20501 86TH PL W.PDF111111111111
8225
20501 86TH PL W
ADDRESS: -2�0 1 -p L, VJ -
TAX ACCOUNT/PARCEL NUMBER: 00�5 #q & 00 (9 0 1-7 0 0
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
-70 DETERMINATION: 0 Conditionat Waiver 0 Study Required
CRITICAL AREAS:— 05-0 Awaiver
DISCRETIONARY PERMIT ff'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
'C5 '3
PLANNING DATA CHECKLIST DATED, , 05
SCALED PLOT PLAN DATED: I �
SEWER LID FEE $:
SHORT PLAT
SIDE SEWER AS BUILT DATED-- �41 1
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
LID #:
LOT: f-I BLOCK:
LATEMKDSTs\Fon-ns\Street File Checklist.doc
PLANNING DATA
NAME: �+OV4?- -* 0010 DATE: 051all'X-OOS
SITE ADDRESS: 1- 0 0 1 9 to'rH PI Ot W4e,�,t PLAN CHK#:-05- 7-03
PROJECT DESCRIPTION: 6)0-tm J jan:tn 10 FZC+ :, "4-IC4-10( OR +V mas
StOl &4101 !a a Ifib a4& 15010VO If Ad'd 1 A4�2
REDUCED SITE PLAN PROVIDED?: (Yes / No)
MAP PAGE: 1, D f5 CORNER LOT: (Yes /0 FLAG LOT: (Yes /0
ZONING: CRITICAL AREAS DETERMINATIONM. 04-2-006-0+0
LJStudv Reauired:
aWaiver
LlConditional Waiver
SEPA DETERMINATION: -e,)(6YY1Pt*
LJ Fee
LJ Checklist
LJAPO list w/ notarized form
(Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger)
Exempt 4 10 CtAlak. Yav-00$1 o Y- ot d i rN.5
SETBACKS: (Wtfit)
Required Setbacks:, 6 0 tolth) I C) (-e4et)
Street- 24S LeftSide: 10 Right Side: Rear: 7-1 5
Actual Setbacks: k I t" ") W8'(CX-dC.C'k-)
Street: ?PV LeftSide: 31' Right Side: to, Rear: 912.' ( ot Ad rfl oYi )
Street map checked for additional setback required? (Yes / No P15N wone. r4mILAirea.
DETACHED STRUCTURES: none- shmm" an slic- 0411.
ROCKERIES:,&X(!AiYj0 V ro(." 5 "OWyk ALM5 wcff f'vPt-v-iy 114e.
Ll FENCES/TRELLISES: none, ShOv/1%.
LJ BAY WINDOWS / PROJECTING MODULATION: YY%4<4v 61rt-WAck-17-
0 STAIRS I DECKS: M'Wrtry
PARKING: Required: Actual: new al-r-cr-z I(P44'
LOT AREA: 14 t -5150 rwAj 3ot,,%sr.
LOT COVl=KAUl=: &s. gicor. X 24L 2-1 (P AA
Calculations: 2-1-4V 40
BUILDING HEIGHT:
Datum Point: C.7fVJ?,Y iNA (At 6W &Vyn'toy- DatumElevation: 100-0�
MaximurnAllowed: 2-152' (17-'l-Li.) —ActualHeight:
A.D.U. CREATED?: Mo ktitvntm pmFo,54r, A, -
SUBDIVISION: PiVIf- P-id@4& F� 11,9- 0 () 6 4 !M 1 1 0j' 1 -4
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: ()Les /0
OTHER:
Plan Review By:--� Ldvv-�
A. IDS-6
B. 10Z.0
C'.106-0
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tyackv
04.4'*Irol =
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NewBPP1anningDataForm.D0C
0 #P20
qJnH-Q5-?__0'3
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City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
Date Received:
City Receipt #:
Critical Areas File#: CA 2.,005-0370
Critical Areas Checklist Fee:. $135.00
Date Mailed to Applicant:
Ile Critical Areas Checklist contained on; this fdrm is" to' A property owner, or his/her authorized representative,
be filled out by any person preparing a Development must fill out the checklist, sign and date it, and submit it
Permit Application, for the City of Edmonds prior to to the,City. The City will review the checklist, make a
-his/her submittal of the application to the City. precursory site visit, and make a determination of the
subsequent steps necessary to complete a development
The purpose of the Checklist is to enable City staff to permit application.
determine whether any potential Critical Areas are, or
may be, present on the subject property. The information Please submit a vicinity map, along with the signd copy
needed to complete the Checklist should be easily of this form to assist City staff in finding and locating the
aya' specific piece of property described on this form. In
Wa s Nff
t S13 addition, the applicant shall include other pertinent
s F information (e.g. site plan, topography map, etc.) or
n conjunction with this Checklist to assistant staff
in completing their preliminary assessment of the site.
