19021 OCEAN AVE.PDF11111111111111
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19021 OCEAN AVE
The City of Edmonds
APPLICATION
for
SIDE SEWER PERMT
NEW CONSTRUCTION E) REPAIRS EASEMENT No . .......................................... .
OWNER ...... .. ........ ..................................... CONTRACTOR
ADDRESS ....... LFO-2 I/ --------------------------- PERMIT No.
..... ...................... ................. LEGAL DESCRIPTION: LOT No . ................... -------------------------- BLOCK No . ............................................
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NAME OF ADDITION
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APPROVED- I-
JAN 19 1970
DATE../ .......
By ..
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14097AWMA
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........ V-01TURIA '40 aMAT4
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CITY OF EDMONDS
Call PROsPect 6-1107 when work
CIVIC CENTER — WATER —SEWER DEPARTMENT is ready for inspection. (No inspec.
SIDESEWER PERMIT if— SatUrd&Y, Sunday or holidays.) N2 3545
ADDRESS .......... �?021 - Ocean Avenue
------------------------------------------------------------------------ I ................................................................................................................
OWNER .............. Eamon Parsons
....... ------------------------------------ ......................... ........ CONTRACTOR ............. K
I . elalake ... $em.e r
Permission is granted ......... Jarivary.__19 ---------- ig.7.0-., for ........ --------------- day,, to REPAIR or CONNECT a side sewe.r
with City Sewers in accordance with application on file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. 1—Theowners of the Property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must
be mployed 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 may develop within one year of completion.
NOTE No. 6—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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Onphoovqh corner of glook 4, unrernvned Pint of MOOS
on thp-Sound 74mb n1i" duotheast norner.ja 521.11 feet Nnrtb and IIAO.27 feet
Wont of tho lnhtbn�"b 0--nor of Government let svotjor 15, Townnbiw 27 North
Range 3 Kst. C. M.1 KKW2 South 31 17.00" West alanp hqptonly waigin of
NOW! View Maceg a HOt,nce of 143490 feet; thence nortb West along:
existi . ng fence Tino F, Ustance of lQ9.64 feet to the trne noint ot beginnige,
of traot hernir desoribep; thenca cOntinue North 75 33t West Kong ow C.Xicst I ir, I
fence line p Katorce nf 186, 1 35 feet. to an intersectinn with AAsterly Maygir
"of Ocean Avenue, Owrop somth KOM West Iona sRid pnaUrly Onypin a distanop
of 40 foot; Lh-rop nn&D 50"Q1 hapt a dietanno of 170 yawk Thenoo jo-vtb
35 Ut East 0 diatwow of V16-14 A& to M truo nalib nf unlit
ining, nQuate
in the County of Snuhomishv StRte of Washington, STr'JN-"" 'P�' epqement sal
the 3 1 outhe I rly I feet of abbVe &Soribed PrOlertY fOr-wMAYnY ingress and
nuvOsPs for Lot D. Reid, Fiddloton FAssop.-jile No. '"010
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C. Contractor:
City of Edmonds
Wiff-WAY CONSTRUCTION
TO
PERMIT Per . mit Number.
Issue Date: ;= ?15
A. 'Address or Vicinity of Construction: - I qQ I 1 0 C— CA NLAU E
-rl%/F; i )/',
B. Type of Work (be specific): Q iz-17 L A r F. I) rr 17 r, r
f- r I r
Mailing Address: -5-3 1 M A i AJ -S T
stateLicense#:* 5UPE,)e'CC-101QA
D. Building Permit # (if applicable):
Contact: -T60 AMDEP—Seir\1
Phone: 7 74 - D46,
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. F-1 Commercial El Subdivision 0 City Project [id Utility (PUD, GTE, WNG, CABLE, WATER)
f-I Multi-Farnily F
] Single Family F] Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut: E]Yes.: �RjNo G. Size of Cut: x H. Chargq�_$
APPLICANT TO READ AND N
tl Y.f
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold Edm ndsharml4sf2ir7urz58,0damages,or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its departments or
employees, including or not limited to the defense ofany legal proceedings including defense costs, and attorney fees by reason ofgranting thispermit.
