21525 98TH AVE W.PDFiiiiiiiiiiii
9651
21525 98TH AVE W
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NOTICE:*
..Wa r-r a n t. y...
for . matlon*shown on the ktached
The in
map(s) was cOm ' piled for u-se by the UtY 01
mpl.oyees and Consultants.
Edmonds/ its E nt the
Th,..e City of does * not warra
set forth on these
accuracy of anything
M a P (s). A n . V person or entity -requesting a
copy should conduct an independent
inquiry regarding the infbrmatlon shown,c
t Fi-�� -m a p (s), including, but not Jimited to,
n of any sewer stub shown, Su(
the lociatio
sewer stubs may or may- not exist and ma�,
or may not exist at the location shown.
Neit-heir the -ity of Edrnbnds nor its
em p'-o-yee*s O*r off i-cers -sh-a-1.1 be 1--ji a-b-Ife for th
inforrnation given On this Map(5)) nor for
any one representation provided based
upon'said map(s).
APPLICATION
SIM= f for
The City of Edmonds SIDE SEWER PERNaT
NEW CONSTRUCTION [:] REPAIRS C] EASEMENT No . ..........................................
109-07200
OWNER ........... &E. Goldman
........................................................................ .................... CONTRACTOR .................................................................................................. PERMIT No . ......................
ADDRESS ....... 21.525 .. m-9.8th --- Ave.-W . .............................................. LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
0
NAME OF ADDITION
Dye Tested On Sewer 1972
Approved:
DATE................................................ By ......................................................................
m
--L -77
2/1
2
Luhc�j
-11 T -T FILE
Er Er- , ,
RECEIVED
AP"% A fl- 13
vj 4 t.-
DEVELOPMENT S:RVICES CTR.
CITY OF ENONDS
Is
'�l
m
RECEIVED
0 CT U 5 2000
BUILDING DEPT.
FILE
+ z I ""
ATE RECEIVED
27-
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
)r�� -
6r;�j aitid'Ale-lelle.
MAILING ADDRESS
'rOA!97
CITY zip TELEPHONE
r-r-WInn-k-15 mew I 111?S1--7W-09`Vej
NAME
ADDRESS
CITY ZIP
TELEPHONE
NAME
kiwl sa-,5- i--r e #
ADDRESS
CITY ZIP
TELEPHONE
jyo 2,
STATE LICENSE NUMBER
EXPIRATION DATE
CI-156�ED k,
14 1,576)
(619
7ROPERTY TAX ACCOUNT PARCEL NO.
NEW RESIDENTIAL
PLUMBING / MECH
ADDITION Ej 'COMMERCIAL
COMPLIANCE OR
CHANGE OF USE
REMODEL APARTMENT
SIGN
0 REPAIR GRADING CY S C] FENCE X
D ( FT)
DEMOLISH TANK
OTHER
GARAGE R E . TAINING WALL� C] RENEWAL
CARPORT ROCKERY
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
NUMBER
NUMBEROF
CRITICAL K/O
OF
STORIES
DWELLING
UNITS
AREAS
NUMBER IWO-37
DESCRIBE WORK TO BE DONE
-6
PERMIT EXPIRES
USE PERMIT
A b�,D
ZONE
NUMBER
VU02,�48
JOB
ADDRESS
200347
PLAT NAME/SUBDIVISION NO.
LOT NO.
LID NO.
