21714 97TH AVE W.PDFiiiiii iiiiii
9541
21714 97TH AVE W
I
2,J `7 1 Zq._ 9-7T, Ptak- ui
RECEIvEo
AUG 3 1 1995
PERMITCOUNTER
+
HEIGHT CALCS
7
L 1% st� r-r
A=+96,7(
B = t97,31
Skop BLtme).
c
9 5'14
AVF— 6 RADE r
CXJ
ACrLAA L= t
+9-8,ot- MAx= f itl-9�9
1 7. 3 /
1 +179,0
-2:a!e sq �rr cot-,c.
Wrl 0 ely./srip4)
JT I
1570� Sq 0 kASt
Cli VU -.,r/06,)
300 sikrt
:'.ASPKALr
APPROVED BY PLANNING - ve-
70.0,
NORTH
/11L DA-rom P—) +100
137PSE-r STORM DeAlAJ A t,4
-of
4;jAA.-
61
J
T
0.f
8.90
0,
C ty.of EdthoiW�-,--,
POO
V-1
ec -ki
CrPti, a �A.reas., Gh`
-7r
qW
ifift, HVIliecity. 7�6 Cit y will
The Critical Areas dieM'ist cbfttaid6d,6i0
this form is -to.be,fiIIed'-,oqVbY,.,any_per I ;makei 0
sont nr_4i� -.1;�,,xeviewAeIcheddist;P
r recursory site
preparing a NW opm��nt Permit - ., I " eterminatto
Wd-` ii'd' - - n of the.
Application for.the of Edmonds p .
sub;.e p compje�
A AI;Ry" ,qu.en.t a
to his/li6i ihibmittal of a development-
-f,-dqYet0PmWt1Permit application.
it
Wo oz�
VViIh a,4 ed, of. this'
form, thiE'
17he purpose of Checklist is to enabl6'
I 2PPlicant should also submit a vicinity ma
City staff tq determine -whether any..-- or -plot plan for individual lots of the parcel
Potential Critical Areas are or may be with enough detail that City staff can find
present on the su�jcpkproperty.:. The
idenfilly-,thesgbjec't parceI(s);I[A
info -fi66ded 16 complete the a4ffifioz4 the,applicant shall include
Checklist shou ' Id bd asil� i frOni Other'Pertinent infonnation (e.g. site,.,
observations of the site or data available at plant topograPhY etc.) i oi k - ud'
City IWI (Critical Ams inventories, maps,... 'Conjunction. with this Che�mijt 'es in
or soil sury s)
1!4�1!.in compl4ing thei
r preliminary..;:%,
assessment 9f t,he site.
An applicant, or his/her representative,
must fill out the checklist, sign and date it,
I have completed. the attached Critical Area Checklist and attest that -the answers provided are
factual. to the best of my knowledge (fill out theaPProPriate column below).
Owner/ Applicant- Applicant Represent'atjv'e:
Name
Name
11r7/ q 07 tA3
Street Address StreetAddress
City. State, ZIP Phon� city, state, ZIP
Phone
Date ii-g—n—atum Date
J
CA FILE NO. k-11.
r ti
c
aL reas ..Ch,e6kiist
U
on),,
Site Information P091*4P _*j!
t e A"d
d,r MID
*ocatk
Prope T Nu biq`
rty ax Account V...
2.
fq
ize (acres or square
3`.,J�v,;;Approxiiiiiie Site S f I'D 3 6 0,
4. Is this� iiii-i'dtirrently developed? �'ei"1.4 no.
y
If Yes; how is site developed7
Ow
"OH
at apply.
5. Describe the general site 'graoh�;",Cfieck all th
Z'4
toml
flac. less change over entiresite.
't6zenerallyriess than
Rqlling;-t7�;lopes,,0Pzi
49rizontal, distance of,66-feet).. lijin-
.)q jj*gtqq�y*�j
,4 Z"t
Js u�
Hi1ly:,'*W4,sldpes pir"e'sien't"'o-hilsite of more than,15% -arid - 1,�sj'thin30% a viiiia rise;
of 10-feet-Oerfa1i&izental distance of 33'i6 6(4i&)�.
Steep.. grades of greater dian 30% present on site (a vertical rise of 10-feet over a':*
horizontal d"Q W6s than 33-fed).