WING THE FINA
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALSI�01?,-A_PERIOD OF ONE YEAR FOLLO L
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION IF, E S "I WILL� BE HELD UNTIL THE' FINA L �; TREET PA TCH
IS COMPLETED B Y CIT Y FORCES, A T WHICH TIME A DEBIT OR CREDIT WILL BE PR OffSSED FOR ISS UANCE TO THE APPLICA NT.
Construction drawing o4proposed work required with permit application.
A"24 hour notice is required for inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control a'*nd Public Safety shall be in accordance with City regulations as required by the City Engineer.
114
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
Ihaue read the above statements and understand the permit requirements andthepink copyof thepermit willbe
available on at all timeAor inspection purposes.
An/ '4� A�15
Signature.- Date:
-(Contractor �-rAgent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
7
ISSUANCE
EnKrg. I)iv. 1991
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.)
Comments: -
I Diagram.:
m
CONTRACTOR CALLED FOR INSPECTION El YES El NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
bCLA N 4kV F,�.
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City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number. -3 7(4>
Lssue Date:
A. Address or Vicinity of Construction: 19021 Ocean Drive
Ni"Amom— GTE to plaae,loperate, and maintain a buried ice
C) B. Type of Work (be specific): wire from existing pedestal # 5682 located at Water St.
90 9 & Ocean Drive then south to a residence at 19021 Ocean Drive. GTE to plow 1201,
Bowcush P no ?ri eway Please neA attanhad skAtch. R.O.W. 60 fAAt-
Mary A r, erm t oord nator
C. Contractor: GTE Northwest Incorporated Contact: Dennis Alexander 771-9036 mobile, 388-1358
2312-C W. Casino Rd
Mailing Address: Everett, Wa 98204-1440 Phone: Mary 206/488-1628 or 710-4130
State License #: Liability Insurance: Bond:
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. 0 Commercial 0 Subdivision El City Project Ig Utility (PUD, GTE, WNG, CABLE, WATER)
Multi -Family [J Single Family E] Other 21OO-9POOlDI3 242310
INSPECTOR: --INSPECTOR:-
F. Pavement D Yes G. Size of Cut: )1. X H. Charg�_$
Please see atta (he tVk Oet '7
APPLICANT TO READ ANDSIGN
INDEMNITY: Applicant understands and by his signature to this application� agrees to hold the City ofEdmondg harmless from injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its departments or
employees, including or not limited to the defense ofany legalproceedings including defense costs, and attorney fees by reason ofgr-anting thispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWIN� THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITYFORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to.be in accordance with City Codes.
Street shall be kept clean at all times.
Tz-afflic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statenjext&and understand the permit requirements and the pink copy of thepermit will be.
availableonsite t 11 urposes.
Signature: John H. Stewart �atq: December 3, 1996
5ec- Mgr.-Kccess es gn
(00ftrgtq##b� Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
NO WORK SHALL BEGIN PRIOR TO
FIELD INSPECTION NOTES (Fund Ill - Route copy to Street Dept.)
I Comments:
I Diagram.:
CONTRACTOR CALLED FOR INSPECTION El YES ONO
Partial Work Inspection by P�.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
LEGEND
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PERMIT SUBMITTED BY
GTE
PEDS 0
POLES 0
ROAD BORES
OVERHEAD LINES-
I.O.UTILITY POTHOLE [Z)
UG TRENCHING ----UGT-
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--------------------------------
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-
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THE FOLLOWING INFO TO BE PROVIDED
RIGHT OF WAY LINES,EOP OR FACE OF CURB, EXISTING SIDEWALK. POLES, ROAD CUTS AND THE UTILITY UNDER ROAD CUTS.
