19025 92ND AVE W.PDF111111 111111
8870
19025 92ND AVE W
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE).
COVENANTS (RECORDED)
CRITICAL AREAS:— DETERMINATION: 0 Conditional Waiver 0 Study Required Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS (OTHER):
PLANNING DATA CHECKLIST DA
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORTPLAT
SIDE SEWER AS BUILT DA
SIDE SEWER PERMIT(S).#: c:;2 ij!'
GEOTECH REPORT DA'
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
LID #:
LOT: BLOCK:
LATEMP\DSrs\Fonns\Sh=t File Checklist.doc
M.- 77-77
9"
# PERMIT NO: 9846.
City of Edmonds*.
SIDE SEWER PERMIT PERMIT EXPIRES_jT/W—
Address of Construction: 19 02=1 5 2 tiv I- L%- - LID #
Property Tax Account Parcel No.
Attach copies of all access and utility
erified and Approved b
Owne I r and/or Contractor: R v-cA\ � c T� 0- 1 L41--
Contractor License Building Permit
Ej� �ingle Family. Invasion into -City *Itight-of Way: F� Yes RIO
F� Multi -Family I(No. of Units .*RW Construction Permit #
f-1 Commercial (No. of Units Cross oth . er *.*Private Property: El Yes 17[-N--o
F-1 Public t *Attach legal description and copy of recorded e aisement.
Ow'ner/Contra'ctor
Owner or contractor signature anj'-a'cknowledgement statement: 4
By signing for this permit I certify that I have read the City's public handout entitled.
Side Sewer Specifications, and shall comply with all City requirements outlined therein.
02 CALL DIAL -A -DIG (1-800-42,,9_-5555) BEFORE ANY EXCAVATION 2
9 FOR INSPECTION CALL 425-771-0220 extensionl3^§2
24 HOUR NOTICE REOUIRED FOR ALLANSPECTION REOtJESTS
FOR OFFICE USE ONLY
a,110,1416,. .4 21,
Pe
Assessment Fee $
City Permit Surcharge Fee
Issued Ely:
Date Issued:
Receipt No: C2
Tot al 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:
FINAL INSPECTION APPROVED: Date: qk �64 Initial: fit I JO As-builtto Street File: F1
1,� PERMIT MUST BE POSTED ON JOS SITE'�j-
White Copy: File Green Copy: Inspector Buff Copy: Applicant
191st P� SW
STUB
5.5'
ISS.
32'
WYE 5T
.8,
C/Of x x FENCE x
45*
@ 4'
BEN 22'
DEM_��
C/o @
2,5' DEEP
x
U
2.
z
w
LL_
19025
U
z
w
oli
m
Eo *
CITY
OF EDMONDS SIDE SEWER AS— BUILT
0
d
ADDRESS
19025 -
92nd Avenue West
HOMEOWNER
CONTRACTOR
SCALE
Archie
ButLer
I NTS
1890
DATE
5-3-2004
IDRAWN
BY
K Haney
PERMIT
NO. 9846
P1 APPUCATION
for
The City of Edmonds FtF SIDDE SEWUR PzRBM
NEW CONSTRUCMON 0 REPAIRS 0 EASEMENT No.
owNm I FR-F-b ------ 17 ----- CONTRACTOR ---fi . ............................................ ......
S .0PA ........ 7x: ('0 e�K ------------------------------- J.�, .............. PFA13M No..-(--,/
ADDRES ......... ----- ------------ --------------------- LEGAL DESCRUrriON: LOT NO . ......... 3 --- Q .......................... BLOCK No . ............................................
NAME OF ADDTrlON .. . ....... C 1) A4 i') t--fo S S-a A- ('G 0 -F -
...................................... V . -.r
..................... ..... ..................
t 0 0 7-k 30
7 L
k
PPROVED
41)
7u,
JAN 18195
WN
Approved:
DATE ... —4--�-E . ............. B
y
NOTICE:
y ot a,,c "a
Now-ar-rant. - . U, U r
The -information *shown on the attached
map(s) was compiled for use by the CitY Of
Edmonds/ its Employees and Consultants.
