21512 90TH AVE W.PDFlill 11.111111
8772
21512 90TH AVE W
-at
W
;IF -VED
.CEI
14AY 3 0 1996
?e�MIT COUNTER
0TY Copy
- —.an
APPROVED BY PLANNING
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6��OH6,�/ ld,4 76b ZO
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4 -
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COUNTER
,CITY
STREET FILE
APPROVED BY PLANNINU"
76b W
-A&,
CITY OF EDMONDS
E PERMIT
ZONE NUMBER 960.514
CONSTRUCTION PERMIT APPLICATION
joB ITE/A
ADDRESS
qr) 14 L) e /_e�
W.�ER NA"AME OF BUSINESS
LEGAL DESCRIPTION CHECK
SUBDIVISIONO NO. LID
NO.
MAILING ADDRESS
L ; -
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING — REOUIRED DEDICATION
TESCP Approved
RW Permit Required 0
Street Use Permit Req'd C3
CITY ZIP
TELEPHONE NUMBER
PROPOSED Inspection
Required 13
Sidewalk Required 13
NAME
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
YES 13 NO 13
W
ADDRESS
REMARKS
CITY ZIP
JTEtERUQtLE.��
NAME')
I C,
ADDRESS
ENGINEERING MEMO DATED REVIEWED BY
CITY ZIP
ITELEPH ONE NUMBER
FIRE MEMO DATED REVIEWED BY
ui
cc
W-,,r',r77_
97
STATE LICENSE NUMBER EXPIRATION DATE
SIGN AREA
ALLOWED PROPOSED
—4f
SEPA REVIEW
COMPLETE 1EXEMPT
V11,
EXP
ADS NO.
SHORELINE#
7--/
Legal.DescripUmPf Property - include all.easements
C li'� c F I, I/, I /
'j
VARIANCE OR CU
PLANNING REVIEW BY
DATE
SETBACKS —FEET
HEIGHT
Li T COVERAGE
FRONT 7-!3' ilDE 2,'REAR
_7�
1
3 57
Z
Pio,
PiRy
Tax Account
Parcel No.
REMARKS
NEW RESIDENTIAL PLUMBING
Lz3tDDITION 11 COMMERCIAL E] MECHANICAL
REMODEL APT. BLDG. SIGN
CHECKED BY
TYPE OF CONSTRUCTION
-'A
CODE
OCCUPANT
GROUP
GRADING FENCE
X
REPAIR CYOS. I— _ FT)
WOODSTOVE' SWIM POOL
DEMOLISH INSERT HOT TUB/SPA
F
GARAGE M RETAINING WALL/
SPECIAL INSPECTOR
REQUIRED
11YES
tKA
OCCUPANT
LOAD
MARKS
PROGRESS INSPECTIONS PER. UBC 305
CARPORT L_j ROCKERY RENEWAL
(RPE OF USE. BUSINESS.OR ACTIVJJX�PPLAIN:
NUM;ER
NUMBER OF
CRITICAL
OF
DWELLING
I
AREAS
INUMBER
STORIES
UNITS' .
IV 5u. ak /qg,// ?q3
4,
DESCRIBE WORK TOSEMONE (ATTACH PLOT PLAN)
C
AL INSPECTIONREQUIRED
A -A /2 1
VALUATION I
FEE
PLAN CHECK FEE
BUILDING
11EAT SOURCE:
GLAZING
%
C 1, T7-
4 C.-
PLUMBING
Plan Check NO.
MECHANICAL
This Permit covers work to be.done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewelks,
STATE SURCHARGE
4, r
driveways,'marquees, etc.) will require separate permission.
Permit Application: 180. Days
Permit Limit: 1*Yeai-'ProvI'dSd Work Is StartedWIthin 160 Days
STORM DRAINAGE FEE
.
