17905 TALBOT RD.PDF111111 lill 1111
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17905 TALBOT RD
A
TAX ACCOUNT/PARCEL NUMBER: n2
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: 01-25V DETERMINATION: F
] Conditional Waiver R Study Required &V6iver
DISCRETIONARY PERMIT
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PLANNING DATA CHECKLIS
SCALED PLOT PLAN DATED
SEWER LID FEE $:
LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:- lb9
SIDE SEWER PERMIT(S)
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DATED:
OTHER:
LATEMP\DSrs\Fomis\Street File Checklist.doc
PLANNINGDATA41
SINGLE FAMILY RESIDENTIAL
IFSTMETF�ILEJ
Name: LA
Dat e: 0
Site Address: J J
Tax Parcel
Project Description: r-6 e,� Z5 vtv-- �eL�
Plan Check #:
Reduced Site Plan Provided: (tES)/ NO)
Zoning:
Map Page:
I Corner Lot: (YES
Flag Lot: (YES
Critical Areas Determination (SA ,� 9 q o e)o
El Study Required
U Waiver — )
SEPA Determination:
a Exempt
El Needed (for over SOO cubic yards of grading)
0 Fee 0 Checklist 0 APO List with notarized form
Required Setbacks e- K/O
Street:
Sid
Side:
1 15
Rear:
1 2 §--
-
ActualSetbacks
Street:
Side:
C)
Side:
Rear:
El Detached Structures:
Rockeries:
Fences/Trellises:
El Bay Windows/Projecting Modulation:
R'Stairs/Deck:
Height
Datum Point:
Datum Elevation:
Maximum Height Allowed:
Actual Height: T�-
Offier
Parking Required:
Parking Provided: T—
Lot Area: -7 145-
Maximum Lot Coverage: 35% Proposed:
d4tc V:oc,-.— C.,V4, ec,,� WJ< tje- d
Lot Coverage Calculations: 00�5 + -f
:3 5.6 y S,61 9L3 I
ADU Created: (YES /P) t VVe VVC-A- WEN ohnS I D I q 1 5-�5—
Subdivision:
Legal Nonconforming Land Use Determination Issued: (YES / 00
Comments
Plan Review By: Planning Data Form 07-14-09.doc
If PLANNING DATA
Plan Review By: Planning Data Form 07-14-09.doc
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Site Area 25,000 sq.ft. (approx.)
COILENO. 94-80
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: C (s* ale,-t al CV �-1
2. Property Tax Account Number: Coo - 0 q�� -
3. Approximate Site Size (acres or square feet): AMM c).-x a-64 acof(S4-
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 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):
r)
6. Site contains areas of year-round standing water: Approx. Depth:
7. Site contains areas of seasonal standing water: \j D 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? P C) 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: On
Rcv.01A)094
& 9 0 . 1 9M.-
City of Edmonds
�q n - ,
70
Aoe
Critical Areas Checklist
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 Edmondsprior
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 the checklist, sign and date it,
e-'o >no/o L-),5, aD11 '7ecpc
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.
With a signed copy of this form, the
applicant should also submit a vicinity map
or plot plan for individual lots of the parcel
with enough detail that City staff can find
and identify the subject parcel(s). 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 Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant:
Name
Street Address
�J 4 '?90 Z-b
City, State, ZIP Phone
q
U'tVL-#-" _' _J
Signature J Dfate
Applicant Representative:
Name
Street Address
City, State, ZIP
Signature
Phone
Date
COILE NO.
Critical Areas Checklist
Site Information (soi.Is/topography./hydrology/vegetation)
C,
1.
Site Address/Location: C 5 A CV uc
-0
2.
Property Tax Account Number: G. cc) - 0ob S,
3.
Approximate Site Size (acres or square feet): ADW11 cD.A CA04 aco (s4,
4.
Is this site currently developed? >� yes; no.
C->
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. JUL 6 1998
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 -
LL.
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
LU
horizontal distance of less than 33-feet).
LU
Other (please describe):
6.
Site contains areas of year-round standing water: Approx. Depth:
7.
Site contains areas of seasonal standing water: Approx. Depth -
What season(s) of the year?
8.
Site is in the floodway NC 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 Oawn,shrubs etc) X
11.
Obvious wetland is present on site: N 0,
RevOl/04/94
ee 7- t-x,,f i4i TD 6tf-'K-�—
Aoe
& 9,0 . 194 -
City of Edmon&
Critical Areas Checklist
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 representaiive,
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 permit application.
