21616 80TH AVE W.PDF111111111111
7190
21616 80TH AVE W
ADDRESS: IX)
TAX ACCOUNT/PARCEL NUMBER:*
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS:. (2 1� 1-00 7-00 1-3 DETERMINATION: E] Conditional Waiver 0 Study Required XWalver
DISCRETIONARY PERMIT #'S:
DRAINAGE P LAN DATED: -5/z5/0P
PARKING AGREEMENTS DA
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED: '2-/-7 /0 f/
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHOkT PLAT FILE: LOT:
SIDE SEWER AS BUILT DATED. -
-Z
SIDE SEWER PERMIT(S).#:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DA
LID #:
BLOCK:
LATEMP\DSrs\Fomis\Strcet File Checklist.doc
v ED
-OF EDMONDS
CITY
121 5TH AVENUE NORTH - EDMONDSMA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED .5-/8/2008
Expiration Date: 5/8/2009
Parcel No: 27043000100500
MWITATYOWNER APPLICAN'r CONTRACTOR
EMERALD PACIFIC HOMES INC EMERALD PAC I FIC HOMES, INC' EMERALD PACIFIC HOMES, INC
DOUGLAS EVERETT DOUGLASEVERETT DOUGLAS EVERETT
21611 80T HAVE W 21611 32ND AVE W 21611 32ND AVE W
BRIER, WA 9803'6 BRIER —WA 98036 BRIEI�, WA 98036
425-750-3185 4254150-3185 425-750-3185
LICENSE#:* EMERAP H I 73MK EXP:8 /6/2008-
SFRAND6FTCEDARFENCE
VALUATION:
PERMIT TYPE: Residential
PERMIT GROUP: 64 - Single Family Residence New
GRADING: Y ' CYDS: 411
TYPE OF CONSTRUCTION: VB
RETAINING WALL ROCKERY: N
OCCUPANT_GkOUP� R3
OCCUPANT LOAD:
FENCE: Y ( 6 X. 120 FT:)
CODE.� 2006'
OTHER: N --------- OTHERDESC: A�_ONE:-RS4
NUMBER OF STORIES: 2
VEST ED DAT E:
NUMBER OF DWELLING UNITS: I
EXISTING
AREk
IBASEMENT: 0 1 ST FLOOR: -0 2ND FLOOR: 0_�
PRO POS ED ARE-k
18�5
BASEMENT: 0. IST FLOOR. 2ND FLOOR: 6OLd
13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
3 RD FLOOR: 0 GARAGE: 650 DECK: 172 OTHER- 0
FRONT S LTBACK SIDESEMACK REA.R S L-FBACK
LEQUIRED:,25 PROPOSED..30 I QUIREI)t 7.5,. 'PROPOSED. W FREQUIRED: 15 PROPOSED: 55
MIGHT ALLOWED:25 PROPOSED:24.25 IREQUIRED:.1.1 PROPOSED: 8:
ET.BACK NOTES:
PEKNUTAPPROVAL
I AGREE TO,COMPLY WITHCITYAND StATE LXWS_oRKG 7E kATINGCONSTRUCTIONAND IN DOING THE:WOkK A
UTH(JkJZEb�
THE#BY, 140 PERS`ON,W_ILL BE EMPLOYED IN -VIOLATION OF 'THE LAi6R,qbD'i'OF THE STATE OF WASHINGTON RELAT4N,
qT0
WORKMEN'SCOMPENSATI(���l�'S�R"'�'E-AND'kCW 18:27..
THIS,YPP.,&ATION ISNOT A kRMIT UNTIL SIGNED BY TH&BUILDING'OFFlciAuOg�HISoq0 DEPUTY AND ALL FEESARE PAIII.—
5-t7'
evee-e-l-r- "f_t, —4
S' ure Print Name Date . j0eleasedl By' Dzite
7.
