18505 79TH PL W (2).PDFIIIIIIIIIIII
6861
18505 79TH PL W
STANDARD DRAINAGE DETENTION SYSTEM
WORKSHEET
OWNER CALC ]ay:
ADD4 �JSZ 624/'77
PHONE:
DATE:
*****DESIGN DATA*****
IMPERVIOUS AREA PIPE DIA PIPE LG ORIFICE
20
DeTENTION PIPE LENGTH, LOCKING LID
(TYPICAL)
FINISHED G
MINIMUM
MIN L%EPhAM1CfGP
TIGHTLI E *ASUR or
CONC BOX OR RISER
.5% TO 1% SLOPE
0 OUTLET
OUTLET CONTROL
MIN.
UPPER CATCH BASIN "ORIFICE
CONTROL CATCH BASIN
SYSTEM CROSS SEC6%1'4
2'X2'X6' DEEP, 4-6' SPALLS OR EOUAL FEB 7 1997
FROM CONTROL CB 2'X 2'X 3' DEEP, 3/4' CRUSHED ROCK EXISTING GRADE
PERMIT COUNTER
FROM CONTROL OUTLET
'-OUTFLOW TRENCH, MIN 10' LONG.
1.5' PERF PIPE TO BE LEVEL
PERF PIPE W/ END CAPS
TR L BE LINED VITH MIRAFI
PR585HTSOMPALLACEMENT OF WASHED DRAIN ROCK
RIPRAP OUTLEr
RUNOFF SPREADER -TRENCH
FOOTING DRMNS SHALL NOT -BE CONNECTED TO DETENTION SYSTEM
NOTES:
1. Call Engineering Division (771-0220) for a tightline and detention system inspection
APPROVED BY
before backfilling and for final inspections.
2, Responsibility for operation and maintenance of drainage systems on private property is the
responsibility of the property owner. Material accumulated in the -storage pipe must be flushed
DATE
out and removed from the catch basins to allow proper operation. Ile outlet control orifice
must be kept open at all times.
b � .
1-1. -a,
Table 1 - Detention Pipe Sizes
Impermeable
Required
Pipe Diameter
Area Sq. Ft.
Vol Cu Ft
150
18" 04M
.30"
2000
50
40
28 16
10
.2500
62
-59
35 .20
.13 -
3000
75
60
42 24
15 Required pipe
3500
87
70
.49 28
18 length in feet
4000
100
80
56 32
21
4500
112
90
63 36
23
5000
125
100
70 40
25
Note: Allowable Pipe Materials: Reinforced Concrete
Aluminized Steel
Aluminum
CMP Asphalt Coated
N - 12 ADS (Not permitted on roads)
Impermeable
Area Sa. Ft.
2000.
2500
3000
3500
4000.�
4500
5000
Table 2 - Outlet Orifice Sizes
Outlet Orifice Diameter (Inches)
5/8
5/8
3/4
3/4
7/8
7/8
7/8
Table 3 - Rectangular Catch Basin Requirements
Detention Max. size Catch Basin
pipe diameter knockout Type
< 181, 20" Type 1, C13 15
18" -to 24" 26u Type IL, CB 16
24u to 36" 36u Type 11, CB 19 19 (48' Basin)
36" to 42" 4211 Type 11, C13 19 19 (54" Basin)
*Source: Assoc. Sand & Gravel Co. Standards
5
Revised 3/16/95
C
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FEB — 7 1997
PERMIT COUNTER
L A
17 H I D D'E N.' G I
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JAN 2 8 1997
PERMIT COUNTER
T -PLA N
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9-5
05
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CITY
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COPY
JAPI 2 3 1997
PERMFI COUNTER,
S LT E PLN� LOT P
111::20 TAX# 'Y7106-00 0 /70004/
H&T Mc's
A 1010- 50 CITY COPY
,B loo-7-5
.50
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-ro+A L Lioq .25 10 1. 0 CO MeAW
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MAX t:, EL 100
=��=: �77:
'21
Proposeo' Hol.1se-
28
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Delve
.201
APPROVED BY P NING
JAN 2 8 1997
4d
PERMIT COUNTER
PROJECT REVIEW CHECKLIST
PROJECT,NAME: 5�f
I
PROJECT ADDRESS:-. 0
PLANCHECK#:
RECEIPT DATE: 7
REVIE
n la ae
PLAN..