The City of 'Edrn.oncls does. not. wa rra nt thle
n these
accuracy of anything set for.th o . -
rnap(�). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown- or
-rnap(s), including, but not Jimited to,
the lociation of any sew-er stub shown. Sud
ay, not exist and may
sewer stubs may or m
or may not exist at the location shown
Neither the city of Edmonds nor its
empl-o-yee*s o*r officers -sh-a-1-1 be lJa-b-1-.e for the
I n on this map(5), nor for
information give'
any one representation. provided based
upon said map(s).
CITY OF EDMONDS
Call Plitospect 6-1107 when work
CIVIC CENTER— WATER -SEWER DEPARTMENT is ready for Inspection. (No bm;pee-
SIDESEWER PERMIT tions Saturday, Sunday or holidays.) N 0-: 2687
ADDRESS-------------------------------- 19.925 ... . ... 9.2nd --- Am-enue ... Wes.t ......................... . .............................................................................
OWNER --------- Fred T. Boo Owner .......... .......
------ --------------------- )��w .......................... --------------- CONTRACTOR .............................. ......................... ........
Pern-dssion is granted ....... jA;xqAry 18 ......
.......... 19_68— for ------------------------ day, to REPAIR or CONNECT a side sevver
with City Sewers in accordance with application on file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. I —The 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 nut 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. 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 sewer or Its appur-
tenances except to insert the pipe into the wye.
SENT BY: 4— 6-98 2:55PM CITY OF EDMOND5-i U2UU24UU1b4;;; S
QA FIL Zr ArO.
Critical Areas Checklist
Site Information (soil s/topography/hydrolo gy/ve 9'etation)
I Site Address/Location,
2. Property Tax Account Number:
,_L_ q —
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? _X yes; —no.
If yes; how is site developed?
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 IS% (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 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 waten Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth.,
What season(s) of the year?
S. Site is in the floodway floodplain_Mo ofawatercourse.
9. Site contains � creek or an area where water flows across the grounds surface? Flows are year-
round? Flows are seasonal? �J (What time of year?
10. Site is primarily: forested in eadow shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland ispresent on site: LIZ
.$CS rnapped soil type(s)? 99e"ad ArhA
5'.' Weda d' * vtnt&V 6T C.A,.-xnap*irjdicatis �vetland pf&s6nt orf site!,'.-.-..'
11 - In
itical Areas inven.ory o.r.. A.. map �ndi6ates Criti.cal Area on site?'
3.- Site . within desi'6*�i6d eirth su*b�i'de�ce"lan* dslide haza'rdarea? -
Sfte:dd�ig on e Enviro�T�6nialt�.Sentilive Ai a�
nated th e Ma ?
p
fta—ch.doc; Rev 10/03/97
SENT BY:
4- 6-98 ; 2:56PM
City of Edmonds
CITY OF EDMONDS-4 82062458154;# 2
RECEIVED*
APR 14 1998
COMMUNITY SERVICES
CRITICAL AREAS CHECKLIST
The Critical Areas Checidist 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/lier 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
inforrnation 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 fffl out
thb 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 st6ps 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 prelirnina*ry
assessment of the site
ar f
I have completed the attached Critical Areas Checklist and attest that the answers provided - e actual, to the
best of my knowledge (fill out the appropriate columh below).
Own er/Applic silt:
Name
Street Address
ZVIW6�)a 2fip -2a
City I State Zip
7 -7c-�--
Signature
Date
craM donVanakad doc
Applicant Representative:
Name
Street Address
City State zip
Telephone
Signa=e
Date
(over)
�1 z? C. 18,91,
April 20, 1998
Mark H. Lundberg
1902592 nd Ave. West
Edmonds, WA 98020
CITY OF EDMONDS BARBARA FAHEY
MAYOR.
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works - Planning/Building - Parks and Recreation - Engineering o Wastewater Treatment Plant
Subject: Determination regarding Critical Areas Checklist # 98-113
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 CHECKLIST OR CRITICAL AREAS SMY.
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
mo, You must submit a copv of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL 40
PERMIT APPLICATIONS 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.
Enc: Critical Areas Determination
* Architectural Design Board
Thank you.
