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DEPARTMENT
C17Y OF EDMONDS
-,")6 DA) I POWUMS varzF�-
CITY OF EDMONDS DAVE FARLING
MAYOR
121 5th AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - fax (425) 771-0221
www.edmondswa.gov
DEVELOPMENT SERVICES DEPARTMENT
June 5, 2014
Thomas Cary
2123092 nd pl. W.
Edmonds, WA. 98020
Case: # COD2014-0111
Subject property: 21230 92nd Pl. W., Edmonds, WA. 98020
Dear Mr. Carey,
The City has received a complaint regarding a separate apartment unit developed at the subject property
creating a duplex out of a single family residence. The complaint also included that more than 5 unrelated
people were living at the property. The second address (212307B) posted at the property does indicate that
a second unit has been established.
The property is located in an RS-8 single-family zone. The City has no record of a legal duplex being
established at this location. Family is defined as follows:
21.30.010 Families.
A. Family means individuals consisting of two or more persons related by genetics, adoption, or marriage,
or a group of five or fewer persons who are not related by genetics, adoption, or marriage and none of
whom are wards of the court unless such wards are related by genetics, adoption, or marriage to all of the
members of such group living in a dwelling unit.
Corrective actions required:
• Please contact me at your earliest convenience by June 12, 2014 to respond to this letter and
advise your compliance plan and schedule. If there is no response, an Order to Correct would be
issued.
• The house will need to be converted back into a single family residence. This will require a
building compliance or other permit, depending on circumstances.
• No more than five or fewer persons who are not related may rent a single-family home as defined
above.
• The City requests to inspect the property at your earliest convenience.
Please let me know if you have any questions at 425-771-0220. Thank you in advance for your cooperation
and assistance.
Sincerely,
Mike Thies
Code Enforcement Inspector
thies(@,ci.edmonds.wa.us
Permit Coordinators, Building
Planning
Manola Munar, 131 N. 203'd St., Shoreline, WA
Incorporated August 11, 1890
Sister City - Hekinan, Japan
July 24th, 2014
Dear Mike,
This letter is to follow up on your visit to my house at 22130 92nd Pl. West, Edmonds, WA.. I
have made the corrective actions required in your letter dated June 5th, 2014 and noted in the
inspection visit. Specifically, the house is now a single family dwelling. There is one lease, in the
name of Burt Copstead. A copy of it is. attached. The lease limits the number of unrelated
people occupying the house to five. The CO detectors have been adjusted to better detect
carbon monoxide.
If you have any questions, or need to inspect again, please let me know.
Sincerely,
Tom C
Z, 30 q V'r PL LA.)
---------------
AGING AND ADULT SERVICES ADMINISTRATION
DM MT CW FIRE SAFETY EVACUATION PLAN
SOCL� K
SAW WAC .388-76-200(il)
An Adult Family Home shall have a posted plan for evacuation to safe areas in event of fire. Draw a diagram of the floor plan
of your home in the space proveded below. Indicate escape routes and designate where staff andresidents should meet
outside the residence. Indicate the location of fire extinguisher(s) and smoke detector(s).
INSTRUCTIONS: Provider/Resident Mana2er completes and posts in a conspicuous location.
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'CITY CLERK
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CITY OF EDMONDS
505 BELL STREET
EDMONDS, WA 98020
NOTICE OF LIMITATION AND COVENANT
ADULT FAMILY HOME
WHEREAS, the undersigned owners of property located at 9-tZSC CVOY'k -?k A,
in Edmonds, Washington legally described below or on the attached Exhibit A, have applied.
for a building permit for compliance and/or to remodel a structure located on the site; and
WHEREAS, the applicant has notified the City of the applicant's intention to utilize the
improvements and/or to convert an existing single family structure to an adult family home; and
WHEREAS, under the Uniform Building Code the number of occupants of a structure
trigger certain requirements relating to the fire suppression and exiting requirements; and
WHEREAS, the City has notified the applicant that the permit wi I I be issued conditioned
on limitation of residents to -,170� or fewer residents and their caretakers; and
WHEREAS, the City has issued a permit based upon such representations;
NOW, THEREFORE, the undersigned property owners (hereinafter "Owner') - in
consideration of the issuance of a building permit and in order to confirm the promises upon
which such issuance is based while providing notice to any future owners or mortgagors of the
property does hereby stipulate, covenant and agree as follows:
1 . Covenant: Limitation on Residence. The owner hereby stipulates and agrees
that occupancy of the structure as an adult family home shall be limited to 6k�k or
fewer adults and their caretakers as allowed by -applicable provisions of state law. The owner
acknowledges that in the event that the applicant seeks revision -of the applicant's state license
to operate an adult family home with an occupancy of,greater thah .'!7* residents or attempts
to rent, lease or otherwise provide residence for additional -residents above
the_:��permitted in the current occupancy classification, the structure shall be vacated and
all residential use ceased until such time as the property is brought into compliance with the
provisions of the State Building Code, under the edition of the Uniform Building Code then in
effect. The owner further stipulates that this covenant touches and concerns the land so long
as the present structure and use continues and shall run with the land to all future purchasers
and assigns,
. 2. Subiect Tract. The above stipulation and promises shall appl ao and run with
the land with respect to a r esidential structure located at zzAaDC Ov", f�
Edmonds, Washington and legally described as:
Pyerr /S-Z 2_�/7-ac
3. Notification to Future Purchasers and Assignees. This notification and covenant
has been recorded in the records of Snohomish County, Washington in order to provide notice
to any and all future owners of the property of the limitation at the current level of improvement
to single families' and adult family home residents fewer than — in number'.
