21031 76TH AVE W.PDF111111111111
6316
21031 76TH AVE W
z
Z
DATE: PLAN CHK#: 03 - 01 7
NAME OF BUILDING PERMIT APPLICANT:
PROJECT DESCRIPTION: -"n' 13,9 40
-A
AD13 FILE #: OR DATE WAIVED:
PLANS MATCH APPROVED PLAN:
SUBDIVISION:
LOT AGGREGATION REQUIRED?: —
REDUCED SITE PLAN (8.5X11) PROVIDED FOR STREET FILE? -
Plan Review By: e��
6,tr '- I �I- Ax— Sfr A111",
401 4., a zs� 1-1 — T&)-Iq 14' A-1.rn 11 . J"Vf-i
35'
13.9
&a re IA I A*'C"7
0
lvt�' S r7r .-ti r- 'j o1A
1:\Iibrary\Ap landatNewComm.doc
z
Z
PLANNING DATA
New Commercial / Mulffamily Proiects
SITEADDRESS: 7-1o3l- --71,-Ae- i�j. ZONING: 43/v
USE(S) PROPOSED: N(- ( 2 1 ALLOWEV: I
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED (Y/N)
CUP File: To Allow What Uses?:
ADBFILE#: q1-3,Y-
PARKING:
Use:
No. Spaces Required:
. X
(floor area, # employees, etc.) =
Use:
No. Spaces Required:
X
(floor area, # employees, etc.) =
Use:
'No. Spaces Required:
X
(floor area, # employees, etc.),=
Use:
No. Spaces Required:
X
(floor area, # employees, etcj�
Total Required:
Actual Provided:
SETBACKS:
Required Setbacks:
Front: Left Side:
Right Side: Rear:
Actual Setbacks:
Front: Left Side:
-Right Side: Rear:
Street map checked for additional setback required? (Yes/No)
MAXIMUM FLOOR AREA: /J C-
Maximum Allowed: Actual:
BUILDING HEIGHT: tvc
Maximum Allowed: Actual Height:
Modulation Allowed?: Modulation Height:
Datum Point: Datum Elevation:
Elevator Penthouse > 3 feet over height limit? If so,VAR#
LANDSCAPING:
Matches ADB approved:
Bid Provided? Bond Amount (100% bid):
CRITICAL AREAS #:
SEPA DETERMINATION: IVA
SHORELINE REQUIREV: Al-6
Continued ...
1A1ibrary\^P1andatNcwComm.doc
Building Permit
ST EET. FILE.
Application Information
Br
�pplicati on #... 9210,52ELDG Date ... 1/14/93 Permit # ... 921052 L4DG
ite Address ... 21-031 76th Ave W
-ob Name ....... AW Pottery/Jacobs.. Unit
----- - -------- -----------
----------------- ----- Owner information ------------
ame .............. Christopher Jatobs ATA#'5669 004 007 02
.ddress...* .... *. 6400.Roosevelt Way NE
ity/st/zip..... Pe . attle, WA. 98115.
ome Phone... r
Work Phone.'.,`,
-- - - - - - - - - - - - - - ---- - - - - - - - - -
M.Contraictor Information' ---------
------ ------
ame ............ Alpine Gustob Biii'Ldings"� Con.- # ... ALPINCB151M9
ddress ........ 929 N 1304-11 #�S
'ity/State/Zip. Seattle, WA'. 9313-3,":.
'ontact ... Mac - McGi lver.y
� one
'Ph
h;ormati — — — — — — — — — — — — — — — — — —
ct
Arcliite'
---------------
ame ........... Alpine Cu*s*tbm Bui,ldin'Os(�* Arch 362-5025
-ddress .......... 929 K. 43-0th, Suite- 8
ity/State/Zip. 'S -Wk.; -§8133-�
onta--t .... .... Gec)ide'.-I�'�i:wkirii;*on;*;'�.*.-
3
62 '502
'�ngine.er`-:In fbtmation-'�- ------------------
e --Engr #..
No. Engine
ssigp'6d,
ddress.,
ity/State/Zip.
ontact. �Phone ...
