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18516 79TH PL W
STREET FILE
USE
I -ITV rlig: C:r)KAr)KIr1Q N ZONE on,-,
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME � BUSINESS
-3-Allpm;, majl(:A '-rVKWF-(2--
7AILING ADDRESS
( e) -7 4T 14 PL
CITY ZIP TELEPHONE NUMBER
r,-QM0QD!57 d1962-4,11-74-17s4-
NAME
DRESS
(a A L--Q Piz-
9;ITY ZIP TELEPHONE NUMBER
-F,DM0&jQ!5 jbd2-0 1-1-74---71Z'l
NAMEC
ADDRESS
STATE LICENSE NUMBER EXPIRATION DATE
CC15,a7-?,/(f- �� /(,,,/ -j - 51 V
Legal Description of Prop&ty� - include all easements
o -r 1 14 1 Do et-j 61
\/0-t-, 2-1 , ?(!S. (0-5
�Wx'i��unt
Parcel No. 4-7 1 o- 000 -o o:5 - evao
NEW
WRIESIDENTIAL
PLUMBING
ADDITION
11 COMMERCIAL
El MECHANICAL'
E] REMODEL
0 APT. BLDG.
1:1 SIGN
E]
GRADING
E]
FENCE
REPAIR'
CYDS.
L— x —FT)
EIDEMOLISH
WOODSTOVE
11 INSERT
SWIM POOL
HOT TUB/SPA
GARAGE
F-� RETAINING WALL/
QAAaQ6XT
9:lr)rtW;:Pv
RENEWAI
(TYPE QF USE. BU"ESS OR ACTIVITY) EXPLAIN
NUMBER' NUMBER OF CRITICAL
OF 01Vr DWELLING AREAS '00%
STORIES I UNITS NA INUMBER 7-6-01*
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
OVH�P 7-b'AZb' ATTACIP
U KI 4 eATet? l51ArZA6,-?F- I
WI-vi
JOB
AIJUHLbS
PERMIT
NUMBER 9 3 05 3 -3
- 7,�, e71- A /-,
I let -
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved 0
RW Permit Required 0
EXISTING — REOUIRED DEDICATION Street Use Permit Req-d C3
PROPOSED Inspection Required 0
Sidewalk Required 13
REMA�r
0 --( /W,,)
ENGINEERING MEMO DATED REVIEW BY
L�� A-�z el�l
METER SIZE 1BUILDING SUPPLY SIZE I NO. OF FIXTURES
SIGN AREA
ALLOWED PROPOSED
�/, k
VARIANCE OR CU
SETBACKS — FEE T
FRONT?_ SIDE
REMARKS
SEPA REVIEW
COMPLETE
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EXP
Pl.
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HEIG�HT
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ID NO
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SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT
REOUIRED 0 YES GROUP LOAD
REMARKS
1PROGRESS INSPECTIONS PER UBC 305
FINAL INSPECTION REOUIRED
PLAN CHECK FEE
BUILDING
HEAT SOURCE, GLAZING
4iw ",# d I PLUMBING
Plan Check No. q�,7 — )3 2
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewplks,
STATE SURCHARGE
driveways, marquees, etc.) will require separate permission.
Permit Application: 160 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
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
PLAN CHECK DEPOSIT
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
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
state laws regulating construction; and In doing the work authoriz.
AUTHORIZES
ed thereby, no person will be employed in violation of the Labor
ONLY THE
Code of the State of Washington relating to Workmen's Compensa-
.,�VORK t.jOTED
ATTENTION
I NSPECTION
NT) DATE SIGNED
DEPARTMENT
a '2
CITY OF
17
EDMONDS
CALL FOR
INSPECTION
771-0220
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
6
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 provided.
0 C NATURE 0 TE
RfLE AS 44144 DATE
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
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W
S TPREET FILE
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critical Areas Checklist' 2 9 03
Site Information ?ERMIT COUNTER
Projec Name: P,,LLlit Number
Site Location: -71 Account Number +71P 060 — 603 "00,00
--61—propertyTax *
Approximate Site Size (acres or square feet):
Have you filled out a Critical Areas Checklist for a project on this site before?
General Site Conditions
1. Has the site been cleared or logged?
/1/0 Date of most recent action:
Soils / Topography
2- In the Snohomish County Soil Survcy� what is the mapped soil type(s)?
3. 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 rise of 10 feet over a
horizontal distance of 66 feel.)
)1illy.- slopes present an site of more than 15% and less than 30Yp ( a vertical rise
of 10 feet of horizontal distance.)
Steep: grades of greater than 30% present on site.
Comments
Hydrology/Vegetation.
