21108 HIGHWAY 99.PDFiiiiiiiiiiiiii
11531
21108 HIGHWAY 99
CITO OF EDMONDS - SIDEdEWER PERMIT
WATER -SEWER DEPARTAMTff
PERMIT N? 5162
Call 775-2525 for side sewer inspections BEFORE covering any portion of the construction.)
Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections.
4 C:::
ADDRESS LOCATION OF CONSTRUCTION ....... AV 104 3 ........... 4;6�
..5/ ........... �..o .... ...................... ........................................................
PROPERTY LEGAL DESCRIPTION .................. .......................................................................................................................................
...................... . ........................... ........... ........... ................................................................................................................................................................................
............................................................. �..O-*-vTfER,01ND/OR BUILDER.
.......... -- ---- ....................................................
CONTRACTOR'S NA3M & ADDRESS ............. j 7 ................................................. . .............................. . ... .......................................................
Permission Is granted .......... 0 #Itio._ - /.; K ........ . ............ 19-75., for repair and/or connection of a side sewer to the city sanitary sewer
system In accordance with City of Edmonds 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—All work performed in city right-of-wav requires an Invasion of RJght-of-Way Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—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 I ad
sharper than % will be permitted. i:d
NOTE No. 5--Trenches In street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to er
work which may develop within one year of completion.
NOTE No. 6—It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the mala sewer or its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVED Date ---- ------ D ---------- -------- ----------- Date ............... . ................... . By ................
"PROVED Date._ . ...... .. By:....._ .................................................................................
Remarks: ....... . ...... . .......................... . .. . ............................ .: ........... ... . . ............ . .............. . ...................................................
— BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection —
....................................................................................... ... I hereby certify that the side sewer installation constructed under this permit
Twner of Contracting Firm Performing Construction)
was installed in accordance with all governing ordinances of the City of Edmonds.
Datedthis ............................ day of ................................................................. 19 .........
V V Check BEFORE you dig for: Water E], Gas E], Telephone C], Power E], Sewer [], Other E] j -4
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER: ;-70 '-/dV00 3 Or.2V(10
BUILDING PERMIT (NEW STRUCTURE): 1 1-17 5-- 00 -,) V
COVENANTS (RECORDED)
CRITICAL AREAS:— DETERMINATION: F] Conditional Waiver F] Study Required aiver
Aw
DISCRETIONARY PERMIT #'S: AM-07
DRAINAGE PLAN DA
PARKING AGREEMENTS DA'
EASEMENT(S) RECORDED
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORT PLAT FILE: LOT:
SIDE SEWER AS BUILT DA
SIDE SEWER PERMIT(S) #: RA 2
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DATED: lljlzfl,�,
OTHER:
LID #:
BLOCK:
L\TEMP\DS7l7s\Fomis\Street File Checklist.doc
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BUILDING DEPARTMEN Ap ticant Flu
inside Ileavy Lines
PLICATION
DDRrA8
PERMIT AP 1 99-1
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LOT COVERAOL < LA:rr (110 Oz
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EXISTIMIW.T R/W , q RTY
--L=— T1 of
NA.MN COMP. PLAL!L WIN,. .0--FT.
REM"Es Dr.jveway slopes not to exceed those
nda�d Dwq. NO 103
indicated on Sta
CITY ITELEP .... .... —
A TER SIZ6 11E.11VICE SIZE CLEA HrICKED BY
STATE LICENSE NUMBEJt
16hu, Below 11 A1141h V111 Copies) R�p"DQ"UAD bliltox )WI�VKIEP
TYPE CONNECTION VERIFI By
5AN) LtAl
I PERC. ';.EST WILBER
REMARKS
IMPROVED
FIREIrE I TYPE 1) TRUCTION [3 YES NO
8TK
St wspwrojt REQUIRED UP NCY GROUP
C3 Yrs NO `7-
...1.13ENTIAL
PLAN Cil XE7 THIS SITE IS LOCATED IN THE CITY
NEW 9� OF EDMONDS. LOCAL SALES TAX
A& 589ULD BE
CODED 31,04,
.DFNTIAL SIGN
F� A.11 RETAINING fir, AR
DEMOLISH WALL ul
ElALTER F-1 EXCAVATE FENCE A41- OaK P&L V,6,' 73
Or, I -ILL Ft.) IL RAW-n mot
PRE-Movr. M MI F6
INSP.
F Pool.
NUMBER Oil STOIll" NUMBER Oil
I)WELLil. Al 0 P V*_
UNITS
0 0 IVOR BE DONE Valuation Fee P"lpt N,
�VORK
Plan ch�k No.
3
BUILDING
_P1 - FiED 1: S E
I'LUMIUNG 7
-1,-LOT —PLN 13.113i� etbarkl. .�uttlrg -tt-) HEAT & GAS UNF
MIN r
FENCI!