LITemptFonnstLMT Cov.Doc
246/95
4 Pa 0 12
4. Enforcement. In addition to any and other remedies civil or criminal which the
bity may have, the property owner hereby agrees and stipulates that this grant of covenant
shall entitle the City to enforce by injunction the provisions of this code and, in so doing, to
recover its reasonable attorney's fees and costs.
DATED this 2-21-1611 day of /l/7/ly 119 "o
ACCEPTED BY:
�I`eannine L. Graf
Building Official
le"ir
APPLICANT/PROPERTY OWNER'
Applicant
1-1�pplicant
0
Owner
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COVENANT AND NOTIFICATION
ACKNOWLEDGED:
Mortgagor
Kir)TAPY ;:r)P r)%A/K]I=P -ql KIATHPF=-q
ko
cn,
State of Washington
)ss
County of
'I certify that I know or have satisfactory evidence that M a ri 0�o M C) tJQ signed this
instrument, on oath stated that he/she was authorized to execute the instrument and
.acknowledged it as the L) iVIv P?- (title) of'ZO- 3 u 17- t". "fffiGme of party on
behalf on whom instrument was executed) to be the free and voluntary act of such party for
the uses and purposes mentions in this instument.Subscribed and sworn to before me
this MgL day of 19 ?,6
Notary P16blic in and for the State of Washington.
My commission expires �,�
I certify that I know or have satisfactory evidence. that ' 6awWl eJG' A 14 LJA/'*? signed this
instrument, on oath stated that he/she was authorized to expcute instrument and
E� vi J
acknowledged it as the OW i�i (title) of 7-) 7- 3�' 6) 2, "-' i'l - 0 i Iname of party on
behalf on whom instrument was executed) to be the free and voluntary act of such party for
the uses and purposes mentions in this instument.Subscribed and sworn to before m.e
this �2 2� day of `7� '19 96
Notary Flublic in and for the State of Washington.
My commission expires 11 . /17, IIFI?6
L%Temp%FormsU-MT Cov.Doc
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YoL. 3 19 4PAGE'0128
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 Permit 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).
Owner/Applicant:
Ma o M L) �,-j �A
Name
2 2 PO -
Street Address
City State Zip
-- '210C -(; �6-
Telephone
Signature
7)'7)
Date
c:rccepfion\jana\caddoc
Applicant Representative:
Name
,Street Address
City State Zip
Telephone
Signature
Date
(over)
CA FILE NO.
Critical Areas Checklist C-,4 - 97- 13
--------------------------------------------------------------
Site Information (soils/ topography/ hydrology/ vegetation)
1. Site Address/ Location: 2 1 -2, -220 C? 2- PI-61 Z�_ID r4 0 y\j o2- o
2. Property Tax Account Number: 2-Y-7
3. Approximate Site Size (acres or square feet): Z Ox
4. Is this site currently developed? Zyes; no. -Zq E C, E I V E C'
If yes; how is site developed? s / tj 6 L L i.) L> 4 in-
2 4 H7
5. Describe the general site topography. Check all that apply. RENT COUNT; —
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 10-feet over a horizontal distance of 33 to 66-feet).
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 seasonal standing water: �Jd tJr Approx. Depth:
What season(s) of the year?
8. Site is in the floodway—IL2— floodplain X,' u of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are
I
year-round? N Flows are seasonal? (What time of year?
10. Site is primarily: forested j meadow ;shrubs, mixed
urban landscaped (lawn,shrubs etc) L Aw K! ggo gs
11. Obvious wedand is present on site: A/ 0 /1/
_T1
�or City:Staff Use Only ----- --- — ------ — ---
Site is Zoned?
:2. SCS,mapped soil typ.e(s),?..—& 44krwrnA L�r&Aj to_4A Lgmptux J�42S
3. Welland inventory or cA. map indicates Nvetland present onsite?
4. Critical Areas inventory or C.A. map indicates Critical Area on site?
Site with . in designated earth subsiden c e la . ndslide hazard area?
-Si m e ta)ly *Sensitive Areas Ma
te designated on the Environ n p?,
DETERMINATION
STUDY REQUIRED CONDITIONAL WAIVER
WAIVER
Rev ie w* e d by:
1VIner Date
^ca_chk.doc; Rey 02/11/97
BUI'LDINg
TO Permit Coordinator, Building Division J U N 3 - 1996
FROM: V"FIRE DEPARTMENT
ENGINEERING DIVISION
PLANNING DIVISION
OWNER "14 212SO 411"2- /10Z /4/
0 ADDRESS
PERMIT#
ADB#. INSPECTED ON If
A f i el d � i nspecti on was conducte'd to determi ne compl i ance wi th approved pl ans.
Final approval denotes there are no objections to the granting of:
Occupancy for the building Performance Bonds may be released
Maintenance Bonds may be released Landscaping is approved
e
_,L_Othe.r inspect d
//P� 1&,.14 7 /*/H/X/ IeIPIW
PASSED FIRST INSPECTION CONDITIONS -NOTED
2.
FAILED INSPECTION - OUTST NDING REQUIREMENTS - RECALL FOR INSPECTION
1.
2.
3.
4.
OCCUPANCY APPROVAL
'X� FAILED FIRST INSPECTION
e� RE -INSPECTED - APPROVED
RE -INSPECTED - FAILED
DATE BY
DATE 5�'3t.' /'�116
DATE -7177-lfc'.
DATE
RE -INSPECTED APPROVED DATE
OCCAPRVL/TXTRECEP/October 13, 1993
FEES '- . RECEIPT#
BU11DING
JUL 2 3 '1996
0
TO: Permit Coordinator, Building Division
_j
FROM: "W DEPARTMENT
ENGINEERING DIVISION
PLANNING DIVISION
OWNER ADDRESS 92, AZ h,---,
PERMIT# ADB# INSPECTED ON
A field inspection.was conducte'd to' determine compliance with approved plans.