ABOVE GROUND FACILITIES.(Ie:) PEDS.BOXES,CABINETS. ETC..UNDERGROUND TRENCHING AND OVERHEAD LINES.
FOOTAGE OF WORK IN R.O.W.
����K�'^K�� Drawing ��= ��� �� ���"���� Water - .~
NEW CONSTRUCTION DEPAIRS0' LID NO. .................. /\SMT.NO...................
OWNER -------------------------------- CONTRACTOR -----------------------_---'PERMITNO.-----.—.
\ 90-2 ( 1�\ ��
'____'________________________'.__'___________________
NAME[8'AI}IDTl{)N-:.....................................................................................................................
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1c)012L \ OCeAN AVE
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Approved: .
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EASEMENT
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CITY CLERI<
civic cEmrER
EDMONDS. WA 98020
KNOW ALL MEN BY THESE PRESENTS, that BURLINGTON NORTHERN RAILROAD COMPANY
(formerly named Burlington Northern Inc.) a Delaware corporation, whose
address for purposes of this instrument is 777 Main Street, Fort Worth, Texas
76102, Grantor, for One Thousand Dollars ($1,000.00) to it paid by CITY W
EDMONDS,.Grantee, and the promises of the Grantee hereinafter specified, does
hereby remise, release and quitclaim unto the Grantee, subject to the terms
and conditions hereinafter set forth, an EASEMENT for the use, maintenance,
replacement and removal of existing Ocean Avenue, hereinafter called street,
over, upon and across the following described premises, situated in Snohomish
County, State of Washington, to -wit:
A 20 foot wide striD of land beina the Southeasterly 20 feet of said
Railroad's 80 foot wide Seattle to Everett Main Line right of way as
originally constructed upon, over and across Government Lot 3, Section
13, T27N, R3E, W.M. in the City of Edmonds, said County and State, said
20 foot strip lying between the South line of said Government Lot 3 and
line drawn at right angles to the centerline of said Railroad right of
way, 600 feet Northeasterly, as measured along the Southeasterly right
way line, from the said South line of Lot 3; as shown crosshatched on
Exhibit "A" attached hereto and made a part hereof.
RESERVING, however, unto the Grantor, its successors and assigns, the
right to construct, maintain, use, operate, relocate, reconstruct an ' d renew
such tracks and facilities as it may at any time, and from time to time,
desire within the limits of the land hereinbefore described, including the
right and privilege to use said land for any and all purposes, not
inconsistent with the use thereof for street purposes..
a
of
The foregoing easement is made subject to and upon the following express
conditions:
1. To existing interests in the above -described premises to whomsoever
belonging and of whatsoever nature and any and all extensions and renewals
thereof, including but not limited to underground pipe line or lines, or any
type of wire line or lines, if any.
2. Any and all cuts and fills, excavations or embankments necessary in the
construction, maintenance, or future alteration of said street shall be made
and maintained in such manner, form and extent as will provide adequate
drainage of and from the adjoining lands and premises of the Grantor; and
wherever any such fill or embankment shall or may obstruct the natural and
pre-existing drainage from such lands and premises of the Grantor, the Grantee
shall construct and maintain such culverts or drains as may be requisite to
preserve such natural and pre-existing drainage, and shall also wherever
necessary, construct extensions of existing drains, culverts or ditches
0783
VOL.2170PAG U
NO EXCISE TAX
REQUIRED
L 1 4.,
Deputy
CITY CLERK
CIVIC CENTER
EDM?,NDf, WA 98020
through or along the premises of the Grantor, such extensions to e o
adequate sectional dimensions to preserve the present flowage of drainage or
other waters, and of materials and workmanship equally as good as those now
existing.
