18811 92ND AVE W.PDFiiiiii iiiiiiii
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18811 92ND AVE W
NOTICE:
N'o---W*a,r.r a n ty ... 04
The information'shown on the attached
map(s) was compil(ed for use by the City Of
Edmonds/ its Employees and Consultants.
Th,..e City of*Edm.onds does. not. warrant the
n these
accuracy of anything set for.th o . *
Map('�_). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding th*e inform-ation shown- or
-Map(s), including, but not limited to,
t -er stub shown. Sud
the lotation of any sew
exist and may
sewer stubs may or may
or may not exist at the location shown.
Neither the city of Edmonds nor its
empl-o-yee-s o.r office-rs -shal] be 1--ia-b-l'-e for the
information given on this map(5), nor for
'ded based
any one representation provi
upon said map(s).
Tbiw4lfy of Edmonds
OWNER ................ Vt ------------------ -------
--- V-25 ........ W-.-,
VAR I
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kn
APPLICATION
for
SIDIS SEWER PRUMT ED ONDS
TRE
NEW CONSTRUCTION El REP i A ENT PLANT
EASEXIENT No.
........... CONTRACTOR ------- �4- k C-�-r - ------ �Q ............... PFAUMW
........... LEGAL DESCRIPTION: LOT No . ..... I -------------------------------------- BLOCK No . .............
NAME OF ADDITION
Approved: Aj
DATz.......... By --- -------------------------------------
-ifY OF EDMONDS
Call PROSPect 6-1107 when work
aC CENTER — WATER —SEWER DEPARTMENT Is ready for inspection. (No inspec,
SIDE SEWER PERMIT tons Saturday, Sun I day or holidays.) N2 39011
ADDRESS ..........................................j (J�;AjAp ... jj,�pq) .............. ... 92nd- _Aye., ... VA
OWNER ........... !�laus Hann
.............................................................................. CONTRACTOR ..... �Yn
..........................
Permission is granted ......... March ... 19_ ............ 19 .... 71. for --------- .............. days to REPAIR or CONNECT a side sewer
With City Sewers in accordance with application on file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. I—Tbe 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 'A 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 may develop within one year of completion.
NOTE 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
tenances except to Insert the pipe Into the wye. sewer or Its appur-
'71
CITY OF EDMONDS
Permit No. '.1" 1
PUBLIC WORKS DEPARTMENT-' 7—
LJILZ Issue Date
RIGHT - OF - WAY CONSTRUCTION PERMIT FILE
A. *Address or vicinity of'Construction Permit Issued To:
2�' D &-VA A-t fi'tE-,
0 Owner- 1=1 c-2 4., Type of Work to be Done:
Name
Work in Co, nriection
Maifing Address F Sub or Plat Wi Single Family
Ly 2z 0 Comml, / Ind, Apt. Condo./
67t-y State, Zip Code pavement Cut: 0 Yes No
Contractor:
Name
1104- 4 T C/ 7"
Mailing Address StatclicenseNumber'
State, Zip 'Code Teleph6fic Number
U
NO WORK -TO BEGIN PRIOR TO PER)4IT,ISSUANC E
B. APPLICANT TO REAPAND SIGN
0 INDEMITY.- Applicant understands and by his signature to this applicatiori, agrees to hold ,the City of Edmonds harmless
from any injuries, damages, or claims of any kind or description whatsoever,
foreseen orunforeseen, that may be made
against the City of Edmonds, or any of it's departments or employees, including � or'not limited to the defense of any legal
2 proceedings, including defense, costs, court costs, and attorney fees by reasm-of granting this permit.
0
U
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until"the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant,
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times, A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this permit t e A�a�MAt 0 'J'ob,. for inspection purposes at all times.
)e av
Date-z--z
Signature:
0#', �0,r or Agent
THIS PERMIT MUST BE POSTED AT THEJOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
Eng, Div. December
L
FIELD INSPECTION NOTES (Fund 111 - Route conv to Street Dent.
Comments:
Diagram:
Contractor called for inspection Yes Lqol
I
Nork Disapproved By: Date: Bv: Date:
Work Avproved By: Date:
Inspector:
Encr. Div. December 1978
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PLANNING DATA
NAME:- �- vo I J IV,, 1�ev
SITE ADDRESS: ITY11 -4�' "'j DATE:
-3 -1 (-'1 -7
ZONING: 12( - 1-7 PLAN CHK#: q 7-9`7
PROJECT DESCRIPTION: fidS �e c, �-
CORNERLOT _(Yes/No)
SETBACKS:
Required Setbacks:
Front: -z5- Left Side: 10 Right Side: 10 Rear:
Actual Setbacks: /6, q t, A,(0 I
Front:16/zl.,�- Left Side: V Right Side: —Rear:
Street map checked for additional setback required? (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED A/(" (YIN)
LOT COVERAGE:
Maximum Allowed: —Actual:
BUILDING HEIGHT:
Maximum Allowed: Z,6 Actual Height:
Datum Point: Datum Elevation -
SUBDIVISION:
CRITICAL AREAS #: q7-31
SEPA DETERMINATION:
LOT AREA:
OTHER:
Plan Review By:
\Z
CA FILE NO.. Grj
Crit"ical Areas'Checklist
-4
RECEIVED
Site Information (soils/topography/hydrology/vegetation)
Sf,t� AddressALocation: MAR'a 1997
COMMUMTY SERVICES
2. Properiy Tax Account Number: 4.,Z 2 c7o T
3. Approximate Site Size (acres or square eet): la,2!7-7
4. Is this site currently developed' -
yes; no.