Other cr
!�lease des ibeh,
X.
6. Site contains areas ofyear-round,stand vrater. Appro ',ib4tW-V�, t�,-b 1-1",
ifig
7. Site contains ireits of skasoi fial 0 Approx.*Pep
6;..xi 0
What se'ason(s), of the
8. Site,is in th!!�-:Rqqdway WQ� floodplain 00 of a water course.�P'�,
9. Site contains a creek or an area Wherilwaier flows across the grounds surface? Flows are year-
round? Flows ateseas6nal?
(What time of yea,03
10. Site is primarily: forested meadow ;shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
� 1'
City of Edmo'nds
RIGHT-OF-WAY CONSTRUCTION
PERMIT
Permit Number-
LssueDate:—&—/O
A. Address or Vicinity of Construction: 17,141
B. Type of Work (be specific): 400a�x_
C. Contractor: Contact:
Mailing Address: Phone:
State License #: Liabili ty Insurance: Bond: $
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. 171 Commercial E] Subdivision El City Project YUtility (PUD, GTE, WNG, CABLE, WATER)
0 Multi -Family E] Single Family E] Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut : [I Yes' 0No G. Size of Cut: — x — H. Chargq�,$
APPLICANT TO READ AND SIGN
INDEMNITY.- Applicant understands and by his signature to this application to hold the City of Edmonds harmlessftom injuries, damages, or claims ofany
kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its departments or
employees, includingor not limitedto the defense ofany legal proceedings including defense costs andattorneyfees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC-
TION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREETPATCHIS COMPLETED
BY CITY FORCES, ATWHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT
Two sets of construction drawings of proposed work required with permit application.
A 24 hour notice i ' s required for inspection. Please call the, Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be. in accordance with City regulations as required by the City Engineer.
All street cut trench work'shall be patched with asphalt or City approved material prior to the end of the working day;
NO -EXCEPTIONS.
J have read the above statements and understand the permit, req�ireinents and the pink copy of the permit will'be
available on site at all times -for inspection purposes.
Signature: Date:
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
NO- WORK SHALL BEGINTRIOR TO PERMIT, ISSUANCE Eng. Di v 1997
V-
FIELD INSPECTION NOTES
Comments:
Diagram.
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION' YES
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
RECEIvEE)
+9-9,0
I% rT-
7- rT-
(PQDPMeb�
-7:2 g sq Fr
PATI 0 0),/srP4�
I-To� SciFrr I-AOtAc.Z
AUG 3 1 1995
PERMITCOUNTER
HEIGHT—CALCS
A=+96,'-7�'
6 z t97,31
c
9 �. 5'14
AVF- 6 RADE r t Of
ACLAR L= t
MAX= i- it I
123 /
+ qgo
-T 0
,z6 Lor
4- lig, 2 3
:'.ASPKALr
P, t ve
+
. x%s-6-tq4)
-70.
NORTH
300 szkFt
X "STI N
/-ft DA-rom P-) -t-100
W)- M D P A CO VeA- --SLr�Q ?LAtl
EF-7- STORM I
1 2-0
C�5 _71
CA FILE NO.
Critical Areas. Checklist.,
Site Information (soils/to
pography/hydr,61ogy/vegetation)
Site Aiftrc�s/Location: q- 1�7
I 1 *10
2. C4TWqpn Tax Account Number:
040
AA
I o-A 6 0
Site Size (acres or square feet):
4. ffently developed?
—yes; W.
IM'Q S. Z d, "
If yes; how is site developed?; IRAeS
r, 44
5. Describe the general site too tmea a tbat apply.
Flat, less than 5-ted elevation diange over entwe sit&
-Rolling. slopes on site generally less than 15%. (a vertical rise of 10-feet over a
-feet).
h.orizontal..distance of 66
Hilly:"*:-�' slopes present on site of more dmn'15%..and less than 30% a vertical rise.
"f' r, of 10-feet over a hodzo�tal dista= of 33 to 66-feet).,
Steep: grades of greater dian 30% present on ske (a vertical rise of 10-feet over a
horizontal distance of less dm 33-feet).
