19130 OLYMPIC VIEW DR.PDF19130 OLYMPIC
VIEW DR
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BUILDING PERMIT (NEW STRUCTURE):
COVENANTS(RECORDED)FOR:
CRITICAL AREAS:. //�"/ /'
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:L
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORT PLAT FILE:
SIDE SEWER AS BUILT DATED: V
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR: j
WATER METER TAP CARD DATED: l
OTHER: ,) -3 q ,"IJ
DETERMINATION: ❑ Conditional Waiver ❑ Study Required kWaiver
LOT:
LID #:
BLOCK:
LATEMP\DSTs\Forms\Street File Checklist.doc
'Critical Areas'Checklist
Site Information (soils/topography/ hydrology/ vegetation
1. Site Address/Location:
CA File No: 0",;
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet): 0913' tXSd�
4. Is this site currently developed? kyes; no.
If yes; how is site developed? �tc5
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over. entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 104eet over a horizontal
distance of 66-feet). .
Hilly: slopes present on site of more tttan�J�°l0,., d 1gss,th 30% a vertical rise7-6f 10-feet
over a horizontal distance of 33 t�v■t1 �►Jt�C^i�t �y1$y ,y g(
• �Y •f! v� rt! � f�S ,: t::. � �:r� �`•. y(tam
Steep: grades of greater than 30% present on site (a vertical rise a
l�o
distance of less than 33-feet): ,
Other (please describe):
6. Site contains areas of year-round standing water: /y O ; Approx.. Depth:
7. Site contains areas of seasonal standing water: N 1 c7 ; Approx. Depth:
What season(s) of the year?
8. Site is in the floodway A10 floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
ti b 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: M6
For City Staff Use Only
1. Plan Check Number, if applicable? 0 3—.571
2. Site is Zoned?
3. SCS mapped soil type(s)? _AM.> Amy. I.ONN �b'�Lt , ;r'. Sc.o-Ver,
AL,6 wwp5 t4a !:� ert.ruc T 1 s V. 6 t-o V-4g s
4. Critical Areas inventory or C.A. map indicates Critical Area on site? h+yn .dry.!- 770 4.TV 'k K
5. Site within designated earth subsidence landslide hazard area? t�-o
DETERMINATION /
STUDY REQUIRED {^ WAIVER
Reviewed bv: lb • O r-A,C Date: i t L (7 4�'
Critical Areas Checklist.dod4.22.2003
r •
OF ED&O
W4C. 1890
•
City of Edmonds, ,..:-
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
•
Qate, Received:
City Receipt #:
Critical,Ares File.#: -iO3, C3q
Critical. -.Are . as Checklist. Fee: 135.00
Date Mailed! to.'Applicant: i Z V VA
The Critical Areas Checklist contained on this form is to A property. owner, 'or his/her authorized representative,
be filled out by any person preparing a Development must fill out the checklist; sign and date, it, : and submit it
Permit Application for the City of Edmonds prior to'......to the City. The City will review the checklist, make a
his/her submittal of the application to the City. precursory site visit, 'and make a !'deteintination of the
The purpose of the Checklist is to enable City staff to subsequent ateps necessary to complete a development
determine whether any potential Critical Areas are, or permit application.
may be, .present on the subject property. The information Please submit a. vicinity map, along with the signed copy
needed to complete the Checklist should be easily of this form to assist City 'staff in finding and locating the
s' to specific' piece of property; described on this_4form. In
1 as t p addition, the applicant shall include other pertinent
surveys . i rmation (e.g. site plan, topographyma etc. or
P. p )
APPUCAEON K
ELDi
� tudies in conjunction with this Checklist to assistant staff
completing their preliminary assessment:.of the site.
.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harmless from any and all- damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information furnished by the applicant, his/her/its agents or employees.
By my signature, I certify that the information and exhibits herewith submitted are .true and correct to the best of my
knowledge and that I am authorized to file this application on the.�elialf of the owner as listed below.
