21806 96TH AVE W.PDFiiiiiiiiiiii.
9429
21806 96TH AVE W
ADDRESS: —
TAX ACCOUNTIPARCEL NUMBER:. SO 56—
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: 6� DETERMINATION: E] Conditional Waiver 0 Study Required aiver
XW
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATEI
EASEMENT(S) RECORDED FOR:
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORT PLAT FILE:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S).#:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:.
OTHER:
LID ff:
LOT: BLOCK:
LATEMP\DSrs\Fbffns\Street File Checklist.doc
APPLICATION
for
The City of Edddn�i SIDE SEWER PERMT
NEW CONSTRUCTION 0 REPAIRS EASEMENT No . ............. ......................
109-04000
OVITNER ............. David C. Nelson
...................................... ---------------------------------------------------------- CONTRACTOR .................................................................................................. PERMIT No . ......................
ADDRESS ........ 2,1-8.0.6 ... . ... 96.th ... Ave.....V . ............................................. LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . .............................
Pi
40
0
0
NAMEOF ADDITION .........................................................................................................................................
Dye Tested On Sewer 1972
Approved:
DATE................................................ By ......................................................................
T23
Minn
M=
EEM
Flow
rl
!I- J_J __L
7
V
ZICE1
�199,
U.-J. J-J.
DEVELOPM NT E
RVICES:
CITYJ F C7Tk.
D
0
J
VVQ_ L�!
__7
J
J
0 7:14n 5
Lu C,
oon
=4 -
7-:7 - j j
J_J;
f _'.jA --- ---- --
e__
1 -.7
__J
BY.
A,
ING.
A
A
-j—
s
ED
J1,
�LE
PLANNING DATA STREETf�LE
_J1
Name: D6104 0. N&149�on
Date:
SiteAddress: ;,1gC)(# 9�,T" Avenue West
Plan Check #: BLD-2006- 0-+ + +
I Project Description: e.*NLAA:)SPe. 1/2, C, 4. r P 0 Or VVI, t-V
V-itVAVA I rC.
Reduced Site Plan Provided: (0 NO)
Zoning:
Map Page: J 6 +
I Corner Lot: (YES
Flag Lot: (YES
Critical Areas Determination #: lqclg - 2,1
El Study Required
E Waiver
SEPA Determination: 15)C eA'A
E Exempt
El Needed (for sites with 500 cubic yards of grading or within 200 feet of Puget Sound or Lake
Ballinger. Requires: (1) Fee, (2) Environmental Chec4-list, and (3) APO List with notarized form).
Re Setbacks,
Stre *2- ___1
et*
Side:
N
Side.
1 6 1-5
Rear-
lit
Actual Setbacks
Street:
UP
Side:
t4
Side-
's *
Re� ar,
W
Detached Structures: ex.
Rockeries: P.X.
Fences/Trellises: ,# 0 + CA C,&
El Bay Windows/Projecting Modulation:
0 Stairs/Deck: 61C -
Parking Required: 7.
Parking Provided: 7.
Lot Area: ig +oo 4b oi yen
LotCoverage: NIC0
Lot Coverage Calculations: ho"64 > 2-� 0 1h, VI G L V dt 67 &VtA"k
ev P
Building Height
Datum Point:
Datum Elevation:
Maximum Height: 2-5
Actual Height: 4;ftrj! 4. 2_ r7 f &e..f_
ADU Created: (YES /0 OKOW-V�+
Subdivision: JL0J0?,ffJ 6. TkOM 46 AdA No. Vo 61k- 00.0, — LVt *Fill
Legal Nonconforming Land Use Determination Issued: (YES / CO)
Other
Plan Review By: gf;W ae�
C, d r-ILE qct
C&ical Areas Check113 L #0 No
— — — — ; -- — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —
Site Inf -Xmation (soil s/topography/hydrology/ve t.
_geta ion
I. Site Address[Location:
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? 74 yes;
If yes; how is site developed9 /
no.
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 I 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
I 0-feet over a horizontal distance of 3 3 to 66-feet).
