18818 94TH AVE W.PDF9172
18818 94TH AVE W
ADDRESS: 16 — kv 1E, � j
TAX ACCOUNT/PARCEL NUMBER: on (0
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: qq-21�8 DETERMINATION: 0 Conditional Waiver OStudyRequired ��aiver
DISCRETIONARY PERMIT 4'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS
PLANNING DATA CHECKLIST DA
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID
SHORTPLAT
q
SIDE SEWER AS BUILT DATED: -
SIDE SEWER PERMIT(S) #: (p W
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
OTHER:
LOT: BLOCK:
LATEMP\DSTs\Forms\Street File Checklist.doe
7 Q'
E NO. qCj —
Atical Areas Checklis#'L
---------------- ---------------------------------------------
Site Information (soil s/top o graphy/hy drology/veget ti
aupri)
1. Site Address/Location: y4jl,�_ W
2. Property Tax Account Number: 4 3 4(o oco o(o(3 io,3
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? yes; _ no.
If yes; how is site developed? &� I j -PY)W 0_/
5. 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 1 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
1 0-feet over a borizontal 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: 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? J
10. Site is primarily: forested meadow ;shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site: Kin
fta�ChUK Rw 10103/97
k
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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 devel*opment
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 infor m-ation (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 belo),v).
Owner/Applicant:
- 4 &r-en
114 ame
Street Address
-6dmOM5 0) 00,�
city State Zip
q;,5- 7
Telephone
Signature
Applicant Representative:
Name
Street Address
City State
Telephone
Signature
Zip
Date
creceptionVanakad.doc
Date
(over)
SLOPES WITH EROSION POTENTIAL
WAIVER ATTACHMENT
During review and inspection of the subject site, it was found that the site is within an Erosion
Hazard Area (see definition below) pursuant to Chapter 20.15B of the Edmonds Community
Development Code (ECDC). Please be aware that the following regulations may apply to the
Erosion Hazard areas on the property that this Critical Areas Determination has been done for.
1. Alterations within identified Erosion Hazard Areas shall not be authorized
without an approved erosion control plan pursuant to ECDC Chapter
18.30, which includes staged clearing, where appropriate. The erosion
control plan must be approved by the City of Edmonds Engineering
Department.
2. Clearing or disruption of the soils within an Erosion Hazard Area shall be
kept at the minimum necessary to provide reasonable use of the site.
3. Any project shall be constructed in compliance with the City of Edmonds
approved plans and code requirements.
4. A Tree Clearing Permit shall be required for trees proposed to be cut on
any portion of the lot that has slopes exceeding 25 percent.
If you have any further questions about this, please call and talk to a planner at (425) 771-0220. For
questions on the city's erosion standards, please call the above number and ask for Don Fiene,
Assistant City Engineer.,
Erosion Hazard Areas are those areas of the city ofEdmonds containing soils that may
experience severe to very severe erosion hazard. This group ofsoils includes, but is -not
limited to, thefollowing when they occur on slopes of 15 percent or greater:
i. Alderwood soils (15 to 25 percent slopes);
ii. AlderwoodlEverett Series (25 to 70 percent slopes);
iii. Everett Series (15 to 25 percent slopes).
.t.,? C. I S C) \)
0: - . 0
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
October 18, 1999
Karen Ho t? ue
18818 94 Avenue West
Edmonds, WA 98020
Subject: . Determination regarding Critical Areas Checklist # 99-278
BARBARA FAHEY
MAYOR
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.
no, You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL -40
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
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
Incorporated August 11, 1890
Sister City - Hekinan, Japan
-VITY OF EDMONDS
PUBLIC WORKS DEPARTr,T FOR INSPECTION CALL O'� Permit NO.
SIDE SEWER PERMIT 775-2525 Zxt. 220 Issue Date
AGWANWAWAMW.
PEP -MIT MUST BE POSTED ON JOB SITE * � - EDMONDS
LVW�MWI=WIMWA=P-A=WAMW�ANWANVANW.MWAMW30P=F,MW,=W-- -
1. Address of Construction TREATMENT PL N
2. Property Legal Description (include all easements) 3
iv 1� I "T
awro=T PH F
I I %%1W%M v W W--
3. Single Family Residence Mulyi-Family No. of Units
Commercial
4. Owner and/or Builder 7-,
5. Contractor & License No.
6. Invasion into City Right -of -Way: No L-- Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (342-5344) before
excavation) .