Other (please describ
6. Site contains areas of year-round standing water. Approx. Depth:
7. Site contains areas of seasonal standing water: P 0 Appo*. Depth:
Wh�i season(s) of the year?
8. Siteis -in the floodway Wo floodplain 00, a wales course.-
9. Site contairii a creek or an area where water flows across the grounds surface? Flows are year-
round? 0 Flows are seasonal? Mhat hm of yearl
10. Site is primarily: forested Meadow snMus ;,mixed
urban landscaped Qawn,shrubs etc)
11. Obvious wetland is present on site: 00
�s
7
6`1
W
V'-
ft! VRO,
69W **bG*V4-0U=
.M.O.-Al
Ihe Critical Areas Checklist contaificW&M*V-490-IMI-IMMI, a W I=
this form is to, be filled out by, 4any.-Persowl
preparing a Development Permit
T
Appli .�qr the 4;iq of Edmonds
ps "q
to his/her �subrhittald a d
aWp
it
tj
W,612�a
Ihe purpose of the Checklist is to
Inap:, �77��
VIOM
City staff to-deternfm.whethcr any:-' tq�-Oan,fdr individual lots of
the
detail that
potential CriticalAreas am or may be..-:- ............
City staff can find
present on the subject. pwperty. - The -
k iiib tidd"v., MV
info 'nieded to complete the
"Ga-
M
Cheddist should bd6s* kNrailablifrom
observations of the site or data available
City EWI (Critical .4seas inventones,� 3.
0 5��I*
or soil
S)
Mw etm
A."
Tyn
_g th
QsSessmat of& U� r
represen
An applicant, or his/her tative,
7
J� 1,
must fill out the checklist, sign and date it ,
I have completed the attached Critical Area Checklisi� i6ith6insi�� proviAraire
Co umn!t�.--.-
factual, to the best of my knowledge (fill out:the�- TMME"11-
Owner Applicant:
"A
—3;2
�,12
. Et
Nam
r? q
A
AddnM -Ad&en
UJ A
3
City, State, ZIP Thon�
�City; shfto ZIP Phone
7,�
Date
Date 7
t
M
N
'44
City of Edmonds
Critical Area
PLANNING DATA
SITE ADDRES&A-11J-1 jjL4:Ag==j&) -DATE: &b-s-
/ t
ZONING: C-5 -p PLAN CHK#: e�sde:�-n
PROJECT DESCRIPTION:
SETBACKS: ftV-, '5*)-P OAAH
Required Setbacks:
Front: 9� Left Side: Right Side:- -7L2-- Rear:--f 4C-L-- 50-P-)
f
Actual Setbacks:
Front: — Left Side:-- Right Side: Rear: CRD
CORNERLOT N 0
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED A�
LOT COVERAGE:
Maximum Allowed: 15(9�_to !t,)Actual: 62, q, (0 YD
BUILDING HEIGHT:
Maximum Allowed: Actual Height:
SUBDIVISION:
CRITICAL AREAS #: 15-- / -7 2- - &A yv��,
SEPA DETERMINATION:
LOT AREA: .10 3( !:�Q
OTHE
Plan Review By:
(Z-
APPLICATION
for
The City of Edmonds SEDE SEWER PERMIT
NEW CONSTRUCTION [:] REPAIRS EASEMENT No . ..........................................
109-06000
OWNER.......... A:j.,j.l-....Da.vi-s ......................................................................... CONTRACTOR ................................
.. .................................................................. PERMIT No . ......................
ADDRESS ....... 2.1.714 ... !! ... .............................. ................ LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
NAME OF ADDITION
Dye Tested On Sevier 1972
Approved:
DATE................................................ By ......................................................................
USE PERMIT
ZONE
CITY OF EDMONDS
7
NUMBER %%-b
CONSTRUCTION PERMIT APPLICATION
oa SU APT a
ADDRISS(_ '14de-
OWN NAMEOFBUSINESS
_�PNAME
M bAVt6
LEGAL DESCRIPTION CHECKFS
�DIVISION NO
LID NO
u-1
MAILING ADDRESS
aAvc.
Z
Al-714 '?l ct).