Steep: grades of greater than 30% 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:
; Approx. Depth: _
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway _ NO floodplain Ne-9 of a water course.
Z
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?
10. Site is primarily: forested meadow ;shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
b'ET'9kMfNAT10N-:
C
AT.-T
P..
,y.
7 7,
ate,�
ftv�_chk.dK Rw IWMM
City of Edmonds A Z/
/0-
NA�P� CRITICAL AREAS CHECKLIST
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
permit 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 detennination 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 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:
6 V)
Name
nco -
AA)
Street Address
City State Zip
�-5 - -3 /,-� 7 7
Tele ho
a e
Signature
'7
_ /
Date
Applicant Representative:
Name
Street Address
city State Zip
Telephone
Signature
Date
1:reception\janakaddoc (over)
Snohomish County, WA Assessor Parcel Data Page I of 2
Snohomishftlino Government Information & Services
County4*
Washington
* R E A L * Property Information
County Home Assessor Home Treasurer Home Information on which Department to contact
Please view Disclaimer If you have questions, comments or suggestions, please Contact Us.
Date/Time:6/22/200610:30:49AM Answers to Frequently Asked Questions about Parcel Data (opens as new window)
Return to Pro erty Information EntU page
Parcel Number 00559700301500 Prev Parcel Reference 55970030150005
jJ View Mip of this parcel (opens as new window)i
General Information
Taxpayer Name 11 Address (contact the Treasurer if you have questions)
NELSON DAVID C 1121806 96TH AVE W--- EDMONDS, WA 98020
If the above mailing address is incorrect and you want to make a change, see the information on Name and
Address Changes
Owner Name 11 Address (contact the Assessor if you have questions)
NELSON DAVID C 1121806 96TH AVE W - - - EDMONDS, WA 98020
If the above name and address is incorrect due to a recent sale, please see the information on Name and
Address Changes After a Sale
Street (Situs) Address (contact the Assessor if you have questions)
21806 96TH AVE W - - - EDMONDS, WA 98020-3919
Parcel Legal Description
ROBERT E THOMAS ADD NO 16 BLK 003 D-00 - LOT 15
Go to top of p3ge
Treasurer's Tax Information
Taxes For answers to questions about Taxes, please contact the Treasurer's office (opens as
new window)
2006 Taxes for this parcel $2,632.93
(Taxes may include Surface Water Management and/or State Forest Fire Patrol fees. LID charges, if any, are not
included.)
To obtain a duplicate tax statement, either download our Tax Statement Reques form or call 425-388-3366 to
request it by phone.
Go to top of page
Assessor's Property Data Characteristics and Value Data below are for 2006 tax year.
Please contact the Treasurer's office for answers to questions about Taxes (opens as new window)
For questions ONLY about property characteristics or property values (NOT taxes),
please contact the Assessor's Office (opens as new window)
'Property Values do not reflect adjustments made due to an exemption, such as a senior or disabled persons
Values exemption.
Reductions for exemptions are made on the property tax bill.
http://web5.co.snohomish.wa.uslpropsyslAsr-Tr-PropinqlPrpInqO2-ParcelData.asp?PN=00... 6/22/2006
Snohomish County, WA Assessor Parcel Data Page 2 of 2
0
Tax Year 2006 Market Land $160,000 Market Improvement $99,5001 Market Total $259,5001
Pending Property Values
Tax Year 2007 Market Land $195,000 Market Improvement $119,2001 Market Total $314,2001
Go to top of page
Property Characteristics
Tax Code Area (TCA) 00213 View Taxing Districts for this Parcel (opens as new window)
UseCode 111 Single Family Residence -Detached
SizeBasis ACRF- Size 0-19 (Size may include undivided interest in common tracts and road parcels)
Go to top of page
Property Structures
Type Yr.Built Structure Description
Dwelling 1957 1 Story View Structure Data (opens as new window)
Go to top of ppge
Property Sales since 7/31/1999
Explanation of Sales Information (opens as new window)
Sales data is based solely upon excise affidavits processed by the Assessor.
