18614 78TH PL W.PDFlill 11111111
6731
18614 78TH PL W
APPLICATION
for IMMI PLAN?
The City of Edmonds SurFIEET FILE SEI)E SEWER PERYaT
OUTSIDE E] INSIDE REPAIRS [1]
OWNER ...... 9,CY1.0 .......... -------------------------------------------------- CONTRACTOR
qTR.RTV.T
HOUSE No - ------ L��(A-
CARD'No. ...: ..................................
EASEMENT No . ......................................
/- /10 -4;�s
....... ............................. PERMIT No.
LOCK No - -------------------------
/ fj I -') ( t"L"'
A P P 1� u v E D
JJ�j
Ai.'
- ----------
Date Approved:
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ .............................................
WORK ORDER ISSUED ..................................... I ----- DATE os 4�-4 .....
------------ ..... . ... ...... 13
--------------
0
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION.
OwNEERaEN&MWAME OF BUSINESS,/
-Ar re_"7-
P74AILING ADDRESS
7 " i�l ,j
USE
ZONE PERMIT
NUMBER
JOB
ADDRESS SUITE/APT 0
.EGAL DESCR 5UBDIVISION NO. ILID—NO
CITY
ZIP
TELEPHONE NUMBER
_7 ;7 3" __5
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING — REQUIRED DEDICATION
RESPCP APprov� (3
W 'mIR ied C3
Street Use Permit Req-d Cl
NAME
PROPOSED
Inspection Required a
Sidewalk Required 0
METER SIZE I LINE SIZE I NO. OF FIXTURES
I 00V 93pni 110c�
W ADDRESS
t
2
< CITY TELEPHONE: NUMBER
NAME
le,1110AI'61C .., s 7,,,,,, L4 7.
I I tj 1 4_�4j )I- Is 113 ()-%[
CITY TELEPHONE NUMBER
-WAI I'P ��T;Ivo b, 6 01
. ]a,
TTATE LICENSE NUMRER FXPIRATIO DATE
00 1 �1 Pri
T7
Legal Description of Property - include al!jAasements
je-7- 1-7 ".o Arrr_eelle 0*0.e
e A-
0/ A3 7—
P-pe=T.. A unt
Parcel No, ri —
I1Kx
NEW RESI IDENTIAL ��PLUMBING/ME CH
/ R COMPLIANCE OR
VADDITION COMMERCIAL CHANGE OF USE
REMODEL LEI APT.BLDG._ 0,SIGN
GRADING PENCE
REPAIR 0 — CYOS. of- x —FT)
WOODSTOVE 0 SWIM POOL
DEMOLISH E-1 INSERT NOT TUB/SPA
GARAGE RETAINING WALL/
CARPORT El ROCKERY RENEWAL
,TYPE OF USE. BUSINESS OR ACTIVITY1 E7JPI AIN-
YES 0 No
,') - L
_S 7 '.)A;. y A i-)
_V,ARIANCE OR CU
99 - /0
ADB
SHORELINE #
SEPA.REVIEW
COMPLETE EXEMPT
SIGN AREA
ALLOWED PROPOSED
HEIGHT
ALLOWED PROPOSED
EXP . V-11,
I
I
Z15' ;73,
I
LOT COVERAGE
ALLOWED
PROPOSED
REQUIRED SETBACKS (FT.)
FRONT SIDE REAR
PROPOSED SETBACKS (FT.)
FRONT UR SIDE* REA A
3
7,0'7
I
�5 I 7'; * 115'
Z31 95Z
30- A.*
LOT AREA
PLAKNING REVIEW BY
DATE
7 ,
2
IEMARKS
V
5.
nA S,04>jLa4_
_fciv
1 REQUIRED I I (� I :;; I UILrULP"ANY I
13 YES LOAD
PROGRESS INSPECTIONS PER UBC. 108
in
tu
0
In
0
NUMBER
OF
STORIES /
I NUMBER OF
I DWELLING
UNITS
CRITICAL
ARE
Nut
I -n
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
FINAL
INSPECTIO
PLAN
4*14
CHECK FEE
HEAT SOURCE:
BUILDING
GLAZING
is'. PLUMBING
Plan Check No. MECHANICAL
This Permit covers work to be done on private property ONLY. GRADINGIFILL
Any construction on the public domain (curbs, aldewplks,
driveways, marquees, etc.) will -require separate permission. STATE
SURCHARGE
Permit Application: 180 Days
STORM
Permit Limit: I Year - Provided Wor� Is Started Within 180 Days
DRAINAGE FEE
Zu
x
9
x
01
"Applicant, on behalf of his or her spouse, heirs, a . saigns and ENG.
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
modify, waive or reduce any requirement of any city ordinanc
nor limit In any way the City's ability to enforce any ordinanc TOTAL
provision."