Final,appro.val denotes there are no objections to the granting of:
Occupancy for the building
Maintenance Bonds may be released
,X--Other inspected...Aldlw/�_ AO/,
Performance Bonds may be released
Landscaping is approved
PASSED FIRST INSPECTION - CONDITIONS NOTED
1 .
2.
FAILED INSPECTION - OUTSTANDING REQUIREMENTS - RECALL FOR INSPECTION
2.
3'. 05
4
OCCUPANCY APPROVAL
FAILED FIRST INSPECTION
RE -INSPECTED - APPROVED
RE -INSPECTED - FAILED
RE -INSPECTED APPROVED
OCCAPRVL/TXTRECEP/October 13, 1993
DATE BY
DATE , _aa; -. �roe BY .!�
DATE B Y
DATE BY
DATE
FEES RECEIPT#
11cens
lialic
ing Reqtoemej
e with and'puisWAt: t6 the Jaws the State of Washhigton and tie Nbitimum
`CqMP
oftW Department 6f Social and Health Services a licefise is hc y graAted
0 -Ndmber 52 U-945119
0 JWA SPWN License
EMLW: OLSM'AMb
LL,
'PIACE IMT
to- conddet aud miintib at. 2JL230 92ND
zip code .98020' Ounty of SKOHMM
City,.of
and'superAsion
'Family
State of Washington;aR Adult Rome for the care cif adults M foll6ws:
adults
221-11ibim family care for no more than 6
MMCH
-InclWung.
CD from the i4mi ''day of 19 gs to �fid
c
Ws'].ReL4e ahaU.be.in fdi. e.
96:- sibject t�'revocadon for due cause.'
th&' i4TH
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V) e, lomfion-above
kOrk: This litens'e, is not transferable, gAd isvdid only for use by the individual(s) to whom It jsUsuedwd it th
LO
Cz -Df Chapter 17� Law of 1967, and RCW.70.128.
ddg�rlbed, Mued by. Autt�ritj
D= W113
Ohl� Mal)
,*CITY CLERK
CITY OF EDMONDS
505 BELL STRSET NOTICE OF LIMITATION AND COVENANT
EDMONDS, WA 98020
ADULT FAMILY HOME
WHEREAS, the'undersigned owners of property located at — 9_V?-W 11;k
in Edmonds, Washington legally described �below or on the attached Exhibit A, have applied.
for a building permit for compliance and/or to remodel a structure located on the site; and
WHEREAS, the applicant has notified the City of the applicant's intention to utilize the
improvements and/or to convert an existing single family structure to an adult family home; and
WHEREAS, under the Uniform Building Code the number of occupants of a structure
trigger certain requirements relating to the fire suppression and exiting requirements; and
WHEREAS, the. City has notified the applicant that the permit wifl be issued conditioned
on limitation of residents to- or fewer residents and their caretakers; and
WHEREAS, the City has issued a permit based upo n such representations;
NOW, THEREFORE, the undersigned property owners (hereinafter "Owner') --in
consideration of the issuance of a buildingpermit and in order to confirm the promises upon
which such issuance is based while providing notice to any future owners or mortgagors of the
property does hereby stipulate, covenant and agree as follows:
1 . Covenant: 'Limitation on Residence. The owner hereby stipulates and agrees
that occupancy of the structure as an adult family home shall be limited to * Vok o r
fewer adults and their caretakers as allowed by -applicable provisions of state law. The owner
acknowledges that in the event that the applicant seeks revision.of the applicant's state license
to operate an adult family home with an occupancy of:greater than' 1P* residents or attempts
to rent, lease or otherwise provide residence for additional -residents above
the_:��permitted in thecurrent occupancy classification, the structure shall be vacated and
all residential use ceased until such time as the property is -brought into compliance with the
provisions of the State Building Code, under the edition of the Uniform. Building Code then in
effect. The owner further stipulates that this covenant touches -and concerns the..land so long
as the present structure and use continues and shall run with the land to all'future purchasers
and assigns.
. 2. - Subiect Tract. The above stipulation and promises shall appl ao and run with
the land with respect to a residential structure located at zwzoo _01,X--
Edmonds, Washington and leg'a fly described as:
49,5--&0-3 Prar
lot
1-07-10
jlmle6v
3.' Notification to Future Purchasers and Assignees. This notification and covenant
has been recorded in the records -of Snohomish County, Washington in order to provide notice
to any and all future owners of the property of the limitation at the current level of improvement
to single families'and adult family home residents fewer than in number'.
LITemplFormsIMT Cov.Doc
V6495
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4. Enforcement. In addition to any and other remedies civil or criminal which the
City may have, the property owner hereby agrees and stipulates that this grant of covenant
shall entitle the City to enforce by injunction the provisions of this code and, in so doing, to
recover its reasonable attorney's fees -and costs.
DATED this 'day of Al y 119
ACCEPTED BY: APPLICANT/PROPERTY OWNER.
M
Applicant C=
< Gz
Kannine L. Graf Ap ficant, C-)
CD 0.
Building Official*b7ib_
Owner-
M
Owner
7 4(ox')
COVENANT. AND NOTIFICATION ...
ACKNOWLEDGED:
Mortgagor
NOTARY FOR OWNER SIGNATURES
J.
State of Washington
)ss
% I ... ...
County of
. I certify that I know or have satisfactory evidence that. /V ari 6�0 Moap� signdd'this
instrument, on oath stated that he/she was authorized to execute the instrument and
-acknowledged it as the 6 IAI^IQI� (title) of -z4?- 3 u 117- "! P/. 0' qh'V0Je of party on
behalf on whom instrument was executed) to be the free and voluntary act of such party for
the uses and purposes mentions in this instument.Subscribed and sworn to before me
this d"t day of, 2gl� 19
Notary F16blic in and for the State of Washington.
