21027 SHELL VALLEY WAY (2).PDF11111111111111
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21027 SHELL
VALLEY WAY
00 i-. '.., - , - .0 0
TAX ACCOUNT/PARCEL
BUILDING PERMIT (NEW STRUCTURE
COVENANTS (RECORDED)
CRITICAL AREAS: 0 Study Required Waiver
W' �J; DETERMINATION: D Conditional Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DA
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
OTHER
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agFees. to indemnity. OQIAftd arib hold T IL
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ployees; 161d jgq4'15'froT an�:anC all: clat s 191 camacbs of
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U IT gent of'%" owner give ?vVith city and This application is not a permit wltil�-
'autho!iz: by BuildinQ Oft[Clal'Oi. his
dn'ot trio L Dor OhLv T�E signed the
ad I a y,' n ollon will'boA a Deputy,, jhd fella are paid, and rectipt.is.
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OFFICIAL S 510hLTIORIE
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T V"'ON 'JOB SITE
-1. Address of 70=t�'dc'tion
a
2. Proper S [TI
ty Legal Description (include all: easement REATMENTA:ANT
Multi -Family
3. Single Family., Residence No. of Units
Commercial
4. Owner and/or Builder
5. Contractor & License No.
6. Invasion into City Right -of -Way: NOX, Yes (If Yes Right-of-
way Construction Permit Required Call Dial Dig before
excavation).
E -4
7. Cross other private property: Yes No Easement required
attach legal description and county e
READ THE FOLLOU,9Z�AND SIGN: in ILE
A4
a. Property owners must obtain a permit to install side sewers,,on
>4 their property. A licensed side sewer contractor must be employed to
construct side sewers in the public right-of-way.
The side sewer contractor assumes full repons,",,ility for each
installation for one year.
c. Commercial establishment requires a minimum of a six inch (6
side sewer line.
d. Side sewers may not be installed closer than thirty inches (3011)
to any structure.
e. Side sewer lines must be laid at a minimum grade of 2% (1.150
0
and maximum grade of 100% (45
0
f. No turn in side s8wer greater than 45 (1/8 bend) is allowed
0
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend) and Wye with removable cap.
q. No down spouts, footing drains or floor drains can be connected
to side sewer system.
h. Pea gravel is required for bedding when installing sewer lines
through other than granular soil.
i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 1001 along sewer 'line run.
j. Trenches within City right-of-way must be restored to original
'conditions. contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
Side sewermust be left uncovered until inspected and approved
by the'City.
1. Inspection during normal working ho n orking
ays, notice required.
;,DAT
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ly With theabove
04"R'k, _' FEE; Aan, 09
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Pr.RMTq# WIRT, ti
Side Sewer Drawing
The City of Edmonds
EASEMENT NO - ------------
NEW CONSTRUCTION g REPAIRS [] LID NO - ------- ---------- - ASMT. NO - ------------------
OWNER --Homrz-�Amo ------ 110-mms ------- IN-C., ---------- CONTRACTOR --H-0MF—LA,-Nj) 4t3_K
_ E_S .... ----- PERMIT NO.
JOB ADDRESS -210-9-7 ----- SAEL.L-V#-LLE�5 ---- W LEGAL DESCRIPTION: LOT NO. ---8 ------------------------------- BLOCK NO - ---------
TT�EAT4',-rsENT PLANT
-----------------------
2102-ri
SHELL VALLE,-
PWW-0001-11/75 (REV.11178)
- Lo-r ' 8
�3
NAME OF ADDITION --- Ml�PLE-CAE.F—K ---------------
4"WREMO-
Gr,c.alW!lE
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6
PROP
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Approved:
DATE..�.--23-----.?3 ------- B,,/, --------- S,0—
0'1-1,9
&to CA File No:
Offical Areas Chec
Site Enformation (soils/ topography/ hydrolo v -.,,,.--tation)
1. Site Address/ Location: Ul'op',
P1 42-21-7 Zhneli r-- Lt- Val.1 a-iIIII L"-4Q U":I-
2. Property Tax Account Number: 00 -7-101 "'JOID0 (c'.,0V (50
3. Approximate Site Size (acres or square feet): opo
4. Is d-ds 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 hurizontal
distance of 66-feet).
V/
H illy: 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- ',�et).
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 s1--asonal standing water: Wo Approx. Depth:
What season(s) of the year?