:"Applicant, on behalf of his or her spouse, heirs, assigns and
ENO. INSPECTION FEE
w
sudcessors In Interest, .'agrees to Indemnify, defend and hold
harmless the: City of'' Edmonds, Washington, Its officials,
x
employees, and agents from any and all claims for.damages of
'nature,
whatever arising directly or Indirectly from the Issuance
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
-way.
X
nor IlAt-in any the City's abillty.to enforce any ordinance
TOTAL AMOUNT DUE
-7
provision."
.1 hereby acknowledge that:l.have read this application; that the
Information given . 16.correct; and that 1. am the owner, or the duly
ATTENTION
APPLICATION APPROVAL
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
state laws regulating construction; and In'doing the work authoriz.
AUTHORIZES
This application Is not a permit until
ed thereby, no person will be employed In violation of the Labor
ONLY THE
signed by the Building Official or his/her
Code of the State of Washington relatInd 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.
SIG, NER OR AG T) -
AG SIGNED
DEPARTMENT
]DATE
CITY OF
OFF"ICIAIG RE DATq
LL!il
EDMONDS
�101�6
'ATTENTION,
CALL FOR
INSPECTION
RE�EASW 13 OAT
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
-
771-0220
ORIGINAL File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC
—
CHAPTER 3.
PINK — Owner GOLD — Assessor
C
CA FILE NO.
Critical Areas Checklist
� .6
Site -Information -(soils/topography/hydrology/vegetation)
I. Site Address/Location: 7-1-1!717-
44,
I At,
All.
P Tax Account Number:
roperty
3.',, Approximate Site Size (acres or square -5
feet): Z
4. Is this site currently developed? �X—yes; no*.
.If yes; how is site devel
oped? �LNGUQ- �,�r
14
5. Describe the general site topog7ph�.',.. that aip
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less, than 15% (a vertical rise bf I0'4e�'t'dv*er4
horizontal distance of 66-feet). C
C,
.,; 1E., IVED
Hilly: slopes present on site of vwie than 15% and less than 30% a vertical rise . * - .
of 10-feet over a horizontal distance of 33 to 66-feet). MAY 3 0 1996
Steep: grades of greate r than 30% present on site (a vertical rise of 104e�i 0%
horizontal -distance of less than 33-feet). -KAMIT COUNTER
Other (please describe):
6. Site containsareas of yea.r-round standing water. -/Vo Approx. Depth:
7
7. Site contains areas of seasonal standing water: "0 Approx. Depth:
What season(s) of the year?
S. Site is in the floodway ^(0 floodplain of a water course.
9. Site contains acreek or an area where water flows across the grounds surface? Flows are year-
round? - ZZC — Flows are seasonal? _ (What time of year?
10. Site is primarily: forested ; meadow ;shrubs ; mixed
.urban. landscaped Oawn,shrubs etc) _Y,,_ .
I I . Obvious wetland is present on site: A/D
For City Staff Use'Only
1. Site is Zoned?
2. SCS mapped soil type(,,%)? Aj&rt�ftA - Ur6,A,, &n& 2 —
3. Wedand inventory or C.A. map indicates wetland present on site?
4;.-. Critical Areas inventory or C.A. map.indicates Critical Area on site? -No
5... 'Site within designated earth subsidence landslide hazard area?
NO
6. Site designated on the Environmentally Sensitive Areas Map?
DETERMINATION
"--STUDY REQUIRED
WAIVER
Reviewed by:_
V Planner
CONDITIONAL WAIVER
Date
Rcv01/M4
W 9 - 19 9 -
City of Edmon&
Critical Areas
Checklist.-,.,
The Critical AreasChecklist 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 sub ' mittal 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,
R
ECEIVED
-79 1996
MAY
COMMUNITY Svivitrzi
and submit it to the City. ne City will
review the cliecklist. make a precursory site
visi4 and make a determination of the ,
subsequent steps necessary to complete a
development permit application.
With a signed copyof this form, the
applicant should also submit a vicinity map
or ploCp-lanfor 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
Street Address
City, State, ZIP Phone
Signature
Date
Applicant Representative:
711v1
Name, , : ': .