D!
APPUCAION P101" %C studies i
The undersign ed applicant, and his/her/its heirs, and assigns,:in consideration on the processing of the application agrees
to release, indernnify, 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 ftimished'by the applicant, his/hef/iis agents or employees.
By my signature, I cer* that the information and exblbt& h6rewith submitted are true and correct to the best of my
knowledge and that I am authorized to file this application on the behalf of th� wimer 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 lan4l:uk application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject erty for the
prop
purposes of inspec . on and posting attendant to thi�applicafion.
ASIGNATURE OF 0:�R DATF,
Owner/Apl#icant!
Name
Street Address
UAOMD5 LJA I
city State zip,
Telephone: 42fi ii � 41121.
Applicant Representative:
Name
Street Address
City State Zip
Telephone:
Email address (optional): Email Address (optional):
#P20 CA File No: 0
Critical Areas Checklist
Site Information (soils/ topography/
L. Site Address/ Location:
/vegetation)
PL. 0 -,
2. Property TaxAccount Number: 2�7 1-7 00
3. Approxianate Site Size (acres or square feet):
4. Is this site currently developed? _-L"'Yes; — no.
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
V' Flat less than 5-feet elevation chan ove'
ge r entire site.
Rolling-. slopes on . site generally less than 15% (a vertical rise of 10-feet over a horizontal
distance of 66-feet).
Hilly: slopes present on site of more
over. a horizontal distance of 33 to 66-feet).
Steep: Orfe over a
grade of greater than 30% present on sitejl(a ertical rik ON
distance of less than 33-feet).
Other (please describe):
6. Site contains areasof 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 year-round?
Plows are seasonal? (What time of year?
10. Site is primarily: forested meadow shrubs mixed
1.,�an landscaped.04wn, shrubs etc)
11. Obvious wedmd is present on site:
1.
2.
3.
Plan Check Number, if appl icable?
site is zoned? _. P-5-1*1-
SCS mapped soil type(s)? (P
-For City Staff Use Only
*VVVo D
*1
4. Critical Areas inventory or C.A. map indicates Criti . cal Area on si 'Nib
5. Site within designated earth subsidence.landslide hazard area? ND
DETERMINATION
STUDY REQUIRED WAIVER
Reviewed br. AVVVh I C/n� Date: 05/ a-;5- �)ry 0,5--
Z
The City of Edmonds
APPLICATION
for
ILE
STREE T- H. SEDE SEWER P R
NEW CONSTRUCTION L7�REPAIRS
EDNOWS
MATMOIT M.MT
EASEMENT No . .....................
(j) f
OWNER ......... ............... 'TOR 4-41 -------- ........ N. PE
................ . ................... ......... CONTRAC J N �� RMIT No.
ADDRESS 6 7-h PL , W, 601'r0d� LEGAL DESCRIPTION: LOT No.—] ... 17 ..............................
............................ ? .................................... ......................... BL40CK No . ............................................
.. ... .. ...
NAME OF ADDITION A/t ........ .. Qf. .................................. . . . ..................................
0
0
40
( ! 0
Approved:
DATE ..... t ........ ....... ?/ ......... —
t E C V1 E: i
APR I
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
Call 776-1107 for side ewer inspections BEFORE covering any portion of the construction.)
Inspection will be providsed within 24 hours after request. NO Sat., Sun., or holiday inspections.
ADDRESSLOCATION OF CONSTRUCTION .............................................................................................................. . .......................................................
PROPERTYLEGAL DESCRIPTION .......................................................................................................................................................................................
.................................................. . ...................... . ............................................................................................................................. ..................................................
0 .......................................................... OWNER AND/OR BUILDER. ........................................................................... . .......................................................
CONTRACTOR'S NAME & ADDRESS ....................................................................................................................................................................................
Permission Is granted ........................................................... 19 ......... for repair and/or connection of a side sewer to the city sanitary sewer
system in accordance with City of Edmonds ordinances.
0 NTION IS CALLED TO THE FOLLOWING:
7 No. I —The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct
side sewer In street area. Do not cover any portion of sewer before it has been inspected.
