18211 85TH PL W.PDF11111111111111
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18211 85TH PL W
ADDRESS: 12�91 � Y5+k —?(, w
TAX ACCOUNT/PARCEL NUMBER: T7 tp D,- oon cog Gco':3
BUILDING PERMIT (NEW STRUCTURE):_
COVENANTS (RECORDED) FOR:
CRITICAL AREAS:- DETERMINATION: E] Conditional Waiver [] Study Required�Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED: ap
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER): look 051 -9 (Agfz�pl�A (&)CiC i Q63 .2W3- 6901 f Pod
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #: q
GEOTECH REPORT DA
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
LATEMP\DSTs\Fomis\Street File Checklist.doc
9(2.3)
CITY OF EDMONDS SIDE SEWER PERMIT
18 0 go, PERMIT ji�j 0 9119
Address of Construction: �YL(
Property Legal Description (Include all easements)
8,�� 0 L_ VJ - -
L,w� 06
Owner and/or Contractor- C)-kVA_-0A^ q o
State License No-1HQRz-4A0Y-_!9 /o/0JL02 Building Permit No.
�±-Single Family. Invasion into City Right -of -Way: FPKN.o 11 Yes
Multi -Family (No. of Units. RW Construction Permit No.
O'Commercial Cross other Private Property: R-No 0 Yes
Public Attach legal description and copy of recorded easement
CAJO
I certify that I have read and shall comply with all city requirements Date
as indicated on the back of the Permit Card.
CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
OFFICE UISE.DWLY.,
FOR INSPECTION CALL 771-3M,PUBLIC WqRKS DEPT.
Permit Fee: Issued By r,4,(__Nt,4
Trunk Charg Date Issued:
Assessment Fee: Receipt No.: t4 I i.,J
Lid No.:
Partial Inspection: Date -Initial -
Comments
Reason Rejected: Date --Initial
Final Inspection Approved: Date nifial
PERMIT MUSTBE POSTED ON JOB SITE
White Copy: �ie or Buff Copy: Applicant
0,'n. Copy: Inspector
Revised 3190
The City of Edmonds
Side Sewer Drawing
EASEMENTNO . ............................................
NEW CONSTRUCTION REPAIRS F1 LID NO . .................. . ASMT. NO . ..................
OWNER........................................ ....................................................... PERMIT NO.
JOB ADDRESS ----- ........ ------------------------ LEGAL DESCRIPTION: LOT NO.# ... 19 .......................... BLOCX NO . ....................................
NAME OF ADDITION .........................
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Approved:
12 1
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PWW-0001-11175 (REV.11/78)
DATE........... � B y - ------------------------
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
r
MAILING ADDHL55
CITY
-j
NAME
I , �v\ (_
ZIP TELEPHONE NUMBER
ci
\t- "I I
NAME
r-- (but
cr ADDRESS
0
L) _T111N1.60,k itot\;3
CITY ZIP TELEPHONE NUMBER
Z o)
STATE LICENSE NUMBER EXPIRATION DATE
M- I I .-.I nocrrintinn nf Pronertv - include all easements
L_ _� � k
ubt MIT
ZONE PER
NUMBER
JOB e SUITE/Al
ADDRESS
LEP�� DESCRIPTION CHECK
SUBD VISION NO.
LID NO.
lko.lt
PUBLIC RIGHOOF WAY PER OFFICIAL STREET MAP,
40 K.A_
TESCP Approved
RW Permit Required
EXISTING REOUIRED DEDICATION —
Street Use Permit Req'd
Inspection Required '/--[I
PROPOSE
Sidewalk Required ,
lvlj�/E SIj
�LIINEJSIZ5
NO. OF FIXILIFIES
PRV I YEUIREI�
YE! NOO
EREMARKS
VV\ 0,
VJ�
Property
Tax Account
oo
Parcel No.
7NRESIDENTIAL
PLUMBINGtMECH
COMPLIANCE OR
ADDITION
COMMERCIAL
CHANGE OF USE
APT. BLDG.
SIGN
REMODEL
GRADING
Aa-0. CYDS.
FENCE
( x
REPAIR
—FT)
D WOODSTOVE
SWIM POOL
DEMOLISH
INSERT
HOT-TUB/SPA
GARAGE
RETAINING WALL/
RENEWAL
LA CARPORT
ROCKERY
(TYPE OF -USE. BUSINESS OR ACTIVITY) EXPLAIN:
CRITICAL tL/,9iV&_1C%
NUMBER NUK4B�R OF
OF DWELLING AREAS
STORIES UNITS INUMBER
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
I . - A
7_16,#74,111f 7'0 15,46&
IGINFERINP MEMO DATED REVIEWED BY
// 1� -
qE MEMO DATED REVIEWED BY
VARIANCE OR CU
ADS #
SHORELINE #
SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWED POSED
V.,
I
I
Z 15 , �, -15,
EXP I
LOT COVERAGE.
