18411 HIGH ST.PDF11111111111111
11502
8411 HIGH ST
7 7
CITY OF -EDMONDS
AUVICC'CENT'ER WATEIC-SEWER DEPARTMENT
'SIIDE'SEWER PERMIT
Call FRospect 6-11 07. when work
is ready for Inspection. (No Inspec-
tions Saturday, Sunday or holidays.)
Ms.: 2694
94th Avenue West
D ESS .......................................................................................................... ......................................................... ................. .................
E ............... W.,...K.-..Rosenqtiist ............................ .......... CONTRACTOR ....... Wes -tern ... Sewer .. Canst ......................
January 23
g,.:Pprpiission.is granted ...................... . .................... ; 19 ... �81 for ........................ days to REPAIR or CONNECT a. side sewer
withr-'City Sewers In accordance with application oil file and governing ordinances.
ON IS CALLED`.-TO�THE FOLLOWING:
1 --T -6w acto
he� hers.,of the prop rty may obtain a permit to construct sewer Inside property line. A licensed Side Sewer Contr r must
'be"erriployed-to construct side sewer in street area. Do not cover.any portion of sewer before It has been Inspected.
NOTTe No. 2—Obtain full.Anforrnattim regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 3—Top of side sewer rmust, have � at -least,30 Inches coverage at property line and 12 inches Inside property line; minimum grade of 2%.
will
No bends In -grade sharper than IJ6 permitted.
NOTE* No. 4—Trenches'In street must be water settl6d' 1,�d surface of street restored to original condition. Contractors shall be responsible for
failure due to Improper work whJ61i may develop within one year of completion,
NOTE N 5—It I
9 unlawful to alter or d� any other work than is provided. for in the permit, or to do any work on the main sewer or its appur-
tenances 6xcept to Insert the pipe into the'wye.
�"iCo s e n qi i i s t 6 3500-57
'1�14_ 1 8411 94th Ave. V1.
Edmonds, Washi
SEC,-4LOT TVIP*BLK RGE LEVY CODE SPECIAL
18 1 154 0214
D-3 PLAT OF SEAHURST
BEG NE COR LOT 18 TH VVLY ALG N LN 213
FT'vTH 8 13'001w 62 FT TO POB TH SELY
TO PT ON E ul 52 FT N OF SE COR SD LOT
APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT
NEW CONSTRUCTION pT-- REPAIRS EASEMENT No.
OWNER k
.. . ........... . ..
ADDRE ...
10*4/// W1 C-oV S 7,f Ar 7-
CONTRACTOR 11--6-C-7-7-7 A,.Ise ........ No.
LEGAL DESCRIPTION: LOT No..—L�� ................................ BLOCK No . ...... /
--------------------------------------
NAME OF ADDITION ...... R. ec ............. o!./ .............. zlr��
RVA
Approved:
DATE i�� . ........
1 (0 /- . ^IP I L -1. 1. lo*_ I t% n a
I
5LPI.
Critical Areas - Checkfist,
Ske Information (soils/topography/hydrology/vegetation)
I. Site Addressi-Locat
ion: - -1--eVa 1-17'gily �5
2. Property Tax Account Number. 5-&T-&-7001.-n[e-02s01
ax,
3. Approximate Site Size (acres or'square feet): Y2- ae-Ke---
4. Is this site currently develbpi�d? no-
-�yes;
4'�
If yes; how is site developed? / -,
5. Describe the general site topography-* Check all
Flat: less than 5-feet el o entire site.
evition change ver
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet ever a
horizonta I distance of Wfeet).
Hilly: slopes present on site of more than 15% and less than 30% a vertical rise
of I 0-feet over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of I 0-feet over a
horizontal distance of less than 33-feet). irx -se—n�e efR-,e,*`,5
Other (please describe):
6. Site contains areas of year-round standing water- Approx. Depth:
7. Site containsareas of seasonal standing water: Depth: j()
Approx C,
What season(s) of the year?. hj,',,+ejL
8. Site is in the floodway floodplam of a water course.
9. ....Site contains a. creek or an am where water flows across the grounds surface? Flowsareyear-
round?
