21423 86TH AVE W.PDFIIIIIIIIIIII
8144
21423 86TH AVE W
CA FILE NO.
Critical Areas Checklist
Site Infoi-mation (soils/topography/hydrology/vegetation)
1. Site AddressALocation: A 1q9t; 9&9� 9V6 Id EbMoAlb!S "Oe(
Account Numb
2. Property Tax 5
3. Approximat . e Site Size (acres or square feet): 10,s �QV04? 1q,
4. Is this site currently developed? _,�_jes; — no.
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
Flat* less than 5-feet elevation change over entire site.
7— Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a
horizontal distance of 66-feet).
Mr. 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: A10 A I pprox. Depth:
7. Site contains areas of seasonal standing water. Alo Approx . . Depth:
What season(s) of the year?
8. Site is in the floodway floodpWn Ala of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? Aj 0 Flows are seasonal? _ (What time of year?
10. Site is primarily: forested . meadow shrubs mixed
urban landscaped 0awn,shrubs etc) V
11. Obvious wedand is present on site: . A/O
Rev 0.%Inm
7kevo �19!14
C* of Edmonds
ity
+
NO
I
untical Areas UheCkfiSt
I'he 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. IMe
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.
Mrith 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 (eg. site
plan, topography map,. etc.) or stucUes in
conjunction with this Checklist to assist
staff in complefing their pmliminary
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 icolumn below). '
Owner I Applicant:
G(AsOrd �Ge-
Name
2tLIA3 2(,P4�- \A/
Sheet Address
Applicant Representative:
Nam
Street Address
. I fo
E-bM01Vbc, WA'qy()Z(, -/78-&24o
;C iiLS twa t e, Z 11 P Phone EiT State, zip
Signature Date Signature
Phone
Date
USE PERMIT
ZONE 950 198
CITY OF EDMONDS
NUMBER
CONSTRUCTION PERMIT APPLICATION
og
OWNER NAME tNAME OF BUSINESS
jTE,APT
ADDRESS
CX -, A & --k Aoc i,
LEGAL DESCRIPTION CHECKI
SUBDIVISION No-
LID NO
MAILING ADDRESS
Z
Ft� An,
9 06�� nve WC-ST
PUBLIC RIGHT OF WAY PERPFFICIAL STREET MAP.
TESCP App,immKI D'
CITY ZIP
U)� 9 S61 TE
LEPHONE NUMBER
EXISTING - REOUIFIEO DEDICATION
RW Pri-it Required CI
street use Parrnit Req'd 13
Inspection Required 0
"`a�"'99A$?'6
NAME
PROPOSED
Sidewalk Required 0
R.
-METERSIZE
/U'V& y
LINE SIZE NO. OF FIXTURES
PRV REOUIRED
uu ADDRESS
Y�s 13 NO E3
U :9990-q /(-?/ sr 5'. 0
REMARKS
w
t� CITY ZIP TE
LEPHONE NUMBER
AUIS id lerj, U.4. 9,ffb9,Q I m&
- 93W9 -13
NAME
60,s--4T,q&Z R) Yvc CAR"n A? L). 6"),jEor
ADDRESS I �uc (
6_aa fV. 1l9S:9"`-57- , 4?1N.
-
ENGINEERING MEMO DATED ,,,,-,Z'EWEO BY
CITY ZIP TELEPHONE NUMBER I,-`
.5Gg-r-rLI:F' 9p) eu,
8 z 331
ED REVIEWED BY
STATE LICENSE NUMBER, EXPIRATION DATE
1WElyrog1k * 0 11 6. Q 5 10-95'
SIGN AREA
ALLOWED PROPOSED
$EPA REVIEW
COMPLETE
AD
Legal Description of Property - include all easements
Z
+
F*Pj
JE.EMPI
SHRX
A-
VARIANCfOR CU
IN
By
SETBACKS FEET HEIGHT
jLOTdb Put
Z
Property
Tax Account r
s&/v6�&o/o-co
FRONT 'Z1002 SIDE EAR 02
/,,I
FIEMA...
Parcel No.
C9
NEW
RESIDENTIAL
PLUMBING
ElADDITION
11
COMMERCIAL
MECHANICAL
APT. BLDG.
El
REMODEL
SIGN
GRADING FENCE
El
CHECKED BY
TYPE OF CONSTRUCT 0 CODE
OCCUPANT
1 R*_
REPAIR CY05. I x -FT)
911/
DEM 0 EIWOOOST VE IM POOL
UiW, . Ho T TU8/SP
INSERT. 0 SW A
EC
�JALDINSPECT R
6 RE
Apot
AR
:�24 )%.-
OCCUPANT
LOAD
I
WARAGE RETAINING WALL/
El RENEWAL
0 YES
MARKS
PORT ROCKERY
0 (TYPEY, S OR ACTIVITY) EXPLAIN:
PROGRESS INSPECTIONS PER USC 305
51ka-11WIfl le.: 8LW& 11541
y
NUMBER
0 OF
NUMBER OF
DWELLING
IYA
CRITICAI
AREAS
f�5-,R�;
STORIES
UNIT S
NUMBER
DESCA113E WORK TO BE DONE (ATTACH PLOT PLAN)
A?), /6, )t .9 0)9PM11-1—
FINAL INSPECTION
REQUIRED
VALUATION
FEE
'37
PLAN CHECK FEE
--7LAZING
BUILDING
5
HEAT SOURCE:
%
N14
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work'to be done on private property ONLY.
