21702 84TH AVE W.PDF111111111111
7926
21702 84TH AVE W
0 V. EDAf
iol
At
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771' * 0220
iqr$ Fax: 425.771.0221.
The Critical Areas Checklist contained on this form is to
be filled out by any person,prep arin a Developm'ent
Permit Application for the City of Edmonds prior to
his/her 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 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).
Date Received: 2:�/c5z -7�'5,
City Receipt#: /
Critical Areas File M
Critical Areas Checklist Fee: $45.00
Date Maile4 to Applicant:
A pr�bperty owner, or his/her authorized representative,
must fill'out - the checklist, sip 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 assistant staff
in completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its heirs, and,ass ' igns, in consideration on the processing of the application agrees
to release, inderrinify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, 'inaccurate or. -
incomplete information furnished by the applicant, his/her/its agents or employees.
By my signature, I certif� that the information and exhibits. herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file this application on the behalf of the owner, as listed below.
SIGNATURE OF APPLICANVAGENT DATE
Property Owner's Authorization.
By'my signature, I certify that I have authorized the above Applic.ant/Agent to �pply for thesubject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application. *-
9,IGNATURE OF OWNER DATE 4ZLA4 Z 0 CI;2—
PLEASE PRINT CLEARLY
Owner/Applicant:
& A16 ree- n otf e,
Name
At 7 0
Street Address
w1n, ax,6
City State Zip
Telephone: 4 -7 -7
Email address (optional):
Applicant Representative:
Name
Street Address
city State Zip
Telephone:
Email Address (optional):
Critical Areas Checklist.doc/3.19.2001
Critical Areas Checklist CAFileNo. 0.,qlr7s
Site Enformatibn (soils/ topography/ hydrology/ vegetation)
1. Site Address/ Location: 2- 17 0 2- — Vq .4 lt/.C4�
2. Property Tax Account Number: 6!� -),�9 50 e�b 10
L
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? yes; no._
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
A 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 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-feet over a horizontal
distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing w Ater: - z2w ; Approx. Depth:
7. Site contains areas of seasonal standing water: eyw Approx. Depth:
What season(s) of the year?
8. Site is in the floodway z6 floodplain erw' of a water course.
9. Site. contains a creek or an area where water flows across the grounds surface? Flows are year-round?
114-0. Flows are seasonal? (What time of year?
S ite is primarily:, forested li-t-V meadow gW shrubs wLo mixed
urban landscaped (lawnshrubs etc) =�j CA,-
67-
11. Obvious wetland is present on site: 7
!t
Y. se: y
4.,
Uffli
I.; "TMh'Ch&- K-N bd
71
PLII�x
2
L e
ytapp.
'ea''on-'s"ite ;�4.
Ar
Nt�i C 0ASJ&6f6 C M
4r6'b�ide"fice"Mki- ;X
5 Site Widiiii d Qe'
/Nd WA V
ER
y Date.
Critical Areas Checklist. doc/3.19.2001
------------------------------- MetroScan
Snohomish : -------------------------
Owner
:Hoffer Noreen
L
RTSQ
:04E27N30 -NW
CoOwner
APN
:27 0430 002 018 00
Site Addr
:21702 84Th Ave
W Edmonds 98026
OldParcel
:3027 042 018 00 05
Mail Addr
:21702 84Th Ave
W Edmonds Wa 98026
Parcel ID
:1003790
Rec Date
:10/01/1985
Deed :Warranty
Structure
$ 8 0, 3 0 0
Price
:$75,000
Loan
Land
$ 8 0, 0 0 0
Aud Fee#
LnAmt
Total
:$160,300
ActualUse
Levy Cd
:00217
Lender
2002 Tax
:$433.18
Vest Type
IntTyp:
Phone
:425-771-4619
Bldg Name
%Owned
Land Use
:111 Res,Single
Family Res,Detached
Volume
Page
NbrhdCode
:3105000
Easmnt
Zoning
:Rs-8000
Census
Sub/Plat
Tract
:SO4.02Block :2
Legal
:SEC 30 TWP 27
RGE 04 ALL TH PTN
Map Grid
:454 J7
Bedrooms :2
Bath F/H :1 /1
Stories :1
Fireplace :2
Units :1
LowerLvlSF :
Bldg SF :2,250
1st SF :1,450
2nd SF
3rd SF
4th SF
BsmntSF :800
LotAcre :.20
Lot SF :8,712
Roof
View
WtrFront
Year Blt :1948
EffYrBlt :1948
BldgGrad :Avg
BldgCond :Good
Water :Yes
Sewer :Sewer
Information compiledfrom various sources. Real Estate Solutions makes no representations
or warranties as to the accuracy or completeness of information contained in this report..
