20431 88TH AVE W.PDFIIIIIIIIIIII
8470
20431 88TH AVE W
Site Plan
20431 - 88th Ave West (Rear house)
STREFT FIL", Tax Parcel # 5446-000-004-0106
Legal: Parcel 'B' of short plat #S- 13 -8 5 as recorded
under Snohomish County recording No. 8507110313
Scale: V= 20'
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Site Plan.
20431 - 88th Ave West (Rear house)
Tax Parcel # 5446-000-004-0106
Legal: Parcel Wof short plat #S-13-85 as recorded
under Snohomish County recording No. 8507110313JUN2 1996
Scale: 1"= 20'
PERMIT coupljr7R
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WATER MMF%
T-1 RE 14 yt)Rntj-r
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7-1 NORTH
Ave 11545
131,6- 'Clary cc)py
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I -Ott APPROVED BY PL�NNING
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CITY OF EDMONDS
CONSTRUCTION PE.RMIT APPLICATION
OWNER NME/NAME OF BUSINESS
AAKE-M PWT T-Affilt
MAILING ADDRESS
lw4tl 92* W
CITY zlp ITELEPH
JW"O"
M
NAME
ADDRESS
CITY ZIF
NAME
=I ADDRESS
IN CITY
I STATE LICENSE NUMBER
ZIP I TELEPHONE
ROPERTY TAXj�@W?Pbn
A JDJ
NEW
RESIDENTIAL
ADDITION
CO MMERCLAL
REMODEL
MULTIFAMILY -1
0 REPAIR
GRADING CYDS
11 DEMOLISH
0 TANK
[3 GARAGE
CARPORT
0 RETAINING WALL
RQCKERY
ITYPE I OF USE- BUSINESS OR ACTIVITY) EXPLAIN:
NUMBER NUMBER C
OF DWELLING
21.0-RIES UNITS
DESCRIBE WORK TO 13E DONE
PERMIT EXPIRES
USE PERMIT
ZONER� N U M B E R,4&Y-
J ADDRESS AW. E:
OB
UBDIVISION NO
LOT NO.
LID NO.
LID FEE $
OF WAY PER OFFICIAL STREET MAP
ES5F_Ap
ps..
R ps..
PUBLIC RIGHT
Sh-w use Pennit Req`d
inspection Roqtdred
EXISTING - PROPOSED
aidwalk Racp1ind
REQUIRED DEDICATION- FT
urdlerground
wiring recuirst!
ETER SIZE LINE SIZE NO. OF FIXTURES
M -
PRV REQUIRED
I
z
i
z
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE is
FIRE 'kFVIiWEO BY
DATE
DATE W
cc
I rL
ION DATE CHECKED BY
'ON
SHORELINE 0---FIN SO
VARIANCE OR CU R ADB# SPE NO
RE POSTED
07D
- ArN
113YES 0 $
EW G L HEIGH
SEPA REEW1 SI N AREA PT
M Ro
COMPLETE I EX7 PROPOSED AL OWED POSED
EMPT ALLOWED
EXP
LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT)
FRONT L/R SIDE REAR
PLUMBING MECH
POS FRONT SIDE REAR
ALLOWED PROPOSED
z
COMPLIANCE OR
OF USE
z
;
1
CHANGE
PARK114G LOT AREA PLANNING REVIEWED BY DAT
4L
SIGN
REOD ROVIDED
__r j - 9 1 3
M"4p�
FENCE
( X_ Fr)
REMARKS
0 OTHER
of 06! AVIA0- OM IJVAI
0 FIRE SPRINKLER
FIRE ALARM
Po CAlAm-IC
CHECKED BY JTYPEIOF CONITRUCTION !2E OCCUPANT
7- GRoul;e
CRITICAL
AREAS
SPECIAL INSPECTION JAREA OCCUOANT
LOAD
NUMBER
REQUIRED [] YES
REMARKS
PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REaO
VALUATION
$
Description FEE Description FEE
Plan Check Z ZO State Surcharge
HEAT SOURCE GLAZING LOT SLOPE % Building Permit City Surcharge
PLAN CHECK NO: VESTED DAT 1 E Plumbing
A
Metthinicaf
T
7
THIS PERMIT AUTHOREMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t:
BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC
Grading
2
3
DOMAIN (CURBS, SIDEWALKS.ORIVIEWAYS, MARQUEES, ETC.),`WILL REQUIRE
t:
SEPARATE PERMISSION.
-
Engr. Review
PERMIT APPLICATION* 180 DAYS
PERMIT UMrP I YEAR - PROVIDED WORK IS STARTED WITHIN 160 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPUCAlfr, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
a EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM. ANY AND
Fireinspection
Soo
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIa PERMIT SHALL NOT BE
DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapeinsp.
Total Amt Due
c
a NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
x
Recording Fee
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
HEF
APPLICATION
APPROVAL
GIVE14 IS CORRECT; AND THAT IAM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
I
G P E,
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
E
CALL
This application Is not a pemit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
TION
Building Official or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
VI
FOR INSPECTION
receipt Is acknowledged In space provided.
LIN
WORKMEWS COMPENSATION INSURANCE AND RCW 18.27.
OFFICIALS SIG14ATURE DATE
Sip ATURE j(5wNEhfiR,AGE ATE IGN D :4:,
1A13
%425)
220
/z
REL DATE
ATTENTION
Off 1333
h4 /,0
m..1LWLq1W14(6
IT, IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
/A /A.
4 - - 9
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE - YEI�1:0411-IVPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK -OWNER - GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
P19
"Jrr-W 7
JL , A SE
EN
ADUL Y-Ho
Lkense Nutnbe*r: 395404,
V
Pursuant to4hi`� laws of and t�e, �N' i4irum-licensing* kequirements
.4v
of D6phrtmeb Y
COES.obi:Wand- iiealth Se'rv`iee*§, a lfd'6�4q ereb. granted to
>
-C
TV 0"...ORATIQW,---]��-,*
LARETE*
I. by W
vl�&c C
If I`Afta�hbip/Corpqr on. represefit6i
V Y
Ad*bdil iidt"14, 0 niaintiin at
4P,
4
,'-'State of Washington,
couht
Cit. of g
N-2 tae-,�-990, N-SK
Tk,;- �,iid f- M�l& i�:
follows!
P,
2, `�i:
VU
.7j;
f
This license: shall be in orce tr me 'ki�-10 rs ect off for,que qu§V�
16 D f
�Coiaditions"'on-'.-Li'c'ense'' if ny:
i a
V Ju
N
Lic
ensing-Autfi6ri
e M tion 1 7
s f I d 4 �M�AC 3�88-76;- 05, based on inspection'.'
NOTE:: Th� debartment renewal 'of a I ensee do no -Rr M
This license Is not transferable, and Is valid only for use by the co; vi ai(s) to whom it is issued and at
dui the location above described.-.
Issued b y* Akhoirity bf Chapter RCW 70.12.
MEL LIC
REQUEST FOR INSPECTION- Adult Family Home
APPUCATION NumsER:
Applicant must complete sections 1, 2, 3, and 4. Application must be complete to be processed.
SITE
PROPERTY OWNER NAME. V
ASSESSORS TAX(PARCELQP599kQa_,2A.Q I
DAYTIME PHONE:
LICENSEE NAME (F ovTEwM: DAYTIME PHONE:
SECTION 3 - FLOOR PLAN I
A complete floor plan must include all sleeping rooms, identifled by number (#1, #2, #3 etc.) and all components for
eKiting, i.e. stairs, ramps, platform rrfts and elevators. (Attach additional sheets if necessary)
ljif4w f%zz - 5TA- in. A -7 1 i,) 0 — 5 MOY-6 AL60M
-bill V1f7T-T7'—"
NMI
io.
02A1
)�a to
9M-5Qf-- )2.0
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V�Jwl"' �-' 'zV11 � c4KI's"
ht Sill
DN 4 —DISCLAIMER /SIG NATLI RF Rl C
I certify under penalty of perjury that the infiormatim furnishied by me is true and correct to the best of my knowledge, and that I am auftrized by
the owner of the above premises to request inspection for and operate an Adult Famffy Home at ft kxation. I furdw certify that I have made
appikationtoftDepa.b.mi of Social and Health Services and the jurisdiction for the appropriate license(s) to conduct such business at this
location. I fLnllw agree to hold harmless the jurisdiction conducting such irspections; at my request as to any claim (including costs, expenses, and
attorneys' fees kxwred in the investigation of such daim), which may be made by any person, including the undersigned, and filed against the
judsdktion, but only where such daim arises out of the reliance of the jurisdiction, including its officers and employ�, upon the accuracy of the
information suoied to the jurisdiction as a part of ft application.
I
NAM1EJTrrLE:_y1Mk1_" , U_� cet) DATE:
.0 PROPERTY OWNER X APPLICANT OLICENSEE
SECTION 5 - INSPECTION CHECKLIST
YES
NO
Home licensed (or applying for license) on or after July 1, 2001
V
0
SLEEPING ROOMS
0
0
Sleeping Room #1 0 S )eNSI 0 NS2
Bedroom door is openable from the outside when locked
A
0
Closet doors are readily openable from the inside
11
Smoke alarm is installed in the bedroom
0
Sleeping room window has a minimum net openable area of 5.7 sf. (minfmumdimensiorts- 24! high; 20"wide)
0
Sleeping room window has a maximum sill height of 44"
ly
0
Sleeping Room #2 0 S NSI 0 NS2
Bedroom door is openable from the outside when locked
0
Closet doors are readily openable from the inside
0
Smoke alarm is installed in the bedroom
0
Sleeping room window has a minimum net openable area of 5.7 sf. (minimum dimensions- 24N high; 200 We)
21
0
Sleeping room window has a maximum sill height of 44"
51
0
Sleeping Room *3 0 S NSI 0 NS2
Bedroom door Is openable from the outside when locked
X
0
aoset doors are readily openable from the inside
W
11
Smoke alarm is installed in the bedroom
RV
0
Sleeping room window has a minimum net openable area of 5.7 sf. (minimum dimensions- 24' high; 201 wide)
JR,
0
Sleeping room window has a maximum sill height of 44"
0
. Sleeping Room #4 0 S NSI C1 NS2
Bedroom door is openable from the outside when locked
0
Closet doors are readily openable from the inside
0
Smoke alarm is installed In the bedroom
0
Sleeping room window has a minimum net openable area of 5.7 sf. (minimum dimensions- 24"high; 20* vdde)
11
Sleeping room window has a maximum sill height of 44"
0
Sleeping Room *5 0 S 1K NSI 0 NS2
Bedroom door is openable from the outside when locked
0
Closet doors are readily openable from the inside
0
Smoke alarm is installed in the bedroom
0
Sleeping room window has a minimum net openable area of 5.7 sf. (minimum dimensions- 24' high; 201 wide)
0
Sleeping room window has a maximum sill height of 44"
0
Sleeping Room *6 0 S 0 NSI 0 NS2
Bedroom door is openable from the outside when locked
0
0
Closet doors are readily openable from the inside
0
0
Smoke alarm is installed in the bedroom
0
0
Sleeping room window has a minimum net openable area of 5.7 sf. (minimum dimensions- 24" high; 20'vWde)
0
0
Sleeping room window has a maximum sill height of 44"
0
0
GENERAL
Bathroom doors are openable from the outside when locked
1�-
0
Smoke alarms are installed on all levels of the dwelling
195,
0
All smoke alarms are audible in all parts of the dwelling upon activation of a single device
7ff
0
Access road and water supply approved by Fire Department
C1
V PASSED 0 CORRECTIONS REQUIRED 0 PERMIT REQUIRED
INSPECTOR: 6,NIL & �- DATE:
19, 6-1::o o4s�(0-5
10�1
Pi
WE
RETURN ADDRESS:
City of Edmonds, City, Clerk
121 5th Avenue North
Edmonds, WA 98020
Reference #:
CONFORMED Copy
200401050536 3 PGS
01-05-2004 04:16p� $21.0o
SNOHOMISH COUNTYj WASHINGTON
NOTICE OF LEAITATION AND COVENANT
ADULT FAAHLY HOME
Grantor(s): (1 V.N*09� -
Additional on pg.
