21817 98TH AVE W.PDF9669
21817 98TH AVE W
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CITY OF EDMONDS
NUMBER
CONSTRUCTION PERMIT APPLICATION
ADD
N 1 01' lit:
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LEOA rffiflr�71r"T 0
. 111), NU
PUBLIC RIGHT OF WAY PER OFFICIAL, t;TRECI M�.P
APPROVED BY
I, 11LEP110-NE N Mbli-
77(�
--INQ lt[QU0I[IIDID1CAToN-----,
NAME
P.010SED
MIAL- C L/
RjdHT Or WAY CONSTRUCTION �FPMIT REQUIRED 0
Z5
ADOPESS,
STRE�T USE PERMIT RCOUIRED C
REVIEW BY
EE ENGINEERING MEMO DATED
CITY TELEPHONE NUMBER
LILL r% I L?M4.
REMAFIK�,,"
n
(,7 N S 7-K C�-Iof
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METER SIZE
SUPPLY SIZE FFtXTURE MRS
Y ZIP
E HONE NUMBER
1BUIL011IG
ngo
REMARKS
t
C,
STATE LICENSE NUMBEn I I
KVF cc I
SIGN AREA
j7.D,. PAOPOFED
ENV. REVIEW
COMPLETE ExEM I
AD6 NO.
L -at Script on of To )erl
Id
SH..EUI
z
( I
'U
PLA NG REIVIFIV-44,
SE.TbACKb' — FEET
GHT LOT COVERAGE/
�-FONT 2-4�— SIDE 9EAR/1:;]
Tax A U. r el N
-C.17 -12
REMARKS
11" im I
z""t
PLUMBING
K0L4zZ"Z,4
NEW
IN JLESIDENTIAL
AODIALTER
COMMERCIAL
NeCNANICAL
REPAIR
-PTmB1-0Cm El so.
F'CAVATE, F 11.1. FENCE
'ED BY ITYPI 01 CONIT N
�H�CK _ :7_
V
HI1G11T
DEMOLISH OR GRADE (_ , _-FT)
.,:"
occul,
NCY
-PANT
F-1 CARPOIEIT SWIM
EIEM.D'EL GARA. []J POOL
SPECIAL -CTOR
rEOUIRE ;NSPE
ZA
GROUP
AD
0WOOD TOVE! f-7 RETAINING WALL/
INSSERT L-J ROCKERY 0 RENEWAL
EXPLAIN:
C 305
SEm P. ACTVjITV?
Orr
�i
NUMBER OF STORIES NLmaER OF
DWE'.LING
ORK TO BE DONE (AT _,cT FL
N T12 -TACH PL A11)
�,&"�A' L INSPECTION REQUIRED
VALUATION
PLAN CHECK FIFE
li__
B UILDIN�
Z
'j,
Plan Check NO.
1190
MECHANICAL
Th—js i3o'Emit covers work to be done on private property ONLY.
GRADINGIrILL
Any constructiOn on the public,dom3in CiJr�z, sdowplks.,
dr;veways, marquees, etc.) will rect uire separate per��Jss on.
Sf SURCHARGE
Permit Applica 71077815DaYs
Pe. mit Limit: I (Lar - Provided V,iork is Started Within 180 Day3
'joirs,
"Applicant , on behalf of his or her spouse. assigns and
g CQSSOrS in ;,nierost, agr2os to Intl "' and hold,
U
nillGJ,?Ieind
arTl;ln5,, 1,10 City of rdmonds, iAe S
s
0
B trip OYOD S , and 6()fjntS lirofn aRy' tind all claims lor darl"190-4 of
It
IIOIR 15stia-cl)
f,
whatever nature, arising directly or indirectly th"
of this permit, !ssuanr.e Of this permit Shall not be deemed to
PLAN CHECK DEPOSIT
M.DaiN, waiVe or reduue any requirement of any city ordinance
'TOTAL
0 nor 1;,�it in any way the Cityms ability to enforce any ordinance
AMOUNT DUE
provision. -
I hereby acknowledge that I have read this appliCIIIG�: that the
jA�,TFNTION
APPLICATION APPROVAL
information given is correct; and that I am the owner. or the duly
au thorized agent of the jwner. I agree to comply -�ith City and
iz-
::j: r�iS PERMIT
This appliCalion is not a permil until
St ate laws regulating construction. and In doing the work author
A1T`-`O11i111S
'HE
Signed by the Building official Or his
n person will be employed in v;olation of the Labor
0 d t he,eb y C
ONLI
v'OnK
Deputy: and fees are d, and receipt Is
Code of S late of Washington totaling 10 Workmen's Compensam
ack Yleoq6di e provided.