DA ZoneG N.W. 1/4, SEC. 30 T.27N, RA E.W.M. 155.
1 L lz:::mr 7
Z.Ic I All --, I MA. -I,
lN 1�1007 2 0
cli
V 1411�11�11M
d.
OL 'Lit
2 Z
ZI, lf 12JOSS 2 il,,,
2/010
4 4 2101 210al
2, 21, 2,l
21020
4;: 40 4D 3
0
e
A zil 09 21030 It I I
2 070 zoozo I IIA
I . 11T ziloo 21104
ca 31 21107
$IA 7 ZZI
lZPA 21106 j
2//20
14K
PAR IMIL 0 10
0 1v2 WA
14
- ul INS TAN tr
00
CA
ex
0 pAAK 2/224 all
14 w
In
If A!, S-141 N vo
fix, ku 213,
F 'PAW Q* 6,21309 313
21310 is co 0, 'o
4D 21316
. V8 A A 0
214TO P
WA
ow 4
07 iZ 21401
4M IJ408 21
Z 41 e4
Al iR4b 21416 .4 17 14JO "I
17
us
214 >
21417
XIC
!Is ZJ423 2 417 21424 ki 1421 It 45 23 z 15 Too ST S.W. 21429 —to
21429 1 215A 502 t =2J506 — OD
216022 ?J432 W X
14 Lu 21-4.25 03.
gisil Qo 2--,- '504 co
5�0 4 19 21SIZ 'o 15 7—_ 2 1 11 D I& It
V510 01 Ch V506 21514 1.
21511' ?J5,43 11507
21518 2/513 Z1411 11SIS 11619 1/5, Z, )s,8 2151
vj-za ? to
O/SZ3 7
215za V5ZZ
5281 10 v J524
;2�,529 20
CID c, 21527 v aor
21 ST. S. W. 216 TH ST.S,W.Z
U � T
loo i
K, 21602
to — ov v
co P-1608 21609 AS9
a,
00 co 00 OD CH'
a ;� g I - I -
00 LA kE.
in 21626 )o
21623, ELEf4.
2)(.!4
_T29 21622
00 21615
21625 00 ao Do 00 21 F'30 2J623 21701
ST. S.W. D) .. ..
2/701 Z"'
ft 21706 'a Q I" 'o p 217 4 21703 2/705-
-N ej
i� - ", q� 21707 _j
CV. 0 & a- 0- ol IL 217iz
X col co Z1718 2171/ J711
21714
0719
14 In IN 2/7/7 all a'. %n V 7 3.Z J 719
ol co 1,
-T3 Q Q. 21754
CIO, OD �w 0 00
go
2-15 —ST S. W. zierp,
M
JIM, azl
218 C-i 61 CID
Go CID A, 21613
00 14 A I !
OD QD wo co
J
A
C,
2102 'C 2/8?1 0 CID 0 7 Pt. 1,,, Z1820 §4 21627
�so
Cj C%l 0 +
OD 90 -3 In 2183'3
2182.3 OD OD CD no Go
Fr
Z1404
�Nh 219 04 21904, 21903 21912 21911 g- 21904
21905 2190
21908 — ul 219 219
Z1914 F19.8 �1910 ID ile"
21915, IL
19
2192
OR C-4
a; I , I
_R7 In 2 2 014
". � _�: 193i to M 1
ON . . il CD
22OT" ST. S.6/. 220'" S S.W. O-r"
lu
>
to Go CD in m
00 to OD to 4J
it, OD aD QD
to
uu
�j % OD
Zzf, OD CD
91
_3
STREET FILE
CITY OF EDMONDS
CIVIC CENTER - EDMONDS, WASHINGTON 98020 * (206) 775-2525
PLANNING DEPARTMENT
I
December 18, 1981
Mr. Dale Dempsey
Olyi�pic-Properties
20101,44th Avenue West
Lynnwood, WA 98036
LOCATION AND PAVING OF DRIVEWAY FOR LOT #2 OF SUBDIVISION AT
21702 84TH AVENUE WEST
N
HARVE H. HARRISON
MAYOR
-7, ECEIVED
0 E C �2 1, 19 81
N 0! VVorks
We do not object to paving the driveway and turn.around into this
lot'� The pavement may be placed anywhere within the access. Prior
to paving, a drainage plan must be approved.by the City Engineer.