E-1 7. Cross other private property: Yes Noj� ", Easement required -
U attach legal description and county easement number.
READ THE FOLLOWI.NG AND SIGN:
04
a. Property owners must obtain a permit to install side sewers on
>4 their property. A licensed side sewer contractor must be employed to
construct side sewers in the public right-of-way.
b. The side sewer contractor assumes full reponsibility for each
installation for one year.
c. Commercial establishment requires a minimum of a six inch (6")
side sewer line.
0 d. Side sewers may not be installed closer than thirty inches (30")
U to any structure. 0
e. Side sewer lines must be laid at a minimum grade of 2% (1.15
and maximum grade of 100% (450).
0 0
E-4 f. No turn in side s8wer greater than 45 (1/8,bend) is 0 allowed
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend) and wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system.
h. Pea gravel is required for bedding when installing sewer lines
through other than granular soil '
i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 1001 along sewer line run.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
k.. Side sewer must be left uncovered until inspected and approved
by the City.
1. Inspection during normal working hours only. Two (2) working
days notice required.
DATE: 3
certify that I have rea
and shall comply with the above
PERMIT FEE: _30 DISAPPROVED BY: Date:
By: Date:
CONNECTION FEE: APPROVED By ����Date:
PERMIT MUST BE PQSTED,ON JOB SITE
NOTICE:
-ra n
The information shown on the attached
for use by the UtY Of
map(s) was com ' piled
Edmonds/ its Empl.oyees and Consultants.
Th,e City of **Edm.onds does ' not ' warrant the
accuracy of anything set for.th on t ' hese
M a p (S"). A n . V person or entity -requesting a
should conduct an independent
COPY
0 ation shown-o
inquiry regarding the 'nf' rm
I
_fFe -rnap(s),; including, but not hrn'ted to,
th . e location of any sewer stub shown. Suc
sewer stubs may or may- not exist and may
or may not exist at the location shown
Neltheir the city of Edm0'nd4(_:z/ nor i
ts
rc e'r s -s b a. b-Ife f o r th E
empi-ovee-s 0-r off* -h-a
I n on this map(5), nor for
infor . mation give' Ided based
any one representation prov
upon -said map(S').
EDMONDS
TREATMENT PLANT.
The City of Edmonds' Side Sewer Drawing
EASEMENT NO . ............................................
NEW CONSTRUCTION REPAIRS LID NO . .................. . ASMT. NO . ...................
OWNER .................................... CONTRACTOR ......................................... PERMIT No . ....................
JOB ADDRESS ....
...........
.............. ................. LEGAL DESCRIPTION: LOT NO . ........... . ........................ BLOCK NO . ....................................
.................. .......................................... �.-I-s . . . ..... ............................................................
NAME OF ADDITION
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Approved:
DATF. �- 01;
TI,
Erin
Im �
LANNING
STREET FILE
2-5 KF-A V, 5-1),
Comer /VFlag Al
Setback
Required
Actual
Front
�-9
Sides
1614
3
Rear
Other
01
Heigbt
FKQ 5.
LOT : 20,908. SQ FT,
� LOT COVERAGE:
,do EXISTU4G HOUSE / GARAGE:
NEW DECK:
4
REC:EIVED
OCT 1 8 2004
PERMIT CWNTER
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UTILI-T R§u
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2246 SQ. FT.
642.5 SQ. FT.
2888.5 SQ. FT. 13.8%
TOTAL:
PLANNING DATA
NAME:—Itrl t' -e DATE: to 1176-170, V
SITE AI)DkEtS: I �'Y 1 f Vf L,,- PLAN CHK#:.
