19200 93RD PL W.PDFiiiiiiii lill
9064
19200 93RD PL W
-fr? C. 18 0)
July 27, 1998
Mike Thorsen
19200 93d Place 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 e Wastewater Treatment Plant
Subject: Determination regarding Critical Areas Checklist # 98-189
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 CHECKLIS OR CRITICAL AREAS STUDY,
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
mo, You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL _4111111
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.
Thank you.
Sharla Graham
Acting Planning Secretary
Enc: Critical Areas Determination
* Architectural Design Board
C:ReceptionUana\CRLTR.doc
* Incorporated August 11, 1890 9
Sister Cities International — Hekinan, Japan
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ITI-PIRR W-1-3 �AG , 9 111998
PLANNING DATA
NAME: __qon��V.
SITE ADDRESS:— /?"0() - � 4�_DATE:
ZONING: PLAN CHK#: .10- 2 7j
PROJECT DESCRIPTION: j co ,� -
CORNER LO (Yes/No) F AG LOT 1119 . (Yes/No)
-�l . t
SETBACKS:
Required Setbacks:
Front: S,5 Left Side: Right Side: Rear:
Actual Setbacks:
Front: :3 1 Left Side: Right Side: Rear:
Street map checked for additional setback required? ___ - .(Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED (Y/N)
LOT COVERAGE: Z_
Maximum Allowed: —Actual:
B . UILDING HEIGHT: Zo,
Maximum Allowed: ; Ito Actual Height:
Datum Point: A14-OL Datum Elevation: 16o
A.D.U. CREATED?: /yt)
SUBDIVISION:
/1(7-
.CRITICAL AREAS #: VO
SEPA DETERMINATION: r d-r:
_I. 2
LOT AREA: — /
OTHER:
Plan Review By:
cAfi1cskpeffniAAp1andaLdoc
City of Edmonds
CRITICAL AREAS CHEC
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).
IT COUNTH*t
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).
Owner/Applicant:
/" 7-7—c 1-,eo,�I- 5e ii
Name
. / 9 Z— 0 c-) 9 3 e-�
Street Address
1/117 6 17-f 'AS &1,),4
City State Zip
('-�z ) —� -?
Telephone
Signature
Date
c:recepflon\jana\cac1.doc
Applicant Representative:
Name
Street Address
City State Zip
Telephone
Signature
Date
(over)
CA FILE N96
Critical Areas Checklist
--------------------------------------------------------------
Site Information (soils/topography/hydrology/vegetation)
I . Site Address/Location: 19 ZOO 1__73
2. Property Tax Account Number: -3-7/1 000 ent:::) 0_3
3. Approximate Site Size (acres or square feet): /Z14'0C') !s;:Q,
4. Is this site currently developed? 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 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 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: /�_Jo Approx. Depth:
What season(s) of the year?
8. Site is in the floodway IV& floodplain_ IV of a water course,
L
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? "C' Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc) �� 5
11. Obvious wetland is present on site-, AZO
: �� . ... .... 1_32�J
-------------- � ----- ��For:City:Staff,:Use:Only ---------------
4 Site is Zoned?. P'6 — I I-
SCS L&-zX
mapped.spil ty
v
:3. e an n entory or C.A. map indicates wetland present on site?
Critical Areas. inventory. or.C.A.map indicates Critical Area. on slteZ. -"'oe' . F2
:5: Site within -designated earth. subsidence landsJidehazard..area? N,,
:61''... Sit�.d��signatc.d.on.,the,EnvironiDentally...SensitiveArea$�,M4 ..............
p ... .... ...
DtTgkMINATION
^ca_chk.doc� Rev 10/03/97
CITY OF EDMONDS
DEPARTMENT OF PUBLIC WORKS
250 Fifth Avenue North, Edmonds, Washington
APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT
(Submit 3 Copies)
Permit to be issued to: ........... MIKE --- TH.OR.SEN
For installation at: (street address) ....... __ ....................................
Addition or Subdivision .... ...... AQM_1.RA1J_y_.V1 EW
- -------------- I ----------------- ................... ................ Lot ------- I ....... Block ................