Sharla Graham
Acting Planning Secretary
C:Reception\Jana\CRLTR.doc
0 Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
SENT BY:
; 4- 6-98 ; 2:56PM ;
CITY OF EDMONDS-,
82062468154;# 2
City of Edmonds
0
RSCEIVED
APR 14 1998
COMMUNITY SERVICES
CRITICAL AREAS CHECKLIST
The Critical Areas Checklist contained on this forrn is
to be filled out by any person preparing a
Development Pennit 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
thb 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 si�ps 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 information (e.g., site plan, topography
map, etc.) or studies in conjunctiot 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 columh below).
Owner/Applicant:
Name
Street Address
10
City State zip
7 -7<--
Signature
Date
Applicant Representative:
Name
Street Address
city State zip
Telephone
Signature -
Date
crecoptionyanakad. doc (over)
SENT BY: 4— 6-98 ; 2:55PM CITY OF EDMOND54
OFILr JV0.
Critical Areas Checklist
---------------------------- : ------------------------------------
Site Information (soils/topography/h drology/vegetation)
_y
1. Site Address/Location:
2. Property Tax Account Number;
_.L_ C_�( —off
3. . Approximate Site Size (acres or square feet):
k Ile BUILDING
4. Is this site currently developed?. 4S yes; — no.
'JUN 11 lb�V8
If yes; how is site developed? 1EA_ PYZ
5. Describe the general site topography, Check all that apply.
V_ Flat: less than 5-feet elevation change'over e
Rolling: slopes on site generally less than 15% (RAbreis over a
horizontal distance of 66-feet). -- - .,. led)5)e
Hilly: slopes, present on site of more than 15% and less than 30% ( a verrtical 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: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway _LL.— floodplai of a water course.
9. Site contains 1 creek or an area where water flows across the grounds surface? Flows are year-
round7 Flows are seasonal? �J D (What time of year?
10. Site is primarily: forested ineadow ;shrubs, mixed
urban landscaped (lawn,shrubs etc)
11. Obviouswetlandis'presenton site: LIZ
A0_chk.doc; Rev 10/03/97
0 0
PLANNING DATA
NAME:.
SITE ADDRESS: Md. 9, 5 eA 6A T E:
ZONING: f�6, /Z� PLAN CHK#:
PROJECT DESCRIPTI
CORNERLOT (Yes/No) FLAG LOT (Yes/No)
SETBACKS:
Required Setbacks:
Front:,45:- LeftSide: la RightSide: AO ' Rear:
Actual Setbacks: —604),�,e Z07- 411AZ;WA,6,
Front: :!-� Left QLrr- _/3 --�Right Side: 11 Rear�o`
Street map checked for additional setback required? �j (Yes/No
V%,-, W /X #e---
'WW , or, 1/0,-l/
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED
LOT COVERAGE: L-5.
Maximum Allowe -R)Actual:
B UILDING HEIGHT:
Maximum Allowed: Actual Height:
Datum Point: a�zhek:�: Datum Elevation:— �0
A.D.U. CREATED?:
SUBDIVISION:
S rj
SEPA DETERMINA'
LOT AREA: A� 000
OTHER:
Plan Review By:
6
cArt1es\peffnifk-p1arW3Ldoc
City of Edmonc#
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number: 9'?�—zu_
Lssue Date:
A. Address or Vicinity of Construction: I qt> Z.T qZ Ajo A vc. W
oc ific): P,6PLACC SC(eVleC fOLC A-d
B. Type of Work (be spec .
U6 t0owing wrV SATC Or POLLe
C. Contractor: swo, co Contact: f3o(& kAV.AL1F'V
Mailing Address: 2 10 1 R RW11 Phone: 4 25 - (070 - 3 2 1 q
State License #: f7ts Akombs. WA 61802G Liability Insurance: Bond: $
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. F] Commercial E] Subdivision 0 City Project E] Utility (PUD, GTE, WNG, CABLE, WATER)
FJ' Multi -Family 9 Single Family E] Other (9�� I "') �r q 5 . .