PROJECT DESCRIPTION: e,-- t9ecK
REDUCED SITE PLAN PROVIDED?.(P�esNo
MAP PAGE: CORNER LOT: FLAG LOT:_T�
#: qq
ZONING: CRITICAL AREAS DETERMINATION
. Q Study Reguired: ' 11�e- 'r't7T&C Ile
gftalver �- Aot-level� 6 (di(-Y^ Y& ZOL'-d zf ^ '��f re 1'42Ca,
L) Conditional Waiver
SEPA DETERMINATION:
Q Fee
L3 Checklist
LJ Apo list w/ notarized form
L3 (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger)
IqExempt
SETBACKS:
Required Setbacks:
Street: IJ Left Side: P Right Side:— Rear:
Actual Setbacks: /I
Street: 0"f . Left Side: 9 3 Right Side: 90 e a r:
Street map checked for additional setback required? QLes i No (D—NIZ
Q. DETACHED STRUCTURES:
0 ROCKERIES: rvfa�-ed
UFENCES/TRELLISES:
LJ BAY WINDOWS/ PROJECTING MODULATION:
LJ STAIRSIDECKS: A
PARKING: Required: �- Actual: �—
LOT AREA: aO I"
LOT COVERAGE
Calculations: q q, 04
BUILDING HEIGHT:
Datum Point: Datum Elevation:
Maximum;.Al owed: Actual Height:
0
A.D.U. C1 AN3 I Yes)
SUBDIVISION:
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: ffes��
OTHER:
Plan Review By*_
NewBPPIanningDataForm.D0C
F�_ o',
18703 IM2 187TH ST SW
0
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18701
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18811
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16805 18809
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Q 1880 18812 41;
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18910 18914
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1 8922 18 22 18914 16920
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402 18916 9313
9 18924
9921 9421 1. T
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19 5 - 190TH ST SW
WATER ST 9 36 9815 19011 />
9425 19005
19018 13 98151 9322 9308 9210
7 19
19017 9719 9711 9611 i: 1901!
19016 19107/ 1901
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19 19024
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19105 19102 19102
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19120
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1596 1523 1542 19210 191
1590 a: 19204 19210
9116
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19222 19213
1561 19212 19214 19200
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19223 19210 1921
19226 19218 19222 a.
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1540 19228 19226 19230
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19316 19309 19311
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1427 1010 1019 /1441 1420 1430
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1016 ------------
1421 031 1440 1416 1109 19516
1 22 1420//\, 1020
1043 142Y ",/ 1417
827 1030
4 1402 1418
306
1424 1047 1\ 1412 1951
'1304
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0 1011 1055 407
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Edmonds 1304 1305 1306 1305
PUG WAY Z
3 Elementary
pp —
I
PPR�OV PLANNING
CITY Copy
Zone Corner Al Flag /L/
Actual
Setbgck
Front
w Sides Id
Rear
-0
Other
Height
mb ago.
-FL A Q I= ZD
LOT SILZE 20,"8. SQ F17, -14
LOT COVERAGE:
EXISTING HOUSE GARAGE: 2246 SQ. FT.
NEW DECK: 642.5 SQ. FT.
TOTAL: 2888.5 SQ. Ff. 13.8%
R C S I V
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,)ERMIT
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UTILI-T
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CITY OF EDMONDS
NEW
El ADDITION
11 RETIREMENT
STREET FILE ASSET INFORMATION SHEET
ASSET NO.
ADDITION TO ASSET NO.
DESCRIPTION
-5,31Z v rz
SERIAL NO.
LOCATION DEPT. NO.
K. ve>
"PURCHASE ORDER NO. *PROJECT NUMBER Lo 2
PURCHASE ORDER DATE PROJECT COMPLETION DATE 6 —3c, &-3
COST COST
B.A.R.S. ACCOUNT NO. C, 3 c3 c� ( -3
ESTIMATED LIFE
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
G.L. ENTRY
REFERENCE
INITIAL
DATE
VERIFIED BY
PROCESSED
BATCH NO.
k�np
DEPARTMENT FILE
;7-77 7
(address) (date)
Street Right -of -Way Exist 1;EQD
Z
�ccess Easeno ts Existing &,Y- IREQD
Utility Easenent Exist
w
Lot Per Subdivision J- 3-?/ Plat Assessor /3-
94
Site Plan Checked for Accuracy, , 4�:
Z
Underground Wiring Reqd. 1-11150
H
0
Check Accuracp of I7,6gal Descrip�/ion lVei,
Z
Review by -4 41 Date
24dA-�t-/
7
Existing Water Main Size
Water Main Required
Service Line Required
Hydrant Size Existing
HYdrant Reqd Per Fire Code— Size
Detector Check Meter Reqd.