Type of Building: New .... k .... Existing. ........ ... Single family residence ..... X ....... Number of* bedrooms ........ ..........
Other: (specify type or use) .......................... ......... ------- ___ ------ .............................. _ .....................................................
Builder................................................... .................................... Address ............................................................. .......................
Designer.RE_J.D_j_..M I.D.D LE_TO_N__&_.ASS_OC_I_AT.E.$.9 ---- 1.NQ_9 .... Address.- ...... ED.M.0-N-DS ........................... ........
Soil Log Hole No. l.. ..... 0.1.1-6.'_'...S.AND .. &_.GR_A_V_EL_..(.F.tLL),. 611-46.", DARK QRN. S I LTY SAND W I TH
..... ..... ...... ..............
TRACE OF GRAVEL. 46"-5011 GRAY SAND & CLAY
--------------------------------------------------------------------------------------------------------------- .............................................. ...........................................
Soil Log Hole No. 2 ....... 0"�n_121__SAXD ... & ... GRA.V.E.L,.-.(F-I.LJ..),..-12"-40'I DARK BRN. SILTY SAND WITH
............ I .................. ..................................
... TRACE ... Of ---- GRAV E L,.. --G.R.A.y .. ... S.O. ME ... C.L.A.Y ........................................... ................................
Elevation of Water Table, if encountered. (Distance from ground surface) ......................................................................
Corrections to control surface water if needed... ... ..GRAD.E ... AREA ... T.0 .. yt�:EI�R ... W.E.S.T ....................
......... A!�kQ ... NpfKIH ... T.0 ... E.XJ_.S.TJ.N G ... RO.AD ... CU.LV-E-R.T.o ........................................ .............. ............................... ......................
. .. .... .... .... .... .... . .. . .
Specify if any removing or grading of topsoil in field area ............................................................................... .....................
....................
Percolation:
Test Hole No. I —Average Rate ..... _9,2 ....................... ... (Fall in inintites/inch-bottom 6" test hole)
Test Hole No. 2—Averige Rate ....... ajk6 ......................................... (Fall in iiiinutes/inch-bottom 6" test hole)
Test Hole No. 3 —Average Rate ....... Tt5 .................. .......... ....... (Fall in minutes/inch-bottoni 6" test hole)
Average percolation rate on which to base drain field design .... 8.4 Date Taken 10/29/64..
Septic tank requirements based on present rules and regulations:
Septic Tank Size ......... 1.2.0.00 gallons.
P.......... '
Amount of Square Fee of; 4,is o/saleld. 21 SQ. FT.
— De ign
Signature si n .... Date ....... 1.Q/N*/64 ........................
DO NOT WRITE BELOW S LINE (To be completed by �/Ss I Agency)
Permit Number ----- 1_F1 .........................
Permit issued (date) .................. /0 ... 7 ... Q7 P.
Remarks: ....................... .................... ........................................ .................... ............................... ....................................
............................................................................. ............................ ........ ............................................... 1 .................................
I ' *4 '
J
SEWAGE DISPOSAL PERMIT
Septic Tank ........... /.0'jQ.Q.__.gals. No . ...... /. ............
CITY OF EDMONDS
Disp. Field ............. 44. _sq. ft. Department of Public Works
Other. ------------------------------------------------- FILE
14 1/ t: I
".110 - -..-: ---- s�/ -------- ----------------------------------------------------- As hereby authorized to install/
Name ------- ------------ Tl'�1�1�� repair sewag disposal system at
------------ ............... & ------
------------------
-------- ----------------- . .......................
....... .............
Date issued on--. .............
Permit expires one year from date of issu e
DO NOT COVER BEFORE APPROVED BY DESIGNER OR SANITARIAN
I hereby certify this system was installed under my supervision and control and complies with all provisions of the City
of Edmonds Resolutioris.
Signatureof Installer ---------------------------------------------------------------------------- Date ..................................