ATTENTION
I U I NLAWFUL TO USE OR OCCUrY A BUILDING ORS . TRUCTUR E UNtIL A NNA L' 1�9PWIi6WHAS BEEN MADE AND;kPPRbVA:L OR ACE RTI . FIC ATEOF
OCCUPANCY HAS BEEN'GRANTED U CIO IBCI 10/ IRCI 10.
STANDARD DETENTION SYSTEM- WORKSHEET
(5000 SF OR LESS)
[TCALC. BY:
ADDRESS: P H EN E!
VVNER- W
APERVIOUS SUFACE AREA IIZ43 L�LE DIA.
FOOTING DRAINS SHALL NOT
RIM ELEV. DETENTION PIPE LENGTH
NISHED
RADE
'IGHTLI
11 MINIMUM
— 0.5% TO 1.0% SLOPE
UPPER CATCH BASIN
NV, ELEV.q,?, 15
CONTROLCB
ORIFICE
2 '1 __7PIPE LENGTI- __3�_340
BE CONNECTED TO
OCKING LID (TYP-)
IM ELEV. /oo.5
6" Min. clearance
FMeasured from top of
Conc. box or riser.
DETENTION SYSTEM
TO CITY CONVEYANCE
" ___' NV�V. q7
E L
I 1___OUTLET
ONTROL
9. 101N. RIFICE
Ion
RIM ELEV.
INV. ELEV 9&.0
2'Y,2'Xl 2" DEEP CONTROL CATCH BASIN
(4'-6- QUARRY SPALLS OR EQUAL) IN. 6" COVER
LCB
FROM CONTRO
T CONTROLCB
RIPRAP OUTLET
SHALL BE PERPENDICULAR
TO SPREADER TRENCH—
PERF. PIPE SHALL BE
LEVEL & CAPPED AT ENDS
NOTES
1
i - .51 N-1
SPREADER TRENCH
TRENCH SHALL BE LINED
WITH MIRAF1 &ON TOP
WASHED DRAIN ROCK
1. CALL ENGINEERING DIVISION (771-0220 EXT. 1326) 24 HOURS IN ADVANCE FOR A TIGHTLINE AND DETENTION
SYSTEM INSPECTION BEFORE BACKFILLING AND FOR FINAL INSPECTIONS.
2. Responsibility for operation and maintenance of drainage systems on private property is the responsibility of the property
owner. Material accumulated in the storage pipe must be flushed out and removed from catch basins to allow proper operation.
The outlet control orifice must be kept open at all times.
CITY STORM
CONVEYANCE
SYSTEM
SPREADERTRENCH
SHALL BE AMIN.
OF 10' LONG AND
PERPENDICULAR
TO CONTROL CB.
45/--5(08
DATE
lw�
I"
*PLANNING DATA
SINGLE FAMILY RESIDENTIAL
0 lr��ET FILE 11
Narne:
Date:
ol
Site Address: (6 9d
Plan Check
f 4"
Project Description:Nmg 5� F12-
Reduced Site Plan Provided: (9/ NO) ning:
Zo_
Map Page: orner Lot: (YES LFlaq Lot: (YES
Critical Areas Determination ff: 0-70'7 5
El Study Required
Wwaiver
SEPA Determination:
�_J/_Exempt U C, V
El Needed (for over 500 Cubic yards of grading)
0 Fee 0 Checklist 0 APO List with notarized form
Requited Sx_-Ibacks
Street: Side: Side.- -7 Rear:
Actual Setbacks
Street: 30 Side: 10 Sid e
Detached Structures:
Rockeries:
19-Fences/Trellises: 6 t -5
Bay Windows/ Projecting Modulation:
&XStairs/Deck: ?_ covqJ-e of- i�e c I'-- Q7
Ht Hei
ght
Datum Daturn Elevation: /0
Maximum Height Allowed: Actual Height: vs- r
Other
Parking Required: 2—
Parking Provided: _371-
Lot Area: 'I
I I O's- �
Maximum Lot Coverage: 35% Proposed:
Lot Coverage Calculations: c-,r OL �e_
ADU Created: (YES
Subdivision: /VO
Legal Nonconforming Land Use Determination Issued: (YES / 0
I Comments
r4c if kA— cu( c S
A— fol-53 - N
qo 445F hVJ.