Cross Connection Inspection
Fire Department Couments
ge eqd. 61
.4ater Yeter Char P
Review by I - 1�> Date_
Septic Tank Design Approved Date
Septic Tank Permit Reqd. Permit No.
Sanitary Sewer Availabi Pro'
�No
Drm,7ing No. ile
Side Sewer Availabilit�� 7
Sanitary Sewer Connection Fee Reqd._
:r
Review by. Date
Open Ditch Existing.�,c.7/�/ e- Reqd.
Z
Culvert Reqd. Size
04
Catch Basin Reqd. 5,02 /," e.. -Indicate on Site Plan
Shoulder drainage maintain collection on swale open runoff
e7. Z -�-
Mmihole re�d. Indicate on Site Plan
Soil Conditions and Ground Water Field Checked �y C�- L4--, e��
Review by, Date-
-. RevisO: 1V.10-t1977-
'BUILDING PERMIT RE -VIEW
Multiple
BUILDING ADDRE .. S S
AI Commercial,,,
BLDG. DEPT. SUSPENSE DATE Z 1,5 (n
f
13OFFICEADMIN. — PUBLIC WORKS LOG IN
I NITIAL DATE
CITY ENGINEER (check)
Access Slope and Vehicle Access
PkDrainage Plan
0 Street File
0Legal Description
OQuit Claim
Easement
Calculate Se,4er. Connection
WATER/SEWER DIVISION
...�.-.'�:UDetermine Meter Size
C3 Complete Building Permit Review
13STREET DIVISION
acomplete�. Building Permit Review
E]OFFICE ADMIN. LOG OUT TO BLDG-.-'.DEPT.
--------------------------------------------------------------------------
0--ibILDI G PERMIT APPLICATION -(COMPLETE). q
&Vj
27COPIES OF SITE PLAN
2 COPIES OF FIRE PROTECTION PLAN
(PREVIOUSLY -REVIEWED BY FIRE DEPT.')
3 COPIES OF DRAINAGE PLAN WITH CALCULATIONS
REQUIRED BY SUBDIVISION
GREATER THAN 2,000 SQ. FT.
IMPERMEABLE SURFACE E3
LESS THAN 2,000 SQ. FT.[3
0 CHECK ZONING'REQUIREME11TS (SETBACKS)
I COPY OF ENGINEERING CHECKLIST
1 COPY OF PUBLIC WORKS MEMO
0 MULTIPLE OR CO14MERCIAL
YES ':(ATrAqH:qqPY OF ADB APPRovALaNct.::ALL DR*jINc.$)
No
13 SUBDIVISION — YES[j NAME . .. .... ..
DATED RECORDED
NUMBER* : '*
NO E] (ATWH -COPY � OF;
REQUI��S)
CHECK SEWE'R DRAWING AND ATTACH COPY
IS DEDICATION' RE'" YESQ (OBTAIN QUIT CLA12,0
QUIRED
CITY CODE.
NO
DOES CITY HAVE EASEMENT ON PROPERTY
YES (ATTACH COPIES OF DRAWINGS)
NO
0 CHECK LEGAL ACCESS' INGRESSO UTILITIES[']
YES [I YES [] -
NO [3 NO
Q HAS SEWER ASSESSMENTBEEN PAID
YES L.-I.D. NO.
PLAT NO.
�SVBDIVISION NO,
C1 �.IF: MULTIPLE: INCLUDE NUMBER OF UNITS
'INCLUDE NUMBER OF FIXTURE UNITS . .......
IF: COMMERCIAL:
14 F_
�41
-4A
f'A
IL
_T
747'L
kS
ZONE
SEif4AC K S:
T
SIDI-
REAR JUL 231982
OTHER
HEIGHT
_j
LU
USE
CI,TY OF EbmMFD's ZONE Oc
CONSTRUCTION PERMIT APPLICATION JOB IV-31
NAME (OR NAME OF BUSINESS) IADURF-55 i C-> c>
ADDRESS
JV 0 Z's
ADDRESS
__ Elom&,-
STATE LICENSE NUMBER
np
Te—gal —Description of F
(show below or attach
94-1-
iISION NO.