B ildihg arjd'�"Zoninq Data
uL
Zone.. E N Lot�-.Cbveragq, - �NIA
He.igPi 25
Front.. 410 S'i d, e�t 6 eat�.'.. 0
2
Addition".,.�`...-...,X�: -Alter',at-Lon. Repair
a t e of Work. .,.Ope'n':'Sided. S t. o r, a g e 9u i1d iriq
�0
ccupancy G-rcup. c�cupant Load,—
uilding Type Cod�'.'-.' .MI-S;:_VN 0 Co'st/SqFt..,, ... .$�6.3.7
a s e M e 'n t .1st Story. .72ndl-Story -3jtd.Story
ver 3.. qarage- Dedks.*. . Shell..
t a I Sq.Ft. Blda Value 4'.. 000; 00 J..Total
Fee.. 49.14' Permit. Fee' 75.60 Fees 124.74
This Permit cover, ucrk to be. dona cin private prc�perty ONLY. Any const - ructi6r, on puhdic domain wil.1
requi r e
seperate permission.
16 Harmless: Appl:cant, on h�eh;,O.f of.his or her spr-k;sE�: heirs, assignes an-3 &ucces3ors in interest, ag_rees to
-ndemnify, defencland hold'harmiess the City of Edmonds, WaEningxon, its officials, em-plojee,', and agents froxv. any
and all C2aims f or 6,qmayes of whatever n ature,'arisinq di.rectly or indirectly fiort the issuanc�. of this nermit.
Issuance of this permit shall not be daex6d to modify. uaive* ot reduce ar�y requirement of any citj ordins.,nce nor
lim.4t in -any wey the City's ability to enforce any ord.inpjice provisioni.
I hereby a.cknovledge that 1 have read tkie, application; '_hat the information given is correct; and that I am the
cuner, or the duly authorized avent of --he olvrne!�- IT aa-fe6to comply vith city and state lj;ws requlatin�
construction and in doing the wor)z authorri.zed therebl, nf� person will. be employ,.;jed in vlolation of the labor code
of the .5T.ate of Waehington relating -to Worhman's Insurance.
_7 ss-ue Date F;-piraton Cate
. �f"J'TRI'HET FILE
Critical Areas Checklist
Site Information
RECEIVE�D.
JUL 2 7 1992
PERMIT COUNTER
A, 1 r_-7 4 &1 .
ProjectName: _1fr_jUqCW#* Permit Number
Site Location: 2 1031 %�_Me zj Property Tax Account Number. '56j6q - OC OC>--;L 696�
Approximate Site Size (acres or square feet): q ") C9 .
Have you filled out a Critical Areas Checklist for a project on this site before? K/ 0 .
General Site Conditions
1. Has the site been cleared or logged? Date of most ro=t action:
Soils / Topography
2. In the Snohomish County Soil Survcy� what is the mapped Soil typC(S)?6-- -qAb4--_WV0b vah�W '44wb
ZCMPAE�< P-,�;
3. Describe the general site topography. Check all that apply.
Flat less than 5 feet elevation clmngc over entire site.
Rolline: slopes on site generally less d= 15% (a vertical rise of 10 feet over a
horizontal distance of 66 feet.)
Ifilly: slopes prcscat on site of more than 15% and less than 30% ( a vertical rise
of 10 feet of horizontal distarim)
Steep: grades ofgreater than 30% present on site.
Comments
Hydrology/Vegetation
4- Site contains - areas of year-round standing water AZ
5. Site contains areas of seasonal standing water. V 0 —Approx. Depth:
6- Site is in the floodway U C floodplain A/0, of a water course.
7. Site contains a creek or an area where water flows ac'ro*'S*s the grounds surface? V-0 -flows
* V V c � 0 A i C tW WE
are year-round? _JVP__Flows are seasonal?
8. Site -is primarily: forested meadow shrubs mixed
9. Obvious wetland -is present on site:
10. Wetland inventory or map indicates wetland present on site: 00 ,
11. Critical Areas inventory or map indicates any Critical Area on site: h)o
R. ev. I Y.2 7/912
City of Edmo'nds
Critical Areas Checklist.
