18425 HIGH ST.PDF11111111111111
11511
18425 HIGH ST
.90 - 199
City of Edmonds
Critical Areas
Ch e-qkfist
The Critical Areas Checklist contained on
this form is to be filled out by any person
preparing a Development Permit
Application for the City,qf 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 the checklist, sign and date it,
a . nd submit it to the City. The City will
review the checklist, make a precursory site
visit, and -make a determination of the
'SukSeqU1 en! �tpps, �pq�ss_ary. to complete a
qgveiopmerit peTm.itiapplication.
a signed'�qoy of this form, the
applicant shou'id"also, submit a vicinity map
or plot plan for iridiVidual 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
il -or st
plan, -topography ma p�, etc.) udies in,
conjunction with this Checklist to assist
staff in completing their, preliminary
assessment of ithe 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:
!k*V-0k' -
Name
Street Address
4W,
City, State,,ZIP Phone
Applicant Representative:
— T R Ms
Nam i z
Str�et Address*
Uj 0\
01KA-
Phone
Signature Date �=ure Date
A
CA FILE NO. CrO -q9
Critical Areas Checklist
Site Information (soils/topography/hydrology/veget2tion)
I . Site Address/Location: /ff �Z_ .57,
2. Property Tax Account Number: 5-6.6-�e -'00 / oR - D � 0 '-7
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? "" yes; — no.
If yes; how is site developed? R L5 �-)-T_� ol� L VC>'v\-,'?_
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
A
41, w
7.1
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a
horizontal distance of 66-feet).
Hilly: slopes piesent 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 o ' f greater than 30% present on site (a vertical rise of 10-feet over a
horizontal distance of less than 33-feet).
Other (please des&ibe):_
6. Site contains areas of year -round standing water: Approx. Depth:
7. Site contains areas of seasonal *staMing water: 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 v�ater flows across the grounds surface? Flows are year-
round? Flows are �8ea_sofial? (What time of year?
10. Site is primarily: forested meadow ;shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious Wetland is present on site:
FoKity Staff Use Only
:.I. Site is Zoned?
��:SCS mapped soil type(s (<��A/ zlo��41t_
:3 ........... Wetland inventory, or C. A., map indicates widland present on site?
4. Critical Areas inventory or C.A. map indicates Critical Area on site?
Site within designated earth subsidence landslide hazard area?
Site designated on the Environmentally, S ensitiv A ' Mapl
!a reas
RMINATION
STUDY REQurRED CONDMONAL WAIVER
WAIVE�Reviewed bv:
Date
Gil
RevOIM04
CITY OF EDMONDS
ASSET INFORMATION SHEET
YN EW
ADDITION
RETIREMENT
ASSET NO. 4slo
ADDITION TO ASSET NO. -
IDESCRIPTION Z/ - ^;/d, I
A
LOCATION DEPT NO
4;
"PURCHASE ORDER NO. -
PURCHASE ORDER DATE
COST
*PROJECT NUMBER
PROJECT COMPLETION DATE
COST QN360'
B.A.R.S. ACCOUNT NO. e)6)' 6'0
ESTIMATED LIFE
INITIATED BY
DATE
APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
2/DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT -
0 G.L. ENTRY
REFERENCE
A5c--
VERIFIED BY
PROCESSED
BATCH NO.
N-7
DATE
INITIAL
(�np
DEPARTMENT FILE
CITY OF EDMONDS
YNEW
E] ADDITION
E] RETIREMENT
ASSET INFORMATION SHEET
ASSET NO.
ADDITION TO ASSET NO.,
DESCRIPTION
SERIAL NO.
LOCATION DEPT NO
"PURCHASE ORDER NO. -
PURCHASE ORDER DATE
COST
B.A.R.S. ACCOUNT NO.
ESTIMATED LIFE
P R 0 J E CT N U M B E R d6 /
PROJECT COMPLETION DATE
COST
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
2/DEPRECIATE-
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT -
G.L. ENTRY
REFERENCE
DATE
A�� -
VERIFIED BY
PROCESSED
BATCH NO.