My commission expires
I certify that I know -or have satisfactory evidence that * C7tFNi9VJ eJG' LJAIIW signed this
instrument, on oath stated that he/she was authorized to exjpduteAe instrument and
t iti J
acknowledged it as the OW �J O� (title) of 7-V 7' 30 C?Z_& Iname of party on
behalf on whom instrument was executed) to be the free and voluntary act of such party for
the uses and purposes mentions in this instument.Subscribed and sworn to before me
this--,P --dav of '.19 96
0-
Notary Flublic in and for the State of Washington.
My commission expires 1,FI?6
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AGING AND ADULT SERVICES ADMINISTRATION
DMAZOM"T CW I
&HEMIM FIRE SAFETY EVACUATION PLAN
WAC-'388-76-200(11)
An Adult Family Home shall have a posted plan for evacuation t o safe areas in event of fire. Draw a diagram of the floor plan
of you ' r home in the space proveded below. Indicate escape routes and designate where staff and residents should meet
outside the residence. Indicate the location of fire extinguisher(s) and smoke detddor(s).
11Mb I NUU I 1UN5: Provider/Resident
V'Af-errt KCt- I
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Critical Areas Checklist
------- ------------------------------------------------------
Site Information (soils/topographyJhyclrol.ogy/Vegetation)
1. Site AddressfLocation: ;?,1,;?3,,7
2. Property Tax Account Number: 3 q3 (o -00,2_-012 cl'o
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? yes; _V no.
If yes; how is site developed? C Le- b-s , L I- A C Lt-j 'A 5 r f V 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 IS% (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
I 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: 0 _ ; Approx. Depth:
7. Site contains areas of seasonal standing water: /)o Approx. Depth:
What season(s) of the year?
8. Site is in the floodway [� 0 floodplain_ /2.Q of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? Flows are seasonal? (What.time of year?
10. Site is primarily: forested meadow ;shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site: — /7 n
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City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
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 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 cbecklis� 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).
PLEASE PRINT CLEARLY
Owner/Applicant:
Go n n vlx+e r 0 cl.-Sca-DC.
Name I J
P o' ec x w-
Street Address
A(
city State Zip
3 cj - - c/
Telephone
UF
Signature
Date
Applicant Representative:
ke e & n n r4
Name
Pe 20)( -3vqn
Street Address
�A c c4—'6 V-\ ,
city 0 State Zip
Telephone
Signature
Date
dseception4ansICACLHandout.doc Revised 4110124300
CITY OF EDMoNbs
CONSTRUCTION PERMIT APPLICATION
OWNER NAME04AME OF BUSINESS
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LU
MAILING ADDRESS
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CITY ZIP I"TEEPHONE NUMBER
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cc CITY ZIP .1TELEPHONE NUMBER
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ADDRESS
CITY ZIP I TELEPHONE N
STATE LICENSE NUMBER EXPIRATIONMA
Legal Description of Property - include all easements
USE
ZONE PERMIT
NUMBER
JOB
ADL)RFSS 2. ejl;t, tv,
'Y1 AA - � I
W,
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING - REQUIRED DEDICATION
PROPOSED
METER SIZE LINE SIZE NO. OF FIXTUf
Vl
Z-4- .
ENGINEERING MEMO DATED
SUITE/APT
0
.11) NO.
TESCP Approved
0
RW Permit Required
0
Street Use Permit Req'd
0
Inspection Required
0
Sidewalk Required
0
PRV REQUIRED
YES 0 NO 11
SIGN AREA SEPA REVIEW ADB-NO.
ALLOWED I PROPOSED LCOMPLETE IE
BY
EXP
VARIANCE OR
PLANNING:REVIEW BY
DATE
S ETBACKS - r&T
FRONT SIDE REAR
LOT COVERAGE
Property
Tax Account
Parcel No.
oi
REMARKS
64h it dw P"-*!jNft 01 A14 64S4 LAjoJA1,,Z%
NEW
ADDITION
El R-EMODEL
REPAIR
EIDEMOLISH
GARAGE
CARPORT
SIDENTIAL
COMMERCIAL
APTtBLDG.'
F� GRADING
CYDS.
WOODSTOVE
r INSERT
RETAINING WALL/
L-J ROCKERY
PLUMBING
MECHANICAL
'SIGN
I
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CHECKED- BY
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I�CODE
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OCCUPANT
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SPECIAL INSPFtTOR AREA-
REQUIRED
OCCUPAN
LOAD
REMARKS
PROGRESS INSPECTIONS PER*UBC 305
(TXYR 0 USE, BUSINJASOR
RIZ-7
NUMBER.,
ACTIVITYIfiXfLAIN:
IMMAY &*V
NUMBER O�
A#�
- _d419.
1W 5/
CRITICAL
OF
STORIES
DWELLING
UNITS
AREAS ;
NUM13EA
..., : �1.
DE�PAIBE W09K
awft&-e
TO BE DONE (ATTACH PLOT Pt. I
-j,FINA
4. I4PEC ION. REOUJRED�:�-
IN T
PLAN CHECK FEE
BUILDING
HEAT SOURCE:
GLAZING
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any constructiorror�the public domain (curbs, sidewpiks,
driveways, marquees, etc.) will require separate permission.
STATESURCHARGE
rmIt 4fAlcation: 180 Dayi:' 4 - � I - - � . . — - J. -
,
.