'Me, Critical Areas Checklist contained on
this fornt-is to be filled out by any person
preparing a Development Permit
Application for the City of Edmonds prior
to his/her submittal of a developmeatTermit
to the City. I
The purpose of the Checklist is to enable
City staffto determine whether any potential
Critical Areas am or way be present on the
subject property. The infornzation needed. to
complete the Checidist should be easily
available fi-om, 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 checidist, sign and date it, and , '
submit it. to the City. The City will review44
the chccldis:t� malce a precursory site visit�
and xnake a determination of the subsequent
steps necessary to complete a development
permit application-
Mrith a signed copyof this form, the
applicant should also submit a vicinity map
of the parcel with enough detail dw City
staff can find and identify the-subJect
parcd(s). In addition, the applicant is
encouraged to include any other pertinent
infbrmation or studies in conjunction with
this Chec1dist to assist staff in completing
their preliminary assessment of the site -
I have completed the attached Critical Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner I Applicant:
Name
06DA)
Title
M61?U 1�//'
Street Address
Applicant Representative:
Name
Title
Street Address
No-6
City, State, ZIP Phone City, State, ZIP
Phone
Date
Sipwiture
Date
0
APPLICATION
CARDNo . ......................................
for
The City of Edmond-s SME SEWER PERMW
EASEMENT No . ......................................
OUTSIDE El INSIDE B-,' REPAIRS 0
4/0 //Y
.......... ................... PERMIT N - -----
OWNER ---------------- -------- ------------------- CONTRACTOR ............. I A�tZ:AZ-V -------
STREIT................................. BLOCK No . ......... . .................................
TE
.. ................
HOUSE No . ....... -sY . ....................... ...... AVENT, WT No . ...... 7...a ----------
�k) 'Z� el
NA.TYIE ADD. ...... -----------
&J. ----------------------------
APPROVED
M 2 64
u)
Date Approved:
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ ---------------------------------------------
DATE ............... By
SEWER WORK ORDER ISSUED .......................................... .. . . ........... ; ..................
T
--�d F EDMO
CITY-
5-1,
'Cajl� Pposp6ct 6-1107 work,
DEPAkiMEN� Y when
is ready f
or insPcctIon.4:.(&o,InsPcc-
d or -h� Mays V.
�Ions Saturday,;-Siin my 0
S-IPE-SEWER: PERM
JT
2.5..tb ... Av.dri .S.o
up.
............... ....
7 ............. �7: .. ..... ......................... ........ .
..... Ra.'..j
-co.......... ... .......... .
......................
-Is granted 64
. ............. 19 ........ j for .............. ... ... d "or CONNEOT
f 'flFt
eweYS:111 accordance W th applica. io o
, �. �, --. . , I A side-sew6r
t n..n- i1e: And governing o nances.
"r.-?�TTI�NTION-JS -CALLED 0
'51 T ::THE FOLLOWING:
�NPTE-NOe- 1--�The owners of the may obtain a 'Permit,.t
e o,7construct sewer Ins -A licensed Side
be, mPloyed- to'construCt Sidi Sewer In street area, Do n �-co er any- p6rt on of Sewer bsiore it
Ide property line
'E .0�t� v Sewer Contractor mus�
has
Inspected.
Vo. 2 Obtain. full. informs, Ion regarding Prdinance 11-16,030 -an
t
d Regulations 'govern ng. side sew rs� when you get Permit.
No.. 3�TOII of sl&se
wer Must. have at leaStL 30 Inches -coverage at property P-
No bends In grade sharper than 'A will be , jhielan�,12 Inches-APSid r perty line; minimum grade of 2%.
._permitted
NOTE NO: 4
�Trench
es in street must be Water -settled- and surface of street. resto
-fa.11ure�-dds to Improper work which ofred to original -conditioin.'.-Coniraetors 'shall be'.respon'
may -develop within:one'year -completion.' Sible. for
NOTE. No. -5--It is unlawful
to alter or. do any oth
er work than�ls proy�ded for In the- er
purtenances' except to, -Insert the Pipe into the wye. _p _mIt, -or to do. any se
Work on the wer or Its - ap-
City of E`4ih s
RIGHT-OF-WAY CONSTRU CTIGN:�----T
nUnXAr1rrV
6 9 0 . 1 9 4 .-
Permit Number:
STREET FILE Issue Da . te:
