21806 87TH PL W.PDF8299
21806 87TH PL W
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10TY'OF EDMONDS
.890-19"
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Address of Construction:
SIDE SEWER PERMIT
PERMIT
Property Legal Description (Include all easements): Ln 7- �t F_ (_\kNV_'F r OOZ7,
Owner and/or Contractor:
State License No. T-0 Building Permit No. 44 8
0-,) o-
NFA f(A
L. N j., PLAN
Single Family Invasion into City Right -of -Way: o !D_Y_e§--
Multi-Family (No. of Units-) RW Construction Permit No.
El Commercial Cross other Private Property:KNo El Yes
El Public Attach legal description and copy of recorded easement
I certify that I J90Mead_`arrr9`halI comply with all city requirements
as indicated offthe back of the Permit Card.
Date
* CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION *
OFFICE USE ONLY
FOR INSPECTION CALL 771-3M, PUBLIC WqRKS DEPT.
-4 M CIA ats�
Permit Fee: ;t issued By
Trunk Charge: k�3- Datelssued:
Assessment Fee: Receipt No.: �7
Lid No.
Partial Inspection: Date -Initial.
Comments
Reason Rejected: Date -Initial
Final Inspection Approved: Date 9, 13, 7 nitial gl, J6,L
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Green Copy: Inspector Buff Copy: Applicant
Revised 3 90
The City of Edmonds Side Sewer Drawing EASEIVENT-1 NO, - ..... ....... .............. .......
NEW CONSTRUCTION P< REPAIRS r-1 LID NO . .................. ASMT. NO . ..................
OWNER................................................................................................ CONTRACTOR .................... PERMIT NO. 9.0
JOB ADDRESS ... 2I.R.NP .. ...... 8 71% ---- et.W ...................... LEGAL DESCRIPTION: LOT NO. ....7 .............................. BLOCR NO . ....................................
................................................................ .............................................................. I ..................................
NAME OF ADDITION .... .........................................................
. ew 4- W E, profc,4 .1
U S C
I � - ' 7 --,r - . -A- 0, -J� #- C-,.% r- C
2
4 Approved:
PWW-0001-1 1/75 (REV.1 1/78) DATE ...... 9 —/3
................................... B ----------------------------------------
District 6 3 7�-
City of Edmonds — Water Department
TAP CARD
Reading: 0 00 0 — DateAuq a-3i
No. 73 0 2- No.
Meter { SiZCN� Tap { Size
Mfgrs. No._5-�WNFS-2- Style
Purchaser:7u-mXtu A_J;Hirs 106
Serv. Add. ?.186(m' 87M P1, W
Lot No.
Add.
Residential:
Other:
Date of
Bik. No.
9— r7 -q 9 Foreman
Guar. Voucher No. $
Proj. No: - WM025
Remarks:
OUTGOING index- Reg. -Route Bk. Stencil- Card-
TXTf-f'%1ffT71Tf-
fl
NOTICE:
..Wa r-ra'n. t*y ... 0 T -d- Ut, U .1 -.Cl U -Y-
No
The information . shown on the attached
Map(s) was compHed for use by the OtY Of
Edmonds/ its Employees and Consultants.
Th.e City of �Edrn.qnds does not . warrant the
accuracy of anything set for.th on t ' hese
Map(�-). Any person or entity'requesting a
copy should conduct an independent
inquiry regarding the inform'ation shown on
including, but not limited to,
ff�e -map(s)/ -h
th . e lociation of any sewer stub shown. Suc
not exist and may
sewer stubs may or may
or may not exist at the location shown.
Neither the City of Edmonds nor its
emp-l-o-yee-s o-r offi-ce-rs -sh-a-'I*l be 11a-b-'Fe for the
information given' on this map(s), nor for
any one representation provided based
upon said map(s).
.1 &',,a 4z�
. 19 -�
City of E&mon&
Critical Areas Checklist
'11 e Critical Areas Checklist contained on
this for -in is to be filled out by any person.
preparing a Development Permit
Application for the City of Edmonds prior
to his/her submittal of a development
permit to the City.