With a signed copy of this form, the
applicant should also submit a vicinity map
or plot plan for individual lots of the parcel
with enough detail that City staff can find
and identify the subject. parcel(s). 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 Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant:
- t-Ylt-
Name J
Street Address
Z-(2
City, State, ZIP Phone
Signature date
Applicant Representative:
Name
Street Address
City, State, ZIP Phone
Signature
Date
dm.oncol
City, of E
RIGHT-OF-WAY CONSTRUCTION,
PERMIT
Permit Numbei-9B-05)
Lssue Date: &1(0191
A. Address or Vicinity of Construction: 1790.5 Talbot Rd.
GTE to place, operate and maintain a buried service
I,q C. B. Type ofWork (bespecific);vira frnm Am isting Pote "service pole" located at
17905 Talbot Rd. then east to a residence -at 17905 N�S!W!dt f�IE to plow
107 ft., push no driveway and push no road.
C. Contractor: GTE Northwest Incorporated
S312C W. Casino Rd.
Mailing Address"'
WA 98204-11,40
State License #:
D. Building Permit # (if applicable):
Contact: Jerry&Scott, 425/774-5921 or 425A88-1628
Phone:Rose Brown, Permit Coord., 425/356-4027
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. E] Commercial EJ Subdivision El City Project a V��flily (PUD, GTE WNG "-CABLE, WATER)
E] Multi -Family [:] Single Family F1 Other GTi�t_.O.'# 28'5'0-"9'P0'01DB 242310
INSPECTOR:
INSPECTOR:
F. Pavement or Concrete Cut: 0 Yes JNNo G. Size of Cut: x H. Chargq�,$
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application to hold the City of Edmonds harmlessfrom 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 or
employees, including or not limited to the defense of any legal proceedings including defense costs and atiorneyfees by reason of granting this permit.
THE CONTRA CTOR IS RESPONSIBLE FOR WORKAIA NSHIP AND M4 TERIA LS FOR A PERIOD OF ONE YEA R FOLIO WING THE FINA L INSPEC-
TION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL B9,HELD UNTIL THE FINAL STREETPATCHIS �OMPLETED
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 permi,t 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 completion:
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 street cut trench work shall be patched with asphalt or City approved material prior" to the end of the working day;
NO EXCEPTIONS.
I have read Vtove st e en�ttnd understand the "permit requirements and the pink copy of the permit will be
fo nsvection-mmDes-es.
available on sV4 t all tZLY, n,
Signature: 1 M 4 . 1,4&� Date., 2-13-98
DaM ��ui_rer_ �eTraN�TrWrAgent) Section Manager -Access Design
. CALIPIAL-A-DIG PRIOR TO. BEGINNING- WORK
FOR CITY USE ONLY
APPROVED BY: RIGHT OF WAY FEE:
TIME AUTHORIZED: VOID AFTER DAYS DISRUPTION FEEIFUND I 11:
SPECIAL CONDITIONS: WA RESTORATION FEE:
T OTAL 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:
CONTRACTOR CALLED FOR INSPECTION El YES E-] NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
LEGEND
PERMIT SU8MITTED By
GTE Z 4*
rl 4 0
-107
1
PEDS 0 G
POLES 0 rIj
ROAD BORES
OVERHEAD L114ES
I.D. UTILITY POTHOLE. CD A
LIC TRENCH114C 4JC T 01
R.O.W.
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Site Area 25,000 sq.ft. (approx.)
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JUL - 6 1998
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Water Service Drawing
The City of Edmonds EASEMENT NO. .... .......................... ............
NEW CONSTRUCTION REPAIRS F LID NO . .................. . ASMT. NO . ..................
OWNER ....................................... CONTRACTOR IAAk�< ....... KWTGOM.ek�� ........................ PERMIT NO . ....................
JOB ADDRESS .179.05 ..... -Tjk.�nso.T ..... ;�-o ........ LEGAL DESCRIPTION: LOT NO . ......... ....... .................... BLOCK NO . ....................................
........................................................................................................................... .................................
NAMEOF ADDITION ..................................................................................................................
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ATE ............... 1:7-55 ................. Byje"4 ..... F** -------
The City of Edmonds
APPLICATION
for
SIDDE SEWER PERBUT
NEW CONSTRUCTION REPAIRS 0
OWNER .... .............. ?r ............................... .... ..........
.... .... .. .... .......... ..... ......... .. ...
ADDRESS JZ1q..0.:5 .......... .......... .............................................
co
EASEAIENT No . .....
