20625 82ND AVE W.PDF111111111111
7559
20625 82ND AVE W
ADDRESS -
TAX ACCOUNT/PARCEL NUMBER:c"0�4475wm�nao I
BUILDING PERMIT (NEW STRUCTURE-):
COVENANTS (RECORDED) FOR --
CRITICAL AREAS PY-RA12DCOD-
DISCRETIONARY PERMIT
DRAINAGE PLAN DA'
PARKING AGREEMENTS DA
EASEMENT(S) RECORDED
PLANNING DATA CHECKLIST DA
TION: E] Conditional Waiver E] Study Required *aiver
SCALED PLOT PLAN DATED:
SEWER LID FEE S: LID #:
SHORT PLAT FILE:
SIDE SEWER AS BUILT DA
SIDE SEWER PERMIT(S),#: a5IA�Fp
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
LOT:
BLOCK:
L-ATEMP\DSrs\Fom,s\Street File Checklist.doc
0 #P20 0
Critical Areas Checklist
Site Information (soils/ topography/ hydrology/vegetation)
1. Site Address/ Location: Q&�
2. Property Tax Account Number.
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? ��_Yes; _
0C)
If yes; how is site developed? _f'106�_C b�
CA File No:c*A-ZOO�N
F1
5. Describe the general site topography. Check all that apply.
kat: less than 5-feet elevation change over 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 than 15% and less than 30% (a vertical rise of 10-feet
over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a horizontal
distance of less than 33-feet).
Other (please describe):
.1
7
F-11
Site contains areas of year-round standing water: Approx. Depth:
Site contairLs areas of seasonal standing water: P9 ; Approx. Depth:
VVhat season(s) of the year?
Site is in the floodway floodplain of a water course.
9. Site contains a creek or an area where water flowm across the grounds surface? Flows are year-round?
- A)Izx—, Flows are seasonal? Jlf�_ (What time of year? Y
10. Site *is pfimarflny: forested meadow
Ian - e (lawn, shrubs etc)
11. � �bvious wetlannd is present on site:
1. Plan Check Number, if applicable?
2. Site is Zoned? P 1C__1_ 19
;shrubs ; mixed
For City Staff Use Only M
3. SCS mapped soil type(s)? �,2 - Mclircacad op,;!je_X1y le -gun., 5� +r, 15M
t
4. Critical Areas inventory or C.A. map indicates Critical Area on site? No
5. Site within designated earth subsidence landslide hazard area?
DETERMINATION
,�;TUDY REQUIRED -WAIVER
Reviewed by- Date.
-V. lb-7
0 #IP20
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
The Critical Areas Checklist contained on this form is to
be filled out by any person preparing a Development
Permit Application for the City of Edmonds prior to
his/her submittal of the application to the City.
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, or
may be, present on the subject property. The information
needed to complete the Checklist should be easily
available from observations of the site or data available at
City Hall (Critical areas inventories, maps, or soil
surveys).
Date Received: I - Q% - OR
City Receipt#:
Critical Areas File #: C42-A 700'6 600Z,
Critical Areas Checklist Fee: - $135.00
Date Mailed to Applicant:
A property owner, or his/her authorized representative,
must fill out the checklist� sign and date it, and submit it
to the City. The City will review the checklist, make a
precursory site visit, and make a determination of the
subsequent steps necessary to complete a development
permit application.
Please submit a vicinity map, along with the signed copy
of this form to assist City staff in firiding and locating the
specific piece of property described on this form. in
addition, the applicant shall include other pertinent
information (e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant staff
in completing their preliminary assessment of the site.
17he undersigned applicant, and. his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information ftimished by the applicant, his/her/its agents or employees.
By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file this application on the behalf of the owner as listed below.
SIGNATURE OF APPLIcANT/AGENT
DATE
Property Owner's Authorization
By my signature, I cer* that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and pg*
Z.,attendant to_Orrs application.