The drainage plan must be designed for all impervious surfaces,
including any paved surfaces.
There is a common utility easement with Lot #3 of this subdivision.
If pavement -is placed on top of these utilities it is important to
have proper maintenance agreements with Lot #3 for any repairs.
This statement has the concurrence of the City Engineer.
HANK LEWIS
Associate City Planner
HL/mt
cc: City Eng-ineer
I-TUWAY MESSAGE]
TO FROM
STREET, FILE
SUBJECT:
PATE.
-7�
lA_
m
1hE
D �rl
f
i c j-1 4 I=-
S.
E
S, 6
F NED
E
p
r7
y
DATE
SIGNED
CASCADE6 Ll-C2375
PRINTED IN U.S.A.
SENDER: DETACH 'THIS PART -AND
VILE. FOR FOLLOW UP.
Z
U
0
U
0
Z
0
W
V)
:D
U
Q:�
0
CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. *Address or vicinity of Construction
A/zo-2- U-1
Owner: �r-- F--, ae/a "/I -
Name
'14 �' 7-6 a v e -r e
Mailing Addrcs s
-7-7 C, J "i-m-
City, State, Zip Code
Contractor: .77
Name
Mailing Address
low.
Permit No.
Issue Date
0 Permit Issued To:
• Type of Work to be Done: LIKV-711 A 41 C
I C-2L, R /�? er-4 d C.., e?, .)�
• Work in Connection With:
W Sub or Plat 0 Single Family
El Comml. / Ind. El Apt. Condo.
• Pavement Cut: 0 Yes 0 No
State License Number
City, S ta te, Zip Code Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ AND SIGN
INDEMITY: 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, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's 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.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will bc processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this perm vailable aj the job site for inspection purposes at all times.
Signature: n s;,,,! Date ;2- I/A 31/ S— I
or"'ent
THIS PERMtIUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
Time Authorized: Void after days
Special Conditions:
Ammendments:
-?0"0,
Permit Fee:_,. —
Security Deposit:
Receipt No.:
Fu nd I I I Fee:
Street Cut Dimensions
X -
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Frig. Div. December 1978
8520
1001
4?
rl
i
Ilvjo
-zm
:1100
N.
;'q d 00
21212
pCor 03
sr to%
A
4F
>
21200
<
N 2
1224 21223
co
-\2" .39 -- . - 1" CO
wM
-21304
2 5
zm4 -
215JO
21316
325
CIO PL
ZIZ
21 s w
t--
tn
21417 - 17 21415'
— '21429 00
'714 1,7
215 AVE S W
tu z1432 U.; 21431
> >
215'ti OD 2�i517 15'04
21SO8 215"01 216'02
f16 215
S�N� �: 21511 — 21542 215714
5271 8 -
21516 21�15
C) 21519 157
a 2 2�
co '21
00
5 T S W 216
%!
JY co
0, 0�. 0, CO. a. �Ol cL
08 't
m to! co > Zr( W 21(o 9
2160
to 216 1
CC co 2 16 1 �t7 [?2 14. 14
21621a
21410
19
'gr 121(,22 0 �.216 2iOS
2 2, Ll I:p 4
2IG23 i� 2
TH 514
37 Z21
2/709
2 1 70,q 2170 ka
3
;1707
or
co:l M,
2/7/2 2t7l/ -it 117?1
z
R �17i9
2170 2"'
CV I
oll cc, 2 72; 1725 1 1 �,74' T
or,
w
Ci
`v
CP
BID
2rg Wig
21903
9
2)913
C4, h 19111 kt
J.
rl
. .,';
� 77 (7,
QQ
CZ4
in
04
-'r
Ar
to
IN
'C'Z-
F_
Z
U
0
U
0
Ln
U
W.
0
CITY OF EDMONDS W -
PUBLIC WORKS DEPARTMENT R$TREET FILE
RIGHT - OF - WAY CONSTRUCTION PE
A. *Address or vicinity of Construction
Owner:
Name
_-La . 2 c, 9- 7-A ty y e x o
Mailing Address
city, S ta te, Zip Code
0' 91 — v? -7
Issue Date a 1.2 S /g/
0 Permit Issued To:
e Type of Work to be D6n e: Z WS-TA7 L1 A41 *CA
e Work in Connection Wifh�:
4 Sub or Plat Ej,\ Single Family
0 Comml� ' // Ind. 0 A Or. Condo.
Pavement Cut. El Yes,,, 0 No
0 Contractor:- LA�) -r7 e- /Z .77 e,
Name
Mailing Address
State License'Num6er
City, State, Zip Code Telephone Number
NO WORK TO BEGIN\PRIOR TOTERMIT JSSUANCE/
B. APPLICANT TO READ AND SIGN,
INDEMITY: Applicant understands a:ncl_.by.4is signature 'to'this application, agrees t6'hold the City of Edmonds harmless
from any injuries, damages, or claims'\,ofany kind or description whatsoever, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's,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.