A
- 64/Al/ . . '�FgLl)
CONTRACTOR ...... ....... 54F ............................................ PERMIT Nu(. .............
LEGAL DESCRIPTION: LOT No.../'
................................. BLOCK No . ............................................
NAME OF ADDITION—���� ........ r4 ... ........... /5k'e . ..........................................................
0L61 '�g Ndv
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A.-pproved:
DATE ..... . ... .............
..........................................
CITY OF EDMONDS
CIVIC CENTER — WATER -SEWER DEPART31ENT Call PRospect 6-1107 when work
is ready for inspection. (No inspec- N2 3684
SIDESEWERPERMIT tions Saturday, Sunday or holidays.) I
ADDRESS ...... ............... tR2jQyKXR ........ 2.72-0 5.Talb.Qt..Rci.ad,
OWNER ................. q1t ... Preimes
.................................................................. CONTRACTOR ........ N�AJ�Ip� & Son
April- 24 .1970 ..................................................
Permission is granted .......... A�X*j4X
19.7Q., for ........ ............... days to REPAIR or CONNECT a side sewer
with City Sewers in accordance with aPPlication on file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. I —The owners of the property may obtain a permit to construct sewer Inside Pro erty line. A licensed Side Sewer Contractor must
be employed to construct side sewer In street area. Do not cover any portion ofPsewer before it has been Inspected.
NOTE No. 2—Obtain full Information regarding Ordinance 11-16.030 and Regulations governing side sewers when You get permit.
NOTE No. 3—Top of ride sewer must have at least 30 inches Coverage at property line and 12 Inches inside Property line; minimum grade of 2%.
No bends in grade sharper than 'A will be permitted .
No. 4—Trenches In street must be water ettled and surface of street restored to 0091nal condition. Contractors shall be responsible for
failure due to improper work whJch'� may develop within one year Of completion.
NOTE No. S—It is unlawful to alter or do any other wor
tenances except to Insert the pipe Into t k than Is provided for In the permit, or to do any work on the main sewer or its appur-
he wye.
'Abb ICU71 PRIDOWNSPOUTS
1-7,14::2 5 -IA�-Et�r
Mb.S'AANOLOCKS
APPROVED BY PLANNING
OWNER/CONTRACTOR IS RESPONSIBLE
FOR EROSION
CONTROL AND DAMAGE
P, r2.0, 6 2!
STREET FILE
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2003
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
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SITE ADDRESS: ' ' 1 -7 qolr- E����PL�ANCH
PROJECT DESCRIPTION- A-"- f Am as%,eo, e2. o
REDUCED SITE PLAN PROVIDED(&Njo
MAP PAGE: L405- CORNER LOT: FLAG LOT: (Yel �s
ZONING: R--5-2-0 CRITICAL AREAS DETERMINATION
13 Study Required:
13 Conditional Waiver
SEPA DETERMINATION:
13 Fee
L) Checklist
L3 APO list w/ notarized form
U (Needed for 500 cubic yards of grading, 'Shoreline Area- site within 200 ft. of Puget Sound or Lake Balilinger)
A30'Exempt
SETBACKS: kN on 10 1_t� 5s,
Required Setbacks; 01
Street: 2�5 Left Side: Right Side: Rear:
Actual Setbacks-
Stree;._:�IELeft Side: C> Right Side: Rear: 0
Street map checked for additional setback required? (Yes No DNA)
U DETACHED STRUCTURES:
L3 ROCKERIES:
U FENCES/TRELLISES:
Q BAY WINDOWS / PROJECTING MODULATION:
U STAIRS/ DECKS:
PARKING:. Required:
_�Actuai:
LOT AREA:
_J7
LOT COVERAGE.