TELEPHONE NUMBER PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EX STING - REQUIRED DEDICATION
IS
PROPOSED
nj 41) F-PL S d)17 RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED 0
STREET USE PERMIT REQUIRED 0
,F A SEE ENGINEERING MEMO DATED
TELEPHONE NUMBER SEE PIW DEPT. REVIEW CHECK LIST DATED
-Sp to _-) - -_7 RFMARKS
METER SIZE BUILDING SUPPLY SIZE FIXTURI
TELEPHONE NUMBER
REMARKS
CITY LICENSE NUMBEA
SIGN AREA ENV. REVIEW
ude all easements ALLOWED i PROPOSED I COMPLETE I EXEMPT
P 1AMS I VARIANCE OR CU
)9:MNL NEW RESIDENTIAL
ADDIALTER NON-RESIDENTIAL
REPAIR RETAINING WALL
EXCAVATE
DEMOLISH OR FILL
PRE -MOVE INSP.1
PLUMBING
MECHANICAL
SIGN
FENCE
( x _FT)
17-1 swim
SIDE SEWER WATER LINE
E-C
�5 NUMBER OF STORIES NUM BER OF
_TDWELLIING
U
K TO BE DONE (ATTACH PLOT PLAN)
0 � C � f\ f3 k11% n - I
UNITS
Lu
ADB NO.
I SHORELINE 0
DATE
YARDS, 111 1 LOT COWGE
0 FRONT SIDE REAR :�byd kAfl I
ED BY ITYPE OF
SPECIAL INSPECTOR AREA OCCUP
REQUIRED GROUP
D YES 1! NO I I
PLAN
CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADING/FILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
w
successors in interest, agrees to Indemnify, defend and hold
(2
j
harmless the City of Edmonds, Washington, Its officials,
a
employees, and agents from any and all claims for damages of
a:
<
whatever nature, arising directly or indirectly from the issuance
X
of this permit. Issuance of this permit shall not be deemed to
0
modify,. waive or reduce any requirement of any city ordinance
TOTAL AMOUNT DUE
0
X
nor limit in any way the City's ability to enforce any ordinance
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
state laws regulating construction; and In doing the work authoriz-
THIS PERMIT
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-
WORK NOTED
tion Insurance.
INSPECTION
SIGN,A�RE 10 NER OR G TY) DATE SIGNED
DEPARTMENT
do 2
CITY OF
THIS SITE IS LOCATED IN THE CITY
EDMONDS
OF EDMONDS. LOCAL SALES TAX
ATTENTION SHOULD BE CODED 31.04.
775-2525
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
JUL 0, 3 A9
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBc
CHAPTER 3.
102-78
VALUATION
HEIGHT
OCCUPANT
LOAD
APPLICATION APPROVAL
This application Is not a permit until
signed by the Building Official or his
Deputy; and fees are paid, and receipt is
acknowledged In space provided.
OFFICIAL'S SIGNATURE
DATE
Z
Z
5
RIGINAL — File YELLOW — Inspector Li
PINK — Owner GOLD — Assessor
K-y- Pg - Ed-ft. WA - 775 W24
DATE:
MEMO TO: Building Division
Corununity Development Department
FROM: Engineering Division
Public Works Department
SUBJECT: op�
After revi�w of the subject Building Plermit application, we, ha -
the following cormnents:
1. Connection to City water system required.
2. *Connection to City sanitary sewer system required.
3. Riaht-of-way Permit —required for any work on City property
4-, Driveway slo'pe not to exceed 14%.
5. Backwater vnlvc required if downsulirs 21umbin'g is belo . w
elevation of upstream manhole.
6. Water and sewer lines to he separated by 10 foot minimum'.
Sip ature
n,
ATE RECEIVED
[PERMIT
EXPIRES
USE PERMIT
ZONE
CITY OF EDMONDS
NUMBER
CONSTRUCTION PERMIT APPLICATION
JOB SUITE/APT#
ADDRESS qj To- POE, 'Al
OWNER NAME/NAME OFOUSINESS
PLAT NAMEISUBDIVISION NO.
