20704 77TH PL W.PDF11111111 lill
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20704 77TH PL W
ADDRESS:m64 -n-m (�L u)
TAX ACCOUNT/PARCEL #: 00FEj51':-,P6W12.(oM
BUILDING PERMIT (NEW STRUCTURE) #:
COVENANTS (RECORDED) FOR:
CRITICAL AREAS #: 01— q5 DETERMINATION: Conditional Waiver El Study Required Waiver
CRITICAL AREAS #: DETERMINATION: Conditional Waiver Ej Study Required Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORD FOR:
PERMITS (OTHER —list permit #'s):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:
SHORT PLAT FILE:
LOT:-,V
BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE/ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER: yw
L\TEMP\DST's\Forms\Jana's Street File Checklist 5-14-08.doc
PLANNING DATA
SINGLE FAMILY RESIDENTIAL
STREET FILE
Name: Date:
/ :Z UF-70 7
trn�_ — -
Site Address: - -7 c e Plan Check # Z 10� 0 -071F,�
1-2 072 0 C(
.7c/
Project Description: 14ac�,, 0(2
Reduced Site Plan Provided: fiFs,� NO)
Zoning-. 5—S
Map Page:
Corner Lot: (YES /00
Flag Lot: (YES
Critical Areas Determination ff: -7-006S_
[I Study Required
.9—Waiver
SEPA Determination:
Exempt
Needed (for over 500 cubic yards of grading)
0 Fee El Checklist El APO List with notarized form
:7 A P AS f % Required Setba4s, fx:
Street:
?
SidY-- /
7- �_
Side. ?_ �
I
Z's 0(
Actual Setbacks_ rdtm A WNEEZ
st�lt- Si
(AAC-4cM
04 C
Detached Structures:
El Rockeries:
Fences[Trellises:
El Bay Windows/Projecting Modulation:
vo\rirl
El Stairs/Deck: oc
HeIght
Datum Point: C&kh
Datum Elevation: t6v,
Maximum Height Allowed:
Actual Height: //7.Ztk
1 4_
Other I W C,,C(C(
Parking Required: Z_
Parking Provided: 2- -t-
Lot Area: � wo 0
Maximum Lot Coverage: 35% Proposed: 7.
Lot Coverage Calculations: #0 U 61 dcl., (15- & 2- -4- 9 3 S72-0 2S 30
ADU Created: (YES / to
Subdivision: .1V0
Legal Nonconforming Land Use Determination Issued: (YES
Comments
HellAt 0'4c ot�(-N-(J e-. (P Al- 6 1� / C - S-A oe
/4 - Id q- ?!�_ i4l 2 to 3 t /or- zr
- 10 J, S-V 10%5, q 2,�- 7S- 106, q + tY
4t�. Of 17�
/0J, d 1115
Plan Review By:
Plarma�q Data Forl" 04 - t I -06.doC
#P20
CA File No: CRA-cil
Critical Areas Checklist
Site Information (soils/ topography/ hydrology/vegetat'ion
1.. Site Address/ Location: T- Izo2f>
2. Property TaxAccount Number:
3. Approximate Site Size (acres or squ e feet):
4. Is this site currently developed?
yes; — no.
If yes; how is site developed?.---
5. Des the general site topography. Check all that apply.
7.Flat.- less than 5-feet elevation change over entire site..
Rolling: slopes on. site generally less than 15% (a vertical rise of 10-fe'et 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 contairLs areas of seasonal standing water: ;Approx. Depth:
What season(sl 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? 14 D
Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow ;shrubs mixed
urban landscaped (lawn, shrubs etc)
1 1. Obvious wetland is present on site: /lip �J& Fie
id�:. I
—For City Staff Use Only
1. Plan Check Number, if applicable?
2. Site is Zoned?
3. SCS mapped soil type(s)?. S (JU wo - j - (I C bo�, tcnd comr, (tK , 22 - 1.,oe-
4. Critical Areas inventory or C.A. map indicates Critical Area on site? Vo —
5. Site within designated earth subsidence landslide hazard area? dU
DETERMINATION
STUDY REQUIRED WAIVER
-7
Reviewed bv.- 6% 6 f RA,� Date: /vv yXA&t1- 1 /*7' / e
-L;. 167
City. ofEd#mp'oonds
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 Application1or 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 (Crifical areas inventories, maps, or soil
surveys).
Date Received'.
City Receipt#:_ V-i5j�104-4-24J-
Critical Areas File #: CQ*A -
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
subsequen t steps necessary to complete a development
permit application.
Please submit a vicinity map, along with the signed copy
of this form to assist City staff in finding 'and locating the
specific piece of property described on this form. In
addition, . the applicant. shall include other pertinent
information .(6.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, indemmify, 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
incomple te information ftimished by the applicant, his/her/its agepts or employees.
By, my signature, I cer* that the information and e=xhibewith submitted are true and correct to the best of my
knowledge and that I am authorized to file thisLappgi e behalf of the owner as listed below.