A. Address or Vicinity of Construction: 9 103/ ?K1 A t16- 1J. FhM1)tJbS.
B. Type of Work (be specific):
C. Contractor:
4't'C.0,4VK Contact:
Mailing Address: w�2-01'0 Phone:
State License #: 8pfe" 'W C- C O's-3/ *--.*9 Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. -F-1 Commercial El Subdivision n City Project 0 Utility (PUD, GTE, W`NG, CABLE, WATER)
F1 Multi -Family Single Family F1 Other
INSPECTOR: 4/19�Jllf
4 A/ INSPECTOR:
F. Pavement or Concrete Cut El Yes []No G. Size of Cut: x H. Charge$
APPLICANT TO READ AND SIGN
�'-'�INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the Chy of Edmonds hatwilessfiromfniuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeen, that may be made against the C71y of Edmonds, or any of its departments or employ-
ees incl�ding or not limited to the defense of any legal proceedings including defense costs, and attorneyfees by reason of granting this permit.
THE CONTRA CTOR IS RESPONSIBLE FOR WORKMANSHIP A AFD MA TERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC77ON
AAD ACCEPTANCE OF 77LE WORK ES77MATED RESTORA77ON FEES WILL BE HELD UN77L THE FINAL S77ZEET PATCH IS COMPLETED BY
411'
CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
t
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Departme PT
Work is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes. 771-0220
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations, as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and understand the permit requirements and the pink copy of the permit will be available
on site at all ti sfior insp"I
Sig ........ = . n I I =4iw Date: -7,-3 1
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE.
Engrg. Div. 1991
FIELD INSPECTION NOTES
Comments:
Diagram:
(Fund III - Route copy to Street Dept.).
CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: 4 Date '
FINAL APPROVAL BY: Date!
Eng. Div. July I
t6/9-nGz-vLslkj
F,
- ----------
;71031 7�- 4 Vr
EDMOND9 S N ZOI,'!'-
OWNEK: CHR15 JACO,51-
HOME- 778 1.2-27.
OFFICF- �93 496q.
Pgopo6clb D'"EOV iqpllkOACAI-
WOOD-S CP/IJI).O*S*
---------- - --
THE WoqD�
6'XP5,r/"q Poolvewfll. e�
A
4
ku
50'
- PA04,E-r,-rL 11AIC
5V6Mjr7Eb SY CY915 �TAC,065
4-83 A e6 1�
PL AN or pp-p--scD 6, Y1qi4
FCAIC6' OA/ rlqOAJr A1.1b --SlbE-S ne,
TO 5,�:A-ErAJ 0477
/y
:5cl/ C -70'
RECEIVED --
DEC 1 7 1992
PERMIT COUNTFR
ttz:
4r
22 n
rid.
ti
do
om a�
�, P�t
4 rN
4;g J lk A,
Is �Z
;�l IV,
�0-
X: 't
51-
Q TO
4 jil
'i 7
L4�
i=�. W-7 -T M-
signs made of formed acrylic
and bolted to existing fence
using supplied hardware
(see drawings of hardware)
-);,Entire sign and fence is within
property line since fence was
constructed 1" within property line.
front of business is 48 linear feet
therfore allowance ofr sign is 48 sq feet
Proposed sign for A Muse In The Garden
8 Capita Is at approx 126 square inches each = 1008 sq inches = 7 sq feet total 13.9 sq ft
22 lowercase letters ataprox45 sq inches each= 990 sq inches= 6.9 sq ft I
Christopher Jacobs
21031 76th ave west
Edmonds WA 98026
2064997566
a W a- %.# L- A v r— "
SEP 2 4 2003
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
FROM AW POTTERY NORTHWEST INC PHONE NO. 1 425 778 1227 .SEP. 25 2003 08:t>8HM Ke
7 .......
7V7 —I_*j_-_
I—L-2
17-1
_i_ J_
Ui
---------- 1--" 7
i Zo,
i.. Zn L
102"
i Fr4
. ..... ......