to ?" ?-,o F_7 Iq --� 10 1 -
C_ (.00.6-7
b- to 1. 5- --�- i s- z6 6
Plan Review By:
PWnftkq Data f-brm 04 -if �06.doc
#P20
Critical Areas Checklist
Site Informaflon (soils/topogr�phy/hydrology/veg�tation
1. - Site AddiresslLocation: 216 1& 90 4 #� ZI
CA File No: LAA UDI a) -75
2. Property Tax Account Number. o:2 A) Vd h6l - ooS- A9
3. Approximate Site Size (acres or square feety- (2. C'. F
4. Is this site currently developed?
yes; — no.
Aaoc
If yes; how is site developed? 611 -e C/)
5. Describe the general site topography. Check all that apply.
Flat less than 5-feet elevation change over entire site.
RolhW. 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 more than 15% and less than 30% (a vertical,rise of 1(Meet
over a horizorttal 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. Approx- Depth,
7 Site contairLs areas of seasonal standing water: Approx- Depth:
What 6eason(s) of the year?
8. 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-rourid?
Flows are seasoxW7 (What fime of year?
10. Site is primarily. forested -;meadow shrubs mixed
urban landscaped (lawn, shrubs �tc)
.11. Obvious wetland is present on site:
ior city staff use dilly — - - -
1. Plan Check Numb� if li&ble?
alp
I Site is Zoned.
3. scs mapped soil type(s)? S-Alkwood I&d ror406 F 010
4. Critical Areas inventory or C.A. nap indicates Critical Area on site?
0
5. Site widiin designated earth subsidence landslide hazard area?
DETERNUNATION
MRED WAIVER
40 #P20
0IDT' City of Edmo'nds
Development Services Department
Planning Division
Phone: 425.771.0220
0 Fax: 425.771.021-1
,4". IS9 I
The Critical Ar= 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
-histher submittal of the application to the City.
The purpose of -the Checklist is to enable City staff to
determine whether any potential Critical Areas are, or
may bei present on the sulJject property. The information
needed to complete the Checklist should be easily
available from observations of the site or data available at
City MI (Critical areas inventorim maps, iDr soil
surveys).
0
atelleceived: '?11WU T-
I
Deity Rece�pt#.
Critical Areas File#;
Critical Areas Checklist Fee: $135.00
Date Mailed to Applicant
A property owner, or. Ms4xr authorized'representative,
must fill out the checklist, sign and date it, and submit it
to the City. Ile City will.review the checklist, make a
precursory site visit, and make a determination of the
subsequat steps necessary to complete a development
permit application.
Mease submit a vicinity map, along with the sWied copy
of this form to assist City staff in finding and locating the
specific piece of property described on this fom. In
addition, thc applicant shall include other perdnent
information (c-g- site plan, topography map, etc.) or
studies in- coqJunction with this Checklist to assist� staff
in completing dicir preliminary assessrnent of the site.
The undersigned applicant, and his/her/its heirs, and assigns,- in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of -Edmonds haiinless ftoin any and all damages, including reasonable
attorney"s fees, arising from any action or infiaction based in whole or part upon false, misleading, inaccurate or
incomplete information furnished by the applicant, his/herhts agents or employees.
By my signature, I certify that the inforination and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file t1ds applicatim on the belwf of the owner as listed below.
SIGNATURE OF APPUCANTIAGENT r4-rr� #/74-t� DATE Z - 2Y—,o 7
PropeNy Owner's Authorization I -
BY my signaturc, I certify that I have authori zed theabove Applicant/Agient W apply for the subject land use application,
and grant my permission for the public officials and die staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting.attendant to this application.
A,
"0
SIGNATURE OF OWNER ivjMM"1%'0ArY W�" e - DATE__J-21—e7__
—A MA
V
Owner/Applicant:
1q, nI,-,I CA ip il.