INITIAL
(tnp
FINANCE
CITY OF EDMONDS
CRITICAL AREAS DETERMINATION
Site Location:
18425 High Street
Tax Acct. Number:
51656-001-019-0607
Determination:
Study Required
Determination #:
CA- 1996-99 - Revised
Applicant:
N/A
Owner:
Thomas Hafford
CRITICAL AREAS DETERMINATION: STUDY REQUIRED 4CA-1996-99)
A Critical Areas Determination of."Waiver" was formerly granted for this site. However, during
inspection of the subject site in association with a pending Variance, it was found that the -site
may contain critical areas, including a Wetland and a Stream pursuant to 4Chapter 20.1,513 of the
Edmonds Community Development lCode (E-CDC).
STUDY REQUIREMENT FOR WETLAND AND STREAM
The site investigation has shown that the site may contain a small wetland and stream near the
eastern boundary of the lot. Based on the above finding, a Critical AFeas Study'is required to
determine the class of the stream and wetland and to locate these features on the. -Pro . perty.
Stream Classification: A critical areas consultant shall perform the following:
o Classification of the wetland pursuant to the crKeria established in -ECDCSection
20.15B.060(A)(5) and stream pursuant to the criteria established in ECDC
Section 20.15B.060(A)(4).
o Delineate the boundaries of the wetland and the edgesof the stream on the site.
o State any mitigating measures appropriate to -preserving and protecting the
wedand and stream.
This part of the study shall be performed as a three partycontract with the city -selecting
the consultant and the property owner or applicant paying the fees. When you are
ready to proceed, please contact a Planner.
Wetland and Stream Delineation: After the critical areas consultant hasclassified the
stream and wetland and delineated the boundaries of these features, a surveyor
licensed by the State of. Washington must perform the following:
• Physically mark the edges of the stream and/or wetland.
• Delineate the required buffer (refer toECDC 20.1,513.1-240. (A) for the required
buffer widths for streams and -ECDC,20.15B. 1 30.(C) for wetlands).
• Delineate the required building --setback from the buffer4required,setback is 15
feet).
o Create a map showing the wetland and/or stream, along with any buffers and
building setbacks.
In order to complete thisStudy Requirement, this map must be submitted 4o the
Planning Division for review and approval.
NOTE: A wetland that is less than 2,500 -square feet in total area is not regulated by
City of E4dmonds Critical Areas'Regulations.
DEVELOPMENT PROPOSALS ON A SITE WITH A STREAM AND/OR WETLAND
Development proposals that -encroach into the stream buffers or,building setbacks may be
allowed through the approval of certain processes. The-�specific process depends on the
individual -site -and development -proposal but may include Buffer Averaging, a Critical Areas
0. . V
Variance,. and/or a Reasonable Use Exception. If you think that you have a -proposal that may
require one of these processes, please contact a Planner for more information.
4W
PROJECT SPECIFIC CONDITIONAL WAIVERS
If the property owner wishes to apply for a specific development permit which they feel would not impact
the -Critical Areas located on the site, they may submit their proposal to the Planning Department for
review. If the Planning Department finds that the proposed development permit will not adversely im . pact
a Critical Area or its buffers, a conditional waiver may be issued on a project by project basis.
EXEMPT DEVELOPMENT PROPOSALS
Certain development proposals maybe exempt from Critical Areas* Requirements (ECDC 26.15B.0'40). If
you think that a specific development proposal may be exempt, contact a Planner for more information.
Name
Sianalure
Li Cited sections of the Edmonds Community Development Code (ECDC) can: befound on the
City of Edmonds websiie at www.ci.edmonds.wa.us.
2
City of Edmonds
Critical Areas Deten'nination
Applicant: I Thomas Hafford Determination M I CA-1996-99
Project Name: Garage Addition to south Permit Number: V-02452
side of house
Site Location: 18425 High Street Property I Tax Acct #: 5656-001-019-0607
Project Description:
Garage Addition at 18425 High Street
Waiver Criteria (all criteria must be found to apply):
X There will be no alteration of the Critical Arta or its r-equired bufkrs;
X The development proposal will not impact the Critical Area in a manner contrary to
the goals, purposes, objectives and requirements of the Critical Areasordinance;
X The development proposal meets the minimum standards of the Critical Ar-eas
ordinance;
X The above findings are based on the following conditions of approval:
Waiver is only for project shown on attached site plan.
Based on the above findin-gs and conditions, the requirtment for a Critical Ar-eas-Study
associated with this development permit is hereby Waived, as authoirized-by Chapter 20. 13B.040
(A)(1) of the Edmonds Community Development Code.
Star Campbell
Name Signature
4W
9/25/2002
Date
The City of Edmonds
OWNER ... L� . ......
