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19213 OLYMPIC
VIEW DR
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ADDRESS: f �.
TAX ACCOUNT/PARCEL NUMBER: _I �J 7 C)Cj
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS
DISCRETIONARY PERMIT
DRAINAGE PLAN DATED:
C:?I� DETERMINATION: ❑ Conditional Waiver ❑ Study Required IwWaiver
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PLANNING DATA CHECKLIST DX
SCALED PLOT PLAN DA
SEWER LID FEE $:
LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED: S jZ ! lCJ ()
SIDE SEWER PERMIT(S) #: `
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DATED:
OTHER:
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LATENINDSTsTorms\Street File Checklist.doc
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City of Edmonds'
Critical Areas Checklist
The Critical Areas Checklist contained on
this form is to be filled out by any person
preparing a Development Permit
Application for the City of Edmonds prior
to his/her submittal of a development
permit to the City.
The purpose of the Checklist is to enable
City staff to determine whether any
potential Critical Areas are or may be
present on the subject property. The
information needed to complete the
Checklist should be easily available from
observations of the site or data available at
City Hall (Critical Areas inventories, maps,
or soil surveys).
An applicant, or his/her representative,
must fill out the checklist, sign and date it,
and submit it to the City. The City will
review the checklist, make a precursory site
visit, and make a determination of the
subsequent steps necessary to complete a
development permit application.
With a signed copy of this form, the
applicant should also submit a vicinity map
or plot plan for individual lots of the parcel
with enough detail that City staff can find
and identify the subject parcel(s). 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 Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant:
Name
Street Address
City, State, ZIP Gr? 2_ e-
�=� 1 k— w
Signature Date
Applicant Representative:
Name
Street Address
City, State, ZIP Phone
Signature
Date
ILE NO. C[ 3 "Zk
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: jgV?i \)lP.LX_) N l u,�2
2. Property Tax Account Number: 4 34 (,-- vczA-0C6 3 - C)q O(
3. Approximate Site Size (acres or square feet): q DLt)
4. Is this site currently developed? k yes; no.
If yes; how is site developed? hC)(ASL)-
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
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Rolling: slopes on site generally less than 15% (a vertical rise of 10-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 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: -k ; Approx. Depth:
7. Site contains areas of seasonal standing water: N A ; Approx. Depth:
What season(s) of the year?
8. Site is Jn the floodway TA f - floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds_ surface? Flows are year-
round? N )� 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:
4 :: Critical Areas inventory or C.A: map indicatzs Critical Area on site? 4r -05 .6�1
5': Site'within designated earth subsidence landslide hazard area'? ,l/6
6. .;:::.Site designated :on the Environmentally Sensitive Areas Map? �-12
DETERMINATION
STUDY REQUIRED
AIVER
Reviewed by:
Planne
CONDITIONAL WAIVER
ate
Rev 09a9/93
•
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.PLANNING DATA
LOT COVERAGE:
Required: T��',-I�T Actual:
BUILDING HEIGHT: 2, i 1 \
Maximum Allowed: % ► ctual Height:
SUBDIVISION:__KIM—
CRITICAL AREAS #: % f'l� 'mil.% /� "� 1PU l l�JJ
EPA DETERMINATION: /V
S
OTHER:
Plan Review By:
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STREET FILE
R-120'-0"
I N •, i
-----_------- - --------------------
100,
EXIST -0"40'-0° 12'
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RESIDENCE
(1186 SF LEV 1)
(995 SF BSMT)CD
UJ CD
c I EXTERIOR i '- �" / % - -------------------- - 00
I00
I DECK 750 SF ' :! /i PAVED I
FL(EXIST) ;; /. WALKWAY
;/ AND STEP
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............... & D
+91.2'----- ----------- +100 I
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R- 120'-0"
~� PLOT PLAN (NO CHANGES)
` SCALE:1 " = 20'-0"
NO CHANGE TO LOT COVERAGE, BUILDING
HEIGHT OR BUILDING FOOTPRINT
DRIVEWAY
(EXIST)
EASEMENT ACCESS
RECEIVED
MAR - 6 2
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
PROJECT
LOCATION
LEGAL DESCRIPTION
VICINITYRIIAP
PROPERTY ADDRESS: 19213 OLYMPIC VIEW DR SW 98020 PARCEL # 00434600008304
PROPERTY OWNERS: KARIANNA TVEIDT & DONALD J WILSON
LEGAL DESCRIPTION:
THE WEST 120 FEET OF THE SOUTH 52 FEET OF TRACT 83, AND WEST 120 FEET OF NORTH 28
FEET OF TRACT 84, EDMONDS SEA VIEW TRACTS, ACCORDING TO THE PLAT THEREOF
RECORDED IN VOLUME 3 OF PLATS, PAGE 76, INCLUSIVE IN SNOHOMISH CO WASHINGTON.
PROJECT DESCRIPTION
PARTIAL INTERIOR REMODEL OF AN EXISTING SINGLE FAMILY RESIDENCE, PARTIAL
CONVERSION OF EXISTING ATTACHED GARAGE TO MASTER BEDROOM (HEATED SPACE).
PROPERTY INFORMATION
LOT AREA- 9600 SF BUILDING FOOTPRINT -1895 SF (NO CHANGE)
PRESENT USE - SINGLE FAMILY RESIDENITAL LOT COVERAGE - NO CHANGE
ZONING - RS-12
HEATED FLOOR AREA
EXISTING - 2181 SF
NEW - 200 SF (CONVERTED GARAGE)
TOTAL -2381SF
BUILDING CODE
DESIGN PROFESSIONALS ASSUME NO CLAIM THAT BUILDING IS OR WAS IN
CONFORMANCE WITH CURRENT BUILDING CODE AT THE TIME OF
CONSTRUCTION.