No sales for this parcel have been recorded since 7/31/1999
Go to top of pgge
Property Maps Township/Range/Section/Quarter, links to maps
Neighborhood 1605000 Explanation of Neighborhood Code (opens as new window)
Township 27 Range 03 Section 25 Quarter NE Find parcel maps for this Township/Range/Section
View Map of this parcel (opens as new window)11
http://web5.co.snohomish.wa.uslpropsyslAsr-Tr-PropinqlPrpinqO2-ParcelData.asp?PN=00... 6/22/2006
CA FILE NO. qQ
Atical Areas Checklist*
----------------------------- --------------------------------
Site Information (soil s/topography/hydrology/ve�getation)
I . Site Address/Location: 5zlgrro — ?e� �X /Vo 6 &-)
2. Property Tax Account Number: 7 0 0 3 0 /6-0 0
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.
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of I 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
I 0-feet over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% 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: 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?
10. Site is primarily: forested meadow ;shrubs ;mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
:F0f-Cjt)*r.i. t W-Ti
----------- — ----- ---` ---- - -----
-ed?
- V.-M ui� V.
""6" d'
: -y A jfid
**-:-:LA""`
reas ftyen or
Axii�bn.s e
Site hi 4
)r�i in. esigp4��.. j��tAde andsi.d
. ........... .
.... ..... .
all
-dc�ign�tid-6 *4.. f . ensit -MaK
gite n. Ton S* tye Meas
Meq.,, y
0�
eviewe
d by..`
I R
AC��Chk.docq, Rey 10/03/97
0
City of Edmonds
4,
st,
40
&� �
lkjOP� CRITICAL AREAS CHECKLIST
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
permit to the City.
The purpose of the Checklist is to enable City staff to
deten-nine 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 devel'opment
permit application.
Please submit a vicinity map along with the signed
copy of this form to assist City staff in finding arid
locating the specific piece of property described on
this form. In addition, the applicant shall include
other pertinent infonnation (e.g., site plan, topography
map, etc.) or studies in conjunction with this Checklist
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:
0 t# � 6Y)
Name
alp OG
Street Address
city State Zip
/-7
Telephone
C , laz
Signature
7—C-V —��
Date
creceptionyanakacl.doc
Applicant Representative:
Name
Street Address
City State Zip
Telephone
Signature
Date
(over)
-'.0 C. 1 gc)'-)
July 23, 1999
David G. Nelson
21806 96t�'Ave. West
Edmonds, WA 98020
0 0
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
Subject: Determination regarding Critical Areas Checklist # 99-212
BARBARA FAHEY
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 it, very important for you to retain a copy of this Critical Areas Checklist "DETERMINATION" for your records.
.......... - ................
.......... 1 ................
............. .......... ........
IMPORTANT INFORMATION TO BE NO TIED:'...
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTAL CHECKLIS77 OR CRITICAL AREAS STUDy.
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL 4E
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
C:ReceptionUana\CRLTR.doc
Thank you.
Sharla Graham
Planning Secretary
Incorporated August 11, 1890
Sister City - Hekinan, Japan
DA ZoneG N.E. 1/4, SEC. 25 T27N., R.3 E.W.M. 154
9S3
ol
ALDER S T.
c
4015
?
14 o,
W
2
N
la
"
v
4
.
"'j L-j I I ., 1, 1
INS
o,
0,
EtAORW��'
'W LNU7 i WD I
Ifth ST.
2120
6 '04 a I T t T 211LOS ' ''
0
a, 21202 21211
M
R! c
CEDAR ST
T- io
CO R PL. fills
1215
60'1 71220
X
t- 2 2122Z (L
o bA _�Z1217 0;�
> z A a, lA 01
�4 MIS 80 21230
Ln 119
SPRUCE ybi --
T.