Name
t�& r Wq Y
-StreetAddi=s Y
ewe-
Z
.a03
City ZI State zip
TeleDhone: -Tl- �4'
Em. I address (optional): Z441'11d& azc
lee I
AppHcant Rep w7tative;
'n'q W, 7 e
Name - - - '
Z//
Sb-w Address
&r J—
city State Z�p
Telephone:_
Email Address (optional): -?,///I r- I
ee
NOTICE:
No warranty of accuracy.
The information'shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of Edmonds does not warrant the
accuracy of anything set forth o,n these
map(�_). Any person or entity -req uesting a
copy should conduct an independent
regarding the information shown on
fh-e -map(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may, not exist and may
or may not -exist at the location shown.
Neither the City of Edmonds nor its
employees or officers shall be liab-le for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
APPLICATION
The City of Edmonds for
EASEMENT NO. .......... . I ...... ...
SIDE SEWER PERMIT
E2> NEW CONSTRUCTION REPAIRS LID NO . .................. ASMT. NO.
OWNER .... ......
. ....... ------- ---------------------------------------------------- CONTRACTOR ............ ............................................... PERMIT NO.
JOB ADDRESS --- - --- LEGAL DESCRIPTION: LOT NO - ------------------ .............. BLOCK NO . ................ ---------------
.... ..... .. . . ... ... --------- ------- --------- --------- ....
it
NAME OF ADDITION ..........
.......................................................................... ..................
OE;�---- By
_M F7
CATrYP"OF EMU, NSIMP"W911D,
�t� E *6 R W.-MMOUT
tv
P
z
(Call, 7.75.-,22525 Jor iside.-:se'�'v'er' insp�Fil` RE! -Cov'erin' ahy.poi4Iotn.*.6f.! !he; :const�uctlon N,
9.
�,ns!. �EFO
Inspection', *will* bei providedl.within,,2i ;h`ouis..�fter reclust; 'NO�:S . S .;:',Or holiday insp
ections*
0
"6Cxn0iv" -CONSTRU
&S'yt OF CTION.: ... N
. .................
74
7:-
-�PROPERTY4!,�L�'ECVA%L,,-DESCRIF�TlijN.: ....... .........
..................................... ............................................
..............
..............................................................
.......... ........................ ... ..... .......................
................................... `-DEP...�'_ ...... A,
....... bWNER, 1A
AN,D/0XBU,1U ............................................... ....
...........................
V
-ICONTlffCTOR',Sllj��-F,,.&,A-DDRESS ..... ............
...... ..... ... .. ..... .. . A ...... t 11!� .............................
ed ....... ........ ....... .......... ........... f6r.'repair,,ana�or�,,conri6etliiii, c;f,'& side 4
SeWerAo :th&, ei '. -
b�6bdid"a'n'c'-e',-'w�ithl(City.�-'6f"kdrwonds-ordinELnees' ty� isaffit se:Wev
�LEDI T01-THE' FOLLOWING:
-1—V�ei o,�nir�: of -thepropert�, may, obtain
a:. permit -to. coinstr�ct:,sewer.,..�njktde�pFo�.er��,:�iffe�.-,�'A�.licen4ed,, Sid e,.Se %4r� Con tractor,.�must,,be.�jeiiii)ioied��t6-,*�co�it-rtib�k.
sidet;s6;A,.er�i�ligtreet'�,�,rea.,...Do not! cov I ;.. . " - 1 .1 .. I
er any portion of sewer. bef6re, It � has' been inspected�'
NO M in,',elty rtght-of-wiy reiiuires' *an Invasion of',Rlrht '&-Wa�.'PermiC obt�alh
abie, the. City Englneer's;.�f
flee,
-NOTE'No-' '�l�-C;�ta'th,:f6lit,inforiniti6n; m ie'giirdi'ng,,6rdlnince.-' 14. 16.0301 and, -Regulations Sgoverning...dide'-seweril,�h��� you.ge&.pernit.