SIGN
RETAINTNO WALL
N
SWI%tMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AINIOUNT DUE
hereby atxbow�edge that I have read this application; that the In.
formn given Is correct: and that I srri the owner, or the duly author.
a own
1.1d agent of th r. I Air... to core Ply With city "d tat. law. reiru. ATrENTio.,; APPLICATION APPROVAL
,.Uhr construction; and In doing the work authorlied thereby, no person
will be employed in violation of the Labor Code of the State of Wsahlngton TIUM PERMIT This application In not a Permit WItil
relating to Workman's Compensation Imuramee. AUI"IOTUZZS sIgn0 by the Building Official or his Dai-
ONLY "IE
NOTE: Permit Limit One Year (Except I)EMOLITIONS which WORK NOTED uty; and fees are puld, and receipt, Is at. -
shall be completed In ninety days: MOVED -IN BUILDINGS hall be win. knowledged In space provided.
pitted 1i six months.)
%OWNER OR AGES TV. SIGNED TNSPMCT.'ON DIRE R' -_
DEPARTMXNT
CITY OF
ppli ED31(ONDS
NOTE: A rant Subject 10 Pldn Cbeck Fee 775-2-52-5
�4
!, -
111"y 0
to b.,.doms mi;V111-t- pro 4
PLANNING DATA STREET=FILE
-- sign5 --
Name: bc-fa-(e- &)e-p
Date: q /,�� L,;;�Oq
Site Address: �J I oca *4-wm- 9q I
Plan Check #: 131-�-200ga_:;2:3
Project Description:
To te,
W
Reduced Site Plan Provided: (YES NO)
Zoning:
Comprehensive Plan Designation: qJ
Map Page: ,40 -7
Corner Lot: (YEV-60)
Flag Lot: (YES
ADB File # (or date waived):
TO TA L A re,3 per Type of
Type of Sign
Allowed in
zone?
Matrix
conditions
met?
Allowed
area per
unit
Unit
TOTAL sign
area
allowed for
this siqn
Proposed
sign area
Example
wall wlInternal
IllumInation
Yes, w1th
condItions
Yes
I 5q. ffllineal
ft. attached
wall
41 ft. attached
wall
41 5quare feet
20 5quare feet
Sign #1
ole, 51
F, 7;
JKW,J1
Pe4-N4ed,
P'Wr-44--4
- 0 1 -.1
1 �
15-& 0.��
/
Y�!. (� 5-
Sign #2
Sign #3
TOTAL Sign Area for TenantlSite.
--Tprevious
Max Permitted:
Total:
Proposed Total:
5ign Height
Sign Type: c-
Max Permitted:
Actual Height:
Sign Type:
Max Permitted:
Actual Height:
Sign Type:
Max Permitted:
Actual Height:
5ignlighting
Sig n Type:
Proposed:
Allowed in Zone:
Sign Type:
Proposed:
Allowed in Zone:
a--
PLANNING DATA 11 STREET!LLEJI
-- signs --
SIgn Colors
Proposed:
Acceptable?
Requires ADB Approval?
SignzLocation
If freestanding and 3-feet or over (unless
a fence) meets setbacks?
Required Setbacks
Street:
Side:
Side:
Rear:
Actual Sethacks I . I . ". ': ',�. 1.
Street:
Side:
Side:
Rear:
Landscaping f6r �Signs
Size:
Location:
Critical Areas Determination #:
El Study Required
Waiyer
Other
Plan Review By:
CID
Cslv
CITYOF EDMONDSSE? 2 6 J994 SIDE SEWER PERMIT
J__ Lw 111�7, e_,r mo
- 1�1 1, P � /PEPI PERMIT N11 8623
19, 6ibc , (_ —
Address of Construction:
Property Legal Description (Include all easements):
0
2V
Owner and/or Contractor: rr fi-vil / /F Ov 1.7 Itz 0 ,�,
State License No. #4�) a 1� IS // ?5 Building Permit No
C3 Single Family' " / /
C3 Multi -Family (No'., of Units
Commercial,)
Public
ViA BALLH�.-E_
L I P-1- S I -A 7 i i-, r'.
lnvasidninto-CityF�ight�ofrWay:AO No, 11 Yes
RW Cops��,uc�ion Permit No
I I I./, j - " " . I ./ 2,' " !, , " _7
Cross other Private Pro'Perty:,% N�l Y'e§'
26, , 1 1, �', , , � .
h legal dies6riptionland,c6oy otribcorded.easernent
I certify that I have read and shall comply with all city requirements
as indicated on the back of the Permit Card.
srhT:2 6, /1
Date
* CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION *
:_6010E. USE ONLY
FOR INSPECTION CALL 771-3=, PUBLIC ORKS D9PT.