I
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved 0
RW PannIt Required 0
Street Use Pennit Req'd 0
EXISTING — PROPOSED
Inspection Required 0
Sidewalk Required 0
REQUIRED DEDICATION FT
Underground
wiring required CL
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV-REQUIRED
�r
YES 0 NO 0
0
3
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REMARKS
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OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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FRONT UR SIDE REAR
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CHECKEDBY ITYPE ONSTRUDN I Cjg,_ OCCUPANT Oz—]
Ulm GROUP
SPECIAL, INSPECTOR JAREA OCCUPANT
REQUIRED [] YES LOAD
REMARKS
PROGRESS INSPECTIONS PER LIBC 108/FINAL INSPECTION REO'D 0
.ree 1,011'e-7
A4-
VALUATION I I FEE
PLAN CHECK FEE
HEAT SOURCE GLAZING % LOT SLOPE %
BUILDING
PLAN CHECK NO: VESTED DATE
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC
GRADING/FILL
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
r-1
'75
SURCHARGE
cc PERMIT APPLICATION: 180 DAYS
Uj
PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG,,.REVIEW FEES
AEE BACK OF PINK PERMIT FOR.MORE INFORMATION —
ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
ENG. INSPECTION FEE
U.1 IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
i
LANDSCAPING
2 EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
INSPECTION FEE
cc ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM 'THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
RECEIPT
PLAN CHECK DEPOSIT
-j DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
01 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
x
R CE177
TOTAL AMOUNT DUE
I O-D
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
This application is. n I ot a permit until signed by the
CALL:
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
B ' uilding
Official or his/her Deputy: and Fees are paid. and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
receipt is acknowledged in space provided.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
OFFIC
URE JbATE
SIGNATURE (OWNER ORAGENT) DATE SIGNED
(425)
;W
771-0220
-Alllo
VEL
DATE
ATTENTION
EXT 333
W
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
1,� L-
771-02
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
e;�
ORIGINAL - FILER YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC.SECTION 109
C__
FAX
PINK - OWNE GOLD - ASSESSOR
5/98
V:.
,ATE RECEIVED
436()
FPERMIT /o/3 6o
EXP RES
CITY OF. EDMONDS
USE PERMIT
ZONE l?-oQzqs
NUMBER,
CONSTRUCTION PERMIT APPLICATION
JOB SUITE/APT#
ADDRESS
OWNER NAMEINAME OF BUSINESS .
PLAT NAME/SUBDIVISION NO.
LOT NO.
LID NO.
Ai4elle tUJ7_CM-5A0,,ddt
LID FEE $
Cc
MAILING ADDRESS
uj
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0
PUBLIC�'RIGHT OF WAX PER OFFICIAL STREET MAP
TESCP Apprwed 0
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EXISTING'— PROPOSED
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Inspection Required 0
Sidewalk Required 0
Z,P2
TELEPHONE
ffe 0 ]
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.
REQUIRED DEDICATION— FT
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Underground
Wiring required 0
NAME.
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
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YES 0 NO 13
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ADDRESS
REMARKS
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OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
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FIRE REVIEWED DATE
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CITY ZIP
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0
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POSTED
STATE LICENSE NUMBER.. EXPIRATION DATE
CHECKED BY
[3 �ES 0 NO
SEPA REVIEW
SIGN AREA
HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO.
COMPLETE EXEMPT
ALLOWED PROPOSED
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EXP
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FRONT UR SIDE REAR
PROPOSED
0
ADDITION 0 COMMERCIAL COMPLIAN CEOR
z
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CHANGE OF USE
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REO'D PROVIDED
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PLANNING REVIEW ED BY DATE
C] REMODEL E] APARTME,,�T SIGN
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REMARKS
DEMOLISH TANK OTHER
GARAGE R -WALL 0 RENEWAL
CARPORTi,L,. iT
A E, A I EN RIN Q
CK
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(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
CHECKED BY
TYPE OF,2"&TRUCTION
E OCCUPANT
GROUP
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NUMBER
NUMBER OF
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SPECIAL INSPECTOR
OCCUPANT:
13
OF
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A
0
STORIES
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N —146i�
REQUIRED (3 YES
JAREA
LOAD
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REMARKS
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F
'Pi to) Aj
in 1. e,
-44 3 0 0 zz)(L
VALUATION
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MECHANICAL
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE P UBLIC
GRADING/FILL,.
DOMAIN L(CURBS, SIDEWALKS, DRIVEWAYS, MARQUEE$, ETC.) W ILL REQUIRE
SEPARATE PERMISSION.
CHARGE
Ui PERMIT APPLICATION: ISO DAYS!
0. PERMIT LIMIT* I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
0 *APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS ENG. INSPECTION FEE
U)
Uj IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING
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2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND INSPECTION FEE
cc
< ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
RECEIPT
x FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENTOF ANY CITY ORDINANCE
-i
01 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. RECEIPT
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRLIC_ CALL This application is not a permit until signsid by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building Officiajior his/her Deputy: and Fees are paid. and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipjA acknowledged in space provided.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
OFFICIALLS S TE
SIGNATURE (OWNER OR Gp� DATE SIGNED (425)
.,q- 3 771 -Q220
REiJK-S FDRY DAA
ATTENTION EXT 333
IT IS UNLAWFUL TO USE OR OCCUP�Y' A BUILDING OR STRUCTURE UNTIL 1
771-0221
A FINAL INSPECTION HAS BEEN MRIDE AND APPROVAL OR A CERTIFI-
ORIGINAL-FILE YELLOW -INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR
FAX
5/98
AEJ�AT E RECEIVED
EXPIR lba 4,
S
:�PERMIT
'CITY.