Approved[J Disapproved Date ---------------------------------------- -----------_----------- By ----------------------------------- ----------------------------------------------
Remarks: ------------------------------------------------------------------------------------------------ ----------------------------------------
SANITARIANOR DESIGNER ------------------------------------------------------------------------------------------------ Date ------------------------ ----------------------------------
This permit shall be posted in a reasonably conspicuous place on the job until inspection has been completed.
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324 Main St. PR B-1171
EINVIONDS, WASHINGTON
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EDMONDS, WASHINGTON
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MONDS, WASHINGTON
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CA FILE N96
Critical Areas Checklist
--------------------------------------------------------------
Site Information (soils/topography/hydrology/vegetation)
1 . Site Address/Location: L2 zoo q 3 /Ix
2. Property Tax Account Number: 3-711 000 c,-nl 0_�3
3. Approximate Site Size (acres or square feet): 1Z-:;r0c:) Z,/,
4. Is this site currently developed? yes; no.
If yes; how is site developed? e�f K /5- CITY COPY
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 10-feet over a AUG 17 IS98
horizontal distance of 66-feet).
Hilly: slopes present on site -df -more than 15 % and less than 3 0% ( a vertical flKe df
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: "C) Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway ' IV& floodplain 14-
of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? /kl/cl Flows are seasonal? . Al(,; (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc) �Z�/ 5
11. Obvious wetland is present on site, a-42
-------------------------------------- ------------------- For City Staff Use Only ---- ------------------------------
4. Site is Zoned?
mgppe0.sqil.ty L,
pe(s)? ..... .
Weiland inventory.or C.A.map. indicatesmetland present. on sitO Nll�
4..'. Critical Areas inventory or.C.A. map. indicates.Critical Area.on.siteZ. sf-oe,� L�/ e 14�,�
5. 'Site earth. subsidence. landslide hazard..area? Nr,
. . ...... .. . ... ..... .
Site designated on the.Environmental�y Sensitive Areas..Map?
DETERMINATION
^ca_chk.doc; Rev 10/03/97
City of Edmonds RECF-iVEC
CRITICAL AREAS CHECKL
I§ X1T COUNTEH.
The Critical Areas Checklist contained on this fon-n 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
Test of my knowledge (fill out the appropriate column below).
Owner/Applicant: Applicant Representative:
/1)1�7 ---7-��la /- 5e Ai
Name
Street Address
ze 1/117 6 9
city State Zip
0 <-
Telephone
Signature
Date
c:recepfion\janakcac1.doc
Name
Street Address
city State Zip
Telephone
Signature
Date
(over)
APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT
-,F-..ET FILE NEW CONSI`j�.UgTION REPAIRS
.................... ..... .............
OWNER ...... .......... . ?�
ADDRESS........... ?L. .............. .. . .........
EASEMENT No . ..........................................
........ PER Z
CONTRLTOR ......... ....... ...... MIT No.(�
LEGAL DESCRIPTION: LOT No . ........ .................................. BLOCK No . ............................................
NAME OF ADDITION ........... ( ................. .........................................
........ . .....
. . . ............. .
Approved:
DATE ............... By
A P P
Nov 3 Igg-7
CITY OF EDMONDS
CIVIC CENTER — WATER -SEWER DEPARTMMNT Call PROSPect 6-1107 when
work
is ready for inspection. (No inspec- 1h To
SIDE SEWER PERMIT tions Saturday, Sunday or holidays.) 2 05 12
ADDRESS__ 9316 192nd Street S.W.
OWNER...
.................................... ........... CONTRACTOR ------
Per"ssion is granted ......... Ngty!� 3. !Pp.i.c.Viel� ............. ............................
... ------ 19-!�T, for ------------------------ days to REPAIR or CONNECT a side sewer
'I City Sewers in accordance With apPlication on file and governing
-it,
ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No- I —The owners of the Property may obtain a permit to construct sewer
be employed to con truct side sewer in street area. Do not cover any portion of sewer before It has been inspected.
s inside Property line. A licensed Side Sewer Contractor must
NOTE No. 2—Obtain full information regarding ordinance 11-16.030 a
NOTE No. 3— -nd Regulations governing side sewers when You get permit.