SIGNATURE OF APPLICANVAGENT
Property Owner's Authorization
By my signature, I cer* that I have]
and grant my permission for the public
purposes of inspection and po
!Ong a�p
SIGNATURE OF OWNER
Owner/AppHeant:
above Applicant/Agent to apply for the subject land use application,
the staff of the City of Edmonds to enter the subject property for the
application.
K"L- Iqr:-
Name.
.Zo 704-
Street Address
cro
G�72:>t1o'-Lc>S �J4 (OOZ-6
city I State Z-44 Zip
DATE i L ZQQ7-
Applicant Representative:
-:f
Name
Street Address
City State zip
Telephone:
Email address (optional): . Email Address (optional):
Z
0
U
0
V.
-C�TY OF EDMONDS_ 0 Clu_r
COMMUNITY SERVICES DEPARTMENT <cz
RIGHT-OF-WAY CONSTRUCTION PERMIT A
A. o Owner: Washington Natural QAp_Compauy B. 0 Contractor:
,3ieMercer Street
WkMgLddress WA 98111
City State Zip
Permit No.
Issue Date —9 1
Name..
Mailing kddress
City State Zip
STREETFILE State License Number Telephone Number
C. 9 Address or Vicinity of Construction: 20704 77 Place West
Type of Work to be Done: Repair Leak at the above address
D. 0 Work in Connection With: El Sub or Plat El Single Family P City Projects
0 Commercial El Multifamily Utility
E. 0 Pavement Cut: Y (2 N F. 0. Size of Cut: — X No cuts
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds
harmless from any injuries, damages, or claims of any kind/or description whatsoever, forseen/o r unforseen, that may
be made against the City of Edmonds, or any of its defpartrh�nt/s�br employ�es" including o'r/noi limited to the defense
of any legal proceedings including defense costs, court cost's',I�hd'att6rney fees�by reason of granting this per*niit.
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 time a debit or cred,it will be
processed for issuance to the applicant.
9. A 24 hour notice is required for inspection; Please call Engineering:. 771-3202
.0 Work is to be inspected during progress and, au completion.
• Restoration to be in accordance with City Code.
• Street to be kept clean at all times.
• Traffic Control to be in accordance with City regulations.
• All street -cut ditches must be patched with asphalt or City approved material prior to end of working day;
NO EXCEPTIONS.
I understand the above and that this permit must be available at the job site for inspection purposes at all times.
M6
14
A
IQ tool
Signature:
Date: anuary P —
Owner or Contractor
This Permit Must be Posted at the Job Site For Inspection Purposes
Call DIAL -A -DIG Prior to Beginning Work
APPROVED BY: &
Time Authorized: Void after .&M&d Z9 days.
Special Conditions:
RELEASED BY:
Date
PERMIT FEE: _dU
Restoration Fee:
Receipt No.:
Fund I I I Fee:
Street Cut Dimensions:
INSPECTED BY
NO WORK TO BEGIN PRIOR TO PERMITISSUANCE
x - = $
Date
tng. uiv. marcn jvn,
FIELD INSPECTION
I I - Route copy to Street Dept)-,
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: —
FINAL APPROVAL BY:
Eng. Div. July 1985
is
40
APPLICATION
for
The City of Edmond SIDE SEWER PERMIT
FILENEW CONSTRUCTION E] REPAIRS E)
J
(EYNN P:LANDT-
EASEMENT No . ..........................................
OWNER ....... ?� ..... Aalcl� ....................................... CONTRACTOR .....
............................................................................................. PERMIT N
.. .... --------- -111* ...... ................. LEGAL DESCRIPTION: LOT No . ... .................................... BLOCK No . ................... ........................
6.elY ... Az
77rw/4. NAME OF ADDITION..7 .............................................................................................
--I r-"-7 Yry
ze2
f
0ou 5c-
(T, E
APPROVED
MAY 11 1967
.......................
Ap ed:
DA ... ................. B
.. . .......
NOTICE:
No warranty of accuracy.
The information shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City ofEdmonds does not warrant the
accuracy of anything set forth on these
map(s). Any person or entity requesting a
copy should conduct an independent
inquiry regarding the information shown on
the map(s), including, but not limited to,
the 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 City of Edmonds nor its
employees or officers shall be liab-le for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
CITY OF EDMONDS
CIVIC CENTER — WATER -SEWER DEPARTMENT Call PROSPeCt 6-1107 when work
is ready for inspection. (No Inspec-
SIDE SEWER PERMIT tions Saturday, Sunday or holida,".) N2 22 3 5
ADDRESS ................. 1�1
... Uqrlh ...
.. J ...........................................................................................................
Ronald P. Horlick
OWNER -------------_------ ------------------------------------------------------------------------ CONTRACTOR ............................ owner
..................................................
Pern-dssion is granted ............... M-ay .... .......... 19-6 .7.,
...... for -----_----------------- days to REPAIR or CONNECT a side sewer
-with City Sewers in accordance with application on file and gov . erning ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. I —The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must
be employed to construct side sewer in street area. Do not cover any portion of sewer before It has been inspected.
No. 2—Obtaln full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
No. 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 % 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. 5—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.