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PLANNING DATA
NAME:-
SITE ADDRESS:— e,622�&TE:
ZONING: PLAN CHK#:
CORNERLoT --- AL—(Yes/No) FLAG LOT (Yes/No)
SETBACKS:
Required Setbacks:
Front: 7-15� Left Side: Right Side: Rear: z5—
Actual Setbacks:
Front: Left Side: Right Side: Rear:
Street map checked for additional setback required? (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED WN)
LOT COVERAGE:
Maximum Allowed: 7-)5, Actual:
I
BUILDING HEIGHT:
Maximum Allowed: -Actual Height:
Datum Point: Datum Elevation:
A.D.U. CREATED?:
SUBDIVISION:
CRITICAL AREAS #:
SEPA DETERMINATION:
'00
LOT AREA:
OTHER:
Plan Review By:
cAffleMpermidAplandadoc
CITY
18 90
- 1 4 C,
,,,Vcn
OF EDMONA' so—
SIBE SEWER PERMIT
Address of Construction: OL/9
V r '0
,llijbu, NNOVkKS DEPI PERMIT 8672
Property Legal Description (Include all easements):
ED,'V,op,j-i)S
7 3 -7 49W7 I 'M% r' � � . — __.- - , -
Owner and/or Contractor: A &QP1q �4_- S -� c,,,- it -, 1"/c
State License No. E,4 or) a's C
Building Permit No
EfSingle Family Invasion into City Right -of -Way: El No El Yes
El Multi -Family (No. of Units RW Construction Permit No.
Commercial Cross other Private Property: 0 No 11 Yes
Public Attach legal description and copy of recorded easement
I certify that I have read and shall comply with all city requirements Date
as indicated on the back of the Permit Card.
CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
OIFFICE�,USIIE:: ONLY,
FOR INSPECTION., CALL 771-3,M, PUBLIC WORKS DEPT.
Permit Fee: C) Issued By
Trunk Charge: cc Date Issued:
Assessment Fee: Receipt No.:
Lid No.:- C;z /,_3
Partial Inspection: Date -Initial
Comments
Reason Rejected: Date -Initial -
Final Inspection Approved: Dateq� �-5_lnitial
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Green Copy: Inspector Buff Copy: Applicant
Revised 3Y9O
k-
k
The City of Edmonds
Side Sewer Drawing
NEW CONSTRUCTION ;� REPAIRS n
OWNER-------------------------------------------- ---------------------------------------------------
JOB ADDRESS
PWW-0001-1 1/75 (REV.1 1/78)
1� c� k..") Ali �=— � W .
EASEMENTNO . ............................................
LIDNO . .................. . ASMT. NO . ..................
W-7 �
CONTRACTOR....................................... ................... ........................ PERMIT NO . ................
LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ....................................
-----------
............................... ..................................................................................... I ..........
NAMEOF ADDITION ......................................................................... — — ---------------------------
;Z 3
— 4+: Y-V-C- c,0 .
-S, D
iD e -e-
C,
Approved:
DATE--��& . . ............................. By ............................................................
I
NOTICE,
NO ..Wa r-r a n ty T -a
formation*shown on the attached
The in
Hed for use by the OtY Of
map(s) was comp
rnpl-oYees and Consultants.
its E
Edmonds., '
Th,.e City ofEdrn.onds does - not warrant the
these
accuracy of anything set for.th on
ntity *requesting a
M2p(*s-). Any person or e. I
copy should conduct an independent
i i orm'ation shown-o
inquiry regarding the
t-FT�� -map(s),, including, but not Jimited to,
the location of any sewer stub shown. Suc
sewer stubs M<-3y or may- not exist and may
-t at the location shown,
or may not exis
r-ity of Edmonds nor its
Neltheir the
e m p` oy e e*s 0,r o ffi -c e -r s -s- h- a, I. I b e !--,I a. b-'Fe o r h
n on this map(5), nor for
infor . mation give' Ided based
c -iny 0 entation prov
ne repres
upon"said.map(S).
7-
Jt nEIET LE
STf F1
CITY OF EDMONDS SIDE SEWEIR. PERMIT
wv() P . ERMIT
9 0 - 1 91 08 4 3 9
Address of Construction: 2 7- il e- Al
Property Legal Description (Include all easements): 7 3 b," — 0 0 1 13 — OR 0 1
ED�M�
QNQ�
'Owner and/or Contractor:
State. License No.