3. Grantee, in its acceptance hereof, hereby agrees to indemnify and save
harmless said Grantor, from and against all lawful claims, demands, judgments,
losses, costs and expenses, for injury to or death of the person or loss or
damage to the property of any person or persons whomever, including the
parties hereto, in any manner arising from or growing out of the acts or
omissions', negligent or otherwise of Grantee, its successors, assigns,
licensees and invitees or any person whomsoever, in connection with the entry
upon, occupation or use of the said premises herein described, including but
not limited to that of the location, construction, operation, restoration,
repair, renewal, or maintenance of said upon the herein described premises or
otherwise.
4. All construction, maintenance and improvements of said shall be done at
no expense to the Grantor.
5. The Grantee shall notify the Regional Chief Engineer of the Grantor at
least five days prior to entering the Grantor's right-of-way.
6. The Grantor does not warrant its title to said premises nor undertake to
defend the Grantee in the peaceable possession, use or enjoyment thereof; and
the grant herein made is subject to all outstanding rights or interest of
others, including the tenants and licensees of the Grantor.
7. If said described premises, or any part thereof, shall at any time cease -
to be used by said Grantee, or by the public, for the purpose, as aforesaid,
or should they be converted to any other use whatsoever, or i should the Grantee
fail to perform any of the conditions herein expressed, then and in any such
event, all the right, title, interest, benefits and enjoyment of said Grantee,
or of the public, in and to said premises, for any purpose whatsoever, shall
immediately cease and determine, and the said Grantor, its successors and
assigns, may, at its or their option, re-enter, retake and hold said described
lands and premises as of the present estate of said Grantor without
compensation to said Grantee, the public, or any other person whomsoever, for
improvements or property removed, taken or destroyed, or liability for loss
of, or damage to any premises or the improvements thereon abutting on said
easement area or any part thereof.
TO HAVE AND TO HOLD THE SAME, together with
appurtenances thereunto belonging to Grantee for
the purposes aforesaid and for no other purpose
terms and conditions hereinbefore stated.
all the hereditaments and
public use and enjoyment for
whatsoever subject to the
a <
i
VOL. 217 OPA,60378' 4
U
I
IN WITNESS WHEREOF, the.said GRANTOR has caused this instrument to be
signed by its authorized officers, and the corporate seal affixed on the
day 1988.
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STATE OF WASHINGTON
ss.
COUNTY OF KING
BURLINGTON NORTHERN RAILROAD COMPANY
BY
J. /./,fTkka
DirL5`6tor - Title Services
ATTEST:
0 A
BY
Anita ff—.-W—eTT—s
Assistant Secretary
-.LL.
On this 7�t57 7L day of 1988, before me personally
appeared J. H. Ilkka, and Anita D. Wo is, io me known to be the Director -
Title Services, and Assistant Secret'Ary, respectively, of Burlington Northern
Railroad Company, a Delaware corporation, and acknowledged said instrument to
be the free and voluntary act and deed of said corporation, for the uses and
purposes therein mentioned, and on oath stated that they are authorized to
execute said instrument and that the seal affixed is the corporate seal of
said corporation.
IN WITNESS WHEREOF, I have hereto set my hand and affixed my seal the day
and year first above written.
BN 8867
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for Oceon Avenue
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Edmonds, WA. 6-9-86
VOL. 2.1 70PAGE.0786.
'P-0!�Ae_s
FILE
RECEIVED
FEB 2 0 2001
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DEVELOPMENT SERVICES CTA.
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CIS
1363
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 * FAX (425) 771-0221
DEVELOPMENT SERVICES DEPARTMENT
Plannine - Building - Engineering
IP C 1 S9 \3
September 27, 2000
Robin Abrahams
Abrahams Architects
611 East Pike St.
Seattle, WA 98122
Subject: Determination regarding Critical Areas Checklistl
Dear Applicant:
GARY HAAKENSON
MAYOR
APR 2 7 2001
PERMIT COUNTER
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
"DETERMINATION" FOR YOUR RECORDS.
Please examine this Determination for additional requirements. You may need to submit additional
information such as an Environmental Checklist or Critical Areas Study.