Calculations: InN" 2�( 0 4 -711,2. 4- 14 19
BUILDING HEIGHT- I
Datum Pol�t:,Sewe-v- Datum Elevation: 00
MaximurnAllowed: --Actual Helght:,;�_4.3S "/I
A.D.U. CREATED?: (No / Yes)
SUBDIVISION:
LEGAL NONCONFORMING LAND USE DETERMINAT1.0N.IS.SUED: (Yps_/ No)
OTHER:
Plan Review By:
NewBPP1anningDataForm.D0C
0
0
PLANNING DATA
SITE ADDRESS: PPDATE:
CL41� N/4-
ZONING: -2b PEFHmff#:— 0(4
PROJECT DESCRIPTION:
SETBACKS:
Renuired Setbacks:
Front:jWb-Left
ctual Setbacks:
Side: Right Side:
Rear:
Front: %6 Left Side: / I Right Side: 43 Rear:
FLOOR AREA:
LOT COVERAGE:
Maximum Allowed: Actual:
BUILDING HEIGHT: -46,L9W -C7� 14APE�-
Maximum Allowed: &IIA- Actual Height: AIIA-
SUBDIVISION:
CRITICAL AREAS #: IZ-7 �
SEPA DETERMINATION:
LOT
OTHER:
9 . . 0
PLANNING DATA
NAME: b66/-77- 1
SITE ADDRESS:— J-M 57 DATE: -7
ZONING: PLAN CHK#:
PROJECT DESCRIPTION: 50 47/c,-,
CORNERLOT A/P (Yes/No) FLAG LOT X/
161 (Yes/No)
SETBACKS:
Required Setbacks: If , \� 5
Front:05' Left Side: IV\ Right Side: Rear:
Actual Setbacks: / -7 -7/
Front: 16'7 Left Side: 10 Right Side: Rear:
Street map checked for additional setback required? , �(Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED (Y/N)
LOT COVERAGE: 76 Z.
Maximum Allowed: Actual:
G55 4� ?5-?
BUILDING HEIGHT: X V
Maximum Allowed: V5 Actual Height: 15
Datum Point: - Datum Elevation:
A.D.U. CREATED?: X04
SUBDIVISION:
CRITICAL AREAS #: 6t,,11 -,f 0 - tj,�- I V.-L-
SEPA DETERMINATION: C X&--,�
LOT AREA:
OTHER:
Plan Review By:
cAfi1es\permit\Ap1andaLdoc
USE NIT
ZONE PERK
CITY OF EDMONDS NUMBER
CONSTRUCTION PERMIT APPLICATION JOB I I E/APT #
OWNER NAME/NAME OF BUSINESS ADDRESS 1
141 " L-0 A (V LEGAL DESCRIPTION CHECKI SUBDIVISION NO. LID NO.
M AIN) M 1A 0
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved 0
N12;�!Z - RW Permit Required 11
CITY' ' I ZIP TELEPHONE NUMBER EXISTING — REQUIRED DEDICATION Street Use Permit Raq'd 0
14Q;� 179), 1 F)EYO) Inspection Required 0
PROPOSED Sidewalk Required 0 Cc
NAME- I Lu
METER SIZE. LINE SIZE NO. OF FIXTURES PRV REQUIRED
YES 0 NO 0
777=
ADDRESS
R MARKS
W
TELEPHONE NUM
0
Z
ZIP" 13ER
NUMBER
97, a
sTAiE LICILNSE NUMBER tZA
. 2. 10,112,
Lecial escription of Property - include all easeme
Property
Tax Account
Parcel No. f)4 r17 - 000
MEMO
EWED BY
VARIANCE OR CU
ADB #
SHORELINE #
SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE
EXEMPT
ALLOWE
PROPOS 01
ALLOWED
I
X
IPROPOSED
EX
LOT COVERAGE.
REQUIRED SETBACKS (Fr.)
PROPOSED SETBACKS (Fr
ALLOWED
PROPOSED
FRONT SIDE REAR
FRONT UR SIDE REAR
10-7 L/3 -7/
D
LOT AREA
ANNIN2,PE IEWBY ,
I
A E
_71 T
e" 5,
LJ NEW
RESIDENTIA
PLUMBINGIMECH
ADDITION
Z,
COMMERCIAL
COMPLIANCE OR
CHANGE OF USE
REMODEL
REPAIR
M
APT. BLDG.
GRADING
-CYDS.
SIGN
FENCE
x _FT)
I
CHECKED BY
TYPE OF CONSTRUCTION
I VL�_ /V
CODE
I q—
FIDEMOLISH
13 GARAGE
CARPORT
WOODSTOVE
INSERT
RETAINING WALL/
ROCKERY
SWIM POOL
HOT TUB/SPA
RENEWAL
SPECIAL INSPECTOR '
REQUIRED 0 YES
AREA
REMARKS
PROGRESS INSPECTIONS PER UBC 108
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPL—:
ISAr tk 41
NUhisdw UMBER� O� CRITICALIlgAjVt
OF DWELLI
IT
STORIES UNITS
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
illilm
FINAL INSPECTION REQUIRED
min
W�M! VALUATION
LOAD
- - %-- #1 1;.- 1 - - I - . -.,
PLAN CHECK FEE
-lot
A A'
I
BUILDING
HEA S10dRCE: JGLAZING
%
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to Wdone on privafe property ONLY.
