21230 SHELL VALLEY RD.PDF11111111111111
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21230 SHELL
VALLEY RD
ADDRESS
TAX ACC(
BUILDINC
COVENANTS (RECORDED)
CRITICAL AREAS:
DISCRETIONARY PERMIT #'
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DN
EASEMENT(S) RECORDED FOR:
PERMITS (
PLANNING DATA CHECKLIST DA'
SCALED PLOT PLAN DA
SEWER LID FEE $:
SHORTPLAT
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S)
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DA
DETERMINATION: 0 Conditional Waiver
LID
LOT: BLOCK:
Study Required
,",*aiver
LATEMP\DSTs\Fom-is\Street File Checklist.doc
BUILDING DEPARTME Z8NE PERMIT
NT Applica t Fill GER
PERMIT APPLICATI 111riside He vy Li r
E (OR NAME OF ADDRESS
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tf A LIN- z LOT LOT AREA T;
DDRESS YES No
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VARIANCE OR
0 ELEPHONC NUMBER COND. USE NO.
P'OPOSC- YARCI 0
N HEIGHT K
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NAME
DATE
STI.
0 ADDRESS
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EXISTING STREET R./W 40 FT. DEFICICNCY THIS PR OPERYY
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COMP. PLAN ST. R/W & Cj FT. , FT.
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REMARK7
Driveway slopes not to excee -those
0
U STATC LICENSE N
4ndicated on Standard 1�efq 140. 103
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CITY LICENSE NumaE:
BY
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Legal Descript on of Prooerty (Show i;elow or Attach Four Copies)
STREET AND/OR UTILITY YES
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WORK REd-D VIN P
UNDERGROUNO
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>9�- E S
WIRING REO'D NO
all
Se PTIC SYSTEM D YES 1PER.I-. NUMBER
APPVD By CITY ENG. 0 No
REMARKS
W
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WALL
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01CUPANCY
GROUP OCCUPANT
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LOAD
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El ..PAIR PRIE-MOVE
PLAN CHEC E By IN THE CITY
b I L 15 LOCATED
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it's, SWIM
POOL
OF EDMONDS. LOCAL SALES TAX
N BE F STORIES
NUMBER OF
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DWELLING
UNITS
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NATU RX OF WORK TO 13C DON,
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WALL
SWIMMING POOL
I, herebi, acknowledg, that r have ,ad th, tPPlIcation: �t ITOTAL AMOUNT DUE
:Jij 01
Ized ;'e' ts Ct: a,id that I = the ._,r, 0, the d,
0: the o—er. r "", to com;lly with �:ty etad stat. law
ILnd In do:ng the work a.Lborl.td th—by. no Penon AT-ENTICN
".O"d violation of the Code of the State of Waebuirt., APPLICATiON APPROVAL
jby
'oru""St� " of 'Wnobp'�O'
1c,titIng to Wolkiren'. Comp,,,.tl.a jo,,,�. THIS PERIVIT
AUTHORIZES This application is not a perinit linlil
NOTE: Permit Limit One Year (E—Pt DEMOLITIONS hl,h ONLY THE eigned by the BUJ!dlng 0ff;cjjI Or his Dep-
ehall be C=.Pleted li� W.,ty day,: blOVE, be h7
3'UjLj)I.,;OS �hitll be ORK NOTCO utY; atnd fees arc Phid, and receipt is ac-
SI E low knuwledged in space provi I
Led.
C S' . 11
SIGNED -C 0"
z TC- T ',S'r 171,'..T T"
;711:;1
CITY .1
EDMONDS
O'zT r.
11PPlica,it Subject
This Permit Covers Work to be dorI 775-2525
e on Private Property ONLY.
Any construction Or� the Public donIain sidilwalks, driveways, z
marquees, etc.) will require "Parate perrilission.
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CITY OF EDNIONWS Ef':GALERING DCPT
r �Karnifled by
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R.cmarks.a ge---
0
C*E NO. qc/ -113
Critical Areas checklist
--------------------------------------------------------------
Site Information (soils/ topography/ hydrology/ vegetation)
1. Site Address/ Location: 72 56
2. Property Tax Account Number:
— �, 'Y Z
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed?C,� yes; _ no.
If yes; how is site developed? - a (
5. Describ e general site topography. Check all that ap' ly.
�r_ p
Flat: less than 5-feet elevation change over entire site.
�Mml
APR 2 1999
PLM6�imi DEPT.
Rolling: slopes on site generally less than 15% (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 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: 40
7. Site contains areas of seasonal stand 7>10r: Approx. Depth: A/0
What season(s) of the year?
8. Site is in the floodwayi_z�(_K floodplain./4 of a water course.
9. Site contains a crep� or an area where water flow. across the grounds surface? Fl�Ws 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:
For City Staff Use Only---
1. 540:is Zoned? MD -7T
I. S.CS,: mapped soil type(s)? -7. A sLaLl I
:3. Wetl4fid.mv'entory or C.A. map ffi dicates t�ietland present on site?
Cri iti d' -0 ry
Are ais invento �-or C.A.: map- indicates Critical Area on site? 21,5 6 k-.,,
5.:: Site"ithifi desi�hated-e'a'rth subsidente landslide hazards area?
OV EIIAf
City of Edmonds
Critical Areas Checklist
10--downw— i)
, C. 1 S9
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.
With 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 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 Area Checklist and attest that the answers
provided are factual, to the best of my knowledge (fill out the appropriate column
below).
Owner/ Applicant:
- .