8. Site is in the floodway 00 floodplain 0 c) of a waten.,jurse.
9. Site contains a creek or an area where water flows across the groui.ds surface? Flows are year-round'?
00 Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow Shrubs mixed
urban landscaped (lawnshrubs etc) V/
11. Obvious wetland is present on site: - Ma
1'1�vl E
1�
15,
e
I WE,-'
W
W
-ife is 4L,
ma
410
v -ry,-
cates,
'eas en o or di
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Critical Areas Checklist.doc/3.19.2001
0,F E D_Af City*f 10monds
,0- "
Development Services Department
Planning Division
Phone: 425.771.0220
loc. 1%9ri 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 RJWe3W 12-- -50 —0-2�
City Receipt #: Z I I 5(o
Critical Areas File#: ;--'00Z-02E�5
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant: 1. — X e) — () 3
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
perniit apiplication.
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 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 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 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 fil his application on the behalf of the owner as listed below.
SIGNATURE OF APPLICANVAGENT DATE 1.213010Z
Property Owner's Authorization
By my signature, I certify 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 postFlin attendant to this application.
SIGNATURE OF OWNER DATE 30/02
— /�l I L
Ownef/Applicant:
Vi�ke--
. Name J 10.1-7 SLh �A&-V -A
Street Address
,V CAM Ad b A lu-16
City State Zip
Telephone:
Applicant Representative:
Name
Street Address
city State Zip
Telephone:
Email address (optional): Vi"a-te - Ktr-"eL--5G �Akoo- c,,,,, Email Address (optional):
Critical Areas Checklist.doc/3.19.2001
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Seller
Zf -e 41,V,,2
CATC44 BASIN:
Am 01s,30(ok
WOUAL)
I
TRr%r4CW LAKNGTH
. ............................. . ..........
-ncwruwir-
V PEKF P%PV -00
6"TEE W/ (6"LONG LEGS
LCVCL TRENC."
CAP
SYSTEM CROSS—SECTION
TILEHC" COVER -
WASWED
GRAVEL
(B"01AM MRF P1
TRENCH CROSS—SECTION
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE I OF 2
for
location ae& K SC
plan by WNQ LAP i AA2-21's
phone 1 14 —�- QB --I.
E:0— %t5--49z>
DESIGN DATA
Trench Perc LF pe� Imperm Trench
Number Rate 1000 sq.ft. Area Req.
- M-O
mm�==l
NOTES
1. Call Engineering Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the responsibility
of the property owner(s). Preventive
maintenance consists of preventing
soil and other materials from entering
trench during construction as well as
after construction. Catch basins should
be cleaned of floating material and.
sediment at regular intervals (at least
twice per year).
CITY OF EDMONDS
9-/-07
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CITY OF EDMONDS
ASSET INFORMATION SHEET
Fk-1 NEW
FIADDITION
1:1 RETIREMENT
ASSET NO.
ADDITION TO ASSET NO.
DESCRIPTION
fi &1"/i
SERIAL NO.
LOCATION DEPT. NO.
C, LV 6 �- o
"PURCHASE ORDER NO. -
PURCHASE ORDER DATE
COST
*PROJECT NUMBER LJ 3 3:
PROJECT COMPLETION DATE 3 0 — E-3
COST Y-3
B.A.R.S. ACCOUNT NO. a. c-c" , 6 f Cf - 3 o r,
ESTIMATED LIFE
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
STREET FILE
DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT -
0 G.L. ENTRY
REFERENCE
DATE
VERIFIED BY
PROCESSED
BATCH NO.
INITIAL
ttnp
DEPARTMENT FILE
CATC44 BA,51H:
&M'OJS-30(Ok
IMUAL
I
TREMCW L.IrNGrH
CDVVR-I,
10 -nCPWTUWK-*1
&.� Pff kF P i PC
6"-rF-E W/ 4"LONG LEGS
LCVrL TRMN"
CA.P
SYSTEM CROSS—SECTION
IM NC W C 0V r= R -
WASWED
G P-AV E L
6"DIAM FERF P1
TRENCH CROSS—SECTION
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE I '%OF 2
for
location
plan by ana,
phone
DESIGN DATA
Trench Perc LF pe� - Imperm Trench
Number Rate 1000 sq.ft. Area Req.
mm� M
MM�Mmj
NOTES
1. Call Engineering Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the responsibility
of the property owner(s). Preventive
maintenance consists of preventing
soil and other mate ' rials from entering
trench during construction as well as
after construction. Catch basins should
be cleaned of floating material and,
sediment at regular intervals (at least
.twice per year).
CITY OF EDMONDS
MEMO TO: Building Division
Planning Department
FROM: Engineering Division
Public Works Department
SUBJECT:
After review of the subject Building Permit application, we have the following
comments:
1. Connection to City water system required.
2. Connection to City sanitary sewer system required.
- -- - X-
3. Right-of-way p - ermit required for any work on City property.
4. Driveway slope not to exceed 14%
5. Backwater valve required if downstairs plumbing is below elevation of
upstream manhol-e--.