INSPECTOR: INSPECTOR: "R�,J
F. Pavement or Concrete Cut: 0 Yes NNo G. Size of Cut: 44�fx H. Clfafg'01
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application to hold the City of Edmonds harmlessfrom injuries, damages, or claims ofany
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 of any legal proceedings including defense costs and attorneyfees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC-
TION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREETPATCH IS COMPLETED
BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT�.
Two sets of construction drawings 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. J
Traffic Control and Public Safety'$hall be in accordance With City regulaiions as required by the City Engineer.
All street cut trench work shall be patched with asphalt or City approved material prior to the end of the working day-,
NO EXCEPTIONS.
I have read the above statements and understand the permit requirements and the pink copy of the permit will be
available on site at all times'for inspection purposes.
Signature.- Date: z I — ?6
U (Contrc rctor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK.
FOR CITY USE ONLY
APPROVED BY: K6'
TIME AUTHORIZED: VOID AFTER 12.0 DAYS
SPECIAL CONDITIONS: wo Aa e_v-r�
RIGHT OF WAY FEE:
DISRUPTION FEE/FUND I 11:
RESTORATION FEE:
T OTAL FEE: 30,00
RECEIPT
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO
ISSUANCE Eng. Div 1997
FIELD INSPECTION NOTES
Comments:
I Diagram.
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION EJ YES NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
I -- -
S*OMISH COLJ'NTY PUBUC UTILrrY DISTRI I
clo.
4-
r 177)
FD
i'C f PIA- -r o P s'.VC: E,
C-r �4 E W 30' 5 V.C,' POLE I PLA I—.
1416 ev. 1
sm.
03
-r
q/0 AL. -TRIPLEx 0. Z VC POLIE -
LOCATION 9 ZAj b
19029
vc. D AA 0 NJV S \Aj A, 6020
SOUfH COUPIJ AREA
stul,4.5 01: -v-? 4L -rv'PtEK 13,K-rwE-iE,\j-'
POLE #
SE 1/4. S �3 T 27R DATE ZS
W.O. # �3 0 qao
S-�I`A L L - S E'C_ RISCR 0 #,j PO L r- I Li 70 S)
.
REASON FOR WORK R 6 P L C f
6 -rAE Poi.E wiT-H ENGINEER 4rA k4 t c
DWG. #
S C-r 'SIE-C - P C b (2 e3ASiE or PO L
30' 5vc POLL-
/co R SEC. R s 1� DRAFTER
U.G. #
4/0
(�G A 5 -) - : .
SCALE Aj
DATE WORK:C'OMPLEtED
FOREMAN.
FEES REQUIRED:
ENVIRONMENTAL ANALYSIS
iffi YES 0 NO
CO EXEMPT 0 NOT EXEMPT
PARA. 18 ITEM C
PRIMARY OVERHEAD
O.H. tj,.G. COND. KV
0 RESIDENTIAL 0 COMMERCIAL
ADD _tCKT-Fr._PH
LEO #
REM _CKT. FT. PH
$
NET _CKT. FT.
SECONDARY OVERHEAD
O.H. U.G. COND. * KV
BASIC FEE $
ADD - CKT. Fr. PH
@ $
REM _CKT. FT. PH
NET CKr. FT.
