21509 96TH AVE W.PDFiiiiiiiiiiii
9412
21509 96TH AVE W
A I'M L
MM", I ROOM
PLANNING DATA
SITE ADDRESS: :�150'9 ATE: :Zkk,�
I t I
ZONING: :?2- - F /,5�5
�i PERMIT#:
PROJECT DESCRIPTION: Ady— A3n2l:r-Im4l
SETBACKS:
Required Setbacks: I
Front: 12,C2 Left Side:-1L.Right Side: Rear: 15
Actual Setbacks:
Front: &Q Left Side: Right Side: Rear: '52--
FLOOR AREA:
LOT COVERAGE:
Maximum Allowed:— Actual: nk�
BUILDING HEIGHT:
Maximum Allowed: Actual Height:
SUBDIVISION:
CRITICAL AREAS #:
SEPA DETERMINATION:
LOT
OTHER:
�BTREET MILE 0,
USE PERMIT
ZON 94,0480
CITY OF EDMONDS
NUMBER
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
o,,. 2.= 9 q1 trElAPT.
ADDRESS
tt
MAAl
'9 Iirlq
LEGAL DESCRIPTION CHECKI SUBDIVISII�N NS.
LID NO
1KVA9A1b6)e&
MAILING ADDRESS
TESCP 0
CITY 41P TELEPHONE
NUMBER
PUBLIC RIGHT OF WAY PE OFFICIAL STREET MAP.
EXISTING — REQUIRED DEDICATION —
APPIO,ved
AW Permit Required C3
Street Ose Permit Reti'd 0
Inspection Required 0
;AME
PROPOSE
Sidewalk Required 0
METERSIZE
LINE SIZE
NO, OF FIXTURES
PAV REQUIRED
U. APORESS
YES 13 NO 13
REMARKS
U,
CITY ZIP -7ELEPHONE
1�41,46EA
w
NAMNVAII�4 eelZ_7 4,16r
R
M ADDRESS
/0 9
ENGINEERING �EMO DATED REVIEWED BY
CITY ELEPHONE
Z A &1Aj*0j
NLIMBER
REVIEWED BY
STATE LICENSE NUMBER DATE
7
SAMRC-C /1Z It 1/�R 74N
i SIGN AREA
!!IEPA REVIEW
M
Legal Description of Property - include all easements
OWED
PROPOSED
COMPLETE
F-1 Or, F77 OF
4�
11E.E.11
E
/-7
tor 6
EfP
VARIANCXAU I
IN EW
BY
SETBACKd- FEET HEIGHT
FRONT SID;711 REAR
[�OJVE�
Z
Z
Property
Tax ACCOUitt
00 �7, oob- 0 /0 3
III
REMARKS
Parcel No.
NEW
RESIDENTIAL
PLUMBING
ADDITION
IAL
COMMERCIAL
MECHANICAL
ElREMODEL
APT. BLDG.
SIGN
GRADING CY.S FENCE
El REPAIR L—X—
CHECKED BY
TYPLQF CONSTRUCT9N CODE
�71/ 1
4? 1
DEMOLISH WOODSTOVE El SWIM POOL
INSERT HOT TLEI/SPA
SPECIAL INSPECTOR
JOCCUPANT
1AREA
REQUIRED 13 YES
2/110
LOAD
GARAGE RETAIN NG WALL/
CARPORT ROCKER'Y RENEWAL
R MARKS
ACTIVITY) EXPLAI
(TYPE TIVITY) EXPLAI
PROGRESS INSPECTIONS PER UBC 305
9
NUMBER NUMBER OF -RITICAL
;91etmiL- RA-liql tt&:,Fc cf-OA&
0 OF
DWELLING
Ir AREAS
W STORIES
UNITS
NUMBER
0
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
A4017-1041 41F 4 -a
FINAL INSPECTION REOUIRED
/no
VALUATION
FEE
PLAN CHECK FEE
BUILDING
132-4
HEAT SOURCE:
6A5
GLAZING
Z,
)�sePWA6-e
PLUMBING
Plan Check No.q�— 3-3
MECHANICAL
This Permit covers work to be dpnq on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewplks,
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
ENO. INSPECTION FEE
In successors in interest, agrees to indemnify, defend and hold
harmless I he 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
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
mo dify, waive or reduce any requirement of any city ordinance
0
any way the City's ability to enforce any ord
nor �imit I nanCO
TOTAL AMOUNT DUE
p rovlsion��
I hereby acknowledge that I have read this application; that the
ATTENTION
APPLICATION APPROVAL
Information given 15 Correct; and that I am the owner, or the duly
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
This application is not a permit until
state laws regulating construction; and In doing the work aulhorlz-
AUTHORIZES
THE
signed by the Building Official or his/her
ad thereby, no person will be employed in violation of the Labor
C State of WashlrAton relating to Workmen's Compensa.
Pnraence
ONLY
WORK NOTED
Deputy; and fees are paid, and receipt is
acknowledged in space provided.
tl� and RCW 1)W.27.
INSPECTION
SLONVURE (OWNER 9R AGEYTIJ ATF 5IUNtU
DE ARTMENT
DATE
CITY OF
EDMONDS
- -/ Iij�-
;W" ? 7-- 9'
CALL FOR
IAELEOLD_q: DATE
ATTENTION
INSPECTION
7 -r;
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
'ORIGINAL
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
- File YELLOW - InSpeCtor
771-0220
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
�WADICM I
r.r)l I) — A",""
f%IrREET FILE
0 1 CA FILE NO.
Critical Areas Checklist - :
SiteInfor - mation (soils/topography/hydrplogylvegetation)
1. Site AddressALocation: V,57Qq--?Ct—'�
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? _:�_yes; _ no.