The Determination for the Critical Areas Checklist you submitted is a site -specific determination, not a
project -specific determination.
YOU MUST SUBMIT A COPY OF THE CRITICAL AREAS CHECKLIST and
DETERMINATION WITH ALL PERMIT APLICATIONS OR YOUR APPLICATION WILL
NOT BE PROCESSED.
Permit applications Include the following:
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Thank you,
Planning Secretary
*Architectural Design Board
J>:mydocumentsISpeliManICACLIetter.doc
�L:`—PlianalCACLlctter.doc
lncOrPoratedq Us
Sister Cit, , , 119 11],
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
Critical Areas File #:
Critical Areas Checklist Fee: $45.00
Date Received by Dev. Serv. Dept: c\\-2-nJ
City Receipt No: i L lli-- -
Date Mailed to Applicant:
"OC. IS19-
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 histher 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 histher 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, 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).
pplicant Representative:
Owneroi�,-A-- A�
7 �J (( -
ff
Name r 74�K
Street Address Street Address
- - t
C-1-1-',-." tie qe L;
LA��
City State Zip city State Zip
_.air
Telephone
Telephone ?
Signature
Date
d.recepUoMsn&/CACLHsndo4A.dw
Rev1w 4(1 WM
CA FILE NO. C411 , 01D -- IS (�)
Critical Areas Checklist
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - I - - - - - - - - - - -
Site Information (soils/topography/hydrology/vegetation) V(�
I Site Address/Location:
2. Property Tax Account Number: -16 U-1 -L-)-falf
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? yes; no.
ped?.e- k") EeI7
If yes; how is site develo .,2 i V
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 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
I 0-feet over a horizontal distance of 3 3 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 descnbe):
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?
10. Site is primarily: forested meadow ;shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
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EDA, 0
CITY OF EDMONDS
SINGLE FAMILY ADDITION /REMODEL COVER SHEET
/fie. 1%9r,
Directions: Applicants are to complete the information in the WHITE BOXE ONLY (Shaded boxes are for City use only).
This cover sheet must accompany each building permit application for a single-family residential addition/remodel project.
PROJECT ADDRESS
PROPERTY TAX ACCOUNT PARCEL #
DESCRIPTION OF WORK
OWNER 'PHONE
CONTACT PERSON P H 0 N E 'ZO&5
14111-311
MAILIN
FAX CORRECTIONS MAIL CORRECTIONS E-MAIL CORRECTIONS
BY SIGNING THIS STATEMENT I UNDERSTAND THAT I AM THE CONTACT PERSON FOR THIS PROJECT. IT IS MY RESPONSIBILITY TO
COORDINATE ALL SUBMITTALS WITH THE CITY AND ONLY I CAN MAKE INQUIRIES ON THE STATUS OF THE APPLICATION. I
UNDERSTAND IT IS MY RESPONSIBILITY TO DETERMINE IN ADVANCE OF PERMIT SUBMITTAL ANY DISCRETIONARY PERMITS THAT
MAY BE APPLICABLE TO THIS PROJECT. I ACKNOWLEDGE THAT TO THE BEST OF MY ABILITY I HAVE SUBMITTED ALL NECESSARY
DOCUMENTATION IN ORDER TO MAKE A CUWLETE-AP)PLICATION AND NO DISCRETIONARY APPROVALS ARE REQUIRED.
SIGNATURE
DATE
L:\temp\building\forms\Add-rvw.vsd -- 7/100
ENGINEERING INFORMAfl6k
DRIVEWAY SLOPE % GRADING CYDS EASEMENTS
EXISTING IMPERVIOUS AREA CONSTRUCTED BEFORE 1977 SO.FT
EXISTING IMPERVIOUS AREA INSTALLED 1977 OR LATER SQ.FT.
PROPOSED NEW NET IMPERVIOUS SURFACE
SQ.FT.