WATER
COMMENTS
FIRE
81 DG`
S.EWI=R
STRFFT ENG.
Setbacks/Variance/Setback Adjustment
Conditional Use Permit
. . . . . . . . . . . . . . . . . . .
2
ADB Requirements
...............
3
Other Zoning Requirements
. .
4
Underground Wiring Required
. . . . . . . . . . . . . . .
5
Lot Slope 15%
6
SEPA Environmental Checklist/Hydraulics Permit
Tree Cutting Plan
8
Plat/Subdivision Requirements
Legal Description Verification
.9
10..
Quit Claim/Street Dedications
Easements - Public/Private
0..
2.
Engineering Storm Drain Review Fee 30
. . . . . . . . . . . . . .....
. . . . . . . . . . . ......... . .
.....
3...
Engineering 2.2 Inspection Fee 3 0
ME
Drainage Plan (On -Site)
Setback - Top of Bank, Stream, Water Courses
Setback - Storm Drain Line
Open Ditch - Existing
Culvert Required
. . . . . . . . . .
19
Culvert Size
0
Shoulder Drainage/Shale Open Runoff—
............. . . . . . . . . . . . . . .
21
Catch Basin Required
;X.-*�-,M;'.**.*-.**
IV
'�F
Driveway Slope & Vehicle Access
Sidewalk Required 4-05
Curb & Gutter Required 14-"
Curb Cut For Driveway Required
1 A
Street Paving Required
..........
Right -Of -Way Construction Permit Required
Street Name Sign Required
Other Signing Reguired
Bond Required For Public Improvements
FEMA Map Check/Water Table
31:::
Side Sewer Availability
Calculate Sewer Connection Fee If No LID # og
..... . . . . . . . . . . M
Create Street File
Existing Water Main
Mll M^.
......
86
Size
Water Meter Size
Service Line Size
V4:1
..........
Water Meter Charge Required
766 -c
. 3 ,
Hydrant Required
X
40-
Hydrant Size Existing
Fire Line Charge Required - Sprinkler
Street Cut
42..
IMiscellaneous
Reviewed By:
FIRE
PLANNING
-7/,A
ENGINEERING
.,AN 2 8 1997
,UgLjo \NORKS DEP',
R E C 0 R D OF C 0 N T A C T S
21
2
22
3
23
-4
24
5
25
6
26
7
27
8
28
RW -PERMIT -DATE ISSUED
9
29
10
30.
11
31
19
321
13
PAID I RECEIPT I DATE
33
SS PER141T lyg6 -7
pATE I SUED�/// IME lop T
14-
PAID $ RECEIPT I DATE
34
35
361
17
37 1
METER SIZE PAID $ DAJ'El.//t RECEIPT I
381
39
40
exp,�'Es �>o :4w Y's
CITY OF EDMONDS SIDE SEWER PERMIT
14, ��
1qq PERMIT 11")
C864
Address of Construction: -79 LLYN NWOOFL17NET
Property Legal Description (Include all easements): R1tCx1VED
i-weipw
NIJB_ L I G_ MOP%
State License No. naAaf Building Permit No. —7( ?
Single Family
Multi -Family (No. of Units-)
11 Commercial
11 Public
Invasion into City Rlglht-of-Way�- No El Yes
RW Construction Permit No. -
Cross other Private Property: x No 11 Yes
Attach legal description and copy of recorded easement
I certify that I have read and shall comply with all city requirements
as indicated on the back of the Permit Card.
Date
* CALL DIAL —A —DIG (1-800-424-5555) BEFORE ANY EXCAVATION *
I OFFICE USE ONLY I
FOR INSPECTION CALL 7"wSM, PUBLIC WORKS DEPT.
Permit Fee: Issued By
Trunk Charge: Date Issued: -47
Assessment Fee: Receipt No.:
Lid No.:- 15 141.
