21001 80TH AVE W.PDF11111111 lill
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21001 80TH AVE W
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 of �Edmonds does not warrant the
accuracy of anything set forth on these
map(�-). Any person or entity -req uesting a
copy should conduct an independent
inquiry regarding the information shown on
t-Fe -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
emp-l-oyee-s or officer,--) shall be lia[D-I-e for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
APPLICATIO RAN PLA
STREEr FRE for
The City of Edmonds SIDE SEVWM PERMff EASEMENT No.
NEW CONSTRUCTION REPAIRS 0
24Zc)-eDS-2-,,-30
OWNEP, ...... R ------ &r-ksaey ...................... CONTRACTOR ......
............................ ......................... --------------------- _ ............. PERMIT No . ...... ................
ADDRE4
...... -ok ---- ilns-o) ............ ................ LEGAL DESCRZP'0TIf0fi:a LOT No . .............................................. BLOCK No - ------------------ ---------
W, //Olt --A 041-e 64jeVeAtS 14,- -7.�
AOTMAUE. tJ- NAME OF ADDITION .......... .................................................. ................ -- ......... .....................................
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PL A7 e C 0 A 4016- AO iy VIA IV Ot 1- 14 0
It
CITY OF EDMONDS
CIVIC CENTER — WATER -SEWER DEPARTMENT Cali PRospect 64107 when work
is ready for Inspection. (No inspec-
tions Saturday, So nday or holidays.)
NO 2014
SIDE SEWER PERMIT
ADDRESS ........................................ 3.2.1 ... . .... 21s.t ... A.ve.n.u.e .... So.u.th
OWNER .............. RQb.eTt..R' ... ..................................... CONTRACTOR .... ReAf PPd ... ... S.Qn .........................................
Permission is granted ... April ... 13 .................... 19.6.7_ for .............. .......... days to REPAIR or CONNECT a side sewer
with City Sewers In accordance witli application on -file and governing 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.
NOTE No. 2—Obtain full Information regarding Ordinance 11.16.030 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.
'E 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 ELIter or do any other work than Is provided for In the permit, or to do any work on the main sewer or its appur-
tena.nces except to Insert the pipe into the wye.
Z�
RATE RECEIVED
(>FPERMIT
EXPIRES
USE PERMIT
C'
CITY OF EDMONDS
ZONE
NUMBER,-�.;�`��
ECONSTRUCTION
JOB SUITE/APT#
PERMIT APPLICATION
ADDRESS
OWNER NAME/NAME OF BUSINESS
PLAT NAM E/SU BDIVI SION NO.
L�D NO.
A
T777
L D FEE $
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MAILING ADDRESS
TESCP Approved
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PUBLIC RIGHT OF WAY PER OFFICIAL STREir.MAP
RW Permit Required 0
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EXISTING — PROPOSED
Street Use Permit Req'd 0
Inspection Required 0
Sidewalk Req ired 0
-Underground
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CITY ZIP
TELEPHONE
REQUIRED DEDICATION— FT
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Wiring required
NAME
METER SIZE
LINE SIZE
PRV REQUIRED
YES 0 NO 0
ADUKESS
REMARKS
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OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
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CITY ZIP
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STA TE LICENSE NUMBER EXPIRATION,DAT� CHECKED BY
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0 Y ES 0 NO
SEPA REVIEW
COMPLETE EXEMPT
SIGN AREA
ALLOWED PROPOSED
HEIGHT
ALLOWED PROPOSED
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PROP5RTY TAX ACCOUNT PARCEL NO. r
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EXP
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L/R SIDE REAR
ADDITION COMMERCIAL COMPLIANCE OR
CHANGE OF USE
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REQ'D I PROVIDED
LOTAREA
[��REVIEWEDBY DATE
REMODEL APARTMENT SIGN
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REMARKS
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CARPORT R CKERY
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(:�YPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
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Ex
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CHECKED BY
TYPE OF CONSTRUCTION
CODE OCCUPANT
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GROUP
NUMBEIR
OF
NUMBER OF
DWELLING
CRITICAI�
ARFA e
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SPECIAL INSPECTOR
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UNITS
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LOAD
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DESCRIBE WORK TO BE DONE
REMARKS
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FMUUKESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D
FIRE MARSHAL
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MUST BE FRBENT FOR
"ANK FILL-.REMOVAt,
OR CA-F.