The purpose of the Checklist is to enable
City staff to determine whetherany
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. 71e City will
review the checklist, make a precursory site
visit,and make adetermination of the
subsequent steps necessary to complete a
developmentpermit application -
With a signed copy of this form, the
applicant should also submit a vicinity map
or plot plan for individual lots of the parcel
iWith enough detail that City staff can find
and identify the subject parcel(s). In
addition, the applicant shall include
otherpertinent information (e.g. site
plan, topography map, etc.) or studies in
conjunction with this Checklist to assist
staff �in co m-pleting their preliminary
assessment of the site.
I have completed the attached Critical Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner I Applicant:
Name
Street Address
City, state, ZIP Phone
- FL
-7'
Signature
Daie
Applicant Representative:
Name
Street Address
J
City, State, ZIP Phone
-AV
Snature Date
informadon (soils/topography/hydrol.09Y/,veget:ation),
1. Site AddressfUcation: r
Z-
0
2. Property Tax Account Number: 7
3.. Approximate Site Size (acres or square feet):
4. Is this site currently developed? yes; no.
44,y
if yes; how is site developed?
#f
.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 10-feet over a
horizontal di stance of 66-feet).
Hilly: slopes present on site of more than 15 % and less than 30 % ( a vertical rise
of 10-fe4t 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 crf year-round standing water: Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(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-
round? Flows are seasonal? (What time of year?
io. Site is primarily: forested Meadow _; shrubs mixed
urban -landscaped (lawn,shrubs etc)
I I. Obvious wetland is present on site:
For City Staff Use Only---
1. Site is Zoned?
2. kS mapped soil type(s)?
3. Wetland inventory or C.A. map indicates wetland present on site?
4;:-. Critical Areas inventory or P.A. map indicates Critical Area on site?
5.. Site within designated earth subsidence landslide hazard area?
6. des*ignated on the Environmentally Sensitive Are -as Map?
IDETERNMAJIM—N
,.;,STUDY REQUIRED
WAIVER
Reviewed by:_
P ariner
Rgv 0 1/04194
CONDITIONAL WAIVER
. . Date,
Attachment 7
e Incorporated August 11, 1890 0
PLANNING DATA
NAME:
SITE ADDRESS: 2-� go& -97' P1, Q, —DATE: 7/( /7
ZONING: iEsl PLAN CHK#: 9)-1&9
PROJECT DESCRIPTION:- Maw 6r- 0,,e*L�. Wr-ftz4,,A 3-,�Ar
U C/
CORNERLOT —#0(Yes/No) FLAG LOT A). —(Yes/No)
SETBACKS:
Required Setbacks:
Front: ?-5' LeftSide: -715 RightSide: 75--Rear:_j5'
Actual Setbacks:
Front: 301 Left Side: 75' Right Side: -7.G-' Rear: ?-I '
Street map checked for additional setback required? A)- - N, FL, (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED N JYIN)
LOT COVERAGE: Z-a &9
Maximum Allowed:— 35% Actual: -0'14-
BUILDING HEIGHT:
Maximum Allowed:— Z- _Actual Height: 5,
Datum Point: 69.5k ow k , Datum Elevation: +4
� m- ii, U 5W
A.D.U. CREATED?: 4,jo
SUBDIVISION:
CRITICAL AREAS #: M-05 (4, 4, WA; vev r4- ov, FAV'6
SEPA DETERMINATION: Lene-
LOT AREA: 901 A 0 - --- .
OTHER:
Plan Review By:
c%fi1a%pcnW1%^phmdudw
W.
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8.5, 00 1 26 If ky
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176.7 2.
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RECEIVED
z
Q, JUN 10 1999
DEVELOPMENT SERVICES GTR.
CITY OF EDMONDS
11 -
T 3
6-rl%-4- - I.,- p9apposr-0
44 :Wt4lGW 6MAX)
F_
T-0. S.
cow-
scale site vlan
Z' 6) 10 f Is 2o, !So 40' so
lot covemas
'!F>. F. / 5,PI-4 -5.,F. cL_oT,&,Pc-,A,) Z.5.8 7.
hek*ft - cal6
5 + 4-+'5, cp 4-4 z q t 44(.. 0 11-71
AL-L,OWF,P) 4(vT6S'> 4:ro-7,s'5 66,,r--MA4, 4&Lc-)
ED
APPROVL BY PLANNING
Tun*ov Bukkn kw,
169U 151h Am H&
Sestft WA W155
toll (206) 216-=4
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CITY OF EWOI-405 SHofzT'FLAT
15 I=- 9 5 -1 G7-
,4&,F * q:�c;4-2j S Ov 1 (21 F, TA ST. 5. W.)