Top of side sewer t have at least 30 inches coverage at Property line and 12 inches inside property line; minimum grade of 2%.
No bends in grade Thl'arper than % will be Permitted.
.NOTE No. 4—Trenches in street must be water settled and surface f street restored to original condition. Contractors shall be responsible for
failure due to improper work which may develop w 0
NOTE No. ithin one year of completion.
5--lt 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,
ev
F1
8-THEET FILE
'2'
CITY OF EDMONDS
250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771-3202
COMMUNITY SERVICES:
Public Works e Planning e Parks and Recreation e Engineering
1 (9 9 0 - 199 -
October 28, 1991
Mr. and Mrs. Michael 0. Thorsen
9316 192nd Street Southwest
Edmonds, WA 98020
RE: Address Change
LARRY S. NALIGHTEN
MAYOR
PETER E. HAHN
DIRECTOR
Thank you for your decision in changing the address of your current
residence. In determining the new address I have contacted the City
Building Official and the City Fire Inspector; we have all concurred
that the new address is more consistant and logical with the
neighborhood:
THE NEW ADDRESS IS: 19200 93rd Place West EFFECTIVE IMMEDIATELY
The City will notify all applicable City Departments of this address
change. It will be your responsibility to notify all others, including
the Post Office. Please note the Post Office guarantees delivery on
old address of up to one year.
Thank you,
Sharon Nolan
Permit Coordinator
cc Fire & Police
Street Files
Address Files
Public Works
Utility Bil.ling
0 Incorporated August 11, 1890 *
Sister Cities International — Hekinan, Japan
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CITY OF EDMO NDS": -
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
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NAME
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Legal Description of Property - include all qasements
(show belor orAt�tgh two cop(e!s(,,
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Tax Account Parcel No. 37/1 -coo -6()l -0003
roll
NEW RESIDENTIAL PLUMBING
ADDIALTER COMMERCIAL MECHANICAL
REPAIR APT. BLDG. El SIGN
EXCAVATE, FILL FENCE
'DEMOLISH OR GRADE I— X —FT)
CARPORT El swim
REMODEL GARAGE POOL
WOOD STOVE I RETAINING WALL/
INSERT ROCKERY- RENEWAL_
(TYPE OF USE, BUSINESS OR ACTI ITY) EXPLAIN:
NUMBER.% NUMBEROF
DWELLING
UNITS
NATURE OF WORK TO BE DONE (A7ACH PLOTPLAN)
WL LA 6W 60 V 5 (2
CW (64 cover< r, C--
USE
ZONE 0
N
I 'PERMIT
NUMBER
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JOB
ADDRESS
........ .... .. ...
.....
SUITE/A�T #
-EGAL DESCRIPTION CHECKI
SUBDIVISION NO.
LID NO,
TESCP
PIUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
APPROVED BY
EXISTING — REQUIRED DEDICATION
PROPOSED
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED C3
STREET USE PERMIT REQUIRED [3
SEE ENGINEERING MEMO DATED REVIEW BY
METER SIZE IBUILDING SUPPLY SIZE IFIXTURE UNITS
REMARKS
SIGN AREA
ENV. REVIEW
ADB NO.
ALLOWED
PROPOSED
COMPLETE
EXEMPT
SHORELINE#
VARIANCE OR CU
PLANNI�013 REVIEW BY
ID TE
SETBACKS - F7ET
HEIGHT LOT
COVERAGE
FRONT 4-15- SIDE dl
REAR Z,&41
A�- /
old
CHECKED BY
TYPE OF CONSTRUCTION
;OD
HEIGHT
I at-, 'I)
I' �e
as
SPECIAL INSPECTOR
AREA
OCCUPANCY
OCCUPANT
REQUIRED
GROUP X� -
LOAD
0 YES
REMARKS
PROGRESS INSPECTIONS PER
UBC 305
FINAL INSPECTION REQUIRED
PLAN CHECK FEE 1/a 06
BUILDING
PLUMBING
Plan Check No. 1�/77
MECHANICAL
This Permit covers work to be done on private property ONL
GRADING/FILL
Any construction on the public domain (curbs, sidewilks,
STATE SURCHARGE
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
harmless the City of Edmonds, Washington, its officials,
2 employees, and agents from any and all claims for damages of
cr
<
whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of. this shall not be deemed
PLAN CHECK DEPOSIT
M, rV7�
permit to
/Od-
01
modify,.waive or reduce any requirement of any city ordinance
x
nor limit in any way the City's ability to enforce any ordinance
provision."