Upon issuance of this permit,/ the contractor\is responsible Tor,,wcirkmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security, Deposit (estimated restoration fee) will be held until, the, final street patch is -completed,, at
which time a debit or credit w'lill\.be processed for issuance to the applicant.
Work is to be inspected' Restoration to be in accordance with City Code. Traffic Control to be in -accordance with Traffic
Sectio/n of City Code. Street to be kept clean at all times. A 24 - hour notice is required for ins ec/tion by Engineering. Call
P
775-2525, extension 220.
I understand that, this perm ust be-ava,flibleat the job site for' inspection purposes at all times.
S ignature: Date
\016Si (Agent
THIS PERM il U T BE POSTED AT THE JOB SIT FOR-JNS PECTION PURP'ES
'OS
CALL DIAL - DIG PRIOR. 'TO BEGINNING WORK
C. Issued By: t1l. %�aack_ Permit Fee:
Time Authorized: Void after S,,,=:?O —days,, Security Deposit:
Special Conditions: Receipt No.:
Ammendments
Fund III Fee:
Street Cut Dimensions
x -
** NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE **
Eng. Div. December 1978
STREET FILE
154A0
5 P-
9 8 awo
IT,
rn
ri)
a44%44.�
AO
A
vv-
OU
APF-RQVEP AS-N
bid
BY ENGIN�ERING;
fit
41
its
-Da
J'al
p
noire
-rh A
RgCr=IVED
%06,
Air, S-S
V�D.16Y rLPPNING
—
-3
AUZ 2002
H EN
7rD C: CT C I'l r-
Bul LDING DEPT.
p
U.1.1 Ti HA�
�17
CITY OF EDMONDS I
PUBLIC WORKS DEPARONT FOR -INSPECTION CALL9 Permit 0
SIDE SEWER PERMIT 775-2525 Ext. 220 Issue Date
PEP -MIT MUST BE POSTED ON JOB SITE li��
REE FILE
1. Address of Construction
2. Property Legal Description (include all easements)
3. Single Family Residence Multi -Family No. of Units
Commercial
41
4. Owner and/or Builder
5. Contractor & License '40
-Way No Yes (If Yes Right-of-
9
6. Invasion into City Ri'ht-of
way Construction Permit Required Call Dial Dig (342-5344) before
excavation).
E-1 7. Cross other private property: Yes No Easement required
attach legal description and county e sement number.
e
READ THE FOLLOWING AND SIGN:
P4
rm
a. Property owners must obtain jermit to install side sewers on
>-I their property. A licen side sevir contractor must be employed to
construct side sewers'*n e publictright-of-way.
b. The side sej�rjcontrac r as mes full reponsibility for each
installation for Tyear.
C. Commerc a 6-9tablis t re re a minimum of a six inch (6")
a4
z side sewer line.
0 d. Side sew s may be al loser than thirty inches (30")
to any structure.
e. Side sew r i mi-319 a minimum grade of 2% (1.150)
0 and maximum grade o % 0
E-4 f. No turi� in ide ss r g eat than 45 (1/8,bend) is 0 allowed
between cleanout, 11 90 turns st be constructed of a 45 (1/8
bend) and wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer syst��&.
h. Pea gravel i's required for bedding when installing sewer lines
through other than gr'a"nular soil.
i. Cleanouts are'Aequired at 30"-60" from each plumbing exit line
and at minimum intervals of 1001 along sewer 'line run.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
k.. Side sewer must be left uncovered until inspected and approved
by the City.
1. Inspection during normal working hours only. Two (2) working
days notice required.
J614DATE:
I cerftily that I have read
and/sh�ll comply With the above
D BY:
PERMIT FEE: DISAPPROVE Da
!gal
By: -Da :1
04 CONNECTION FEE:
APPROVED By: —Date:
0 L;ji. i rumic
rz4 PERMIT MUST BE,PQSTED ON JOB SITE
00
99
March 10, 1981
a
MEMO TO: Cindi Cruz
Treasury Clerk
FROM: Cindy Noack
Building Division Secretary
SUBJECT: REFUND ON RIGHT-OF-WAY CONSTRUCTION PERMIT
Please refund $30.00 to Mr. j. P. Adair at 1226 8th Ave
South, Edmonds, WA 98020. Permit No. 81-27, R/W Construction.