NOTE:.No� A Top�.of�'gild�,'sewer must, have at least 30 inches, cojeragi"kt; p &.42t,irichei*. Insideopr6perty 'line;, minimum-,-graAe,of;,2 -rfd'g,'in,,!gr a'
alia;rperthim 'A wilD.be:�erffiittedt pro erty line.&n
tler of: street �restored -to, originali,conditiom,' �es�onsl6le e r,.
T eni
NOM, N� r ches,An,�street 'must. -be�wa
work, wfiI6fi.'mw*vcIop; within-., one 'year of'.compi'etion.
t
epi;td�.
sewer or-jt`j� ppurtenances,�exc
is, uniawfulAo. alter,orr do �aji� o her work than is -provided, for In thekpermjV, or'.to,,doi-an y.�,wo�k'on the main
�sertthe'.plpe, Into'the, 1�yet
r
Idat
e. ........ .............. * .... ........... ......
J�IS"PRQVVED' ]�,alt ........... ................
.. ......... .
........ ............. . BY ......... ! .... ................... ......................................................................
APPROVED., --E]! �,Date:: .... 14*__-4�-1 75.
..................................................... ......... ............... ........
........... ................... ....... ......... ............................
..........................
............... .................... ........
................. ........... ................................... . ..... .
...... ..... ......... ... .......
. .........
qwnerr ricif, Firm e, onning;, t Fdr lnspedi*�
6E'8� PR16k,'To Re4uest n
�B6-�Sikhedi:B P` Coilg ru
__y
. . ... ... ..... .. .. ........... .... hpreby- �cer�ifyj�that, thekside,,sew
...... .. er installatidn.,constr-.uc�t-ed-.,tndi�--
�Perforniini'�bon. ructlon-)�,
w .�l �Coii c ng'-Fiis
h ovehiink. Ordinancegl` 'lie-
�jn, a !Of..t ),City -Of*Edin'0fidS:,
............
...............
49�
Gas I E], Se%ve'r' -'.Other-
Ch6ek,BEV0RE.,You,,d1k,for. Water
The City of Edmonds
APPILICATION
for EASEMENT NO - ------------------
SIDE SEWER PERMIT
NEW. CONSTRUCTION Qf REPAIRS LID NO. A .'NO. -* - ---------
OWNER
...........................
JOB ADDRESS ------ ;fe� A-'�
- ------------------------------
CONTRACTOR -- - --------- - -----
... �2� ------------------------- - -- ..... PERMIT NO. -S24-4
LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
......................................................... -------------------------------------------------------------------------- ----------------------------
NAME OF ADDITION tiff
a -2 KRA(k. Y F W 14 es Cox
,aF SRIV S-,w6 ThclvcF- 41v, eFsojo 481ptv
U T# r4wv) 1,
r7 XNCO w AvXFllCl- 7*p 1;�,c N A Al, ar
F7711,FNCA5 tY 1�90V-fh'k 19-1- rd 1�r'C 115 41y, 60rgArll- S*e011-
M�e -0, 0.4- A15 X'CO�Pr ?* A-5 N / 70 *.-7Z OX404�-
j-/, 7e 7L-5 7-4,c N iN 7e
04
f
I
Approved: I
RECEIVED
JUN 10 1975
DATE--------------- - --------------------------- By
*I*
Date Februar.y 7. 1974 —
Memo to: Director of Maintenance & Operation
Public Works
From: City Engineer
Subject: Sewer Connection Charges
Legal Description:
Beginning at the NE corner, SW -1-4, NE �4-, Sec. 30, T 27 N, R 4E;
th S 251.78 ft.; th W .135.20 ft.; th N 251.78 ft.; th.E to POB
LESS N 170 ft.
Commonly known as: 21616 80th Avenue W. Owner: Ernst Schuller
Z.F.F. Calculation:
83.85 Z.F.F. x 7.50 Connection Fee
Lateral x $ -0- Lateral Charge
Unit x $ 25 25.00 Trunk Charge
-In-oo Permit
t 663 88 TOTAL
cc: Ernst Schuller
.0, Vtl
FILE
0
Memo to: Director of Maintenance & Operation
Public Works
From: City Engineer
Subject: Sewer Connection'Charges
Legal Description:
Date February 7. 1974
Beginning at the ME corner, SW k, ME 4, Sec. 30, T 27 N, R 4E;
th S 251.78 ft.; th W 135.20 ft.; th N 251.78 ft.; th E to POB
LESS N 170 ft.