LOT NO.
LID NO.
LID FEE $
�F,r,:j 91 0
MAILING ADDRESS
TESGP Approved Ll
q AV F, V)
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
Rw Permit Required 13
0
EXISTING PROPOSED
Street Use Permit Raq'd 13
Inspection Required 13
Sidewalk Required 0
CITY ZIP
TELEPHONE
%OzDPP�1`14-oqt)�
REQUIRED DEDICATION— FT
.
Undergrourid
Wiring required E3
NAME
METER SIZE LINE
SIZE7.
OF FIXTURES
PRV REQUIRED
0
YES NO C1
3
W
ADDRESS
REMARKS
z
z
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
W
A 1,0F1k_ :55 1
CITY ZIP
I YELEPHONE
t
r-,D MMO '5, _"11162D
147_�7 114 -7/'2 6'
NAME
CBL?Aj
ENGINEERING REVIEWED BY DATE
cc AdUREMS
P.
FIRE REVIEWED BY DATE
W
CITY Zip
0
6&(04-4 WA
TELEPHONE
47,5- F 111,
18ou
718-
VARIANCE OR CU
SHORELINE 08 ADB#
I
INSPECTION
REQQ..-
BOND
POSTED
STATE LICENSE NUMBER EXPIRATION DATE
A4+4_-rrj-r+ b0lolo
rED
q0
"I—
CIYES *0
$ —
SEPA REVIEW
COMPLETE EXEMPT
SIGN AREA
ALLOWED PROPOSED
HEIGHT
ALLOW/D PROP OSED
PROPERTYTAX A
PARCEL NO. . %-�� I
.9COUNT
0o
4 ip o vle —2—
Y,
EXP
NEW rid RESIDENTIAL 13' PLUMBING / MEC . H
LOT COVERAGE
REQUIRED SETBACKS (Fr.)
PROPOSED SETBACKS (Fr.)
Lfkl
ALLOWED PROPOSED
FRONT SIDE REAR
f /
FRONJ LJRADE ?�AR
ADDITION COMMERCIAL COMPLIANCE OR
15ii ___" �,5
It
.14 53 1
) 24
z
z
CHANGE OF USE
REMODEL MULTIFAMILY SIGN
z
5
CL
PARKING
REO'D I PROVIDED
LOT AREA
I P4NINC6 �WEVIEWE B DATE
FENCE
REPAIR GFIAW
CYDS x —FT)
REMARKS
'—.'N
DEMOLISH TANK
GARAGE RETAINING WALL FIRE SPRINKLER
CARPORT ROCKERY FIRE ALARM
_13
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
rE .5 r r
CHECKED BY
TYPE OF CONSTRUCTION
CoDf
OCCUPANT 007:1,
— /' I . -1 \
VE
GROUP
NUMBER
OF
STORIES
0 Z_ I
NUMBER OF
DWELLING�j
U I
CRITICAL
AREAS
NUMBER
SPECIAL INSPECTION
REQUIRED
AREA
OCC'PANT'
LOkib
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER.UBC 1'6i'/'IBC109/IRC109 FINALINSPECTION REO'D
aa(k/_. 5-01Lf) j\,,) t�,LAJ 2 - LE.�Z
VALUATION
$ b I 9li
-'Desciription
FEE
Des6ription
FEE
'Pla . n �Qhe'c'k,
State Surcharge
L.15U
HEAT
,7URCE
GLAZZ %
LOT SLOPE, %
Building'Permit
City Surcharge
PLAN CAE-CK NO:
VESTED DATE
Plumbing
Base Fee
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED THIS PERMIT COVERS WORK TO
Grading
I= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
2
:3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
It= SEPARATE PERMISSION.
Engr.. Review
PERMIT APPLICATION: 180DAYS
Ehgr. Inspection
OIL PERMIT LIMIT! I YEAR - PROVIDED WORK 15 STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION.
APPLICAW, ON BEHALF OF HIS OR HER SPOUSE, HEIRS ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THECITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS,. EMPLOYEES, AND AGENTS FROM ANY AND
M
Fire Inspection
Receipt #
1151U 1
4 ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Landsbapeinsp.