Permit Limit: I Year;%Provided Work Is Started Within 180 Days
:STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
u)
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
m
employees, and agents from any and all claims for damages of
cc
<
whatever naturei-arising,.directly or indirectly from the lss,U.4xice
of this permit. lssua466', of this permit shall not be deemed to
PLAN CHECK DEPOSIT
0
modify, waive or reduce #ny requirement of any city ordinance
mi
nor'llmit in any'way the City's ability to enforce any'ordinan6e
TOT, ��L AMOUNTDUE
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:!,,
J0 ""APPROVAL
AP .L ATION
authorized agent of the owner. I agree to comply with city and
.state laws regulating construction; and In doing the work authoriz-
THIS PERMIT
AUTHORIZES
This application ds. not a permit.,until
pf the Lab or-
ed thereby, no person will be employed In vi6latiQp,
ONLY, -THE..
r ned by the B'uil*ding Official or his/her
Code of the State of WasKi4gton relating to Workmen" C ompensa-
WORK'NPT,�D':
De put ; and fees are paid, and receipt Is
y
-tion InsuraRce and RCW 18.27. - I I
INSPECTIO 'L N
�ackn6wledged in space provided.
GNA,j1URE (,OVVNER OR AGENT) DATE SIGNED
DEPARTMENT
f f-k
L kif
CITY OF
MOFATORE
S
EDMONDS
Z��ek
ATTENTIO&,-/
CALL FOR
"FICLEA�&Vk
INSPECTII
IT IS UNLAWFUL TO USEOR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
-
771-0220
ORIGINAL — File" YELLOW — Inspector
CERTIFICATE OF OCCUPANCY HAS- BEEN GRANTED. UBC
CHAPTER" 3. �1
10247 1 ; . # KE ;VZ'//%
PINK — Owner GOLD — Assessor
51 Co
A "SPECTIOW"
KC P QjF. IN,
INSPECTOR DATE APPROVED
............
—.-,,.,-FQUNDATION:.
Footing ....................
Pier/Porch ................
Retaining Wall ...
41
glab -'sulation ... .........
PLUMBING:
Underground .............
4ugh;;�In,,., ........
Commercial Final ........
1. - "Wo
'Gas .......
das Piping ................
EqLpment ..................
Commercial Final .........
EXTERIOR SHEATHING
NAILING ....................
FRAMING� .....................
INSULATION:
FloorInsulation ...........
Wall Insulation ...........
Ceiling Insulation .........
SHEETROCK NAILING ......
SPECIAL INSPECTION ......
RADON MONITOR AT SITE.
FINAL APPROVAL
FOR OCCUPANCY ..........
JX, t 4-1, 1,
STREET F
IN _-F
CITY OF EDMONDS ZONE
CONSTRUCTION PERMIT APPLICATION Job
OWNER NAME/NAME OF BUSINESS 1ADDRESS
V L A u-S. -a:). �, Pt K 01�,T
w MAILING ADDRESS
Z J\0
CITY ZIP TELEPHONE NUMBER
E:!�� l-(,0ikj ZZ�. UJ Pit, �iq �06- 77S 7V e-
INAME
ADDRESS
TY ZIP ITELEPHONE NUMBER
NAME
ADDRESS
CITY ZIP I TELEPHONE NUMBER
STATE LICENSE NUMBER
Legal Description of Property - include all easements
Tax Account Parcel No. 3IR-005_010-03`0
NEW
RESIDENTIAL
PLUMBING
010D TER
COMMERCIAL
MECHANICAL
REPAIR
AR��LIRIG�:_\
SIGN
GRADING
DEMOLISH CYOS.
FENCE
El
CARPORT
REMODEL r
(—x—FT)
swim
GARAGE
POOL
Ewoob STOVE/ 'F� RETAINING WALL/
] INSERT ROCKERY
RENEWAL
ITYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
15_15X-7
NUMBER OF STORIES
NUMBEROF
DWELLING
UNITS
—
eelve
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
a
0
PERMIT
NUMBER
SUITE/APT #
AAD i , %
sim" — 0=4 �� C-) - �/- e9
.EGAL DESCRIPTION CHEC N NO,
T7
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISI ING — REQUIRED DEDICATION
PROPOSED
REMARKS
ENGINEERING MEMO DATED
LID NO
TESCP Approved 0
RW Permit Required 0
Street Use Permit Req'd 0
Inspection Required 0
Sidewalk Required 0
REVIEW BY
METER SIZE BUILDING SUPPLY SIZE ES.
;7h ARKS
COMPLETE T_ ADB NO.
SIGN A;EA SEPA R VIEW
ALLOWED I PROPOSED I IEXEMPT
EXP
VARIANCE OR CU PLANNI�L�gVIEW BY -V� DATE
NCI
SETBACKS — FEEZZ HEIGHT, LOT OVE AG Z
Z
0 T
L_Z'571 �/� REAR
FRONT SIDE__j Z
REMARKS
-)14, rAgpr <, -6 2-1 *' roe
rt
BY I TYPE
r SPECIAL INSPECTOR I AREA JOCCUPANCY OCCUPANT
REQUIRED 0 YES GROUP LOAD
sp
RE
E
c
'u I 'AL
RE
REMARKS
P RESS INSPECTIONS PER LIBC 305
ROG
&ve 44iili 7b kIU417-
FINAL INSPECTION REQUIRt-D-
V LU
PLAN CHECK FEE
BUILDING
PLUMBING
Plan Check No. \5_�,_? 67 MECHANICAL
This Permit covers work to be done on private property ONLY. GRADING/FILL'-
Any construction on the public domain (curts, sidewplks,
driveways, marquees, etc.) will require separate permission. STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
whatever nature. arising directly or indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT
modify, waive or reduce%@if req1F
n provision." LreTeoraf4irly city ordinance: U N�
or limit in any way the City's ability to 6n-f orb e any ordinance T?TT A L T Du
I hereby acknowledge that I have read this application that the
information given is correct; and that I am the owner, or i the duly
ATTENTION
APPLICATION APPROVAL
authorized agent of the owner. I agree to comply with city and
state laws regulating construction; and in doing the work authoriz-
I
THIS PERMIT
AUTHORIZES
This application is not a permit until
ed thereby, no person will be employed in violation of the Labor
ONLY THE
signed by the Building Official or his/her
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
Deputy; and fees are paid, and receipt is
I tion Insurance. .