NOTE No. 2—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtaln full Information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 inches inside property line; minimum grade of 2%. No bends in grade
sharper than V8 will be permitted.
NOTIE No. 5--Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper
work which may develop within one year of completion.
NOTE No. 6--It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the main sewer or its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVEDE] Date ... . ................................... By ................ Date .................................... By ................ Date --------------- . ................... By ................
D /Z
APPROVED ate ... . ... ....... --------------- Z -----------_---_---- By ..... ..............................................
Remarks: ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
............ ....... . ....... .... hereby certify that the side sewer installation constructed under this permit
(Ownir"'OT �'o' n-,t, r-a"c"t'in, g .... F-lr'm' ----- Per"i c**r-m- i-n, g- --- Construction)
installed in accordance with all governing ordinances of the City of Edmonds.
Datedthis ............................. day of ...... i .......................................................... 19 .........
,I N1 Check BEFORE you dig for: Water E], Gas E], Telephone [], Power 0, Sewer F], other E] -� I
0
8 9 0 . 1 9 C) -
City oAdmonds
27rr
N�M'"&NST*RUCTION
PermitNumber.
Issue Date:
A. Address or Vicinity of Construction: - 20501 86 P1 W (951:1428)
B. Type of Work (be specific): Install New Service
C. Contractor: Washingtou Natural cas
Mailing Address: 1122 75 St SW Everett
State License #:
D. Building Permit # (if applicable):
EM
Contact: Frank Swau
Phone: 447-3284
Liability Insurance: Bond:$
Side Sewer Permit # (if applicable):
E. E] Commercial 0 Subdivision 0 City Project Utility (PUD, GTE, WNG, CABLE, WATER)
n Multi -Family F] Single Family F] Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut : 0 Yes Mo G. Size of Cut: — x — H. Chargik,$
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the City ofEdmondg harmless from injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made againstthe City of Edmonds, or any of its departments or
employees, including or not limited to the defense ofany legalproceeding8 including defense C08ts,'and attorney fees by reason ofgrantingthisperntit.
*-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 WIJICH TIMEA D&8IT OR CREDI17 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.
I have read the above statements and understand the permit requirements and the pink copy of thepermit will be
available on &1it,e at all, tinws for inspection purposes.
411V
Signature: Date: 03-06-95
-"-'?M�tracior or_A��n'W`
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: kA-) RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFTER A f kl�; —DAYS
SPECIAL CONDITIONS: Lill S 7 L_
fAL0 L_J�JC_ rocj,
vje,�i �,4, of
COMMENTS:
DISRUPTION FEE/FUND Ill:
RESTORATION FEE:
PERMIT FEE:
TOTAL FEE: 13-0. 00
RECEIPT FEE:
DATE:
ISSUED BY -
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. 1994
FIELD INSPECTION NOTES
Comments:
Diagram.:
CONTRACTOR CALLED FOR INSPECTION
Partial Work Inspection by P.W.:
Work Disapproved By:
FINAL APPROVAL BY:
(Fund 111 - Route copy to Street Dept.)
El YES
Date:
Date:
13 NO
%A
Viad*xjton
NaturMGas`�
Avvb0vxjicn Energy Cornparry
WNG to window
Watermain depth *-Lc=�
'2-" gas main
Addendum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
#356-7500 X7596
')OB CISH42%
SA-ol - C' C-5 T- !S -
4POSO) 4"aco PL-
L,L-)
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
1]
SAAL-
VVad*Mtm
NaturMGas��
AVAZW�ErIerWC-V&V
I
Addendum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
1356-7500 X7596
,)oa cIS1142S
t-4� C' 0 T- 15
1;20soj 41�co PL-
WNG to window Key:
-W- Water
Watermain depth f4c) I QDI C,&,-n -G- Gas
-SS- Sewer
gas main -& Water hydrant
0 Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331
' SLA
V&mhkxjWn
Natwid Gm
AVAthngtonEneWC-P"
i
Addendum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
1356-7500 X7596
'��B CISA142-%
SA.c�, c. c-5 T-
12 Oso i L-
WNG to window Key:
-V- Water
Watermain depth *-Ic> jQDjC.AMOO -G- Gas
-SS- Sewer
gas main -& Water hydrant
0 Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331
..... '7 L�L
0VVNLlR100Nf: IS RESPONSIBLE
44Lo'
EX -PECK
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RESUS
JUL 2 12085
BUILDING DEPARTMENT
CITY OF EDMONDS
SCOPY, OF PROJECTC
EXTEND ENTRY 10 FT.