Grantee(s); City of EdmoUdj
ilegal Descrip, . tion (abbreviated): Sec--d—TwnAZ&—Rng
.
OR Lot
Assessor's Tax Parcel ED#(s): OM4 D t
----.Assessor's Tax Parcel I]D# not yet assigned
AUTHORIZEI) FOR RECORDING
dMC191Af Edmonds
BY "4a= Date:
Page--Lof.A-:
WHEREAS, the undersigned owners of property located at 0
in Edmonds9 Washington legally described
below or on the attached Exhibit As have applied for a building permit for
compliance and/or to remodel a structure located on the site; and
WHEREAS, the applicant has notified the City of applicant's intention to utilize the
improveme nts and/or to convert an existing single family structure to an adult
family home; and
WHEREAS, under the Uniform Building Code the number of occupants of a
structure trigger certain requirements relating to the fire suppression and exiting
requirements; and
WHEREAS., the City has notified the ap li ant that the permit will be issued
condition ed on limitation of residents to or fewer residents and their
caretakers; and
WHEREAS, the City has issued a permit based upon such representations;
NOW, THEREFORE, the undersigned property owners (hereinafter
"Owner") in consideration of the issuance of a building permit and in order to
confirm the promises Upon which such issuance is based while providing notice to
any future owners or mortgagors of . the property does hereby stipulate, covenant
and agree as follows:
1. Cayguanle Limitation on ResidAnce. The owner hereby stipulates
and agrees that occupancy of the structure as an adult family home shall be limited
to —or fewer adults and their caretakers as allowed by applicable
provisions of state law. The owner acknowledges that in. the event that the applicant
seeks revision'of the applicant's state license to operate an adult family home with
an occupancy of greaterthan residents or attempts to rent, lease or
-otherwi provide residence for additional residents above the
permitted In the current occupancy classification, the structure shall
be vacated and all residential use ceased.until such time as the property is brought
into compliance with the provisions of the State Building Codeq under the edition of
the Uniform Building Code then in effect. The owner further stipulates that this
covenant touches'and concerns the land so long as the present structure and use
continues and shall run with the land to all future purchasers and assigns.
2. Subject Tract The above stipulation and promises shall ly to and
0
run with�e. land with respect to a residential structure located at fifff
Edmonds, Washington and legally described as:
' . .3. Notification to Eutnre Purchasers and Assignees. This notification
and covenant has been recorded. in the records of Snohomish County, Washington
in order to provide notice to any and all* future owners of the property of the
limitation at the current level of improvement to single families and adult family
home residents fewer than 0 in number.
4. EnfUrcement. In addition to any. and other remedies civil or criminal
which the City may have, the property owner hereby agrees and stipulates that this
grant of covenant shall entitle the City to enforce by injunction the provisions of this
code and, in so doing,, to recover Its reasonable attorney's fees and costs.
AUTHORIZED FOR RECORDING
City f Edmonds
By: aw nzttd.! AP/"MV.'7
Page4�Lof_'q - I
DATED this day of
ACCEPTED BY:
OWNER:
Jeannine L. Graf
Building Official
NOTIFICATION
NOTARY FOR OWNER SIGNATURES
State of Washington )
)ss
County Of &ohow ts�)
APPLICANTIPROPERTY
Applicant
Applicant
Owner
Owner
COVENANT AND
ACKNOWLEDGED:
Mortgagor
I certify that I know or have satisfactory evidence that OV14U 6LAP--ETf—
signed this instrument, on oath stated that he/she was authorized to execute the
instrument and acknowledged it as the 9eukE:6M—/Q YbAy (title) of
&99"&Y(name of party on behalf on whom instrument was executed)'to be the
free and voluntary act of such party for the uses and purposes mentions in this
instrument. Subscribed and sworn to before me this .U4,0 da %&ceoi1jek-
M
....... lot
t
Notary Public in and gilthe State of Washingl6s.
&VIOVI 0:
My commission expires--4--Z9 -0 S.
I certify that I ow or have satisfactory evidence that r
signed this instru nt, on oath stated that he/she ized to'e�%�t;te the
instrument and ac ledged it as the (title) of
(name of on behalf on om instrument was executed). to be the
0"
free.and voluntary act of suc arty if � �euses and purposes mentions in this
instrument. Subscribed and sw before me this day of
—919
otary Public in and for the Stalft(,Washingtou.
My commission expires
AUTHORIZED FOR RECORDING
City of Edmonds
By: Date: —IA
P
age of
L-NTEhMBUILDINGVORMS%ADF-COV.DOC
C�l
RETURN ADDRESS:
City of Edmonds, City, Clerk
121 5th Avenue North
Edmonds, WA 98020
Reference#:
-NI -, .,- �1 I , , '(;io,
Coy 0:-
CONFORMED Cop
200401050536 3 PGS Y
01-05-2004 04:16pm $21.00
SNOHOMISH COUNTY, WASHINGTON
NOTICE OF LIMITATION AND COVENANT
ADULT FAMILY HOME
Grantor(s):(1&�'�jAqOj �,LAO\ Additional on pg.
Grantee(s): City of Edmonds
Legal Description (abbreviated): Sec_jq _—TwnAIAL Rnz
/�&Qt
OR Lot Block Plat
Assessor's Tax Parcel ID#(s): (1)2�41 0 0WO 0 (2)
Assessor's Tax Parcel ID# not yet assigned
AUTHORIZED FOR RECORDING
C*t f Edmonds
By: Date:
Page / OQ�
WHEREAS, the undersigned owners of property located at A' AL,
in Edmonds, Washington legally described
below or on the attached Exhibit A, have applied for a building permit for
compliance and/or to remodel a structure located on the site; and
WHEREAS, the applicant has notified the City of applicant's intention to utilize the
improvements and/or to convert an existing single family structure to an adult
family home; and
WHEREAS, under the Uniform Building Code the number of occupants of a
structure trigger certain requirements relating to the fire suppression and exiting
requirements; and
WHEREAS, the City has notified the ap licant that the permit will be issued
conditioned on limitation of residents to or fewer residents and their
caretakers; and
WHEREAS, the City has issued a permit based upon such representations;
NOW, THEREFORE, the undersigned property owners (hereinafter
"Owner") in consideration of the issuance of a building permit and in order to
confirm the promises upon which such issuance is based while providing notice to
any future owners or mortgagors of the property does hereby stipulate, covenant
and agree as follows:
1. Covenant: Limitation on Residence. The owner hereby stipulates
and aerees that occupancy of the structure as an adult family home shall be limited
to U --or fewer adults and their caretakers as allowed by applicable
provisions of state law. The owner acknowledges that in the event that the applicant
seeks revision'of the applicant's state license to operate an adult family home with
an occupancy of greaterthan 0 , residents or attempts to rent, lease or
otherwir provide residence for additional residents above the
permitted in the current 'occupancy classification, the structure shall
be vacated and all residential use ceased until such time as the property is brought
into compliance with the provisions of the State Building Code, under the edition of
the Uniform Building Code then in effect. The owner further stipulates that this
covenant touches and concerns the land so long as the present structure and use
continues and shall run with the land to all future purchasers and assigns.
2. Subject Tract, The above stipulation and promises shall apply to and
r n with the land with respect to a residential structure located at %4-fl gkbn-
AVG . W - , Edmonds, Washington and legally described as:
3. Notification to Future Purchasers and Assignees. This notification
and covenant has been recorded. in the records of Snohomish County, Washington
in order to provide.notice to any and all future owners of the property of the
limitation at the current level.of improvement to single families and adult family
home residents fewer than (0 in number.
4. Enforcement. In addition to any and other remedies civil or criminal
which the City may have, the property owner hereby agrees and stipulates that this
grant of covenant shall entitle the City to enforce by injunction the provisions of this
code and, in so doing, to recover its reasonable attorney's fees and costs'.
AUTHORIZED FOR RECORDING
City f Edmonds
By: Date:
Page ��_ Of _q
DATED this day of
ACCEPTED BY:
OWNER:
Jeannine L. Graf
Building Official
/�ZF# 4ff,1-VW �.
NOTIFICATION
NOTARY FOR OWNER SIGNATURES
State of Washington )
)ss
County of 5-noilorn I �J)
APPLICANT/PROPERTY
Applicant
Applicant
-A44
Owner
Owner
COVENANT AND
ACKNOWLEDGED:
Mortgagor
I certify that I know or have satisfactory evidence that .006W "',L
signed this instrument, on oath stated that he/she was authorized to execute the
instrument and acknowledged it as the Aeuv—AAmXY 140AV (title) of AW-40,w0*1
,V4,h'AA-W1tZWrame of party on behalf on whom instrument was executed)'to, be the
free and voluntary act of such party for the uses and purposes mentions in this
instrument. Subscribed and sworn to before me this daLy,4A-&cej76ee
-,! 0s, -Tie''l -11
00 �3
N
Notary Public in and r6ythe St-afe of Washingio 0
A
My commission expires -0
-A
I certify that I ow or have satisfactory evidence that
signed this instru ent, on oath stated that he/she was utgo-rized toe'�%eWi&� the
ow 0
en
stru
r have sat'sfa
t' on oath stat
ctor'
ed t'
instrument and ackin ledged it as the
Ic (title) of
n m p
ame of ty on behalf on h6m instrument was executed) to be the
ry
ry I
free and volunta act of su% arty fort e uses and purposes mentions in this
I
Su scri n
_t
swor
instrument. Subscribed and�wor- to before me this — day of
Kotary Public in and for 'the Sta&,QkWashington.
M y commission expires
AUTHORIZED FOR RECORDING
City of Edmonds
By: D a t e:;
'iage 3 of
L.,\TEMP\BUILDINGkFORMS\ADF-COV.DOC
E.!
14
Adult* a I -Iff
. � ... .-F. � y . Ome tcen6c
in compliance with and vursuant to- athe laws of Me State of Washingkin and Lhe MHUmum Lican - ='g Requirementj
of the Dep4rtment of Social and -Health hcense is here.�y g manted
bD TIKOTKY L.- COLLINS
1icense-Number 395401
to conduct W:maintain at, -20431 SCITH AVWM WEST
oily of IDMCNDS' Zjp eoCle 98026
County of —MONOrRISW
State of Nkishlngtoo,. an Addt PaTfiW Rome tot the care and supervision of adults as.follows:
.24�hwr fami ly Me 0 no mom than adults
nis lifflase sta.-be ih f6ree from ibe '.!Mm :day 6f. AIUGUSk 97.
to and including
&e.-_ 25TH day.. of MOM 10 98 nibjeettcjmvocatio-n-forduecauw.
speeial llenm-
q4.,
J 814
.— jaume - W4,L116h.
Ka3CY DOLalag& AvAunly
14METhis fiee&% b not trindembb, and is valid oyft for w.by.theindivMual ocaon hove
(s) to whom kis-isavetd at the I a
Auwad byAuUw*y of Chq.ter IT2, Lac of 1961, mid RCV.70,12
dweTibe&
Dal-wiTs at". Pat)
5
5twf-e
Site Plan
20431 - 88thAve West (Rear house)
Tax Parcel # 5446-000-004-0106 JUt) 9 1997
Legal: Parcel'B'of short plat AS-13-85 as recorded PERMIT G01JNTF-R
under Snohomish County recording No. 8507110313
Scale : I "= 20'
W -ST
r, — tueb I C-vV+r es, ticw*l V,
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LIN.
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REMMADDUS&
cityofEdmonds, City Clerk
121 5th Avenue North
Edmonds, WA 98020
9707160504
07/16/97 14:57
p.0002 Recorded
Snohomish County
B U 1A INC,
AUG -- �3 11).97.
NOTICE OF UMITATION AND COVENANT
ADULT FAMILY HOMR
Reference
Grantor(s): (2) '&_bdel E. 06116
Grantee(s): Ci. A - Additional on pg.