. . I
Total Amt. Due
I
X FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0
Xi NOR LIMIT IN ANY WAY THE C11 . YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.,
Recording Fee
I
I Receipt #
I HEREBY ACKNOWLEDGE THAf I HAVE READ THIS APPLICATION; THAT THE INFORMA I 1__
APPLICATION
_. _
APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF�
TUC nWMCD i A�_MCC 7^ WIYU Amn Q't i
I
14. U � I 1his application is not a permit until s gne by a .
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE. EMPLOYED CALL Building Official or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LA40R-SQDE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided.
WORKMEN'S COMPENSATfNINSUVNCE AND RCW-18.27.
"bfFICjALS SIGftTURE ji-j IAJIE
SIGJURE,(OWI�R, OR AV, DATE SIGNED (425) AA NIJAk 00
771-0220 U-rA Ifly
RqpSto(��_ '4k DATE
ATTtNT16N Off 1333 ol 1�
ITIS UNLAWFULTO USE OR OCCUPYABUILDING 08 STRUCTURE UNTILAFINAL
INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU-
ORIGINAL-VILE -1YELLOW-INSPEAR
PANCY HAS BEEN�GRANTED. UBC109/.IBC110/iRC110.
OWN�R -ASSESSOR
PINK GOLD
�PRESS HARn -YOU ARE MAKING 4 COPIES
W
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t6s�
� 4W
—70 - 0'
W
0
P
4
D ECV, ARM FLAT
zzo
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C (A
PROJECT ADDRESS / OWNERS:
BERT &KAREN HOGUE
18818 geH AVE WEST
EDMONDS 98020
425 774 0987 home
TAX No: 00434600006503
LEGAL:
EDMONDS SEA VIEW TRACTS� BLK 000
D-03 LOT 3 SP 13 — 81 REC.
AFN 8109010204i BEING PTN OF TRACT 65
EXIST PLAT TGW AND UND 1/3 RD IN PRIV RD
AS SHOWN ON FACE SD;PLAT.
S13 T27 R3SE
SCOPE OF PROJECT:
REMOVE EXISTING DECKS. NEW UPPER
AND LOWER WOOD DECKS.
986 SQ FT NEW TOTAL..
rl
ZONE: R-12
LOT" SIZE: 20,908. SQ FT,
LOT COVERAGE:
EXISTING HOUSE / GARkGE: 2246 SQ. FT.
NEW DECK: 642.5 SQ. FT.
i
TOTAL: 2888.5 SQ. FT. .13.8%
GRADING: NONE
*NEW IMPERVIOUS: ZERO
CONTACT DURING PERMIT PHASE:
KRISTIN HANSON
HANSON DESIGN
652 ALDER STREET
EDMONDS WA 98020
Any request for modification, variance or other
4257747129 1 FAX425771-3152. administrative deviation (hereinafter 64variance")
ecificallY called ollt and identified.
CONTRACTOR: must be sP ns
Val of any plat or plan containing prov1s'0
Appro city code and for which a
which do not comply With
variance has not been specifically identified,
requested and considered by the appropriate. city
official in accordance with the appropriate provision
of city code or state law does not approve any items
not to code specification.
SMOIKE ALARM REQUIREMENT
Pursuant to R313, when work requiring a permit is
issued, battery operated smoke alarms (smoke
detectors) shall be installed in each sleeping room,
outside each separate sleeping area (i.e., hallway),
and on each additional story of the dwelling,
(including basements and split level dwellings).
APPRO B PLANNING
Zone P� - /'� Comer /1,"Fla&.L-11
Setbacks
Required
Actual
Front
ag "
-- xq
Sides
L-g.3 r
Rear
Other
Heig
�,ht
OLI-qe)-�
C",TNI f,'-)F EDMONDS
r--PJ1U,)1M(?,, DEPARTIVIENT'
2003 EDITION IRC ADDRESS --
OWNER
W/WAC AM M" E N DIVal E NTS
Df,
BLDG. OFF16
j Ali S
PER N 1�t E A
fut I I
.D
RECEI.VF
NOV 9 RECEIVED
PERMIT Co I UNTER ""Ir"y d"Opy OCT 1 8 2004
PERMIT COUNTER
[IN
10