I INSPECTION
acknowledged in space provided.
I RE (OWNER OR AGENT)
DATE SIGNED _N
DEPARTMENT
9 1
CITY OF
I
OFFICIA�'S SIG ATURE DAT
j
EDMONDS
1/ye
111118mmi
MENTION
CALL FOR
KELEA219CV:
DATE
INSPECTION
r IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
1NTIL A FINAL INSPECTION HAS P MADE AND APPROVAL OR
CERTIFICATE OF OCCUPANC' BEEN
771-3202
OR16INAL — File YELLOW — In Splc�tp
GRANTED. UBC
HAPYER 3.
12-137
PINK — Owrier GOLD — Assessor
. q6,5- gli-
SEC TION 250 TO WNSHIP 2 7 NOR TH. RA NGE 3 EA S To W, M.
0 �If General Notes
N 88*50'31 W
0 2111 2q?, 07- clef
a V0 /L, P r D 4-_,dw,
Vo _e P-ef crt r-&J
FJA.-;n 0 o
-2,
C;
I.t. I L VV _�j 'D
C14
qr,.*z.,,%,,y 0381 2-10, V3 A -to -Co r -2, ji-if -ery louj
A A
17' (TYP) 3 4' 2.1 V/ Z es 1104 r
1
02-,/ 3
0-0__Mr�� 13-0
GARA-GE _95-03 4)' 9 -*,-/ _*__� S 4 0 C-4 13 C)-V\ Ver II
DIRT FLOOR 2- _(f w
23' -2 'Z L (C X
7 AS HALT 10 00
Ajil
C14 2011); tj 62+
771
50.4' f
BLOCK 5
- I
MARK 11 'U" -1-1 EtH Nl Etz_
A%,'EE:_* A(
i 'VA annj:,
E-TI-E-A., V.
REMOVE EX
WITH STAIRS
SSMH#1A RIM=2875 INV
�j r - -WIVC
N fo
/Y1 CP 00,11 '04 M 9
C:)
47-
is, 7;
E X. CS
1,201, RIM 298-JZ/
*0?. 9. IE SW 296.9'7�
0
1?7R SET F
JOIN EX S.D. MANHOLE ATINV=285. 01 7- 10"W, J�L NAIL
LOCATEISAS SHOINN- SEE SECTA-A Co C
OZ., 4V
M/01 A In/Omr/OIIIA A InM-A 1A1 MI A A/
SCALE. 1"= 20"1
'r U
SPECIFIC NO TES
1. Sidewalks shall be per City of Edmonds Standard Drawing.
and surfacing shall be per City standards also.
2 An additional mailbox shall be constructed on 92nd P1 W according to US Postal standards and
coordinated with the local postmaster.
3. A# new driveway paving from 92nd P1 Wto new house shall drain to plastic CB shown.
4. Power and TV cable shall be installed underground from the existing
oulet to the new home site shown on the S.D. Site Plan, sheet I of 2.
5. Utility locations are approximate and the contractor shall explore and
locate existing lines to make sure of location, depth and alignment.
The City and Engineer are not responsible for said locations shown hereon.
6. Driveway and approach radii shall be 10.
7. The contractor shall be responsible to obtain all necessaly permits and
notify the City 24 hours in advance of any construction.
8. Traffic control shall be coordinated with the City of Edmonds Traffic
Engineer prior to Bowdoin Way utility work commencement.
9. Tie all do wnspouts in lot 2 to the storm system using 4 " P VC pipe as sho wn.
ialn new CB#3 add a 6 " plastic tee for oil separation to filter water going to the public storm drain.
11. IF ROCKERY OVER 4'IS REQUIRED, GEO-TECHNICAL INSPECTION WILL BE
REQUIRED BEFORE AND DURING RECONSTRUCTION OF THE ROCKERY
N/, Ij M ,e
d
5 3,
7 9.6 cC4
SHADED�SIPH L
5TAREA
ADED AR CLASS B ASPHALT
W 2�
SECOUR E- CRUSHED AGGREGATE
E
S71C CB) LOCATE AS SHOWN
C TO CB#1 - USE 6" PVC TEE AS OIL SEPARATOR
>
USE EXTRUDED CURB AS SHOWN TO CB
VCPEP @ 17 %
V M.
R Y POL YALIr WTR SER 14CES - 2 EA.
IIGHROCX�Y& REPLACE
SS MH# I RIM=400.69
IN V=395.71
< NOTE: ELEV EQN. -91.9'TO ASSUMED BENCH
V
WXXM���
L-
EXIST SHRUBBRY, 6'HIGH PLUS
0
EVERGREEN TREE, OR
DECIDUOUS TREE, SIZE SHOWN(DIA)
DOWNSPOUT
NEW CONTOUR LINES
CLE4RING LIMITLINE
X_
2'REFERENCE POINT TO R1W LINE
LOT CORNER SET(REBAR WICAP)
SET2X2" STAKE& TACK
X
LOT CORNER SET (TK IN LEAD WIDISC)
El
SET2'X2-STAKE& TACK(I'RP)
NEW WATER MAIN OR SERVICE
NEW SAN. SEWER MAIN OR SERVICE
EX WATER MAIN OR SERWCE
EX SAN, SEWER MAIN OR SERVICE
SET CORNER
OF LOT 10
Y
VIC NIT MAP
i` = 2000
NEWHOUSE
GARFLR=304,0
'ILI
TOP OF RESTRICTOIL=30� I I
k
MM
S E(03; TION A a- A
SCALE: HORIZ; I"= 10�-O"- VERT- 1'�--4t-Orr 7-
(ALONG NEW STORM DRAN ALIGN, AS SHOWN) -
GENERAL NOTES
-7 TO -7
D
EX. CB RIM=298.37 0
INV=296.97
. 1C.