Legal Description (abbreviated): Sec Twn —Rng—Qtr
OR Lot_JS Blocl(�Plat6[10600- + 343-85
AssessWs Tax Parcel ID#(s): (I 21:Nk- -mo -at4_0104-0
--------Assessor's Tax Parcel 110 not Yet assigned
WITEREAS, the undersigned owners Of property located at 2-0 q
in Edmonds, Washington legally' described below or on the attached
Exhibit A, have applied for a building permit for compliance and/or to remodel a structure located
on the site; and
WEE RE' AS, the applicant has notified the City of applicant's intention to uti I lize the improvements
andlor to convert an existing single family structure to an adilit family home; and
WHER-EAS, under the Uniform Building Code the number of occupants of a strncture trigger
certain requirements relating to the fire suppression anti exiting requirements; and
WHEREAS, the City has notified the applicant that the permit will be issned conditioned on
limitation of residents to —Aix—or fewer residents and their caretakers; and
WHEREAS, the City has issued a permit based upon such representations;
NOW, THEREFORE, the undersigned property owners (hereinafter "Owner") in
consideration of the issuance of a building permit anti in order to confirm the promises upon which
such issuance is based While providing notice to any fuhire owners Ol* mortgagors of tile property
does hereby stipulate, covenant and agree as follows:
1. LR-esidence- The owner hereby stipulates and agrees that
Occupancy of the structure as an adult family home shall be limited to
fewer adults and their caretakers as allowed � 619 or
acknowledges that in the event that the applic by applicable provisions of state law. The owner
ant seeks license to
-eater than
operate an adult family home with an Occupancy of gi revision Of tile lipplicant's state
to rent, lease or otherwise provide residence for ..60( residents.:or attempts
'Idditional residents above tile 5 1 X
wation, tile structure shall be vacated And all residential
permitted in the current Occupancy cl8ssir I
use ceased until such time as the property is brought into compliance with the provisions of tile
State Building Code, tinder the edition of the Uniform Building Code then in effect. The owner
further stipulates that this covenant touches and concerns the land so long as tile Present structure
and use continues anti shall run with the land to all ftiture ptirchasers and assigns.
I of 3
41 . .1,
City of Edmonds,. City Clerk
121 5th Avenue No
Edmonds, WA 98020
2. SAWcAMAct The above stipulation and promises shall agly to and run with the
land with respect to a residential structure located at _Zotl;�, i6a
Edmonds, Washington and legally described as:
i 4-
5— e�+ 11�Afto
3. irchasers atid Assignees. This notification and covenant
has been recorded in the records of Snobomisi, County, Washington in order to provide notice to
any and all future owners Of the property Of the limitation at the current level of improvement to
single families and adult family home residents fewer than 5ZI/AgALin number.
4. FAI&MMML In addition to any and other remedies civil or criminal which the
City may have, the property owner hereby agrees and stipulates that this grant of covenant sball
entitle the City to enforce by injunction the provisions of this code and, in so doing, to recover its
reasonable attorney's fees and costs.
DATED this 77-Y day of I e ,
19 -) �-,
ACCEPTED BY: APPLICANT/PROPERTY OWNER:
4 k-l'( '
JeanninoeZ:�raf���
Building Official
NOTARY FOR OWNER SIGNATURE, S
State of Washington ,
/ / P1 /7/)SS
Applicant
COVENANT AND NOTIFICATION
ACKNOWLEDGED:
Mortgagor
County of &-u
1 certify that I know or have satisfact V . ence that -
this instrument, on oath st —5 om Olvsils,
gned
ated thatwyo s autho rized to execu te tike
acknowledged it as the instrument and
of party on b pal (title) of (name
V111 'Migpi instrument was executed) to be tile free and volunta - --
party fo 4n osq�stentjoi�sT 1 - ry act of such
!ON
N
VIX � .0 1 tilsfustTnep-Sm -ibed and sworn to before me
s P, psc,
thi �� XV
&J-#O1^ffjo
47y Pu
mis'
iflam forth StateA)17Y,�asl' t
expires (,a � 77FT-
9707160504 2 of 3
10/16�'96 U8: 13 FAX
October 16, 1996
Mr. Paul Stroinme -
Stromme Construction
9623 - Sth Avenue N.E.
Seattle, WA 98115
RE. Hoffman Short Plat, S-95-197
Dear Mr. Stromme:
6;,�v
RECEIVED
OCT 2 8 1996
PERMIT COUNTER
01" r'opl
You intend to construct homes on three contiguous lots in Edmonds. The site is in the
vicinity of 20618 - 88thAvenue West Two of the lots are on a shared moderate slope and
the third is below the slope and relatively flat Attached as page 3-of this letter is a partial,
scale -altered site and topo plan prepared by Dean Read, architect.
You have a long familiarity with the combined properties and were aware that foundation
conditions were unfavorable for conventional shallow foundation support on Lot 3. For this
reason and to head off any future questions about slope or foundation support for Lots 1
and 2, you asked me to inspect and prepare this letter. '
At my suggestion, you arranged for the services of a backhoe at the time of my inspection
last week. Three test holes were dug; their locations are shown on Page 3. A summary of
conditions found is presented on page 4,
The stratigraphically de * epest soil type is glacial till, found at location three- Locations one
and two are in an ancient swale which first collected sandy sediment then organic silt and
peat- Grade bas been raised about 5 feet with fill. You can expect that there might be
intermittent groundwater presence at 2 to 3 yards depth at Lot 3, though none was observed
during test digging.
Soil conditions are highly favorable for developing Lots I and 2- The glacial till there is a
hardpan at a depth of roughly one yard. I recommend that all parts of your foundation
system be dug sufficiently deep to bear on the hardpan. Because of the unusually hlcrh
M
strength of the till, slope stability is not an issue.
Conditions are not favorable for conventional foundation support on Lot 3. 1 recommend
that.the bouse there be supported on small -diameter steel piles. The piles would be
between 2 and 4 inch diameter and of length determined by driving performance. The
piles would be driven to practical refusal as defted by the procedure and equipment
employed. Below is a summary of size -capacity options- Higher capacities or different sizes
might be allowed subject to load testing or other justification.
wi 0 02
JAMES EATON, PE Q, GEOTECHNICAL SERVICES
(206)682-6942 IVI Box 126 * Hobart, WA 98025
10"1-6/96 08: 13 FAI
[a 003
Mr. Paul Sttomme
October 16, 1996
Page 2
Pile Type
2" Schedule 80
3" Schedule 40
4" Schedule 40
Driven By
90 psi pneumatic
hammer
350 lb. hydraulic
hammer
350 lb. hydraulic
hammer
Nominal Allowable
Capacity
4 to 5 K
12 K
16+ K
'ne substance of this information was verbally passed to Clark Johnson Assoc., your
structural engineers. At that time ihe garage floor options were briefly discussed. Withless
than a full structural slab there is some risk of slab settlement You can minimize the
effects of settlement in ways short of pile support. The choice may reduce to a practical
and economic one and will be discussed with you, and your design team.
Conditions beneath Lot 3 are not so adverse as to require special recommendations for
utilities or for inci.dental improvements such as the driveway or sidewalks -
Please see that I am provided with copies of the foundation plans when available.
Yours very truly,
.��o N.
Orr WASH,
I rr A
James Eaton, PE 11917
62-8791 Ila-r IL
cc: Dean Read, Architect WIRES
Clark Johnson, Structural
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PROVED BY P
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PROJECT REVIEW CHECKLIST
PROJECT NAME: (C); P V E S PLAN CHEC'K' #: tj�g
PROJECT ADDRESS: RECEIPT DATE:
Z'� /- o'e Abc 1� ., 65, 7- 2�
REVIEW
D BY: (nitial/Da
e)
PLAN.
W ATER
COMMENTS
—,FIRE
BLDG.
Si
SEWERISTREET
..EN..G..
Setbacks/Variance/Setback Adjustment
Conditional Use Permit
ADB Requirements
Other Zoning Requirements
Underground Wiring Required
Lot Slope 15%
SEPA Environmental Checklist/Hvdraulics Permit
Tree Cutting Plan
Plat/Subdivision Requirements
Legal Description Verification
- - -
Quit Claim/Street Dedications
- - - - - - - - -
.. . .
.
...
........
..........
............. ..
t
Easements - Public/Private
.
..........................
Engineering Storm Drain Review Fee 30
. . . . . . . . . . . . . . . . . . . . . . . . . . .
........
........
3�:
Engineering 2.2 Inspection Fee 30
. . . . . . . . . .
14
Drainage Plan (On -Site)
.............
Setback - Top of Bank, Stream, Water Courses
. . . . . . . . . .
:46..
Setback - Storm Drain Line
.0
. . . . . . . . . . . . . . . . . . . . . . .......
7
Open Ditch - Existing
Culvert Required
. . . . . . . . . . . . . . . . . ....... .......
.18:)
Culvert Size
Shoulder Drainage/Shale Open Runoff
Catch Basin Requirecl
Driveway Slope & Vehicle Access
................
. . . . . . . . . . . . .
28
Sidewalk Required
. . . . . . .
Curb & Gutter Required
. . . . . . .
-,x . . .........
Curb Cut For Driveway Required
. . .
Street Paving Required
..
2.
Right -Of -Way Construction Permit Required I -PR
..... ...... ..
Street Name Sign Required
151:
Other Signing Required
Bond Required For Public Improvements
. . .
. . . . . . . . . . . . . . . . . . . . . . . . .
FEMA Map Check/Water Table
. . ........
till
Side Sewer Availability
3:.,.
Calculate Sewer Connection Fee If No LID # I h I
.......... ..... .....
. . .
Create Street File
.11-- ........ .... .
. . . . . . . . . .
. . ......
. ..... ...
.. ....... .....
. . . . . . . . . . . . . . . . . . . . . . .*,.*,.*,.*,.*,.
...
........ ..
. . ....... ......
Existing Water Main Size
............
86
Water Meter Size
----------
- ------
Service Line Size
. . . . . . . . . .
.... .
88
Water Meter Charge Required
Hydrant Required
............
Hydrant Size Existing
. . . . . . . . . .
Fire Line Charge Required - Sprinkler
4Z�:
IStreet Cut
. . . . . . . . . . . . . . . . . . . . . .
I Miscellaneous
:.A: X..
Reviewed By:
FIRE
PLANNING
*"� /V\
ENGINEERING
PALIC WORKS
V-CEI,VF-U
R E C 0 R D OF C 0 N T A C T S
1
21
2
22
3
23
4
24
5
25
6
26
7
27
8
28
RW PERMIT # DATE ISSUED RECEIPT #
9
29
10
30
'll
31
12
32
13
PAID $ RECEIPT # DATE
33
SS PERMIT # DATE ISSUED RE,CEIPT'#-�/943
14
PAID-$ RECEIPT # DATE
34
35
36
37
METER SIZEN PAID $ DATE�" RECEIPT
18
38
f I
19
39
20
40
V:
JOB NO-
TRAVEL/PREP TIME. _V 7
cy r'r_E c H
A, CONSULTANT S-, INC. TIME ON SITE MILES.
/6)" 3 A -A,
TIME OFF SITE PAGE
(206)747-5618 13256 N.E. 20th St' (Northup Way) #16
Fax- 747-8561 Bellevue, WA 98005 , / OF
WEATHER VISITORS
DAILY FIELD REPORT Z
JOB LIOCATION CLIENT/dWNER PERMIT NUMBER
"I 9"�of'?3
0 ;z o 4(3 'e Vw pq Wr Coseado llp.,_s o/ ^.'ev 4"
I E' DAY OF WEEK
GENERAL NfRACTOR GENERAL CONTRACTOR'S SUPT. 77,n 4o DAT
Po
GRADING CONTRACTOR GRADING FOREMAN HRS.CHARGEO
Qm �;AP 42 in ( 0 At '�42 el If 1'^ dl'l;lo 4 r
r-o-c 54 6 /'q /1" /",o �"q q-, 0 V 0.- clk-Air, .0
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NEXT SITE VISIT:
COPY TO
ATUOE:
A411 PIE p
Grading Plan,`051'g�vl '7 77
, M
A
20431 - 88th Ave West (Rear house)
Tax Parcel # 5446-000-004-0106
Legal: Parcel '13' of short plat #S-I 3-85 as recorded
under Snohomish County recording No. 8507110313
Scale : I"= 20' 02
1998
'T r-_ wt-: -S -r
PPDPOSED
F� Y I t-M M 6,
1-f-46, �fhrvn S60 cu61d y4oz,
APPROVED AS NOTED
Aspki
tURIJA
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f
1) V.
