18507 90TH AVE W.PDFlill iiiiiiii
8759
18507 90TH AVE W
ADDRESS:
TAX ACCOUNTMARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE): 19-7(o —
COVENANTS (RECORDED) FOR:
CRITICAL AREAS:— 0-9 — I 1 0 DETERMINATION: n Conditional Waiver Ej Study Required JxWaiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:
--*7- 11 C Rg 4 -J- b —
SHORT PLAT FILE: la LOT: BLOCK:
SIDE SEWER AS BUILT DATED. 1019'K r/�,
SIDE SEWER PERMIT(S).#:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED: ao
LATEMP\DSrs\Fomis\Street File Checklist.doc
#P20 CAFileNo:
Critical Areas Checklist
Site Information (soils/ topography/ hydrology/ vegetation)
1111C
1. Site Address/ Location: J��o- qof)4 kvajt�e �axau,3 q'i
2. Property Tax Account Number: 00 w95 ono o b
3. Approximate Site Size (acres or square feet):
4. Is this site,currently developed? X yes; — no.
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Rolling: slo' es . on s . ite generally less than 15 % (a vertical rise of 10-feet over A horizontal
p
distance, of, 66-feet).
Hilly: slopes present On site of more than 15%-,pi
pdjess,,�
tp 1, 1 � 'N
_,,303 (a prhca1-,,rise,,_qf 104eet
W, 3
over a -horizontal distance of 33 -to 6qL.,fe&),.. r4 H U
tical
Steep: grades of greater than 30% present on sfi6 (a ver rise 10-feet over a horizontal
fr14
distance of less than 33-feet).
tA
Other (please describe):
6.
Site contains areas' of year-round standing water:
Approx. Depth:
7.
Site contains areas of seasonal standing water:
Approx. Depth:
What season(s) of the year?
8.
Site is in the floodway floodplain
of a water course.
9.
Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
Flows are. seasonal?
(What time of year?
10.
Site is primarily: forested meadow
shrubs mixed
urban landscaped (lawn, shrubs etc)
11.
Obvious wetland is present on site:,
------- — - --- --- - --
For City Staff Use Only
1. Plan Check Number, if applicable? P& * 05 - 3 4?),
2. Site is Zoned?
3. SCS, mapped soil type(s)?. `51 MdM1yD0d Vy,1oA&1 LAnA urnpltX. 1-6-1- 51opc
J?,/ In: A4 A PAmft-)n/l i I vWaAA 1 --A AA.A I ntAAAD I P A( - q 1i g:Z-4 r'l nf)lr,- �,__
4. Critical Areas inventory or' C"A. ma . p indicates Critical Area on s i te? - e,5 . syp 6 i qyi fta -t-a r 4
5. Site within.designated earth subsidence landslide hazard area? 0 in QW41VVY P2,MAJ CUAIA
0 ff 1* LA* (A I f 7D vyi a 1 6( e.4 C* wVyi (A-n U)",
DETERMINATION
STUDY REQUIRED K WAIVER
Reviewed bv: 0 (MAJ (ATb1r_A1V,_,1 Date: 09; 1 ON ,)C5
Critical Areas Checklist.doc/3.25.2004
#P20
0
E
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
1� Fax: 425.771.0221
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 the application to the City.
.Date Received: :7(90/66
City Receipt#:
Critical Areas File #: CA - 1,00,6'11 D
Critical Areas Checklist Fee: $135.00
Date Mailed to Applicant: 8-:44—,P-005
A property owner, or his/her authorized 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
Ine purpose of me Checklist is to ena e C ty sta to permit application.
determine whether any potential Critical Areas are, or
may be, present on the subject property. The information Please submit a vicinity map, along with the signed copy
needed to complete I the Checklist should be easily of this form to assist City staff in finding and locating the
available from observations of the site or data available at specific piece of property described on this form. In
vsoxc_1C_.i" - ps addition, the applicant shall include other pertinent
rMHE information (e.g. site plan, topography map, etc.) or
un V OnINI Pt studies in conjunction with this Checklist to assistant staff
A r%P%l 10t A &MO&I 0 M NAk . A< deft in completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its; heirs, anTIO �gns, in consideration on the processing of the application agrees
to release, indemnify, defend and hold,the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part ..Upon false, misleading,. inaccurate or
incomplete information furnished by the applicant, his/her/its.agents or employees.