The permit application was denied since the City will
be doing the work and not Mr. Adair.
Approved: �,�Zelv
FIELD INSPECT137 NTTES (Fund. 111 Route cony to Street Dent.)
Comments: 5:7r . ' e_-
Diagram:
91
ST I
!ZY�� 42
Contractor called for inspecti- Yes No
Work Disa.pproved By: P Date: Bv: Date:
Work Approved By: —Date:
Inspector:
Ena. Div. December 1978
APPLICATION
;the City of Edmonds for EASEMENT NO . ............... -------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS LID NO.
ASMT. NO.
OWNER ----- L - — ---------
---------------------------------------------------------- CONTRACTOR --- ................................................ ....... PERMIT NO.
JOB ADDRESS %44-LEGAL DESCRIPTION: LOT NO - ------------------------------- ...... BLOCK NO - ------------------------------------
............................................................................................................................................................... -
NAME OF ADDITION ----- -----------------------------------------------------------------------
APPUCATION
The City for
SIDE SEWER PERM EASEMENT NO . ............... ............................
NEV CONSTRUCTION E] REPAIRS El LID NO. - ---------------- - ASMT. NO - ------------------
OWNER ------ --- -- ------------------------- CONTRACTOR
-------------------------------------------------- --------------------------------- PERMIT NO.-5;;�-.
JOB ADDRESS ------------------------------- LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ---------------------------
- ---- ------------ - ... . ..
.............. I ----------------------------- I --------------------------- -- ....................................................................
NAME OF ADDITION ........
-------------------------------------------
Approved:
DATE-------------------------------------------- BY ------------------------------------------------------------
SIDE, SEWER PEWIT
CITY OF EDMONDS
WATER -SEWER. -DEPARTMENT
PERMIT
Call 775-2525 for side sewer Inspections BEFORE covering any portl= of the constr ction,
Inspection will be provided, within 24 hours after requst. NO Sat_ -Sun., or holiday Inspeutional
...................... ............ .......................................................
ADDRESS LOCATION OF CONSTRUCTION ......... ....... ......................
PROPERTY LEGAL, DESCRIPTION ...................
........... . ..... . ................................ ...... * ....... ........ *-,*-***'* ......
.................................................. . .................................................................................... ............ ............... .......................................................................................
................................................................ OWNER AND/OR BUILDER ..................... ...................................................... . .......................................................
....... ...........
Cr_-TRACTOWS NAME ADDRESS ......... t
............................................ ...... . .... ........ ................... .................... .......................
P"sslon Is granted . ........... ............... ........... Jor repair and/or connection of a side sewer to the, city sanitary sewer
.......... . .....
sy,+,em in accordance, with City of Edmonds ordinances.
A TION IS CALLED TO THE FOLLOWING:
NOTE No� 1—The owners of the property may, obtain a permit to construct sewer inside property line. A licensed Side Sewer contractor must be employed to construct
side sewer in street area. Do not cover any portion of sewer before It has been inspected.
NOTE No. 2—All work performed In city right-of-way requires an Invasion of Right -of -Way Permit obtalrrable. from the City Engineer's office.
NOTE No. 3—Obtain full information regaxding Ordinance 11.16.030 and Regulations governing. side sewers when you get permit.
NOTE No. 4—Top of side sewer must have at least 30 . Inches coverage at property line and 12 Inches Inside property line; minimum grade of 2%.. No bends In grade
sharper than "A will be permitted.
NOTE No. 5--Trenches in street must be water settled and surface of street restored to original condition, Contractors shall be responsible for failure due to improper
work which may develop within one year of completion.
NOTE) No. 6�—It Is unlawful to alter or do any other work than is provided for in the permit, or to do any, work �on the maJn sewer or. its appurtenances except to in-
sert the pipe Into the wye.
DISAPPR0�_V. ED Date ........................................ By ................ Date .... *,*,,A& ..................... By .... . ...... Date ............... . ................... By ...... !..; ......
D Date ........ .................. By,& '0_1 -
APPROVE ....................................................................
_ -
Remarks: .........................................................................................................................................................................................................................
........................ .... .........................................................................................................................................................
,,e5 .... .. ....... .................................. .......
viv�instl in'
Be Signed By,Owner of Firm Performing Construction PRIOR To Request For Inspection
......... .... hereby certify that the side- sewer
irm. i�r* .. ..... in "6on.truction)
ning ordinances of the City of Edmonds.