ADDRE.r/g4,5�� . ..... .... . ....
0 1
/MZ� Al., &M S
rl�-�-, A7
APPLICATION
for
SIDE SEWER PMMW
NEW CONSTRUCTIONX REPAIRS 0
........... CONTRACTOR .
........... LEGAL DESCRIPTION: LOT No - -------------------------------
NAME OF ADDITION ...................................................
c
'ON
AfPRO ED
YA 21 WA
Approved:
D A TE
10017
EASEMENT No . ..........................................
------ PERMIT No.
.... BLOCK No . ................................ ...........
............................................................................
'�' 9 0 - 19 " -
City of Edmonds
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 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 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
City, State,, -ZIP Phone
Signature
Date
Applicant Representative:
-TR&)KI WSL
Name
Ll Y5- I; -
Street Address
City, State, ZIP Phone
Signature Date
CA FILE NO.
Critical Areas Checklist
Site Information (sol,ls/topography/hydrology/vegetation)
1. Site Address/Location�: F,
2. Property Tax Account Number:
A
3. Approximate Site Size (acres or square feet):
4. Is this site currently oleveloped? yes; no. 119s,
If yes; how is site developed? L5 t b E. �J7_� �A, L C) P'\-
5. Describe the general site topography. Check all that apply.
Flat: I e�ss than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a
ori zontal 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).
I
Steep: g rades of greater than 30% present on site (a vertical rise of 10-feet over a
horizontal distance of less than 33-feet).
Other (plea ! se describe):
6. Site contains areas of year-round standing water: Approx. Depth:
7. Site contains areas ofil'seasonal standing water: Approx. Depth:
What season(s) of the t year?
8. Site is in the floodway floodplain of a water course.
I
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: for�sted meadow ;shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is pr'esent on site:
DETERMINATION
STUDY REQUIRED
CONDITIONAL WAIVER
WAIVE
Date
Reviewed by:
PI ner
Rev 0 1/04194
P TA
NAME:
SITE ADDRESS: (f(41.!E� �L.DATE: -ql ,?2 - - -------------
ZONING: AS - 12- PLAN CHK#: 6 14<-
PROJECT DESCRIPTION:- O-A !;9
--d A
CORNERLOT N4 _____�(Yes/No) FLAG LOT A].
-(Yes/No)
SETBACKS:
Required Setbacks:
Front; 5 Left Side: to
Actuaf Setb , ---Right Side: I& Rear:-Z.5
- Ack'%
Front: . Zf(, Left Side:-4k-' Right Side:_L4 _'Rear:__L,�
Street map c ckeed—for additional setback requir ed?__L_.&_z4e-- -m(Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED A)
(Y/N)
LOT COVERAGE:
Maximum Allowed:- ---Actual: 4,1�. i, -�.5t
V
BUILDING HEIGHT:
Maximum Allowed: 2�5_1 -Actual Height: - 2-4'
Datum Point: 4 �-rtr o�, (�aturn Elevation:- 1 7o,
A.D.U. CREATED?:
SUBDIVISION: -
CRITICAL AREAS
SEPA DETERMINATION:
LOT AREA:_1 8-, o 1
OT
Plan Review
C/vv�o — cp—
PLANNING DATA
NAME: 1:�� a 4 C%�&A DATE: 10— C-1 0-2-
SITE ADDRESS:' (923C4 b) D U PLAN CiT1
PROJECT DESCRIPTION:
REDUCED SITE PLAN PROVIDED?: (Yes / No)
MAP PAGE: CORNER LOT: (Yes FLAG LOT: (Yes No
ZONING: CRITICAL AREAS DETERMINATION g;,_�
U Study Required: k C1 GP - 9Ck
U Waiver
PConditional Waiver -
SEPA DETERMINATION:
Q Fee
Ll Checklist
Q APO list w/ notarized form
(Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger)
,,%m Exempt
SETBACKS:
Required Setbacks:
Street:an' LeftSide: )0' Right Side: 10 Rear:
Actual Setbacks:---'>,? f 14 ' I
StreetAg Left Side: Lj 5 Right Side: S Rear:
Street map chocked for additional setback required? (Yes / No DN
U DETACHED STRUCTURES:
U ROCKERIES:
U FENCES/TRELLISES:
U BAY WINDOWS / PROJECTING MODULATION:
U STAIRS/ DECKS:
PARKING: Required: -2- Actual: ':� -2 — t.40 t "'
LOT AREA: 15- C) (L4 �X 6-r-
L
L-4
LU I %,UVr_KAUr_:
Calculations:
BUILDING HEIGHT: co Q_e_X 100'
Datum Point: Datum EIevWFo-ff--__ .4-
Maximum AJIowed: al Helght:_ I OC?