GRADING/FILL
Any construction on the public domain (curts, sidewolks,
driveways, marquees, etc.) wilVirequire separate permission.
STATE SURCHARGE
Permit Application: 180 Days
STORM DRAINAGE FEE
Permit Limit: I Year - Provided Work Is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of th is permit shall not be deemed to
PLAN CHECK DEPOSIT
modify, wa ive or reduce any requirement of any city ordinance
nor limit In a ny way the City's ability to,enforce any ordin'ance
TOTAL AMOUNT DUE
provision."
I hereby acknowledge that I h;1_e readi his application; that the
ATTL - NTION
APPLICATION APPROVAL
Information -given is correct; and that I am the owner, or the duly
authorized *agent of the owner. I agree to comply with city and
THIS PERMIT
This application is not a permit until
state laws regulating construction; and in doing the work authoriz-
AUTHORIZES
signed by the Building Official or his/her
ed thereby, no person will be employed in violation of the Labor
ONLY THE
WORK NOTED
Deputy; and fees are paid, and receipt is
Code of the State of Washington relating to Workmen's Compensa-
acknowledged in space provided.
tion Insurance aria RCW 18.27.
INSPECTION
SIGNATURE (OWNER (nt ENT), SIGNED
DEPARTMENT
OFFICIAL'S SIGNATURE DATE
JUAIr
I'AN
V
CITY OF
hl,
EDMONDS
'19/w 7
CALL FOR
7ELEASED . I . 31L/ UAI.
ATTENTION
INSPECTION
71A I
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL. INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220
ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
SECTION 109
1
-
or, Yt' I cip,
PINK — Owner GOLD — Assessor
0
Z
RECEIVED
CITY OF EDMONDS
coms r_TInN PF UIT APPI I(%_AT1nM
PERMIT EXPIRES
USE
ZONE PERMIT
E6,�Ul NUMBI
J013
OWNER "E/NAME OF BUSINESS ADDRESS 17'J' 0 5 =4 i
hQ 0 4A " 1_� +- F-rr— I PLAT NA.MEISUBDIVISION NO. I LOT NO.
MAJILING ADDRESS
I -7q 05- -fkL eOT- W19
CITY ZIP TELEPHONE
.t I) "tV 05
NAME
ADDRESS
-72-7& Am. A)&
CITY ZIP 7TEL.EPHONE
.."�S654-raz- .1slir
NAME St. #
K426AI-xa"r-fr Ic
ADDRESS
. . _:� ;?- 2 ;�&l A AV
CITY ZIP TELEPHONE
!!*74 M k. cl j;.5- Ly -7 to
STATE LICENSE NUMBER EXPIRATION DATE QWORRN
PROPERTY TAX ACCOUNT PARCEL NO. . I —
0 0
0 NEW
RESIDENTIAL
PLUMBING / MECH
C&ADDITION
0 COMMERCIAL
COMPLIANCE OR
0 CH ANGE OF USE
REMODEL
0 MULTIFAMILY
0 SIGN
0 REPAIR
FENCE
0 M CYDS 0 ( X FT)
0 DEMOLISH
0 TANK
0 OT;JER
0 GARAGE
CARPORT
o RETAININGWALL
ROCKERY
FIRE SPRINKLER
0 FIRE ALARM
(TYPE OF USE. BUSINESS OR ACTIVTM EXPLAIN:
'51V44d
A
NUMBER
NUMBER OF
CRITICAL
OF
DWELLING
AREAS
STORIES
UNITS
NUMBER
DESCRIBE WORK TO BE DONE
APO n4W
10,9DAMIn 50/MF
A-60 t, t 6.81)k Il�i
6hW4iCv9 -
2191P
JJEAT DOURCE f GLAANG % LOT SLOPE %
F&A F �z
PLAN CHECK NO: VESTED DATE
-7
THIS PERMIT AUTHORIIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
It BE DONE ON PRPIATE PROPERjON
VgA CONSTRUCTION ON THE PUBLIC
DOMAIN ICURBS, SIDEWALKS, MARQUEES, ETC.) WILL REQUIRE
TEPESSEPARAnPE ISSION.