4. Site contains areas of yea r-round . standing water A10
5. Site contains areas of seasonal standing water. ArO Approx- Depth:
6. Site is in the floodway A10 floodplain of a water course-
7. Site contains a creek or an area where water flows across the grounds surface? AID flows
are year-round? Flows are seasonal?
me
8. Site is pri-marily: forested (low V, shrubs Mliced
9- Obvious wedand i's Preseint on . site:
10. Wetland inventory or map indicates wetiandpjresent on site: /Y"D
I I- Critical Areas inventory or mao'inaicates aiiyCritical Area on site:
IND
CitY of Edmond S-*.
Critical Areas Checklist
'Me Qitical Arms Ch=Mist 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&cr submitta Ofa development permit
to the city�
The Purpose Of the Checklist is to enable
CitY staff to determine 'whether any potcatial
Gdtical Areas are or may be present on the
subject PrOPCItY. The information needed to
cOmPletc the Checidist should be easily
a 'lable from observations of the site or
vai
data available at City Hall (Critical Areas
inventories, maps. or soil surveys) -
An applicant. or his/her representative
,. must
fill out the chccklist� sign and date it md
submit it to the, City. 1hc City Will review
the cheddist, make a precursory site visit,
and make a determination of the mbscqucnt
steps necessary to -complete a development
Permit application -
With a signed copy of this form, the I
applicant should also submit a vicinity map
Of the ParcclVith enough detail that City
staff can find and identify the subject
parccl(s)- In addition, the applicant is
encouraged to include any other pertinent
information or sttidies in conjunction with
this Checklist to assist staff in completing
their prellminarY assessmcnt of the site -
I havecompleted. the attached Critical Area Checklist and attest that the answ - provide I d re
factiml. to the best of my knowledge (fill out the approp'r*iate column'below).' ers a
Owner / Applicant -
Name
0 W
Title
[Lo
Str=t Address
fTtl 0 714 7e4-
CAT, State, ZIP
Phone
S4'ature Date
Applicant Representative:
. �—Rt "
Name
D �-
Title
(Or-2P2- A-LU)sL_
Street Address
t�- OMP-e5- VUA IW-b -774,--7j2-J
City, Stat ZIP Phone
Signature Date
STREET
FILE
City of Edmond S-'.
Critical
Areas
Ch-ecklist
-QC Critical Amu (Mmklist contained on
&is form is to be filled out by my pown
preparing a Development permit
Application for the City of Edmonds prior
to his&cr submittal of a development
to the city.
The purpose ofthe Checklist is to cnable_
City staff to daCrIninewhether any potential
Cdtical Areas are or may be present an the
Subject Property. Uc information neodod. to
ComPlctc the Checklist should be easily
available Irom, observations of the site or
data available at City Hall (Critical Areas
inventories, maps, or soil surveys) -
An applicant. or his/her rcpre=tativc� must
fill out the chccldis4 sign and d[ate it, and
submit it to the City� Uc City Will levicw
the checidist, make a precursory site visit,
and make a dacrmfimfion 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
of the parcel with enough detail dw City
staff can find and identify the subject
Parcel(s). In addition, the applicant is
encouraged to. include any other pertinent
information or sttidics in conjunction with
this Checklist to assist staff in completing
their preliminary assessment of the site -
I havecompleted the attached Critical Area Checklist an attest that the answex-� providedare
.4
factual, to the best of my knowledge (fill out the aPPrOPriate column below) -
Owner / Avoicant-
Name -nLMA -fog
0 W KSV---7
Tide -
I t3t;�' ILP -� I * q- �-1
Street Address
V'�)tl 0
CUT, State. ZIP Phone
S' ature Date
4t, -
Applicant Representative:
Name
-V F,
Title
(Or�2-- ALosp
Street Address
IWO
City, Stat , ZIP Phone
Signature
Date
RECEIVED
Critical Areas Checklist' 2 1993
Site Information PERMIT COUNTER
Project Name: 6PA?A�if," Permit Number.
Site Location: Fl— W Property Tax Account Number- 000 — 0.03 —o"'100
Appro�imatc Site Size (acres or square feet):
11ave you filled out a Critical Areas Checklist for a project on this site before? —1V6
General Site Conditions
1. Has the site been cleared or logged? /Vo Date of most recent action: —
Soils I Topography
2. In the Sn�6mish- - CountiSoil Sii&�y, what is the iiiV—�od` —Soil -tYPO(s)?
3. Describe the general site topography. Chock all that apply.
V� Flat less than 5 feet elevation change over entire site -
Rolling: slopes on site generally less than 15% (a vertical rise of 10 feet over a
horizontal distance of 66 feet.)
)ffilly.- slopes present on site of more than 15% and less than 30Yp a vertical rise
of 10 feet of horizontal distance.)
Steep: grades of greater than 30% present on site.
Comments
HydrologyfVegetation.
4. Site -contains areas of year-round standing water Al 0
5. Site contains arms of seasonal standing water- ArO Approx- Depth:
6. Site is in the floodway 4/0 floodplain of a water course-
7., Site contains a creek or an area where water flows across the grounds surface? All) flows
are year-round? Flows are seasonal?