DATE RECEIVED
vi, �hf f A z 0 411 ec
CITY OF EDMONDS
CONSTRUCTION, TERMIT APPLICATION
MAILING ADDRESS
q0bl 32* AVE- - W -
CITY ZIP TELEPHOVE
NAME
ADDRESS
CITY ZIP TELEPHONE
FERMIT EXPIRES
P L
USE PERMIT
�ZONE
NUMBERWS
Z
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SUITWAPT#
AW - W. . E!qmmlps
PLAT NAME/SUBDIVISION NO.
LOT NO.
LID NO.
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP AP ;;ad
RW Permit Required
Street Use Permit Raced
EXISTING — PROPOSED
Inspection Required 13
Sidewatic Required 13
REQUIRED DEDICATION— FT
UndwWWW
wiring required E3
METER SIZE
LINE SIZE
NO. OF Fj)ITURES
PRV REQUIRED
I
I
YES 13 NO 13
REMARKS
z
z
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
—
0
51
NAME
CBL #
JU
EN�IN EERING REVIEWED BY DATE
ic ADDRESS
FIRE,,.REVIEWED I;Y DATE
Iz
CITY ZIP
PHONE
0
rL
�VARIANCEORCUtlll
SHORELINE OR ADB#
INSPECTION
REO'D
BOND
POSTED
STATE LICENSE NUMBER EXPIRATION DATE
A" Ark
P S
s
$EPA REVIEW.
COMPLETE EXEIAPT,,'
SIGN AREA:
ALLOWED PROPOSED
HEIGHT
.,.ALLOWED PROPOSED
i4k Unp
PROPERTYTAX.1 C( 0
L4 I
M5
-o
EXP
13 NEW RESIDENTIAL 1:1 PLUMBING/MECH,
LOT COVERAGE
ALLOWED PROPOSED
'REQUIRED SETBACKS (FT)�-
FRONT SIDE REAR
.�PROPOSED SETBACKS (Fr.)
FRONT URSIDE REAR
ADDITION COMPLIANCE OR
COMMERCIAL
CHANGE OF -USE.
z
REMODEL MULTIFAIVIILY� 13, SIGN
PARKING
RE
LOT AREA
PLANNING REVIEWED. B`Y DAT
1629
W'ej�=
GRADING�., � o FENCE...,:,
REPAIR CYDS X FT)
REMARKS
DEMOLISH TANK OTHER
A�C-' .1 a I r RM /Joi
AV
[3 GARAGE _,RETAINING WALL F:RE SPRINKLER
z CARPORT 0, ROCKERY- F RE ALARM'
V.11 ""4
(TYPE OF BUSINESS 0 R ACT!VITYk EXPLAIN:
CHECKED BY.
TYPE, POF
COIN16TRUCTION
OCCUPANT
GROU
NUMBER'0V
CRITICAL
SPECIAL INSPECTIN
AREA
OCCUPANT f
LOAD
NUMBER
OF
DWELLING
A EAS
�,STORIES
UNITS,,,q
NRUMBER
REQUIRED
YES
J,-ISe8dRIiE'WORK TO.BE DONE
REMARKS
-IN -0
PROGRESS SPECTIONS�PERMBP'1108/FINAL INSPECTION REG
'quit RwAi
VALUATION
$
Descriptio n
FEE
Description
FEE
Plan Check
44
0
State Surcharge
HEAT SOURCE GLAZING% AOTSLOPE %
I
iBuiIdingPermiV--' City Surcharge AT
#_
PLAN CHECK NO: VESTED DATTE
Plurnbih�g)
Mechanical
THIS PERMIT AUTHORRES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
23 DOMAIN (CURBS, SIDEWALKS, DRIVIEWAYS. MARQUEES, ETC.) WILL REQUIRE
It- SEPARATE PERMISSION.
Engr. Review
PERMITAPPLICATION: ISO DAYS
AL PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICAP9 ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Fire Review Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection Receipt #
IALL CLAIMS FOR DAMAGES OF WHATEVER MATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT.. ISSUANCE OF THIS PERMIT SHALL NOT BE
!3 DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapelnsp.' Total Amt. Due 4Z 2-
01 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.*
x
Recording Fee Receipt #
1 HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
This application Is not a permit until signed by the
CALL
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
Building Official or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION receipt Is acknowledged In space, provided.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
OFFICLAIS SIGrATURE DATE
W E! _A 'AGE IGN
3,
(425) 4X*j?)
.30
771-022 1
0
RgLfj5Mfkx/1 DATE
ATTENTION
Off 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
OVAM
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
4
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORIGINAL -FILE - YE1104-106--
PINK -OWNER - GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
—
4"r
Y�
P OMIT EXPIRES
77777 .:CITY OFEDIVIONDS
USE �'PERMIT,
ZON E
NUMBE
-CONSTRUCTION, PERMIT APPLICATION
JOB
SUITE/APT#
'ADDRESS.
:2 e.
bwNt�i NAMONAME OF: BUSINESS
M44 Col i. I N1,
E§CRIPTION CHt
SUBDIVISION,N6:'.'
LID NO
I MAILIhG AbDRESS
$ _i�
_3`30-2i
:2 LI
P,
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MA
TESCP App—ed 0
RW Pe-11 R.qubed 0
CITY
EXISTING — REQUIRED DEDICATION
Street Use Permit Req'd 0
tj C)
inspection Requived 0
PROP SED
"o
Sde—Ilk Aequ.,ed 0
NAME',
METER SIZE
LINE SIZE
NO. OF FIXT
PRV,REQUIRED
YES 0 NO 0
.'ADbRESS;'
REMARKS.
W
z
z
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CIT_yw
W
'NAME
ENGINEERING MEMO DATED;_ REVIE EDBY
FIRE MEMO DATED! REVIEWED BY
ILI
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U.
CITY. ZIP
[TELEPHONE
VARIANCE OR CU
ADB#.1
.�STATE_,LICENSE.NUMBER �-:EXPIRATIOWDATE.
C
C ECKED BY
SEPA REVIEW
SIG�'AREA
HEIGHT
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWED PROPOSED
INC ALL�EASEMENTS
'LEGAL DESCRIPTION OF PROPERT LU13E�
'e7,
X P
EXP
q
L 0
LOT.COVERAGE,
REQUIRED. SETBAC �S ' 1FT.Y '
.�PROPOSED�S TBACKS�FT.)
A 0 W
ALLOWED PROPOSED
FRONT SIDE REAR
:�?FRONT:;UWSIDE REAR.
LL
z
.PROPERTY TAX. ACCOUNT PARCEL'NO.'
LOT A REA
PL ANNING:REVIEW BY DATE
Q.
PLUMB -MECH:--
ING1
REMARKS..,
R E M A
COMPLIANCEOR:
"ADDITION: CPMMERCIA _E1:,CHANGE 6F,USE..�
APARTMENT,7�:.:
EMODEL 0 SIGN
E] REPAIR FENCE-_
CHECKED BY
TYPE OF CONSTRUCTION
-.00CUPANT-'-*
CYDS, X FT).
f -1 DEMOLISH -TANK OTHER-,.,,
7 A
V—,41
7 ZM
GARAGE
SPEC,
SPECIAL INSPECTOR OCCUPAW
R E�AIN'!
:_R _— .
CARPOR El —Ell RENEWA��?':
T
JAREA
,REOU,
".REQUIRED LOAD
El YES
(j kl�,
.....................................
REMA , RKS
ffOF:USE,�BUSINESSOR'ACTIVi EXPLAIN
TY :,In
A4
66
S
E S JN$FEPT1PNS.f!ER UpobEl
�NUWER
NUMBER OF CRITICAL.
;SfbR1ES:.:.
G,
DWELON' AREAS
UNITS 40V
NUMBER
7
DESCRIBE ORK.TOBE DONE'77-77 ...... I
4 tne
-FINAL. INSPECT(OWREQUIRED-V
0:1:
VALUATION
FEE
�PLAN CHECK FEE
HEAT SOURC G LAZING! LOT SLOPE%
IL DING
4 i�:
PLAWCHEMNO: jVtSTED DATE 'PLUMBING—
.—HANICAL
THIS:PERMIT AUTHORIZES ONLY THE WORWNOTED THIS PERMIT COVERS -VY
BEDONE.ON PRIVATE'PROPERTY ONLY.% ANV CONSTRUCTION ON THE PU6L.IC :GRADING/FILL,
bomAiN:(CURBS,SIDEWALKS,DRIVEWAYS;',MARQUEES 3ETC;) WILL REQUIRE
SEPARATE PERMISSION.
STATE SURCHARGE
PfRMITAPPI�ICAtib�:.,-�,,ii6�6A4s
PERMIT LIMIT. 1. YEAR. PRovibEb:W , 6ifk"is STARTED WITHIN 180 DAYS STORM DRAINAGE FEES
P iER SP06k��HltMS ASSIGNS AND SUCCESORS ENG. INSPECTION FEE
A 'CANT" 'ON
T RE 'A
ST ITY OF
MO S YAND
ED D - W
ALL ' CLA MS F -0 ECTLY
FROM THE I SS OTBE
DEEMED To MO ANCE PLAN CHECK DEPOSIT'
NOR LIMIT IN AN Slow
�TOTAL AMOUNT DUE
IHE Y ACKNOWLEDGE:THATVHAV9 9EADt.H]S�ARPLICATION; THAT THE INFORMATION
S AND.THAT4%.AM...THE "' -THE DULY�AUTHORIZEDAGENT;01`
I V CORRECT, -OWNEW"OR APPLICATIONAPPROVAL
TH NtW14 AGREE TO COMPLY WITH;CITYr'AN6.STATE LAWS;REGULATING GONSTJRUC-
CALL
This applicatiori'm not ii permit.until sighed by the
TIbN,.-ANb:IN'DOING�THE WORK AUTHORIZEDJHEREBY��NO PERSON�WILL'BEVMPLOYED
. ees are paid. and
4 -TH t RELATING -TO Building Official or his/her Depiity:.�and'F
INVIOLATIOWOF. E LAboh�cbb_E�OrTkEigl`Af ;oFWASHINGT6N. FOR IN9PECTION
I. ceipt is acknowledged in space:provided.
W RKMEN'S!COMP.ENSATIONINSURANCE;AND;-RCI��18:2,7.,
0
OFFI I LS SIGN URE E
NATUR -(OWNE9.6R ENT)" DATE-SIGNED1 DAT
E (425)
771,70-220 hl?
WLEASED BYL114 DATE.
kkt-'TIENT OW
I�UNLS.6NL A . FUL30 USE:ORsOCQVPY.A--I3UILDING OR ST.RUQT.URE UNTIL
:FINALJNSPECTION--HAS�, BEEWMADE-AND APPROVAL OR A CE13TIR-
I ANCYHASIBEEN .6 RA : NT . ED: UBC SECTIO . N 1 09 ORIGINAL - FILE YELLOW - INSPECTOR
IATE..OF*OCCUP PINK - OWNER: 4 GOLD - ASSESSOR
i
i1c)
ce'
RECOR6.90FINSPECTIONS...._
J�
INSPECTOR iDATE APPROVED
�:SETBACKS ....... ....... ep!"
FOUNDATION:
Footing ......................
.......................
Pier/Porch .................
Retaining Wall ...........
...... . ......
PLUMBING:
U�erground ..............
6 u I n.'.'.."._..'._;'.'.'..
Yi
Commercial Final ......
-HEATING:
Gas Test .....................
Gas Piping .................
'Equipment .................
Commercial Final .......