PERMIT APPLICATION:' 180 DAYS
9L PERMIT LIMM I*YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY; DEFEND* AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY To ENFORCE ANY ORDINANCE PROVISION.*
I HERE13Y 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
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWSREGULATING CONSTRUC-
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
'WORKMEN'S COMPENSATIO&4NWRMCE AND RCW 18.27. 1
SIGNATUR (OWNER OR 41ENT)/ DATE 817ED
`* 6 .0 ^�2
�Rioel_IA2 jr-M,410-- I V 1
FU13UC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING PROPOSED
REQUIRED DEDICATION -00#fF FT
METER SIZE LINE SIZE I NO. 0
'�rRB
REMARKS
OWNER/CQNTRACTOR RESPONSIBLE FOR EROSION CQf
ENGINEERING REVIEWED BY
FIRE REVIEWED BY
VARIANCE OR CU
SEPA REVIEW
COMPLETE , EXEMPT
EXP
LOT COVERAGE
ALLOWED PROPOSE
-�-S;Xp
PARKING
REO'D PROVIDED
12 1 -21
CHECKED BY
SPECIAL IN711C
REQUIRED YES
LID NO.
LID FEE $
TESCP Approved
RW Permit Required
Street Use Permit Req'd
PRV REQUIR
YES 13 NO
DATE
SHORELINE OR ADS#
I INSPECTION
BOND
1$
POSTED
1REQa,
13YE!C��O
SIGN AREA
-
HEIGHT
ALLOWED PROPOSED
ALLOWE5 PROPOSED
:;57
I .711.W /
REQUIRED SETBACKS (Fr.)
PROPOSED'SETBACKS (Fr.)
FRONT SIDE REAR
FRONT
IJR SIDE REAR
9, :�5 10 A52.5
qj� 1,
op'A' -1.0
LOT AREA I PLANNING REVIEWED BY DATE
1�ovx7b F:--49F-
MAII-r r4f)
r -P PT r>
�'F r-7y
OF CON&UtTION
_Wy
TAREA
:�P'- 11;-1 la
AeCfi�'SS&:,F_y-
,4 Art- - 97,14^4-5 b
46A//V.Cr
;0 OCCUPANI .
GROUP
j OCCUPANT
INSPECTIONS PEA UBC 11081FINAL INSPECTION REO'D
$ I oto oci
J
Description
Plan Check
Building P ermilt
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Fire Inspection
Landscapeinsp.
Recording 8
I g Fe4
FEE Description FEE
ea:). State Surcharge q. _50
014Z. CitySurcharge
I I r-), �_ y'z11e_'9 .
CALL
FOR INSPECTION
IAO
1425)
771-0220
ATTENTION W Off 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
I—A-N __'
Plan Chk. Depos# (t pql-q.
Receipt #
Total Amt Due
Receipt #
APPLICATION APPROVAL
This application Is not a permit until signed by the
Building Official or hlsftter Deputy: and Fees are paid, and
receipt Is acknowledged In space provided.
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES
z
z
I
g6& 2��Ln
BY DAflf
ORIGINA ' L - FILE YEI I ON - INIS
PINK -OWNER GOLD -ASSESSOR
GREEN - ACCOUNTING
0
TKMENTONACCE99�RVL;, TNV-TINIrT.Q
)0
Property Address:. A L, LQ+
Edmonds, Washington
Legal Description:. Lo� 4:5'-TW66+ �OcLt-j QLCC.Off-t>L!�&
'> I tA LM4 ',k
-P& rPR-t> 0- C k-2� CQ— *t-4— n�A+C, 0CAQ0 161
V) AS tt k VQ G,--ro �-1
Assessor's Parcel Number:
I bave read the requirements for accessory dwelling units contained is Cbapter 20.21 of
the Edmonds Comnivelty Development Code and understand that an Accessory
Dwelling Unit, Including a second kitcbeo, is probibitid until after. as Accessory
Dwelling Unitpermit bas been approved by the City of Edmonds.
I also understand that approval of an Accessory Dwelling* Unit permit Is subject to
compliance with Identified criteria, to public comment, and neither this statement'nor
the Issuance of a building permit sball act to limit the discretion of the City is the review.
of any application for an Accessory Dwelling Unit permit.
, .1
Property Owner Signature: U10IL4i A.
N\ 4AR9- �\Q N 4�..
Date: 10
ARY kl%%
x :0
Pueor, I
.STATE OF WASHINGTON 2 Opp
OF 05
COUNTY OF SNOHOMISH) 1-1r,1111�
I cartify that, I know.or have satisfactory evidence &at ki 44.
signed this inst�ment andaftowledge it to be Wis/her free and voluntary act for the
uses and
purposes mentioned in this instrument.
