20830 80TH PL W.PDF11 lill 111111
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20830 80TH PL W
Critical Areas Checklist CA File No: 0 A -
Site Information (soils/ to' ography/ hydrology/ vegetation)
P
1. Site Address/ Location: �La ri
2. Property Tax Account Number: tv 0 �4_9 6 4!5),j
3. Appr6ximate Site Size (acres or square feet):
4. Is -this site currently developed? -4,-4es; no.
If yes; how is site developed?
5. Describe the general site topography. Check aU that apply.
Flat: less than 5-feet, elevation change over entire site.
Rolling: slopes on site generally less than 1.5% (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 corittins 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?
M=� Flows are seasonal? e,j t) (What time of year?
10. Site is primarily: forested 0 ' w_; meadow U shrubs t,_; mixed
urban landscaped'(1awnshiubs etc)
11. Obvious wetland is present on site:
4.
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Critical Areas Check] ist.doc/3.19.2001
City of Edmonds
Development Services Departmint
Planning Division
Phone: 425.771.0220
Fax: - 425.371.0221
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: Z-6199-4
City Receipt#:
Critical Areas File M
Critical Areas;Ch'ec'klist FeA: - $45.00
I Date M.ailed to,�pplicant:
.,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 thei checklist, 'make a
precursory site visit, and make a determination of the
subsequent steps necessary to complete a development
permit application.
Please submit a vicinity map,,along with the signed copy
of this form to assist City staff in finding and locating the
specific piece of property. described on this form. * In
addition, the applicant. shall include other pertinent
inf6imation (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, inderrmify, 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, inadcurate'or
incomplete information famished by the applicant, his/her/its agents o . r 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 APPLICANVAGENT
DATE
Property Owner7s Authorization
By my signature, I cer* that I have,authorized the above Applicant/Agent to apply for the subject land use application,
erty for the
and grant 9�yp
gnnl�ision o-r-t4e public officials and the staff of the City of Edmonds to enter the subject prop
porpag-e—s6f inspection aridpost�ig attendant to this application.
SIGNATURE OF OWNER
.............
Name
Street Address
Z
City State zip
Telephone:
Email address (optional):
Critical Areas Checklist.doc/3.19.2001
DATE 0—? 20 0 kf
Applicant Representative:
Name
Street Address
City State Zip
Telephone:
Email Address (optional):
51TE PLAN
SCALE: I" = 20'
APPROVED AS -NOTED
BY. ENGINE NG
lb�j
Date:
t
+ 2.5'
ip
PARCEL 0: 0055-880-000-1000
20830 00th PLACE WE5T
EDMONDS, WA
100, +01
B +I,
A + I' �j�,g
EX15TING
RESIDENCE
1211 5Q. FT.
ADDITIONA
EXISTIN TO
5E REM VED
D + I'
_4
D GUTTERSIDOWNSPOUV/
AND SPLASHBLO90
sa FOR
is IIE"5
C4 wo 0919GE
JY--
IN
80th PLACE WEST
401-00
+01
1p . \ �-
MANHOLE
COVER
REF. ELEV.
ZAPPROVED BY PLANNING
31( 910
ZONE
SETBACKS:
FRONT, 2-5'
SIDE -_ - 7.57
REAR 15-,
OTHER
HEIGHT
IMPERVIOUS SURFACE CALC5
EX15TING BUILDING:
1211 5QFT�
EX15TING [DRIVEWAY:
2a5 SQFT.
PIROP05ED ADDITION:
_4l3r5Q.FTl
TOTAL:
1148 SQFT
2.5 PECEIVED LOT AREA- 83131 SOFT
UREET FILE MAR - 5 2002 LOT COVERAGE: 20.8%
BUILDING DEPT.
PLANNING DATA
NAME: tv"t-11- --6e DATE:_3/0 /,?.vz2_
SITE ADDRESS: Z-OR3 0 - ?a- --PLAN CHK#: -02- -
PROJECT DESCRIPTION: -336 t_ rzv� N
REDUCED SITE PLAN PROVIDED?: No)
MAP PAGE: 2'0& CORNER LOT: (Yes FLAG LOT: QLOS �/
ZONING: CRITICAL AREAS DETERMINATION #: CA - Zw2 - 4 2-
L1 Studv Reduired:
6111 Waiver
L3 Conditional Waiver
SEPA DETERMINATION: f5xiryi-
U Fee
L3 Checklist
U APO list w/ notarized form
L3 (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger)
� Exempt
SETBACKS:
Required Setbacks:
Street: ;?-5' Left Side: -7. 5 Right Side: 7,5' Rear: / 9,
Actual Setbacks: - h ow%��.