TESCP Approved 0
O�
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING — REQUIRED DEDICATION —
RW Permit Required 0
Street Use Permit Req'd 0
0
CITY ZIP—
,�?e
Ebm 6�j L-6 A�o
TELEPHONE NUMBER
oJ-1*6&
ROPOSED
Inspection Required
Sidewalk Required 0
Lu
NAME
METER SIZE
N�
NO. OF FIXTURES
PRV REQUIRED
L)
uj
YES 0 NO 0
0
ADDRESS
REMARKS
a:
t
3:
L)
W
Lu
W
Z
CITY ZI�7-713HONIE
NUMBER
5
Z
Lu
NAME
—�Am6 A,5 &wk46,e 111rob A&Y25
ADDRESS
cr
0
ENGINEERING MEMO DATED REVIEWED BY
cc
CITY Z115
TELEPHONE NUMBER
FIRE MEMO DATED REVIEWED BY
Lu
0
Lr
0
STATE LICENSE NUMBER EXPIRATION DATE
SIGN AREA
SEPA REVIEW
ADS NO.
ALLOWED PROPOSED
COMPLETE,
Legal Description of Property - include all easements
JEXEMPT
V'
SHORELINE 0
1
EXP
ll�
/ li-p
VARIANCE OR CU
PLrINV IE�W BY
0 TE
U
4 y
0
SET13ACK EET
-7 V,7
HEIGHT
LOT COIJER
K-
Z
Z
FRONT SIDE REAR
Properl y
Tax ACCOUn I
REMARKS
Parcel No.
ElNEW RESIDENTIAL Ej PLUMBING
EjADDITION D El
COMMERCIAL MECHANICAL
ElREMODEL APT. BLDG. El SIGN
GRADING FENCE
El
CHECKED BY
TYPE OF CONSTRUCTION
1 -7—
CODE
1?
OCCUPANT
IF
REPAIR — CYDS (_ x _FT)
A
�1'
WOODSTOVE SWIM POOL
DEMOLISH INSERT El HOT TUB/SPA
SPECIAL INSPECTOR
REQUIRED
I
AREA
OCCUPANT
LOAD
13 YES
-3 f
FGARAGE RETAINING WALL/
CARPORT ROCKERY El RENEWAL
REMARKS
PROGRESS INSPECTIONS PER UBC 305
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
LL
cc
to
L)
U )
W
0
NUMBER
OF
STORIES
NUMBER OF
DWELLING
UNITS /o4
CRITICAL ?
AREAS 6
3ER
INUMB I
co
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
FINAL INSPECTION REQUIRED
(7 Lj C - j t) j__1 V -
A 6% -e C,
VALUATION
FEE
PLAN CHECK FEE
B UILDING
11,3
HEAT SOURCE: 77L�
e,(
L.j P--) L-%-4?1A1T*
PIL UMBING
Plan Check No.
MECHANICAL
GRADINGIFILL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) Will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
STORM DRAINAGE FEE
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
ENG. INSPECTION FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnity, defend and hold
12
harmless the City of Edmonds, Washington, its officials,
m
employees, and agents from any and all claims for damages of
107
whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
modify, waive or reduce any rejulrement of any city ordinance
0
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
5—V
;-- ZVI`
1 provision."
I
I hereby acknowledge that I have read this application; that the ATTENTION APPLICATION APPROVAL
information given is correct; and that I am the owner, or the duly
authorized agent of the owner. I agree to comply with city and THIS PERMIT This application is not a permit until
state laws regulating construction; and in doing the work authoriz- AUTHORIZES
signed by the Building Official or his/her
ONLY THE
ed thereby, no person will be employed in violation of the Labor WORK NOTED Deputy: and fees are paid, and receipt is
Code of the State of Washington relating to Workmen's Compensa. acknowledged in space provided.
tion Insurance and RCW 18.27. INSPECTION
WS4.1,1ATURI,�ER OR AG T DATE SIGNED DEPARTMENT 0 IAL SIGNATURE F E�
C
CITY OF
�ft� 16 A A /J40
III V.&AtAV 49 EDMONDS
ftEl
BY i
M" CALL FOR
ATTENTION INSIPECTIO -------
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
BEEN MADE AND APPROVAL OR 771-0220 ORIGINAL — File YELLOW — Inspector
UNTIL A FINAL INSPECTION HAS
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3. PINK — 0,,,,r.er GOLD — Assessor