�, Applicant
L;temp;bldg;forms;sspermitjlg4/00
1179011 15' 3'
4'
F C/o 45*
18, 16'
22* 13' 26'
C/o
7 - — -----
(D 18' C/'Oj
2' 45*/'
22' '1
Wye, -30, [\K'
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[,MT1GF- NOWARRAMOFACCUMOV Th!,in-formg-.-C� sht1.�j1jcjtIje
aft?.,:hajd map wass compiled for use by the City of Edmont% j�
anc, coisultants. The City of Edmonds does not warrant .3f
ariyl,ling set forth on the map. Any person or entity ;y
conduct an independont Inquiry regarding the infurnii-,ji'r,
th�, r.r....ap, including, but not limited to, the location of a.9y
811U.' ' !,, Such stubs may or may not e)dst and may or m--y na c:,,,',.i u
th,: l0oai,oii shown, Neither the City of Edmonds nor its employ�_7, cr
Offiw;b shall be liab!e forthe Infonriation given on this map, nor for any or,
reprisenagon pruvided basdd upoil s?Jd map
0 E.D* CITY OF EDMONDS SIDE SEWER AS- BUILT
<) ADDRESS: PERMIT
17901 69TH AVE W NO. 9423
CONTRACTOR: HOMEOWNER: SCALE:
JAMES NEWTON UNKNOWN NTS
DATEINSPECTED: INSPECTED BY: DATE DRAWN: DRAWN BY:
&t. 1890 5/8/01 xx 10/16/06 LABILA