Street: 5 P Left Side: 3V Right Side: 30' Rear:
Street map che-cked for addition tback required? (Yes / No / DNA)
DETACHED STRUCTURES:
ROCKERIES:
U FENCEsrrRELLISES: A.,-,
0 BAY WINDOWS / PROJECTING MODULATION:
Q STAIRS/ DECKS: I\r-, S I
PARKING: Required: ?_ Actual: 'VIA,
LOT AREA: 091 d
LOT COVERAGE 17, -7 1 33�
Calculations: . 9�9' -:. I C)
BUILDING HEIGHT: 6,�jj - 0 V.
Datum Point: Datum Elevation:
Maximum Allowed: 2- c5 Actual Height:
A.D.U. CREATED?:(�/ Ypgs)
SUBDIVISION:
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: (Yes
OTHER:
Plan.Review By-
NewBPPlanningDataForm.DOC
The City of Ed -S*de Se Drawing
�MIPET FILE waie., se-vv-
EASEMENT NO.
NEW CONSTRUCTION F1 REPAIRS 1$ LID NO - ------ ..... ASMT. NO.
OWNER ------- H-oid-A-1 ------- -- ------------ ---------------- CONTRACTOR C4$-9449 ---- cam;truc P.Pt ------------ PERMIT NO - --------------------
S()T" pL.
---------------------------- ----------------------------- _W
JOB ADDRESS ---- 2-08307 -- ---- -- ----------- LEGAL DESCRIPTION: LOT NO - ------ ------- ----------------------- BLOCK NO - --------------------------------
NAME OF ADDITION ------------------------- ----------------------------------
�&r Serv. U mc - A.B.S. - 160 P. S.I:.
4.o- Q sl' c.u.
wi�Nr C.4m mAir-r.
80TIl PL. W.
Approved:
PWW-OWl-I 1/75 (REVA 1/78)
DATE ... ...... � B, Z�
SO K
----------
0
ll� lq
The City of EdmiaissREET FILE
APPLICATION
for
SIEDE SEWER PERMIT
NEW CONSTRUCTION E] REPAIRS 0
1
OWNER ..... �; ...... ...............
ADDRES(I-0.4 ......... 1.0 ............... 6%-UA
................. . ..........................
0? 10 �13 () — t6 r-04 A4 . J.
1 0 *1. aAA-1- Y
Avla �o -
LYNN PLANT
EASEMENT No . ..........................................
CONTRACTOR .14.1111�.O .......... ------- PERMIT No.
LEGAL DESCRIPTION: LOT No . ....... kc) ........................... BLOCK No . ............................................
NAME OF ADDITION kAkql.-� .......... . e ... ......
/0 z
r0j,
APPROVED
MAY b wbi
5** 0
Approved:
DATE -57-."4::�:r ...... ............. e-
...................................................
NOTICE:
No warranty of accuracy.
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 warrant the
accuracy of anything set forth on these
map(s-). Any person or entity -req uesting a
copy should conduct an independent
inquiry regarding the information shown on
t4e -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
ernp'foyee-s o-r officerS) sha-11] be 1--ia-b-1-e for the
information given on this map(s), nor for
any one representation provided based
upon said map(s)..
6TY-eF EDMONDS can Pitospect 6-1107 when Work
CIVIC CENTER — WATER -SEWER DEPARTMENT is ready for inspection. (No inspec- 2213
tions Saturday, Sunday or holidays.) N?
SIDE SEWER PERMIT
ADDRESS -------------------- 2 - 0 - 6 ---- - ---- 2 - 0 - th --- Ave - nu - e ---- S - o - u - t - h --------- -------------------------- A - 1 - 1 . ie . d --- S . e . p . t . i . c .... S . e - rvi . c - e .......... : ......
Kennard E. Hoidal .... CONTRACTOR --------------------------------------------------------------------------------
OWNER----------------------------------------------------------- ------------------------------
May 8 . ........ I Ig.. 6 .7 ., for _---------------------- days to REPAIR or CONNECT a side sewer
Pern-lission is granted ------------------------------------
with City Sewers in accordance with application on file and governing ordinances.
ATTENTION IS CALT D TO THE FOLLOWING: A licensed Side Sewer contractor must
NOTE No. I —The owners of the property may obtain a permit to Construct sewer inside property lin :f-ore it has been Inspected -
be employed to construct side sewer in street area. Do not cover any Portion of sewer b
NOTE No. 2—Obtain full information regarding ordinance ll,.16.030 and Regulations governing side sewers when you get permit -
NOTE 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. to original condition. Contractors shall be responsible for
No. 4—Trenches in street must be water settled and surface of street restored
failure due to improper work which may develop within one year of completion. er or its appur-
iNOTE 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 sew
tenances except to insert the p I Jpe into the wye.