A.D.U. CREATED qii�/ Yes) Q.)IS 9. A 100
SUBDIVISION:
4- Q Q
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: (Yes
L4
C-)
VC-1 0
L
NewBPPIanningDataForm.D0C
. City of Edmonds
Critical Areas Determination
Applicant: Thomas Hafford Determination #: I CA-1996-99
Project Name: Garage Addition to south Permit Number: V-02-152
side of house
Site Loc ation: 18425.High Street Property Tax Acct #: 5656-001-019-0607
Project Description:
Garage Addition at 184M High Street
Waiver Criteria (all criteria must be found to apply):
x There will be no alteration of the Critical Area or its required buffers;
x The development proposal will not impact the Critical Area in a manner contrary to
the goals, purposes, objectives and requirements of the Critical Areas ordinance;
x The development proposal meets the minimum standards of the Critical Areas
ordinance;
x The above findings are based on the following conditions of approval:
Waiver is only for project shown on attached site plan.
Based on the above findings and conditions, the requirement for a Critical Areas Study
0
associated with this development permit is hereby Waived, as authorized by Chapter 20.15B.040
(A)(1) of the Edmonds Community Development Code.
Star Campbell I act- 9/25/2002
Name Signature Date .
CITY OF EDMONDS
CRITICAL AREAS DETERMINATION
Site Location:
18425 High Street
Tax Acct. Number:
5656-001-019-0607
Determination:
Study Required
Determination #:
CA-1996-99 - Revised
Applicant:
N/A
Owner:
Thomas Hafford
CRITICAL AREAS DETERMINATION: STUDY REQUIRED (CA-1996-99)
A Critical Areas Determination of ."Waiver" was formerly granted for this site. However, during
inspection of the subject site in association with a pending Variance, it was found that the site
may contain critical areas, including a Wetland and a Stream pursuant to Chapter 20.15B of the
Edmonds Community Development Code (ECDC).
STUDY REQUIREMENT FOR WETLAND AND STREAM
The site investigation has shown that the site may contain a small wetland and stream near the
eastern boundary of the lot. Based on the above finding, a Critical Areas Study is required to
determine the class of the stream and wetland and to locate these features on the property.
* Stream Classification: A critical areas consultant shall perform the following:
• Classification of the wetland pursuant to the criteria established in ECDC Section
20.15B.060(A)(5) and stream pursuant to the criteria established in ECDC
Section 20.15B.060(A)(4).
• Delineate the boundaries of the wetland and the edges of the stream on the site.
• State any mitigating measures appropriate to preserving and protecting the
wetland and stream.
• This part of the study shall be performed as a three party contract with the city selecting
the consultant and the property owner or applicant paying the fees. When you are
ready to proceed, please contact a Planner.
• Wetland and Stream Delineation: After the critical areas consultant has classified the
stream and wetland and delineated the boundaries of these features, a surveyor
licensed by the State of Washington must perform.the following:
o Physically mark the edges of the stream and/or wetland.
o Delineate the required buffer (refer to ECDC 20.15B.120. (A) for the required
buffer widths for streams and ECDC 20.15B. 1 30.(C) for wetlands).
o Delineate the required building setback from the buffer (required setback is 15
feet).
o Create a map showing the wetland and/or stream, along with any buffers and
building setbacks.
• In order to complete this Study Requirement, this map must be submitted to the
Planning Division for review and approval.
• NOTE: A wetland that is less than 2,500 square feet in total area is not regulated by
City of Edmonds Critical Areas Regulations.
DEVELOPMENT PROPOSALS ON A SITE WITH A STREAM AND/OR WETLAND
Development proposals that encroach into the stream buffers or building setbacks may be
allowed through the approval of certain processes. The specific process depends on the
individual site and development proposal but may include Buffer Averaging, a Critical Areas
Vatiance, and/or a Reasonable Use Exception. If you think that you have a proposal that may
require one of these processes, please contact a Planner for more information.