USE -PER MI
-ZONE
OFEDIVIONDS
Numath
JOB SUITE/APT#
RE' S
ADD S.
AT N
CONSTRUCTION PERMITAPPLIC 10
OWNER NAME/NAME OF BUSINESS
PLAT NAME/SUBDIVISION NO.,
LOT NO. -
LID NO.'
NIC hELL6'54WI ELL
:L ID FEE $:
LX
U
MAILINGADbRESS
TESCP Ap"1=1
Fb j
P66LIC RIGHT OF WAY PER'OFFICIAL STREET MAP
Rw Permit - .11
Permit Req'd. E)
EXISTING PROPOSED —
Ikepec6n Req6lred (3
Sidew�slk Aequired C)
CITY ZIP
TELEPHONE
REQUIRED DEDICATION FT
Un 9"'*Und
W "d
in.,.q.,r.
METER SIZE
NO.�Of FIXT URES
�RV REQUIRED
C5
YES 13 NO 0
3
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ADDRESS
REMARKS
OWN EPI/CONTRACTOR� RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
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ITY,
ELEPHONE
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VARIANCE
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REQ'D
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DATE
BY
OYES:�ONO
SEPA REVIEW
�SIGNAREA
,,HT
HEIr
PROPERTY TAX ACCOUNT PARCEL NO.
COMPLETE EXEMPT
ALLOWED' PROPOSED
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0
EXP
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0
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COMPLIANCE OR
ADDITION,,,, COMMERCIAL CHANGE OF USE
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REQ'D. OVIDED
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REPAIR GRADING FENCE
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PARAGE RETAINING WALL
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PIOCKEhY. R1
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(TYPE OF USE. BPNESS OR ACTIVITY) EXPLAIN:
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RITICXL(waw
ui
*b"
tEEQ�9UI1&RLEfDkS:ft
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0
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STORI
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UNITS.'
AREAS
N UMBER
DESCRIBIEWORK TO BEIDONE
REMARKS
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C,
PROGRESS"INSPECTIONS, PER UB OWFINALINSPECT11ON REO'D
70
.Il,1, Sit:
do 1-6 1&
61
C).
aL UATIOJ '>41"'
..........
FEE
PLAN CHECK FEE
HEAT SOURCE' GLAZING % . LOT SLOP E %
BUILDING
0
CHECK NO: VESTED DATE PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PIERMIT'COVERS WOR K TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MA GRADING/FILL
RQUEES, ETC.) WILL REQUIRE
SEPARATE. PERMISSION.
STATE SURCHARGE
ui 11 PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT* I YEAR.- PROVIDED WORK IS StARTED WITHIN 180 DAYS ENG.;REWEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
U) NG. INSPECTION .FE.E,L'
(A 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, iEIRS, ASSIGNS AND SUCCEs6RS I E
.
ul IN INTEREST, AGREES INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON; ITS OFFICIALS, EMPLOYEES, AND AGENTS�FRQM ANY AND A
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURiE,jARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF T IS PERMIT SHALL NOT 13E F�CE
H PLANVECK.DEPPSIT
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQU'!REME'NTOF ANY CITY ORDINANCE 4�:? 7
01 NOR LIMIT ItNANY WAY�.'THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROO-01'.
RECEIPT
TOTAL AMOUNT DUE
I HEREBY.ACKNOWLEDGE THATI.HAVE READ THIS APPLICATION; THAT THEINFORMATION APPLICATION APPROVAL
GIVEN ISCORRECf, AND THAT I
AM THE OWNER, OR ITHE DULY AUTHORIZED AGENTOF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE'LAWS REGULATING CONSTRUC-. This'application is not a permit I until slined by th G
CALL I
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Buildi ng Official or his/her Deputy: and. Fees are paid. and
IN VIOLATION OF THE LABOR CODE OF THE SfATEOF WASHINGTON RELATING TO: FOR jNSP�ECTION �aceiptisacknow dgedin space provided:
WORKMEN'S CO ENSATION INSURANCE AND RCW 19.27.' A
t6FPl S SIGNATURE DATE
SI If WINER
G A
PA -TIU
G�� DATE SIGNED (4251
_.R
IT 10, .3 771-0220 4
RELEASItID BY DATE .