Commonly known as: 21616 80th Avenue W. Owner: Ernst Schuller
Z.F.F. Calculation:
83.85 Z.F.F. x 7.50
Lateral x
Unit x 25
cc: Ernst Schuller
7 7 f-
$ 628.88 Connection Fee
$ -0- Lateral Charge
S 25.00 -Trunk Charge
$ 10.00 Permit
$ 663.198 TOTAL
Ce Xx_
a a -acl --wylti�-L
88,29
erti ��; E��
'r .1 1
2 *--1 *s
0 '20 G-L -L--z4 -Z
H -(. Im tf-i- S -a Pf-.�
a '/y cz -L 'o >as N -a- 5) -:g 2.
-7 i6fcP a-7
Is <3 N 0 WC23
2 _--9 -7 -7 ti .7:;) -a
-Z 61 *(3'-Z -7 M Z -Lorq- A-LV-CR440244:4
Rocklined overflow
— 6" Freeboard
3"CoarseWoodchp
N I min Bottom Wd1h — Pondir@ De, pw comp
lulch Above Varies (See Note 1) _�jcteq Berm
Ponded Area
I . , ty I
.3-i
1!e'fjjZ; Depth Varies
(See Notes 2 & 3)
Rain Garden
Bottom
Z, Compost Mulch
In Ponding Area
--ND- Piped Overflow
CFWH MWEN.
Notes: CMGFEDHOM
1. Ponding depth shall be as specified in Table 5 (6" or 12").
2. Bioretention soil depth shall be a minimum of 12' for flow
control and a minimum of 16* for water quality treatment
..A
3. Scarify subgrade 3" min before bioretention.soil installation.
4. Size to convey design overflow.
r4 igure A-2. Typical bioretention (rain garden),
-12-
C -1 E 00
14 2 U 13
DEVELOPMENT SERMES C113.
CITY OF EDMONDS
Al 7A
%-., N..F -A. .A. A. .& JL V -&-A v v &" %-I, &.
OWNER/CONTRAOTOR IS Rr':SPOjqSlBLE FOR
EROSION CONTROL AND DRAINAGE
EXISTING HOUSE W1 EAVE
EX15ITNG DRIVEWAY: 990
EX15TINGWALK: 1305Q. F
EX15TING PATIO: 216 5Q. F
5TING IMPERVIC
riON/COVERE0
EKVIOU5: 5722
'ALCULATION
101.45'
DE: 101.43'
17.85'
3HT.- 12ro.43
3057 5(2. FT (Zfoj�)
�. FT.
)5: 4593!5Q.FT---)- wkoior�
ECK W EAVES: 1329 5Q. FT
Q. FT.
z
<
�T4 0)
Lu
z
z
11,057 5Q. FT.
COVERAGE: 3,6(39.(ao
cq
LOT COVERAGE
3,699.50 (53%)
0
Lu Q
.
FE: 3% E-W
<
-EL NUM13ER:
30100500
viARK:
0 z
'13 GRATE
a
0
RIPEN:
)U5 1329 5Q.FT.
X 51ZING
%— :2
cq C:,
3.2% = 82.4 5Q.1
FT.
Lu
,�S-t Comer
14_Fla&j-j-
4.21.13
5 Recluired
Actual
30
REVISIONS:
//.I
--7 :Z
.