SIGNATURE OF
Owner/Applicant:
Name
,7
Street Address
city State Zip
Telephone:
Email address (optional): 67
DATE /— �-
. Applicant Representative:
Name
Street Address
city State Zip
Telephone:
Email Address (optional):
d�LANNING DATA
SINGLE FAMILY RESIDENTIAL
40 11 STREET F::[L:E:]l
Name-
ch ef— Date:
__La
Site Address: Plan Check #: 2-00 97 -00
Project Description: 400(q_(dn
Reduced Site Plan Provided NO) J Zoning: S-
Map Page: 04!� Corner Lot: (YE . S -[Flag Lot: (YES /(0
Critical Areas Determination ff A2,4 -7
11 Study Required
(A�Waiver
SEP;A �De rmination:
)_�, Exempt
El Needed (for over 500 cubic yards of grading)
E) Fee F-I Checklist 0 APO List with notarized form
Street: Side Si
S
-IV -7s— Rear: IS—
Actilal Setbacks
-_-_-
Street: Sid.e e Rear:
> (57
11 Detached Structures:
Rockeries:
Fences[Trellises:
Bay Windows/Projecting Modulation. -
El Stairs/Deck:
Buildin
Datum Point: 14,
_�f(vht
Datum Elevation: 37o,5-7
Maximum Height Allowed:
Actual Height: / q. �5- �10
Other
Parking Required:
Parking Provided:
Lot Area:
OS-
Maximum Lot Coverage: 35% Proposed: Z 3�
Lot Coverage Calculations: -7 Y
CM �264 2-q 74 Y 2 -S
ADU Created: (YES /100
Subdivision: pto
Legal Nonconforming Land Use Determination Issued: (YES
I I Coniments
tfeo�,Klr Cato
— -5 75.-7
376.3 f 3-0 S_- A -- 3-7 q ot v5
C- -377.3
b - J-76- q 40 1.
Plan Review By: 4, 4��4�
Ptanmq Oata form 04-11 ".doc
C'o
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-0
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0 In shown on the
ARRAwyof 'oom"'on
Nome No W Edmonds, ils employees
anached Map was Compiled to warrant the aCCU111-cy Of
Cit (A
uftant The City 04
and consultants
Snything set. forth on the Map. Any person or entity requezl�',!.o a COPY
Ct an Independent Inquiry regarding the Informalic" shOvjn on
shculd condu Vjer stub
the map, including$ but not limited to, the location of any so
shown. such sevier stubs may or may not eyist and may or may not exist at
h Cljy of Edmonds nor its emPIOY3'Qs Or
the localion shown, Neither t e this map, not jot any or2l
officers shall be liable for the Information given on
representalion provided based upon Sid MaP
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NOTICE:
N�owarrantyof accur-acy.
The information on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of 'Edmonds does not wa rra nt the
accuracy of anything set forth on these
map(�_). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
tHe -map(s)l including, but not limited to,
th-e location of any sewer stub shown. Such
sewer stubs may or may'not exist and may
or may not exist at the location shown.
Neither the Gty of Edmonds nor its
ern p-[o-yee-s o-r off icle rs s-h-a 1.1 be 11- a ble for the
information given on this map(s), nor for
ion provided based
any one representat*
upon . said map(s).
APPLICATION
rW.& for
9,o'h* City of Edmonds SIDE SEWER PFAINUT
NEW CONSTRUCTION REPAIRS EASEMJW.NT No . ..........................................
ovvNm ........................ 7T-b.kk� ......
ADDRESS ........... 2-6..(0 �2 !r S-
............... ........................................... A.�� ......
CONTRACTOR ......................
— ........................ S ....................................... PERMIT No... 0-3-y:�
LEGAL DESCRIIMON: LOT No . .............. I ..................... 13LOCK No . ............................................
NAME OF ADDITION ...................... LO .. bk,��
<
0 L-s e-
D/W
APPROVED
SEP 10,1968-
ApprOed:
DATE ... ------ 13Y
CITY OF -EDMONDS
CIVIC- CENTER — WATER -SEWER DEPARTMENT
SIDE SEWER PERMIT
Call PRospect 6-1107 when work
Is ready -for Inspection. (No Inspec-
tions Saturday, Sunday or holid"s.) N2 39 4 43
ADDRESS....................... 29Q.25 ... r .... Und ... Amenue ... Weat ..................................................................................................................
OWNER.......... TqTR..�i.ng ............................................................... CONTRACTOR ...... SAnA --- SAfe ...................................................
Permission is granted ............. 19-5.9., for ........................ days to REPArR or CONNECT a side sewer
with City Sewers in accordance with application on file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. 1—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.
NC- * No. 2—Obtain full information. regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
N, ,Zo. 3—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 Vs will be permitted.
NOTE No. 4—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 appur-
tenances except to Insert the pipe into the wye.
lo�lrl
�17c. 1 S9%J
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS,WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
IFl
*PERMIT MUST BE POSTED ON JOBSITE
STATUS: ISSUF,
Perrnit Number: ENG20080133
Job Address: 20625 82ND AVE W, EDMONDS
LACHER KURT 0
20625 82ND AVE W
EDMONDS, WA 98026-6724
ENG20080133
Expiration Date: 5/6/2009
R T H CONSTRUCTION
15708 70TH AVE W
EDMONDS, WA 98026
LICENSE #: RTHCO**054JR EXP: 4/21/2009
N
JOB DESCRIPTION
PAIR N PROPOSE TO REUSE LATERAL LID NUMBER-
1GRINDERPUMP N I PROPOSE TO REUSE SIDE SEWER
Addition over e)dsting sewer be. Need to add 4" clean out outside new addition.
EASEMENT INFORMATION
FPROJECT
CROSSES OTHER PRIVATE PROPERTY
NVERIFICATION
OF RECORDED EASEMENTS COMPLETE
INDEMNITY- The Applicant has signed an application which states helshe holds the City ofEdmonds harmlessftom injuries,
damages or claims ofany k ihd or description whatsoever, foreseen or unforeseen, that may be made against the City ofEdmonds or
any ofits departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and
attorneyfees by reason ofgranting this permit.
CALL DIALA-DIG (1-800424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT. 1326
24 HO UR NOWE REQ UIRED FOR ALL INSPEC-11ON REQ UESTS
THIS APPLICATION IS NOT A PERNUT UNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACE PROVIDED,
RELEASED BY
F-] FILE COPY
> INSPECTOR COPY
Printed: Tuesday. Mav 06.2008
DATE
[-] APPLICANT COPY
STATUS: READY TO ISSUE
ENG20080133
Refer to City of Edmonds Side Sewer Information handout for approved pipe materials, inspections and other requirements.
A 6" cleanout with 12" locking cast iron lamphole cover is required at the property line.
Maintain 10'separation between the sanitary side sewerand the waterservice line.
Applicant shall repair/replace all damage to utilities or frontage uinprovements in City fight -of -way per City standards that is
caused by or occurs during the pen-nitted project.
0 E-Sanitary Side Sewer Inspection
PARTIAL INSPECTION DATE:
PARTIAL INSPECTION DATE:
FINA 1. INSPECTION APPROVED DATE:
INITIAL: NOTES:
INITIAL: NOTES:
INITIAL:
#P20 CA File No:ckA-Zoo�b2
Critical Areas Checklist
Site Information (soils/ topography/ hydrology/ vegetation)
1. Site Address/ Location: ;706 Z:5- 8:�,? "f-�'A(2� e,-J
2. Property Tax Account Number: co q ?P2 00 3W
3. Approximate Site Size (acres or square feet): /0,
4. Isthis site currently developed? ��—yes; _ no.
If yes; how is site developed?.
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal
distance of 66-feet).
Hilly: slopes present on site of more than 15% and less than 30% (a vertical rise of 10-feet
over. a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a horizontal
distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: Approx. Depth:
7. Site contains areas of seasonal standing water: X-) M ; 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 flowA across the grounds surface? Flows are year-round?
- A ) rZ A- Flows are seasonal? 4JIft (What time of year?
10. Site is primarily: forested meadow ;shrubs mixed
urban landscaped (lawn, shrubs etc)
11. Obvious wetland is present on site:
For City Staff Use Only CDO ,
1. Plan Check Number, if applicable? tq
2. Site is Zoned? RIC2�1- 9
3. SCS mapped soil type(s)? Q - Mcler,)nd ar-:�,Aly 2 A-r,
4. Critical Areas inventory or CA. map indicates Critical Area on site? /go,
S. Site within designated earth subsidence landslide hazard area?
DEFERMINATION
REQUIRED WAIVER
Reviewed
#P20
'ec. 1%9-
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
Ile Critical Areas Checklist contained on this form is to
be filled out by any person preparing a Development
Permit Application for the City of Edmonds prior to
his/her submittal of the application to the City.
'Me purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, or
may be, present on the subject property. The information
needed to complete the Checklist should be easily
available from observations of the site or data available at
City Hall (Critical areas inventories, maps, or soil
surveys).
Date Received: 0% - OR
City Receipt#: --
Critical Areas File #: C42-A 100'6 Q00E-
Critical Areas Checklist Fee: $135.00
Date Mailed to Applicant:
A property owner, or his/her authorized representative,
must fill out the checklist, sign and date it, and submit it
to the City. The City will review the checklist, make a
precursory site visit, and make a determination of the
subsequent steps necessary to complete a development
permit application.
Please submit a vicinity map, along with the signed copy
of this form to assist City staff in fmding and locating the
specific piece of property described on this form. In
addition, the applicant shall include other pertinent
information (e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant staff
in completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harniless 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 furnished by the applicant, his/her/its agents or employees.
By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file this application on the behalf of the owner as listed below.
SIGNATURE oF APPLicANT/AGENT
DATE
Property Owner's Authorization
By my signature, I cer* that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and pq
,Oin
1,attendant tofids application.
SIGNATURE OF
Owner/Applicant:
— klu 2 --7" .
Name
,,7 �) t3—
Street Address
city State Zip
Telephone:
Email address (optional): ge-awlf,-- I-,
DATE Z—
Applicant Representative:
Name
Street Address
,city State Zip
Telephone:
Email Address (optional):