0 00 'D . — Q 21224 21SOL
213
w3o8
cc
1� I a
710 IL 1.132, 21306 2131T S09 —
TV 707 2: -a 213"
721
�J323
21316 0
N 21401 aisle 4r
�2,6 3 2 9
7/4 7/1 LN , ?14,t. fS21
731 7(o 121400 �9 21411 21406). Z1324 I . 21321 21AOS Mos
08 1330 9 2132 14ol
Z 2 CY) 21424 21419 Z' 4og S 21329 ?Jj 12
21 2141q
803
21429 . 21M p4l 21115 in -21413
10
2MI6 cu
214 T' PL'. 5.W 1jd,2, N R
81
all
:11
25
S.
7
ill
oq
gos
ao
coo
I
N
F—
.
(r.
R
'16
21522
1
7-
�4
m
JA
PINE
)10
1009
N
01
I
Njl,�J�
21506
21525
15z4
S94
21522
?n
CM
7r.'
rn
(71
-
7"' '
' i
A
OD
21502
11
215
0-
21510
21506
so
a,
21509
215,18
513
"1
W22
519
k
01
q,
AL
216-
ST
S. W.
16TH
1607
21
216" PLI
124 )013 1015 2]6zs 01 21611 1
— 103=1 10)7 2/630 21629 21626 21627 21628
36 U1 tu 217 11h S T 5v 21625
> 3 21700 21701
c� JO35 )OR 21702 > 2170/ 21704 2170
21710
to In cm cm 21705
217/0, 709 Q� 0- 4:4
21707 6 *, 0, 0,
48 - .7111 � IT"- I 1'�! 1 1" 1 "' 1�!' 1
1041 125 21708 2170 21705 i 21714
Lu 2)717
2/7/5 217/4 > 1719 217/6 4715 1709 0-911 m ZI 714
1051 121 9:26 217/6 722 141
,54 21726 21118 1723 21-no Z1729 C4
— - 21
1061 cz. rq 72 '72.
922 21728 [723 Z1727 V730 z - 217
Z?72 9 2tl2t. 727 21728 1791
r- 9 A# 21804 21802 1807 21801. 21802 A A .91801 2)802 a
— 218ry a, (M x
1109 917 it 80,21807 13, 1
k 21810 -j 21805 Z04A PJ805
21912 219/7 21814 2f819 2iglf. lei Z�
1123 91,5 916 co U) 2 1 Igll 218it 21917
2
ZIPS 0)
1125 21820 cm 1821 21822 2182T 21921 21019 21818 ?J819
2182.1 2/922 24 821
218, 21826) 2 81 91829 21626 2J827 21
- 21824 . 1829 21926 2;je2i3] 7 Lu 21923
131 zz I A& rill
19 S 2)900 19 > 2)901 21932
16
ztglo 2191/ 21900 21821 2623 — It 1 ?1905'
J41 N 10 - 1 21916 Z1901- 2igog 21908 —
R! 21920 )1 �41 a 20
219/9 Is 0� 1909
t;! 01 FZ-1912 n 21920 1923 219167
1139 P" in 01 19, ?J9146
cm , 1 31
0 21925 C4 ej w
00 co 00 a N 4tlql5 � �, I - ;� 01
In r.
01 f"
x . 0,
2fo TS ST S.w 220 ST S. W. 20,rm
— zZaas 11V� 1� , ,
22004 22.006 92011 wffS-r(.ATE 's,
ELM.
22014 2201S 22014 ZZ01 5 Zo� Z7011 '07
ZZ,014 tM
it.
01.
22024 CK 221125 22aq 40 22017 15
04 22022 22027 0251— ---
1 k2mi IW7 22030 03 1
CA FILE NO. cict '1A Ll-
Atical Areas Checklist *
--------------------------------------------------------------
Site Information (soils/topography/hydrology/ve t tion)
(I X �e a
I. Site Address/Location: �5zlgoo —
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? -4yes; no.
If yes; how is site developed? LA-5;-.Q-
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 I 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
I 0-feet over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% 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: O(JO _; Approx. Depth:
7. Site contains areas of seasonal standing water: ___ 1A)Q Approx. Depth:
What season(s) of the year?
8. Site is in the floodway - NO floodplain No of a w. ater 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?
10. Site is primarily: forested meadow. ;shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
:F
rat
4..ty k �S..)
W.
4004. :% 44
etli idl.,' afc'ato'
"K
jqyFn o
.9p. -%,,.!.,.,.
FZ_
.: Icat
'en ' ;.' .. 'i '� � * "�' 17'..
dtical'*Af�asltw ory p
im oct r n s
.y
-tje �Yj�hln d*e* '"ii' d i*o%aiidillde.
eas
Y,
. . . . . . . . . . . . . . . .
',L V
a
A:,
Ac�.dk.dM Rev 1WMM
City of Edmonds
NA�V CRITICAL AREAS CHECKLIST
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
permit 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
th� 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 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 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 Cbecklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/Applicant:
6AO.�560
Name
0 co
Street Address
city State zip
'1-197
Telephone
Signature
Date
creceptionVanakad.doc
Applicant Representative:
Name
Street Address
Citv State
Zip
Telephone
Signature
Date
(over)
01 0
PLANNING DATA
NAME:V&"
SITE ADDRESS: IA(V 9&�L—WDATE: C�
ZONING: PLAN CHK#: jq - zq,
PROJECT DESCRIPTION: 1VOUT UVJ—
CORNER LOT_jLQ
.(Yes/No) FLAG LOT.
(Yes/No)
SETBACKS:
Required Setbacks:
Front:-*'24; Left Side: RightSide: 7�;�Rear:—L�—
Actual Setbacks:
Front:-20 Left Side:--7,5' Right Side: Rearl
Street map checked for additional setback required? — (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED— —(Y/N)
LOT COVERAGE:
Maximum Allowed: Actual: N
—4— ZO--
BUILDING HEIGHT: " 1�
Maximum Allowed:-f!��—Actual Height:
Datum Point: Datum Elevation:
A.D.U. CREATED?: 46
SUBDIVISION:__u
CRITICAL AREAS #:-N— /Wn
AA
SEPA DETERMINATION:
LOT AREA: -
OTHER:
Plan Review By;
c%fi1cjkpv7W*1p1&ndudao
A
:.A.
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
0ANER NAME/NAME F BUSINESS
MAILING ADDRESS
,-� / �q � ) /, — 9/, zk-
�"I�
TELEPHONE
NAME
0 W I to aj
ADDRESS
CITY ZIP TELEPHONE NUMBER
STATE LICENSE NUMBER EXPIRATION DATE
Legal Description of Property - include all ea?ements
'I U11 A 1; lqjj. MA
USE
ZONE
PERMIT
NUMBER
JOB
ADDRESS
SCFITE/APT
#
IIPTION CHLUBON14040.
LID NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCP Approved
0
EXISTING
REQUIRED DEDICATION
RW Permit Required
0
—
Street Use Permit Req'd
0
Inspection Required
13
PROPOSED
Sidewalk Required
13
cc
METERSIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
I_
W
YESD NO 0
REMARKS
Lu
a:
W
0
ENGINEERING MEMO DATED REVIEWED B�
cu I A A'014.0 I SN(YRELINE #
COMPLETE I EXEMP ALLOWED' ' P OPOSED ALLOWED I PROPOSED
EXP _W14 IVIA
LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETYACiKS (Fr.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT UR VSID REAR
/<
Tax Account
ParceINo.
LOT AREA _-`(
'd
JANNrl
,f,EVIEW B
'I, � /
115ATE
-
EINEW
RESIDENTIAL
El PLUMBINGIMECH
REMAPKS-
El
COMPLIANCE OR
1.00i ADDITION
COMMERCIAL
CHANGE OF USE
1:1
El APT. BLDG.