ih�
Esperance Court
s - 1-7 -q9
PERMIT EXPIRES
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
'7, , I I i4 kg�
,I,
MAILING ADDRESS
! , �,, , --, i
CITY
I _�r
NAME
t Wl� c
t- ADDRESS
CITY
NAME
�11 I , "*. jAt")�
a: 1 ADDRESS
0
CITY
z
0
L)
STATE LICENSE NUMBER
ZIP TELEPHONE
I < Z. 7 1
ZIP TEC��HONE
A 7
ZIP I TEtERHONE
EXPIRATIONDATE I .,CHECKEDBY
—7
LEGAL DESCRIPTION OF PROPERTY INCLUDE ALL
ZE
;c,.,
L)
U)
W
a
_j
.I
0 PROPERTY TAX ACCOUNT PARCEL NO.
Lu
_j
(7/1 NEW
V-1-
I RESIDENTIAL
7—
[:) ADDITION
COMMERCIAL
r-1 REMODEL
APARTMENT
F-1 REPAIR
GR�AQING
CYDS
DEMOLISH
TANK
GARAGE
RETAINING WALL
zi CARPORT
C] ROCKERY
0
PI (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
a- I
aj NUMBER NUMBER 0
a
C3 OF DWELLING
0 STORIES UNITS
DESCRIBE WORK TO BE DONE
PLUMBING / MECH
COMPLIANCE OR
CHANGE OF USE
SIGN
F-1
FENCE
( X
OTHER
RENEWAL
CRITICAL
AREAS
NUMBER
i
USE PERMIT
ZONE
/V NUMBER
JOB SUITE/APT#
ADDRESS
0 4
LEGAL DESCRIPTION CHECK
SUBDIVISION NO.
7. 7
LID NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Appro�eclj>j A 7
RW Permit Required
EXISTING — REQUIRED DEDICATION
Street Use Permit Re NY" C:
Inspection Required, �4�
PROPOSED
Sidewalk Required.,
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
YES�R NO 0
cc
REbAAKS
uj
z
z
lv-, 1,v'p 7*Z,,
Aw
0
z
V 'T � t V
2 2
ENGINEERING AEMO DATED REVIEWED BY
FIRE MEMO DATED REVIEWED BY
VARIANCE OR CU
ADS#
SHORELINE #
SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWED PROPOSED
EXP I
,
LOT COVERAGE
REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT L/R SIDE REAR 0
C-,
Z_ I z
z
LOT AREA
PLANNING REVIEW BY 15ATE"
FT) CHECKEDBY jTY'_ nFCON
SPECIAL INSPECTOR JAREA
REQUIRED E] YFS
REMARKS
PROGRESS INSPE
ri-r
CODE I OCCUPANT
D
1 0
PER UBC 108 Z9
FINAL INSPECTION REQUIRED
IVALUATION
PLAN CHECK FEE
HEAT SOURCE
GI!AZINGj.'
LOT SLOPE %
BUILDING
I
o
—FL—ArJ 'CAECK NO: I
VESTED DATf
PLUMBING
I
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE W ORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADING/FILL
DOMAIN (CURBS,SIDEWALKS, DRIVEWAYS, MAROUEES,ETC.) WILL REQUIRE
SEPARATE PERMISSION.
STATE SURCHARGE
cc
W
PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT: I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
STORM DRAINAGE FEES
(n
W
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
ENG. INSPECTION FEE
X-
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
M
EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
_j
0
DEEMED TO MOD IFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
PLAN CHECK DEPOSIT
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE 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
TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
application is not a permit until signed by the
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Building Official or his/her Deputy: and Fees are paid, and
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
receipt is acknowledged in space provided.
SIG.NATUIRE (OWNER 9R AGENT)
DATE SIGNED`�
(425)
OFFICI �,SIGI\14TURE DATE
771-0220
"REL�ASEb BY"
ATTENT�ION
IT IS UNLA�VFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORIGINAL FILE YELLOW - INSPECTOR
PINK -OWNER GOLD - ASSESSOR