1. A# workmanship and materials shall be in accordance with City of Edmonds
standards and the 1998 edition of the State of Washington Standard
Specifications for Road, Bridge and Municipal Construcdon(WSDOTIAPWA).
2. Temporary erosion/Waterpollution measures shallbe required in accordance
with the latest edition of the D. 0. E Manual.
3. Comply with all other permits and other requirements by the City of
Edmonds Community Services Group or other go vering authority or agency.
4. A preconstruction meeting shall be held with the City of Edmonds Community
Services Group office prior to start of construction.
5. All storm mains and retention1delention areas shall be staked for grade and
alignment by Exacta Surveying Service or an engineering or surveying firm
capable of performing such work.
6. Storm drain pipe shall meet the following requirements:
A. Reinforced concrete pipe conforming to the requirements to AA SHTO M- 170.
B. Corrugate metal pipe with asphalt coating conforming to manufacturers requirements.
C. Steel aluminized pipe conforming to its manurfacturer's standards.
D. Steel pipe conforming to the requirements of A WWA C 151, thickness
class as shown on the plans.
E. Polyethylene smooth wallpipe perAdvance Drainage Systems (ADS) N- 12
constructed per WSDOTIAPWA Standard Specifications 7-04.
7 Sp ecial structures, oillwater separators and outlet controls shall be installed
per plans and manufacturers recommendations if applicable.
8. Call underground locate line 1-800-424-5555 minimum 48 hours prior to any
excavations.
9. Where connections require "Field verifications", connection points will be exposed
by contractor and fittings verified 48 hours prior to distributing shut -down
notices,
I WIRE& 4/5/02
SECTION 25, TOWNSHIP 27 NORTH, RANGE 3 EAST, W.M.
3:-'; 7t*,,
. - I I I 6�- .Al,
n
I, V'VA
SILT FENCE ALIGNMENT
SEE SILT FENCE DETAIL HEREON
M44"
CLEARING LIMIT
CLEARING AREA 56
N 88'50'31 W
RICHARD -04HIT, E
04 n q:, 0, 1 *-1 0
04
VVA CIAII 11 C14
3.0' 0. 7' (TYP) 3.4
f 0-2 V
12.25' 20 79
GARAGE 7 195.0
LOOR
0.39 li- SPRU-C d DIRT F
101
k, 23'
F) R
24' AS HALT
T P 4
N MIETAL��Oq C14
0) GARAGE
N
-N
111)
C
291.4
8" FIR� I
?
�
0 f
0
C�
w
C7)
F-
w
0
Z
C
0
11,11� FIR
0
['20"
FIR
C14 C
I
n
co
0)
to CV
(6
/E3 WOOD
f�%7co/
3RIDGE
PON�
1i
/ /
F -nc
REMOVE EX.
WITH STAIRS
N 10"
ALDERS
-Cq
06
C14
0
Z)
10.3'
50.4'
LOT I
EXISTING HOUSE
21230 92nd PI W
FL ELEV = 308.62
11.2'
2.1'
0
C�
9.7' co
V4
.51
22.4'
ram
'A L
OPO 411d
-NEWTOPO TJ J7
19 a
-,LD --/<,
"�3" MA r
0
N C. 2.3'
0 WAL/f
OV �A�' 04 M.
'9A
6 - ENC
4 16"All, L: Z
EX. CB
1 0.19, RIM 29
IE SW 2115.
0
1&0 J
SET PK
NAIL (I
114 14
1111W-11 T t
r
1, A CONSTRUCTION ENTRANCE ACCORDING TO THE DETAIL HEREON SHALL BE INSTALLED FROM 92ND PL AS SHOWN.
Z ALL EXPOSED SOILS SHALL BE HYDROSEEDED AND MULCHED WITH STRAW WHEN EXPOSED FOR MORE THAN TWO WORKDAYS
3. FABRIC SILT FENCE SHALL BE INSTALLED ON THE WESTAND SOUTH SIDES AS SHOWN AND PER DETAIL HEREON.
4. MAINTAIN ALL EROSION CONTROL MEASURES DURING CONSTRUCTION AND INSPECTAND CORRECTANYEROSIONANDIOR
SILTA TION ON A DAIL Y BASIS.
5 OTHER BMPS MAYBE REQUIRED BY THE CITY OF EDMONDS AND THE CONTRACTOR SHALL INSTALL AS THEYARE NEEDED,
6. DURING INSTALLATION OF UNDERGROUND UTILITIES THE CONTRACTOR SHALL CONTROL AND COVER EXCAVATED MATERIALS
AND PLACE SUCH MATERIALS ON THE UPSTREAM SIDE OF THE TRENCH.
7 FILTER FABRIC SHALL BE PLACE UNDER THE GRA77NG OF THE NEW CBS AND MAINTAINED DURING ALL STAGES OF CONSTRUCTION.
8, REMOVE FILTER FABRIC ONLYAFTER ALL CONSTRUCTION IS COMPLETE AND GRASS IS FIRMLY ESTABLISHED.
9. MARK CLEARING LIMITS BEFORE ANY CLEARING IS DONE,
iaEROSIONISILTATION CONTROL MEASURES SHALL BE INSPECTED BY CITY OF EDMONDS INSPECTOR PRIOR TO ANY CLEARING OR
EXCA VA TION.