6. Water and sewer lines to be separated by 10 foot minimum.
BD 6/82
W
co
HU G .1,1. CW E N 7 1 E
�1051
JOHN W. ::>ACE C)
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SO,
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JOHN W. PACE
8320 S.F.
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70'
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8008 S.F.
J
CITY 0 F EDMONDS
84'
8000 S.F
ptrindld--al
me A4
367 m
col
30 m 10"H.
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8000 S.F,- 800,0 S.F
7'
64' -'10 2'
39 9'
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2 10
8032 S.F
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-BUILI)iNU
BUILDING ADDRES
-Nuitiple -
Commercial
BLDG. DEPT. SUSPENSE DATE 0 V INITIAL DATE
[I OFFICE ADMIN.' '— PUBLIC WORKS LOG IN
CITY ENGINEER (check)
C1 Access Slope and'Vehic.le Acccss
0 Drainage Plan
0 Street File
0 Legal Descripti6h
OQuit C.1aim,
Ease.ment
u
late Se,;4er. Connection
WATER/SEWER DIVISION
A
Detdrm
Ni �11
ine, Meter,;
erm
iCReview
,,..ElgTREET;D'IVISIbN';-,*',,--'..�'i
-;Building
_.Comp 1 e t e' Pexm Review
[]OFFICE A'DMIN..'.'- LOG OUT -TO BLDG -.-' DEPT.
----------------------------------------------------------------
[3-BUILDING PERMIT APPLICATION (COMPLETE).
.13'2 COPIES OF SITE PLAN
2 COPIES OF FIRE PROTECTION PLAN
(PREVIOUSLY REVI-EWED BY FIRE DEPT.)
COPIES OF DRAINAGE PLAN WITH CALCULATIONS
REQUIRED BY SUBDIVISION
GREATER T11AN 2,000 SQ. FT.
IMPERMEABLE SURFACE
LESS THAN 2,000 SO. FT.
CK ZONING'REQUIREMENTS (SETBACKS)
FQ OF ENGINEERING CHECK LIST
PY OF PU.nLIC'.WORKS MEMO
MULT,PIPLE OR COMMERCIAL
YES (AMCH!COPY OF ADB APPRDVAL INCL. ALL DP,*JINGS)
U/NO
SUBDIVISION — YES[] NAME. e le' ,
DATE44
NUMBER - t-,-3 -
N 0 F-1 (ATIACH -COPY'OF -R M-UIRJ-2,UMS)
rCHECK SEWER DRAWING AND ATTACH COPY lu-e�
V
I IS
S DEDICATION REQUIRED YES[] (OBTAIN QUIT CLA120
CITY ODDE
No�ff
DOES.CITY HAVE EASEMENT ON PROPERTY
YES[] (ATTACH COPIES OF DRAWINGS)
NO
CHECK LEGAL ACCESS' INGRES�d UTILITIPSTf' I=PH FILE
Vx? Q rA vre
NO [3 NO
0 HAS SEWER ASSESSMENT BEEN PAID
YES L. I. D. NO.
PLAT NO.
01'-IF; MULTIPLE: INCLUDE NUMBER OF UNITS'"
Eli:
]�,.COMMERCIAL: INCLUDE NUMBER OF FIXTURE UNITS'
0
0
PtMLIC WORKS I)EPARTMENT CHEacun
BUnDING PERMIT REVIEW
(address) (date)
0
Street Right -of -Way Exist'
Z
Access Easements Exist* REQD
H
ge
Utility Easement Exist A0,0r t7 4 )r REQD
lot Per Subdivision Plat 2, Assessor e- r-
Site Plan Checked for Accuracy oK
Z
Underground Wiring Reqd.-
0
Check Ac acy of_Legal Des tion 014 W,91,e4 1�71,rlxr -kcoww
Z
Review b Datef 2-11, fy
Existing Water Main Size
Water Main Required #1A
Service Line Required
Hydrant Size Existing,
Hydrant Reqd Per Fire Code Size.
Detector Check Meter Reqd.
f-4
Cross Connection Inspection
Fire Department Comments
Water Meter Charge Reqd.--'5
Review b �m Date
y
Septic Tank Design Approved Date
Septic Tank Permit Reqd.— 114 Permit No.
Sanitary Sewer Availabili ty oi -
Drmqjng No. '�-File No.
V4
Side Sewer Availability
94
Sanitary S ection Fee Reqd.