Partial Inspection:
Comments
Date -Initial
Reason Rejected: Date -Initial
Final Inspection Approved: Date lnitialci��.-
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Green Copy: Inspector Buff Copy: Applicant
Re,,sed 3'90
NOTICE:
No.warranty of accuracy.
The -informati on shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of'Edmonds does not warrant the
accuracy of anything set for ' th on these
map(s). Any person or entity -req uesting a
copy should conduct an independent
inquiry regarding the information shown on
the -map(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may'not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
empl-oyees or office rS S13ha III be 1-ia-b-l-e for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
The City of Edmonds Side Sewer Drawing EASEMENT NO . ............................................ 1
NEW CONSTRUCTION Ej REPAIRS F-1 LID NO . .................. ASMT. NO . ..................
OWNER................................................................................................ CONTRACTOR .................................................................................... PERMIT NO. 89.6-q-
JOB ADDRESS I ... .... 0 .... � --.. 7 - 9. T q ... ........... LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ....................................
.......... ................................................................................... . ..............................
I LY=-�NNWOOD LINIE ..............................
NAME OF ADDITION ............................. .................... - ------------------
V, t. t
V
PWW-0001-11/75(REV.11/78)
Approved:
DATE.6= ... ......... By .... 2�-
Water Service Drawing
The City of Edmonds EASEMENT NO . ............................................
NEW CONSTRUCTION Pel, REPAIRS El LID NO . .................. . ASMT. NO . ..................
OWNER................................................................................................ CONTRACTOR ................................................................. * ------------ * ... PERMIT NO.
.T 11
JOB ADDRESS ........ ......... ............. LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ............................
..................................................................... I ...................... ..........................................................
NAMEOF ADDITION ............................................. * ..........................................................................
-z
Vi
Approved:
E ...
PWW-0001-1 1175 (REV.1 1/78) DAT ....... .............. By
7
1'r2 — S 9 ()
C. 1.
C. Contractor:
Mailing Address:
State License #:
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT PermitNumber.
Issue Date:
A. Address or Vicinity of Construction:
B. Type of Work (be specific):
D. Building Permit # (if applicable):
Contact:
Phone:
Liab ility Insurance: Bond: $
Side Sewer Permit # (if applicable):
I
E. n Commercial E] Subdivision I-] City Project F%V Utility (PUD, GTE, WNG, CABLE, WATER)
F1 Multi -Family El Single Family Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut: 0 Yes 0No 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 qf Edmonds harmlessftom 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 attorneyfees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC-
TION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREETPATCHIS COMPLETED
BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WII L BE PROCESSED FOR ISSUANCE TO THE APPLICANT
Two sets of construction drawings of proposed work required with permit 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 the above statements and understand the permit requirements and the pink copy of the permit will be
available on site at all times for inspection purposes.
Signature:
APPROVED BY:
Date:
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
TIME AUTHORIZED: VOID AFTER
SPECIAL CONDITIONS:
FOR CITY USE ONLY
RIGHT OF WAY FEE:
DAYS DISRUPTION FEE/FUND I I I -
RESTORATION
7 OTAL
.-RECEII'T.
._.,.ISSUED.fl
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div 1997
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.)
Comments:
1 61%
CONTRACTOR CALLED FOR INSPECTION El YES El NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
City qf Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT -0
it Number. ?7
Per=
L-sue Date: E3- 32-
A. Address or Vicinity of Construction: 18"Soz -79TIl P L IN
B. Type of Work (be specific):
890
P\V�10 NQ_Z1tQ1CA_k "13 UV L
C. Contractor: 'S�ZmAcm�S\A Co\Wt-1 9-\)-(1C:n.1ct: Q\ oA krm"
Mailing Address: Phone: (0�7
State License #: t_b\-%\4S 600A�0 Liability Insurance: Bond: $
D. Building Permit # (if applicable):
E. F] Commercial E] Subdivision
C] Multi -Family Wr'!2(,Single Family
INSPECTOR:
Side Sewer Permit # (if applicable):
El City Project E] Utility (PUD, GTE, WNG, CABLE, WATER)
Other
INSPECTOR:
F. Pavement or Concrete Cut 0 Yes ;-qNo - G. Size of Cut:
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the City ofEdmonds harmless from injuries,,damages, or
claims of any 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 ofany legalproceedings including defense costs, and attorney fees by reason ofgranting thispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THEAPPLICANT.