VALUATION
FEE
PLAN CHECK FEE
HEAT SO�RCE GLAZING % LOT SLOPE %
BUILDING
PLAN CHECK NO: VESTED DATE PLUMBING
is
'MECkAMCAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GR�91NG/FILL
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION. ARGE
w PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT., 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. R I I EW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
U) 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS ENG. INSPECTION FEE
Cn
uj IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
i LANDSCAPING
2 EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
INSPECTION FEE
cc ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
RECEIPT
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
= I R CYIPT A_
TOTAL AMOUNT DUE
I HEREBY 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.
�ANCE AND FIPW 18.27.
WORKMEN'S COMPENSATION IN��
`OFFICIALS SIGNATURE DATE
—SIGNATURE (OWNER 0 AGENT)' DATE SIGNED (425) (1-It'
4,
771-0220 'DATE
RELEASED BY
ATTENTION EXT1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR
5/98
'P
0 STREET FILE 0
HARVE H. HARRISON
CITY OF E * OM"INDS MAYOR
CIVIC C�NTER - �DMONDS, WASHINGTON 9802C, - (206) 775-2525
DEPARTMENT OF: PUBLIC WORKS
February 10, 1978
Mr. Robert Nelson
21001 80th Avenue West
Edmonds, WA 98020
Dear Mr. Nelson:
SUBJECT: VACATION OF RIGHT-OF-WAY ON 80TH AVENUE WEST
ABUTTING YOUR RESIDENCE
On February 7, 1978, the City Council decided to proceed
with the right-of-way vacation without requiring the payment
by the abutting property owners of the costs encountered by
the City. The City is proceeding to record this action in
the county. You will, therefore, be able to adjust your
property boundaries accordingly in approximately 30-days.
Your Check No. 1619, in the amount of $25, is enclosed
and is no longer required.
Yours very truly,
J,
LEIF R. LARSON, P.E.
Director of Public Works
0 .71 R1 =
Enclosure
A�-Slt.C.E. Vate -A-21in.Sec. ate
CITY OF EOMV )NDS
CIVIC CGNTEP - GDMONDS, WASHINGTON 98020 - (206) 775-2525
D�PARTMENT OF PUBOIC WORKS
November 30, 1977
Mr. Robert R. Nelson
21001 80th Avenue W.
Edmonds, WA 98020
1
Dear Mr. Nelson:
HARVE H. HARRISON
MAYOR
SUBJECT: VACATION OF SURPLUS RIGHT-OF-WAY.ON 80TH
AVENUE WEST ABUTTING YOUR RESIDENCE
- The City Council has agreEtd to vacate surplus street
right-of-way adjoining your residence. This right-of-way
would be vacated subject to the abutting owners'paying the
appraisal and reco * rding fees. It has been determined that
the fee for each owner is $25.
Upon submittal of the fee to the City of Edmonds, Public
Works Department, the City will.file an Ordinance with the
Auditor in Snohomish County. The title companies will then
pick-up this information from the records. You may then wish
to contact the title company for further.arrangements to
clarify any fee title interest you may have in the vacated
right-of-way. In order to complete this action at the earliest
possible time, it is requested that you remit the fee to the
City of Edmonds by December 16, 1977.
If you have any questions on this matter, please contact
Mr. Richard Allen, Assistant City -Engineer, at 775-2525,
ext. 220, between the hours of 8 a.m. and 5 p.m., Monday
through Friday.
Yours very truly,
LEIF-_R. LARSON, P.E.
Dire4or of Public Works
RHA: lv
01 Ty Ovi Emmons
ME
q.-mr-r-T FILE
LOT APPROVAL STREET lu
NAME ADDRESS
ADDRESS OF PROPOSED BUILDING ;5 A
C) �
LEGAL DESCRIPTION: LOT BLOCK ADDITION
SEYTYPE OF U OF BEDROORS SIZE OF -LOT
SOURCE OF DRINKING WATER: Public Supply___�� Private Well
a. SURFACE DRAINAGE
1. Is� disposal field site well drained9 �Po
2. Any water course (stream, drainage ditcK, etc—.T—through site? .2(-o
b. TOPOGRAPHY
Any heavy slopes in field area?
2. Will present topsoil in field area be removed or'graded before field tiles!
are installed?
3. Will any fill material be used in the disposal field site?
If yes, how much?
c. SOIL CONDITIONS
1. Has�a hole at least 4 feet deep been dug in the disposal field area to detelb-
mine the type of soil 'Present?
2. After hole is dug record the soil /conditions at the following depths. (Re-
cord as sand,'gravel, clay., packed sand., loam'. etc.)
12 inches 30 inches,44)/e,
1-8 inches
,�inches
24 inches,' IJ� inches
3. Any ground water encountered before reaching a depth of 4 feet?
r)
If so at what depth? d. WATER TEST
A simple water test will show how well this soil will drain or percolate wiat
To perform this test:
1. Dig hole at least 36 inches deep. Use a shovel or post hole digger —
size of hole makes no difTerendt—Unly depth.