X. -7 'S-/ i3O
6.23.13
9�A
UB
JUL - 9 2013
PRINTED:
BUILDING DEPARTMENT
CITY OF EDMONDS
6.23.13
a a,
� W�
BEE . I HLt
SCALE: 1" = 20'-0"
STREETF
PLANNINGDATA
SINGLE FAMILY RESIDENTIAL
Name: 15�
Date: 0,
Site Address:
TaxParcel
Project Description:
Plan Check #:
BL-Wot36I5 t S
Reduced Site Plan Provideq: NO)
Zoning: F
Map Page:
Corner Lot: (YES CN:b)
Flag Lot: (YES /(ND�
Critical Areas Determination#! (M8100700-75
11 Study Required
N�Waiver
SEPA Determination:
�Y'Exempt
Needed (for over 500 cubic yards of grading)
El Fee 0 Checklist F-1 APO List with notarized form
Required Setbacks
Street:
Ts:l*: -7
Side:
1 Is
Rear:
1
Actual Setbacks
Street:
So
Side: -7
I
Side: ]-�ear:
El Detached structures:
El Rockeries:
a'Fences/Trellises:
Bay Windows/Projecting Modulation:
El Stairs/Deck:
Suildin Height
Datum Point:
Datum Elevation: L) L)
Maximum Height Allowed: Lt-3
Actual Height:
Other
Parking Required: -)o
Parking Provided:
Lot Area:
Maximum Lot Coverage: 35% Proposed:
Lot Coverage Calculations: 36?
ADU Created: NO)
Rf'o �0—s �5 L)
J
Subdivision:
Legal Nonconforming Land Use Determination Issued: (YES
Comments
Plan Review By: Kr Vi-M-1-
Plan6lng Data Form CY7-1+09.doc
PLANNINGDATA
!LLEJI
Plan Review By: Planning Data Form 07-14-09.doc
OV ED
-41
CITY 0 EDMONDS
17- 121 5TH AVENUE NORTH - EDMONDS,WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221 -
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20080178
SIDE SEWER PERMIT (I -Single Family)
Permit Number: ENG20080178 Expiration Date: 5/20/2009
Job Address: 21616 80TH AVE W, EDMONDS
APPLICANT CONTRACTOR
Emerald Pacific Homes EMERAL PACIFIC HOMES INC
21611 - 32 Ave W 21611 32ND AVE W
Brier, Wa 98036
BRIER, WA 98036
425-750-3185
LICENSE #: EMERALPH173MK EXP: 8/6/2008
-qREPAIR
NCRINDERPUMP
.JOB DESCRIPTION
N I PROPOSE TO REUSE 1ATERAL LID NUMBER
F-N I PROPOSE TO REUSE SIDE SEWER
Install SS SFR
•
•
LkSENIENTINFOICNIATION
PRO= CROSSES OTHER PRIVATE PROPERTY
VERIFICATION OF RECORDED EASEMENTS COMPLETE
IADEMAVTY- The Applicant has signed an application which states helshe holds the City ofEdmonds harmlessfrom injuries,
damages or claims ofany kind or description whatsoever, foreseen or unforeseen, that may be made against the City ofEdmonds or
any ofits departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and
attorneyfees by reason ofgranting this permit.
CALL DIAIL�A-DIG (1-800424-5555) BEFORE ANY EKCAVATION
CALL FOR INS PECTION (425) 771-0220 EXT. 1326
24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS
THIS APPLICATION IS NOTAPERNHTUNTIL SIGNED BY THE CITY ENGINEER OR HISMER DEPUTY: AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED IN
SPACE PROVIDED.
Printed: Tuesday, May 20, 2008
0- �11111111111'1'111n
F-1 FILECOPY INSPUCTORCOPY 0. APPLICANT COPY
STATUS: ISSUED
ENG20080178
• Refer to City of Edmonds Side Sewer Information handout for approved pipe materials, inspections and other requirements.
• A 6" cleanout with 12" locking cast iron lamphole cover is required at the property line.
• Maintain 19 separation between the sanitary side sewer and the water service line.
• Applicant shall repair/replac6 all damage to utilities or frontage improvements in City right-of-way per City standards that is
caused by or occurs during the pertnitted project.
• E-Sanitary Side Sewer Inspection
• E-Engineering Final
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE- INITIAL: