18727 94TH AVE W.PDFiiiii lill
9167
18727 94TH AVE W
7, ;-4,
PERMIT NO: 9623
City of Edmonds 'V"1kAr1rrV UVn "UQ 11 14A,7 amm
SIDE SEWER PERMIT
Address of Construction: LID #
Property Tax Account Parcel No. M-m4- mo- osn - 05
Attach copies of all access and utility easements -Verified and Approved b
Owner and/or Contractor: 6kwto�
Contractor License#: Vlow, N-SS Building Permit #:
Single Family Invasion into City *Right -of Way: Yes No
Fj Multi -Family (No. of Units *RW Construction Permit #
F� Commercial (No. of Units Cross other "Private Property: El Yes NJ No
E]4ublic "Attach legal description and copy of recorded easement.
/V.M 6/j/01 -
I) Czntractor
L/
Owner or coAtractoif sig' 'nature and acknowledgement statement: Date
By signing for this permit I certify that I have read.the City's public handout entitled
4iM
1�Side Sewer Specifications, and shall comply with all City requirements outlined therein.
11w,
9 CALL DIAL -A -DIG (1-8004f$5555) BEFORE ANY EXCAVATION,
2 FOR INSPECTION CALL 425-771-0220 extensionl'_ISOt�g
24 HOUR NOTICE REOUIRED FOR ALL INSPECTION REOUESTS
TOR OFFICE USE ONLY
Perm it F e e $ Repair Fee $ Issued By:
-) I
$
Trunk Charge Date Issued
goAssessment Fee $ Receipt No:
City Permit Surcharge Fee $5.00 Total Fees Paid $
NOTE: IF JOB SITE IS NOT READY FOR INSPECTION WHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION FEE WILL BE CHARGED.
Job Site Ready YES NO Date: Initial:
Partial Inspection: Date: Initial:
Partial Inspection: Date: Initial:
O'Z
FINAL INSPECTION APPROVED: Date: LJ2 (10 Initial: _YDrj As -built to Street File:
t� PERMIT MUST BE POSTED ON JOB SITEt,
White Copy: File Green Copy: Inspector Buff Copy: Applicant
L;temp;bldgforms-,sspertnitjlg4/00
C/o
C/o
w
C/o 10,
56'
CITY OF EDMONDS SIDE SEWER AS -BUILT
ADDRESS
18727 94TH AVE W
PERMIT
NUMBER 9623
HOMEOWNER CONTRACTOR
CONTRACTOR
. EAGLEWOOD HOMES INC,
DATE
06/10/02
DRAWN
BY ISMAEL ABILA
9-7
0
_96Z
NOTICE—
n -c
No"War-ra
The inform ation'shown on the attached
Hed for use by the City Of
map(s) was com ' pi
Edmonds, its Empl.oyees and Consultants.
Th,.e City of *Edm.onds does * not * warrant the
th on these
accuracy of anything set for.
M a p (s"). A n . y person or entity -requesting a
copy sh,ould conduct an independent
orm ation shown-o
inquiry regarding the inf
tp�� -map(s), including, but not limited to,
the location of any sew-er stub shown, Suc
sewer stubs may or may not e.xist and may
or may not exist at the location shown,
Neitheir the 'CIty cf Edmonc.14S, nor its
M p., 0-y e e-s o -r o ff i -c e -r s -s h- al- I b e 1--i a. b-1--e
n on this map(5), nor for
infor mation g Ve 'ded based
any one representation provi
upon'said map(S).
E RECEIVED
1 TGAT
CITY OF EDMONDS Is
CONSTRUCTION PERMIT APPLICATION
I OWNER NAMEINAME OF BUSINESS
\ �W -) Vk, k,.
CITY zip
NTE
ADDRESS
— ' 11
PERMIT EXPIRES :52 11D
7- r--
USE PERMIT
ZONE NUMBERzGt9_C�3&q
JOB
ADDRESS SUrrE1APT#
PLAT NAME/SUBDIVISION NO. LOT NO. LID NO.
UO FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MLkP TOM Appaysd
� R
"*W U� — RKM
EXISTING — PROPOSED map� Raovaad
ffid— Aq*
REQUIRED DEDICATION— FT Unftm�
wInno fae—
METFf LINE S NO. �VFRES PQ, !QUIRED
YE 7
a V NO
,912MARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
DET2010 LJL40ILT PLAT, ELL S2-6QIA0fJ RMI04i
TUEF- mEr.
I L eEX-T
z
z
5
se
FIRE R'
FIRE REVIEWED BY DATE
C.%1TY
0
Tr437
STATE LICENSE NUMBER EXPIRATION DATE
-1
vlo nl� 1q NM
4EXP
AR
VARIANCE OR CU
SHORELINE OR ADB#
INSRPEE.CPON
.