REQUIRED SETBACKS,(Fr.)
PROPOSED SETBACKS (FT.)
P�POSED
A;;�
FRONT SIDE REAR
FRONT UR SIDE REAR
a I v
2_5 ' 10 ' Z b
101/1
51 le ?_ . 3�
LOT ARE
PLANNING R;XIEW BY
DATE
F&U;K*ja
SPECIAL INSPECTOR AREA j Z 47 OCCUPANT
REQUIRED LOAD
0 YES
REMARKS
PROGRESS INSPECTIONS PER UBC 108
,�Wjvw .02—
y 3 1
4y 6N I Irfolle-l"A
FINAL INSPECTION REQUIRED.
nsffl��� VALUATION FEE
PLAN CHECK FEE
(i y
BUILDING
H T OURCE:
GLAZING
%
PLUMBING
Plan Check No. 6?
MECHANICAL
GRADINGIFILL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewelks,
driveways, marquees, etc.) will require separate permission.
STATESURCHARGE
A <12
Permit Application: 180 Days
STORM DRAINAGE FEE
no
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
ENG. INSPECTION FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
'Unj harmless the City of Edmonds, Washington, its officials,
I
I employees, and agents from ainy and all claims for damages of
from the issuance
117
a: ly or indirectly
whatever nature, arising direct
C&.iW>e
C14ECK DEPOS
of this permit. Issuance of this permit shall not be deemed to
TOTAL AMOUNT DUE
27
modify, waive or reduce any requirement of a ny city ordinance
0
nor limit in any way the City's ability to enforce any ordinance
provision."
1. hereby acknowledge that I have read this application; that the
ATTENTION
APPLICATION APPROVAL
information -given is correct; and that I am the owner, or this duly
n
authorized agent of the owner. I agree to comply with city and
a,
THIS PERMIT
This application is not a permit until
state laws regulating construction; and in doing the work authoriz-
sl
AUTHORIZES
ONLY THE
signed by the Building Official or his/her
ed thereby, no person will be employed in violation of the Labor
e,
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
Deputy; and fees are paid, and receipt is
acknowledged in space provided.
tion Insurance arid RCW 18.27.
1 NSPECTION
S" NATURE (OWNP 0 !�p t, lill �11 - ATE SIGNED
DEPARTMENT
OFFJCI�L'S S�GNA RE DATEi
i4-wi�k�t J�� /o ?
CITY OF
EDMONDS
ONJ &
/,414W blq�
CALL FOR
'RELEASED BY1 DATE
ATTENTION
INSPECTION
IT ISUNLAWFUL 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, USC
PINK — Owner GOLD — Assessor
SECTION 109
NOTICE:
N'o- wa rra nt Y- 0 T U- -1 - -c' u -Y.
The information'shown on the attached
map(s) was compiled for use by the City Of
Edmonds/ its Employees and Consultants,
The City of �Edm.onds does not ' wa rra nt t, ie
accuracy of anything set for.th on t hese
Map(�_). Any person or entity -requesting a
copy should conduct an independent
orm'ation shown on
inquiry regarding the inf'
-map(s), including, but not limited to,
th'e lociation of any sewer stub shown. Such
-not exist and may
sewer stubs may or may
or may not exist at the location shown.
o nor its
Neither the r"ity of Edrn nds
empJo*yee*s o*r office-rs shal'l be 1.-Jab-'Fe for the
n on this map(s), nor for
information give
tation provided based
any one represen
upon said map(s).
or 9 0 - 19 '5 -
City of Edmon&
Critical Areas Checklist
The Critical Areas Checklist contamed on
this form is to be filled out by my pawn
preparing a Development Permit
Application for the City of Edmonds prior
to histher submittal of a development
permit to the City.
Ite 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 coinplete the
Checklist should be easily available from
observations of the site or data available at
City Hall (Critical Areas inventones, maps,
or soil surveys).
An applicant, or his/her representative,
must fill out the checklist, sign and date it,
RECEIVED
JAN - 3 1996
COMMUligy SEJWICES
and submit it to the City. -Me City will
review the checklist, make a precurwry site
visit, and nuke a determination of the
subsequent steps necessary to complete a
development permit application.
With a signedcopy 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
adMon, the applicant shall include
other pertimmt. information (eg. site
plan, topography map, etc.) or studies in
coqjumfion with this Checklist to assist
staff in r n , pleting their preliminary
assessment of thesite.
I have completed the attached Critical Area Checklist and anest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column befow).
