200 2ND AVE N.PDF111111111111
4783
200 2ND AVE N
0 d
ADDRESS: AVE- ["4 A-5F�eP,,- (�-N-Do
TAX ACCOUNT/PARCEL NUMBER: (Ei I b - Qa' ) - 71) Z- --00
BUILDING PERMIT (NEW STRUCTURE): W70 -001(0 111-5 UN-] -
COVENANTS (RECORDED)
CRITICAL AREAS: DETERMINATION: E] Conditional Waiver E] Study Required n Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DA
EASEMENT(S) RECORDED
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORT PLAT FILE:
SIDE SEWER AS BUILT DATED:. (511 (a I �
SIDE SEWER PERMIT(S) #: �b 45
SOILS REPORT DA
STREET USE / ENCROACHMEENT PERM[IT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
LID #:
LOT: BLOCK:
LATEMP\JDSTs\Fon-ns\Street File Checklist.doc
-TION
APPLICA
mo S.,: 7
7�ie cit�- df I& nd' E MENT NO ---- - ----------
A�
SIDE. SEWER. PE MIT'
SM
NEW CONSTK.UCTION,:-E LID NO.' T
Y'.REPAIRSI A
k- 2-it--A;0:2—S Z_-
CON "Er--ne5 "-
NO.
----- -----
-OWNER ... ..... --------------- ------------- . .............. ...
:1 -JF-:
- tEE� CONTRACTOR --- !E)F— ------ PERMIT
--- ----------------------------------------------------------------------- ..........
-IO--N: LO T--Nb.� --- I v I
-72 ------------------------------------------------------------------------------- — ------------ - ------
JOB ADDRESS - LEGAL DESCRIpt BLOCK NO - ---------------------------
.......................................................................................................................................................
NAME OF ADDITION 5:>;7
- ---------------------------- --------------------------- ------------------------------------------------------------
ir
sls�
TA
ru
3Z
16,
Approved:
...... ----
--- By
—411�140-
)ATE ------ ............
MEV
7771 t Ag
7
na
i;f
PERMIT
MONDS SIDE SEWER
CITY 0 F ED
WATER SEWER DEPARTMENT
P MIT
ER
on
BEFORE covering any Portion of the constructi
Call 775-2525 for side sewer inspections qust. NO S&t., Sun., or holiday inspections.
provided Within 24 hours after re
(Inspection will be
.................................
.... .....................
................ . ..........
F CONSTRUCTION ------- city (of E&Cmf'o ...................................
ADDRESS LOCATION 0 2� .................. .........
................. ----------------------------------------
10, 11'. 1
.. .......... .. . ......
LEGAL DESCRIPTION ---------------------------------- -------- ..............................
PROPERTY ... . ....................
......... . ............... .........................
...............................
........... . .... ........ ..................
j ......................
...................... . .......................... . ........... &�
'17. ......................... . ...............................
-R---
3
7 OWNER AND/OR BUILDF
--------------------------- ........ .............................. . .. . .....................................................
..............................
DRESS ...... ------------
&&TRAC"WS NAME & AD
19.76, for repair and/or connection Of a side sewer to the city sanitary sewer
........... . .... ... ...
permission Is granted City oi Edmonds Ordinances'
with
sv-tera In accordance
milst be employed to construct
e sewer Contractor
A licensed Sid
construct sewer inside property line.
�TION IS CALLED To THE IVOLLOWING: tain permit to
of the property may ob it has been inspected.
the city Engineer's office.
No. 1—The owners 6treet area. Do not cover any portion of sewer before obtainable from
side sewer in an invasion of Right-Of-WELY Permit
—A med in city right-of-way requires 30 and Regulations governing side sewers when you get Permit.
11 work perfo e of 2%. No bends in grade
71 NOTE No. 2 ion regarding Ordinance 11-16.0
NOTE No. 3—Obtain full informat line and 12 inches inside property line; minimum grad
at property
—Top of side sewer must have at least 30 inches coverage responsible for failure due to improper
NOTE No. 4 rmitted. Contractors shall be
sharper than % will be pe
er settled and surface of street restored to original condition. in-
)TE No. 5--Trenches in street must be wat letion. .1 . i,
one year of cOmP the permit, or to do any work on the main sewer or its appurtenances except to
N(
work which may develop within 0 is provided for in
ther work than
NOTE NO. 6--It is unlawful to alter or do any
ert the pipe into the wye.
'BY ----------------
--------------- - ------------- ---
By ---------------- Date
.......................
..... . ................................
.. . .. . .. . .........................
/_-7 ------- By._
Date ....................
'F'_ G "
te ...... ......... Date_
DISAPPROVED
... ...... ...
.........................
APPROVED ... ........
............... . .. .................
............. ..........................
...................... ............ .........
......................................... or Inspection
.............. PRIOR quest F 7W
ST Be Signed BY owner of Firm Performing Construction
BOTH Permit Copies MU
trucated under this permit
sewer installation cons
.... hereby Certify that the side
% -
4. 1 .. I. . .. I ...... . ... .........................
ed in a danc
install (owns f C racting Firm Performing Construction) of the City of Edmonds. :19 .........
e with all governing ordinances
.................... ...........
cr�oric /;ra Yn
Dated this ---------------- ----------- day of --------------
Other C]
Power Sewer 11,
Check BEFORE YOU dig for: Water n, Gas C31 Telephone
7'�
APPLICATION
D
The City of Edmonds for EASEMENT NO - --------------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION n REPAIRS LID NO - ------ --------- - I MT. NO - ------------------
------------ PERMIT NO.
