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21503 90TH AVE W.PDF1111111.111111 8769 21503 90TH AVE W ECEIVED PERMIT EXPIRES CF I USE ZONE PERMIT CITTOF EDMONDS CONSTRUCTION PERMIT APPLICATION J B SUITE/APT# ADDRESS OWNER NAME/NAME OF B SINESS 404 `9C6A, PLAT NAME/SUBDIMSION NO. LOT NO. L�D NO. M MAILING ADDRESS L D FEE $ W z PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved 0 RW Permit Required 0 Street Use Permit Req'd 0 0 CITY ZIP TELEPHONE EXISTING — PROPOSED Inspect on Required 0 SIdowa:k Required 0 REQUIRED DEDICATION FT Underground V A6 T' t Wiring required 0 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRVREQUIRED YES 0 NO 0 W ADDRESS REMARKS z z x OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE cc z W CITY ZIP TELEPHONE 1,a, NAMA A_j m ADDRESS 4 1 t� 11� (aZ M "- CITY ZIP z TELEPHONE 0 77- 1) lyll�o STATE LICENSE NUMBER EXPIRATION DATE Cl�qCKED BY A� e) /0 PROPERTY TAX ACCOUNT PARCEL NO. 0 W oo NEW RESIDENTIAL PLUMBING MECH ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE 0 REMODEL C] AP ARTMENT E] SIGN GRADING FENCE REPAIR CYDS X FT) DEMOLISH TANK OTHER ARAGE 0 RMERING WALL RENEWAL 'bd Z CARPORT R Y r- (TYPE OF USE�.BUSINESS OR ACTIVITY) �EXPLAIN:; U �i NUM13ER OF NUMBEROF DWELLING t� CRITICAL AREAS o STORIES--./ UNITS NUMBER, DEqCRIBE WORK TO BE DONE L? r) 6"t ENGINEERING FIRE REVIEWED BY DATE W 5 LAL MRIANCE OR CU SHORELINE OR ADB# INSPECTION BOND REO-9 POSTED I 0 YES _�e SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWE PROPOSED — ­­- -4-­­­ EXP LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROF�OSED FRONT SIDE REAR FRONT L/R SIPE REAR psz z PARKING AREA PLANNING REVIEWED BY UtFr REO'D I P� VIDED /LOT 1,�q h4 '54.We. '��IIV 1, 1.9 CHECKEDBY ITYPE FT$TRUC.ION CgDp--%,- OCCUPANT GROUP SPECIAL INSPECTOR JA,REA OCCUPANT REQUIRED YES "q LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D VALUATION FEE PLAN CHECK FEE 2 HEAT SOURPIE /1//,V GLAZING % LOT SLOPE % ( f::� e., A,r) BUILDING s PLAN ItHECK NO- 0/_ VESTED DATE PLUMBING 61/7 MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE GRADING/FILL SEPARATE PERMISSION. STATE SURCHARGE PERMIT APPLICATION: 180 DAYS ENG.* REVIEW FEES PERMIT LIMIT: I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS ENG. INSPECTION FEE IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITYIPF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM -LANDSCAPING I ANY AND INSPEOTION-FEE ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY PLAN CHECK DEPOSIT RECEIPT z' FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMEDTOMODIFY, WAIVEOR REDUCEANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION' TOTAL AMOUNT DUE RECEIPTI I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILLBE EMPLOYED CALL This application is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid. and IN VIOLATION OF THE CABOR CODE, OF THE STATE OF WASHINGTON �. RELATING TO FOR INSPECTION receipt is acknowledged in space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. OqPCIALS SiGNATURE DATE. SIGN4TOE (OWNER ORAd`ENT). 7 DATE SIGNED (4 2 E-5) 771-0220 A17ENTION EXT 333 f�ltl_EA L BY D?,kT E I IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221, A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX, ORIGINAL - FILE PINK -OWNER GOLD - ASSESSOR 5198 6L6 L) —76�v 10 1 �,, �L,5,) lo�-G" pAtmo -ZiA T'\ A ocD c) o-1 R05,FWoob rkk DDO ILI 2Lqo I IL-1-7 ls-� �zl wt V; 4 Z 10 K/ r! LOT V EfC,� C,_r, 0 Ll C, 4 1, CPO ]s q, 14-7 0 3 (10 TO -FAt- o T- CD,-) ro- Q, m 19 (�o 1 0 G\Al z 14 z -7 To SPLJ�S��3LOL-V-,-�, V o r Zr- Al, �A F� A ta� 4%1 70 ST O�P 0 j v ZVI I L- \T--Z:> -p I iz� 7 Lo Z-9 H r s — - -------- ZL4 T' Zq oo (A/ R, o" CEIVED FEB.,2 3 2001 HOL%J_ A\jc.,- coo�,fjz- M*�, * � S' DEVELOPMENT SERVICES CTR. 1000 1 /1411 CITY OF EDMONDS AS "OTED City of Edmonds Development Services Department Planning Division Phone: 425.771.0220 Fax: 425.771.0221 Critical Areas File #: Critical Areas Checklist Fee: $45.00 Date Received by Dev: Sery. Dept: �2-ow City Receipt No: k /0 Date Mailed to Applicant: 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 I factual, to the best of my knowledge (fill out the appropriate column below). PLEASE PRINT CLEARLY Owner/Applicant: city State Zip �/Z, 5�- 7 7er-- 1,.'Pr Telephone Signature loo" Date Applicant Representative: Name Street Address city State zip Telephone Signature Date d:rweptiort4onatCACLHandoLit.doc Revised VIM= cA FILE No. Critical Areas Checklist -------------------------------------------------------------- Site Information (soils/topography/hydrol.ogy/vegetatio I Site Address/Location: 2. Property Tax Account Number: 5,-61,0 qe'Oepeg /4/,0 0 0 3. Approximate Site Size (acres or square feet): ree,() 4. Is this site currently developed? yes; _no. If yes; how is site developed? M e�- 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 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 I 0-feet over a horizontal distance of 3 3 to 6.6-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: Ala Approx. Depth: 7. Site contains areas of seasonal standing water: Approx. Depth: What season(s) of the year? 8. Site is in the floodway 0�� fioodplain--.,� �,o of a water course. 