El
REMODEL
SIGN
GRADING
FENCE
E]
CHECKED BY LTYPE OF CONSTRU
CODE
OCCUPANT
REPAIR CYDS.
x _FT)
I X_
v
G 0
WOODSTOVE
DEMOLISH D INSERT
SWIM POOL
HOT TUB/SPA
&V VIX)
SPECIAL INSPECTOR JAREA
OCCUPANT
REQUIRED
LOAD
GARAGE RETAINING WALL/
13 YES
jai_—
E] C 1:1 ROCKERY
RENEWAL
,
REMARKS I - .
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
PROGRESS INSPECTIONS PER UBC 108
NUMBER
NUMBER OF
IT'C L
CRITICAL
OF
DWELLING 7AREAS
I
2 Z
_40
STORIES
UNITS
UM R
NUMBER
D�ERI ORK TO BE DONE (ATTACH PLOT P N)
r
�!71E
_4_ 7 ny\ /0
All
6tt
FINAL INSPECTIOA REQUIRED
VALUATION
FEE
PLAN CHECK FEE
1,47
BUILDING
HEAT SOURCE:
GLAZING
PLUMBING
Plan Check No. (,Irl
MECHANICAL
This Permit covers work to be done on privatili prolsertVONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
successors in interest, agrees to indemnity, defend and hold
2
harmless the City of Edmonds, Washington, its officials,
m
employees, and agents from any and all claims for damages of
a:
<
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 requirement of any city ordinance
0
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
I
provision."
I hereby acknowledge that I have read this application; that the
information given is correct; and that I am the owner, or the duly
ATTENTION
APPLICATION APPROVAL
authorized agent of the owner. I agree to comply with city and
.
state laws regulating construction; and in doing the work authoriz-
THIS PER MIT
AUTHORIZES
This application is not a permit until
ed thereby, no person will be employed in violation of the Labor
ONLY THE
signed by the Building Official or his/her
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
Deputy; and fees are paid, and receipt is
tion Insu rance aria RCW 18.27.
INSPECTION
acknowledged in space provided.
SIGNATURE (OWN 0,R A N
!9q, GE T DATE SIGNED
D EPARTMENT
CITY OF
OFF��l �LIGNtl�RE DATE
EDMONI )s
V,1A A
ATTENTION
CALL FOR
R&CEAJE6 _DATI!
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
0220
ORIGINAL — File YELLOVV — inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC,,.771
SECTION 109
in'3.R7
kE (� - "wk) c
PINK — Owner GOLD — Assessor
W
ALAI
DAVID 6 NELSON TAX ID. s;sWO030150005
21W64@YH- A"E
EDMONDS, WASHINGTON SQUARE FOOTAGE: 8,276.4G
ZOWNGc R" ACRESr 19 -00 LOT 15
LEC-AL DESCRIPTION: ROBERT E! THOMAS ADD. NO. 16 BLK 003 D
to
_c
LA- c,' F
&
9P
144
rt4lo
'!�5 Dka' " 6o
STREET Fl.LE
) j 0 '�:7 .10 /
F 18 4.2oo
BUILDING DEPARTMENT
CITY OF EDMONDS
I I -?Yvl�o
STREET FILE
V,'& w
RECEIVED
FEB 14:2008
BUILDING DEPARTMENT
CITY OF EbMONDS
L,
B
LL-
LLA
w
C=
al 5-n N C-�
OWNER: PARCEL # 0056970030`1500.
DAVID C NELSON
21806 86YH- AVE. W TAX ID. 55970030150oa5
EDMONDS, WASHINGTON
I
ZONING: RS-8 ACRES: .19 SQUARE FOOTAGE: 8,276.4G
LEGAL DESCRIPTION: ROBERT E. THOMAS ADD. NO. 16 BLK 003 D-00 - LOT 15
Ar
3
A
N
129�
.---...-...REcElVED
FEB 14 .20as
BUILDING I)EFARTMEN?'