Dated this ........................... day of...
V V Check BEFORE you dig for: Water E], Gas E], Telephone 0,
constructed under this permit
....................
Other !F]
1. Residence.1 ocated.at 21702 84th West, Edmonds,
Washington described as:
Sa . id.portion of thelsE 1/4.of the NW 1/4 of,
Section 30r' Township 27 Niorthr Ranqe.A E.W.M.1
described as follows: Beqinning at the,northeast
corner of said subdivision; thence south 83*54'
West 434.35 feet; thence South 1061 East 294.79
feet to the*true point of beginning; thence con
continuing South 16.61 East 50 feet; thence N,orth
89007' East 150 feet'; thence South n006' Fast'
for 75 feet; thence North 89007' East 264.85
feet; thence North 10101.14est, 125-feet; thence
south 89007' Alest 414.70-f6et to the true point
le ,o. 1115350.
of -L)eginning. . Auditor's Fi . 14
NOTICE:
NtnvAjarrantv o
The information 'shown on the attached
map(s) was compiled f . or use by the City of
Edmonds, its Employees and Consultants.
Th.,e City of �Edm.qnds does not * warrant th . e
accuracy of anything set forth on these
map(s). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the inform-ation shown on
t-Fe -m a p (s) , Including, but not limited to,
th'e lociation of any sewe r stub shown, Such
sewer stubs may or may not exist and may
or may not exist at the location shown.
Neither the �ity of Edmo"nds nor its
emp[o-yee-s o-r office-rs -sh-a-11.1 be Viab--Ife for the
information given on this map(s), nor for
ov'ded based
any one representation pr I
upon . said map(s).
APPLICATION..
11 ifor,
mo, a - -- - ;,
-of Edi n s TI-NO . ....................... ....................
EASEME�,
�',SIDE SEWER PERMIT
................. ...
NEW CONSTRUCTION REPAIRS ..... ASMT. Nq.,*.?Z:�_...-
LID NO%
IL c—
tsc>r
IR CONTRACTOR ........................................................................ ........... RE,
... .............................................................................................
BLOCK- NO . ................ ...................
DDRESS iO LOT NO . .....................................
. .........
.........
........................................................................................................................................... ......................
IGCIV%1�10N (p CON _4-*.-"N:"*(,_'j*1, ...... .... ............... ... . ...... 1_.._..._ ...........
TION. T - _- t S:'r
........... ... ....... . ................... . .... : . ............................. ......................................
NAME OF ADDI ..........................................
. .... ..... . . . . ... ........... ............... ............. - ----------- -------------
7-1
Cj
�7' 1
CO3.
"'D ii
lat.
*, 7i
cew
Approved:
/f
y
DATE
4* THE LAND * REFE RRED TO IN THIS COMMITMENT IS LOCATED IN THE
COUNTY'OF SNOHOMISH, STATE OF WASHING'TON9 AND DESCRIBED AS F I OLLOWS:
THA ' T PORTION OF,THE SOUTHEAST QUARTER. OF THE NORTHWEST QU ARTER OF SECTION
309 TOWNSHIP 27 NORTH9 RANGE 4 EAST" WeMo
9 DESCRIBED AS :FOLLOWS:
BEGINNING AT THE NORTHEAST CORNER'OF SAID SUBDIVISION; THENCE SO UTH 38*541
WEST 434o35..FEET; THENCE SOUTH 1*061 EAST 294o79 - FEET TO THE . TRUE POINT
OF BEGINNING; THENCE CONTINUING SOUTH 10061 EAST 50 FEET; THENCE NORTH
89*07.1 EAST 150 FEET;.THE�NCE SOUTH.1-061 EAST 75 FEET; THENCE NORTH 89*071
EAST 264985'FEET; THENCE NORTH 1*1011 WEST 125 FEETI-THENCE SOUTH�89 . 0071
w T. 414.70 FEET'.TO THE TRUE POINT
ES— OF BEGINNING*' -
SITUATE IN.THE COUNTY OF SNOHOMISH9 STATE OF WASHINGTON.
A A % r'% A r,% 1- 11 r
I.-
07J
v 'lvI y -
84
p I %
-PONNE. LINNANF-L -PLACE wl ROEW-RT H. J40NES V J. DOBBELANK
LARRY
10
NOR -TON
3: ACCESS AND UTILITY
EAS E M EN T- J. 0.. WIEBE
ELI H^M5LET z JOHN C. LYON JR.'