7.
ATTENTION EXT)333
6phio
4T IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 4",
771-0221 oa�
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIF - . 4
: , : . ORIGINAL - FILE - YELLOW - INSPECTOR
�0'�CATE OF OCCUPANCY HAS'BEEN GRANTED. UBC SECTION 109 /
FAX .
L I PINK - OWNER - GOLD - ASSESSOR
5/98 I
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
72'7w-;, /",tw
MAILING ADDRESS
11�1_,
CITY ZIP TELEPHONE
1;0,�23_- 7'1'1 6`101
NA
ADDRESS
CITY ZIP TELEPHONE
NAME
ADDRESS
CITY ZIP TELEPHONE
STATE LICENSE NUMBER EXPIRATION DATE -T—CHECKED BY
PROPERTY TAX. ACCOUNT PARCEL NO.
2 1'2-703
0
S�� -0606
NEW
RESIDENTIAL
0,
PLUMBING I MECH
ADDITION
COMMERCIAL
ci
COMPLIANCE OR
CHANGE OF USE
F1 REMODEL
Ej
APARTMENT
SIGN
REPAIR
Cj
GRADING
CYDS
C3
FENCE
( X FT)
DEMOLISH
TANK
OTHER
oGARAGE
CARPORT
ROETAINING WALL
R CKERY
RENEWAL
PERMIT EXPIRES -
USE PERMIT low
ZONE NUMBER
JOB
ADDRESS
SUITE/APT#
PLAT NAME/SUBDI VISION NO.
LOT NO.
LID NO.
LID FEE $
TESCP A0proved 0
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
RW Per.1t Required 0
Street Use Permit Req'd (3
EXISTING — PROPOSED
inspection Required 0
Sidewalk Required 0
REQUIRED DEDICATION— FT
Underground!
wifint; requaea 0
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
I
YES 0 NO 0
REMARKS.
z
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
ENGINEERING REVIEWED/DATE
FIRE REVIEWED BY DATE
ui
LL
VARIANCE OR CU
SHORELINE OR ADB#
INSPECTION
OND
5EO'D
PB
OSTED
(:)YES [3 NO
SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWED PROPOSED
EXP
LOT COVERAGE
REQUIRED SETBACKS (FT.).
PROPOSED SETBACKS IFT)
ALLOWED PROPOSED
FRONT SIDE' REAR
FRONT UR SIDE REAR
z
z
PARKING LOT AREA
PLANNING REVIEWED BY DATE
REO'D I PROVIDED
I
(T�YPE OF -USE. BUSINESS OR ACTIVITY) EXPLAIN
CHECKED BY
I TYPt &'CO"t 06T ON
C
OCCUPAJ�
GROUP
NUMBER
NUMBEROF
CRITICAL (�W,4jyeX)
OF &
DWELLING
AREA
SR R000-37
SPECIAL INSPECTOR
REQUIRED
AREA
OCCUPANT
LOAD
STORIES
UNITS
NUMBE
C:] YES
DESCRIBE WORK TO BE DONE
REMARKS a
z
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RECI'D 5
D
n A
VALUATION I * FEE
PLAN CHECK FEE
HYAT�OUR GLAZING % LOT E.N.
BUILDING
PLAN CHECK NO: VESTED DATE
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADING/FILL
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
PERMISSION.