SIGNATURE OF APPLICA I`A—GENT�����(L \nI - I U`0�_ DATE
Property Owner's Auth-6flization
By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public o ials and the tall of the City of Edmonds to enter the subject property for the
purposes of inspection and posting atter4arto JW?JppAcation.
SIGNATURE OF OWNER /k UV'DATEIF
Owner/Applicant:
-�OAAJ "Mac,
Name
Street Address
L7�_da16
City State Zip
Telephone: 7 -7 19
Email address (optional):
'Applicant Representative:
Q=/Vl 13,rnc
Name "
Street Address
City State Zip
Telephone: ;)-o) b
Email Address (optional),
Critical Areas Check] ist.doc/4.22.2003
PLANNING DATA
NAME: A4,a.1 a S DATE: 7-40l
SITE ADDRESS: o7157 PLAN CHK#: 03- S$/
PROJECT DESCRIPTION: t2 cateck—
REDUCED SITE PLAN PROVIDED?: es / No
MAP PAGE: 3D� CORNER LOT: a No FLAG LO .Yes No
ZONING: CRITICAL AREAS DETERMINATION #: c,3_ y
❑ Studv Reauired:
UWL-Valver
❑ Conditional Waiver
SEPA DETERMINATION:
❑ Fee
❑ Checklist
❑ APO list w/ notarized form
❑ (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or lake Ballinger)
jpLYExempt
SETBACKS:
Required Setbacks: , f ,
Street::;� LLeft Side: 10 Right Side: Rear:
Actual Setbacks:
Street:_(f Left Side: 30 Right Side: Rear:
Street map checked for additional setback required? (Yes / No / DNA)
❑ DETACHED STRUCTURES:
❑ ROCKERIES:
❑ FENCES/TRELLISES:
❑ BAY WINDOWS / PROJECTING MODULATION:
STAIRS / DECKS: /
PARKING: Required: Actual: Nd fIA
LOT AREA: 30�� (J
LOT COVE
Calculations- 5-/
BUILDING HEIGHT: l v / '
Datum Point: atum Elevation:
Maximum Allowed: U Actual Height:
A.D.U. CREATED?: No / Yes r
SUBDIVISION:
LEGAL NONCONFORMING LAND USE DETERMINATION. ISSUED: Ye�/�o
OTHER:
Plan Review By:
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C. Contractor:
PERMIT
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Permit Number. � p• p
Issue Date: "Z O /
A. Address or Vicinity of Construction: 19130 Olympic -View Dr ( 9501243 )
B. Type of Work (be specific): Install New Service
Washington Natural Gas Company ',Contact- Frank Swan
Mailing Address: 815 Mercer Street, Seattle Phone: 224-2278
State License #: WA 98111 Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. ❑ Commercial ❑ Subdivision ❑ City Project [K] Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other
INSPECTOR: INSPECTOR: VJ c.-1`{'
F. Pavement or Concrete Cut : ' ❑ Yes 11No G. Size of Cut: 1-10 H. Charge $
APPLICANT TO READ AND GN
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INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City Iof Edmonds harmless rom ir4 Ties, 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 depar pnents or
employees, including or not limited to the defense of any legal proceedings including defense Coats, and attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS P",, PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES1WIL' I BE HELD UNTIL THE FIAk- dyRtET PATCH .
IS COMPLETED BY CITY FORCES, A T WHICH TIME A 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.
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 permit requirements and the pink copy of the permit will be
available on site at a es for ins ection purposes.
Signature: November 11, 1994
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
1 FOR CITY; USE ONLY.
APPROVED BY: RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFTER F"A iL. DAYSDISRUPTION FEE/FUND Ill: ,. p
SPECIAL CONDITIONS: N 0 A. !C � � RESTORATION FEE:
PERMIT FEE:
COMMENTS:
DATE:
TOTAL FEE:`J DO
RECEIPT FEE:
_.
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE .'t :.-
Eng. Div. 1994
FIELD INSPECTION NOTES
Comments
Diagram
CONTRACTOR CALLED FOR INSPECTION
Partial Work Inspection by P.W.:
Work Disapproved By:
FINAL APPROVAL BY:
(Fund 111 - Route copy to Street Dept.)