N Af
(31kONS TR b1c; TI(0)N S CHED .1,01.1.1. E
1. HOLD PRE-CONSTRUC77ON MEETING IN FIELD WITH CITY OFFICIALS AND CONSTRUCTION WORKERS PRIOR TO ANY CONSTRUCTION.
2 MARKALL TREES FOR CLEARING THATARE 8" DIA. AT 5ABOVE BASE OF TREE,
3, INSTALL CONSTRUCTION ENTRANCE PER DETAIL AND PLAN HEREON.
4. SET FABRIC FENCE AS SHOWN AND UNDERLA Y CB GRATES WITH FILTER FABRIC.
5 SA INCUT EXCA VA TE, TAP MAINS TO PROPERTY LINE & RESTORE PA 14NG AND GRASSED AREAS TO PROPERTY LINE.
6, CLEAR TREES FROM PROPERTY THATARE MARKED AND INSPECTED BY CITY FOR CLEARING,
Z EXTEND SEWER, WATER AND STORM UTILITIES FROM PROPERTY LINE INTO AND TO THE NEW HOME SITE.
8. PA VE REST OFACCESS ROAD BEYOND CONSTRUCTION ENTRANCE TO NEWHOUSE SITE.
9. EXCA VA TE AND BUILD NEW HOME COMPLETE FOR OCCUPANCY
ia REMOVE CONSTRUCTION ENTRANCEAND FINISH PAVING TO PUBLIC FAVING.
11. REMOVE FILTER FABRIC ONL Y30 DA YS AFTER FINAL GRASS IS STABLIZED,
ESC Minimum Requirement - Stabilization of Exposed
Areas. A# soils exposed by land disturbing activities
shall be stabilized by suitable application of BMPs,
including, but not limited to, sod, hydroseeding or
0
ther vegetation, plastic covering or mulching. A#
BMPs shall be selected, designed, and maintained in
accordance with the Manual, The exposed soils shall
be stabilized according to an approved timetable,
(Typically, no soils shall remain exposed for more than
two (2) days from October I through April 30 and no
more than seven (7) days from May I through
September 30).
40 V� SHA D.-D ASPHALTARE4
4E SIVADED ARE� W12.5" CLASS B ASPHALT
3" BASE COURSE - CRUSHED AGGREGATE
POL ZJ I+TRSER14CES-2EA.
Y� r
-ki�
L-J
L J
>
.>
ty)
L.LJ
SET CORNER
----
OF LOT 10
2;;,6.
CD
0
EXIST SHRUBBRY, 6'HIGH PLUS
0
EVERGREEN TREE OR
DECIDUOUS TREE, SIZE SHOWN(DIA)
0
DOWNSPOUT
NEW CONTOUR LINES
CLEARING LIMITLINE
X-
2'REFERENCE POINT TO R1W LINE
0
LOT CORNER SET(REBAR WICAP)
SET2X2" STAKE& TACK
X
LOT CORNER SET (TK IN LEAD WIDISC)
SET 2'X2 " S TA KE & TA CK(Y'RP)
NEW WATER MAIN OR SERVICE
NEW SAN. SEWER MAIN OR SERVICE
.
EX WATER MAIN OR SER WCE
EX SAN. SEWER MAIN OR SERVICE
R=251
70_
IF THER
-IS A ROADSIDE DITCH PRESENT
LL DRtVEWA Y CULVERT
15,
4"�8"QUARRYSPAL
12" THICKNESS
DRIVEWA YS SHALL BE PA VED TO THE EDGE
OF R-O-W PRIOR TO INSTALLA71ON OF THE IT IS RECOMMENDED THAT THE
CONSTRUCTION ENTRANCE TO A VOID ENTRANCE BE CROWNED SO THAT
DAMAGING OF THE ROADWAY RUNOFF DRAINS OFF THE PAD.
CONST ENTRANU10`111=-� DETAIL'.
(NOT TO SCALE)
514MWOMAWMI WAA ga- =041
(OW9611W.1aby-
woonsommonsonow 0 - I
:HHHHHUNHUN,
HHHHHoll', ..... :
ANNONZENHHHHUN:
NNUNNUNHUNN
NNEEMMENHHH:
mom
Walloon
INHHHHHUNN:
MUNHHHHUNN
:00ORREMANNUHN
MHUNN: ...
NNNO.M
2"x 2"BY 14 Ga. WIM
EQUIVALENT
FILTER
..... BACKFILL TRENCH W1
NA71VE SOIL OR. 7611- 1
WASHED GRA I
6'MAX
POST SPACING MA Y BE INCREASED
U TO 811F WIRE BACIING IS USED
NOTE. FILTER FABRIC FENCES SHALL BE 25r4"WOOD POSTS, STE,
POSTS
INSTALLED ALONG CONTOUR WHENEVER POSSIBLE,
SIL T FENCE DE TIJA IL
(NOT TO SCALE)
UTILITY PROFILE
SCALE., HORIZ, III= 10'-0", VERT- 1'�--4t-0"
(ALONG EX SIDE SWR PIPE TO EX. HOUSE)
0+78.40
General Notes
1. FLOOR PLAN CHANGE& DETENTION 114,401
No. Revision/Issue Date
Firm Name and Address
DEAN H & ASSOCIATES
8918 11THSTNE
EVERE7T WA 98205-1407
PHONE 425-335-0262
WNBY- DS HOUGH
Project Name and Address,
EDMONDS SIP #98-161
21230 92ND PL W
SEATTLE WA 98133
'r8ke' "set
S OMA DEVELOPMENT
2 LOT SIP PROJ
Date 2
NOVEMBER 13,1998
Scale
I IN = 20 FEET
P2.-GC82.9RDWG
EWIRES, 4/5/02