Permit Fee: 3 0
Issued By
Trunk Charge:_/0 Date Issued:
Assessment Fee: Receipt No.: Ile —
Lid No.:
Partial Inspection: Date —Initial —
Comments,
Reason Rejected: Date -Initial
Final Inspection Approved:
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Greari Copy; Inspector Buff Copy: Applicant
Revised 3?90
The City of Edmonds
,,x
Side Sewer Drawing
EASEENT NO - --------------------------------------------
NEW CONSTRUCTION REPAIRS LID NO . ................... ASMT. NO . ..................
OWNER ------------------------------------------------------- ---------------------------------------- CONTRACTOR ... ................................................................................ PERMIT NO. a- 6
... .... ....
JOB DDRESS2;znbcl-'Y- ........................... LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO. .--, ................................
70 -r q 4-L) rz--- - tk�-P -
-Z� /"-
i
0
PWW.0001-11175 (REV.11178)
(-, "P. V. e- do -
SD -e- e- P.
M.
0
�Aw � q ct
NAME OF ADDITION .........................................................................
L 1 41
x,
e
q j
...........................................
VIA
Approved:
DATE . . ...... I ................ By ..J ... ! ........
0
.0
0
0
&90:. 199
City of Echnon&
.-Critical Areas Checklist
Thet nitibal Areas Checklist contained on
this form is to be filled out by any person
preparing a Development Permit
Application for the City of Edmondsprior
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.
W'ith a signed copy of this form, the
applicant should also submit a.vicinity map
or plot plan for individual lots of the parcel
with enough detail that City staff can find
and identify the subject parcel(s). In
addition, the applicant shall include
other pertient information (e.g. site
plan, topography map, etc.) or studies in
cordunction with this Checklist 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 / Applicant: Applicant Representative:
1
'3
Name Name
Al to?� 00,
Street Addrem Street Addrem
�fJw�,ds & z--3#
4 Ci , S te, 4ZIPI Phone City, State, ZIP Phone
I _gg 4
Sign ture T_J Date Signaftue Date
C,*LE NO.
Critical Areas Checklist
Site Information (s6ils/topography/hydrology/vegetation)
1. Site Address/Location: ?110V 4w V gi
2. Property Tax Account Number: au - 3 - C),Z�_ 0001
3. Approximate Site Size (acres or square feet): — V2 QrA Re7 fb�5UNTER
4. Is this site . currently developed? 4,yes; no. RECEIVED
If yes; how is site developed? JUN 0 2 1994
5. Describe the general site topography. Check all that apply -
Flat: less than 5-feet elevation change over entire site. PERMIT COUNTER
Rolling: slopes on site generally less than IS% (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 tha n 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: N Approx. Depth:
7. Site contains areas of seasonal standing water: 00 Approx. Depth:
What season(s) of the year? M 0
8. Site is in the floodway &10 floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? 0 c) Flows are seasonal? W -0 (What time of year?
10. Site is primarily: forested meadow _; shrubs mixed
urban landscaped Qawn,shrubs etc)
11. Obvious wetland is present on site:
For City Staff Use Only
L. - - -Site is Zoned?
S"C** S mapped.sbil "e(sr .
RCV01/04W
Ask Alk
CITY OF EDMONDS
250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 77.1-0220 FAX (206) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works e Plannino e Parks and Recreation e Ennineerinn
9 0 - 19 9 -
LET= OF TRANSAIMAL
Date: June 8, 1994
To: Sofeea Koures-Huffman
21108 Highway 99
Edmonds, WA 98026
Subject: Critical Areas Checklist
Transmitting:
LAURA M. HALL
MAYOR
For your information: xxx
As you requested:
For your file:
Comment and return:
Note attachments:
Comments: Please bring in a copy of the Critical
Areas Checklist when applying for a building
permit.
Planning Division
0 Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
9
A
i
The City of Edmonds Water Service Drawing EASEMENT NO . ............................................
NEW CONSTRUCTION 0 REPAIRS LID NO . .................. ASMT. NO . ..................
7 7ao7- 60
OWNER J.1.1 YIVPIV ..... ..................... CONTRACTOR .................................................................................... PERMIT NO . .. ................
JOB ADDRESS .... 1.7 ................ : ...................... LEGAL DESCRIPTION- LOT, NO . .......................... ...... BLOCK NO . ....................... ...........
.............................................................................................. ........................ ................................... I .......
21108 rywy ff -1 NAME OF ADDITION ..: ............................................................................................................... I.-
/A00
f V2-
W1o'TAAcxA
A-u V
U. I I
78.5"
21031- 70'rR
A I(OJ- 70"'
14
__j
7 0 A
Approved:
PWW-0001-11/75 (REV. 11178) DATE .................... BY.J ... . . . .. .... ee�.. ....... ........