19812 86TH PL W.PDF111111111111
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19812 86TH PL W
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS: DETERMINATION: E] Conditional Waiver El Study Required aiver
�w
DISCRETIONARY PERMIT XS:
DRAINAGE PLAN DA
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
rOERMITS (OTHER):— �7 2 b
PLANNING DATA CHECKLIST DA'
SCALED PLOT PLAN DATED: Ze
SEWER LID FEE S:
SHORT PLAT FILE:
/401
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S).#: /1-0- L7
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DA
OTHER-
LID
LOT: BLOCK:
LATEMP\DSrs\Fonns\Street File Checklist.doc
#P20
CA File No:. UA 40-Tt) A -ID
Critical Areas Checklist
Site Information (soils/ topography/ hydrology/vegetation)
1. Site Address/ Location: 1�j
2. Property TaxAccount Number: 09.6prl'2,000012,�OCO--)
3. Approximate Site Size (acres or square feet)-
4. Is this site currently developed? _k-y'es; — 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 nise' 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: W 0 Approx. Depth.
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway'' flood' fil' of ;�w . ateico'*u s�e.
p am. r ,
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) L--**'
1 1. Obvious wetland is present on site:
For City Staff Use Only
1. Plan Check Number, if applicable? i�SLO — tQ319
2. Site is Zoned?
3. SCS mapped soil type(s)? An, RX, --&p
4. Critical Areas inventory or C.A. map indicates Critical Area. on site?
5. Site within designated earth subsidence landslide hazard area? Mes
DETERMINATION
WIRED
WAIVER
Reviewed
Date:
Ile Critical Areas Checklist contained on forr� 'is to
be. filled out by any . person preparing a Development
Permit Appli cation for the City of Edmonds prior to
his/her submittal of the application to the City.
The purpose of the Checklist is to enable Cit . y 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).
'A� property owner, or his/her authorized 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. I
Pleas * e 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 assistant staff
in completing their preliminary assessment of the site.
Ile undersigned applicant, and his/her/its heirs, and assigns, 'in consideration on the processing of the application agrees
to release, indeirmify, deferid 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 finnished by the applicant, his/he�/its �gents or employees.
By my signature, I cer* that the information and exhibilt herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file this application on the behalf of the owner as listed below.
TV% -0
SIGNATURE OF . APPLICANTi6� V--,M1e7-rLQ RAP500 DA ID - '7
Property Owner's Authorization
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 officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and p2sting aVendant to this application.
�,IGNATURE OF OWNER
Owner/Applicant:
&Ce- PASgDAP,6iF� ' -
Name.
Street Address
V'D kt) !n 000
city State Zip
Telephone: 42,c7- 7-7t- -AZJ,
Applicant Representative:
Name
Street Address
City /State Zip
Telephone:
Email address (optional): - Email Address (optional):
0
TREET FILE J
PLANNING DATA Es
SINGLE FAMILY RESIDENTIAL
Name:
Date: ko h qlc)-q
t
Site Address: 2L - W
Plan Check ff: aoo7 - toa?
Project Description: 1/350 over- kA6rXf"\ C-ec"Cdd, necD
1/5 Z# ?,-t�, raj�.
Reduced Site Plan Provided:(9�/ NO)
Zoning: 91110ES — S
Map Page:
Corner Lot: (YES /0
Flag Lot: (YES 0D
Critical Areas Determination #: 'X07— 01YO
0 Study Required
14 waiver
SEPA Determination: 4�xe-", P-)c
Exempt
Needed (for over 500 cubic yards of grading)
El Fee 0 Checklist El APO List with notarized form
Required .. . cks
Street:
Side:(,,
Side:
Actual Setbacks
Street:(4
Side:�M)
Side: (15) 71101,
Rear: 64) 1.5 +
El Detached Structures: Noc.\e-
Rockeries: Nop- !S\nQkzc\-
Fences/Trellises: 140,\,—
Bay Windows/Projecting Modulatio�: ExiQA', C1\l4-V%C',4P-y Ahmz" 0,\
Stairs/Deck:
Height
Datum Point:
Datum Elevation: + too
Maximum Height Allowed: e�t,51
Actual Height: Q119to, (ual
Other
Parking Required:
Parking Provided:
Lot Area - 1�) 00 R. 25 "4
Maximum Lot Coverage: 35% Proposed:
Lot Coverage Calculations:
ADU Created: (YES
Subdivision: Ldr
Legal Nonconforming Land Use Determination Issued: (YES &
Comments
Plan Review>- Planning Data form 04-11-06.doc
IE
The City of Edmon IL
cra
5%
APPLICATION
for
SIDE SEWER PERYaT
OUTSIDE ta"" INSIDE C] REPAIRS El
CARDNo . ................. ...................