1
INSPECTION FEE
CHECK DEPOSIT
AMOUNT DUE
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 W, 1; h city and THIS PERMIT
state laws red ul'�t Ong construct lo ii; and lndol ng the w r1latithoriz-AUTHORIZES.
ad thereby, no perison will be erriployed'in violation I f1th6 Labor ONLY THE
Code of the State of Washington relating to Workmen'�s Compensa- WORK NOTED
-tion Insurance —aria RCW 18,27.
G R A DATE71GNED I NSPECTION
.DEPARTMENT
CITY OF
EDMONDS
CALL FOR
ATTENTION INSPECTION
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 771 0220
SECTION 109
102-07
vi,EOUIRED
11
3, �;b,
APPLICATION APPROVAL
This application Is n.ot,a permit until
signed by the Building Official or his/her
Deputy; and fees are paid, and receipt Is
acknowledged In space provided. -
I IA SIG7)
ArE DATE
NV`
M1"AdW V I
1_311: I - . I* 6ATt
IGINAL — File YE_LLOW — ln�pector
PINK — Owner GOLD Assessor
OPP
amp
ojmi�,IF OF
I-LVEL �i�
t Ix ozye& ,::� rA
E-Xjar�&- r&70
A-100 L Mk5'
�6f if, R�Acc
fpo
6' Z T R z E: Firm=- T F u",
RECEIVED
JUN 0 3 1999
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS---,0
JUN i
Z/o
6Aq7E-
VY
Uj -
43 S-40%A)
1. 4:r7 rrg 6 �: Loorr,
5e-C� APr,4,-1 �`V%
4v- ITE:
,�qj r.* ln a t4
APPROVED BY PLANNING
v
PLANNING DATA
NAME: Pobe�
SITE ADDRESS:—(9'6/4 12, Q. -DATE: 612e199
ZONING: 'PLANCHK#:
PROJECT DESCRIPTION: 1�'4'
CORNERLOT A FLAG LOT. PJ- _(Yes/No)
SETBACKS:
Required Setbacks:
Front: 2-,S7 Left Side: 7, 5' Right Side: 7 Rear: .15'
Actual Setbacks: -�oi46"
Front: 30' LeftSide: — Z31 Right Side: 57 Rear: S?-'
Street map checked for additional setback required? /y.. (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED /V JYIN)
LOT COVERAGE: 1516.S-
Maximum Allowed:— 350Z —Actual: -7. faui—
BUILDING HEIGHT:
Maximum Allowed:— Z5' —Actual Height:
Datum Point: ?"m �-� 6ae a 19 7 7r Datum Elevation:-
A.D.U. CREATEW:
SUBDIVISION:
CRITICAL AREAS #: C4 - 99 - (3 - L401\ffl-
SEPA DETERMINATION: fx�,-g-
LOT AREA: - -7 Z' -1 -- - 6 9 "
OTHER: VAe -92 5'' f*k-'- ok
Plan Review By:
C:W1CAP0-fnf*V1andadW
'RMIT
L E- E
S E W 04,
T '00 V, als.
Septic an _,P�ag No. /44 ...........
CITY OF ED.MONDS
Disp. Field ... PaA: ......... sq. ft. Department -of Public Works
Other....................................................
............... is hereby authorized to, install/
Name....
-repair sewage disposal system at
................................................. ................................
. . ................. ............ ..............
V =IJ
Date issued 'on
............ ...............
................
Permit expires one year from date of issue
DO, NOT COVhk:. BEFORE- APPROVED BY DESIGNER OR SANITARIAN:'
I hereby certify this system was installed under my supervisioti and control and complies with all provisions of the City
of Edmonds kesolutions.
-Signature of Installer ....................... ..................................................... Date ..................................
Approved'Disapproved Date ................................................................ By.: .................................................................................. .
Remarks: ..................................................................................... .......... .... ...........................................................................................................
............................................ Date ..........................................................
SANITARIAN OR DESIGNER .................................. ..................
This permit -shall be posted in a reasonably conspicuou's place on the job� until inspection has been' compleited.
/Vi
CITY OF EDMONDS
DEPARTMENT OF. PUBLIC WORKS
250 Fifth Avenue North, Edmonds, Washington
APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT
(Submit 3 Copies)
Perm it to be issued to: .........
For installation at: (street address) ............ . .. ....................................................................
Addition or Subdivision... ....... .0 ... A�lel< ........................... ...... Lot..._4�.. Block ................
2 Existing../6-1 Single family residence Number of bedrooms ....... '.:� ... . .......
Type of Building: New..71a-
Other: (specify type or use) ........... ................... I ................... I .................. __ ................................................................................
Builder............. .............. __ ....... ...... Address ........................................... .............. ......... ............ ......
Designer. ..... '&*I-V A1"4f-"Z"e J" ..................
....................................... ......... .... ------------- Address..