METER/CONV. POLE s—
PERMITS (DATE GRANTED)
PRIMARY UNDERGROUND
U RESIDENTIAL U COMMERCIAL
U TREETRIM
BASIC.FEE $
U STATE
LEU It
U COUNTY
$
a CITY 'rp""opi 0 1
U REQUIRED 8 NOT REQUIRED
SECONDARY UNDERGROUND
BASIC FEE $
UNDERGROUND PLAT
DATE RELEASED
FEE $
-BASIC
FOREIGN CONTACTS
0 GTNW JPN #
M CATV JPN #
STREET LIGHTING
- oft a $-' = $
0 JOINT TRENCH GTNW & CATV
U JOINT BORE GTNW & CATV
WORK IN RIGHT-OF-WAY
• PRIMARY
cl
• SECONDARY
POLE STENCILING
$
FROM -TO
TAKE OFF POLE
MISCELLANEOUS FEES
VAULT $
PRE-CONSTR. REQUIREMENTS
PERMIT $
U TREE TRIM U PUD LOCATOR
cog-r es.-.rtl"A $
UBACKHOE 0 FLAGGING
$
6 ONE CALL DATE
TOTAL DUE: $ 4-5/6
INDEX
POLESI
IP
DATE PAID
LOGS
I U-MAP
RECEIPT It
XFMR
J_C-MAP
NEW SVC APPLIC. #
LOCATION MAP PAGE
APPROVED i DATE PRINTED
SUBSTATION A4APt_,-k)ooD
CIRCUITNO. 12-3'1-5- PHASE 112,3
BoG KAKALEY
�q2S) 7,?7- 7123
z49 4
9 3SZ3- X
d 9 0 - 1 9 4 -
City of Edmoncle
F -W
AYCONSTRUCTION
FUILRMIT '73 613
Permit Number:
Issue Date:
A. Address or Vicinity of Construction: - 19025 92 Av. W. (9308521)
B. Type of Work (be specific): Install New Servic-A
C. Contractor: -Washington Nat'l. Gas Co. Contact: Frank Rwnri
MailingAddress: 815 Mercer. St.Seattle, Wn. Phone: 224-2278
State License #: 98111 Liability Insurance: Bond:$
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
P.
E. F� Commercial E] Subdivision C] City Project KJXUtility (PUD, GTE, WNG, CABLE, WATER)
[-] Multi -Family 0 Single Family R Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut : 94 Yes 15tNo G. Size of Cut: - x H. Charge$
APPLICANT TO READ A4@S1"GN
INDEMNITY. Applicant understands and by his signature to this application, agree old the Chy of Edmonds hat -nil mages, or
foreen, that nst the City o
f Edmonds,
claims of any kind or description whatsoever, foreseen or un e*i -, or at 9�f i�aartmenls or employ-
ees, including or not limited to the defense of any legal proceedings including defense costs, and attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AAD MATERIALS FOR APERIOD OF ONE YEARFOLLOWIA� 11VAL NSPEC77ON
r
AND ACCEPTANCE OF THE WORK ES77MA TED RESTORA77ON FEES WILL BE 4L16) TJAWL THE FINAL STREET PATCH D BY
CITYFORCES, AT WHICH 77MEA 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 Departme
Work 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 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 statements and understand the perm - i ' t requirements and the pink copy of the permit will be available
on site at all timesfor inspection purposes.
Signature:
Date: 2/11/93
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGUiNING WORK
...PERMrr.
In
�t
Eng. Div. July 1985
Addendum to : City of Edmonds
ight or ay
Permit Application
Submitted by:
Engineering Aide
Washington Natural Gas
/qO?-c5 612- L\-t v,,j 2�4
260d
WNG to window
Water main depth
unknown
z11 gas main
�-Jo PL,\-11QC-1 C-U7-s
Key:
-w-
water
-g-
gas
-ss-
sewer
-6-
water hydrant
0
water valve
915 Merccr St. (P.O. Box 1869), Scattk, WA 98111 (206) 622-6767
V.,
-1-17 C. 1 S(4�3
E
0
CITY OF EDMONDS BARBARA FAHEY
MAYOR
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works a Planning /Building - Parks and Recreation - Engineering * Wastewater Treatment Plant
January 27, 1998 ]SUIEDING
Mr. Mark H. Lundberg JUN 1998
19025 - 92nd Avenue W.
Edmonds, WA 98020
Dear Mr. Lundberg:
This letter is to confirm what we discussed in our meeting on January 22, 1998 regarding using
average front setbacks.
Edmonds Community Development Code Section 16.20.040.A allows exceptions to required
setbacks when a block has residential buildings on more than one-half of the lots on the same
side of the block with legal nonconforming setbacks. Using a survey to prove the exact setbacks,
an owner of a lot on that block may use the average of all the front setbacks of the existing
residential buildings on. the same side of the street as the minimum required front setback for the
lot. Detached structures such as garages; carports; and uncovered porches, decks, steps and
patios less than 30 inches in height, and other uncovered structures less than 30 inches in height
shall not be included in the "average front setback" determination.
