21415 86TH AVE W.PDFIIIIIIIIIIII
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21415 86TH AVE W
PLANNING DATA
SINGLE FAMILY RESIDENTIAL
S TREE T =FILE
Name:
Date:
Site Address:
Tax Parcel:
w/
no-5coll 00001 Jc2c)
Project Description: &clo-se- Cx-Sk!'%3 c,-A—ror-k-
Plan Check #: SLb-.Xo\-
Reduced Site Plan Provided��NO)
Zoning:
Map Page:
Corner Lot: (YES
Flag Lot: (YES N(�T_)
Cri tical Areas Determination #: cooCk, dces,��
El Study Required (e,%cAeslc�5 exvaV.,\
11 waiver
SEPA Determination: Fx,,,,,, ?N:
.9— Exempt
El Needed (for over 500 cubic yards of grading)
0 Fee 0 Checklist 0 APO List with notarized form
Requir�d 56tbacks
Street:
Side*
Side:
I Rear:
Actual Seibacki
Street:
Side:
Side:
Rear:
NO Ck 11?
CKO.
Detached StrucO�:
Rockeries:
F-1 Fences/Trellises: No,%e-
0 Bay Windows/Projecting Modulation:
Stairs/Deck:
-HN�ht
Datum Point:
Datum Elevation:
A//A
Maximum Height Allowed:
rc -bln n C,%c
Actual Height: .-I-- - , ;�,
Other
Parking Required: _e c
Parking Provided:
A_
Lot Area:
Maximum Lot Coverage: 35% Proposed:
Lot Coverage Calculations: A0
ADU Created: (YES /(0
Subdivision:
Legal Nonconforming Land Use Determination Issued: (YES NO) See -
Comments
No. lio� C-0 -f- r4cd
cA,-V�l AVeA 15, Aq57.
Plan Review By:
Planning Data Form 07-14-09
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
IT
Permit Number.
STREET F1
Issue Date:
A. Address or Vicinity of Construction.'
Z
89 0 9 B. Type of Work (be specific): A&I" Ab
C. Contractor:\6&�8- Wa9p., C-cs Contact.eDQQ/s CL4��
Mailing Address: Phone: V::�Q_\ — t?
State License #: Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. El Commercial
F1 Subdivision
El City Project
0 Utility (PUD, GTE, WNG, CABLE, WATER)
E] Multi -Family
[:] Single Family
n Other
INSPECTOR:
INSPECTOR:
F. Pavement or Concrete Cut: D Yes 0 G. Size of Cut: x H. Chargf�_$
ON
APPLICANT TO READ AND N
INDEMNITY. Applicant understands and by his signature to this application, agrees to ho of Edmonds harmlA..1.:X;;e14g_e., or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edm9nds, or any of its departments or
employees, including or not limited to the defense ofany legal proceedings including defense costs, and attorney fees by reason ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MA ikj�lAt4 FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
I f
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATIO;v FET WILL BE HELD UNTIL TRF 'ALVREETPATCH
is COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILLXF_'1t896FqSED FOR ISSI TAWCE W PlJfANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regu�atiqns as required by the 0,5ty k�gifnl etr.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I ha ve read th e a bove s ta temen ts and understand th e perm it req uirem en ts a n d th e pin k copy of the permit will be
available on site at all times �g�pection purposes.
Signature: i'�4w Date: August 25, '1994
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: RIGHT OF WAY DEPOSIT
TIME.AUTHORIZED': VOID AFTER 1 %4 FA DAYS
SPECIAL CONDITIONS: blv
COMMENTS:
DATE:
DISRUPTION FEE/FUND 111:
RESTORATION FEE:
PERMIT FEE:
TOTAL FEE:
RECEIPT FEE:
ISSUED BY: —
AF
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. Nv. 1991
ROUTE & FILE
Nakwid Go
AVA9VVM&-WGM10SW
10 0
1115500
Apra,
unwry
WOMK
7,
-Z
WNG to window
Water main depth
unknown
11 gas main
Addendum to City of Edmonds
Right of Way
Permit Application
ub tted. Connie Carbon
Field Representative
Washington Natural Gas
t 521-5264
n
21
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NZA-v
A�JD 726-FF:iC- CD�,A-rIWL-,
PL4&IJ
�L 14- 1 u:5'
Z' x 4, 140 LS
IN Cq0ts'-sS
(r- E
UIIL�ITA
Key:
-w- water
-9- gas
-ss- sewer
-0- water hydrant
0 water valve
WNG926.1 S j1VSJ1
%V
TN sk9b -10416
A& 76
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0 Vol.