By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file this application,on L the behalf of the owner as listed below.
g��,yrv, C )&_
ry
SIGNATURE OF APPLICANVAGENT 4WAM01\74 P6�)I(!9W 'd_W10 DATE
Property Owner's Authorization
By my signature, I certify that I have Authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property. for the.
purposes of inspection and posting attendant to this app)ication.
SIGNATURE OF OWNER _e.0 DATE -
777
Owner/Applicant
-b a- sma� -cm-Ase
Name J
1609-
Street Address
Z�� Q",
City State Zip
Telephone: 42-S MA III
Email address -(optional):
A�pii.ciant Representative:
Name�
..I., . W-M 0140 To.
20M,_ ONAAN6-OP-
Street Address
Wk ell 5 1 �`6
'Zip
,City State
Telepho ne:ZjQ 1�0 _010 (15LL-
Email Address (optional):
B U I LD I" G DEPARTMENT
App;;cant Fill
ON
Inside
PERMIT APPLICATION
Heavy Lin e
J013
ADDRESS
ZLOT_
or "us] 5 S)
LI!1;AL LOT'
LOT AREA SufIVISION NO.
71i 711
NO
'7c;L
III
Z
'SS
MA'C G AIDORL
YES
11��L?00'_
VARIkNCE OR ADD
COND. USE NO.
0
C III
TELEPHONE Nur,6
-7797,6)
//S-
PR YARMS
OF7SED /
FRrIG
Z
FRONT SIDE REAR
A
ALLOWABLE: PROPOSED
SIGN AP E A ISIGN AREA
U
OTHER
RrOUIREMENTI��'
U
01.
-61 T _Y
)AL DATE
P� N N G 11 P P R CIX�V
s tv,
NAME
STREET RjW
EXISTING STREET RjW15_V_10FT. DEFICICNCY THIS PROPERTY
It
0
ADDRESS
COMP. PLAN ST. R/W 1106011. FT.
I-
U
---
REMARKS
Dri...,eway slopes not to exceed those
Is
i
M
TELEI'HO-
CITY
indicated on Standard Dwq,
Z
0
__��C_ -
:KEO CY
IJ
U
_§T__A-rrL1_C7ffSe NUMBER CITY LICENSE NUMBER
0
Z
Legal Description Of vroperty ionow setow or ActIch —Fo.r Copies)
AND/OR UTILITY YES
WORK REO'D NO
UNDERGROUND -MES
Z
WIRING REQ'O N 0
0
:ORNECTION
va.1 V I
26
VgS
PERMIT 141
U
1IC
III
:YSCTIUM
APPVO Y 7Y ENr
W
REMARKS
W
METER SIZr sup vice SIZE JCLCARA.CE ]CHECKED Vv
eel,,
\j
7�t
I
A..
FIRE ZONE
coo'
�73
N
ADO
RETAINING
E] DEMOLISH
_a
SPCCIAL INSP
R EOUIRED
OCCUP N Y
GROUP
UPANT
LOA
OCC
WALL
0 YES ul� �0
ALTER EXCAVATE E] PENCE
OR FILL -I
PLAN C y
IHI ITE
S LO ATED IN THE
CITY
LOCA SALES TAX
OF EDMONDS. L
EPAIR IR.-..V. OS WIM
R P
INSP. OOL
HOULD BE CODE Re
.0
MAqK
11r2F
NUMBER OF STORI j7NUMLaR
OF
DINE LING
UNITS
NA TO Be DONE
RE OF WO
V ALUATION
FEE
Z
PROPOSED USE
PLAN CHECK
0.
2
PLOT PLAN iINDICATE BUILDING SETBACKS.
ABU REETS)
TTING ST
13UILDING
a
U
0
PLUMBING
14CAT & GAS LINE:
0
SIGN
RETAINING WALL
SWIMMING POOL
AMOUN DUE
TOTAL T
hat the In-
I hereby k..wj,d9. that I ba- e.d thle application: that th
form:tIon gtven,I,,cort: and thv.t I anz the 0-7. or the duly authez-
tzed gent of th wner. I agree to COMPIY with city and *late laws reg-
ATTENTION
APPLICATION APPROVAL
rating COWI�MCI[on; and In doing tb4 work authorized thereby. no r—on
will Do tmp oyed in vlolatlon of the Labe, Code of the State of Weutbington
TIIIS PERMIT
This t�npllcatlori is not a permit until
ral Ing to Workmen*. CoMP"1"&tI0D
AU1II01nIZCS
allmed by the Bulldir�- Official or his Dep-
NOTE: Permit Limit One Year (rz,pt I)Z.MOUTIn.N5 hilh
—L THE
ORK NOTED
uty; and fees are paid, an d receipt is
ac-
t. mplet,d in ninety daye: NOVIED-1 It BULLDI.1;08 hall be
knowledged j.1 space provided.