ALL WORK TO BE MODIFIED OR ADJUSTED SHALL BE IN COMPLIANCE
WITH THE LATEST LOCAL CODES AND ORDINANCES INCLUDING BUT NOT
LIMITED TO THE FOLLOWING:
INTERNATIONAL BUILDING CODE (2003) UNIFORM PLUMBING CODE (UPC)
INTERNATIONAL RESIDENTIAL CODE (2003) WASH STATE ENERGY CODE
NATIONAL ELECTRICAL CODE (NEC) WASH STATE VENTILATION CODE
UNIFORM- MECHANICAL CODE (UMC)
DRAWING INDEX
C1 COVER SHEET/SITE PLAN
Al PROPOSED MAIN LVL PLAN / SCHEDULES
A2 EXISTING PLANS (MAIN LEVEL & BASEMENT)
AS PARTIAL ELEVATIONS/i'YP. WALL SECTIONS
LEWIS + SMITH
2265 N. 56t SL T 206 985 9411
Seale, INA F 'M 05 9412
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PERMIT SET
3-2.06 , Wison he
REVISIONS DATE\
SITEPLAN
GENERAL NOTES
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CITY EDMdNbS-:"
CIVIC' EN ER, SEWER.. -DEP,ARTMENV:,,
is ready Or. Inspection.W:(No
SIDE,� SEWER ':.'
de
.1 ADDRESS ....................... I .......
1921W
7
.':OWIVER: ..............
........ ......................
OR,
....
h-ssU)n,,(N,;gran 24,
.Peri t'�d •............... days, r.:_,2"
II&Iiy.SDWersinaccordance ,H'lth ipp,cation owe and'governlngordinanes.
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ATTENTIONJS CALLED TO FOLLOWING:'NG`- C.
I No 1-The :ov�ners6f. the. -property may,; obtain a -permit to construct sem;�rinside ,prbperty line. A: 116ensed�`Side'_Sewer 'Contractor_ :must
. I I . .1 , :�. , j
-'to construct, side -sewer An. street ,'area. ,jDo1;not- coyer?any!porti6fi7Of'sewer, before It: has, been:Anspected.
be 6mpl6y6d.
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_�NO..2—O.Ptainn. full information.. regarding. Ordinance'ALM03O.'and: liegulatlonsj�govern ng,, s e.sewersWhen,you get permit
_NOTE No.: 3—.Top of, side sewer. must have-Aat. least30Anches.,coyerage,,-a:t. property jIlnei and,;712 inches inside prop6rty� line; ..znInimum ',grado el"'f-2
N 6ends I �ade'shi'than %*ill,lbitted. 0; Grper.we perm4
NOTE 'Iiw-*4 ':Trenches,,In street j M..t-:6O' w�ter.,settledi'andt-su of streeV. restored., .6 ,original , conditionC ontractors shall %be responsible :for
!-failure, due, to: iinproper',work- which!may, develop!,wlthln one year of completlon.`
a
:N ' OTE No; 5—ItAs unlawfulto,,,!adter;Lor.,d6..any. other.4ork;thw6�i. p*rdvleiled.4or in the-. permM,,or�to do',any worli.. on the main, sewer*,,br,'its ' a ur-
tenances, except to. Insert,.Ahe pipe Into the, Wye...
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~� ity of Edmond*
�90 19.y-
Z5 L n]kfdH�!b1r-WAY .CONSTRUCTION
PERMIT Permit Number:
Issue Date: '�!� % 1 • .
A. Address or Vicinity of Construction: 19213 Olympic —View Drive
B. Type of Work (be specific): Tnstal l New Service
C. Contractor: Washington Nat'l Gas Co.
Mailing Address: 815 Mercer St. Seattle Wn
State License #:
D. Building Permit #.(if applicable):
E. ❑ Commercial ❑'`Subdivision
❑ Multi -Family ❑ Single Family
INSPECTOR:
F. Pavement or,Concrete'Cut : laGYea RNo
Contact: Frank Swan
Phone:
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
❑ City Project XgJtility (PUD, GTE, WNG, CABLE, WATER)
Other
INSPECTOR:y,t�lt�c.v4�
G. Size of Cut: 0 1 2 x 4@ Wtr. H. Charge $
APPLICANT TO READ AND -SIGN }} '
INDEMNITY. Applicant, understands and by his signature to this application, agrees t the City of Edmonds&armles;MinjulFC damages, or
claims of any kind or description whatsoever, foreseen or unforeen, that may be made against th C' of Edmonds, or any of its departments or employ-
ees, including or not limited to the defense of any legal proceedings including defenseleosts; aopt((orney fees by reason of granting this permit?
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING ,T'HE FINAL INSPEC77ON
AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HZ13)JA74 THE FINAL STREET PATCIf-IS C64LE7ED BY
CITY FORCES, AT WHICH 77ME 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 Department -
Work is to be inspected during.progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean ati ah times. t -� ,/ ,-fA
Traffic Control and Public Safety.shall be in accordance with City regulations as required by the City'••Engine@r.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS. ,
1 have read the d'bove statements and understand the permit i'requirements and the pink copy of the permit will be available
,"on site-arall. times for inspection purposes.,w�
Signature:' 1 Date: January 15, 1993
-(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
PRIOR TO PERMIT ISSU
Engrg. Div. 1991
• � n
FIELD INSPECTION AS Route copy to Street Dept.)
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION, ❑ YES ❑ NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. h
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A�*�Fr�apyCortpory
Addendum to City of Edmonds
Right of Way
Permit Application
by: RIc NAP.,D h ►" AQr - -
Engineering Aide
Washington Natural Gas
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