:3:
. /Zei
Review b Date
Open Ditch Existing. ,Reqd.
Culvert Reqd. 00F)2- Size —
94
Catch Basin Reqd. /I Indicate on Site Plan
0
Shoulder drainage maintain collection on swale opan runoff
Mmihole reqd. IVC-7e gl-.,4 Indicate an* Site Plan
Soil Conditions and Ground Water Field Checked
Rc-Aew by Date
Revised: IvIO-1977
Page 2
Street Paving Reqd. Per- ve�,Qf
0.=b and Gutter Reqd. I
Sidewalk Reqd.
Curb Cut for Driveway Reqd.
od Right -of -Way Cznstruction Permit Reqd.
Bond Reqd. for Public Inprovements-
Street Name Sign Reqd._ A4-7-
Other Signing Reqd._PP12 JOLAT7
Pre Permit Site Inspection made an
z
c,' BY: S94ER
4
W WATER
z ST=
ENGINEERING
Special Requirements listed in merm to Commmity Development Departumt,
Building Division
BY -Date
All items filled in on Building Permit Application
BY ---Date.
DrawrhT,s Starrped and Notations Made
BY Date
Approved by Public Works Department
Ftevised: 1v 10-1977
CITY OF EDmwbs
CONSTRUCTION PERMIT APPLICATION
INAMEJOR NAME OF BUSINESS)
Z �40 -2- q- 4-
CITY
611 Vli,�
NAME
DRESS
CITY
NAME
b(i -
7 7 6--2-o -3 E,
'ELEPHONE NUMBER
?k�7 -,q It q 47'
( L -IL . /-T -A-
3 V
ADDRESS
7- P1 M
CITY- TELEPHONE NUMBER
STATE LICENSE NUMBER CITY LICENSE NUMBER
no M e- It 2- /no's
Legal Description of Property - Include all easements
(show below or attach four copies)
MOO
�j NEW
9 RESIDENTIAL
PLUMBING
1:1 ADDIALTER
0_ NON-RESIDENTIAL
MECHANICAL
1:1 REPAIR
F1 RETAINING WALL
0 SIGN
DEMOLISH
EXCAVATE
1:1 OR FILL
FENCE
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17-1 PRE -MOVE INSPJ
r-1 swim
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1 09, 1 r-� 12- 1 k/
PUBLIC RIGHTff WAY PER OFFICIAL STREET MAP.
EXISTING 4u REQUIRED DEDICATION L9
PROPOSEKAO�
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRE() U
STREET USE PERMIT REQUIRED I
SEE ENG'zAEERING MEMO DATE---id�6-2
SEE PIW DEPT. REVIEW CHECK LIST DATED
REMARKS
TRISIDE SEWER WATER LINE
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0 NUMBER OF STORIES NUMBERO
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DWELLING
UNITS
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NATUR A]FWORK TO BE DONE (ATTACH PLOT PLAN)
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METER SIZE IBUILDING SUPPLY
REMARKS
E UNITS
SIGN AREA ENV. REVIEW
ALLOWED I PROPOSED I COMPLETE I EXEMPT
VARIANCE OR CU
YARDS
25- FRONT SIDE
CHECKED BY ITYPE OF
SPECIAL INSPECTOR
REQUIRED
LJ YES L! NO
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADING/FILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to Indemnity, defend and hold
harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
i whatever nature, arising directly or Indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirement of any city ordinance
TOTAL AMOUNT DUE
nor limit In any way the City's ability to enforce any ordinance
provision,"
I hereby acknowledge that I have read this application; that the
Information given Is correct; and that I am the owner, or the duly
ATTENTION
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
state laws regulating construction; and in doing the work authoriz-
AUTHORIZES
ed thereby, no person will be employed In violation of the Labor
ONLY THE
Code of the State of Wash Ingto relating to Workmen's Compensa-
WORK NOTED
tion IDsurance— 71-�
INSPECTION
DEPARTMENT
—
$40ATPE (OWNER OR V-Fb� DATE SIGNED
CITY OF
IEW BY
OCCUPANCY
GROUP
VALUA
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ADB NO.
SHORELINE#
DATE
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OCCUPANT
LOAD
APPLICATION APPROVAL
This application Is not a permit until
signed by the Building Official or his
Deputy; and fees are paid, and receipt is
acknowledged In space provided.
OFFICIAL'S SIGNATURE
THIS ITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX 775-2525 DATE
ATTENTION SHOULD BE CODED 31.04.
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3. FEB 14 1991 PINK — Owner GOLD — Assessor
102-78
V . E�. W.
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