EXTEND GARAGE 28 Irr. WITH
MASTER & DECK ABOVE.
666.25 SQ FT NEW LIVING
630 SQ. FT. NEW GARAGE
169 SQ. Fr. UPPER DECK
ZONE: RS-8
LOTSIZE: 70'x2051 -14,350SQ.Fr.
EXISTING RES.: 1056 SQ, FT,
NEW: 770 SO ff.
TOTAL: 1826 SQ Fr. 12.7%
7
�MV qArZACIE.
A5o\/F-
10 -Z N cl
to 4-
iaE RVIOUS
RESIDENCE: 1826 SQ. FT.
WALK 100
DRIVE: 771
REAR DECK 250 so FT.
1cp TOTAL: 2,946 SQ. FT 20.5%
ADDEDSINCE1977: 770-SQrr.
LESS THAN 10 CU YDS. USED ON SITE.
tA\WA37R PUBLIC
S : PUBLIC
HEAT: GAS F/A
to I
0, 0,
SEWr�. M -STORK pipt-A ��Z43
too
at" fj
PLACF-- V/1�5-r oj
APPROVED As NOTED
PA-TUH . 100-0
NL SEWER L& AT SW CORNER. loo.0,
BY M-31NEERING ADD GUTTERS/DOWNSPOUTS A. 105.51
AND SPLASHBLWKS B. 1021
C. 105,
Date: 21=
-=LLI 104.4 104.4 + 251 1
PROPOSED RIDGE:
15..
PA-TUH . 100-0
NL SEWER L& AT SW CORNER. loo.0,
BY M-31NEERING ADD GUTTERS/DOWNSPOUTS A. 105.51
AND SPLASHBLWKS B. 1021
C. 105,
Date: 21=
-=LLI 104.4 104.4 + 251 1
PROPOSED RIDGE:
15..
'PL-
*Vbc
RESUB
JUL 2 1 NO
BUILDING DEPARTMENT
CITY OF EDMONDS
N
a
,*APPROVE0- , 9Y p , CANNING
Zone f0f�'VL Comer%AO FlagJ2)0
Setbacks Required Actual
Front (w)
SidesW;).
Rear (�,)
Other
Height E5'
OWNER/CONTRk' " OR iS RESPONSIBLE,
RESUB
F013 EROSION CONTR.01- AND DAMAGE 61
Vil
JUL 2 12005
SUILDING DEPAR-I'MENT
CITY OF EDMONDS
_j,
o'
SCOPE
OF PROJECTz
EXTEND ENTRY to FT.
DEcK
EXTEND GARAGE 28 Fr. wrm
MASTER & DECK ABOVE.
A
%k
666.25 SQ FT NEW LIVING
630 SQ. ff.
NEW GARAGE
169 SQ. Fr. UIPPER DECK
I DEklr-F--
ZONE: RS.8
LOT SIZE: 70' x 2051 14,350 SQ. Fr.
LOTCOVERAGE,
EXISTING RES,z iom SQ, irr,
0 0
NEW: 770 SO rr.
TOTAL: im SQ Fr. 12.7%
CIAR-A, cl I-
7
Te, R
A5o\/F_
ell,
4-102-24
N 0
Komf e0b.
ImRVIOUS:
RESIDENCE: 1826 SQ. FT,
WALK too
*Jul
DTE 771
RE D CK 250 so Ff&
TOTAL: 2,946 SQ. FT 20.5%
Jy ADDED SINCE 1977; 770, SQ FT.
I vt
GRADING: LESS THAN 10 CU YDS. USED ON Sin
WAXE : PuBuc
AW
tk\ SAWARY PUBLIC
HEAT: GAS F/A
-1-i o, ofL *-TIP
-------- SEWet --5101ZK pr—Al
cr-
PLACF-- v/r-.s-r
&PPROVED AS NOTED'
PA-TUH . 100.0 1
3114EEHH�Lj C—Non-
UTS
BY EN, ERINq IMIG A
1111 ADD GUTTERSMOWNSPO rUM; AT SW CORNER. 100.01
A. 105.51
B. 102:
'T�7 AND SPLASHBLOCKS C. 105
Date: 1). 105,
AMLL- 104.4 104.4 + 251
PROPOSED RIDGE:
T c--
REsuB
JUL 2 12005
BUILDING DEPARTMENT
CITY OF EDMONDS
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