30
ROBERT W.'... 404.70'
BURW
'Z -5 4. 76 j - 1 .150.00, 20 30" ERNEST H.
SC14ULL
E.;Z A
4� 490.000, a
zo 0
150-00 1
w
Z OAVI D
Ll.j '5c'-6 eb 8 7 5 0'* Hous HENSLEY
—7
0
NET
-I:r- p
P. STEPHEN
MARY A.
U) >
TWOMF'som W:r-LCH HlOY
0
80.00 30
104-85' zo
to J.
JAMES A .
MALLON
OLGA, F. W. L. JENNING5
I
LOKE.W TZEN
QD
T
SU501VIS(ON PLAW
-T
FOR S T R F. S. W.
TH
j." P. ADAIR
JJ
IN NW 1/4:4 OF SFECTION 30, -TWP. ?-7 N.p .;2. 4 E., W. M.
-9781
I REV LOTS 5
7- 0 4 EDMONDSJ WASHINGTON
Age
orland &
Lovell-sau
SUF!4Ef0FW a awyeLopmeff ... ... ;
23108 IWTH AWfW. EDMO!M. WAL
. 3.81
ips
P to
I '-, a V j I W 1 6 — — . I .. — .
It � 7 C, 4
RONNE LINNANE PLACE w ROBF-fz r H. JONES
J DOMBELA&K
LARRY
NOWTON
,,IACCESS AND UTILITY
EA61EWNT
ELI- H^M5LET JOHN C. LVOM -]P--
30
anprp-r UU1 I
I
J-0- WIEBE
SUIZWE-LL'--" td 1. 1
156-00' WATEQ Sewee,%, (51' 30' EIZNF-ST H.
Z
SCH"Ll 1:
I I
L-1.j
MARY A -
THOMPSON
T-
I
to -%I-BUILC>. GET�EI,40c'
0
KE17H P. S7�PHEtV
WELCH HOY '
AUTHORIZED
FOR
RECORDING
CITY 0 M s
Z�PM7
by
Page -Of
LINE (TY, IC4L) I
Nil 3 .
-0 1�9,8,zo*
4
NF-t
16 --;� (, ;- V-/
IST. It
L — :
-Acm -,
w
-EXIST
a
DAVI D J.
NZ
HOUSE
-4
S,
HENSLEY
ui
7
u)
50-00'
10, zo,
30'
owr -- I., -a 8 -.1 K- 30 J^,ME-5 A.
OLGA 9 - I W. L. , JENNINGS MALLON
LOP-E-NTZEN
OD
EXHIBIT "A"
SU501VISION PLAN
FOFZ
J. P. ADAI R
IN NW 1/4 OF SF -CT ION 30, -TWP. Z7 N..) R. 4 E., w. M.
F-DMONDSJ WASHINGTON
, CITY OF EDMONDS
P- W DEPT. ENGINEERING DIV.
EXAmINED
BY 41L;joeal DATE_11CLC-�X
REMARKS',�
F1
STREE-7 S.W.
REV - LOTS 3-9-81
f1e).
Zr
Lovell- Sauerland & Assoofates. Ine,
SuFrA-YORS ;. DEVELOPMEN'r CCNOMTAKM o PtANNERS
MOB IWTH AVE. Eamcom w1k so= PHONE 775-in--d
W3
IZFH I JIS 2-13-81 1155, P. 111 1"-60'
As,
RECEIVED
PERMIT EXPIRES
UA PERMIT
CITY OF EDMONDS
ZONE
NUMBE""
CONSTRUCTION PERMIT APPLICATION
JOB s
ADDRESS CQ /7,
OWNER NAME/NAME OF BUSINESS
PLAT NAME/SUBDIVISION NO.
LOT NO.
LID NO.
r
MAILING ADDRESS
LID FEE S
4 7,
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved
RW Parnift Required
Street Use permit Recild
CITY ZIP
TELEPHONE
EXISTING - PROPOSED
Inspection Required
Sidewalk Required 13
zl� 7 7
REQUIRED DEDICATION- FT
Underground
Wiring required 13
NAME
METER SIZE LINE
SIZE
NO OF FIXTURES
PRV REQUIRED
YES 13 NO 13
z
ADDRESS
REMARKS
z
z
x
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
CITY ZIP
TELEPHONE
-noms PIMALap
NAME
CBL#
ENGINEERING REVIEWED BY Qx
it
0
ADDRESS
03 )12
D BY DATE
CITY zip
TELEPHONE
M
0
3 r
A/ S-
STATE LICENSrNUMBER EXPIRATION DATE
CHECKED BY
=AA NC E'O
SHORELINE OR ADB#
INSPECTION
REOD
BOND
POSTED
TA L1, 0
.