EASEMENT No - -------------- 41 . .......... I
........ ................. CONTRACTOR --- --- 1�0.P ---------- C<74:52-A,. 6q,%.. PERMIT No.
.................
STREET
HOUSE No - --------- z ...... . ........... ...... . A--=- ........... AVENUE LOT No.
......... .......................... BLOCK No . ...............................................
..................
NAME ADD. Z-1-R.- ........ . --
. .................. ......
....... ....
PC) VE- D
-, - - Al /w
,5 ;,= 1 jD� - '
Date
BACKFILL WORK '--- -lv.R ISSUED ................................... DEPOSIT, � .........
WORK ORDER ISSUhi� . ..............................
-4
Appro.ved:
...........................
DATE ........ .
................... ............
17
WATER-SE'WER DEPARTMENT Call PRosilect 6-1107 when worii
is reacty for Ins
11"tio.n. (No insp ee- 1.2 9
tions Saturday, Sunday or holidayu.)
MER PERMH
SPE SE
ADDRESS ...... 19812 86th A*venue West
........... ....... I .............. i ........ ....... * .......
............................. ............................... ......... .... * ----------
OWNER-...Betty ... Lippincott
........... ............... ........ ................................................ CONTRU Lynnwood -Construction Co.
CTOR ..............
Permission is grant,_-d ..9qtqber 7. 1965
-------------------- 19 ......... for
..... .......... days, to REPAIR or CONNECT a side se-xer
with City Sewers in accordan . ce with alPlication OP file alld -,overning orfflnances.
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 Sevver Contractor,must
be empioyed tc, construct side sewer in street area.. Do not cover an y portion of sewer b-efore It has been irspected.
)TE No. 2--Obtain full information regarding Ordinance 11.16.030
and Regulations governing side sewers whey' Y013 get permit.
7E No. 3—Top of side sewer must have at least 30 inches coverage at Property line and 12 inches inside property line;
No bends in grade sharper than 'A will be permitted. m;nimurn grade of 2%.
NOTE N*o. 4—Trerches in �treet must be water settled and surface of street re'stored to original condition. Contractors shall be responsible for
failure due to improper work wh�ch may develop within one year of completion.
'�E NO. 5--It is unlawful to alter or do any other work than is Provided for in
PUrtenances except to insert the Pipe late the wye. the Permit, or to do any work On the main sewer Or its ap-
STREET4V, ILE City of EdmonA
RIGHT-OF-WAY CONSTRUCTION
6? 9 0 . 1 9 9 -
PERMIT Permit Number: 1�� -C-�
Issue Date: 9- /7- ��
A. Address or Vicinity of Construction: - 19812 86 Place West
B. Type of Work (be specific):
C. Contractor: Washington Natural Gas Compan
Mailing Address: 815 Mercer Street,
State License #: Seattle, WA 98111
D. Building Permit # (if applicable):
Install New Service
Contact: Frank Swan
Phone: 224-2278
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
C
1W
E. E] Commercial El Subdivision El City Project Ff Utility (PUD, GTE, WNG, CABLE, WATER)
El Multi-Fan-ffly F� Single Family Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut : El Yes MNo G. Size of Cut: — x — H. Charge$
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees'to hold the monds hatwil mniui n?e ka n i a g e s, a r
claims of any kind or description whatsoever, foreseen or unforeen, that maybe made against the City off monds, or any of its departments or employ-
ees, inchiding or not limited to the defense of any legal proceedings including defense costs, and aitorneyfees by reason of granting this perinit. '
THE CONTRA CTOR IS RESPONSIBLE FOR WORKMANSHIP A ND MA TERIALS FO RIOD OF ONE YEAR FOLLO��G F NAL INSPEC77ON
A VPLETED BY
r TCHT
AND ACCEPTANCE OF THE WORK ES77MATED RESTORA 77ON FEES WILL � E.6 MX THE FINAL STREE7 I Z Y�
C17-Y 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 Departme
Work is to be inspected during progress and at completion.
Restoration' is to be in accordance with City Codes. 771-0220
Street shall be kept clean at all times. k-
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 all timesfor inspe, pofflrpnumose�, 1
Signature: -��M &AWA"� Date: August 7, 1992
(Contractor or Agent)
CALL DIA1,A-DIG PRIOR TO BEGINNING WORK
. ... ..... I ....... .. PERMrF
. .. ....... I —
....... .. ....