BUILDING CONSTRUCTION INFORMATION
:.CODE OITIONt 1997 UBC, UMC, UPC, WSEC, VIAO WITH AMENDMENTS
WIND SPEED 80 MPH
WIND EXPOSURE B
Floor Live Load 40 Roof Snow/Live Load
Floor Dead Load to Roof Dead Load
NUMBER OF STORIES,- BASEMENTS
LOT SLOPE % N�A .
SEISMIC ZONE 3
Balcony.Live Load
Balcony Dead Load
FLOOD ZONE
SOILS REPORT PROVIDW/4_ Lj YES
FLOOR AREA (Measured face of'exterior wall)
Existing
Proposed Total
Living Space 1 U(005.
L4 I to
Garage
Carport
Deck/Cov. Porch
w t0DT-
—
Other a��-
11 NO
Ceiling Insulation Window U-Value
Wall Insulation 9ky!I'ht U-Valu6�.
Floor Insulation Glailno % czk,
Door U-Value .+0 Slab Insulation'.
Energy APrescriptive [].Target . [31Systems
Whole House Ventilation System Re-q-rW,,.: N o.,,.
a
Any request for modification, varla-nce or other administrative deviation (herinafter 'variance") must be specifically called . out
and Identified. Approval of any plat or plan containing provisions which do not comply with the city code and.for which a
variance has not been specifically identified, requested and considered by the appropri , ate city offical In.accordance with the
appropriate provision of city code or state law does not approve any Items not to code specification.
BUILDING REVIEW & APPROV
ALL DATE_aj= I&D i
CONDITIONS OF APPROVAL:
City of Edmonds
C.�.x . . . . . . . . . .
Development Services Department
Planning Division
----- — — ------
- - ----- — -----
P ne: 425.771.0220
Fax: 425.771.0221
Critical Areas File #:
Critical Areas Checklist Fee: $45.00
Date Received by Dev. Serv. Devt: '�\� -�-nj �) 's,
City Receipt No: 1110 a:] ��-
Date Mailed to Applicant:
CRITICAL ARUEJAS 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, 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
Owner4� p �71�ca
Applicant Representative.
14a e7A4,))r
Name in
Street Address Street Address
city State Zip city State. Zip
A� 2- -,�?- — _71 --1-
Telephone
Signature
Date
Telephone
§ignature'
DaW
d:recept1omqana1CACLHandout.doc Revhwd 411=000
CA FILE NO. C-A -0-C) .- ts (�)
Critical Areas Checklist
---------------------------------------------------------------
Site Information (soils/topography/hyclrology/vegetation)
% vv/_�
1. Site Address/Location: ue /
2. Property'Tax Account Number: I SQL_� - C) —:�, L/ t,�Z -
I (_'17)
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? yes, no.
If yes; bow is site developed? _�2 WV
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
I 0-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: Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway floodplam' 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:
77717
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PLAN NING DATA
SINGLE FAMILY RESIDENTIAL
Name: p p
Date:
Site Address: D C>co�-— fa(/e—
Tax Parcel: 2-70 3 (3,6o -f 4 06
01 _Jsar
Pr' Description:
Plan Check #:
Reduced Site Plan Provided: NO)
Zoning: 2,-
map Page:
Corner Lot: (YES /(Q
Flag Lot: (YES /<1b)
Critical Areas Determination #Cs�A
El 'Study Required.'