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the
Iformation given Is correct; and that I am the owner, or the duly
ATTENTION AP�LICATION APPROVAL,
authorized agent of the owner. I agree to comply with city and
�application
state laws regulating construction; and In doing the work authoriz-
THIS PERMIT This is not a permit until
AUTHORIZES
ed thereby, no person'Will be employed in. violatiOD70f the Labor
ONLY THE signed by the Building Official or his
Code of the State of Washington relating to Workii"eini's Compensa-
WORK NOTED Deputy; and fees are paid, and receipt is
tion Insurance.
acknowledged in space provi
INSPECTION ded.
SIGNATURE, (OWNER OR
AGENT) DATE S NEI)q
DEPARTMENT
CITY OF Off'I jA NATU DATE
EDMONDS
ATTENTION
CALL FOR ED BY
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
771-3202
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
PINK — Owner GOLD — Assessor
102-87
0
Fr
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USE PERMIT
CITY OF EDMONDS ZONE NUMBER
CONSTRUCTION PERMIT APPLICATION jos _�l SUITE/APT #
ADDRESS joqZ )O.q-5r
OWNER NANXE/NAME OF BUSINESS
LEGAL DESCRIPTION CHECKI SUBDIVISION'No. LID No.
AIA I K IEF-- __l C) L S �= �-J- - - - ) I ,
MAILING ADDRESS V /,A
Z
I C:� Z ( -) (--) li�: C) Y PER OFFICIAL STREET MAP. TESCP Approved 13-1
0 % q - PUBLIC RIGHT OF WA
TELEPHONE NUMBER RW Permit Required iv-, 1)
CITY ZIP EXISTING _===::::_�RE0UIRED DEDICATION - Street Use Permit Req'df`�Ll:)
EFC> 0`IJtt_-05 -1 qt, 0 *Zf') 21L Inspection Requiredk/E_5 U-
NAME OSED Sidewalk Required 0
METER SIZE LINE SIZE ] NO. OF FIXTURES PRV REQUIRED
YES 0 NO 0
t_�-% t-A%f-
LOU ADDRESS
REMARKS
0 Lu
w
'5 CITY ZIP-_ ITELEPHONE NUMBER r) re! 0 V A (�J Z
a
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NAME —)4 s
cr ADDRESS
ENIINEERIN) MEMO g(ATED RMD BY
0
Wo-1 I Jvv�
zip TELEPHONE NUMBER
cc CITY REVIEWED BY
FIRE MEMO DATED
Z
0 S
L) STATE LICENSE NUMBER EXPIRATION DATE VA IAN DR cu ADB# SH0�RXjWE--__
Legal Description of Property - include all easements
SEPA REVIEW SIGN RE HEIGHT
COMPLETE I EXEMPT ALLOWED OSED ALLOWED jPROPOSE0_,
Z
EXP
U- V L) v,, E. C4 LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT.)
ALLOWED � PROPOSED FRONT SIDE REAR FRONT R E REAR
w 3 r:"% 21 0
a % - .,7X� > 1� /i, _3.1 _rz 2
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Property 5
Tax Account + gA E _��NIJ�G IEW a-
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Parcel No. -3 REMARKS
EINEW RESIDENTIAL' PLUMBING(MECH
M COMPUANCE OR
I � I ADDITION COMMERCIAL CHANGE OF USE
APT. BLDG.
EIREMODEL El SIGN CHECKED BY TYPE OF CONSTRUCTION COOt? PANT.