8. Site is primarily: forested .-.rnr-a(JOW shrubs.. mixed
9- Obvious wehand is present on site:
Rev 3/27/92
0 if
0"FIREET FILE
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. -Me 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 chedidist, sign and date it, and
submit it to the City. The City will review.
the checklist, mWw 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
of the parcel with enough detail that City
staff can find and identify'the subject
parcel(s). In addition, the applicant is
encouraged to include any other pertinent
information 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).
J
Owner / Applicant:
. -5-
- / / 4'� � 4
Narne
626--C14-L-el-
Title
-/,7
Street Address
a;, el-i -1 ro,2- (� -7 71i'- �;7J-�
City, State, ZIP Phone
gnature Date
Applicant Representative:
Name
Title
Street Address
City, State, ZIP Phone
Signature
Date
a G
Critical Areas Checklist -
Site Information
Project Name: A=kfim�� 7E�P,ro_r Permit Number.
6 5 11, _Pril �; � - V 7/0
Site Location: . C4�:, I �',- �4roperty Tax Account Number.
Approximate Site Size (acres or square feet):
Have you filled out a Critical Areas Checklist for a project on this site before? /170
General Site Conditions
1. Has the site been cleared or logged? r) 0 Date of most recent action:
Soils / Topography tUzZ,,,, alld
,J tLrh.,z-n J
2. , In the Snohomish County Soil Survey, what is the mapped soil type(s)?
3. Describe the general site topography. Check all that apply.
'Y-' —Flat less than 5 feet elevation change over entire site.
_Rolling: slopes on site generally less than 15% (a vertical rise of 10 feet over a
horizontal distance of 66 feet.)
I
Ifilly: slopes present on site of more than 15% and less than 30%_( a vertical rise
of 10 feet of horizontal distance.)
. Steep: grades of greater than 30% present on site.
Comments
Hydrology/Vegetation
4. Site contains areas of year-round standing water. n C)
5. Site contains areas of seasonal standing water. t) —Approx. Depth:
6. Site is in the floodway n 0 floodplain /� o of a water course.
7. Site contains a creek or an area where water flows across the grounds surface? _11L.-flows
are year-round? Flows are seasonal?
8. Site is primarily: forested meadow ;shrubs
mixed
9. Obvious wetland is present on site:
10. Wetland inventory or map indicates wetland present on site: )"IC
11. Critical Areas inventory or map indicates any Critical Area on site: nr
F6r City Use Only
NOTICE:
No warranty of accuracy.
The information 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-reque sting a
copy should conduct an independent
inquiry regarding the information shown on
the rnap(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
employees or officers S)hall be liable for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
APPLICATION
for LYNN PLANT
The City of Edmonc'STRvtmr, i r SIMIM SEW= Pmxm EASEAE I ENT No.
NEW CONSTRUMON 0 REPAUts 0 011)
A-[ D /,-� 9
owmm ....... oil
-------- ............................ CONTRACTOR ----------- PERWT No
ADDRESS ...... W ............................ LEGAL DESCR=lON: LOT No . ........ a Z TO
..................................... BLOCK No . ............................................
NAJ�M OF ADDMON .............. ��
-Z.n ... ..... ::�- ., ;lt��., �, ........................................
I
0
A AA
APR 2
Approved:
DATE ......... r.
----- 0-4
�_c
ITY OF EDMONDS
CaII PRospect 6-1107 when work
civic CENTER — WATER -SEWER DEPARTMENT
1.9 reakly for Inspection. �No inspec-
1 0 2942
tions,Saturday, S.imday-or bolidays.) N
SIDE SEWER PERMIT
18516 - 79th Place West
ADDRESS............................................................................................................................................................... ........................................
Veterans Administration Better Plymbing & Sewer Const.
.OWNER .............................................................................................. CONTRACTOR ...................................................... .........................
April ... 29.., 19..6.8,
Permission is granted ..................... ........ ..... for ........................ days to RE PAIR or CONNECT a side sewer
with City.Sewers in accordance with application oil file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. I —The owners of the property may obtain a permit to construct sewer Inside property line. A licensed Side Sewer Contractor must
be employed to construct side sewer In street area. Do not cover any portion of sewer before it has been inspected.
NOTE No. 2—Obtain full Information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 3—Top of side sewer must have at least 30 Inches coverage at property line and 12 inches Inside property line; minimum grade of 2%.
No bends In grade sharper than % will be permitted.
NOTE No. 4—Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for
failure due to improper work which mey develop within one year of completion.
N No. 5—It is unlawful to alter or do any other work than is provided for In the permit, or to do any work on the main sewer or Its appur-
tenances except to insert the pipe into the wye.
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STREET FILE