14(oq(o IYC- /79-"-
Street Address
Y14 O/A
City, State, ZIP Phone
/,'Signature Date
PLANNING DATA
NAME: V00 964-tr
SITE ADDRESS:—,?15-1 2 -`20" W DATE:
ZONING: PLAN CHK#:— ,9,6 - (00
PROJECT DESCRIPTION: om—
CORNERLOT NO Yes/No)
SETBACKS:
Reg uired Setbacks: -7 t
Front: 2-5' Left Side: 17- Right Side: -7 Rear: 15'
Actual Setbacks: (o
Front- 2- 7 �lz "Left Side: Z 2' Right Side: Rear: 3o- -3-?'
Street map checked for additional setback required? /V. �v, ry., ) (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED N (Y/N)
LOT COVERAGE: (3444(t2z+t(704,D) 1932-
..-= 2-4q
Maximum Allowed: 3 5-f'z Actual: -76 x /IT �0 5,4
BUILDING HEIGHT:
Maximum Allowed: 7- �5 Actual Height:
Datum Point: 5�WL 5 Datum Elevation:
V
SUBDIVISION:
CRITICALAREAS#: C-A -96- 9-7 -
SEPA DETERMINATION: Ar
LOT AREA:
OTHER: �,) �- i. I ��b k �� .1-ft - A;*, , 6 7,A � �-,t -�,- I " .
Plan Review By:
CA FILE NO.
Critical Areas Checklist
Site.Info!r;. ils/topography/hydrology/vegetation)
nation fsd
1. Site Addressfi-ocation: 7-1-S"-17- 90 At')F—i
-k-
Pr�'pe�6 Tax Account Number: _67eQ2-QM-00�,-0n!:A
-2.1
3. Apo iiinate Site Size (acres or square feet): 17) X I
roxt
4. Is this site currently developed? �X_yes; no
If yes; how is site developed? _(�LNCILC- zle_ct
5. Describe the general site topography- ChecOVI thiiapply
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).
Hilly: slopes present on site of in6ie 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 vertiqal 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: /V() Approx. Depth:
7. Site coritains areas of seasonal standing water: "0 "Approx. Depth:
What season(s) of the year?
S. Site is in the floodway Ho floodphim of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? 6L Flows are seasonal? - . (What time of year?
10. Site is primarily: forested ;rneadow —;shrubs mixed
urban. landscaped (lawn,shrubs etc)
11. Obvious wedand is present on site:
For City Staff Use,Only
1. Site is Zoned?
2-. SCS mamed soil (yPe(s)? Alkcwn Lrb,,- L—tty 2 - V
3. Wetland inventory or C-A. map indicates wetland present on site?
4;..%. :-,Critical Areas inventory or C.A. nap indicates Critical Area on site?
5_ within designated earth subsidence landslide hazard area?
6. _"Site designated on the Environmentally Sensitive Areas Map?
DETiRMINATION
--STUDY REOUIRED CONDITrONAL WAIVER
WAIVER
V_
Reviewed by:
Planner Date
RCVOIM4/94
90 - L9-1
City of Edmonds
Critical Ar-e-'as- Checklist.i,
ne Critiml. 4xeasChecklist 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. lie
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,
klidEIVED
'(Wn'— 9 1996
COMMUNITY SrnVwrb
and submit it to the City. The City will . --
review the chedidist, 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 indiv ual lots of the parcel
with enough detail that City staff can find
and identify the subject parcel(s). In
addition, the appficant shall include
other pertinent inforination (eg. site
plan, topography map, etc.) or studies in
conjunction Vith this Checklist to assrLA
staff in completing their preliminary
assessment of the site. .
I have completed the attached Critical Area Checklist and attest that the answersprovided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant: Applicant Representative:
I'll Ve
Name Name
Street Address
City, State, ZIP Phone
Signature
Date
HLE /7c)�
Street Address
City, State, ZIP Phone.
ZSZignature Date
i