If yes; how is site developed? 10
S. 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-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 30% present on site (a vertical rise of 10-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: Qen 'Depth:
Approx.-
Whai sea'son(s) of the y
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:
KWOU004
090-199-
City of Edmon&
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 Edmondsprior
to his/her submittal of a development
permit to the City.
1. RECEIVED
. MAR 12 1997
COMMUNITY SERVICES
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.
With a signed copy of this form, the
The purpose of the Checklist is to enable
applicant should also submit a vicinity map
City staff to determine whether any
or plot plan for individual lots of the parcel
potential Critical Areas are or may be
with enough detail that City staff can find
present on the sub
jept property. The;
and identify the subject parcel(s). In
information needed to coMplete the
addition, the applicant shall include
.
Checklist should be- easily a�ailable
other pertinent information (e.g. site
observations of the site or data available at
plan, topography 'map, ek.) or studies in
City Hall (Critical Areas inventories, maps,
conjunction mith this Checklist to assist
or soil.surveys).
staff in completing their preliminary
assessment of the site�,
An applicant, or his/her representative,
must fill out the checklist, sign and date it,
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/ Applicant:
1 f - I I
Street Address
City, State, ZIP Z> e--2 0 Phone
S�r
igpwature Date
Applicant Representative:
Shiet Address
city'.. tate, ZIP F�—'KJ. �, ZIA�—Vhone
4A*3 C
Date
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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER N6ME�NAME OF BUSINESS
TY ?5 C
E
ITY 9e>1 - 71 ZIP TECEPHONE NUMBER
r�t I
NAME owntr
ADDRES, idec
s
CITY M� TELEPHOKE N�U;r;O�ER
STATE LICENSE NUMBER EXPIRATION DATE
Leaal Description of Property - include all easements
i I to
USE PERMIT
ZONE NUMBER
jOB
ADDRESS Aq <_
FF—GALDESCRIPTION CHECKI SUBDIVISION NO. I LID NO
SUITE/APT 0
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
TESC Approved
AW Permit Required
0
11
EXISTING —REQUIRED DEDICATION
Street Use Permit Req'd
13
Inspection Required
0
PROPOSED
I
Sidewalk Required
E3
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
I
YES 0' NO 13
Tax Account
Parcel No.
0c-;,0,,0e>1.d:;o0Cs40
FINEW
E]
4K
RESIDENTIAL
PLUMBINGIMECH
R.DDITION
El
COMMERCIAL
El
COMPLIANCE OR
CHANGE OF USE
DREMODEL
APT. BLDG.
atGN
GRADINP
FENCE
REPAIR
- CYDS.
I- x _FT)
WOODSTOVE
SWIM POOL
DEMOLISH
INSERT
HOT TUB/SRA
FGARAGE
IC
1:1
RETAINING WALL/
ROCKERY
R NEWAL
(TYPE OF USE. BlolpINESS OR 4CTIVITY) EXPLAIN
NUMBER OF CRITICAL ews-1
NUMBER
OF DWELLING AREAS
STORIES UNITS NUMBE
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
MEMO DATED
SIGN AREA SEPA REVIEW ADS NO.
ALLOWED i PROPOSE I D COMPLE7:___ I EXEMPT SHORELINEJI
EXP V.
VARIANCE OR CU PLANNIJG R171EW BY DATE
I . A; - N 3-tt-07
SETBACKS — FEE T HEIGHT I LOT COVERAGE
FRONT SIDE ( 0 REAR
BY ITYPE OF
VS SPECIAL INSPECTOR AREA
P .[OCCUPANT
REQUIRED YES LOAD
RFMARKS
PI
PROGRESS INSPECTIONS PER UBC 108
FINAL INSPECTION REOUIRED
Y PLAN CHECK FEE
BUILDING
HEAT SOURCE: GLAZING % PLUMBING
Plan Check No. �& - - K
MECHANICAL
GRADING/FILL
This Permit'covers work to be done on private property ONLY.
Any construction on the public domain (curts, sl dewolks,
driveways, marquees, etc.) will require separate permission.
.
STATE SURCHARGE
Permit Application: 180 Days
STORM DRAINAGE FEE
Permit Limit: I Year - Provided Work Is Started Within 180 Days .
ENG. INSPECTION FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
'Uni harmless the -City of Edmonds, Washington, its officials,
and agents from any and all claims for damages
of
P LAN CHECK DEPOSIT
2 employees,
'
a: Iy'qfJpdIrectly from the Issuance
whatever nature,jarisihg direct
a p;,,e.n4 shall not be deemed to
of this permit. Ijsu"6'6c I of th sl
modify, waive of redude any requirembrit of any city ordinance
0 nor limit in any way the City's A bility to enforce any ordinance
TOTAL AMOUNT DUE
T
I provision." I
1 hereby acknowledge that I have read this application; that the
ATTENTION
information given is correct; and that I am the owner, or thjD duly
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
WORK NOTED
Code of the State of Washington relating to Workmen's Compensa-
tion inswrance and RCW 18.27
INSPECTION
SIGNAT E (OWNER O!�,AGENT) ATE SIGNED
DEPARTMENT
L_.__1
m; V 71, %,5 @19 *(7'7
VA�
CITY OF
EDMONDS
_T4
CALL FOR
T FN 1,6 N
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
BEEN MADE AND APPROVAL OR
771-0220
UNTIL A FINAL INSPECTION HAS
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED.* UBC
SECTION 109
11"AT
501
APPLICATION APP.ROVAL
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.
446
ICIAL'S'SIG,0,&TURE ir bATI�
- I --' ,
�IG AL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
Z
Z
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