Flows are seasonal? (What time of year?
10. S ' ite is primarily: forested Meadow _;shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site: A
__j 6
For City Staff Use Only
I. Site is Zoned? IZ-5 - I -z- -
2. kS mapped soil typ*)?.
3- Wetland inventory or C.A."map indicates wetland present on site?
:-,Critical Areas inventory or C.A. map indicates Critical Area ou site? A/0
5-- �ite within' designated earth subsidence landslide hazard area?, k2
6. 'Site designated on the EnvironmenUffly Sensitive Areas Map?
-DETERMINATION
DY REQUIRED
WAIVER
Reviewed by:
P--Y otm"4
CONDITIONAL WAIVER
ksnlc��--
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71be Critical Areas Checklist contained on
this. form is to be filled out by any person
prepanng a Development Permit
Application for the City of Edmonds prior
to his/her submittal. of a development
permit to the City.
Ile Purpose Of the Checklist is to enable
City staff to determine whether any
potential C ' ritical Areas are or. may be
present on the subject property. IMe
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,
J!
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 lotsof the parcel
with enough detail that City staff can find
and identify the subject parcel(s). in
addition, the applicant shall include
other pertinent infonmation (eg. site
plan, topography amp, etc.) or studies in
conjunction with this Checklist to assist
staff in completing their preliminary
assessmentof the site.
I have completed the attached Critical Area Checklist 'and attest that the answersprovided are
factual, to the best of my knowledge (fill out the appropriate colu *n be
In low)..
Owner I Applicant:
CIS
Street Address
— F r I
LN� � ':-) U-�-
Citv- Statp 71P rd
Fnone
,7-1d--i&
Date
Appricant Representative:
. Ta4, t),
Nam
Street Address
0
City, State
P Phone
91K
ture
Si ture Date
ENGMERING
ROUTETO -T on 42 B
Add?
ack
Total Days,
Mailed
RESUB #I ON TO Back
Add?
—Total Days
Mailed
RESUB #2 ON To Back
Add?
Total Days
MaS
TREET FILE
1. Site/Drainage Plan & Calcs.
2. Grading Plan/Calcs/CYG —SEPA?.
PK
OK
Corrections Required
1.
3.. Driveway Slope % Profile OK 2.
4. Truck Route Plan
OK
5. Street Dedication? -0— _FEET
3.
4.
6. Easement A, 0 _Type OK 5.
OTHER COMMENTS:
PW REVIEW Date Sent Back FIRE REVIEW Date Sent Back
Received
PLANNING REVIEW. TIME
TOTAL DAYS
ENG REVIEW TIM
TOTAL.DAYS
FIRE DEPT REVIEW TIME
TOTAL DAYS
PW REVIEW
TOTAL DAYS
BUILDING DEPT REVIEW TIME: In -House —Outside
TOTAL DAYS
ORDINANCE COMPLETION DATE COMPLETION DATE TOTAL REVIEW TIME DAYS
PERMIT # ISSUE DATE
*CONTACT PERSON STATEMENT*
BY SIGNING TMS FORM I UNDERSTAND TRAT I AM THE ACKNOWLEDGED CONTACT PERSON FOR
THIS PROJECT. IT IS MY RESPONsiBjLrrY TO COORDINATE ALL SUBMITTALS WITH THE CITY
AND ONLY I CAN MAKE INQUIlUES ON THE STATUS OF THE PERMIT. I UNDERSTAND THAT IT IS
my REsPoNsIBILITY TO DETERMM IN ADVANCE OF PERMIT SUBMITTAL ANY DISCRETIONARY.
PERMITS THAT MAY BE APPLICABLE TO TEIIS PROJECT. I ACKNOWLEDGE TRAT TO THE BEST OF
My ABILITY I HAVE SUBMITTED ALL NECESSARY DOCUMENTATION IN ORDER TO MAKE A
COMPLETE APPLICATION.
Signed Date
Contact Person (PrintClearly)
Phone Number FAX Num er
R09.D_?0_C1L �empl giForms-5/96
Mailing Address,
0M
PERMIT APPLICATION REQUIREMENTS
To: Applicant
From: Jamal Mahmoud, Engineering Inspector -STREET FOILLE
Owner: 3owes Plan Check No: q6- 1-1 1 3
Address: I Date: A -A ci - -7. 9 6
------ - - -- ------------ -- ---- - ------------------ - ----------------------------------------------------- - -------------------------
After review of the subject permit application, the following requirements must be met:
1. Construction hours are: WEEKDAYS — 7:00 A.M.-10:00 P.rvL;WEEKENDS/HOLIODAYS — 10:00 A.M.-6:00 P.M.
2. A separate RIGHT-OF-WAY CONSTRUCTION PERMIT is required for all work on public property. (ECDC 18.60)
3. Truck haul route plan must be submitted and approved prior to permit issuance.
4. Builder/owner is responsible for containing all temporary runoff and erosion control on site (ECDC 18.30.030d).
5. NO WORK SHALL BE DONE WITHIN 15 FEET OF STREAMS OR 10 FEET FROM ANY CLOSED DRAINAGE
FACILITY. BUILDER/OWNER IS RESPONSIBLE FOR IDENTIFYING CONDITIONS ON THE DRAWING.
(ECDC 18.30.50G)
6. FILTER FABRIC FENCE SHALL BE INSTALLED AND INSPECTED PRIOR TO CLEARING AND CONSTRUCTION.
(ECDC 18.30)
7. INSPECTIONS ARE REQUIRED ON STORM DRAINAGE SYSTEMS, TIGHTLINES AND CATCH BASIN
INSTALLATION. INSPECTIONS ARE REQUIRED PRIOR TO BACKFIELLING. (ECDC 18.30)
8. Repair.or replace all defective existing curb, gutter and sidewalk adjacent to the property. If an intersection is involved, a handicap ramp
may be required. Contractor shall meet with the City Engineering staff to -determine the extent of repair prior to issuance of the permit.
(ECDC 18.90j
9. Driveway slope shall not exceed 14% without a waiver. Every attempt should be made to keep the slope below 14%. Waiver granted to
0 le. %. (ECDC 18.80.060D)
10. Driveways must be paved from' property line to City RIGHT-OF-WAY. A separate permit is required. (ECDC 18.80.060C)
11. INSPECTIONS ARE REQUIRED ON DRIVEWAYS AND SIDEWALKS PRIOR TO AND AFTER POURING. (FcDC 18.30)
12. No burning of construction refuse without a permit from the Fire Department.
13. Connection to City water system is required. There is a separate charge for the water mete r (ECDC 7.20).
14. A back water valve is required if downstaiis plumbing is below the elevation of upstream manhole. (ECDC 7.20)
15. Water and sewer main lines should be separated by 10 feet minimum. (ECDC 18.10)
16. Connection to the City sanitary system is required. A separate permit is required.
LEW Fees paid: Yes— No— Charge 3 0. (ECDC 18.10)
11. 'Underground wiring is required on' all new construction, and for additions, alterations, and repairs that.exceed 50% of the tot al assessed
value of the structure. (ECDC 18.90)
18. A FINAL ENGINEERING INSPECTION IS REQUIRED PRIOR TO THE BUILDING DIVISION GRANTING OCCUPANCY
OF THE BUILDING OR STRUCTURE. (ECDC 18-90)
USE
CITY OF EDMONDS ZONE 17 PERMIT
NUMBER
.CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT #
OWNER NAME NAME OF BUSINESS ADDRESS jtb e_-_,,v _<v-
WeI& &,4 se, V, qml( P7 (3 LEGAL DESCRIPTION CHECK SUBDIVISION NO. LID NO.
a:
w MAILING ADDRESS
Z Z
0 + TESCP Approved 0
I �,+( I 'r'% h _-S - PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
CITY �j ZIP TELEPHONE NUMBER EXISTING REQUIRED DEDICATION RW Permit Required 0
nd'�. Street Use Permit Req'd 0
39 4, PROPOSE Inspection Required .9-
NAME Sidewalk Required 13
cc
uj
X)IA METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED— <
YES 0 NO 11
W ADDRESS
REMARKS
cc
ir W
CITY ZIP TELEPHONE NUMBER w
0
Z
w
NAME
V e +
a: ADDRESS ENGJNEERING MEMO DAT REVIEWED BY
0
�- / Y//,/ —,;:;A .
CITY ZIP TELEPHONE NUMBER -7,
A
Avsk
Z e�:Ill q 7 FIRE MEMO DATED REVIEWED BY
0
STATE LICENSE NUMBER EXPIRATION DATE
0 f7 SIGN AREA SEPA REVIEW ADB NO.
V x 23 4 4 6-7-7
Le -al Description of Property - include all easements ALLOWE PROPOSED COMPLE IXEMPT
9
SHORELINE N
Z r
2- :XP
VARIANCE OR CU PLANNING REVIEW BY DATE
( 0
n
w
HEIGHT LOT COVERAG Z
SETBACKS — FEET E
DE /0' REAR Z5' 35-7.
W FRONT Z 5' SI Z
Property
Tax Account REMARKS
ParceINo. !!Z&S6,-001-,-vk-0301
A g-A 6*e_A 76 ""k. jjr,�jie
NEW RESIDENTIAL PLUMBINGIMECH U
COMPLIANCE OR -f�j
COMMERCIAL CHANGE OF USE
ADDITION F
0 V
REMODEL APT. BLDG. SIGN
GRADING FENCE CHECKED BY TYPE-0 INISTRUCTION CODE - OCCUPANT
X_ G7
FIREPAIR E] — CYDS. x _FT) 941
DEMOLISH WOODSTOVE SWIM POOL SPECIAL INSPECTOR OCCUPANT
INSERT HOT TUB/SPA . I AREA
1:1 REQUIRED rf -11 LOAD
rZ.71 GARAGE RETAINING WALU 13 YES
j!-j-0ARMF1T ROCKERY RENEWAL REMARKS
PROGRESS INSPECTIONS PER URC 108
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: Z
0
Ex jr A�e%klr.�n D
0
(0 NUMBER NUMBER OF CRITICAL
W
OF D ELLING AREAS
STORIES A UWNITS NUMBER
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
C017—s-11r,�ec -t( C4--A-. ckng/ r- FINAL INSPECTION REQUIRED
VALUATION FEE
PLAN CHECK FEE
AkI Q E LO A "it BUILDING
HEAT SOURCE: LAZING
!E
PLUMBING
Plan Check No. MECHANICAL
This Permit covers work to be done on private property ONLY.. GRADINGIFILL
Any construction on the public domain (curLs, sidewolks,
driveways, marquees, etc.) will require separate permission.- STATE SURCHARGE -4.,-50
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE G
w successors in interest, agrees to indemnify, defend and hold
2 harmless the City of Edmonds, Washington, its officials,
I employees, and agents from any and all claims for damages of &_-niouc c4
Ix
< whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT
'73 0,0,mo
modify, waive or reduce any requirement of any city ordinance
nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE
provision."
I hereby acknowledge that I have read this application; that the
information given is correct; and that I am the owner, or the duly ATTENTION APPLICATION APPROVAL
authorized agent of the owner. I igree to comply with city and THIS PERMIT
state laws regulating construction; and In doing the work authoriz- AUTHORIZES T . his.application is not a permit until
ed thereby, no person wi�l be employed.in 'violation, 2!e Labor ONLY THE signed by the Building Official or his/her
Code of the State of Washington relating to Workmen s � om pensa- WORK NOTED Deputy; and fees are paid, and.receipt is
tion,.Insurance and RCW 18.27. ISIS . PECTION acknowledged in space provided.
SIGNk41UR (O�VNER ORA E T) DATE SIGNED DEPARTMENT
/ _ . OFF1&C11IjG1Z DATE
CITY OF
EDMONDS
RELEA 9D DATE
ATIF�NTION!: CALL FOR
INSPECTION
IT IStONLAWFUL TOJE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-0?20 ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
SECTION 109 PINK — Owner GOLD — Assessor.
10247
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RECEIVED
SEPI 0 1996
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