❑ YES
Date:
Date:
❑ NO
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Right o Way.
Permit Application
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CITY OF EDMONDS Permit No. �� 7
COMMUNITY'SERVICES DEPARTMENT - �: 9
RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date % L
A. • Owner: Rick / %, lye�C Y1 9, NIL B�• Contractor: ��� m✓�1C �
awe r�
N!`e 30 alvit' 6'c �/22!e��r, Na#'eC1, t�0
Mailing Addres Mailing Address
City State Zip Civ State Zip
7/400 / State License Number Telephone Number
C. • Address or Vicinity of Construction: .`, ' ` f
Type of Work to be Done:.. /
D. • Work in Connection With
'Single Family
' ❑ Commercial ❑ Multifamily ❑ Utility
❑ Sub
❑ City Projects
E. • Pavement Cut: ❑ Y x N F. • Size of Cut: X
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds
harmless from any injuries, damages, or claims of any kind or description whatsoever, forseen or unforseen, 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, court costs, and attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND . MATERIALS FOR A PERIOD OF ONE
YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF; THE WORK.
Estimated restoration fees will be held until the final street patch is completed by City forces, at which time a debit or credit will be
processed for issuance to the applicant.
• A 24 hour notice is required for inspection; Please call Engineering: 771-3202
• Work is to be inspected during progress and at completion.
• Restoration to be in accordance with City Code.
• Street to be kept clean at all times.
• Traffic Control to be in accordance with City regulations.
• All street -cut ditches must be patched with asphalt or City approved material prior to end of working day;
NO EXCEPTIONS.
I understand the above and that this permit must be available at the job site for inspection purposes at,all times.
Signature: Date:
61 Owner or CqKtractor
This Permit Must be Posted at the Job Site For Inspection Purposes
Call DIAL -A -DIG Prior to Beginning Work
APPROVED BY:
Time Authorized: Void after 3 D -days.c'
Special Conditions:
RELEASED BY:
PERMIT FEE:
Restoration Fee:
Receipt No.:
4.
.Fund 111 Fee:
Street'Cut Dimensions: x
Date �% INSPECTED BY
NO WORK TO BEGIN PRIOR TO PERMITISSUANCE
D -
_ Date
Frig . Div. March 198
FIELD INSPECTION NO S (Fund I I I - Route copy to Street Dept.)
Comments:
Diagram:
c�.
CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. July
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CITY OF EDMONDS
CIVIC CENTER • EDMONDS. WASHINGTON 98020 (206) 775-2525
COMMUNITY DEVELOPMENT DEPARTMENT
Douglass Herman
19130 Olympic View Dr
Edmonds, WA 98020
E
June 23rd, 1981
HARVE H. HARRISON
MAYOR
PERMIT #: 760531
JOB ADDRESS: 19130 Olympic View Dr
Building Division records show that you have a building permit
which has expired without a final inspection. Section 305 of
the Uniform Building Code, as adopted by the City, states "it
shall be the duty of the person doing the work authorizers by a
permit to notify the Building Official that such work is ready
for inspection".
Please contact the Building Division within 30 days, either to
schedule a final inspection or to renew your permit. After
this, expired building permits will be referred to the City
Attorney.
If there are any questions, contact the Edmonds Building
Division at 775-2525.
Harold Reeves
Building Official
HR/cn
STREET FILE
CITY of EDMONDS --- PUBLIC WORKS DEPARTMENT
Routing of Building Permit Applications
Proposed Property Address of Application: 19130 Olympic View Drive
DEPARTMENT
COMMENTS
DATE
WATER
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S T R E E T
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NOTES
BUILDING
DEPARTMENT COMMENTS
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B U I L D I N G D E P A R T M E N Applicant Fill
USE PERMIT
ZONE NUMBER 976
PERMIT APPLICATION inside Heavy Lines
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61d
LEGAL LOT
❑ YES ❑ NO
LOT EA
SUBDIVISION NO.