.. ......... ...
EXTERIOR SHEATHING
-,NAO.NG�w; .... ..................
1W
RAMING
INSULATION ... ................
Floor Insulation .........
"A
Wa-11 Insulation .............
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIA�INSPECTION:-,.*-,-.��,.',*;
MISCELLANEOUS ........
4
FINAL APPROVAL:FOR
OCCUPANCY
F
N'f
4.,
1-9" __ U-0
LIUILG146 TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE 2-
PLEASESIGN
ENGINEERING DIVISION DATE
PLEASESIGN
PLANNING DIVISION DATE
PL&&812 SIGN
PROJECT T/M C61_-Lt,,,J Z
SITE ADDRESS 9-0Y 3 L e�_
PERMIT# q?-O 0 q? ADB# DATE INSPECTED I
DESCRIPTION OF WORK TO BE INSPECTED Z-r-c- Z(/C-
A field inspection was conducted to determine compliance with approved plans. Final approval denotes that
there are no objections from the above signed Department to the granting of:
— '2�_ Final approval of the described work
I .
1 .
2.
3.
—Performance Bonds associated with the project may be released
GRANT FINAL PROJECT APPROVAL
GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
—FAILED FINAL INSPECTION - OUTSTANDING ISSUES
RE- INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
ocaprvl.doc.l:temp:bldg:forms6/98
STREET FIV-F
aw
OF
SOCIAI.&MALTH SEP 1997
Adult.�f_ ome tceft6c
in. compliance with and -pursuant to- ike laws of the State of Wasbington. and. the Mirahum . Livansing RequirenienU
of the Deptrtmeiat of Social and Health Services. a license is here.�y granbed
T3240TRY L.- COLLINS
Iicem'Numher 395401
20431 80TH AVMNUR WEST
to conduct and..mainiain at,
oily of EDMONDS zip M
de ..98026 county of
State of Wasbington, an Adult Parfilly Home forthe icare and sd'pendsion. of adults as follows-
Mour family C Ar no More than FIVE (5) adulls
71 is licahm 00. be in fone from the �25TJII_ ftof. AUGUST 19 97. to and incluchng
25TH &Y AUCUS7 98 subi ect to revo-catio . n for due cause.
-of M_
14
HOTE: This ficam 1� not trandemble, and is valid onb for uw.bVthi�UtdIvkk WI(s) to whom iC is -issijed'and at the lotafion above
(Jesaibet- Imml by AutlwdLy Ctmpter M, Lan- of 1061, and RCW-I(k 128"
z4
DM Win otn. 001)
NOTICE:
a'r.r a ffy ... 0 Y._
-N'o n the a'ttached
The -information shown o
map(s) was compiled for use by the CitY Of
Edmondsi its Employees and Consultants.
Th,.e City of "Edmonds does. not. wa rra nt the
hing set forth on these
accuracy of anyt
rnap(s�. An . y person or entity a
copy should conduct an independent
ormation shown on
inquiry regarding the inf
__tF� -map(s)., including, but not limited to,
the lociation of any sew-er stub shown. Suc
sewer stubs may or may- not exist. and may
or may not exist at the location shown
Neither the City of Edmo-nds nor its
flompl-o-yee-s or offi-ce-rs -shatl be 1--ia-b-1--e for the
information giVen' on this map(s)j nor for
any one representation provided based
upon said. map(s).
The City o� Edmords Alater Service Drawing EA�3EMSINT NO . . ... .. ...... .. .... .. ... ..... ........
NEW CONSTRUCTION REr-AIRS 0 LID NC . .................. . ASMT. NO. ...... .........
OWNER................................................................................................ CONTRACTOR .................................................................................... PERMIT NO . ....................
JOB ADDRESS ..................... LEGAL DESCRIPTION: LOT NO . ..................... ................ BLOCK NO . ....................................
.... ... ...... .. .. .. .. ...... ... ....... ......
..................................................................................................................................................................
X
�4
NAMEOF ADDITION ....................................................................................................................
441
N,
L
RART A
Approved:
PWW.0001.11175 (REV.11/78)
DATE............................................ By ............................................................
1-tot—W—C"W92
City of Edmonds, Ci ty C1 erk
121 5th Avenue North
Edmonds, WA 98020
9707160504
07/16/97 14:57
p.0002 Recorded
III 1111111111 Snohomish County
B U IA ING
AUG — 8 1997
NOTICE OF LIMITATION AND COVENANT
ADULT FAMILY HOME
Reference
Grantor(s): (1) SoAj,-rA A - Dmi/6 (2 A "14- del 1�- t)6k16 - Additional on pg.
Grantee(s): Ci
Legal Description (abbreviated): Sec______�_Twn ----_Rng—Qtr
OR Lot-3—Block—plat
Assessor's Tax Parcel ED#(s): (1) 1
3WK- C" -4Z14-01040 (2)
--Assessor's Tax Parcel 1D# not yet assigned
WHEREAS, the undersigned owners of property located at 7-0 q,�; �qgm
In Edmonds, Washington legally described below or on the attached
Exhibit A, have applied for a building permit for compliance and/or to remodel a structure located
on the site; and
W`]1ERE AS, the applicant has notified the City of applicant's intention to utilize the improvements
andior to convert an existing single family structure to an adult family home; and
VMEREAS, under the Uniform Building Code the number of occupants of a structure trigger
certain requirements relating to the fire suppression and exiting requirements; and
W'HEREAS, the City has notified the applicant that the permit will he issued conditioned on
limitation of residents to 5 ( )L—or fewer residents and their caretakers; and
WIRREAS, the City has issued a permit based upon such representations;
NOW, THEREFORE, the undersigned property owners (hereinafter "Owner") in
consideration of the issuance of a building permit anti in order to confirm the promises upon which
such issuance is based while providing notice to any future owners or mortgagors of tile property
does hereby stipulate, covenant and agree as follows:
1. Covenant: Li - - n es* n the owner hereby stipulates and agrees that
occupancy of the structure as an adult family home shall be limited to -51,K or
fewer adults and their ' caretakers as allowed by applicable provisions of state law. The owner
acknowledges that in the event that the applicant seeks revision of the applicant's state license to
operate an adult family home with an occupancy of greater than - 6 f X residents,or attempts
to rent, lease or otherwise provide residence for additional residents above tile 6 1 X
permitted in the current occupancy Classification, the structure shall be vacated and all residential
use ceased until such time as the property is brought into compliance with tile provisions of the
State Building Code, under the edition of the Uniform Building Code then in effect. The owner
further stipulates that this covenant touches and concerns the land so long as the present structure
and use continues and shall run with the land to all ftiture purchasers and assigns.
I of 3
� A.- -t- I
W
City of Edmonds,. City Clerk
121 5th Avenue No.'
Edmonds, WA 98020
2. 51ft—CLIM91, The above stipulation and promises shall a I to and run with the
land with respect to a residential structure located at 20 q M ywrl-� 7-
Edmonds, Washington and legally described as:
Cl� AA1&10 & V (� I -1Z -
3. Notification �ndAs�sine s This notification and covenant
has been recorded in the records Of Snohomish County, Washi
ngton in order to provide notice to
any and all future owners of the property of the limitation at the current level of improvement to
single families and adult family home residents fewer than SASYAW—in number.
1
4. Eft&Urmatt In addition to any and other remedies civil or criminal which the
City may have, the property owner hereby agrees and stipulates that this grant of covenant shall
entitle the City to enforce by injunction the provisions of this code and, in so doing, to recover its
reasonable attorney's fees and costs.
DATED this /3m
day of Tuye 19
ACCEPTED BY: APPLICANT/PROPERTY OWNER:
J e 64n Ani n e �L
Building Official
NOTARY FOR OWNER SIGNATURE S
State ofWashington*. )
Applicant
COVENANT AND NOTIFICATION
ACKNOWLEDGED:
Mortgagor
County of )ss
ffil V 1) /1-V ( S> is'
I certify that I know or have satisfact v ence that 4:-�5 nl) � C4_ 14
this instrument, on oath stated thati 4� signed
acknowledged it as the was authorized to execute the instrument and
of party on b (tifle) of.. (name
dom instrument was executed) to be the free and voluntary act of such
�-n this lust"rep�,,
party fo
pfts;
iON
f, -, Subscribed and sworn to before me
this
oull P Pu
U
�mmis%
in and for thd Stt��
expires
9707160504 2 of 3
CITY OF EDMONDS
5iE
ZONE
PERMIT
NUMBER
CONSTRUCTION PERMIT APPLICATION
_970547
JOB
0,/ ITE/APT #
S
OWNER NAME/NAME OF BLISINES 6101f.
ADDRESS
Lq ) ) ,
Ike IN-E 1.
LEGAL DESCRIPTION CHECKI
,
SUBDIVISION NO.
LID NO.
ir
LU
MAILING AD—
Z
0
'STREET
TESCP Approved 0
PUBLIC RIGHT OF WAY PER OFFICIAL MAP.
CIT ZIP _]TELEPHONE
NUMBER
7
EXISTING — REOUIREO DEDICATION —
RW Permit Required 0
Street Use Permit Req'd 0
3 X5_
Inspection Required 0
NAME
PROPOSED
Sidewalk Required 0
& h)
METERSIZE
LINESIZE
PRV REQUIRED
Ow
ADDRESS
�N573��
YES 13 NO 0
L)
ZI E NUMBE R
REMARKS
duf14tes_r1_1y,1e
0
Le
Cr
W
<
CITY
TELEPHON
Z
W
NAME
. rt-k->(
cc
0
ADDRESS
;3 -7 (;0 71A0 rw V_ /V
�1,
ENGINEERING MEMO DATED j REVIEWED B
0:
Z
Cl ZIP
TELEPHONE NUMBER
LU
FIRE MEMO DATED REVIEWED BY
0
STATE LICENSE NUMBER EXPIRATION DATE
Ot V A 6 &P
SIGN AREA
SEPA REVIEW
AD R-N . 0;
Legal Description of Property - include all easements
ALLOWED
PROPOSED
COMPLETE
EXEMPT
SHORELINE III
z
EXP
Q.
VARIANCE OR CU
PLANNING REVIEW BY
DATE
0
7
Vol' 1-3 46�7
SETBACKS — FEET
HEIGHT
LOT COVERAGE
Z
'.0
R!!3
I I
FRONT. -75' SIDE 10' REAR?c
3
Z
Property
Tax Account
Parcel No. Oct) - 00;-/ - o 10 6,
REMARKS
:5
o.
4� 4oLk /,w pC��^j tj ja44 IAAA A !4. r, 1A am
NEW
RESIDE NTIAL
PLUMBINGIMECH
K
COMPLIANCE OR
ADDITION
COMMERCIAL
CHANGE OF USE
_j
APT. BLDG.
Ab'
4j REMODEL
SIGN
.,td
GRADING FENCE
CHECKED BY
TYPE OFS&NSTRUCTION
OCCUPAW_�
GRO
or
REPAIR CYDS. x _FT)
&L-0 I
WOODSTOVE
DEMOLISH SWIM POOL
Ej INSERT El HOT TUB/SPA
SPECIAL INSPECTOR
:REQUIRED
AREA
CU
OCCUPANT
LOAD
GARAGE RETAINING WALL/
YES
Z
REMARKS
CA ROCKERY
1W
0
(TYPE OF U S NESS OR AOTIVITY) EXPLAIM
BU I
PROGRESS INSPE&IONSI�ER UBC 108
W
NUMBER
it CRITICAL
UMBER Of
AAim
0
�OF
DWELLING AREAS
I
M
STORIES
UNITS NUMBE
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN,
/I (f
FINALINSPECTION
REQUIRED
VALUATION
FEE
PLAN CHECK FEE
HEAT SOURCE: GLAZING
BUILDING
100
A0.6 %
PLUMBING
1fZ
[Plan Check No. Z_
MECHANICAL
This Permit covers work to be done on private property ONLY.
Any construction cin the public domain (curbs, sldewolks,
driveways, marquees-, etc.) will require separate permission.