E9 Single Family
El Multi -Family (No. of Units
0 Commercial
11 Public
I KtATMENT PLANT
R E CC _1E 1 V E D
FFR 0 1 1993
PUBLIC WORKS Opor-
�# 1.
Building Permit No.
Invasion into City ll3lght-of-Way: RL No El Yes
RW Construction Permit No.
Cross other Private Property: 52 No 0 Yes
Attach legal description and copy of recorded eakment
I Vf
.y that I ha.ve read and shall comply with all city requirements
as indicated on the back of the Permit Card.
Date
CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
OFFICE.USE ONLY
FOR INSPECTION CALL WORKSDEPT.
PermitFee:_ IW913y
Trunk Charge: Date Issued:
Assessment Fee: Receipt No.: (le
Lid No.:
Partial Inspection: Date -Initial
Comments
Reason Rejected:
Final Inspection Approved: DatcZ Initial
Date -Initial
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Greent Copy: Inspector Bu . if Copy: Applicant Revised 3190
The City of Edmonds Side Sewer Drawing EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION REPAIRS F� LID NO. NO . ..................
OWNER------------------------------------------------------------------------------------------------ CONTRACTOR ............ ............................................... ....................... PERMIT NO. LEM-
JOB ADDRESS AV --------------- LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
PWW-0001-11/75 (REV.11/78)
NAMEOF ADDITION -----------------------------------------------------------------------------------------------------------------------
E ONDS
T_AjPi\.lMENT PLANT
4j y-.
4 T3
S',D- e
15'
(�u V14
Approved:
DATE 22 ...... 3 ................... By�---
..............................
CA FILE NO. 3 `5
Critical Areas Checklist
------------------------------------------------- - ------------
Site Information (soils/topography/hydrology/vegetation)
I Site Address/Location:
2. Property Tax Account Number:
I Approximate Site Size (acres or square feet): �ILA Cc re-
4. Is this site currently developed? / yes;. no.
If yes; how is site developed?
5. Describ the general site topography. Check all that apply.
7 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 3 0% 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: 4 ; Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway Ni/� floodplain-10 of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? t,) jA, Flows are seasonal? . N j N (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc) V'_
11. Obvious wetland is present on site:
E7.(
3,
DETCRMINATION
^ca_chk.doc: Rev 10/03/97
RECEIVED
0
0
DEC 0 2 1997
City of Edmonds COMMUNITY SERVICES
Critical Areas Checklist
47 C. 19 ) ,
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 determination of the subsequent
steps necessary to complete a development
permit application.
With a signed copy of this form, the
applicant should also submit a vicinity map
orplotplan for individual lots of the parcel
with enough detail that City staff can find
and identify the subject parcel(s). In
addition, the applicant shall include other
pertinent information (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 Area Checklist and atte . st that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant:
. YY�Ck,%/'�4 C-4-
Name 1�
.. -'� �s I -D, 9 1
Street Address
F- C� Yy) 6) I!f) d& 0 ;�' 0
City, State, ZIP Phone
-7 1 (p - L18 ff
Signature J f)ate
Applicant Representative:
Name
Street Address
City, State, ZIP Phone
Signature
Date
CITY OF EDMONDS BARBARA FAHEY
MAYOR
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works a Planning/Building o Parks and Recreation Engineering o Wastewater Treatment Plant
12-5-97
Mary & John Storm
21812 93rd Ave. West
Edmonds, WA 98026
Subject: Determination regarding Critical Areas Checklist #97-233
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 is very important for you to retain a copy of this Critical Areas Checklist "DETERMINATION" for your records.
IMPORTANT INFORIKA'TION TO BE NOTED.
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTAL CHECKLIST 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 -400
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
Note Attachments: Drawing
* Architectural Design Board
C:Reception\Jana\CRLTR.doc
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Thank you.
Diane Cunningham
Planning Secretary
0 Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
"AR
LMI,"
CITY
OF EDMONDS
ZONE PERMIT
-CO"TRUCTION
PERMIT APPLICATION
NUMBER
9 902
OWNER NAME/NAME OFEILISINESS
jo 5—tvtl
JOB
ADDRESS 7 z ej
-3 /9 SUITE/APT 4
P7.
LEGAL DESCRIPTION CHE
SUB ISION NO.