DATE RECEIVED
1�
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NA,ME OF BUSINESS
,vt'L K - Zf R A tr
"LING ADDRESS
�9
0930 80-APt- 6v,
CITY ZIP TELEPHONE
�gi;-26 ift Y-;) 7 7'�--
NAME
PERMIT EXPIRES'
0011P
USE PERMIT
ZPNE
NU MI 3ELt=
.
JOB Su,
ITEJAPT*
ADDRESS Z
le to
PVT NAM1E./SUBDIVISIbN NO.
LOT ko.
bD NO.
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
'TESIOP Ap*0ved
RW Penrdl Req4
Street Use Perntft Reci'd
EXISTING PROPOSED�
kupembn Reqy1red
Shlewalk ReWkwl
REQUIRED DEDICATION- Fr
UrAerground
1 winno raqwm 13
METER SIZE
LINE SIZE
NO. OF FWTURES
PRV REQUIRED
YES 11 NO
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY ZIP
TELEPHONE
jIyWM:dIU&,% me_v�x U 1!!jVr1L4rVtr
03 Fi�JA I -
NAME
ENGINEERIN'G_:
REVIEWEIYDATE
k; 5LO 2
ADDRESS 7,
FIRE REVIEWED BY
DATE
ul
cc
CITY zip;
NUMBER EXPIRATION DATE
CHECKED BY
VARLANCE'OR:CU,
�SHORELINE ORADB#
INSPECTION
REO'D
BOND
POSTED
[3 YES are
SEPA REVIEW
C OMPLETE EXEMPT
SIGN AREA
ALLOWED PROPOS ED
HEIGHT
',-ALLQWED PROPOSED
ERTY TAX ACCOUNT'PARCEI:NO.
EXP
0
Z'S, 1 )2,1
NEW RESIDENTIAL,::.,
El"PLUMBING,/ MECH
:: :� LOT. COVERAGE','-
AEO01RED� SETBACKS, (FT)`
PAOPOSEO SETBACKS (Fr.)
ALLOWED PROPOSED.
FRONT SIDE REAR
FR RS E RE
.,AR
CO MPLIAN C E OR
ADDITION COMMERCIAL [3
357.
Z.5 '?.q 19
57
CHANGE OF USE
PARKING
REO'D PROVIDED
07T AREA
PLANNING Aim' 64Y DATE
13 REMODEL APARTMENT,
13 SIGN
E3 REPAIR [3r ..,GBADINO FENCE
I
kill
REMARKS
CYDS x' Fr)'
1:1 DEMOLISH 0 TANK OTHER
GARAGE RETAINING WALL
CARPORT E3 ROCKERY 0,'RENEWAL.
OWE OF USE, BUSINESS OR ACTIV" EXPLAIN:
CHECKED BY 'ITYPE".
STA U ON
0 CCUPANT
41 LAREAS
GROUP
NUMBER
OF
NUMBER OF
DWELLING,
CRITICAL
SPECIAL INSPECTOR
AREA
CCUPAI4f
I
STORIES
UNITS
N "..r
REOUIRED,10 vCQ
AD
DESCRIBE WORK TO BE DONE
REMARKS
"17701L) 10,1
!PROGRESS INSPECTIONS PER UBC�108/01NAL INSPECTION REaD
I'k T;,Q
I
Vi ko I t,� 12 411
.00F -
VAWATION $
Description
F�E
Description
FEE
'Plan Check
G
HE,�T qOURCE LAZING %
�:Buildi
PLAN ONECK NIL�� STED DATE'
r
'�Iumbi'�'-
Ing
Mechanical
THIS P ILY THE ARK NOTED. THIS PERMIT COVERS WORK To
BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC
31 DOMAIN SIDEWALKS, DRIVEWAYS. MARQUEES,
Grading
Recording Fee
3 (CURBS, ETC.) WILL REQUIRE
SEPNIATE PERMISSIOIL
Engr. Review
City Surcharge
PERMIT APPUCATION: ISO DAYS
PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE
EngrAnspection
State Surcharge
BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE 01 T "r
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Fire Ins
Fire Inspection
Total Amount Due
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.,
Landscapeinsp.
Landsc
Receipt #
I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN 4 CORRECT: AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
rFR
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONMUC_
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
CALL
TWs application Is not a . permit until signed by the
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
Building Official or h"er Deputy: and Fees are paid, and
FOR INSPECTION receipt is acknowledged In space provided.
0 1
WORKMEWS COMPENSATION INSURANCE AND RCW 18.27.
GENT) DATE SIGNED
SIGNATURE(�OW
(425)
OF I JR DATE
k, ,
VNIOR
I
he's 0"
rag
771-0220
ATTENTION
EXT 1333
R go BY
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI_
771-0221
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORIGINAL - FILE - YE
10/01
FAX
PINK -OWNER - GO . LO - ASSESSOR