Waiver
SEPA Determination:
Exempt'
El Needed (for over 500 cubic yards of grading)
0 Fee 0 Checklist El APO List with notarized form
Required Setback5
Street:
Side:
Side:
Rear:
ActualSetback5
Street:
Side:
Side:
Rear:
F� Detached Structures:
F-1 Rockeries:
El Fences/Trellises:
El Bay Windows/Projecting 'Modulation:
Stairs/Deck:
ffelght
Datum Point:
Datum Elevation:
Maximum Height Allowed:
Actual Height.
other
Parking Required:
Parking Provided:
Lo I t Area
Maximum Lot Coverage: 35% Proposed:
Lot Coverage Cafculatlons:(�--3`,--(1Bt S�
ADU Created: (YES MTD
Subdivision:
Legal Nonconforming Land Use Determination Issued: (YES
Comment5
Plan Review By: :S--� Planning Data Form 07-14-09
rDATE RECEIVED
[PERMIT EXPIRES'. 0L—AJAZ,-Z-
sells
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
USE
ZONE
PERMIT
NUMBER,�&,
JOB
ADDRESS
SUITE/APT#
NER NAME/NAME OF 13USINESS
Y�
PLAT NAM E/SUBDIVI SION NO.
LOT NO.
LID NO.
LID FEE $
LING ADDRESS
02-1 OCtAN 7,,W-67
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved 0
RW Pernut Required 0
Street Use Pannit R 'd n
eq
CITY
TELEPHONE
EXISTING - PROPOSED
Inspection Required 0
I_Fmow;
MON
q(_ZIP20
1-34/
REQUIRED DEDICATION- FT
Sidewalk Required C3
I Underground
I w,dn,,equlr. 13
NAME
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
bA
N
1
YES 0 NO 0
I 6m,�dv`3
Lu
ADDRESS
C.A
REMARKS
z
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x
0 WNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
0
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KIE� e5
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4AAkW_1V
ZIP 4
TELEPHOIEL
NAME
kn,/ I
Idce 'rl7- _/J
REVIEWED/DAT
/ENGINE!�!,�G E
ADPRESS
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REVIEWED BY
DATE
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WTATE
TELEPHON
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"ADB#
SHORELINE OR�ADB#
.0,
INSPECTION
RE D
L I C ;MBER EXPIRA71ON QATE
LIE 1)
0
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0 YES 0
IPBOND
OSTED
SibWAREA
�POSED,�l
HEIGH
LOWED PROPOSED
-j
0
W
PROP RTYTAX ACCOUNTPARCE L NQ
0
NEW RESIDENTIAL,,: �L, !*73�
'6:,
8 A C KS ',,(FT.)
Sl DE�,,�,',-REAR
PROPOSED SETBACKS (FT.)
F ONT, REAR
R
LIAN E
6OMP', 'd, -bl`l�
�/RSIDE
ADDITION
COMMERCIAL
HANG EOF-USE:,.;,
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REMODEL
S
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RO DED",
REPAIR
��G A ING
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CYDS
FENCIE'
FT),
REMARKS V
DEMOLISH
TANK
OTHER;�
GARAGE
CARPORT
RETAINING,WA4''�
J
R NEWAL
0�
R
(TYPE OF USE, BUSINESS 0 ACTIy!TyY,_X�LA.!N:
CH D,113
OCCUPANT
057
GROUP
0
NUMBER
OF
DWELLIN
CRITICAL
AREAS
SPECIAL INSPECTO
OCCUPANT
0
S TORIES
UNIT S
NUMBER'
LOAD
DESCRIBE WORK TO BE DONE
ii�' iARKS,�
PROG BESSINSPECTI N �PEWMB �,1108/FINAL
INSPECTION R EQ'D
0
A _7N
I W
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tk
VALUATION FEE
HEAT SOURCE
-AZING %
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V11LPT SL f
3P�Y.