17
INSPECTION
RTM
p EPA TY C, C I IT
C
N ATU- r
all—
EDMONDS
NOTF.- Applicant Subject to Plan 0ICCej_CC
775-2525
This Pormiticoverl, workuto be done on private property ONLY.
the blic doTain (curbs, sluewiflks, driveways.
ORIGINAL - I,- YELLOW 1,
Any construct on on p
mprque", etc.) will reqUire separate pormi,gion.
GOLD -
o'. .: .'
RECORD) OF J�ISPE.CTiONS-
FOUNDATICN.
L
Hot!sc
P-Dr--hs. pinr�
-iZ6R �W;'
pl,
roil -id
,V�Itcr s-rvirc
�JEAIING
_10
FRAMING
NOTIC�:
0
N'O..War-ranty---o-_ a..
The -information'shown on the attached
f (Dr use by the City of
map(s) was corn . piled
Edmondsl its Employees and Consultants.
Th,..e City of Edrn.onds does. not . wa rra nt the
accuracy of anything set for.th on t. * hese
map('�). An . y person or entity -requesting a
copy should conduct an independent
inquiry regarding th*e inform-ation shown or
ffi�� -rnap(s), including, but not Jimited to, -1
er stub shown. Suc
the lociation of any sew
sewer stubs may or may, not e.xist and may
or may not exist at the location shown.
Neither the City of Edmoinds nor its
empl-o-yee-s o-r office-rs -sh-a-1.1 be I -Jab -'Fe for the
I n on this ma p(5), nor for
information g'Ve'
any one representation provided based
upon'said map(s).
3, APPLICATION
The City of Edmonds for EASEMENT NO - ----------- ................................
SIDE SEWER PERMIT
�NPW CONSTRUCTION REPAIRS LID NO - ------------------ ASMT. NO. ----------------
OWNER ------- . ....................................... CONTRACTOR
----------------------------------------- PERMIT NO.
JOB ADDRESS ------ w -------------------- LEGAL DESCRIPTION: LOT NO - ------------ cm ..................... BLOCK NO . ................... ----------------
N
----------- ---------------------------------------- ----------
r---1 "-� _-_l L.
...........................................
DATE ... ----------------- By, ............
0 /11/1
AONDS I 11P IT. F:.,
E ROM, I
"E&M E�W%j E K
M,
CITY OF
If TMEN'T44t;
DE
WATER�, I _1 :,
�4
A,^
P MIT
ER 7�4.
n o the constructiom
("Ca.1pl -7.75-2525 for,' side, sewer Inspections BEFORE :covering: :a�y, poitio f
In ' , . I ": z
ectibn will b�, provided �Ithin�'24,,hours after reciust. NO 'Sat., Sun,. or holiday; :inspections.),"
'N ......... ........................... .
-t-n 7", ..... , ............ . .. .... ......... . ..............
ADDRESS- LOCATION -OF CONSTRUCT
Lot 6 Tt 11 -F,i
-s ell".1 ..................................... ..........................................
r
�PROPERT.Y.-L�'EGA�L,,DESCRI-P,�T-ION ......... .
.......... ........
............
.............................. ........................... ................................................................................... ......................................... ........... ......................................
VALKEk.
.................... O�WNER AND/0K BUIEDER; ............................. ............... : ................................ ................... ... I ....................
........... ............. ................. .......
CONTRACTOWSJ'NAME & ADDRESS. C M EXO-AVato'rg
............................. :i ......... ............................................ ................................ .......................................................
P' tssion,'Isotmnt�&.....- A11011-St _3 for repair and/or connection of a -sid sewer.to the,.cltyls�n _y
W.; .............. .... 19,..
...... ..................
F niih,ac�dorditiice,.w,'Ith.CitiLof2Edmondg ordinances.
;S
�;A-.MMIOK M CALED,,TO,, TH&FOLLOWING:
y� iruct
-;,NOTE, No.- I —The, owrf6s1;of,,the'. property ma obtain. a permit tb, construct -sewer Inside. property'llne. A,116ensed�,SW6 Sewer Contractor must'llie employed, to'cons
0 1 .,,, , �J, L " .
sideil sewer' in',.street a�ea.�, Do not'cover any, portion, f 'sewerL before It. has,,been inspected. i . . . . , I ', , .