C3 YES' C3 NO
PSOND
STED
:9 PROPERTY TAX ArO NT PARCEL N(
U
_FILU
SEPA REVIEW
Co.FLE PT
SIGN AREA
ALLOWED , PROPOSED
HEIGHT
ALLOWED, , PROPOSED
ESIDENTIAL
HE W R MOING I MECH
0 ADDITION COMMERCIAL C] COMPLIANCE OR
x CHANGE OF USE
0 REMODEL 0 APARTMENT SIGN
11 REPAIR M Gt4' CYDS 0 X FT)
DEMOLISH TANK OTHER
GARAGE o RETAINING WALL
z CARPORT ROCKERY RENEWAL
LOT COVERAGE
ALLOWED IFIDPO
0 Q
REQUIRED SETBACKS (FT)
FRONT SIDE REAR
C', I .,), I C �
PROPO;EQ SETBACKS (FT.)
FRONn PR SIDE REAR
I
PARKING
R�D PROVIDED
LOT AREA
PLAN,"G REVIEWED BY DATE/
n
REMARKS
(IR OF �, �USINE%Z r%EXPLAIN:
It -
�, W
_MON
CHICKIO BY TYPE 01 CQi CJ!77J
SPECIAL INSPECTOR JARE
L00W
REQUIRED 0 YES
OCC FT
GROU P
t3 N MOER F
UMBER 0
OF U WELLING
a STORIES ON
I NITS
0 1
C RITICAL I
AREAS
NUMBER
LOAD
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC I 081FINAL INSPECTION REO'D
,dit I k-Wt4 &E,9116 -WJV/Af,.
(4j—c H-T4-t�, -7� U m ff "(71-
j
Lit -7-t-A) LOJ I L7122
I LV� EL
VALUATION $
C1 6 , 4-if ?S
Description
FEE
Description,
FEE
Plan Check
�XCE 11 or LOjbjjE3%
Me
Building
41. 71
PLAN CHECK NO- VESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORCES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY OHLY, ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES. ErC.) WILL REQUIRE
Grading
Recording Fee
SEPARATE PERNI;SSION.
Engr. Review
City Surcharge
PEI'MnAPPUCATION: 180 DAYS
PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
*APPLICAN1. ON BEHALF 01 1118 OR HER SPOUSE. HEIRS. ASSIGNS AND rUCCES ORS
Traffic Mitigation
P Ian 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 Review
Re6iipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT
I
BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Fire Inspection
TotalAmountDue
N
x OR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
Landscapoinsp.
Recei
�t - I I
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APP CATION: THAT THE INFORMATION
GIVEN 11 CORRECT.' AND THAT I AM THE OWNER. OR UTHE DULY AMORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
Tm -pplicisto Is not a penrdt until signed by th
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERS N WILL BE EMPLOYED
Building Official or= Deputy: and FIft we and
IN VI�L.JION OF THE LABOR CODE OF THE STATE OF WASHIONGTON RELATING TO
FOR INSPECTION racelpt Is &(�knovdodgod in space provided.
WOR S, 'S C90" �TION INSURANCE AND RCW 10.27.
SlO�ATARE I V 6F 611 AGENT) DATE SIGNED
(425)
DsTE
5m M/ Mr;
77
771-0220
RELEAY I DATE
A170TION
EXT 1333
IT IS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
FILE .
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
SPECT
_PRI.GINAL - YELLOW - IN OR
'IN.. OWNER - GOLD -ASSESSOR
10/01
PLANNING DATA
NAME:G-b-CALqt.-,pr3,---> Pny-krtc- -DATE: R6 ��—o
SITE ADDRESS: IR -7 a -1 Ci LOU- A, PLAN CHK#'C);L -
PROJECT DESCRIPTION: ':�FIL
REDUCED SITE PLAN PROVIDED?<�/ No)
MAP PAGE: CORNER LOT: (Yes -FbkG LOT:GL/ No
j
ZONING: ft - 1 2- CRITICAL AREAS DETERMINATION #�-'A-0 k - I QP
Study Required:
Waiver
U Conditional Waiver
SEPA DETERMINATION:
L1 Fee
Q Checklist
APO list w/ notarized form
(Needed for 500 cubic yards of grading, Shoreline Area. site within 200 ft. of Puget Sound or Lake Ballinger)
Exempt
SETBACKS:
Required Setbacks:
5 Ce, -Street-.1 U -Lvft Side: Right Side:_ 10 Reaf,
Actual Setbacks: pz Left Side: 16 Right Side: 0 Rear: . I CD
PreWet'*map che additional setback required? s / No / DRA)
U DETACHED STRUCTURES:
Q ROCKERIES:
LJ FENCES/TRELLISES:
Ll BAY WINDOWS / PROJECTING MODULATION:
L3 STAIRS/ DECKS:
PARKING: Required: Q Actual: 2!