Soil Log Hole No. 1 -------- _,X74,-,AP'V _ .
........................................................................................................................... I ........ ....................................... ....... .....................
SoilLog Hole No. 2...-.. ............................................ I ............................................................................................................
Elevation of Water Table, if encountered. (Distance from ground surface) ......................................................................
Corrections to control surface water if needed ......... ..................................................................
Specify if any removing or grading of topsoil in field area— .... . . ... ..... ....... .. . ...... .....................
.......................................................................................................................................................................... : ..............................
Percolation:
Test Hole No. I —Average Rate ....... ......... (Fall in minutes/inch-bottorn 6" test hole)
Test Hole No. 2 —Average Rate ........ S., �, 1; ;� ...................................... (Fall in lilinutes/inch-bottom 6" test hole)
Test Hole No. 3 —Average Rate ........ ........................ ............. ....... (Fall in minutes/inch-bottom 6" test hole)
Average percolation rate on which to base drain field design ....... Date Taken . . ........
Septic tank requirements based on present rules and regulations:
Septic Tank Size .....
jallons.
Amount of Square Feet of Dis osal Fi Id ......... 456;�;O ... .....
0, "Is ....
S;
Signature — De igner ......
.. . ........... Date ..... -_ -----
- ------- -- * ...... ... ... ...... .
DO NOT WRITE BELOW THIS Ll�$E (To be completed by Issuing Agency)
Permit issued (date) ......... /I ................
............. ............... Permit Number --------- .....................
Remarks: ...................... __ ........ ....................................................... ......................... .....................................................................
................................................................................................................... _ .................................................... ............ I .................
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7301 - 179th S.W. P,�
EDMONDS, WASHINGTON PR 6.5880
:R
TEST
S
PERCOLAT;ON TEST
PLOT PLANS
PLAT DEVELOPMEN'T C!OORDINA
; TOR
9 .9/&;3
CA FILE NO,
Critical Areas Checklist
Site Information (soils/topography/tiydrology/vegetation)
I . Site Address[Location: /;�� co (,4 70-A /3 1, W -
2. Property Tax Account Number: -37 '57 - - 0 4r-g -,:::v e 0 C-1.
3. Approximate Site Size (acres or square feet): 7Z F-
4. Is this site currently developed? X yes; _ no.
C'
If yes; how is site developed? '5F , >e'o J4 Ai -t
5. Describe the general site topography. Check all that apply. P44kvit U 1-999
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of I 0-feet over a
horizontal 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).
Steep: grades of greater than 3 0% present on site (a vertical rise of I 0-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: jvg' 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— "Ito of a water course.
9. Site contains a creek or an area where water flowi acr oss the grounds surface? Flows are year-
round? "K..b Flows are seasonal? _-Ko (What time of year?
10. Site is primarily: forested meadow NV�-6 ;shrub
s mixed
urban landscaped (lawn,shrubs etc) Q.
11. Obvious wetland is present on site:
^ca_chk.doc; Rev 10/03/97
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.
Please submit a vicinity map along with the signed
copy of this form to assist City staff in finding and
locating the specific piece of property described on
this form. In addition, the applicant shall include
other pertinent information (e.g., site plan, topo'graphy
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 Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/Applicant.;F'r6'16"-7— Applicant Representative:
AAR77.�-) �J Q; s-
Name Name
/ 4
Street Address
j�7D44z>A) PS� Q)?4- *o,2- ca
City State I- Zip
7 7-*
Telephone
Signature
Date
*Z)2. S. ft--fZIOO-AX�D
Street Address
4 cl)k (/5
City State Zip
czc,c�)
Signat
Date
c:rccepdonVana\cac1.doc
(over)
0,0r_
BARBARA FAHEY
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221 MAYOR
CITY OF EDMONDS
E!�� COMMUNITY SERVICES DEPARTMENT
Public Works - Planning/ Building e Parks and Recreation * Engineering - Wastewater Treatment Plant
tzle �_1_189C3
January 22,1999
Martin Koenigs Architects
4212 South Ferdinand
Seattle, WA 98118
Subject: Determination regarding Critical Areas Checklist # 99-13
Dear Applicant:
Enclosed please find a copy of the Critical Areas Checklist you submitted. The "DETERMINATION" reached by the City
is located on the reverse side of the form (bottom of page).
It is'very important for you to retain a copy of this Critical Areas Checklist "DETERMINATION" for your records.
IMPORTANT INFORMATION TO BE NOTED:
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTAL CHECKLIS_ OR CRITICAL AREAS STUDY.
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
mio, You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION INITH ALL
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
cc: Robert L. Kerslake
Enc: Determination
*Architectural Design Board
C:Reception\Jana\CRLTR.doc
Building Permits'
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Thank you.
Planning Secretary
1 9 Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
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 forth on these
map(s). Any person or entity requesting 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-o-yees or officer,--) shall be liable for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).