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TELEPHONE NUMBER
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PROPOSED YARDS
FRONT SIDE REAR
HEIGHT
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SIGN AREA SIGN
AREA
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REQUIREMENTS
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TELEPHONE NUMBER
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NAME
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ADDRESS
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Legal Description of Property (Show Below or Attach Four Copies)
STREET AND/OR UTILITY ❑ YES
C9 a 7U`7
WORK REQ'D ❑ NO
UNDERGROUND ❑ YES
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SEPTIC SYSTEM
APPVD BY CITY ENG. ❑ NO
NUMBER
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NEW L.i RESIDENTIAL ❑ GAS
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NON-RESIDENTIAL ❑ SIGN
❑ ADD ❑DEMOLISH ❑
RETAINING
WALL
ElALTER EXCAVATE FENCE
❑ OR FILL ❑ 1 X_PT9
• ❑ REPAIR PRE -MOVE SWIM
❑ INSP. ❑ POOL
FIRE ZONE
TYPE OF CONSTRUCTION CODE
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SPECIAL INSPECTOR AREA
REQUIRED
ElYES ❑ NO
OCCUPANCY
GROUP
OCCUPANT
LOAD
PLAN cHECKED.BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04,
REMARKS
NUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
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VALUATION
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BUILDING,
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- -
-11VISION WAN FO*R DUNCLOTHOMSON (AMENDED)
.Portion of Gov't Lot 3, Section 13,. Township 27 North, Range 3 East, W.M.,
described as: Beginning at'a point 30 feet west of the southeast corner
of said Gov't Lot 3; thence north 150 feet; thence west 240 feet; thence
south 150 feet; thence east 240 feet to the point of beginning.
Snohomish County, Washington.
Cherry Street
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tTEPET FILE
October 12, 1976
MEMO TO: HARRY PIFIITCUTT
BUILDING OFFICIAL
FROM: RICHARD H. ALLEN
ASSISTANT CITY ENGINEER
SUBJECT: BUILDING FERMIT FOR DESIGN HOhIES, INC. AT 19130 Olympic View
Drive - NO..760531
In reference to our memo of September 10, 1976,.and the subdivision re-
quirements of S-1=75, the builder is required to install a paved access
road to the:house. 1,1e inadvertently missed indicating the:requirement.
that a bond -be posted for this work.
Since the permit has.been issued, we will not require a bond at this'
time; however,.fin.al release of the building permit should be.he'ld.
until this requirement is.completed.
Please advise the Engineering Department at the appropriate time for.:
final. inspection.
CITY of EDMONDS ST RE
ENGINEERING. DEPARTMENT
505 BELL STREET .
EDMONDS, WASHINGTON 98020
APPLICATION FOR INVASION OF RIGHT-OF-WAY
(Submit In Duplicate)
Permit to be issued to:
For work at: (address or vicinity) e,,2,e—
Type of work to be done: l�, k2! U �ttj
(Attach Drawing When Applicable)
11�\ KemarKs
Owner: v-C. a2.jc� A 7
Name --
Mailing Address
,City _ ...State —Telephone Number ,
Contractor: F'lfC,�✓f /'—�J�11� ��
Name
Mailing Address
' City $fate ,.,', Telephone Number
Signature:
Ovvmer or ent,g
r. Date/Signed
i;
DO NOT WRITE. BELOW THIS LINE' (To be completed. by Issuing Agency)
Permit 10
Issued" (dais) �•' 6 7 •�� - V Permit.Number
Remarks: 'O
Upon of i!ti; r^r na, t', contractor is
;INEER'S APPROVAL DATE. r` !-0; jilaLcria!s.for
a;�,cticn. of .
the restoration byJthe Er,.i:.,ee
rino Dept.
CITY OP EDMONDS
ENGINEERING DEPARTMENT
Insp Date .... ..__.----By........ .__.....Remarks.....
InspDate... _ _ BY .......... Remarks ....... ...-_......_.._.._._..._........................._..................
Insp Date ....... -...... -By ........................Remar. ks.........
Insp Date ................. .By ................... ,.... eciar'.-s.--...-...-.....
F'.iTial ..._i, BY. —.—_...Remarks ..... _..._ ..:,...._ _...
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