Construction drawing of proposed work required with permit 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.
'I'faffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
Ihave read the above statements and understand thepermit requirements and thepink copy of thepermit will be
f
vailable o j t
e
a at all-time in=oses.'
Signature: — Date: 5 77
(Contractor or Ag&A)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
NO WORK SHALL BEGIN* PRIOR TO PERMIT ISSUANCE Eng. Div. 1994
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.)
Comments:
I Diagram.:
CONTRACTOR CALLED FOR INSPECTION E] YES E] NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Pao
'SIC
Pok�t
16sos
-79T-4 P�, Q'
I
s%wo
C-A)s
LwZ-�
R L
pt-
olt.�,Gil- 0 P
cation:-27N4El8A Scale 1:30
\p
C-D i2t_;� 7
4r
SNOHOMISH COUNTY PUBLIC UTMM DISTRICr No. I
M
r-DMFD
1476 Rev. .1094
CN
LOCATION E
7 9r-'
Q
AREA
POLE #
-7 R
1/4 S \�')TD,
DATE F% - wo. #
REASON FOR WORK �_>
fro ENGINEER DWG. #
DRAFTER U.G. #
SCALE
DATE WORK COMPLETED
FOREMAN
.FEES REQUIRED:
ENVIRONMENTAL ANALYSIS
ES 0 NO
CO EXEMPT 13 NOT EXEMPT
PARA. 18 ITEM C
PRIMARY OVERHEAD
O.H. U.G. COND. KV
El RESIDENTIAL 0 COMMERCIAL
ADD CKT. FT. -PH
LEO
REM CKT FT -PH
$
NET _CKT. Fr.
SECONDARY OVERHEAD -
O.H. U.G. COND. KV
BASIC FEE $
ADD CKT. FT. PH
$
REM - CKT. Fr.. PH
NET _CKT. Fr.
METER/CONV. POLE- s
PERMITS (DATE GRANTED)
PRIMARY UNDERGROUND
0 RESIDENTIAL U:COMMERCIAL�
0 TREE TRIM
BASIC FEE $
0 STATE
LEU #
$
U COUNTY
$
EASEMENTS
Q REQUIRED 0 NOT REQUIRED
$
SECONDARYUNDERGROUND
BASIC FEE $
$
UNDERGROUND PLAT
DATE RELEASED
BASIC FEE $
0/ft $
FOREIGN CONTACTS
U GTNW JPN #
U CATV . JPN
STREET LIGHTING
$
0 JOINT TRENCH GTNW & CATV
U JOINT BORE GTNW & CATV
WORK IN RIGHT-OF-WAY
0 PRIMARY
0
CISECONDARY
POLE STENCILING
$
FROM -TO
TAKE OFF POLE
MISCELLANEOUS FEES
VAULT $
PRE-CONSTR. REQUIREMENTS
PERMIT $
0 TREE TRIM 0 PUD LOCATOR
$
LIBACKHOE 0 FLAGGING
$
Q ONE CALL DATE
TOTAL DUE: $
DATE PAJD
INDEXI
1POLES1
PLAT
LOGS
I
U-MAP
I
RECEIP`r#
XFMR I
I C-MAP
I
NEW SVC APKjC. #
LOCATION MAP PAGE HL2--
APPROVED uAl c rrum 1 mu
SUBSTATION
CIRCUIT NO. PHASE
y \'-)k \ N' L)k.)M�-\"
78-
USE
11"E PERMIT
CITY OF EDMONDS NUM13ER
TU
CONSTRUCTION PERMIT APPLICATION Joe ::I I
ADDRESS FL TJF—SUITE/APT
OWNER NANIEINAME OF BUSINESS
LEGAL DESCRI PTIO N CHECK SUBDIVISION NO. LID NO.