STATE SURCHARGE
permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Art licant on behalf of his or her SnoUse heirs assinns and
ENG. INSPECTION FEE
Cn
'Wn
successors in interest, agrees to Indemnify, defend and hold
harmless the City of Edmonds, Washington, its officla 'Si
lqe,
lot)
employees, and agents from any and all. claims for clamageso
/ �- W
a:
<
whatever nature, arising directly or Indirectly from the issuance
M
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
(6t:yl
0
modify, waive or reduce any requirement of any city ordinance
0
I
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
?3 6
provision.-
I hereby acknowledge that I ov, ��eacl thib �ppilcatl n; that the
information given is cc �d that I Am thelowner, r the duly
�agfr4
ATTENTION
APPLICA TION- APPROVAL
authorized agent- of the ownen I to. comply wji�hl city and
state laws regulating construction; and In doing the wbrk authoriz-
THIS PERMIT
AUTHORIZES
This application is not a permit until
ed thereby, no person will be employed in violation of the Labor
ONLY THE
signed by the Building Official or his/her
as
Code of theSlaWof W tingtorlielating to Workmen's Compensa-
WORK NOTED
Deputy; and fees -are paid. and receipt is
tion Insurafie—ehnil RCW18.27/.
INSPECTION
acknowledged in space provided.
SIG NATU�R�`.,,R;�OEINIT)
NE SIGNED,,
DEPARTMENT
]DATE
.7
CITY OF
EDMONDS
71CIA �SSI NATURE DATE
ATTENTION
CALL FOR
4 DA*
REAELEASt
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220
171RIILINAt" File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
SECTION 109
PINK — Owner GOLD — Assessor
Grading Plan
20431 - 88th Ave West (Rear house)
Tax Parcel # 5446-000-004-0106
Legal: Parcel'B'of short plat #S-13-85 as recorded
under Snohomish County recording No. 8507110313
Scale I "= 201
,91z
'T
PROPOSE13
N O'c 'fhn-n 560 cub,4 pjgpt
APPROVED AS NOTED
I;t LUZ
<
i F6IAkA(,f--
Aspknl+
fV11MAR6040
77 fps
iA MI
MI
r;
qf Pv r
4
I
(,C;, Omer
-ro exe, r
C, e)
v-wo---r- f. rl
,To axerr
CIG -
too,
P2rl,pnc%r. rl%
7-0to TO czts
0,
I E 3 150, Cr
izo LX
WNER
M*v A05
APPLICPFNT
CA SCAI'�5.�-:�'.'HOM RIS'-
K Elk I Z)TA-9 -14 fq
-AV
I L
-ALLUP---.W-`A-.-- 9 -rt*,-,-",*,*-,-,--.
PUY eZ
LEGAL--b'
T..
?A ME LS
... Uaoz P
--.- A . s SO
IONA N2
'0 F
AS j�ietk. -PLA-T
RA CT 4� .0. 1 N
VOLUM f,.r. �.'.PL.Xr S.,,
P-ROv.-ED
.711
ACCEPTABLE TIGHTLINE MA-MNAL -CASCADIE.- AVE V-PROPER
N-12 AnS s-rc)gm*,.,-.....i:�l:�-A'IN'AGr'E. IPLAN
Sch 40 PVC
SEALEt 14.= Z�- APPROVED BY: DRAWN BYT.
SDR 35 (ASTM D3034) REVISED HAMNE
DATE; (a/z I
JUN 2 7 1996
WATER SERVICE INSPECTIONS
DRAWING NUMBER
REQUIRED. CALL 771-0235
-F
Citymof
RIGHT—OF—WAY CONSTRUCTION
PERMIT rmit Number.
Pe e? 7- 03
Wue Date: �1!z
A. Address br Vicinity of Construction: 20431 88th Avenue W. ---- i ce
11%�� -� I . GTE to place, operate, and mainatan a BurieT sery
I C, B. Tyg; ofWork (be specific): wire from existing pedestal # 2893 located at 205th Plc.
9 0 9 C� Sw & th Ave. W; then north to a residence at ZU431 56th Ave. W. GTE to—p7ow 60 f&.,
push no driveway and push 1 rnAd 40 ff- R-()-W- Rnft- PlpanA RAP attanhad sketch.
Marilyn HoMgren, Permit Coordinator
C. Contractor:GTE Northwest lecorporated Contact: Dennis Alexander 771-9036 mobile 388-1358
Mailing Address: iy'e'2rattW,C0AiQ92D21440 Phone: Marilyn 206/488-1628 or 710-0786
State License #:
D. Building Permit # (if applicable):
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. F] Commercial El Subdivision C1 City Project ff3 Utility (PUDI G`114 WNG, CABLE, WATER)
n Multi-Farni!y El Singlefamily Other
210 - P 01DB 242310
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut: MYes 0No G. Size of Cut: 'k x 5 0X841 Ug(?"I.,
Please seea ached.sk-etch. -7 two tP.;0
tt
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the City ofEdmonds harmless from injuries, damages, or
I I I
claims of any kind or description whatsoever, foreseen or unforeseen, 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 legalproceedings including defense costs, and attorney fees by reason ofgranting thispermit.
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 TIMEA 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.
Ihave read the abovestatements and understand the permit requirements and thepink copyof thepermit will be
available on site " all tinVs-fm%4.nspection purposes.
Signature: t. & z'- d—L--al 'John H. Stewart Date: 2/10/97
SjgtWgW lec Mgr -Access Design
Tpr Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY. RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFTER V01 0 2 DAYS
SPECIAL CONDITIONS: A 5, rl
COMMENTS:
DISRUPTION FEE/FUND III:-
RESTORATION- FEE:
PERMIT FEE: 30
TOTAL, FEE: e�, 3a
RECEIPT FEE:
DATE: ISSUED,
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. 1994
w 4
FIELD INSPECTION NOTES
Comments:
Diagram.:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION 0 YES
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
LEGENI)
PEERMIT SUBMITT"ED BY
GTE
PEDS a
POLES 0
ROAD BORES
OVERHEAD LNES--
I-D-UTILlry POT-11OLE [--1
UG TRENC14ING ---U(;T—
R.o.w.
------------------------------- EOP
-------------------------
r %- w
m
:X"qi
;14
0 - I I I - I -).-
NJ
CD
co
THE FOLLOWING INFO TO BE PROVIDED
RIGHT OF WAY LINES,EOP OR FACE OF CURB, EXISTING SIDEWALK. POLES, ROAD C(JTS MID THE UTILITY UNDER ROAD CUTS,
ABOVE GROUND FACILITIES,fle.*) PEDSwBOXES,CA13INETS, ETC.,UNDERGROUNI) TRENCHING Ahl) OVERHEAD LINES.
CD
&- FOOTAGE OF WORK IN R.O.W.
I
mi
5�
CITY OF EDMONDS
SIDE SEWER PERMIT
11,9 9 PERMIT 1`,�12
c�z 8 8 G 4
Address of Construction: --204-3/ - 0 0 tA Lve_/67
Property Legal Description (include all easements): I—V I
* S - I -; - F) 5- -
Tt�y 'S_1-06-;)-00G)-00q-Q10b
Owner and/or Contractor:
TMENT, PLANr,,
SEP Z 4 1996
"MBLIC WORKS DEP-r
e 14 ('
State License No. 0 E - Building Permit No. 17600 VC/
q6 Single Family
C3 Multi -Family (No. of Units—)
El Commercial
El Public
Invasion into City Right -of -Way: Iff No El Yes
RW Construction Permit No.
Cross other Private Property:�6 No El Yes
Attach legal description and copy of recorded easement
I certify that I ha&readys-� 11 comply with all city requirements
, - " ., 11
as indicated on the back of �t ffePermit Card.
q_2t1_96 -
Date
* CALL DIAL-A-D IG (1-800-424-5555) BEFORE ANY EXCAVATION *
OFFICE USE -ONLY
FOR INSPECTION CALL"Y" ""C") PUBLIC WORKS DEPT.
,�70 -7-71-0,91l
Permit Fee: — Issued By
Trunk Charge: Date Issued: -9 y - 9(10
Assessment Fee: A) Receipt No.:
Lid No.:— /6/
Partial Inspection: Date —Initial —
Comments
Reason Rejected: Date —Initial
Fin'a'l Inspection Approved: Datd lnitial,�;L4
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy; File Gree�n Copy. Inspector Buff Copy: Applicant Revised 3190
The City of Edmonds Side Sewer Drawing EASEMENT NO . ............................................
NEW CONSTRUCTION REPAIRS n LID NO . .................. IASMT. NO . ..................
OWNER................................................................................................ CONTRACTOR ..................................... .......................... PERMIT NO.
JOB ADDRESS -- - ---- 470Z�t ... LEGAL DESCRIPTION: LOT No . ..... CK NO . ....................................
-TREKrtjZWf, - -PLA tf�f
..................................................................................................................................................................
a
NAME OF ADDITION ....................................................
A
0 5,To Km MaAcke,
? C-0 ,
t 0 4 e-- P - I
c- 1-ci
r7 8
Approved:
t
16
H
qYP"1-e-
.�L4 Ozx-f -
r:j
PWW-0001-11/75 (REV.11/78)
DATE ......
By .. ......
..... ...... ....... .......
Site Plan
20431 - 88th Ave West (Rear house)
Tax Parcel # 5446-000-004-0106
Legal: Parcel 13'of short plat #S-13-85 as recorded
under Snohomish County recording No. 8507110313 JUN 2 7 1996
Scale: I"= 20' PERMIT COU -j
'R
H F- wr-: 5 -r *— 'tuvb I 6.-M-ce, 4 es, 4-cu'm V,
WAM MCTrf�
A- =
t 10-d
6=
iiq- o%
12-1 -D
"toss—
se-wte
5�,jb
APPR
. OVED BY
PLANNING DATA
NAME:
SITE ADDRESS:—ZO431 e4w 0 DATE: 7/a
ZONING: �4- PLAN CHK#: 96 - (3ff
PROJECT DESCRIPTION: 2
U
CORNERLOT A —(Yes/No)
SETBACKS:
Required Setbacks:
Front: Z67 LeftSide: tO'—RightSide: tO* Rear: 'S;,
Actual Setbacks:
Front: V; Left Side: 10' Right Side: 3o' Rear-'3(v'
Street map checked for additional setback required? e o)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED (Y/N)
LOT COVERAGE: 23-74-
Maximum Allowed: ;67 Actual: --A 3 - 101 11 '7,5-2-
BUILDING HEIGHT:
Maximum Allowed: 2-F Actual Height:
Datum Point: vo-p., Datum Elevation:
SUBDIVISION: '�> - 13 - �� - +t,,rnAn� mt. — lazu vie, ", 2±3 I I'-- -
CRITICAL AREAS #: 95--7-3( . bj,�_Vc_
SEPA DETERMINATION: Le
'4'
LOT AREA: 9t 5`6 n0- 4r, �,k�ptp)
OTHER:
Plan Review By:
"to
SE PERMIT
ZONE
CITY OF EDMONDS NUMBER
9G0494
CONSTRUCTION PERMIT APPLICATION joB
RESS WUITEIAPT #
0 Wr INESS ADD
;AME NAME OF BUZ
r tyke 6 LEGAL DESCMAI P'TIO'N"11H ECK SUBDIVISION N07"a LID NO.
Cc IW MAILING ADDRESS
Z trt
': TY) 121-rLdiOV L-AQ
0 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved 0
CITY ZIP TELEPHONE NUMBER RW Permit Required 0
EXISTING REOQUIREP DEDICATION -:61z-
0 Street Use Permit Req'd 0
V, PROPOSED Inspection Required
NAME Sidewalk Required, 0
IfF UNEP)ZE NO. OF FIXTURES PRVf�QUIRED
0 ADDRESS Y NO 13
EMAIRKS
W
ZIP E NUMBER
< CITY
Z
W
ADDRESS
0 ENGINgERING MEMO DATED FIEVIEWEDBY
CITY zip TELEPHONE NUMBER.' A4 M
FIREMEMO DATED REVIEWED BY
Z W
0
STATE LICENSE NUMBER E SIGN AREA SEPA REVIEW ADS NO.