CITY OF FbMoN[),-,
Southwest comer of property
(picture taken from roof of home)
42-
To
STREET FILE
RECEIVED
FEB 14.2008
BUI G UgM I
Mg�
WIN gj%,
OTY oF q
'�'�CITY OF EDMONDS
BUILDING DEPA TME
WORK le�
ADDRESS
0 r
WNER
APP:ROV:ED DATE,
AL� __
rBLDG. OFFICIAL
Ir Ml JaRr
MIT NUMBER
STREET FILE
RECEIVED
FEB 14 2008
BUILDING DEPARTMENT
C4TY OF EDMONDS
jar "N
OL
619 0 - 199 -
0 City of Edmonde,
RIGHT-OF-WAY CONSTRUCTION
EET FRILLFE
-W 01 DRA 10 WA
Permit ilumDer:
Issue Date:
A. Address or Vicinity of Construction: 21806 96 Avenue West
B. Type of Work (be specific): Install NEw Service
C. Contractor: Washington Natural Gas Company
MailingAddress: 815 Mercer Street,
State License #: Seattle, WA 98111
D. Building Permit # (if applicable):
Contact: Frank Swan
Phone: 224-2278
Liability Insurance: _
Bond: $
Side Sewer Permit # (if �pplicable):
E. [I Commercial El Subdivision El City Project fR Utility (PUD, GTE, WNG, CABLE, WATER)
F1 Multi -Family 0 Single Family Other
INSPECTOR: INSPECTOR: vi %A &M-1
F. Pavement or Concrete Cut 0 Yes IMNo G. Size of Cut: x H. Charge$
APPLICANT TO READ SIGN
INDEMNITY. Applicant understands and by his signature to this application, agreesk.ld the City of Edmonds harmlelfrom injuries, damages, or
claims of any Aind or description whatsoever, foreseen or unforeen, that may be made agaim§t the City of Edmonds, or any of its de a en oe pay-
p� rim L�, F m I
ees, including or not limited to the defense of any legal proceedings including defense cosollqnd'attomey fees by reason of granting this permit.
THE CONTRA CTOR IS RESPONSIBLE FOR WORKMANSHIP A AD MA TERIALS FOR IA-R.�09-ff ONE YEAR FOLLOWQ; Wd_&F[ffJL.INSPEC77ON
AND ACCEPTANCE OF THE WORK ES77MATED RESTORA77ONFEES WILL BE HELD UN77L THE FINAL STREET PATCH IS COMPLETED BY
CITY kZ)RCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Departm
Work is to be inspected during progress and at completion. 771-0220
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 ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and understand the permit requirements and the pink copy of the permit will be available
on site at all timesfor inspection purposes.
Signature: Date: September 14, 1992
CALL DIAIA—DIG PRIOR TO BEGMNING WORK
k MW I "m W1.4Lve K-1 0 0
ANCE
Engrg. Div. 1991
FIELD INSPECTION
III - Route copy to Street Dept.,�� � 14,
Co,mments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION
Partial Work Inspection by P. W.:
Work Disapproved By:
FINAL APPROVAL BY:
0 YES 0 NO
Date:
Date:
Eng. Div. July 198'
AMI
Naboid C", Me
Addendum to city of Edmonds
Right of Way
Permit Application
Submitted by:
Engineering Aide
Washington Natural Gas
622-6767 x2761
0)(, AV LJ pager,q(-
q
0 WNG to window
�)�Water main depth -w- water
unknown -g- gas
-ss- sewer
gas main -&- water hydrant
0 water valve
815 Ma= St. (P.O. Box 1869), Scattle, WA 99111 (206) 622-6767
R rut=
=T FILE
Nemo to: Director of P blic lliorl�s
From: Assistant City Engineer
Subject: Sewer Connection Oiarges
Legal Description:
DATI;_ARr�l 13, 1977
7
The south 106 feet of the north 424 feet of Lot 9, Block 7, Plat of
Alderwood Manor No. 9 as recorded in records of Snohomish County,
Washington.
Comionly 1�ma�m as: 21813 96th Ave. W
Z.1--.F. Calculation:
(121.65 Z.F.F. X $5.50
Lateral X
Unit X $ 25
Vcc: Owner
(Xmer: Ms. Pam Foster
669.08 Connection 1ee
$ Lateral Cliarge
$ 25.00 Trunl< (liarge
10.-00 Permit
704.08 TOTAL
&'�p - I
'RICHARD H. ALLEN
a I *GOT
bi
4 0 1.