X ?Pf M,
w MAILING AD08ESS
Z
3. 105�`i �Vt S7E
0 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved 0
-CITY -TT-EL—EPHONE NUMBER RW Permit Required 0
EXISTING REQUIRED DEDICATION 5Q=m Street Use Permit Req d
0 M. 1. Zip PROPOSED 5o Inspection Required 6111,
NAME Sidewalk Req uired be
cc
w
METEF) SIZE LINEISIZE NO. OF FIXTURES PRV REQUIRED
0A StA 11 fAv 5 1 < I
Y
ES 00
w ADDRESS
REMAFIKS
L)
BER
q( 1
77
ZIP 7T—ELEPHONE NUMBER LOI 14 tO L4�.. (te i-r, Lu
< CITY f.- Z
;4�
NAME ra
�/j /V 0/e ve /oa tn Aic
ADDRESS
0 ENGINEERING MEMO DATED tEVIEWED —BY
U A Irk-4 2/7/ 9-7 7 Ai.
('r CITY ZIP TELEPHONE NUMBER
FIRE MEMO DATED REVIEWED BY
le . Lu
Z I 5-4,m If
0 !61y" E
STATE LICENSE NUMBER EXPIRATION DAT
7 - SIGN AREA SEPA REVIEW ADB NO.
7 7' ALLOWED PROPOSED COMPLETE J�XEMPT
Legal Description of Property - include all easements
SHORELINE11
z
0 EXP
(L VARIANCE OR CU PLANNING REVIEW BY DATE
W Lu V- 76 1 't
_j SETBACKS - FEET HEIGHT I
JIL T COVERAGE
L.0 Property FRONT 7, 7-< 7 f ZZ
a 5" 'SIDE REAR 5-1
REMARKS
Tax Account
Parcel No. L4-710 -000 —0 /7 000y
\41 ie
RNEW EflRESIDENTIAL PLUMBINGWECH
COMPLIANCE OR
ADDITION El COMMERCIAL E] CHANGE OF USE
REMODEL F] APT. BLDG.
SIGN
GM CHECKED BY ITYPE CO UCTION E OCCUPANT
] FENCE 7E
REPAIR c.s. E L_ x _FT) C4
WOODSTOVE SWIM POOL SPECIAL INSPECTOR OCCUPANT
:7_t 7-7 LOAD
FIDEMOLISH, D INSERT HOT TUB/SPA REQUIRED
13 YES "4"
EDRAGE RETAINING WALL/
AcA ROCKERY RENEWAL REMARKS
PROGRESS INSPECTIONS PER LIB.0 108
.-I (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
NUMBER NUMBER
NGOF CRITICAL
OF DWELLI AREAS
CO STORIES UNITS NUMBER eA -74(-/
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
. Cloris4ru C � 0 0- Uj Hom -e
? to
107- Slow /C7
FINAL INSPECTION REOUIRED
I VALUATION
PLAN CHECK FEE
Vt>
BUILDING
HEAT SOURCE:
r-r h S
GLAZING ./
IN,
PLUMBING
Plan Check No.
MECHANICAL
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.
GRADINGIFILL
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
-0-
"Aoplicant, on behalf of his or her spouse, heirs, assigns and
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 this permit shall not be deemed to
modify, waive or reduce any requirement of any city ordinance
nor limit in any way the City's ability to enforce any ordinance
provision.'
ENG. INSPECTION FEE
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the
ATTENTION
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
state laws regulating construction; and In doing the work authoriz-
THIS PERMIT
AUTHORIZES
This application is not a permit until
ed thereby, no person will be employed in violation of the Labor
ONLY THE
signed by the Building Official or his/her
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
Deputy; and fees are paid, and receipt is
ion InsuraffU-e1&nd RCW 18.27. - 11 -_
INSPECTION
acknowledged in space provided.
IGNAT E (OWNER_P AGENT) DATE SIGNED
DEPARTMENT
/I '? /1, .
� "I
1 ban j
CITY OF
OFWFIC14* t N��Jltlg ATE
17Y a
EDMONDS
CALL FOR
06LEASiQ DA'�.t
ATTENTION
INSPECTION
.,.