OWNER ....... CONTRACTOR ----
A!5��
S .....
L ...........
wwQ;2- 17 - ------- BLOCK NO - ----- 8 ---------------------------
JOB ADDRESS . ------- ------------------ - ------------------------------------------ LEGAL DESCRIPTION: LOT NO - ------ 1.0- -
77- A31�� --------------------------------------------- ........... ------------- -----------------
NAME OF ADDITION ... P-4A--T ------ (1)17 ------------------------- ----------------
td,
-z- OZ�,
,K3 -r,-, tm S-Tor>
74)
Approved:
RECFivrn
AUG 111976
Public
DATE-------------------------------------------- BY --------------------------------------------------- Vi
Date —August 10,
1976
RECEIVF
---L---"-555;2'Memo to: Director of Maintenance &
Operation
Public Works.
AUG 11 1976
From: City Engineer
Public Wks L,-p;L.
Subject: Sewer Connection'Charges
Legal Description: Lots 1 0, 11 and
12 of Block
8, Plat of Edmonds
Commonly known as: 200 Second Avenue N.
Z.F.F. Calculation:
Z.F. F. x
Lateral X
15 Unit x $25
NOTE: R�evious Hotel was connected and
.assumed to have paid connection cha.rge
. . CC:
owner: Harbormaster Condominium
Connection Fee
Lateral Charge
$ 375.00 Trunk Charge
$ 10.00 Permit
385.00 TOTAL
2108
PLANNING DATA
New Commercial MulffamiFy Proiects.
SITE ADDRESS: 4V". ZONING:
--USE(S) PROPOSED: Co,, doy ALLOWED?. yf
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED—
(Y/N)
CUP File: to Allow What Vses?:
Exev�pr
ADB FILE #: I.T-
PARKING:
Use: No. Spaces Required:
X (floor area, # employees, etc.)
Use: No. Spaces Required:
4
X V /T (floor area, # employees, etc.)
Use: No. Spaces Required:
X (floor a ea, # empldyees,� etc.)
Use: ---,No. Spaces Required:
X
(floor are * a, # employees, etc.)
Total
Required Actual Provided:
SETBACKS.
d�'� � 'e' t b*' W
:S acks:
Require E
10 -LL
At -Front: .244 Side: -Right Side:
Actual Setback
-s:
Left Side: Right Side: Rear: 'N
..Front:
RE Street ma,p;ohecked for additional setba6k,required? _(Yes/No)
z
0
0
MAXIMUM FLOOR AREA:
Maximum Allowed: Actual:
BUILDING HEIGHT:
Maximum Allowed:— Actual, Height:
Modulation Allowed?: /VO uryAl Modulation Height:
Datum Point: I Datum Elevation:
Elevator Penthouse > 3 feet over height limit? If so,VAR#
LANDSCAPING:
Matches ADB approved: IVA
Bid Provided? Bond Amount (100% bid):
CRITICAL AREAS #: IVO ck dole sycr - , - ref E/'Ircd 7
SEPA DETERMINATION: Exe "'Cl
SHORELINE REQUIRED?: /V4
Continued ...
1Ahbrary\^P1andatNewComm.doc
z
0
t:
cdll t loq.
DATE: 01 AN r"lcfi-
NAME OF BUILDING PERMIT APPLICANTz
T�rxe5
PROJECT %SCRIPTION: Ale L-, wqAja,-d
co o�-' -1 -r t^/0
�cwlio, J -
114(
-/0T'h*'^t, 2XIM
1
ADB FILE #: OR DATqLW�ED�-.�'gtt �01
PLANS MATCH APPROVED PLAN:
SUBDIVISION: IV4
LOT AGGREGATION REQUIRED?: A/b
REDUCED SITE PLAN (8.5X11) PROVIDED FOR STREET FILE?
OTHER:
Plan'Review By:
lAlibrary\AplandatNewComm.doc
City of Edmonds
Development Services Department
Pla,rmm*g Division'.
4 J�
Phone: 425.771.0220
Fax: 425.771.0221
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 the application 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).
bate Received: C4- (I
City Receipt,#:
Critical Areas File #:
Critical Areas Checklist Fee:
Date Mailed to Applicant:
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.
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' assistant staff
in completing their prelin,iinary assessrr�ent 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. fumished 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 behalf of the owner as listed below.
SIGNATURE OF-APPLIcANT/AGENT DATE
Property Owner's Authorization
By my signature, I cer* 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 postin att dant to this application.
9_ __2
SIGNATURE OF OWNER DATE
PLEASE PRINT CLEARLY
Owuer/Applicant: Applicant Representative:
city of tdmonds/Steve Koho CHS Engineers, Inc./Rodney Langer, P.E.
Name Name
200 Second Avenue South
Street Address
Edmonds, WA
City State
12507 Bel -Red Road, Suite 101
Street Address
98020 Bellevue, WA 98005-2500
Zip City State Zip
Telephone: 425-771-0237-
Email address (optional): steve@ci. edmonds. wa. us
Telephone: 425-637-3693
Email Address (optional): rodneyl@chsengineers.com
Critical Areas Checklist.doe/4.22.2003