. .. . ......
:..�COMMENTS;..
DATE: ::....JSSUED
- /7- �
011 "M 1-14M.1 1110
Engrg. Div. 1991
FIELD INSPECTION NOTES (Fund I I I - Route copy to Street Dept.)
C'omments:-
I Diagram:
4
CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
r-ng. Lpay. Jul.,
Wtsh*ff)gtm
Naturid Ges"N'
Addend= to Citj of Edmonds
Right of Way
Permit Application
Submitted by:
Engineering Aide
Washington Natural Gas
622-6767 X2761
pager OLe,9- I(oSip
o Cu-r-<,
WNG
P�A Watex main depth
unknown
gas main
Z%C.Y;
-w- water
-g- gas
ss- sewex
V3UD water bydrant
915 MC= SL (PC). BM 1369). SCOWC. WA 99111 C206) 622-6767,
NOTICE:
iq -. �.w�a r �ra 7n—. Y ... OT -atcuv:dl�,:Y...
The information . shown on the attached
iled for use by the CitY Of
MaP(S) was Comp
Edmonds� its Employees and Consultants.
Th.e City of 'Edmonds does not . warrant the
accuracy of anything set for.th on t ' hese
map(�). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the inform - ation shown- on
but not limited to,
t -m a p(s), -h
th'e location of any sewer stub shown. Suc
i and may
sewer stubs may or may not ex st
at the location shown.
or may not exist
Neither the City of Edmo'nds nor its
empl-o- ee-s o-r offi-ce-rs sh.a]] be l..'la-b-Ife for the
Y
n on this rnap(5), nor for
information give*
e representation provided based
any on
upon . said map(s).
allothing in this permit approval proms shall be
i.t.rpWW as allowing or permitting the
maintenance of any currently exWdn; illegal,
nonconforming or unpermitW building, structure
or site condition which is outside the scope of the
ermit applicaUou regardlm of whether such
tuikling, FitmetuW or condition is shown on the
site Ian or drawing Such building, structure or
0onTition may be the' subject of a separate
enforcement action.01
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KI E V) e ('AVINICI
PROJECT ADDRRESS / OWNER:
RICK & KATHY HASHBARGER
19812 86TH PLACE W
EDMONDS 98026
425-771-1421
TAX No: 00565200001200
LEGAL: SCOTTS FIR VIEW BLK 00 LOT 12
T-27-R-04 S-19NW
SCOPE OF PROJECT:
ADD: 435 SQ FT. MASTER SUITE OVER
EX. GARAGE. REMODEL KITCHEN.
ZONE: RS-8
LOT SIZE: 12, 0,065SQ FT.
LOTCOVERAGE: 35% MAX
EX: RESi—DENCE /GARAGE: SQ FT
NEW: PORCH ROOF: 45 SO FT
NEW TOTAL: 112,e? SQ FT
BUILT: 1962
IMPERVIOUS: BEFORE 1977:
RES, WALK, DRIVE, PATIO: 311MQ. FT.
AFTER 19,77: 45 SOFT PORCH ROOF
-4s �J SQ FT
HEIGHT. CALCULATIONS:
DAIF'UM: WATER METER: 100."
A: 100' 00
B: 100,
C: 100'
D: 100'
400' 4= 100.' BASEELEV 00
+ 21'-9" PROPOSED 0�
121'-9" PROPOSED 125�- 019M.AX.
CONTRACTOR: UNDECIDED
Zone M>— Corner &gFlag_Ai�
wo Ck
.Ve,ft INV
Setback R Actual
2gulL
Front (=AA i
Sides (W) tv% net,
Rear
Other'
Heip,ht
DESIGNER:
KRISTIN HANSON
HANSON DESIGN
652 ALDER ST
EDMONDS 98020
425-774-7129 / 425-771-3152 fax
hansondesign(d�,hotmail.com
STRUCTURAL ENGINEER:
AL X MOROS OUS, P.
CUSTOM DESIGN & ENGINEERING, INC. RESUB
11006 60TH AVE W
MUKILTEO, 98275 OCT 2 9 2007
425-343-7517 / 425-493-8388 fax
BUILDING DEPAKIMEN1
CITY OF EDMONDS
N
mv
RECEIVED
OCT 2 6 2007
BUILDING DEPT.