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL'OR
771-0220
ORId'1NAL - File YELLOW - inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
Critical Areas Checklist
q
Site Information (SOils/topography/hydrology/vegeL-ition)
1. Site Address/.Location:ff-LO-L 22ZX �2 an/K�
2. Property Tax Account Number:Lt/�- 4,4- /7 �710-06o-,617-
3. Approximate Site Size (acres or square feet): Z 6_0 0 /3 io* 4 0 r6)
4. Is this site currentlydeveloped? A yes; no -
If yes; how is site developed ?—WOUS f- 0A,1 16 V&+A/7- M 17
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 riseof I 0-feet -over a
horizontal distance of 6&feet).
Hilly: slopespresent on site of more than 15% and less than 30% ( a vertical rise
of I 0-feet over a horizontal distance of 33 to 6&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-fw).
Other (please describe):
6. Site contains areas of year-round standing water: Approx. Depth:
7- Site contains areas of seasonal sta:hding water: Al d Approx. Depth:
What season(s) of the year?
8. Site is in the floodway j," floodplain of a water course.
9. Site contains a creek or.2n area where water flaws across the grounds surface? Flows are year-
round? . ri 61 -_ 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 sit e: fa 6
-For City Staff Use Onl
L Site is Zoned?
sr
2. kS mapped soil type(,
3. Wedand inventory or C.A_ map indicates wetland present on site? C117Y COPY*
4;.,,. :-,Critical Areas inventory or C.A. map indicates Critical Area on site?
5.. within' designated earth subsidence landslide hazard area?
6. ''gitt designated on the Environmentally Sensitive Areas Map? W/1)
DETERMWATION
_--`��rUDY REQUIRED
WAIVER
Reviewed by:����:::>
UPliEner
P_-V01M4ffl4
CONDMONAL WAIVER
Date
JAN 2 8 1997
PERMIT COUNTER
'-'J
890 -19",
City of Edmon&
Critical Areas Checklist
'ne 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 sub.-ruttal 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, sicn and date it,
4VX
.40
zi tr., - .' ".
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 permitapplication.
MrAh a'sighed copy of this io r-rn,"the
applicant should also submit a vicinity map
or plot plan for individual lots of the parcel
Vith enougb detail that City staff can find
and identify the subject parcel(s)- In
addition, the applicant shall. include
otherperfinent infomiation (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 I -Applicant: 'Applicant Representative
6,4RX- A. Po.5,�-
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9troet Address Street Address
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PERMIT COUNTER
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PERMIT COUNTER
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JAN 2 8 1997 J.
PERMIT COUNTER
ENGINEERING
ROUTE T6 11 0 �n43 d? tal Dayk_Mailed
()_Back 2 Ad �`To
RESUB #1 ON Back Add? Total Dayk Mail
FILE
RESUB #2 ON TO Back Add? Total Days Mailed
S4,
1. Site/Drainage Plan & Cale.,
-12-5 OK Corrections Required Received
2. Grading Plan/Calcs/CYG 111A SEPA? _OK
3.. Driveway Slope VILZZL Profile
./VPT &-0 CKC�48 ILI
4. Truck Route Plan OK
5. Street Dedication? —'/VA FEET
6. Easement 11�4 Type�__OK,,__
OTHERCOMMENTS:
CX__
I. Pak, K��j
2.
3.
4.
5.
PW REVIEW Date Sent Vz_,F,_Back FIRE REVIEW Date Sent Back
PLANNING REVIEW TIME TOTAL DAYS *** ENG REVIEW TIME 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 TEIIS FORM I UNDERSTAND THAT I AM THE ACKNOWLEDGED CONTACT PERSON FOR
TECIS PROJECT. IT IS My RESPONSIBILITY TO COORDINATE ALL SUBMITTALS wrm nE CITY
AND ONLY I CAN MAKE INQUIRIES ON THE STATUS OF TFLE PERMIT. I UNDERSTAND THAT IT IS
My RESPONSIBILITY TO DETERMINE IN ADVANCE OF PERMIT SUBMITTAL ANY DISCRETIONARY
PERMITS THAT MAY BE APPLICABLE TO THIS PROJECT. I ACKNOWLEDGE THAT TO THE BEST- OF
My ABILITY I HAVE SUBMITTED ALL NECESSARY DOCUMENTATION IN ORDER TO MAKE A
COMPLETE APPL7TION.