If yes; how is site developed7
. SIF e��
5. Describe the general site topography. Check all dig apply.
Flat less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a
horizontal distance of 66-feet).
Irdly.- 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-fe6t over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contain areas of year-round standing vrAw. Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?.
S. Site is in the floodway floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? A10 Flows are seasonal? A10 (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wedand is present on site:
R"OW4N
8.90.199.-
City of Edmonds
Critical Areas.Checklist
'Me Critical Arm Chwklist 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 avAlable fiom
observations of the site or data available at
City EWI (Critied Areas inventories, maps,
or soil surveys).
An applicant, or his/her representative,
must fill out the checklist, sign and date it,
.CF
jUN 13 1994
COMMUt41-N SEWJJCES
and submit it to the City. The City will
review the checkist, iiake a precursory site
visit, and maim a n of the
subsequent steps necessaryto complete a
development perinit 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 thd City staff can find
and identify the subject paccl(s). In
additioii4 the applicant shall include
other pertinent information (eg. site
plan, topography map, etc.) or studies in
conjunction with this Cheddist to assist
staff in completing their preliminary
a ssment of the'eke.
I have completed the attached Critical Area Checklist and attest that the answers provided am
factual to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant*
1-7AP-y
Nam
Av5 AJ
Street Addrew
El) /7 0 /V/3
city, Staw, ZIP
Phone
Signature Date
Applicant Representative:
Nanie
. 1,n,;t -7 - N07 S-r AI&
Street Adds=
city-'Ad�
�Sd -Z03
Phone
DOW
AV
Z
U
:5
0
U
0
F_
>4
0.4
Z
0
W
00
�D
U
94
0
vo
V
CiT-Y OF EDMONDS Permit No.!,v
STREET FILE
COMMUNITY SERVICES DEPARTMENT Issue Date
RIGHT-OF-WAY CONSTRUCTION PERMIT
A. * Owner: Washington Nattral Gas Company B. 0 Contractor:
NM e Mercer Street Name
%Jej1%ddre,s WA 98111 Mailing'Address
City State Zip City State Zip
State Licen�e Number Telephone Number
9 Address or Vicinity of Con rjrld�i,91�5_��--5,QAP14PAV W 164-67,006
Type of Work to be
Sui_.,ol/
Work in Connection With: I /. 5" 11 Single Family El City Projects
0 Commercial 0 Multifamily EX Utility
Pavement Cut: It Y 0 N
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City'of Edmonds
harmless from any injuries, damages, or claims of any kind or description whatsoever, forseen or unforseen, that may
be made against the -City of Edmonds, or any of its departments or employees, including or not limited to the defense
of any legal proceedings including defense costs, court,,costs, and attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE
YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed
by City forces, at which tinfe a debit or credit,will be processed for issuance to the, applicant.
• A 24 hour notice is required for inspection; Please call Public Works: 771-3202
• Work is to be inspected during- progress and at completion.
• Restoration to be in accordance witli i2ity Code.
• Street to be kept clean at all times.
• Traffi� Control to be in accordance with City regulations.
.0 All street -cut ditches must be patched with asphalt or City approved material prior to end of working day;
no exceptions.
I understand the above and that this permit must be available at the job site for inspection purposes at all times.
Signature:
FIE=, 0 414, IFA
Owner or Contractor
Date: April 27, 1989
This Permit Must Be Posted at the Job Site For Inspection Purposes
/Call DIAL -DIG Prior To Beginning Work
ISSUED BY: PERMIT FEE: t�o - xar O&C., /0 A&
3 0 ays.
Time Authorized: Voilafter Security Deposit:
Special Conditions:
Amendments:
Receipt No.:
Fund I I I Fee:
Street Cut Dimensions:
X
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. July 1985
FIELD INSPECTION NOTES
(Fund I I I - Route copy to Street DO.)
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION 0 YES E3 NO
Partial Work Inspection by P. W.:
Work Disapproved By:
FINAL APPROVAL BY:
Eng. Div. July 1985
4
V),t
LLJ
196 Q +101
182's
1173 7101 2 7G'vv 2, OTW I P 10,5
'17076110,3
NISOM
in N Co
(LAUREL ST)
PL
I p Ilk,
01,101-OSO,
9&/7 q,&Ol
CO
it
p 9
�9 K A
N k
OVIO a**
LAUREI LN
V,
11
ry
40 IQ CD
81c)ib
1103
b)
a o
141 7s
0.
6 S wab-�
NZ 9010 516 40,
P L
F4 ST)
-..-(PINE
DUN.
TalL
N
'S
W255'S
IC55_�
5
AW2 55'3�5
co
in
W507'5
1 68
558
a. a
N
Its
"M 117!j
U)
X
A5015
0)
55-5-
%A
CD
a)
cl�
NE
R E rE vi F I L. �4�
gjjX 2K ERMONDS
PUBLIC WC1RM - EMINEERM
ACTION REPORT
N? 4104
SUSPENSE DATE: -
Date: 0 Time: 'File
I Attarhments: =Yes
REQUESTOR: NAME:
ADDRESS: 4:5-09 -
PHONE: -7-7&- R-710
REQUEST RECEIVED BY:
TELEPHONE
CONTACT IN OFFICE r-1
OTHER:_ r---1
RECEIVED BY:
rumOF-ALI
Mo
All Concerned Notified =
Action Completed/pil:,��,
STREET FILE
RECElvet)
//0,2 TH JON 3 0 1994
j-,r6,AL,: )r- ior(, PERMI*T COUNTEF1
Oq
96 �A- A Ve W