Owner / Applicant:
25 -
1ARV 1��OAII
Naihe
6 Y6111,e
Street Address
&KM4
City, Stat�. 9P Phone
'Y'
Sig Date
Applicant Representative:
Name
Street Address
City, State, ZIP — :,. Phone
Signature
Date
CA FILE NO-____�J�-
tical Areas Checklist
Site Information (soils, raphy/hydrology/v"tion)
,-L". ..,site.Address/Location:
:Z, Property Tax Account Number: 7702-0,06 P0
3.. Approximate Site Size (acres or square feet): )2,9&P
4. Is this site developed? _A"' yes; — no -
If yes; how is site developed? h4,
5. Describe the general site topography. Check all that apply.
Y- 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):-- PA117--r R�OL� 1&)e-
6. Site contains areas of year-round standing water.- FV0 Approx. Depth:
" Z�
7. Site contains areas of seasonal standing water. IVO Approx. Depth:
What season(s) of the yea&, /Vo
8. Site is in the floodway floodplain A/60 of a water course-
9. Site contains a creek or an area where water flows acrow the grounds surface? Flows are year-
round? �/Q 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 13F
Site
2.`W: Scs mapped soil type(t)?
Weiland ventory or C-A. map indicates wetland present on site?.
in
4.�-'.**�. .:.,.Cntical Areas inventory or C. A. 'Map indicates Critical Area on site?
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PERMIT'COUNTp
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DEVELOPMENT SERVICES CIP
CITY OF EDMONDS
SUN/FUN NORTHWEST, INC.
Swimming Pools & Pool Structures
P.O. Box 1333 Bothell WA 98041
(425) 885-9697
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By PLANNPqR
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PUNT R
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PLANNING DATA
NAME: Et-,f- .5� 7ktxaj.�
SITE ADDRESS:— 12- 24 1 - 65�P"J- -DATE:— 4-IM
ZONING: PLAN CHK#: 7a - 3 5-r-
PROJECT DESCRIPTION: New �9 Pes,,6t,,(t
(.� ,- 4,-LI;, �'Pb "
CORNER LOT (Yes/No) FLAG LOT--- 0j V Ye's/No)
SETBACKS:
Required Setbacks:
Front: '2-57' Left Side:- 10' Right Side: Rear: 75'
Actual Setbacks:
Front: - 5/ ' Left Side:-10' Right Side: 2,' Rear: 36'
Street map checked for additional setback required? J�( - . —(Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUE'D A) (Y/N)
LOT COVERAGE: 701
� 7
Maximum Allowed:— 32% ----.Actual:_ — I z vob
B UILDING HEIGHT:
Maximum Allowed: 7-5 —Actual Height- 40tL�
Datum Point: nmk6t,- caxe or+- s,-. Datum Elevation: 33 4, 4-5-
0-It An --A
6944--ulf cq�e�
A.D.U. CREATED?: Ej, Ine- — we4-
on bt"X.,
SUBDIVISION: P - 5' - ff 5' - t,,,, F
rer.,t 12-
CRITICAL AREAS #:- 9 & 2-
SEPA DETERMINATION:
LOT AREA: -I,- /z, 000 10
OTHER:
Plan Review By:
PAI
9tS--,V< b FA-)
c:Tdes*ffnit%Ap1&nd2LdGC
PjpJECT REVIEW CHECKLIST
PROJECT NAME: PLAN CHECK #:17-,55-0
PROJECT ADDRESS: RECEIPT DATE: /0
LA 7
,&7
jREVIEWfD BY- (Initial/ ate)
N. IWATER
COMMENTS FIRE I QpLLDG. ISEWER STREgIL__gNG.
Setbacks/Variance/Setback Adjustment
Conditional Use Permit
��*** . . . . . . . .
ADB Requirements
ONE
.........
. .
.
. .
.... ....
Other Zoning Requirements
m........
.4
Underground Wiring Required
............ ------
Lot Slope IS%
-'6
SEPA Environmental Checklist/Hydraulics Permit
7
Tree Cutting Plan
.............. ..
0-
8
Plat/Subdivision Requirements
9
Legal Description Verification
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
--------- -
Quit Claim/Street Dedications
.......................... ...
- ------------
IVIA
Easements - Public/Private
. . . . . . . . . . . . . . . . ...............
Engineering Storm Drain Review Fee
00
. 1 .. 3*:.
Engineering 2.2 Inspection Fee
....
11 . . . . . . . . . . . .
14
Drainage Plan (On -Site)
Setback - Top of Bank, Stream, Water Courses
:16
Setback - Storm Drain Line
.
. . . . . . . . . . . .
Ax-
17
Open Ditch - Existing
/0 0
Aj 1A
-18 1
Culvert Required
Al A6,
Culvert Size
V
-20-
Shoulder Drainage/Shale Open Runoff
7P
jV
21
Catch Basin Required
. . . . . . . . . . . .1", 'D
Driveway Slope & Vehicle Access
23,
Sidewalk Required
2-
Curb & Gutter Required
ma
A
/V 0
Curb Cut For Driveway Required
..............