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16
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PL
APPLICATION
for
The City of Edmonds STREET FILE SIODE SEWER PERYHT
NEW CONSTRUCTION E] REPAIRS EASEMENT No . ..........................................
OV17NER "�',�'--77 �7,
.......................................................................................................... CONTRACTOR ....................................... I LO ----------------------------------------- PERMIT No.
774, 14 � - f�-- )
ADDRESS ..... ........................................................... ..................... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
NAME OF ADDITION ................
..... ----- .... ..... ....................................
G i e-z 0 , -
4 >
Approved:
2
DATE.. /
................... -...
By
. ........
CITY OF EDMONDS
CIVIC CENTER — WATER -SEWER DEPARTMENT Call PROSPeCt 6-1107 when work
is ready for inspection. (No inspec-
SIDESEWER PERMIT tions Saturday, Sunday or holidays.) N2 "'2517
ADDRESS -------------------------- 16-th-I'Ve"m4le
------ S&,utb
OWNER .............. jAMO.;�__A. Pelham
----- - ---------------------------------------------------- CONTRACTOR .......... Owner
---------------------------------------------------------------------
Permission is granted ... NO.Rejo-b
. .............. 19 .... - 7 ' for ------------------------ days to REPAIR or CONNECT a side sewer
with City Sewers in accordance with application an file and governing 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 sewler in street area. Do not cover any Portion of sewer before it has been inspected.
NOTE No. 2—Obtain full information regarding *-Ordinancel 11.16.030 and Regulations governing side sewers when you'get permit.
NOTE No. 3—Top of side sewer must have at least 30 Inches coverage at property line and 12 inches inside property lix I ie; minimum grade of 2%.
No bends in grade sharper than % 'will. be, permitted.
NOTE No. 4—Trenches in street must he water settled and surface of street restored to original condition. Contractors shall be responsible for
failure due to improper work which may develop within one year of completion.
NOTE No. 5—It is unlawful to alter or do any other,work'than is provided for in the permit, or to do any work on' the main sewer or its appur-
ten&nces-except to insert the pipe into the wye. J.
NOTICE:
Mz
y 0
-No_'Warranly ... 0 ached
The information shown on the att
Map(s) was compiled for use by the City Of
Edmonds/ its Employees and Consultants.
Th,.e C'Ity of does not * wa rra nt the
t forth on these
accuracy of anything se
Map(�-). Any person or entity -requesting a
copy should conduct an independent
-ation shown on
inquiry regarding the inform
including, but not limited to,
_tF�e -rn a p (s)
t h . e lociation of any sew-er stub shown. Such
sewer stubs may or may not exist and may
or may not exist at the location shown.
Neither the City of Edmoind's nor its
emp'fo-yee-s o-r offi-ce-rs -sh-a-11 be Viab-'Fe for -the
information given on this map(s), nor for
e representation provided based
any on
upon said map(s).
i
OlRodfing in this permit approval process Shall be
interpreted as allowing -or permitting the
maintenance of any currently existing illegal,
nonconforming or unpermitted building, structure
or site condition whiel is oute7de the scope of the
=it lication, regardless of whether such
, structure or condition is shown on the
site plan or dmwing. Such building, structure or
condition may be the subject of a separate
enforcement action."
31MID sft�L
APPO
00
.000
Zone Comer &oF1aQ4c.
Selback Required Actual
Front
Sides
Rear
Other
Hei&t
RESUB
SEP 2 5 2012
Dg SNT
B U& M F =De
oz -liA zi GA 4- el? f - -------------------------
N PROJECT- 21415 86TH AVE W
PARECL NO.: 00561100001100
LOT SIZE: .26 ACRES
DRAWING SCALE�, �-