In your case, one of your neighbors has already furnished a survey by a licensed surveyor
showing the'setbacks of the three houses on your side of the street. On your side of the street, the
only other two lots do not need to be shown, as one is vacant, and the other is essentially at the
end of the cul-de-sac so it would have different setbacks. The survey provided shows your house
at 6.6 feet, the next house at 9.4 feet (carports are excluded) and Mr. Baldwin's house at 10.5
feet, for an average front setback of 8.8 feet. Since this survey was done, Mr. Baldwin has added
an addition at the same 10.5 foot setback, which would not change the average setback, and
therefore no new survey is needed.
I have also called the Washington State Department of Licensing to make sure that the survey
was done prior to Max Meyring losing his license to do business, and was told. that Mr.
Meyring's Engineering license was revoked in March 1997, which was after the survey was
done. Therefore the survey by his company done prior to that is acceptable.
If you wish to use the average front setback instead of continuing with the variance, please write
us a letter to withdraw your application for file V-97-162. If you wish, you may request a refund
of the balance between the $132 fee and any hours we have spent processing it.
Please submit a copy of the survey when you submit your building plans, showing that the
average front setback is 8.8 feet.
If you have any questions, please contact me at (425) 771-0220.
S * ncerely,
'y
M4eg well
Planner
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Legal. Description
POO ON 1-�
STREffuIf%q ERMIT REVIEW - FNGINFFRING DEPA.RTMF.NTNTI IVAQrD
CHECK LIST
Reviewer's
Intials
1. Septic Tank System nesi'gn.Approved
2. Sanitary Sewer Availability��Sht. of Dwa. No.—P,IM
Projett: Side Sewer Availability:
3. -Any Sanitary Sewer Connection Fees
4. Si te Drai nage Checked_
5. Storm Sewer Availability:r)��� Sht. f Dwg. No.
Project: Roadside Ditch.
6. Grading & Final Contours
7. Sidewalks (Site Inspection shows condition of-existinq walks as follows):.
8. Curbs
9. Cur b.Cuts
10. Underground Wiring A Street'Lightinq
.11 Street Right-of-way. & Bldg. Setbacks:12&j 6(o sht.
of Dwg. NO. of Official Street Map.
12. Existing Utility Easements
13. Access Easements
14. Water Mains A Fire Hydrants (Indica-te Size I -later Main)
15. Bonds for Site Work iV A-
16. Special Requi rements lis I ted in memo to Bl dg. D pt drV
e
17. Commercial Apt. Requirements form completed A-
18. Drawings stamped & not . ations madeu-immi o
9 D KM
19. Site Inspection made on
20. All items filled in on Rldg. Permit Application
21. This L6t.included in Subdivision (List any spectal requirements):
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
,/11) A /,;) le" / , ) , i
i6NE PERMIT
NUMBER
JOB
ADDRESS jqo�
LrUAL UtWK11- I IUN LNt:L;Kl SUBDIVISION NO.
MAILING ADDRESS f; � 4__,_
/ C�o PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
CITY ZIP TELEPHONE NUMBER EXISTING
REQUIRED DEDICATION
cj?0�0
PROPOSED
NAME
77iter METER SIZE LINE SIZE I NO. Og FIX-I�U
CITY
NAME
DRESS
CITY
'980630
SUITE/APT #
TESCP Approved(. PZ__,Q-
RW Permit Required Yr'5 2-
Street use Permit Req'dr,40
Inspection Requiredt/,V3 0
Sidewalk Required " 11
uj
PRV REQUIRED
YES NO 0
- X - 0
REMARKS 9
Cc
TELEPHONE NUMBER 7 /1_� AJ /7- Ll'
LIJ
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0 Z
IENGINEERI G M
ZIP TELEPHONE NUMBER E 71? � ,
STATE LICENSE NUMBER EXPIRATION DATE
!VA�R�IANCE �Cu
ADB #
SHORELINE #
Legal Description of Property - include all easements
00(:) G- o It F. T- *7?
SEPA REVIEW
COMPLETE EXEMPT
EXP )<
I
SIGN AREA
ALLOWED I PROPOSED
I_
HEIGHT
ALLOWED PROPOSED
Fr -
LOT COVERAGE
ALLOWED � PROPOSED
REQUIRED SETBACKS (FT.)