STATE SURCHARGE
Uj PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
"APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
- tpficae*,�
w IWINTEREST, AGREES oTd` INDEMNIFY, DEFEND AND HOLD HARMLESS THE Cily OF
LANDSCAPIN6,
2 Ebm6NDS,WASHINGTON�,ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
INSPECTION FEE
ALL CL&AIMS FpF.i IJAMAGESbRWHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY,
RECEIPT
FROM THE ISSUANCE OF-THIS'PERMIT., � ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
:OEEMEDT MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
j .. .91
01 NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFOR.CE ANY ORDINANCE PROVISION.-
RECEIPT
TOTAL AMOUNT DUE
"H"EIREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT T HE INFORMATION
GIVEN -IS CORRECT, AND THAT I AM THE OWNER, OR THE DULVAUTHORIZED AGENT OF
THF6WNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
1��t'
TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
Buil
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
WORKMEN'S C91v &%G,1IlTION INSURANCE AND RCW 18.27.-
..OFFI(
DATE �IGNED
(425)SIGNATURE
I oy-OA 0
771-0220
?7
LE
A17ENTION
EXT1333
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
5/98
APPLICATION APPROVAL
This application is not a permit until signed 1:ry the
Jing Official or his/her Deputy: and Fees are paid. and
receipt��ciii�owlqqg!din space provided.
4�1_� S16N��URE'%' DATE
DATE
ORIGINAL -FILE YELLOW- INSPECTOR
PINK -OWNER GOLD -ASSESSOR
CA FILE NO. Cft 7,06
Critical Areas Checklist
---------------- ---------------------------------------------
Site Information (soil s/topogra�hy/hydrology/vegetation)
I. Site Address/ . Location: al-" 5' — 4v-e, 67d-,Prewe6 IX�2,0
2. Property Tax Account Number: 70 3 — I — — eo' 0 &
3. Approximate Site Size (acres or square feet): eZj�� , 75- et-&�W
4. Is this site currently developed? yes; _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.
Rolling: slopes on site generally less than 15% (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
1 0-feet over ahorizontal distance of 3 3 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: A/0 Approx. Depth:
7. Site contains areas of seasonal standing water: NO _; Approx. Depth:
What season(s) of the year?
8. Site is in the floodway IVO floodplain IV49 of a water course.
9. Site contains a c eek or an area where water flows acro s the grounds surface? Flows are year-
round? ro 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: AID
""-Chk-d0q RW IWM/97
City of Edmonds Cz eas
NEW M
1 45 a
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
pen -nit 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 mgp 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 infor m-ation (e.g., site plan, topography
map, etc.) or studies in conjunction with this Checklis't
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).
Owner/Applicant:
'Pul,//, "IL, S4,1,11
Name
Street Address
— anoxw�,-� --
city State Zip
e;oz�tlou; ;;Foy/ -d,1S--23Ar
Telephone
Signature
41V hV
Date
Applicant Representative:
Name
Street Address
city State Zip
Telephone
Signature
Date
execeptionyanakaddoc (over)
�11? C. 189")
March 10, 2000
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering .
Michelle and Tom Sawtell
21525 98" Ave. West
Edmonds, WA 98020
Subject: Determination regarding Critical Areas Checklist # 2000-37
GARY HAAKENSON
MAYOR
Dear Applicant:
Enclosed please find a copy of the Critical Areas Checklist you submitted. The "DETERMINATION" reached by the City
is located on the reverse side of the form (bottom of page).
it is very important for you to retain a copy of this Critical Areas Checklist "DETERMINATION" for your records.
IMPORTANT INFORMATION TO BE NOTED:
PLEASE EXAMINE THIS"DETERMINATION"FORADDIT70NAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMAT70N SUCH AS AN ENVIRONMENTAL CHEVUJar OR CRITICAL AREAS STUDY,
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific. determination.
wo, You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION MTH ALL
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Enc: Critical Areas Determination
* Architectural Design Board
Thank you.
Shada Graham
Planning Secretary
C:ReceptionUana\CRLTR.doc
Incorporated August 11, 1890
Sister Citv - Hekinan. JaDan
ay-11)
A
CITY OF EDMONDS
SINGLE FAMILY ADDITION/REMODEL COVER SHEET
C. 1
PJLe-oLlops. Applicants are to complete the information In the WHITE BOXES ONLY (Shaded boxes are for City use only).