PROJECT SPECIFIC CONDITIONAL WAIVERS
If the property owner wishes to apply for a specific development permit which they feel would not impact
the Critical Areas located on the site, they may submit their proposal to the Planning Department for
review. If the Planning Department finds that the proposed development permit will not adversely impact
a Critical Area or its buffers, a conditional waiver may be issued on a project by project basis.
EXEMPT DEVELOPMENT PROPOSALS
Certain development proposals may be exempt from Critical Areas Requirements (ECDC 20.1513.040). If
you think that a specific development proposal may be exempt, contact a Planner for more information.
Se
Name Signdture
iber 2
Date
u Cited sections of the Edmonds Community Development Code (ECDC) can be found on the
City of Edmonds website at www.ci.edmonds.wa.us.
2i
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APPROVED BY PL '46
t,4.50,i
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RECEIVED
DEC 2 0. 2002
Ro
14 PERMIT COUNTEli
0"'REET FILT
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wpm, P.,
40o
ADD JUTTERS /DOWNSPOUTS
AND SPLASHBLOCKS
E DO
SEP 2 3 2002
DEVELOPMENT SERVICES CTR-
CITY OF EDMONDS
IZWNEki /CONTF ACTOR iS RESPONSIBLE
OR EROSION CONTRO'L AND DAMAGE
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NAO 100
APPROVED RY ENGINEERING
si
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Al
V, Date:
A- W&VA'T9,
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APPROVED BY PLANNING
4
F:
'EUM' NDS'
CIM�,OF�:--
Call PYC69 6-1107 when work
CENTER �FtW,4T- 5"A I)EPARTMENT is ready for Inspection. (No 1pspee-
lions Saturday, Sunday or holidays.)
N2 �046
I �'S
IDE-7- -EWER-,;,P_._ERM1T
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..................................... ..............................................................................................................................................
V,
e -.;E i ............ CONTRACT
.... ;Aiarswi ....................... .............. OR ....... Qxjwr� ............................................................
P lssidn Is; granied..:...
erni ............ 19 ... 6.8, for ........................ days to REPAIR or CONNECT a. side sewer
on file and governing ordinances.
TENTION..- -IS CALLFD_,!i6.,�ii-_'_�,6_
wners:�of�thelprop��*
erty'r, permit to construct sewer Inside property line. A licensed Side Sewer Contractor. must
&nployed,: t6 - constru&`!sid�� iewer' in street area. Do not cover any portion of sewer before -it has been Inspected.
rdl
-_-_�OTiD-.,No 2—Obtaln- full- lnfo�Tatt2n,�rpg_ din -0 ance 11.16.030 and Regulations governing side sewers when you get permjt.,��
I perty�, line:,: infrilm-u-m r e oi,
11%�NOTE--No. 3�Top_�of- side -.sewer. z��st`4�_-at,.'ii AG� nehes coverage at property line and 12 inches. Inside pro
irper Ai�abi. %'.-,will be* permitted.
No'b6nds lngrad6.shi
-N(�T-E.�No..-, —Tiefiche-,'i e settle -to original- -:Condition;-�4r,(j6n"ot6rs�!.B*b�iiiz. be'Zffres nsi'16'�7
s n_stree0must,.b 'water,� d.&nd surface of street restored
fafluie,*&Wto lmprbper��ivork,whj6h may,- develop within one y
ear of completion.;',.
the permit, .'or to do any�work-'or t e mat s its.
NOTE No. to�alter or, do'kny. other work than Is provided for in n ewer
tenances. except. to lnseft',th& pipe lntbi:the wye.
DATE RECEIVEDj7
I FPERMIT EXPIRES
USE ERMIT
ZONE Z P
CITY OF EDMONDS NUMBER
08 UITEIAPT
CONSTRUCTIONVERMIT APPLICATION ADDRESS
OWNER NAMEMME OF OUSINE HL�LQ5
e.
7`bo-� e. PLAT NAMF/SUBDIVISION NO. LOT NO. LID NO.