zt
Signed Date Mailing Address
20ziLlIf-12 /ZE/Z 10V�Ille fZ�
Contact Person (Print Clearly)
ZOr, �Sl 2q377__1 306- 45W �77_5'1
,
Phone Number FAX Number f
ROUTE1)OCA,/Temp/Bldg/Forms-5/96
PERM[IT APPLICATION REQUIREMENTS
Applicant
om: Jamal Mahmoud, Engineering Inspector poll
*ner . ACt� Plan Check No: 9 7 - 3 2 nEET HLE
1dress: 1./- 14,1 Date: -7. 9 1.
fter review of the subject permit application, the following requirements must be met
Construction hours are: WEEKDAYS - 7:00 AbL-10:00 P.bL;WEEKENDS/HOLEDAYS - 10:00 Ar*L-6:00 P.rvL
A separate RIGHT-OF-WAY CONSTRUCTION PERMIT is required for all work on public property. (ECDC 18.60)
Truck haul route plan must be submitted and approved prior ta permit issuance.
Builder/owner is responsible for containing all temporary runoff and erosion control on site (ECDC 18-30.030d).
NO WORK SHALL BE DONE WITHIN 15 FEET OF STREAMS OR 10 FEET FROM ANY CLOSED DAA
JXA E
FACILITY. BUILDER/OWNER IS RESPONSIBLE FOR IDENTIFYING CONDITIONS ON THE DRA.Mih�G.
(ECDC 18.30.50G)
FILTER FABRIC FENCE SHALL BE INSTALLED AND INSPECTED PRIOR TO CLEARING AND CONSTRUCTION.
(ECDC 18.30)
INSPECTIONS ARE REQUIRED ONSTORM DRAINAGE SYSTEW TIGHTLINES AND CATCH BASIN
INSTALLATION. INSPECTIONS ARE REQUIRED PRIOR TO BACKFILLING. (ECDC 18-30)
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 1&90)
Driveway slope shall not exceed 14% without a waiver. Every attempt should be made to keep the slope below 14%. Waiver granted to
12- (ECDC 18.80.060D)
Driveways must be paved from' property line to City RIGHT-O&WAY. A separate permit is required. (ECDC 18.80.060C)
INSPECTIONS ARE, REQUIRED ON DRIVEWAYS AND SIDEWALKS PRIOR TO AND AFTER POURING. (ECDC 18.30)
No burning of construction refuse without a permit from the Fire Department
Connection to City water system is required. 'There is a separate charge.for the water meter (ECDC 7.20)..
k A back water valve is required if downstaiis plumbing is below the elevation of upstream manhole.' (ECDC 7.20)
Water and sewer main lines should 6e separated by 10 feet minimum. (ECDC 18.10)
Connection to the City sanitary system is required. A separate permit is required.
LID# 13 9 Fees,paid: Yes— No— Charge 5-5 (ECDC 18.10)
Underground wiring is required on all new construction, and for additions, alterations, and repairs that exceed 50% of the total assessed
value of the structure. (ECDC 18.90)
A FINAL ENGINEERING INSPECTION IS REQUIRED PRIOR TO THE BUILDING DIVISION GRANTING OCCUPANCY
OF THE BUILDING OR STRUCTURE. (ECDC 18.90)
FV-
10 KKIIJ-016-101
PLANNING DATA
NAME: -
SITE ADDRESS: 17 101- SfEbATE: —27 b
ZONING: 1� 5 -,� — PLAN CHK#: 77— 3 7
PROJECT DESCRIPTION: T P A
CORNERLOT Ye j Yes/No)
SETBACKS:
Required Setbacks:
Front: 21- Left Side: 7,k Right Side: Rear:
Actual Setbacks: Rear: 7
Front: I s- Left Side: Right Side:.
Street map checked for additional setback required? (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED (Y/N)
LOT COVERAGE: .3 51. 1 7-,rPo
Maximum Allowed: - —Actual:
BUILDING HEIGHT:
Maximum Allowed: Actual Height:
. -2"( / I.0"
Datum Point: 5e -,e - Datum Elevation: 1'"
SUBDIVISION:
CRITICAL AREAS #: q6 —(7C
SEPA DETERMINATION: A111q
LOT AREA:
OTHER:
Plan Review By: blrt-r-