21214 SHELL VALLEY RD.PDF11111111111111
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21214 SHELL
VALLEY RD
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW
COVENANTS (RECORDED)
CRITICAL AREAS: DETERMINATION: n Conditional Waiver n Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
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PERMITS (OTHER):j / gfg�2
PLANNING DATA CHECKLIST DATED:
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 #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
LATEMP\DST's\Fonns\Street File Checklist.doc
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1_1�1 .91 1 the lwnfr. I agree to cc=p:y wit. city W,.,
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will be p:oyed !1. of the Cd, r, th. S,.at, APPLICATION APPROVAL
relati.g to Coupejtjob j_,ac,, TH!S PERMIT
AU HOR17C cation is no, a pemit unLil
, 5 ThiS rip;"
NOTE: Permit 0.imif One Year (EP' X)ENf0J,1TIOS �-hich ON�Y THE fgn^;� by the . Euildfr:7 Offxial Or )II'S Dep-
sliail be co.,Pl,'.ed !tI cl.ety :.y.: Y.oVED_Lr j)UfLoj.NGS 'Itall b� -ORK NOTED ZtY; and lfe2f: are paid, it�d recc-ipt is ac-
1-10WIC171gea in Splice provided.
tNSPI- 'CTION
0 PARTMCllT
.1 j"r TO: -NAT-J`iiE
CITY OF
EDMONDS
J%OTI.'.- ApTIicva Szebfeci o Plat? eck Fe- DATC
This Pormit covers work to be done o 775-9-525
il Private PlcPe11y:qN_N'.
ArIY construction on the pub!.c do; r*jin curbs. �:devvalks, cr,veVs,
ITarquees, etc.) w;II require eParate perinission. YE, 1,C.1-
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CITY OF EDNIONDS ENGINEERNG DEPT.
:-,L�L— Date
Remarks—W-1—
09/20/1999 13: 36 42bb4U�JU28 ULKLA: Uj
B�P-2C-1999 12:53 -ITY OF EDMONDS 10 4257710221
titical Areas Checklist q q
--- -------------------------------------------------------
Site, information (soilsAopography/hydrolo /Ve eta i0n)
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I Site Addrej&fLocaiion: �5kr( 0_-, ( I"
2. Property Tax Account Number: _� 4 q I - o 0 0 - 0,q -P
3. -Approximate Site Size (acres or square feet):
4. Is this site currently developed? V yes: _
Z2
If yes, how is site developed?. �� 1 (71 P_ V U_ I[ <1
5. ;Describe the general size topogmphy. 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 Meet 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 I 0-fect over a
hori2omid distance of less then 33-fem).
Other (please describe):
6. :Site contains areas of year-round s=ding water: Approx. Depth:
7. Site contains areas of seasonal mridins water: V11Z Approx. Depth -
What senson(s) of the year?
Site is in the floodway JlocAplain of a water course.
9. � Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? FloVV are seasonal? (What time of year?
10. 'Site is primarily: f0J_ 7 ; meadow shrubs
�;�MU mixed
urban landscaped (lown,shrubs etc) I
I]. Obvious wetland is present on site:
- --------------- - -----
I.. -Site i3':Z0nCd!..-
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09/20/1999 13: 36
-BEP-22-1999
4256401302H rlkor- U4
12:52 0 YOF EDMONDS 4 2577 1;�Z 2 1 or-; - 103
City of Edmonds
CRITICAL AREAS CHECKLIST
T-he Critical'Areas Checklist contained on this form is
to be fill4d out by any person preparing a
Nvelopmerit Permit Application for the City of
Edmonds ptior to his/her submittal of a development
permit to thn City -
I
The purpos� of the Checklist is to enable City staff to
determine mbether any polenti&I Critical Areas are, 'or
may be, present on the subject property. The
information needed to oomplete the Cbecklist should
be easily a,/ailable from observations of the site or
data available at City Hall (Critical Areas inventories,
xnaps, or Aofl SurveYS).
.An applicant, Or his/her rcpre3Cnt3tiVr., must fill out
the' checklist, sign and date it, and submit it to the
City. The Cily will review the checklist, make a
precursory site visit. and make a determination of the
subsequent steps necessary to complete a development
permit application.
p1me submit a vicinity map along with the signed
copy of this form to assist City staff in finding and
10C3ting the specific piece of property described or.
tMs form. In addition. The applicant shall include
other pertinent infor mation (e.g., site plan, topography
map, etc.) or studies in cor�unction with this Checklist
to assist staff in completing their preliminary
assessment of the site
I have co4eted the arached Critical Areas Checklist and attest that the answers provided are facival, to the
best of my Ymowledge (fill out the appropriate column below).
OwmerlApplicant:
P—
Name
Street Addrm
kf jov
tate Zip
r4c�s) 4,46aloo
Signature
L?
Date
Applicant Representativo:
',N, ane
Street Address
city State Zip
Telephone
Signature
Date
(ovtr)
.(,?? C. 1 W)
October 6, 1999
Fischer
21214 Shell Valley Road
Edmonds, WA 98026
0 0
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
Subject: Determination regarding Critical Areas Checklist # 99-264
Dear Applicant:
BARBARA FAHEY
MAYOR
Enclosed please find a copy of the Critical Areas Checklist you submitted. The "DETERMINATION" reached by the City
is located on the reverse side of the form (bottom of page).
It is very important for you to retain a copy of this Critical Areas Checklist "DETERMINATION" for your records.