Notary's pr essure seals must be an I udged. ated: Ids 163
Signature of
Notary Wqt
Residiniat:
My Appointment
Expires:
THIS 0OCUM1ENT MUST BE RECORDED WITR 111E SNOKOMSH COUNTY AUDITOIFL
CITY OF EDMONDS
PUB *%S DEPARTMENTj ENGIN ^TIN IVISION
APPLICATION FOR RIGHT—OF—WAY CONSTRULTION PERMIT
THIS PERMIT MUST BE AVAILABLE AT THE JOB SITE FOR INSPECTION PURPOSES
Applicant to Complete Parts A and B
A. Permit to be issued* to: —7 �/, 9/ VAS / �_
For Work at :(addre-ss or vicinity) `_/7 F05-
Type of Work to be done: eeaL�AVA 4
(attach drawing when applicable)
Time Required -- Start: L/ /2�; ZC ish: 6
Fin
Owner: to"' T R" ELE, I F I L E
Name
1.772'95- ZA—Ani- AJ
Ma�i�ln Addr ss
/,L, �j
:S, �Vxl
City State Zip Telephone Number
Contractor: 01V,5
Name'
&k Z 0 CZ
Mailing Address
State Zip
9 �?3 — 0/— OL —4S —0 31
State License Number
7F -3 X�
Telephone Number.
Be INDEMNITY: 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 applicant or the City of Edmonds, or any of its 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 subject to inspection and restoration in accordance with City Code. A
24-hour notice is required for inspection by Engineering. Call 775-2525, ext. 220.
I understand that this permit must be available at the job site for inspection
purposes at all times.
Signature: D ate
Owner or Agent
TO BE COMPLETED BY I SUING AGENCY:
Date Issued :15-// —Permit No . Fee:! -
Security Bond:
Time Authorized:
APPROVED B
11
Date
E3
ro-90=
'71
Ur"400eL
PUBLIC TAORKS DEPAR CHW. IST
T4
BUILDING PEPM RFVIE
!!SRI IV —
(address) tdate)
Street Right -of -Way Existing
56 o REQr�- NA
Access Easements Existin
Utility Easemmt Existi
Mg
Lot Per Subdivision
P.lat— Assessor Map
Site Plan Checked for Accurac y.
—F;i--
ek
Z
Underground Wiring Reqd.
Check Accuracy of Legal Description 07A
.Z
Review by_ K) MA
I Date 312a /70
Existing Water Main Size—
Wate Required
Service Line red
Hydrant Size Exist'
r4
Hydrant Reqd Per Fire Code
Size
Detector Check Meter Reqd.
Cross Connection Inspecti
Fire Department Co s
30
—00-�
Charge Req d.
Review by.
Date
Septic Tank Design Approved
Date
t Ic T P
ank e *t Reqd
ic Tank Permit Reqd.
Permit No.
an t r i I
S Sanit Sewer Availability
Sew e Ava lab
Proj.
DbraMwing To
in �
File No
ide Sewer Avai ility
S S - _ r vj jlj
—
14
Sanitary Sewer Conne , n Fee
I w r 0 c
S S C
Reqd.
�3:.
j
Review by
Date
Open Ditch Existing— z�
Reqd.
Culvert Reqd.
—Size
P4
Catch Basin
cate on Site Plan
cate on
0
Shoulde ainage maintain collection on swale open off
f
%Zole reqd.
Indicate an Site an
Soil Conditions and Ground Water Field Checked
/00001
I
Review b
Date
N,
Revised: MO-1977
0
Page 2
SF?tet-.RAi4pg Reqd.
Curb -and Cutter
Sidewalk Reqd.
Curb Cut for Driveway Reqd.
ID4 Right -of -Way Construction Permi
Bond Reqd. for Publi ovements
S: ee
C cj) Street Reqd.'
igning Reqd.
:e� Permit Site Ins ection made on
p
0 S
�_l FA BY: SLUM
WATER
Pq
STREET
ENGINEERING
Special* Requirements listed in nmm to Conmmity Development Department,
Building Division
> BY D Date—..% .