LOT AREA: 1,2,
LOT COVERAGE
* L2 . r) t�V L4 Q I T) 9N c,-v=
Calculations:
BUILDING HEIGHT:
Datum PointC-. 0�-� QLP Oall CittMp Ugatum Elevation:1 *7 1491
_ -1-1 _' F -rRL—
Maximum Allowed:alg� �) A + -Actual Height: ,Ace - cl, ( ;10R' q
A.D.U. CREATED3�D/ Yes) / CK& -CM
SUBDIVISION: ',::�r lcio I - I (D
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED:
OTHER:
Plan Review By: 4-.9-
NewBPP1anningDataFonn.D0C
EXPOSED SURFACES TO
;-A COVERED WITHIN 2 DAYS
WATER & SEW9R
INSPECTION$ RE-00
CALL 42r,771-00 W- lt'
T CbrJam T wilugm
IWAL# � dmf� I * . .
kca Mos, ItL ohoftnw,
(sces, i-ww'fiw,
[pis I I *�
-w
1716"o.
z -1. %a
to & SIDEWALK �OR�A
INSPECTIot4S REQUIRED
TEMPORARY CONSTRUCTION
ENTRANCE Al0UjA9b
La eAWAoor, OW.(A--
Rouss) co"MI&M41vem 4
F001ING DRAINS NOT
TO BE TIED INTO
DETENTION SYSTEM
site hown I - w t7-- JA4...ky, vi. gogam. lw;w. RIGHT-OF-WAY CONSTRUCTION PERMIT
ew(e. AND INSPECTION REQUIRED
....Ojww Amayop Tat AbiM.* fftl�% owwow wmoo .- 116 wo. -
. wk to fu*w 00 cft (0- w-ur wwmotkav %Ojv
t7m Ulf
'&UtUie Ls iM %kat WMWIM
Vaft t QVW, I W " = 400 ft. - -%7a - (or - ea
4 tle ziwsws/ % m*1 tftkt I k"
M�mw w W10-w-M INSAW
APPROVED By PLANNING
C
.FIVF,D
APR 2002
CES Clfl-
US
DEVEL,o,9VMF-t4T ES&AVOIN
OF
8, T H- F! wF ' " I L E
City of Edmond's
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
CA _,o I, UC,
Critical.'Areas File #:
Crii�idi�.��Ai,'e*asCheck.list,F6e $45.00
,Dite'�Riceived by Dev. Serv� Dept:
City Receipt No:— 1815A
Date Mailed to Applicant:
CRITICAL AREA8�*-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 histher sub*Lal 6K WeSiMent
permit to the City. APR I 12002
DEVELOPMENT ESDEMRVINCES CTR.,
CITY OF 0 Ds
The purpose of the Checklist is to enable City staff to
determine wfiether 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 bir
data available at City Hall (Critical areas inventori6s,
maps, or soil surveys).
An applicant,'"or'hi.Vhdi'representative,' must fill out
thel. checklist, -sign and date it and submit it to the
City. The City will review the checklis� 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, 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 Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below). .
PLEASE PRINT CLEARLY
Owner/Applicant:
��&M4,ot
Name
Street Address
\rf
City State Zip
Telephone
Signature
Date
Applicant Representative:
.1 .
�4\twok VD " QPL (A ktKr
Name.:
Street Addregs
Iwo
City State Zip
d:receptiortlanatCACLHandoifi.doc
Revised 411 Gr2=
CAFILENO.
Critical Areas Checklist
--------------- -- ----------------------------------
Site Information (Soils/topography/h drology/vegetation)
I . Site AddressALocation: 4�
0A.
2. Property Tax Account Number: orn 0� 14
3. Approximate Site Size (acres or square feet):
----------
<led
4. Is this site currently developed?.�� yes; _ no.
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
Tlat: 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"/o and less than 30% ( a vertical rise of
I 0-feet over a horizontal -distance of 33 to 66-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-feet).
Other (please describe):
6. Site contains areas of year-round standing water:
_; Approx. Depth:
7. Site contains areas of seasonal standing water: 1\� Approx. Depth:
What season(s) of the year?
8. Site is in the.flo6dway 1�\O,
floodplain of a water course.
9. Site contains a creek or an area where w ater flows across the grounds s I urface? Flows are year-
round? �0 Flows are seasonal? (What. tfine of year?
10. Site is primari ' ly: fbr6tea'� ; meadow shrubs mixed
urban landscaped (lawn,shrubs'eic)
11. Obvious wetland is prewnt.dn site:
'�taff Use Only-.-- - . . . .......... ----------
F t C*
1. Site is Zoned?
I:— SCS mapped soil type(�)?';,` X)y
.3:::' Wetland ihventory'or C.A. maO'ixidicates wedand present on site?
:4. Critical Areas inventory or C.A. map indicates Critical Area on site?
'Si within deisilgn'at6d ihiff subs'ide:nc'6*6dslide ha?ird'
.5. he area
-6-' Site designated on the Environmentally
t * " pvcAreas Map?
02
'DETIMMINATION
STUDY j1;MQUikED_
CONDITIONAL WAIVER
WAIVER�W
Reviewedby:
V '—A—anner Date
-a_chk.dm Rev 10/03)97
/�W///;
745
ZZ)
5,- V-,- .. p ('62A
APR 1 12002
DEVELOPMENT
CITY OF