Street Paving Required
....... ..... . . . .
. �,mm c
x m,
Al 0
27-
Right-Of-Way Construction Permit Required
:28.�.,;o
Street Name Sign Required
. . . . . .
jV0
��29,�:
Other Signing Required
N---------------
Al 0
:30:,:,.:
Bond Required For Public Improvements
. . . . . . . . . .
0
..31 ...
f EMA Map �Checkfflater Table
_3
Side Sbwer Availabl1ity
..... ................... ........ ....
...........
Calculate Sewer Connection Fee If No LID #IV
Create Street File
IX
Existing Water Main Size
?"Or a-r
----------
Water Meter Size
------ ---- Ty
— -
-7
Service Line Size
---------- -----
. . . . . . . . . . . . -
- - - - - ----- -
. . . . . . . . . - -_X,.
38
Water Meter Charge Required
-3-7S--
..............................
.
Hydrant Required
Hydrant Size Existing
. . . . . . . . . . . . . . . . . . . . . . . . r
1". 4 1 ..
Fire Line Charge Required - Sprinkler
% ......
.......
IStreet Cut
.. . . . . . . . . . . AA�
IMiscellaneous
. . . . . . . . . . . .
Reviewed By:
FIRE
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PLANNING EERING PU(3L.IC WORKS
0 C T � 8 1997
MUG WORKS DEpr
14 ezzzi:s
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R E C 0 R D OF C 0 N T A C T S
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21
2
22
3
23
4
24
5
25
6
26
7
27
28
RW PERMIT # DATE ISSUED RECEIPT #
9
29
10
30
31
32
13
PAID $ RECEIPT # DATE
33
SS PERMIT # DATE ISSUED �-bLUD RECEIPT #
14-
PAID $ RECEIPT # DATE
34
15
35
16
36
1�
:
37
p �DATE
METER SIZE AID.$ RECEIPT J/
18
38
19
39
20
40
I
6 0
PLANNING DATA
NAME: N^C�-
SITE ADDRESS:
PROJECT DESCR71
REDUCED SITE PLAN PROVIDED?: (Yes / No
MAP PAGE: �Z) CORNER LOT: (Yes
DATE
FLAG LOT: (Yes KA)
ZONING: ( 2 — CRITICAL AREAS DETERMINATION #:-(2A — <qr-- 0
Ll Study Required:
0 Waiver
Ll Conditional Waiver
CH
SEPA DETERMINATION:
Ll Fee
Ll Checklist
LJ APO list wl notarized form
Ll (Needed for 500 cubic yards of grading, Shoreline Area. site within 200 ft. of Puget Sound or Lake Ballinger)
r
U Exempt (0, &_7 &7
SETBACKS:
Required Setbacks:
Street: acg , Left Side: t c,' Right Side: i o' Rear: Zq:z
Actual Setbacks :
Street: Left Side:;j —�-Right Side: Rear:
Street map che�c—kedfor additional setback required? (Yes / No / DhA)
L1 DETACHED STRUCTURES:
13 ROCKERIES:
L3 FENCES/TRELLISES:
U BAY WINDOWS / PROJECTING MODULATION
L1 STAIRS/ DECKS:
:D.-O - q0. C' 4-'='*-<:- -
PARKING: Required: Actual: (- (:�;'1-0
LOTAREA- 1-7- coo Jy
LOT COVEOCkUt:
Calculations:
BUILDING HEIGHT:
Datum Point:— Datum Elevation:
Maximum Allowed: Actual Height:
A.D.U. CREATED?: (No I Yes)
SUBDIVISION:
LEGAk NONCONFORMING LAND USE DETERMINATI N4S9`UED: (Yes / No)
O-TH E R: )---kCA-') t S-VV�n 11-1-41-7C- -f'-) 1 f- --% A -4--
Plan Review
NewBPP1anningDataForrn.D0C
W
Water Service Drawing
The City of Edmonds EASEMENT NO . ............................................
NEW CONSTRUCTION CK REPAIRS F] LID NO . .................. . ASMT. NO . ..................
IT NO. �0.75.7
OWNER... .......... ...... ..... ............................. CONTRACTOR .................................................................................... PERM
0.
JOB ADDRESS ... PL ...... W ............ ; ...................... LEGAL DESCRIPTION: LOT N ) . .......... ........................... BLOCK NO . ...................................
....... .... ......
...................................................... ....................... .................................................................................
NAMEOF AT)DiriON .. .................. ..........................................................................................
N.
--Approved:
BYDATiL ...................... ....... :�Y .............. ...
17927
17905
17922
17926
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