E o. 2_`� Ml 11 r1i,.pprform4 in city, right-of-way.r I equired an, 1nvaalon��of, Right -of -Way Permit obtaJnable from the City Engineer's office.
"NOT
;.-Wo - N6� 3—Obt . ain! full 11 in . f I 6rmation,-regarding Ordinance +1.M030 and, Regulations. :governing,side sewers when, you get permit.
e of*.20/0. `Nbtb�rids, in! grade
4-��,NO No. 4—Top"of �side -sewer- must have,atAeast.30 inches coverage at� property line and 12 inches, Inside property line; minimaim: lgro
sharper, than 2/s w ill �be permitted* 7.
,NOTE. No. 5--Tienchevin street must -be water settled and surface of. street restored to orlgInaJ condition.L Contractors shall be responsible for failure�'Clue. to improper
work whibliv may, develop :within one year of completion.
NOTE) No� -6—it'ls, unlawful -to alter or do,.any other- work'than is provided f - or in the permit, or to do any, work' on the maih,spwer or its appurtenances��ekcept to in-
the-ililpe into the wye.
DISAPPROVED: -F�i.," bate� ... .................................... . By ......... ........ . ................
.......... By� ............... Date ..... ............. ....... . ..
TPROV ....... I ..........
A E
........................... ....
........... ...........
Remarks:: ...... .................. ................................................ ........................................................................................ ............................ I ..............................
. .................. .. ................... ........................ .........
............................................. ............................................................ .......................................................................
BOTH� -Permit- Copies, MUST'Be� Signedi By 6wner. of, Firm. Performing,�,Construction. PRIOR. To!.Req�est For Inspection
p
certify tha : t I `,the�-side sewer ins tallation",:cons tructed, urfder, this.permi t
... .... her6by
.................. . ..............
f:`4, f f
(Owner, of Contracting,"F rme er orming Construction,)'
ie(iii�acco'rdan6e,with.al erning Ordinances,& the.Qity of Edm6nds;-
119:i�v
—,,Instal
7
Y, of ............ ..........
............................. 19..
Dated this... ........ .......... da .......
Ak�
iec BEFOREyoulAigfor: Water E],,, Gas, E],, Te1ephon'q`-Q3,, Powerk E], Sewer ED; _Other
APPLICATION
The City of Edmonds for EASEMENT NO - --------------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION Ej REPAIRS E] LID NO - ------------------ ASMT. NO . ..................
0 W N E R 'V4 W CONTRACTO� ....... PERMIT NO. �,-�557V-
-- - -- -------- --- --------------- I ...
JOB ADDRESS ... !-- woo --- --- V4 LEGAL DESCRIPTION: LOT NO - ------------ 6 ------------------- BLOCK NO - ------------------------------------
-------------------------------------------------- 4 -- --------------------- ... .... ---------- ----- ? ........ ...............................
NAME OF ADDITION ..... ......... .. do!
------------------------------------ ................. : ---------
r -I
L-A
I
11C
-1 1
I -L, <'
Approved:
I\i
4
DATE
................. By .............
......................
11/75
EET FILE
Permi t Address
On -cal Description
7AU, R 25%
BUILDING PERMIT RUIEW - FMGINFFRTNG- DEPARTMFNT
CHECK LIST
Reviewer'.s
Intials
'000 NJ
Septic Tank System Design Approved
Sanitary. Sewer Availahilit'flt:�q Sht. I of Pwn. No . <
.y
Project:
Side Sewer Avai,lability:
Any*Sanitary Sewer Connection Fees
S -ite Drainage Checked
Storm Sewer Availability: Sht. of Dwq. No.
Project:_Vt-k1TTXV &Aln —Roadside Ditch.
6 Grading Final Contours
7 Sidewalks (Site Inspection shows condition of existina walks as follows):
4=1 L
Curbs
U_nd,_e_r,_gr*,`o_und Wiring A Street Liqhtinq
A-1000 Street Riqht-of-wav & Bldg. Setbacks: Sht.
T?h
of Dwg. No. of Official Street Map.
� 4r�_
1/2. Existing Utility Easements (0
Access Easements
Water Mains A Fire Hydrants (Indicate Size !-later Mai,n)
-,L
Bonds for S*ite 1,lork
Special Requirements listed in memo to Bldg. Dept.__
_0001< Commercial & Apt. Requirements form comnleted
- Drawings stamped notations made
Site Inspection made on
All items filled in on Rldg. Permit Application
his Lot included in Subdivision R&TO, (List any special
,�W�7
3/9/76
requirements):