01-
0
v /wo
'eV
eG —407
7&* �V
(7/y a aw cr Z97
ftj 7Z
'i"
401V
CITY 0-0 L-OMONDS
PUBLIC WORKS DEPARTMENT
TO:
LU
D
0
�7-
SUSPENSE DATE:
DIRECTOR
Investigate
and Report
Take Appropriate
Action
Prepare
letter/memo
for my signature
For Information
Previously Ref'd
Status of Action?—
Return to:
ADMINISTRATIVE SECRETARY
BUILDING MAINT. FOREMAN
EQUIPMENT RENTAL FOREMAN
PARK DEPARTMENT SUPT.
STREET DEPARTMENT SUPT.
TREATMENT PLANT SUPT.
WATER/SEWER SUPT.
COMMENTS:(: 7
/,P) 8A
LOP
U
FROM:
DATE: 17 7
MAKE REMITTAI,
MENT
REAL ESTATE TAX STATE 1977 KIRKE
SNOHOMISH COUNTY, STATE OF WASHINGTON
COUNTY, MUNICIPAL, SNOHOMISH Co
OF ALL STATE, P.O. BOX 568 E'
SCHOOL, AND ROAD. TAXES.
L E V Y MARKET VALUE TOTAL GENERA
CODE RATE- LAND BUILDINGS 1:
741 61 1 _3 . 1 6�5 013 7, 5 C, t.- 13 1 §9!- 21 91 rt, 1. -
imm _. : .. t�i7t -
YOUR TAX DOLLARS GO TO THE FOLLOWING: - T 0
SCH OLS, STATE COUNTY SCHOOL DISTRIC FOR
CITY OR ROAD/LIB. IT
6 27.5 42.2 15
'SCEH I * y
OO'S''
0
CL FI PITA WAT SEWER FOREST FIRE DIKE
FIR I ICT HOS L ER
F DISTR
0 130 3L) Juv5b I EGAL DESCRIr I f%_
NAME AND ADDRESSt
S T e
ALOERWOOD MA r
N)p 9
P 0 S T E R P AAMELE
IT
BLk 007 D—C-7 4
E D MON, ri S WA 9802.0
ui
PLEASE PRINTCHANGE:01
_�j OR 'CHANGE
'RE
<::(erAXPAYElD CERPT NAME
NOTICE: ADDRESS—.
CITY TATE
-I ST HALF DUE TO AVOID FULL TAX PLUS INTEREST
:S PAYABLE TO: F APRIL 30
r DU OCT. 31-2ND HALF DUE TO AVOID INTEREST
DA TAX UNDER $10.00 TO BE PAID IN FULL.
IEVERS..- LRKV q - �
4TY TREASURER I i ,
RETT, WA.98206
1=114,14,111, m
jaj:j:J:L44fflI0ll:U -71*
Lu
PR�OCESS co
11
UMB ACCOUNT NUMBER
T A X NUMBER I
SPECIAL N z
7 0 4
-57 40
9 7 3 3736-007--OJ9 4
1977 Lu
RICT OTHER 1977 FULL TAX D11111-
276.97
91 0 _2
No.
14U DRAIN NO. Z.
ION, IF ANY
4Y
LESS EXEMPT 122.32
0
.0
FULL ix
: I u
.................. I W
CHECK BOX TO
INDICATE FULL OR
9
HALF
V7
156.65
'. J33
4A
HALF PAYMENT
7
78.33
1--
0
C-4
<
C-4
0
LF
A -H
z
OMIT ROLL
TAX AMOLiNT
OR
INTEREST -F
YEAR YEAR
UJI
>
UJI
bu
Ix
tfi
ui
d
cz
Z
�g
I I —
CHECK
zip's
�.__CODE M.O. -57EL
CASH 0—
CD
TOTAL ONLY
AL