7
LID NO,
MAILING RIESS
T
3 Iq v e- k,-
PUBLIC RIGHT 9F WAY PER OFFICIAL STREET MAP.
EXISTING REOUIRED DEDICATION
TESCP Approved 0
RW Permit Required 0
TELEPH NENUMBE
7��I(vi-v
_
Street Use Permit Req*d 0
Inspection Required 0
NAME
Sidewalk Required
cc
METER SIZE LINESIZE W
NO. OF FIXTURES PRV REQUIRED
is <
YES 0 NO 0
REMARKS Z
ZIP TELEPHONE NUMBER Er
ui
UJI
NUINLLRING MEMO DATED REVIEWED BY
CITY ZIP
TELEPHO E NUMBER
Z
8
IRE MEMO DA I tu R EV I EIME D �BY
STAg LICENSE NUMBER EXPIRATION DATE
uwlvee jFxemotaroov 2A�
Legal Description of Property - include all easements
VARIANCE OR CU ADB N SHORELINE
Z
E
372( 07 0/� OF 07
SEPA REVIEW
COMPLETE EXE MPT.
EXP
SIGN AREA
ALLOWED I PROPOSED
HEIGHT
ALLOWED I PROPOSED
ui
a
.j
u,j
LOT COVERAGE
ALLOWED PROPOSED
�17
rx.
REOUIREDSLIUACKS(FT.)
FRONT SIDE REAR
PROPOSED SETBACKS (FT.)
FRONT URSIDE REAR
Property
Tax Account
Parcel No. ory - aFTZILD e, n�
&OT
I
�NINIEW BY IN
/7DAT9
NEW RESIDENTIAL 1:1 PLUMBING/MECH
11tWAHA5 OF
i r
COMPLIANCE OR
t&:J—ADDITION COMMERCIAL CHANGE OF USE
REMODEL APT. BLDG. SIGN
Z
0
E
0
.
0
GRADING
CYOS. FENCE
REPAIR X —FT)
WOODSTOVE SWIM POOL
DEMOLISH F� INSERT HOT TUB/SPA
GARAGE RETAINING WALL/
CARPORT ROCKERY RENEWAL
HECKED BY
ITYPE OF CONSTRUCITION
VIN
CODE
CUPANT
G P
SPJECIAL INSPECTOR
R I F9yIREO
13 YES
1771 �
Ms -
R7
OCCUPANT
LOAD
HLMARKS
PROGRESS INSPECTIONS PER USC 108
(TYPE OF USEs BUSINESSAR ACTIVITY) EXPLAIN:
.5 .� g
—NUMBER
A
OF
STORIES
NUMBER OF
DWELLING
UNITS
CRITICAL
AREAS
INUMBERJ"7-.g3,
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
A\ .4 lzoam 4
;7
FINAL INSPECTION
REQUIRED
VALUATION
FEE
PLAN CHECK FEE
Z-7z4
HEAT SOURCE:
GLAZ It4G
/0
Wlfr[,30�
BUILDING
PLUMBING
Plan Check No.
et — /-/ 7
MECHANIC
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewEklks,
driveways, marquees, etc.) will require separate permission.
GRADINGIFILL
STATE SURCHARGE
4
Permit Application: 180 Days
STORM DRAINAGE FEE
Permit Limit: I Year - Provided Work Is Started Within 180 Days
u)
ow
2
<
X
0
x
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
harmless the City of 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 deemed to
modify, waive or reduce any requirement of any city ordinance
nor limit In any way the City's ability to enfor— -- Al
ENG. INSPECTION FEE
PLAN CHECK DEPOSIT
provision." y .. nance
TOTAL AMOUNT DUE
/1360
1 hereby acknowledge that I have read this application; that the
Information given is correct; and that I am the owner, or the duly
ATTENTION
0
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 PERMIT
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 Stati of Washington relating to Workmen's Compensa-
WORK NOTED
Deputy; and fees are paid, and receipt is
tion Insurance aria RCW 18.2 .
__]DATE
INSPECTION
acknowledged in space provided.
SIGN UREQO�W!N OR AGENT) SI NED
DEPARTMENT
CITY OF
OFF CIA 0rciGNAIPTR DATE
EDMONDS
TTENTION
CALL FOR
L S By
RE1E&_.EO.1t
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
INSPECTION
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
ORIGINAL File YELLOW — Inspector
SECTION 109
PINK — Owner GOLD — Assessor