PLEASE EXAMINE THIS" DETERMINATION"FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENWRONMENTAL CHECKLIS OR CRITICAL AREAS STUDY,
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINAT70N INITH ALL
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Enc: Critical Areas Determination
* Architectural Design Board
Thank you.
Shada Graham
Planning Secretary
C:ReceptionUana\CRLTR.doc
Incorporated August 11, 1890
Sister City - Hekinan, Japan
APPLICATION
The City of Edmonds for EASEMENT NO - ------------------ .........................
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS E] LID NO . .................. ASMT. NO
OWNER .... W. F. -?, ---------- �40 ---------------------------- CONTRACTOR = ik-
... ..... - --------------------------------------- - - -------------------- PERMIT NO.
-it;
JOB ADDRESS ---- 24-2-14 --- - --- LEGAL DESCRIPTION: LOT NO - --------- � -2-2 - ------------------- BLOCK NO - ------------------------------------
----------------------------------------------------
0
0
0
0
---------------------------------------------------------------------- -- ----------------------------------------- ----------------------------------------------
NAME OF ADDITION ----- ---------- ............ C=A��A---�PlCxt.4 ........ �L
DAT . ..... 1 1,7. W .............. By 14�94� .........
PA,
X 40�'
4WAR- PERMIT
W I
'ALM,
CITY
_0 AW,
88T FILE
PERMIT .1j? 5635
call M,1101111 for side sewer bespectioux naresix cover
WX say portion of the construction.
Inspection will be provided within 24 hours after Must. NO SM., Sun., or holiday inspections.)
ADDRESS LOCATION or coNmuc"oN ....... Z121.4....Sball .... Valle-y-RoAd ............................. .......... . ...........................................
Lot No. 22, Shell Park Diviiion #2
.......... .................................. . ....................
PROPMTY LEGAL DESCRIPTION ....................................... I ................................ ..........................................
...................... . ...................... . .. . ...................... . ....................................................................... ...............
. .................................. . ..................................................
..... . ....................................................... 0114NTER AND/OR BUXIMER ...... W.411Cker.—HOMe.6 ...... JnC ........ .
C & M Excavators. 15015 - 2nd Ave. W.,
0ONTRACTOR'S NAME & ADDRESS ....... ...... . ................................ .......... . .. ...................... . ............................... .. . ........ ;�yn
.... �td
........................
Permission is granted .... Nam a n, b e. r.... 90. . .. . ............ 19.7.6., for repair and/or connection of a side sewer too the ds
,y madiary sewer
sp%tem In aaeordance wtth City of Edmonds ardbuawm
A AJCNTION IS CAMAD TO THE FOLLOWING:
NOTE No. 1--Irhe owners of the property may obtaJn a Permit to construct sewer inside property line. A licensed Side sewer Contractor mug'be *sayloy" to construct
side sewer In street area. Do not cover any portion of sewer before It has bem inspeated.
NOTE No. 2—All work performed in city right-of-way requires an Invasion of filght-of-way Permit obtaInsible from the City Engineer's. office.
NOTE No. 3--Obtaln full Information regarding Ordinance 11.16.030 and Regulations govarntuff side sewers when you get permit.
NOW No. 4—Top of side sewer must have at lesAt 30 inches coverage at property lin* and 12 Inch" Inside Property line; minimum grade of 2%. No bonds In grade
sharper thail % will be permitted.
NOTE No. 5—Trenches in street must be water &Atl*d and surface f street restored to original condition,
Contrwtors shall be responsible for fallure due to improper
work which may develop within on* ymr of completion
N( �To, 6--It I. unlawful to alter or do any other work than isopr'ovided for in the permit, or to do any work on the ma4n sewer or it* appurtommoss except to In -
soft the pipe into the wye.
DISAPPROVED [:] Date ... . ...... ..................... By ................ Date .......... ............. illy ................ Date ........... . .. . .. . ............... By ................
APPROVED �e .............. By..
LU . . .. . ............................... .......................................................
Remarks: ....... . ...... . .......................... . ....................................... ..
............................................. . ................................................................................................................. .................................. . ................................................... ...
BOTH PerTy Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspeetton
ol
I ...... f..� ... .. 11 .. . ....... :,e . . .............. ... hereby cartifY that the side sewer installation constructed under this permit
Wwner"of contractin formi�-g-4on�struetion)
"'�rning ordinances of the City of Mmonds.
w. L*talled in accordance withtall, ' ve='
Datedthis ........ ....... ........... day of ........................................................... .... 19 .........
V Check 11EFORE you d1g for: Water
G"'O. Weimphosis [j, Power [3, Sewer Other [3 j V
"Woo*
9
.. The City of Edmonds
APPLICATION
for
SIDE SEWER PERMIT
NEW CONSTRUCTION j��EPAIRS F�
- ---------------------
OWNER ........ .4a.
2-1
.. . ............
JOB ADDRESS ----------- ..... -dev Wd
- I -- --------
EASEMENT NO.
LID NO . .............
..... ASMT. NO - ------------------
CONTRACTOR ----- C V, )"I
--------- ................................................................... PERMIT NO.
LEGAL DESCRIPTION: LOT NO - -------- -2 ---- Z . ........... BLOCK NO - ------------------------------------
e - .44- ?
---------- I ------------------- ...................................................................
--- /111
NAMEOF ADDITION .......................................................................................................................
Approved:
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17�
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DATE
.......... By ....
....................... ..........
11/75