A ALLOWED PROPOSED COMPLETE JEXEMPT
;�al Description of Property - include all eagements SHORELINE N
13 s/ 16P 11 1) Attl EXP
0.
"4 �3 5- VARIANCE OR CU PLANNING REVIEW BY DATE
FC
LLJ
SETBACKS — FEET HE16HT LOT COVERAGE
-K Z
0 1 FRONT SIDE 101 REARZ-5' 2— q' _%G,07. Z
'_uj Property
Tax Account 0-
Parcel No. Y t 4
91EW RESIDENTIAL PLUMBINGIMECH
COMPLIANCE OR
EJADDITION El COMMERCIAL E] CHANGE OF USE
EIREMODEL El APT. BLDG. SIGN
CHECKED BY YPE OF CONSTRUCTION CODE ocr,
FENCE GRN
REPAIR CYDS. I x —FT) 7 -W-P I
WOODSTOVE SWIM POOL SPECIAL INSPECTOR , �0 OCCUPANT
DEMOLISH El INSERT HOT TUEI/SPA REQUIRED LOAD
r.71 GARAGE RETAINING WALL/
AJ GAma@" 11 ROCKERY El RENEWAL REMARKS
(TYPE 0 SE, BUSINE OR ACTIVITY) ExPLAIN: PROGRESS INSPECTIONS PER UBC 108 Z
E D
W 7) to i W
16 NUMBER
W NUMBER OF CRITICAL
93 OF DWELLING AREAS
03 STORIES,, I UNITS INUMBER
0
DESCRIBE V�OW TO BE D N ( TTA LOT PLAN)
FINAL'INSPECTION REOUIRED
VALUATION FEE
6_7Mdw
100, Z,4W CY PLAN CHECK FEE
till -11,07
Xor 51042-e 4&
1170 BUILDING
HEAT SOURCE: GLAZING
% PLUMBING -70
Plan Check No. MECHANICAL 169
This Permit covers work to be done on private p!.operty ONLY. GRADINGIFILL .
Any construction on the public domain (curbs,.Sidewpiks,
driveways, marquees, etc.) will require separate �ermlsslon. STATE SURCHARGE '50
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
successors in interest, agrees to Indemnify, defend,and hold
21 harmless the City of Edmonds, WashinMon, its officials,
5 employees, and agents from any and all claims for damages of
(X
< whatever nature, arising directly or Indirectly ftom the Issuance
of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT
modify, waive or reduce any requirement of any city ordinance
0
=1 nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE
provision." (0/7
I hereby acknowledge that I have reSd*this application; that the
information given is correct; and that I am the owner, or the duly A17ENTION APPLICATION APPROVAL
authorized agent of the owner. I agree to comply with city and THIS PERMIT
state laws regulating construction; and In doing the work authoriz- AUTHORIZES This application is not a permit until
ed thereby, no person will be employed in violation of the.Labor ONLY THE signed by the Building Official or his/her
Code of the State of Washinyt �n rel hig to Workmen's Comoensa- WORK NOTED Deputy; and fees are paid, and receipt Is
acknowledged In space provided.
tion Insurance and RQW 18 INSPECTION
SIGNATURE (OWNER 9K NX DATE SIGNED DEPARTMENT
ATE
OFFICIAL' NATTV, _714SAA
CITY OF
EDMONDS
7W 1 . 4n V
CALL FOR REL-EAS r,2Z E'
ATT NTI0'Nt/--"/ INSPECTION J�7
IT IS UNLAWFUL TO USE OR occupy A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — FiN
A CERTIFICATE OF OCCUPANCY AS BEEN GRANTED. UBC 771 - Q220 7
SECTION 109 PINK'— Owner GOLD — Assessor
10247
8 go - 199 -
Oty of Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT e,
Permit Number.
Usue Date: A/
A. Address or Vicinity'9f Construction: 20431 88 AV W (9702315)
B. Type of Work (be specific)� Install Service
C. Contractor: - Washington Natural Gas
MailingAddress: 1122 75 St 9W Everett
State License #: 98203
D. Building Permit # (if applicable):
E. n ' Commercial E] Subdivision
E] Multi -Family E] SingleFamily
INSPECTOR:
F. Pavement or Concrete Cut: El Yes
Contact: Mariamnia Kingghury
Phone: 556-7500 IC7596
Liability Insurance: Bond:$
Side Sewer Permit # (if applicable):
F1 City Project n Utility (PUD, GTE, WNG, CABLE, WATER)
F] Other
INSPECTOR:
3. Size of Cut: i" H. Chargq�
Ll V X 4 = 400
4" APPLICANT TO READ AN6SfGN
(-Z) -zx
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the City ofEdmonds harmless from injuries, 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 departments or
employees, including or not limited to the defense ofany legalproceedings including defense costs, and attorney fees by reason ofgranting thiapermit.
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 TH E FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIMEA 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.
Ihave read the above statements andunderstand thepermit requirements and thepink copyof thepermit willbe
available on site at all imes for inspect. purposes.
Signature: Date: 11-6-96
(Yontract,�,`or 4ienV
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY! PtOY V-4% '14 �eM RIGHT OF WAY DEPOSIT
TI . ME AUTHORI I Z ED: VOID AFTER JAt*) 30 DAYS DISRUPTION FEE/FUND Ill: 0 0
SPECIALCONDFPIONS- MA% 'TA%Q
&_AA(s%1FvL 'THAtJ 2- -44
CAQ A Fv-Tu(tF_ SWP> ISE ?LACED
WE'S-T C-F 6)A!� -TtC-%1V AL�SO..
COMMENTS:
RESTORATION FEE:
PERMff FEE: 30
TOTAL FEE:
RECEIPT FEE:
DATE,:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. 1994
FIELD INSPECTION NOTES
Comments:
Diagram.:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
El NO
UA -A-IL- -AL---MP-40�
WWWWRIVOWIN -
NaftirM CIM
AVVb#VxjIOnEMTWCOnX-W
Q
20 4-
Ail
Watermain depth (:73' 0 it
4- gas main
0.
Addendum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
1356-7500 X7596
') 'n 0*
--t>(P— T-
JOE> 9
q *CILA-;r S
10"Or-61 56 Aq�)
Key:
-W- Water
-G- Gas
-SS- Sewer
-& Water hydrant
0 Water valve
Washington Natural Gas Company
1122 75th Street S.W.. Everett, Washington 98203, (206) 355-3331
IUL A IL-2— --a--
womwon
Natu --a- Gas
AvMO*igIonErvfwCcffV&V
Q
.0
C�—
Watermain depth �1/
4- gas main
Addendum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
1356-7500 X7596
JDE� 9 -4oZ3� S
q "C's� S
'2-0"�s I a e; Aqj C4-
Key:
-w- Water
-G- Gas
-SS- Sever
-& Water hydrant
0 Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett. Washington 98203. (206) 355-3331
01-
v
City offdmonds
RIGHT-OF-WAY CONSTRUCTION
do
PERMIT Permit Number.
Issue Date:
A.' Address or Vicinity of Construction: 7308 175th SW
GTE to place, operate, and maintain a buried vi ce
B. Type of Work (be specific): wire from existing pedestal # 3380 located at 7311 175th
9 0. 19 SW then'east to a residence at 7308 175th SW. GTE to plow 218 -Feet,
push 1 driveway 121case nee Attached sketch R 0 1 718 feet -
Marilyn Holmgren, Permit Coordinator
C. Contractor: GTE Northwest [Neotporated Contact: Dennis Alexander 7il-9036 mobile 388-1358
2312 W. Casino Rd Phone: . Marilyn 206/710-0786
Mailing Address: guarott, WA 98204-3440
State License'.#:
10
D. Building Permit # (if applicable):
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. E] Commercial E] Subdivision 0 City Project @ Utility (PUD, GTE, WNG, CABLE, WATER)
n Multi -Family SingleFamily EJ Other 2850-9POOlDB 242310
INSPECTOR: INSPECTOR: Rw
F. Pavement or Concrete Cu t: �[]Yes MNo G. Size of Cut: x H. ChargE�,$
Please see attached., sk_e:tch�.
APPLICANT TO READ AND SIGP4
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City ofEdmondgharmle8sfrom injuries, 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 departments or
employees, including or not limited to the defense ofany legalproceeding8 including defense costs, and attorney fees by reason ofgranting thispermit.
THE CON L WING THE FINA
.TRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOL 0 L
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE-TO.'THEAPPLICANT.
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.
Ihave read the above statements and understand thepermit requirements and thepink copy of thepermit will be
available on si spection purposes.
Signature- 2Z� John H. Stewart Date: Dece mber 1 . 6, 1996
ObnAt"Wtor Agent) Sec Mgr -Access Design
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY. �USKONLYY
APPROVED BY:
TIME AUTHORIZED: VOID AFTER. DAYS
SPECIA L CONDITIONS:
RIGHT OF WAY DEPOSIT
DISRUPTION FEE/FUND 111:
RESTORATION FEE:
_.PERMIT FEE:
-TOTAL FEE.
0,:7
COMMENTS: RECEIPTFEE:
J
DATE:, -
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE -
Eng. Div. 1994
FIELD INSPECTION NOTES
Comments:
Diaaram.:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES El NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
LEGEND
PERMIT SUBMITTED BY -7038
GTE
leo
tool
-----------
roT
I I k R. 0.
—LA—L 41 5-rdq rA se- wc
— — — — — — — — — — — — — — — — — — — — — — — — — — — — —
(n
- - - - - - - - - - - - - - -
S
I
I? — — — — — — — — — — - - — — — —
El
0
cq
(D
CUTS, ��
CA FILE NO.
Criticat Area's Checklist
eg on
Site Information (soils/topograph /h d I eta
y P'Ozy V
1. Site AddresstLocation:** 4
2. Property Tax Account Number-.. —(5ko;yrn cm)w
qu
3. Approximate Site Size. (acres or s are feet)
4. Is this site currently developed?.�ayes-'��(?.
.:n
If yes; how is site developed?
Z " Ar
�Check
5. Describe the general site topograpli�.' all,that apply.
Flat: less than 5-feet elevation change over entire site.
JU
Rolling: slopes on site generally less than 15% (a ��tical rise of 10-feet ov 170
horizontal distance df 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 ona
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: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway —floodplain --of a'water course.
9. Site contains a creek or an area where water flows across the grounds'surface? Flows are yeair-
round? Flows are seasonal? at time of year?
10. Site is primarily: forested ;meadow _;shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
Tor City Staff Use Only ------
-1. Site''is Zoned?
mapped soil type(s)?. �nv--g
icates
3a:.�:'�''Wetland inventory or C.A. map indi wedand present on site?... 410
Areas inven i6ry or C. A. map indicates -Critical Area on siiO
-'�ite within designated earth subsidence -landslide h a*zard'area? A'IV
6.;.:: .:..Site designated on the Environmentally- Sensitive Areas Map? A/0
:DETERMINATION.-.
STUDY REQUIRED . .....
CONDITIONAL WAIVER
WAIVER
'Al
Reviewed by: Vu, L.
Planner
Date
RevO110094
4
fi �ia
0
.6.
418-1.9 OR 9
7-,
r
City of Edmonds ... ...
Critical Areas''C.
ftojak I
� I .. -� t .; . -, -.'
The Cfitical Areas Checklist contained on
this f6rm 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
permitto 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. Ile
information needed to complete the
Checklist should be easily available from
observations of the site or data available at
City Hall (Critical Areas inventones, maps,
or soil surveys).
An applicant, or his/her representative,
must fill out the checklist, sign and date it,
7
and submit it to the Ci li�`Citj--
ty-
review. the. di ..'o-make a precursory . site
visit� and make a determination of the
subsequent steps necessary 6'complete a
de4eibpment'pamit application.