13YEs. ONO
$
PROPERTY TAX ACCOUNT PARCEL NO.
SEPA REVIEW
COMPLETE EXEMPT
SIGN AREA
ALLOWED 3 ED
PROP
r
HEIGHT
ALLOWED PROPOSED
5
a�()IJL -�00C?J_01800
46�
0/
1
1 ;A
as
'9
,
EXP � .1
NEW
RESIDENTIAL
PLUMBING ME . CH
LOT COVERAGE
REQUIRED SETBACKS (Fri
PROPOSED SET13ACKS (Fr.)
COMPLIANCE OR
ALLOWED popoSy
ey
FRONT SIDE REAR
I I
- _7Y
FRONT. LANSIDE REAJ
zyb
K
ADDITION
COMMERCIAL
0
Is
z
CHANGE OF USE
IREMODEL
3
muLfimmy
SIGN
PARAING
RECID PROVIDED
I
LOT AREA
IP NG R EW W/%BI
.
2. I
2-
1�1
REPAIR GRADI NG FE NCE
El
CYDS x M
REMARKS
[3-..DEMOLISH. 1:1 TANK E:y-OTHER
GARAGE. RETAINING WALL �RE SPRINKLER
z
0
CARPORT RbCKERY FIRE ALARM
(rYPE OF SE. BUSINESS OR ACTIV", EXPLJO11.
CHECKED BY
LICTION
CODE
1
OCCUPANT
NUMBER ;
NUMBER OF
CRITICAL
L4L
!� 2,
1
OF
DWELLING
AREAS
SPEbI IN CTION
AL SPE
AREA t.
o
STORIES
UNITS
NUMBE
REOUIR'l
LOAD
DESCRIBE WORK TO BE DONE
REMAR K S
PROGRESS INSPECTIONS PER UBC.108/FINAL INSPECTION REG-0
Cy
15_14_��l )1`_ 2,24u�,
:
/
o.
(
:
Y, `x 0j/
VALUATION
L -A IY�fl
Descriptloh
FEE
Description
FEE
LCOU I Ir.
'Plan Check-
199W
State Surchawrge
'C
HEAf SOURCE GLA23NG %
LOT SLOPE %
Building Permit
City Surch:a a
rg
?LAN CHECK NO.
VESTED DATE.
Plum.bing
Mach anicall
THIS PERMIT AUTHOREMS ONLY THE WORK. Haim. --riiiis PERMIT COVERS WOkiK TO
BE DONE ON PRIVATE PROPERTY ONLI ANY CONSTRUCTION ON THE PUBLIC
Grading
32
DOMAIN (CURBS, SIDEWALKS, DRWMAYS,�MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: 180 DAYS
OL
PERMIT UMrP 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AN . D SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST. AGREES To INDEMNIFY:. DEFEND AND HOLD HARMLESS THE CITY OF
2
EDMONDS, WASHINGTON, 117S.OFFICIALS, EMPLOYEES, AND AGENTS FROM ANYAND*
Fire Inspection
Receipt #
I
ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE. ARISING DIRECTLY OR INDIRECTLY
7
FROM THE. ISSUANCE OF THIS PERMrr. ISSUANCE' r
0 THIS PERMIT SHALL NOT BE
9
DEEMED*TO MODIFY, WAIV�E OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapeln6p.-
Total Amt. Due
&7,9
1
0
x
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
Recording Fee
Receipt #
41�� 3
I HEREBY AC KNOW LEDGE 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-
CALL
This application.le not a permit until signed by the
TION; AND* IN.DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
Building Official! or his/her Deputy: and Fees are paid, and
.IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTO N RELATING TO.
FOR INSPECTION
receipt Is acknowledged In space provided.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
OFF1 SIGNATURE DATE
?ffs
8j19NT
ATURE WNER rn
uRE2R AGEN
L /4�Aj
DATE SIGNED
1A&3
1 TA65)
�4_1111111111111
5/' 2 3
.771-0220
bATE
A
.:
TI
ENTION
M 1,313
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING 00 STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC. SECTION 109
ORIGINAL - FILE YEL I OW - INSP R
04/02
PINK - OWNER GOLD - ASSESSOR
PRESS HARD -YOU ARE MAKING 5 COPIES GREEN -ACCOUNTING