MAILING ADDRESS LID FEE $
C 'ECPrffAP'=
< PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Pe I
Street Use Permit Roo
Crry�� zip EXISTING — PR Inspection Required 13
TELEPIJO OZPOS--
- -? z Sidewalk Req ked [3
C? REQUIRED DEDICATION— FT Underground
do- VAring required 13
NAMEe4,7F'_k; METER SIZE LINE SIZE NO. OF FWWRES PRV REQUIRED
YEs13 NO 13
7 1 1
ADDRESS REMARKS z
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
z
CITY LEPHONE AVb rJ1,0KK tff 10 W, (0 t-A fIllaxwb 6499
6yrf 0 -er- -7 VoIrleg avit 5"ea NAK. SE4�p��_
NAllijAq— CBL#
'15AT
lC ADDRESS
Mel",
FIRE REVIEWED BY DATE
CITY ZIP TELEPHONE
0 rL
0 UU&10,0 773-5q&&,
�'VARIANCEE 6R'CUI� kSHORELINE OR ADB#,. IJ INSPECTION BOND
I - '.REIJL POSTED
13YE6 01$
STATE LICENSE NUMBER EXPI 1OF4 ATE 'C
SEPA REVIEW SIGN AREA,:,..' HEIGHT
PROPEZIr ACW NT NO COMPLETE , EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
-or 06,0
EXP
NEW PLUMBING MECH LOT COVERAGE REQUIR AETBACKS (FT.,)-, RROPOSED SETBACKS (Fr.)
;fkRESIDENTIAL ALLOWED PROPOSED FRONO�MDE REAR FRON IJR SIDE REAR
j— COMPLIANCE OR 0 1 .1 1
DDITION COMMERCIAL ,'- &51/ at; t;)' z
13 CHANGE OF USE gn Ci I z
X PARKING LOT AREA
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muLnFAMILY SIGN REOID I PROVIDED t
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1:1 41gf) CYDS ( _ X_ Fr) REMARKS
DEMOLISH TANK OTHER
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MPE OF USE, WSINESS OR ACTIVITY) EX!T
6 CHECKED BY ITYPE OF CQW118UGnON "0 _OCCUPA
GROUP
NUMBER NUMBER OF CRILICA —V&L "'T
OF DWELLING AREAS SPECIAL INSPECTION AREA ftJ30 OCCUPANT
,+C
TORIES UNIT$ NUMBE REQUIRED [:I YES _01W LOAD
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6L on�c_ REMARKS
P GRESS INSPECTIONS PER UBC 10, S/FINAL INSPE9WXN REa
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Description FFF Description FEE
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PLAN CHECK NgkT� VESTED DATE
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Mechanical
THIS P ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
1= BE DONE ON PRIVATE PROPERTY ONLY. AM CONSTRUCTION ON THE PUBLIC
23 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) MILL REQUIRE Grading
1= SEPARATE PERMISSION. Engr. Review
2
PERMIT APPLICATION: ISO DAYS
PERMIT UMM. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection /010
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due
01 NOR LIMIT IN ANY WAY THE CrTY`S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' 1
I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION Recording Fee Receipt # L
GIVEN IS CORRECrL, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL Building Official or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknovAedged in space provided.
WORKMEWS 5PAW
wwwwwwwwww ,,ENSATION INSURANCE AND RCW 18.27. OfF/CVLS SIGNATURE DATE
SIG 1KNER)OR D27� k
GN0Ey6r_1 1
6 L. Z (425) on
M�m �� 1 771-0220 R BED By DATE
A17ENTION Off 1333
T IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL Alz
k FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL-FILE YELLOW-INSP R
,ATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OMER GOLD - ASSESSOR
�/02 ---_----PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING
7
JSE
PERMIT
ZONE
UITY OF EDMONDS
NUMBER 960,318
CONSTOCTION PERMIT APPI.LICATION- JOB SUITE:APT o
OWNER NAME NAME OF BUSINESS ADDRESS
LEGAL DESCRIPTION CHECK SUBDIVISION NO. LID NO
MAILING ADDRESS
Z
0
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved 0
CITY ZIP TELEPHONE NUMBER RW Permit Required C1
EXISTING — REQUIRED DEDICATION Street Use Permit Req*d D
?81 0,� 0 -75*3 f 0 PROPOSED inspection Required 0
NAME Sidewalk Required 0 cr
METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
r
YES 0 No 0
ADDRESS 0
REMARKS
cc
0 w
cr w
< CITY ZIP ITELEPHONE NUMBER Z
j W
NAME �g A
Pik Nt yj 1
ADDRESS Nil
0 ENGINEERING MEMO DATED REVIEWED BY
35 A\) E
ZI TELEPHONE NUMBER
CITY
Z FIRE MEMO DATED. REVIEWEDBY
0- se-c', 75 7-7-37
Nri
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STATE LICENSE NUMBER 1, EXPIRATION DATE
SIGN AREA SEPA Rit IEW,*� AOB NO.
OSE
-t7ANK W, m--�T- A ALLOWED. PROP D OMPLETE �,IEYJMPT
Legal Description of Property - include all easements
SHORELINE I
Z WOL oo F-0.---06 1�4. N L cz%~ 3
EXP
P8 T� S be VARIANCE OR CU PLANNING AEVIEW BY DATE
5 WQsTALI6tJ LIP Ise
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C3 —r 7), e':�: R, -4 SETBACKS — FEET OT C2h--AAGF..
- 1(- 3. Fu*
< o 5 Z
0 FRONT SIDE REA
u.' Property . 4
REMARKS
Tax Account
Parcel No. 1, of 7 (v 0-7
FINEW% L--'S RESIDENTIAL PLUMBING
ADDITION COMMERCIAL MECHANICAL
REMODEL F-1 APT. BLDG. F-1 SIGN
GRADING FENCE CHECKED BY TYPE OF CONSTRUCTION ICODE OCCUPANT
I GRLP
_FT)
X
BEPAIp
4
1NSERT SWIM POOL SPECIAL INSPECTOR 11AREA OCCUPANT
DEMOLISH WOODSTOVE F HOT TUB/SPA REQUIRED LOAD
GA RETAINING WALL/
ROCKERY
AG
CAR�POFIT RENEWAL REMARKS
PROGRESS INSPECTIONS PER LIBC 305
(TYPE OF USE. BUSINESS OR ACTIVITY): EXPLAI N:
Co
Ir PeE o') (,) u 04 \--1:
(n -MBER CRITICAL
NUMBER OF
0 OF DWELLING AREAS
OD STORIES UNITS NUM83ER
0
DESCRIBE RK BE. DONE (ATTACH PLOT PLAN)
T, FINAL INSPECTION REOUIRED
bk�--E- 300
LTD, i� VALUATION FEE
PLAN CHECK FEE
BUILDING
HEAT SOURCE: 0/0 PLUMBING
Plan Check No. MECHANICAL
This Permit covers work to be done on private property ONLY. GRADINGIFILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission. STATE SURCHARGE
Permit Application: 180 Days
STORM DRAINAGE FEE.
permit LimW-,1 year - Provided Work 19.�,Stqr.jed Within 180-D,4s. ..� 411
"Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE
successors in interest, agrees to indemnify, defend and hold
ow harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all clairris for damages of
whateveir�n
_�ture, arising directly�or indirectly ff.o,m the issuance
of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT
modify, waive or reduce any requirement of any city ordinance
0 nce
nor limit in any way the City's ability to enforce any o 1v TOTAL AMOUNT DUE
provision."
I hereby acknowledge that I have r ad this apblication; that the
APPLICA
a� the owner, or the duly
information given is correct; a4UZ ,ATTENTIOk), TION APPROVAL
-17
authorized agent of the owner.) agree to comply with city and 4IRMIT r
This application is not a permit until
state laws regulating construction; and in doing the work authorii� AUTHORIZES
signed by the Building Officia or his/her
r ed thereby, no person will be employed in violation of the Labor" ONLY THE
Code of the State of Washington relating to Workmen ',s.96rfI0ensa- WORK NOTED Deputy; and fees are paid. and receipt is
ion Insurance and RCW 18.27. 4 acknowledged in space provided.
INSPECTION
DATE SI
IGNATURE (OVfNER,,OR AGENT� GNED DEPARTMENT UR�
OFFICIAL 97SIGNAJ DATE
CITY OF
EDMONDS
i&
CALL FOR RELEASEDIBY: DATE
ATTENTION INSPECTION
I 'BUILDING OR TRIJC�URE
IT IS UNLAWFULJO USE OR OCCUPYA
UNTIL A FINAL INSPECTION HAS BEEN MADt A0 APPROVAL OR 771-0220 ORIGINAL — File YELLOW — Inspector Li
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER PINK — Owner GOLD — Assessor
110247 )j.%
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APPROVE) BY PUINNINCi
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Sioist, m 6(l n
AM,
11 / 10
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER rME/�A �EOF BUSINESS
MAILING ADDRSW
I c6- 9
CITY ZIP TELEPHONE
Ect rVN0 nc(s 9 0,?0 114 7- 5- 61 )L- 4f c
NAME
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CITY ZIP TELEPHONE (4
4\1y)%%Q0oCk I �r M+1415-
NAME it CBL #
"Ti" �w
`,ADDRESS
4-1-09 Aaxi�v-r 4xt-C,0,�Kt-s Dr -
CITY ZIP TELEPHONE
STATE LICENSE NUMBER EXPIRATION DAT CkWCKED BY
_2
3rV 112
PROPERTY TAX ACCOUNT PARCEL NO.
.56 4;_ (6 00 10 1 C,
NEW RESIDENTIAL PLUMBIN MECH
1�9 * . �3
ADDITION COMMERCIAL COMPLIANCE OR
11 CHANGE OF USE
REMODEL 0 MULTIFAMILY 0 SIGN
REPAIR GRADING FENCE
1:1 CYDS ( _X—FT)
DEMOLISH 13 TANK OTHER
GARAGE RETAINING WALL F RE PRINKLER
CARPORT ROCKERY F:RE ASLARM
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
M ev� 11 CE--a g f -i'-, -+ P)
NUMBER 1Wj NUMBER OF CRITICAL
OF U001211 DWELLING AREAS
STORIES UNITS NUMBER
DESCRIBE WORK TO BE DONE
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C-C si CA
HEAT SOURCE I GLAZING % . I -.LW SLOPEW
PLAN CHECK !R_4 1 VESTED DATE
THIS PERMIT AUTHORIZES ONLY THE WbRK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN.(CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: 180DAYS
PERMIT UMM 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 MATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMrr. 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 CITY% ABILITY TO ENFORCE ANY ORDINANCE 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 AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING 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
WORKMENSPA)MRINSATION INSURANCE AND RCW 18.27. 1
DATE
?o/ 0 '2--
USE
ZONE
JOB
ADDRESS
PLAT NAME/SUBDIVISION NO.
�4,`] PERMIT EXPIRES 4JI I
Jr
PERMIT
NUMBER 2W-3 - X 2- 7,
11 1 � .11
LOT NOU LID NO.
I LID FEE$
,:.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
I CXr:
AW It= ad
treat Use Permit Req
EXISTING — PROPOSED—
inspection Required
Sidwalk Required
REQUIRED DEDICATION— FT
Underground
wiring required
E3
*TER SIZE
LINE SIZE
NO. OF FWURES
PRV REQUIRED
YES [3 NO C3
z
09
REMARKS
z
10
OWNERMONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
z
5
REVIEWED BY DATE
FIRE REVIEWED BY DATE
cc
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OR CU
SHORELINEORAD1111
INSPECTION
BOND
REO'D
I
POSTED
1
[3YES WO
$ —
SEPA REVIEW
SIGN AREA
f . HEIGHT
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWED PROPOSED
V
a5l 15 ._1 51
LOT COVEAdE
REQUIRED SETBACKS (Fr.)
PROPOSED SETBACKS (Fr.)
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT L/R SIDE REAR
No
I
Gks 10,
. L
50
C_W A f�,A C:4
- I Qn
Q-1
z
PARKING
LOT AREA PL.AZING REVIEWED BY DV
REO'D I PROVIDED I
k —
REMARKS
CHECKED
SPECIAL INSPECTION JAREA OCCUPANT I
REQUIRED [] YES LOAD
REMARKS
z
PROGRESS INSPECTIONS PER UBC 10.8/FINAL INSPECTION REQ'O
1��, Vt." ... -aj J4 . I ) ,_ I - L,_ I viit_—
VALUATION
1:!561 CA;Z3 7 1
. :
.. .
DiescrIption
FEE
Description
FEE
Plan Check
State Surcharge
Z15,9
Building Permit
City Surcharge
AO�
Plumbing
Mechanical
Grading
Engr. RAW
Engr. Inspection
Fire Review
-------------
Plan C�.k. Deposit
4//6v—
Fire InsOM16
Receipt A'
Landscapeln,sp;
Total Amt. Due
Recording Fee,
Receipt #
tALL
FOR INSPECTION
(425)
771702.20
APPLICATION APPROVAL
This application Is not a permit until signed by the
Building Official or his/her Deputy: and Fees are paid, and
receipt Is acknowledged In space pravided.
OISFG;g �NAT DATE -
RELEASED BY Oftiv
ATTENTION 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL' W11
A FINAL INSPECTION HAS.. BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
04/02 PRESS HARD -YOU AIR I E MAKING 5 COPIES
PINK. -OWNER - GOLD -ASSESSOR
GREEN - ACCOUNTING