With a signed copy of this form, the
applicant should also submit avicinity map
or plot plan for individual lots of the parcel
with enough detailthat City staff can find
and identify the subject parcel(s). In
adffition,'the applicant shall indude
other pertinent information (e.g.--site
plan, topography map, etc.) or studies. in
conjunction with this Checkuist 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: Applicant Representative:
C11 <1 C le, ci3O-4
Name
/ el - "Y
Street Address
City, State, ZIP Phone
Signature
Date
Street Address
City,
Phone
Date
JUL- 9-96 TUE 3:52 IPM P. 2
4.jrading Plan
c�o qz 20431 - 68th Ave West (Reor ho-1.40)
Till FSMO # 5446-000-004-0106 Yt T fflb
Ugal: PmI Wof short plat OS-13-85 as recorded
under Snohormish County recordimg No. 8507110313
i nEET FILE Scale; 1"- 20'
M� WC-:5T
M
/I 9se
Cjt, MI;TIAIC,,
A6i
APPRow) As tiOTED,
(0,
5 q -O%k
0*1
i
+
Fot
Felt Ce
Asfipj+
Uzi
, . .J.UL- 8-96 MON 4 : 38 P M
P. 2
Project
Grading Calculations
20431 - 88th Ave west.
Edmonds, Wa
Plan Cluck # 96-138
R Ir 0- Ir F%/ r-W r-
JUL 9 1996
ENGINEERING
RECEIVEL
JUL 0 9
PERMIT COUNTER
cut STREET FILEj
Area 6,380 sq. ft
Existina grade aye 367,5
Proposed grMe ave 366.4
Net dffcrcncc 1. 1 x 6,3 90 (area) - 7,0 1 &sq ft or 259.9 cubic yards
APPROVED
FM%" -1 /1
- EXST ca
Xlm 35a.9?-
LIS
Af
Pvc
Li 0
UTLErT
*TO ax5lT
vro To C z
(-Ty P;� u)
?'Im z4io-o
...... ....
'lzo L-9
?..4*v A05
CANT
'APPLI
I L
WAS,
IA,
0 MCI
ONAL
Ri:-
41
L 6 1 P'l Ct
S A
Roy-ED
lb
ACCEPTABLE TIGHTLINE MATERML
N-1 2 ADS
Sch 40 PVC
SDR 35 (ASTM D3034)
WATER SERVICE INSPECT ONS
REQUIRED. CALL 771-02135
-------- ----
-N 2
AS,
-co
AV
--CAS-CMS ... E W" NOPERTIES.
JUM 2 7 199G
SCALE: APPROVED BY: DRAWN BY
I "= 2. o *0 1
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F i L-mp% irmi c maiRl AL. 6e WID5
9MV9, U% STAPLES ()?.WlPg RWI�S
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CDN160_5�'CWR60, wsisa) -749 'PONC9, flos'rS 54PLA. St� 50ftVt� A
MAXIMVM:6.fe-._e APAXT "4+'t)FLl\l6Ns6tvRZLY INTO GPJJVMr.>.
w
C-A -TUNCH .�514AQ-.Vjg. 9�)(CAVATEPI goldCrAV. 00WID6 (3-1 ll-e DCEPf UPSWPLtr
AND- RDSAC,91\17- To -TI415 W`00t� POST TO A LLOW T405 'FIL-UP. 'FASIZU- -1`0 515
Do -rlir, 11UNCAt', LL N9, WKPILWM lY rrH INCH MINIMM,
FA-15PLIC, reAMC,96 SffgtJ,- S5 10-1C- M CN 00 WHC-N lliCY PAVE
seewerD -rig'mz-.V5Lrl9L)L PURMS15. 13VT NCrr BeF09Z -TNr VPSWP9
A?-6A VAS '600l--k Pr,9_t6ANtM'rl.'Y 'STABIL17.&TZ,-,
S AN5mCr FWrlm, 'PAWwc, varr-iccg5p tmmuDiA-rrlff C-gcH.
,XAINFAL'L ANOAT t_CAS-r- 6AILY.DUPLING MOLDN&fft, 'P31NFALLo EXST c
'AN4 1146�02-gb R-e"IIZ5. 1614AW.. 13-r MAt�tl; jMMC-blA'T6FL%f`- Rim it '55?-101?.
I
25' MIN. (TYP)
17M I N
4"- 8" QUARRY SPALLS
/00''
,40
Z4�
Nr 4
/; 0 4?e
0
SO'S so,
.4113.5 47_'�t
4,
'S CIA i
Wr
Z P T H ss
61
NOTE;
THE ENTRANCE SHALL BE MAINTAINED IN A CONDITION MICH WILL
PREVENT TRACK I NG OR FLOW OF MUD . ONTO PUBIL I C R I GHT-OF-WAY. TH I S MAY
REQUIRE PERIODIC TOP DRESSING WITH 2" STONE, AS CONDITIONS
DEMAND, AND REPAIR AND/OR CLEAN -OUT OF ANY STRUCTURES USE TO TRAP
SEDIMENT. ALL MATER-IALS SPILLED, DROPPED, WASHED OR TRACKED FROM
VEHICLES ONTO ROADWAYS OR INTO STORM DRAINS MUST BE REMOVED
IMMEDIATELY
TEMPORARY CONSTRUCTION ROAD
ENTRANCE DETAIL
NTS
. I - - —_ '' .
+
IN:) I 1-iLjL I tl� I V-W Mfl n I %.-V IA I nV N % 1;.J IN
I- N-f RAI 1 0 S17E. _SSE DETAIL-.
5-Tos C)UT
5 ANJ 4: T:70TORE
5709,V1 NZAIN ATTAC;H
C0NStPUC.-rl0N SGgbSNc9.rl.'
.mvC.MON� Em RAN)CF, SeV C>eTqlL-.
INSTAL.L. Co�js
N STALL. V I L-Mg. OASRLIC 'IF13. C4 NICre 5 M L:"- DMrA I I—
CU erAlt, AND G,2VS -Na 9-C-quip-60. An -a -A.
4,
-5.*'0fqc's coms-mmUrtON IS COMPLOwT60 lAr'wc)IN3cr 4",
51-rC- S-rAj3jLXZ.Al-10l`Q IS IN3 PLACCF, CL"N ANJ:�,
.-FL��v+ T4+C- OIZAIMACrE t5y5-TOM.
AVTt7f2L ACCrP-rANCS Zy city
7C� MP09A"
Sol �'-
S-Tocy.,pi
z
0
maw
J ON 2 7 199 "S'
jMV,
711
SCAM 1 0 APPROVED BY: DRAWN BY-M HAYQGS
DAII: REVISED
DRAWING NUMBER
, E. f 1: 11 Lf,
&A � /,c) A 6, E--
JUNI 7
Ma
ON
PROJECT REVIEW CHECKLIST
PS1.13 .9 FNT� f.
PROJECT ADDRE�Z.:.'LWY,,3-/-- 00� Abt=--t�
PLAN CHECK #:
RECEIPT DATE:-
EY!EW P,E! n i a e
.PLAN'* ER
WAT
0 ENTS:-."::
":131MG- SEWER STAF
mm F
�l - I Tf f�
Setbacks/Variance/Setback Adjustment
Conditional Use Permit
ANN,
2
ADB Requirements
.. ........ .
. . . . . . . . .
Other Zoning Requirements
. . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . .......
4
Underground Wiring Required
5
Lot Slope 15% ok
SEPA Environmental Checklist/Hydraulics Permit
7..
Tree Cutting Plan
Plat/Subdivision Requirements
Legal Description Verification
lo-.
Quit Claim/Street Dedications
Easements - Public/Private
Engineering Storm Drain Review Fee 30
.... .......... - -- ------- - --
Engineering 2.2 Inspection Fee 30
Drainage Plan (On -Site)
Setback - Top of Bank, Stream. Water7dourses
Setback - Storm Drain Line
Open Ditch - Existing
(0e
Culvert Required
Culvert Size
Shoulder Drainage/Shale Open Runoff
---------------............. ..........
21
Catch Basin Require(f
. . . . . . . . .
2..
Driveway Slope & Vehicle Access
Sidewalk Required
Curb & Gutter Required
Curb Cut For Driveway Required
Street Paving Required
Right -Of -Way Construction Permit Required J�PA
Street Name Sign Required
Other Signing Required
Bond Required For Public Improvements
FEMA Map Check/Water Table
2:
Side Sewer AvaR ability
......
33*la
Calculate Sewer Connection Fee If No LID # lb
V
Create Street File q�"
Existing Water Main Size
F 36:.,
Water Meter Size
3 .......
Service Line Size
2-Al
Water Meter Charge Required
Hydrant Required
...........
Hydrant Size Existing
Fire Line Charge Required - Sprinkler
.
...... .....
Street Cut
-7.7
....... .....
43.
Miscellaneoug
[44:
Reviewed By:
FIRE
PLANNING
ENGINEERING
PU6LIC WORKS
V%w cE IV F. U I
PERMIT APPLICATION REQUIREMENTS
To: Applicant S I HEET FIL E
From: Lyle Chrisman, Engineering Ifispector
Owner. C OL- Plan Check No: -133
Address:-2-014 3 1-- Date:
After review of the subjea permit application, the following requirements must be met:
1. Construction hours are:
WEEKDAYS — 7:00 A.M.40:00 PhLWEEKENDS/ROL1[DAYS 10:00 A.M,-6:00 P.M.
Z. A separate RIGHT-OF-WAY CONSTRUCTION PERMIT is required for all work on public property. (ECDC 1&60)
Truck haul route plan must be submitted and approved prior to permit i
t. Buildedowner Is responsible for containing all temporary runoffand erosion control on site.
(ECl)C 1830.030d)
i. NO WORK SHALL BE DONE WrMM IS FEET OFSTREAMS OR 110 FEET FROM ANY CLOSED DRAINAGE
FACUIM- BUILDER/OWNER IS RESPONSIBLE FOR IDENTWYING CONDITIONS ON THE DRAWING. (ECDC
1830-50G)
i- FILTER FABRIC FENCE SHALL BE DWALLED AND INSPECTED PRIOR TO CLEARING AND cONSTRUCMON.
(ECDC 18.30)
INSPECTIONS ARE REQUIRED ON STORM DRAINAGE SYSTEM TIGHTLINES AND CATCH BASIN
INSTALLATION. INSPECTIONS ARE REQUIRED PRIORTO BACKFHAING. (ECDC 18.30)
Rep* or repim all defective ads*g cork gulter and sidewalk &*cw to dw
1300PUtY. Ifan Intersedion Is Invohred. a handicap ramp
mayberequira Conftctor" meet with dw City En&ecring staffto determine die aftt afrepair prior to Lssu=ce ofthe permit.
(W= 1&90) -
Driveway slope shall M exceed 14% WWWA a walver, EvuY aMempt should be made to keep die slope below 14% Waiver granted to
-- _Ole % (ECDC I&SUOD)
0- &WewVs must be Paved fim V*"Y lift to CAY RIGHT-OF-WAY. A ste penuk is requhv&
(ECDC IU0.060C)
I- INSPECTIONS ARE REQUIRED ON DRIVFIWAYS AND SIDEWALIM MORTO AND AFTER pOURING. (gCDC1&30)
2. No burning ofconstniction refuse without a penult frout die Fwe Depm*neaL
3. Connedion to City water system is sequhv& Ihm is a separate �� for die waW meW.
(UMC7.20)
4. A back water valva is required ifdownstdo . plmbiqg is below do clevatim efopstream menhole.- (ECDC 7.20)
S' Wder and sewer malu lineS Should be SePE110d by 10 f0d minimum (ECDCI&10)
6. C4=mxd to th City sanhuy system is required. A i PF uste, penult 11
LW# Ft= p*W Yes .
Jk_ chuV
Qx=
UAdUV0=d wiring is required an all new cousbucdon. and for additions, aftwadou4 and repairs diat =ceed 50@A ofthe toW assessed
v6" Of the structure. (ECDC 1&90)
A FINAL ENGINEERING INSPECTION IS REQUMED PRIOR To TIM BUILDING DIVL
OF THE BUILDING OR STRUCTUM QgCDC 1&90) SION GRANTING OCCUPANCY