2. Fill hole with water. Now let all water run out of hole. This soaks
the ground and will give a more accurate reading.
3. Again pour water in hole to a height of 12 inches from the bottom.
Let water run out until there is just 6 inches from bottom left in hole.
4. Note how many minutes it takes for this last 6 inches to seep away.
Record this time below.
Number of minutes for last 6 inches to seep away
5. Divide this time by 6 to obtain the rate per inch
6. Date water test was performed 5>1 2-/6
I hereby certify the above infonnation to be correct and the above tests were
perfonned by me as prescribed.
Signed
Address
NOTE: A septic tank permit is issued on the basis of the above information. If
there are any changes or alterations in the above stated soil conditions it may
result in the installation being rejected at the time of inspection.
Percolation Rate and Required Absorption -Area. For,single Family Dwellings.
Percolation Rate (Time in Lineal feet of 4 inch tile
minutes for water to fall using trench with width of
one inch) two feet
3 150 minimum
4 175
5 190
7 225
10 250
12 2 5
15 285
30 -375
Over -30 Soil Unsuitable
CA FILE NO.
Critical Areas Checklist
LA-00- (q4-
---------------- ---------------------------------------------
Site Information (soil s/topography/hydrology/vegetation)
q100( </D+A_ A),( , ,
I Site Address/Location: L.-)
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet7
4. Is this site currently developed? X y e s; no.
If yes; how is site developed? _01'
c_C
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 1 0-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
1 0-feet over a horizontal distance of 3 3 to 66-feet). .
Steep: grades of greater than 30% present on site (a vertical rise of 1.0-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: y-\-- 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? V�_Z Flows are seasonal? (What time of ?
10. Site is primarily: -forested meadow shrubs -mi-.ed___-
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site: L/-\-A
"O.ChUm; Rw 10103/97
a-/
City of Edmonds
CRITICAL AREAS CHECKLIST
The Critical Areas Checklist contained on this form is
to be filled out by any person preparing a
Development Pen -nit Application for the City of
Edmonds prior to his/her submittal of a development
permit 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).
An applicant, or his/her 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 finding 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 assist staff in completing their preliminary
assessment of the site
I have completed the attached Critical Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owne icant:
—
Name
-,�J 0
Street Address
- FDmDoq fy, wA � o 2-6—
City State 447,in
-- D 7--
ate
A ?,c a res7t,
�:ep ive:
Name
Street Address
r+ 67R) t I
C 7ity State Zip
Signature
Date
crecepdon�anakacl.doc
(over)
City of Edmonds
NA�V CRITICAL AREAS CHECKLIST
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 1-�s/her submittal of a development
permit to the City.
0,
An applicant, or his/her 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.
The purpose of the Checklist is to enable City staff to Please submit a vicinity map along with the signed
determine whether any potential Critical Areas are, or copy of this form to assist City staff in finding and
may be, present on the subject property. The locating the specific piece of property described on
information needed to complete the Checklist sbould this form. In addition, the applicant shall include
be easily available from observations of the site or oth r err-tinent information (e.g., site plan, topography
data available at City Hall (Critical Areas inventories, n Vtt r studies in conjunction with this Checklist
'LOP
maps, or soil surveys). to
%�a\ staff in completing their preliminary
assessment of the site
I have completed the attached Critical Areas Checklist and attest that the answers. provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/A 'icant:
—V
Name
A 0 61
Street Address
- , F�Qm 0,�
City State 7in
/i �,
Date /
A Uc
,pr,�,ant RepresItive....
Name
-/Q�iul.
Street Address
r+ qSz t i
City State
Zip
Signature
ta /
Date
execeptionVanakad.doc
(over)
CAFILENO.
Critical Areas Checklist
- - - - - - - - - - - - - - - - - - - - - I - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Site Information (soil s/topo graphy/hydrology/ve getation)
1. Site Address/Location: q 100 )f L j' AA1) f\- I I
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? yes; no.
If yes; how is site developed? 0
6f �
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 I 0-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
1 0-feet over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 3 0% present on site (a vertical rise of I 0-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: kL,� Approx. Depth:'
What season(s) of the year?
8. Site is in the floodway VL---,,-, floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? - V\-,-O Flows are seasonal? (What time of yCar?
10. Site is primarily: forested meadow shrubs mixed
..�rban landscaped (lawn,shrubs etc) rZ
1 1. Obvious wetland is present on site:
AM.ChUK Rvy 10/03/97