9. Site contains a cFe5k or an area where water flows across e grounds surface? Flows are ar- .round? /1/41 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: .............. d-p4i V., -;;-ii i W." -il—d �l- 1-44A .." - R -A v:v a-1 UK Q& X V ew V ft Aog_dLdK Rw IWOM CA FILE NO. Critical Areas Checklist opography/hydrology/vegetatio Site Information SOESTt ------------------------------------------- 1. Site Address/.Location: �7—IS-';195 'fAo�-e- 2. Property Tax Account Number: 0 '9 ep "'-9 1'�le 3. Approximate Site Size (acres or square feet): e% 7e, 0 4. Is this site currently developed? --Zyes; _no. If yes; how is site developed? Aft e-- 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 15% (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: Ala Approx. Depth: 7. Site contains areas of seasonal standing water: �4/-" Approx. Depth: What season(s) of the year? 8. Site is in the floodway floodplain o_ of a water course. 9. Site contains a c�e5k or an area where water flows ac�o7A!ie grounds surface? Flows are , year- round? /C/41 — Flows are seasonal? (What time of year? 10. Site is primarily: forested meadow— �_j shrubs mixed urban landscaped (lawn,shrubs etc) V ae�--57 11. Obvious wetland is present on site: V �c .15 dad, e "e "-Cm #v -00, !SM*' s Sk PP., ignat do ty -M.,.NA V-A t A S :1 RN Mow.` Aes-chkAK Rev 1WMM T EDA. . . . . . . . . . . . . . . . . . City of Edmonds . Development Services Department Planning Division Phone: 425.771.0220 -fac. 1%90 Fax: 425.771.0221 Critical Areas File #: Critical Areas Checklist Fee: $45.00 Date Received by Dev. Serv. Dept: 4 L;7i3oc) City Receipt No: i /0 Date Mailed to Applicant: CRITICAL AIREJAS 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). PLEASE PRINT CLEARLY Owner/Applicant: city State Zip tl . 7, 7 Telephone Signat—ure Date d:rwept1oftqena/CACLHandwA.doc Applicant Representative: Name Street Address city State zip Telephone Signature Date RevisW 411MM 21230 � 9122 o elvo o .-o : 9 9 .. ......... . . ..F �21230 17 CR c4 f o o 0 o o o F P o ; 9025 o o o e o e e 4 b ,.P . . o . o o d. o d. 3of 2130�2 21 9124 Ip e o P e 000 0000 e o 0 . 21303 —9 '1 21318 o P Oo.- o P, P o e o e . of o '51 5 21308 — 9232 9126 o 0 o 0 cL 21309, �-21308 0) 21324 �2 o o f 'Flo 21312 % c\I M co 0) cn si % aD co Go 21313 21313 co 21329 % to ?9 1 21318 2131,11 m 21316 2 9 08 21332 0) Cr) z 9122 9126 21335 Op cIj (D 14 CI4 2132 GO aD 403 21408 21403 9106 21402 ao 80 8813 8715 11 14091 21328 21t327 214 2 21412 21407 9104 21408 3: r., Z; Go aD Go Q 04 co 04 m 921 92 03 21415 9102 21416 W 21417 w N 04 Q > > clj co co c1l ol cm 21423 ; 21424 N < co - 21421 21429 co 21502 21429 21504 21503 to QD c, C) 21505 I N cIA I-T C) Ob 21507] 0) m Q 21510 21505 c%j 21512 0) 21511 to 21517 N co ao N c.) c) 21518 21513 21421 21518 21519. 21518 21511 21527 LO 21522 21522 21523 21519 IN c\I 6, cn c.) 04 21519 8703 21528 21529 QD 6TH Oq, \A/ 21527 tc," Go ST sw 1 9202 co Q o) c's o) 04 m 21,616 N 8730 21602 cli N N to 9 — QD o) co co aD QO m Go Go co co Go co 21617 21608 w) N 1 N LO m u*j N 9025 — o) 0, Ch ch 0) 21611 LE 0) 21621 co co 21614 2 TTH ST SW 0) m Go Go Q0 co co co 8803 0 21625 21622 9033 21629 627 8627 z 217TH— ui ST sw oo c') N 2 0) 9032 > < 217TH ST a N 0) a) c4 21701 8630 Q 21705 8802 867, 9024 c1l 04 N c\I 21707 8620 9404 922 9 21714 t:21714L 0) aD co co o) oo ao 21718 8626 8626 c.) 21719 QD APPLICATION for The City of Edmonds SME SEWER PERNaT NEW CONSTRUCTION E] REPAIRS 0 EASEMENT No . .......................................... 111-04400 OWNER.......... D.O.U0.1dS ... P0.03 --------------------------------------------------------------------- CONTRACTOR -------------------------------------------------------------------------------------------------- PERMIT No . ...................... ADDRESS ...... 21503 - 90th Ave. 1-1. .................................................. ................................................. LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ......... .................................. NAMEOF ADDITION ......................................................................................................................................... F- I L 0 Dye Tested On Sevier 1972 Approved: DATE................................................ By ................. ......................................