q. IV1114*
zyo(
IBUILD[Ndj,�131 4
PLAN CHECK NO:
VESTED DATE
),PLUMBING
OU
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t 8 E DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADING/FILL
2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
vil
riD 0
STATE SURCHARGE
1
cc
UJI PERMIT APPLICATION: 180 DAYS
'30
PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
'i
I
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
L)
U) "APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
U)
ENG. INSPECTION FEE
�,
IJU IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
j
LANDSCAPING
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
INSPECTION FEE
cc
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
RECEIPT
DEEME D TO MODIFY, WAIVE OR REDUCE ANY REOUIREMLNTOF ANY CITY ORDINANCE
/
0 NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
TOTAL AMOUNT DUE
RECE7
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT;AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
This application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
Building Official or his/her Deputy: and Fees are paid. and
IN VIOLATION OF THE.LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
receipt is acknowledged in space provided.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
0 ICIALS SIGNATURE DAJE
DATE S11 NED
PDWNER
(4255
fW_ �qFl
/01
771-02,20
I�E
ATTENTION
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-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORIGINAL -FILE - YELLOW- INSPECTOR
FAX
PINK rOWNER - GOLD -ASSESSOR
5/98
4
Parcel No.: 2703130041-1400
Project Scope of Work:
"Nothing in this -,itrmit- approvai process shail b6
-iAterpreted as allowing or pennitting the
maintenance of any currently existing illegaL
nonconforming or unpermitted building, strudpre
or site condition which is o --tsidr. the sw-,, -i of the
1.
ermit application, regardless of whether such
guilding, Btn.icture or condition is shown on the
site plan or drawing. Such building, structure or
o3ndition may be the af P— -n-parate
enfomer.-;
Section
TolArnship
Range
I Quarter
1. Removal of existing rear deck complete, including all
guardrails, decking, joists, beams and posts.
2. Installation of new 18'*xl 8"x1 2" & 12"xl 2"xl 2" concrete
footings with new P.T. 4x4 posts per plan.
3. Installation of new P.T. 4x1 0 beams and P.T. 2xi 0 joists.
4. Installation of new 1 x4 IPE decking face screwed to joists
decking is to be installed with 1/4" gap typical.
5. Installation of new Crystalitigaluminum guardrail with S.S.
cables (ci) 4"o.c.
13
27
03
T SE
Project Standards
Building Code
IRC 2012 Edition
Energy Code
1
WSEC (by WSU) 2012 Edition
Floor Loading
40psf LL / 12psf 131-:� 52psf
Roof Loading
25psf LL/ 17psf DL/= 42PSf
jurisdiction
City of Edmonds
Zone 2— Comer — Flag_
Setbacks Required :�Aua—1
APPROVED BY PLANNING
Front _Z45: LJ
Sides I
2- --3
/I S
0111:) 18 Rear
4-� - Other
JV 743
'33'ootrw Height 7-S
Ock
00,
FE
01
'r, 11ZA
N,
EXISTING RESIDENCE
N, N, 1,845.00 sqft
N,
OWNER/CONTRAC-1 OR IS RESPONSIBLE N1.
FOR EROSION CONTROL AND DRMNACU E /44�,
"PREET FILE
EXIST. DET. 5z) 01
/ 1z
00. GARAGE cc
OWNER/CONTRACTOR RESPONSIBLE 0/" /00:)
CPO ,- 0 656.00 sqft <'�
FOR LOCATING ALL ON -SR UTILITIES. `6
-1ELOCATION/REVISION TO ANY UTILITIES �r 0� -
MAY REQUIRE SEPARATE PERMrr N,
00,-, JAN 2 0 20115
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS P
N1.
Applicant shall repair/replace all damage to
utilities or frontage improvements in-Ctty
right-of-way per City standards that is caused /*
or occurs during the permitted project. N1.
S'aln n e d
PLOT PLAN SCALE: 1"=20'-O"
Hardscape ]Lot Coverage
EXISTING DWELLING:
1,845.00
sqft
EXISTING DETACHED GARAGE:
656.00
sqft
EXISTING DRIVEWAY:
2,358.00
sqft
REPLACEMENT WOOD DECK:
+ 374.00
sqft
TOTAL HARDSCAPE AREA:
5,233.00
sqft
PROPERTY AREA
13,289.00
sqft
PROPERTY HARDSCAPE AREA
39.00%
L
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0
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/Itle:
Rear Deck
Replacement
D. Almond
01/14/2015
R , Plan:
T
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