FRONT SIDE REAR
PROPOSED SETBACKS (Fr.)
FRONT UR SIDE REAR
Property
Tax Ac nt
P. el CZU J1.1-'jq 0 00.
rc
LOT
MG,7EVIEW
,4
1-7 7W
NEW R RESIDENTIAL PLUMBINGfMECH
tri COMPLIANCE OR
DDITION COMMERCIA'L CHANGE OF USE
REMODE L APT. BLDG. SIGN
GSRAgDG FENCE
x
REPAIR CYDS. x -FT)
WOODSTOVE sw IM POOL
DEMOLISH 0 INSERT HOT TIJB/SPA
GARAGE RETAINING WALL/
CARPORT ROCKERY RENEWAL
REMARKS
"IWO
11HECKED BY
TYPE OF -CO STRUCTION
CO�Dh
OCCU
GROU
. W. )
SPECIAL INSPECT OR
REQUIRED
0 'YES
�R OFA ;�OCCUPANT
LOAD
4EMARKS
PROGRESS INSPECTIONS PER.UBC 108
. (TYPE OF USE. BUSINESS ]05ACTIV(T-Yj EXPLAIN:
X& t
$9k IL e1b /,i W 1�,Vjmj�bl L 1 1. C_ a
NUMBER
OF
STORIES
NUMBER OF
DWELLING
1 UNITS
CRITICAt,
A
IN 1 -113
-
JVDESCRIBE
WORK TO BE DONE JATTACH PLOT PLAN)
kflD420�
_i9r:.
FINAL iNSPE . =104 RE011ARED
�51 tJ4
---------
PLAN CHECK' FEE
-
FEE
IV, -- -_
BUILDING -
I I ngg
0-7
HEATSO RCE:' f
GLAZING'
PLUMBING
Plan Check No. M'-
MECHANICAL
This Permit covers work to be done on private property ONLT_
Any construction on the public domain (curbs, sidew,-Iks,
driveways, marquees, etc.) will require separate permission.
GRADING/FILL
3
STATE SURCHARGE
AS-0
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spou6�, WKS, assigqA�,BnO,,�
successors in interest, agrees to indemnify,f de -fend and hol!t_`
harmless the City of Edmonds, Washington, its officials
employees, and agents from any and all claims for damage's a-,
whatever nature, arising directly.or indirectly from the issudricq-
of this permit. Issuance of this permit shall not be detimeb.16
modify, waive or reduce a�y*rdquirement of any city ordinance.,,
ENG. INSPECTION FEE
PLAN CHECK DEPOSIT
0
3:
nor limit in any way the City's atillity to enforce any ordinainde
provision."
TOTAL AMOUNT DUE
I
know"
I hereby acknowledge that I have read this application; that the
I hereby ac
ATTENTION
APPLICATION APPROVAL
information given is correct; and that I am the owner, or the duly
i nL a on Ivan I!
1 r m " g
'i g t
authorized agent of the owner. I agree to comply with city and
au ho zed a an 0'
0
state laws regulating construction; and in doing the work authoriz-
state I aws reg ulat in
THIS PERMIT
AUTHORIZES
This application is not a permit until
ed thereby, no person will be employed in violation of the Labor
ed I he reby , no p erS
ONLY THE
signed by the Build i ng Official or his/her
Code of the State of,W'ashington relating to Workmen's Compensa-
de 0 he a of
Co it St t
WORK NOTED
Deputy; and fees are paid, and receipt is
I
tion lnsurancea�'61`ICW_18..�,,
'Cl
acknowledged in space provided.
IGNATU Z POF�IAGEPTI DATE IGNE
RE QW.
ell
; OF "
:
I NSPECTION
DEPARTMENT
CITY OF
OFFICIA S IGNAT RE D4TE
11"y/
EDMONDS
CALL FOR
�El_e,'SED P- DAIE
ATTENTION
INSPECTION
afif
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220
t I — . I .
File YELLOW inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
—
SECTION 109
"NPINK — Owner GOLD Assessor