GRADING F-1 FENCE
REPAIR E] CYDS. x_ FT)
WOODSTOVE SWIM POOL SPECIACINSPECTOR OCCUPANT
DEMOLISH INSERT HOT TUB/SPA REQUIRED lye,* LOAD
13 YES 2227,
DQA*RAg RETAINING WALL/
CX REMARKS
ORT ROCKERY RENEWAL
PROGRESS INSPECTIONS PER UBC 108
0 (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
NUMBER CRITICAL
Lu NUMBER OF
0 OF DWELLING AREAS 0(
Co STORIES UNITS INUMBER
0
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
'Z_4 7 4 FINAL INSPECTION REOUIRED
VALUATION
PLAN CHECK FEE
BUILDING
HEAT SOURCE: G�AZINGJ
,.;:7. - L - ' 11 � 11.__..-,,,,,,�1 %
,4,_rZEt :> PLUMBING
Fan Check! No./ /7' MECHANICAL
PI
This Permit covers work to be done on private property ONLY. GRADINGIFILL
Any construction on the public domain (curbs, sidewplks,
driveways, marquees, etc.) will require separate permission. STATE SURCHARGE
Permit Application: 180 Days STORM DRAINAGE FEE
Permit Limit: I Year - Provided Work Is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE -3C-2
u) successors in interest, agrees to indemnity, defend and hold
harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance ;�71
PLAN CHECK DEPOSIT
of this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirement of any city ordinance
ox nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE
V.)i,
provision."
I hereby acknowledge that I have read this application; that the ATTENTION APPLICATION APPROVAL
information given is correct; and that I am the owner, or the duly
authorized agent of the owner. I agree to comply with city and THIS PERMIT This application is not.a permit until
state laws regulating construction; and in doing the work authoriz- AUTHORIZES
ed thereby, no person will be employed in violation of the Labor ONLY THE signed by the Building Official or his/her
WORK NOTED Deputy; and fees are paid, and receipt is
Code of the State of Washington relating to Workmen's Compensa-
tion Insurance aria RCW 18.27. INSPECTION acknowledged in space provided.
SI NATURE (OWr�tFt OR AGENT) DATE SIGNED DEPARTMENT
OF� Ufs.
CITY OF 116.,AIGNAT D#TE
EDMONDS
4LEA� B
CALL FOR
ATTENTION INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-0220 OKIGINAL — File YELLOW — Inspector L
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
S ECTION 109 PINK — Owner GOLD — Assessor
GENE�AL NOTES
Owner'
Mike ThorSen
19200 93"' Pl. W..
Fdmonds, WA 98020
4 '77(
25) �7088
(425)775-0163 FAX
Contact Person
Mike Thorsen
Connectoft
-Raftets..to beams: Hl'(Simpson)
oist rs: LU210
columns obeams: BC4.
Columns, o'decking: BC4 half base
Framing to. foundation: 2 - HD8A, SSIB16 anchorbolts
Nailing Schedule
Roof declOng, wall. sheathing and walking deck: .8d common, 6" edges, 12" field
Door'Schtiltile
One.2-8" x 6-8%. 13/87, solid core with self closer
Window
d in place.
..One W-0" X 1 '-.0" double panej stopPe
SCOPE OF.
AM a 13"ji. 241� garage 4djacent.to an existing attached garage.'. The roof of the prage is
to be a wal cing deck of glass reinforced. polyester resin over plywood to continue the
existing do -k surface. An I F x 17' section will be added to'the existing torch -down roof
ngi. eered to support a' future hot'tub (live load of 150 lbs./sq.ft.).
Floor/r6of.� Wits are e ' in
The existing garage andthe now garage are not heated. An asphalt driveway will
integrate with the.existing driveway.
A D44047Y
)ED IN L/W 6WE _-
0, I.C)g C 0, L/A/ T Y
V,
1�4p-j
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PAW
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...........
,V
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17-3
Rece,
JUL 0 7 1999
D'VELOP ENT SERV S CTR,
CjTyMEONF� SERVICE
EDMOND-SS CTR'
Nr