GRADING/FILL
Any construction on the public domain (curts. sldewplks,,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: 1 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,
I employees, and agents from any and all claims for damages of
5 whatever nature, arising directly or indirectly from the Issuance
x of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
0 modify, waive or reduce any requirement of any city ordinance
nor limit In any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
I hereby acknowledge that I have read this, application; that the
ATTENTION
APPLICATION APPROVAL
information given is correct; and that I am the owner, or the duly
authorized agent of the owner. I agree to com�ly with city and
3 tate laws re gulating construction; and in doing the work autho riz.
THIS PERMIT
ALT HORIZE S
This application is not a permit until
ad thereby no person will be employed in violation of the Labor
ONLY THE
signed by the Building Official or his/her
Code of th; State of Washington relating to Workmen's Compensa.
WORK NOTED
Deputy: and fees are paid, and receipt is
tion Insurance and RCW 18.27.
INSPECTION
acknowledged in space provided.
SIGNATU%,^,PNER OR AGENT) DATE SIGNED
C
DEPARTMENT
Cl TY OF
CI
�S�G;;T RE
-e
11-��;4��_-e�i 02-:)Q
EDMONDS
I
C
ATTENTION
1�'-
CALL FOR
INSPECTION
R
ylezw 3-
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A F�NAL INSPECTIOWHAS BEEN MADE AND APPROVAL OR
771-0220 ORIGINAL - File YELLOW - Inspector
!,CERTIFCATE OF OCCUPANCY HAS BEEN GRANTED. USC
9CAS A 0,3
e),)
. 4QS 9,64J�AM U)85,r
Ebmolvlosl WA.
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RECEIVED
FEB 2 2 1995
PERWCOUNMR
41.
-0
MXiAivn) H-V�11T- C)i--
CAF�z-- Ir5'
APPROVED BY PLANN",
- "-,4 2JZ71%5—
)4.. A/OT5;�.
NOTICE:
-a'.ral 7 -y
-N:O,*,w r n. - �.-..O ac.c
The information . shown on the attached
map(s) was compiled for use by the City of
Edmonds" its Employees and Consultants.
Th.e City of does not - warrant the
accuracy of anything set for.th on t * hese
Map(�-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the inform-ation shown on
-_____Fe -map(S), including, but not limited to,
t er stub shown. Such
the lociation of any sew
sewer stubs may or may, not exist and may
at the location shown.
or may not exist
Neither the city of Edmo'nds nor its
empl-o-yee-s o-r office-rs -sh-@I] be Viab-lfe for the
n on this ma p(5), nor for
information give'
tation provided based
any one- represen
upon said map(s).
i
CITY OF EDMONDS Call PRospect 6-1107 when work
CIVIC CENTER — WATER -SEWER DEPARTMENT is ready for inspection. (No inspec-
tions Saturday, Sunday or holidays.) N? 2653
SIDE SEWER PERMIT
ADDRESS ------------- P19 ---7 --- 16th Avenue Sogth -------------------------- .....................................................................................
..................................... --------- ---------
Ronald E. Rafter ------
OWNER ................. ............................................................................ CONTRACTOR ..... 4f!!�_YRO�Y_ P'P!q ---- ------- -
rern-iission is granted ... Jaxwary _----_------- 2 .... 19.6.8— for ........................ days to REPAIR or CONNECT a side sewer
xvith City Sewers in accordaiice with application on file and governing ordinances.
ATTENTION IS CALT, D 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—Obtain full Information regarding Ordinance 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 line; minimum grade of 2%.
No bends In grade sharper than % will be permitted.
NOTE . No. 4—Trenches in street must be 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 Eater or do any other work than is provided for In the permit, or to do any work on the main sewer or its appur-
tenances except to insert the pipe into the wye.
.........
APPLICATION
for
EET Fill SIDE SEWER PERMIT
The City of Edmonds EASEMENn ....................................
NEW CONSTRUCTION El REPAIRS E]
OWNER', ...... ..... 'TOR PERMIT No.
........... CONTRAC .........
.. .......................
.......... �F ..........
ADDRESS, '2�zt ....... . LEGAL DESCRIPTION: LOT No . .......... Zxf .......................... BLOCK No . ......... ................................
—7 ................
..............
4-4
NAME OF ADDITION ......
...... . ... -
T
I
--e2 �,16-z/
Approved:
----7---1
DATE ............. By
A P FR 6,- Y'E D
IJAN 2. lgbj