Name
,2 1 1 20 '�, VA L�L;=—V VA
Street Address f
16nfni J.5� q <�O -2-
City, State, ZIP,,. Phone
Signature Date
Applicant Representative:
Name
�treet �kddress
L /,, a &, � � �, 7
Cit�' State, ZIP Phone
Signature Date
I--�- (3
tic. 1,8 9
Deck Crafters
1030164 1h Steet SW
Lynnwood, WA 98037
Subject:
Dear Applicant:
0 6
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
May 6,1999
Determination regarding Critical Areas Checklist # 99-113
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 ENVIRONMENTAL CHEE�� OR CRITICAL AREAS STUDY,
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
mio, You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION MTH ALL .411111111
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
Enc: Determination
cc: Coburn Douglas
21130 Shell Valley Rd
Edmonds, WA 98026
Architectural Design Board
C:Reception�Jana\CIRLTIR.doc
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Thank you.
Planning Secretary
Incorporated August 11, 1890
Sister City - Hekinan, Japan
APPLICATION
The City of Edmonds for EASEMENT NO . ............................ ---------------
SIDE SEWER PERMIT
F--- NEW CONSTRUCTION 0 REPAIRS LID NO - ------------------ - ASMT. NO . ..................
OWNER W KEE;2i ....... I -�.. t, AE -=- �-Z � -------------------------------------- CONTRACTOR ��.A� --- M .....
------------------------------- PERMIT NO.
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JOB ADDRESS ---- -------------------------------- ................................................ LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------ -----------------------
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NAME OF ADDITION . ...... RPh-RIA ..... DI-V I S;1-1 (P ... . ...........................
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DATE ... 0411 ------------- By --- TUY�y
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ary, wowotm SEWER PERMIT
PERMIT
Call 7Wsals, for side sewer. inspectioro VWFV= eav" any portion of the construotion.
(Inspection will be provided within 24 1 hours &Mr Most. SO "t-, SO., Or holiday lasPOcil"O.)
21230 Shell Vallev*--'R'oad
ADDRESSLOCAUON OF CONOMUCTION .. . ...................................... .._.J� ........................................ ............................ ..................
PROPERTY LEGAL DESCRIMON ............ 2�00�1 .... DiViS.ion..A� .................. ............................ LU ...............
... ........... . . ..........
... 1. ....... . ........................ Iz ..... I ...........
. .............. . .. . .............. . ...... . ........
.................................................. ........... . .......... . ..................................... ..............
211:
0,0112M.46ND/OR BY .............................
& M Excavators, 15-015 - 2nd Ave. W. , jyn ��q2d
CONTRACTOR'S NAME &-ADDRESS. .. ...... . .................................... I ......... . .......................... ............. I .......... ... . .... .............................
Parnwon is granted Mr ... 9 ....... ............ 19_1� for repnk wWor connection of a *we sower to ale cuy seamw sewer
w—tern In &e0orftum with City of Zdmom% ordinanme.
ATTENTION IS CALLED TO THE FOLLOWING: be osayiny" to construct
NOTE No. I —The owners of the property may Obtain A, permit to construct sewer Inside property Una. A licensod Side Sewsr Contractor must
side sewer in street area. Do not cover any portion of sewer before it has be" JIM"WtOd.
NOTE No. 2—All work performed In city right,01-way reWires an Invasion of Right -Of -WILY Portnit obtainable from the City Engineer's office.
OTE No. 3—Obta-in full information regarding Ordinance II-16,0W and Regulations 901troing NIAO 0swas when you get permit - No bonds in grade
?PM No. 4—Top of side sewer must have at )east 30 inches coversge at property line wA 12 inckwo inside property 1100; minimum grUds Of I% -
#harper than 'A will be permitted. Ition. Contracton shall be responsil" for j&UVft d" to improper
TE No. 5—Trenches In street must be water *Atltd 444 surface of street restored to oricinal cood
worlt which may develop Within 040 YOU Of COMPlstl0n- to do any work on the maln sewer or Its ASOU111MA&M WOW to In -
NOTE No. 6--It in unlawful to alter or do any other work than is provided for in the permit, or
sort the pipe into the wYe.
1W..............
DISAPPROVED [:] Date ... . ........ ... 44 .................... BY ................ D&t111L ............ ]3y ................ DMO ...............
-ffrjDate ........ . ...... . .............................. . ............................. . . ........ . ...........
................
AMADVED
Roemwks: ....... . .. . .. . ...................... . .................................................................. . ...................................... ....... . ...... . ...................................................
................. . ......... .........
......................................... . .............................................. . .. . ................
... ...................................................... . ...............................
BOTH Permit Copies XUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
ation constructed under this permit
hereby certify that the side sewer instaU
;;�� �'O'n'tracttus'
';rer .4fGrm g ordinances of the City of Edmonds.
WS& Instaned acc�Idance wiffi a overnin
DatedthIS ...... . ................... dAW of ................................................................ 19 .........
Check BEVORE youft for: Water Gem ri, Telepbaft Power El, sewer a OtbW [3 -4 -1
hTC
APPLICATION
.ie City of Edmonds for EASEMENT NO - --------------------------------------------
SIDE SEWER PER
NEW CONSTRUCTION REPAIRS n LID NO - ------------------ ASMT. NO - ------------------
OWNER ------ . ..... --------------------------- CONTRACTOR --------------- 4�) -------------------------------------------- PERMIT NO. 0
.. . .........
JOB ADDRESS --------- 2.t-2,3ja --------- LEGAL DESCRIPTION: LOT NO - ---------- ............... BLOCK NO - ------------------------------------
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NAMEOF ADDITION ........................ ............................................................................................
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Approved:
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DATE............................................ By --------------------------------------------------- j-j7.yg