o All items filled in an Building Permit Application
P� BY Date
P' Drawings StaTrped and Notations Made
P4
BY Date
Approved by Public Works Department
Ask
1.%T In-ia,7-7
0,
CITY CLERK
CITY OF EDMONDS
121 STH AVENUE NO.
EDMONDS, WA 98020
200310140355 1 PG
10-i4-2003 11:49am $19.00
SNOHOMISH COUNTY. WASHINGTON
STATEMENT ON ACCESSORY DWELLING UNITS
Property Address: __ I � q 0 S— —1 A L, �,-+ �
Edmonds, Washington
Legal Description:
1;� P c-p R-�--> P- C'> I tA U-0-� U�,
SLC,�Jc) t+gvvv (4 t?o L),
L/ q +nA
S sritgxp- cl
0 V- V\-4--\.4 a ill� 0 46
U U
Assessor�s Parcel Number: 440 0 o (0 (4 S`0 0
7
I have read the requirements for acceisory dwelling units contained in Chapter 20.21 of
the Edmonds Community Development Code and understand that an Accessory
Dwelling Unit, including a second kitchen, is prohibited until after an Accessory
Dwelling Unit permit has been approved by the City of Edmonds.
I also understand that approval of an Accessory Dwelling Unit permit is subject to
compliance with identified criteria, to public comment, and neither this statement'nor
the Issuance of a building permit sball act to limit the discretion of the City in the review.
of any application for an Accessory Dwelling Unit permit.
Property Owner Signature:
R r) 44� �%9- \ON
Date: 1�� -C)
R
:0
PIU1300
STATE OF WASHINGTON
��OPNP,5
COUNTY OF SNOHOMISH)
I certify that I know,or have satisfactory evidence that 7401/1
signed this instrument and acknowledge.it to be his/her free and voluntary act for the uses and
purposes mentioned in this instrument.
Notary's pressur . e s eials must be smudged. Vated:
Signature of
-7
Notary Public
Residing at: _Lvtl to td,�
My Appointment
Expires:
THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR.
Type
Area (�q'uare Feet)
Impervious surface:
Hw much and what type?
(fill 11i colored boxes)
See Definitions, Handoutpg 9
Figure-C, Handout pg 7
Examples, Handout pg 10,
su pplement
Chapter 21
&
Figure-C
Exempt
geplaced
7r
--- -- --
Exempt Non -Exempt
3. New
Total Replaced +New (Non -Exempt)
4.
(add i�ttiyibers hi. bhte bov4!�)
IMPERVIOUS SURFACE CALCS (SOLID SUIRFAC r-- e-,
Existing Building Roof Outline: 3884 sf. (constr.. in 1954)
Existing Sunroorn: 881 sf. (constr. IN 1998),
Existing Covered Deck: 231 sf. (constr. -after 21303)
Existing Driveway & Walkway: 2459 sf. (constr. in 1954)
Proposed Roof Cover o/ (E)Deck: 152 sf.
Proposed Roof Cover o/ Front Porch- 88 sf,
HEIGHT CALCS
A = + 102.2 1
B = +106.1'
C = + 106.7'
D = + 102.6'
AVG GRADE = 104.4'
ACTUAL = 128.75'
MAXIMUM = 129.4'
LOT COVERAGE.
7151315' SQJ
LOT AREA
24,715 SQ.FT.
ADDRESS & PARCEL-#
.17905 Talbot Rd. - — 00594400004500
81
SCALE: 1:10,
OWNER:
Denny Liggitt
17905 Talbot
Road
PHONE: (425) 778-1550
Edmonds, WA
98026
------------------------------------------------------------------------------
DESIGN FIRM:
Estate Homes
Design, Inc.
Craig R. Carney, AIT.
16300 Mill Creek Blvd. #121
PHONE: (425) 743-3373
Mill Creek, WA
------------------------------------------------------------------------------
98012
EMAIL: 1 craigc@estatehomes. net
STRUCTURAL ENGINEER:
Reed & Associates, PS
Andy Gahan, PE
8311 — 212th
St. SW
PHONE: (425) 778-2793
Edmonds, WA
98026
EMAIL: :amg@reed—assoc.com
CONTRACTOR:
Zone Cornerjl jlag±�_
.Setbacks
Actual
nt
y/10 —Sides
o
Rear
9- 5_�_
01her,,,4
--- IL
Be:iof
Estate Homes, Inc. Jeff Reed, Field Operations Mgr.
16300 Mill Creek Blvd. #121 PHONE: (425) 345-5334
Mill Creek, WA 98012 EMAIL:. jef f r@estatehomes. net
AVI ROVEIDY PLANNING
ApPROVED AS NOTED
STREE-7 FILE
DEC 0 12010
DEVELOPMENT SEFjVIC
EDMONg CTn.
CITY OF
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CONSTRUCTION:
(E)2x4 & (N)2x6
HEAT SOURCE:
GAS
SNOW LOAD:
26 lbs.
00
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DRAWN BY: CRC
DATE: 11130110
REVISED:
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