This cover sheet must accompany each building permit application for a sinala-family rpcielantial 0f1#4M^n1rA-1
PLAN CHECK 09-
APPLICANT
D E RECEIVED
AT
PROJECT ADDRESS 2-15 -L -5 Ot 87')A (A�
PROPERTY TAX ACCOUNT PARCEL #
DESCRIPTION OF WORK— Uevj �v v,,jCArTA_T- Ll 18"
OWNER -LCf'Cn 0- PHONE
CONTACT PERSON all— PHONE_
E-MAIL MCk FAX
MAILING ADDRESS VCj 1-3 -T�!-Jmoac-Ac, Lu A -
ElFAX CORRECTIONS MAIL CORRECTIONS E-MAIL CORRECTIONS
BY SIGNING THIS STATEMENT I UNDERSTAND THAT I AM THE CONTACT PERSON FOR THIS PROJECT. IT IS MY RESPONSIBILITY TO
COORDINATE ALL SUBMITTALS WITH THE CITY AND ONLY I CAN MAKE INQUIRIES ON THE STATUS OF THE APPLICATION. I
UNDERSTAND IT IS MY RESPONSIBILITY TO DETERMINE IN ADVANCE OF PERMIT SUBMITTAL ANY DISCRETIONARY PERMITS THAT
MAY BE APPLICABLE TO THIS PROJECT. I ACKNOWLEDGE THAT TO THE BEST OF MY ABILITY I HAVE SUBMITTED ALL NECESSARY
DOCUMENTATIej�IN OIRDER:TPMAKE A COMPLETE APPLICATION AND NO DISCRETIONARY APPROVALS ARE REQUIRED.
SIGNATURE. C DATE
116kiNG ik06AMAt*ibN'
ZONE
LOT,
A4REA
OF DWEL]ONG UNITS
EXISTING
DEMOLISHED
PROPOSED
bISCRttidkAA'y'APP4OVAiL'S'
.. .. w - ''.. . � 11 I....
CA - 7 D e t e r rn I n a t I
o n1,e441V,6FP-- SUBDIVISION CU
VARIANCE SHORELINE SEPA
Expires
OTHER
LOT COVERAGE INFORMATION
EXISTING SF
PROPOSED SF 7
TOTAL SF
HEIGHT CALCULATION INFORMATION
DATUM
'A B
D
AVE
ACTUAL
SETBACK INFORMATION
FRONT
SIDE
SIDE
REAR
PROPOSED. .FRONT
SIDE
SIDE
REAR
S N
. E 0
LA' GUM YES
N*O STJ EDIC,
YES-NO FT.
ADU STATEMENVRE601016
YES
NO
RECORDING
'.STAFF COMM'EN'TS:
L.itempiouiiaingiiorms%Aoa_rvw.vsa -- 7/00
DRI V E WA Y SLOPE % G RA DI NG CY D S EASE'MEN T'S
EXISTING IMPERVIOUS AREA CONSTRUCTED BEFORE 1977
EXISTING IMPERVIOUS AREA INSTALLED 1977 OR LATER
SO.FT
PROPOSED NEW NET IMPERVIOUS SURFACE
SO.FT.
SO.FT.
(City Use Only)
SIDEWALK REO'D []YE,S[:]NO DRAINAGE PLAN REO'D YES NO LID
UNDERGROUND WIRING RE01D
[]YES'[:]
NO STREET DEDICATION
FT.,
STAFF COMMENTS:
BUILDING CONSTRUCTION INFORMAT169'--
CO DE EDIT 10 NS
1997 UBC, UMC, UPC, WSEC, VIAO WITH AMENDMENTS
WIND EXPOSURE 8 WIND SPEED 80 MPH
—&E1MC--Z 0 N E 3
Floor Live Load Roof Snow/Live Load
Balcony Live Load
Floor Dead Load Roof DeadLlo�� Balcony Dead Load —
NUMBER OF STORIES ----'BASEMENTS FLOOD ZONE
LOT SLOPE %
SOILS REPORT PROVIDED YES NO
FLOOR AREA (Measured.to face of exterior wall)
Existing Proposed Total
Living Space
Garage
Carport
Deck/Cov. Porch
Other
(-City Use Onw
Ceiling Insulation Wind ow U-Value .36
.Wall Insulation Sky - light U-Value
FIloor lnsulation:j�- tCl_ Glazing %
Door U-Value Slab Insulation
Eiler= 0 Pres�criptive 0 Syste, ms,
t.0
Whole House Van ea'd Yeis No
Any request for modification, variance or other administrative deviation (herinafter "variance") must be specifically called out
and Identified. Approval of any plat or plan containing provisions which do not comply with the city code and for which a
variance has not been specifically Identified, requested and considered by the appropriate city offical In accordance with the
appropriate provision of city code or state law does not approve any Items not to code specification.