_n Inl
—7-
r I -- - ---
Z4,
N
444
fW4C
di
_L _�j
I I T_' I I I I i
1117r- - - - — L.~ I- 4w - -
tu
Q
tri
lz�
APPRUVED AS NOTED
BY ENGINEERING
Date:
C)" Tr-%,4 klq-
Pro�oscct 9�n
rl ovnt4 6101 cc
40
-rO A, E PA 0 ;—'- 6 e�(/5 7 1A1,5
'r %
,90 PO-7-7e-K/ 514N ' .
-74� �) Ocb-5
STREET FILE
A/0
iol
RECEIVE- D
SEP 2 4 2003
DEVELOPMENT SERVICE&-CTR.
CITY OF EDMONDS
IN
15
of
APPROVED CY PLAN'#111-vu
al OfI031 74tf IX Rtl4F IK)
—10,0-L-1-0-3
J1 i
7 7g - egg!;=
-- b-ITY OF EDMONDS
BUILDING DEPARTMENT
IWORK :5�
ADDRES�SZ/�3/.L_j�yll
OWNER
APPROVED DATE:
-Jj1kz2i
BLDG OFFICIAL
IPMRMOT Num
-e� 7F 7
STREET FILE
R F- C F- I V F- D
SEP 2 4 2003
IDEvELOPMENT SERVICES CTR.
CITY OF EDwoNDS
Z
0
U
C4
0
W.
CITY OF EDMONDS RECEIVEE:) Permit No.
COMMUNITY SERVICES DEPARTMENT
RIGHT-OF-WAY CONSTRUCTION PERM . IT OCT 0 8 1991� IssueDatetQ
PrAFAffAFAFAFAFAFAFAFAPFAW
A. Owner: Washington Natural Gas Company B. Contractor:
WITeM Name
ercer.Street
Mailing, Address M ailing Address
Seattle WA 98111 0.
City State zip City State Zip
60 (Ay
state License Number Telephone Number
fflnRZET FN
21031 '76 Avenue West
C. 9 Address or Vicinity of Construction:
Type of Work to be Done: Install New Service
D. 0 Work in Connection With: 0 Sub or Plat 0 Single Family 0 City Projects
0 Commercial 0 Multifamily X] Utility
E. 0 Pavement Cut: El Y 0 N F OS I ize of Cut: 2 4 (2) @ Gas and Water
:X(
APPLICANT TO READ AND SIGN
INDEMNITY: ' Applicant understands and by his signature to this applibation', 'agre'es to hold the City of Edmonds
harmless from any injuries, damages, or claims of any -kind or description whatsoever, forseen or unforseen, that may
be made against the City of Edmonds, or any of its &�artfti�nts orl6mplbyees;' including or not limited to the defense
of any legal proceedings.including defense costs, court costs, and attorney fees by reason of granting this permit.
MANSHI_ 3AN'
THE CONTRACTOR IS RESPONSIBLE FOR WI& I () IP I -CA '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 credit will be
processed for issuance to the applicant.
• A 24 hour notice is required for inspection; Please call Engineering: 771-3202
• Work is to be inspected during progress and at completion..
• Restoration to be in accordance with City Code.
Street to be kept clean at all times.
9 Traffic Control to be in accordance with.City regulations.
.9 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 a 11 times.
Signature: Date: September 20, 1991
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 PC4- (.0—days.
Special Conditions: Z e�ui-_5 oxa__y
x — = $
RELEASED BY: Date I Q -7— 9 INSPECTED BY Date
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
PERMIT FEE:,-?
Restoration Fee:
Receipt No.: —
Fund 1.11 Fee:
Street.Cut Dimensions:
Eng. Div. March 1089
FIELD INSPECTION NOTES
f
(Fund I I I - Route copy to Street Dept.)
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION 0 YES 13 NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. July 1985
Washingtqn�'
NaturalGas�=
AVM1-gt0nE-'9VC0nVaW
Addendum to City of Edmonds
Right of Way
Permit Application
Submitted by: Kerry Walsh
Engineering Aide
Washington Natural Gas
622-6767 x2761
v vq pager 995-6914
' Y
WNG to window ---
Water main depth
unknown
2- 11 gas main
C"
Key:
-w- water
-g- gas
-ss- sewer
water hydrant
815 Mercer St. (P.O. Box 1869), Seattle, WA 98111 (206) 622-6767