I on nsurance.
ECT,OV
IN S"I"T. 0"
-------------- ..........
CITY OF
N 0 IE
L
EOMCr!DS
ATTENTION
CALL FOR
�,,;INSPIECTION
KLEASED DATE
IT IS,UNLAW.1UL TO USE OR OCCUPY A BUILDING OR STRUCTURE'
'771:-3202
UNTI. A FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORi, ORIGINAL — File YELLOW In p,)Ct r
A CERTIFICATE OF OrCUPANCY HAS BEEN GRANTED,
USC!
Ass
PINK 0,,er COLD or
CHAPTER 3.
V
IP
T�
74)F
1:: loll
k-� i4e 0
OF
C-p- AP��Tlok tA [\Y
rERM11 COUNTER 'I
SI& 1-7
WA
I
CA FILE NO-__2�2
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: I)-i'BI-1 99W &-VAi vuh- F WA 2-0
2. Property Tax Account Number: -_ GS9'1 -- OC'L — C)z a C� 01;��
3. Approximate Site Size (acres or square feet): 60iX 12-C'I
4. Is this site currently developed? --)Lyes; no.
If yes; how is site developed? L_(3T
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 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 water: NQ)NjF- _; Approx. Depth:
7. Site contains areas of seasonal standing water: Nor,�G- _; Approx. Depth:
What season(s) of the year? DOR
8. Site is in the floodway t�4i� floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? i�i tQj E7 Flows are seasonal? No_f,,)E- (What time of year? bNf)
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
—For City Staff Use Only—
Siteis*7.0ned? �2;
SC*S mapped soil type(s)? A5�w 1,Azty Zr,� oop) Z^g 7 2- -
inventory or C.A. map indicates wetland present on site?... et2
4.;�*:`::' 'Cn* ti c*al: Areas inventory or C. A.- map indicates Critical Area on site?
landslid� hazard area?
d
.5 Within esignated earth subsidence
6 �.��..:�:i::�Sitedesiknat6 d on the Environm
ental ly Sensitive Areas Map?
DETERNIINATION.
...... ....
STUDY REQUfR.ED CONDITIONAL WAIVER
WAIVER
R e. y."
i..ew y: A11�6
date
R.ev 0 1104194
111-90 - 19" -
City of Edmon&
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,
,IF
.CF
.IVED
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
or plot plan 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 attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant:
Name
Street Address
City, State, ZIP Phone
Applicant Representative:
1 1
17� -/-Z//V4= I
Name
L L (L
- P QS
Street Address
.'s Gpi-TR C= Vf V (6 -? (0
City, State, ZIP Phone
Signature Date SigGa Date
r
CA FILE NO -
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
AMIR-11
L Site Address/Location: 9_XB(-1 99W &-Dfq %A;& F GJA Wd _—�'O
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet): GGiX 12-(Il
4. Is this site currently developed? __)Lyes; no.
If yes; how is site developed? L_0T
5. Describe the general site topography. Check all that apply.
�K Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generafly 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 water: NONC-- - ; Approx. Depth:
7. Site contains areas of seasonal standing water: Not.�6_ _; Approx. Depth:
What season(s) of the year? 00A
8. Site is in the floodway Nb floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? t,,�C' — Flows are seasonal? No_p,,)E' What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc) Ng_ .
11. Obvious wetland is present on site: h!
—For City Staff Use Only—
_4 ..Site'is'Zoned?
"map' soil type(s)? &�"xe 2- -
ped 1!�2(_
ventory or C.A. map indicates wetland present on site?...
3.!"' "'YoWand in.
4ii�,-��tical�Areas inventory or C.A.-'Jinap -indicates critical Area on site?
te within -designated 'earth subsidence1andslide'liazard area?
ae2-
ated on -the Eiivironmentally Sensitive Areas M
6 ao
gn
:DETtRkwAT1ON.-.
REQUIRED CONDITIONAL WAIVER
WAIVER
Re�i..6wid by:
I- date
RcY0J/M4
a 9 0 199,Cj
City of E&mon&
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 areor 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,
R EC:F
.J'VE:0
A 1996
CGMM�J%1_V $jA'60
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
or plot plan for individual lots of the parcel
Vith 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 attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner I Applicant:
Street Address
City, State, ZIP Phone
Signature Date
Applicant Representafive:
& -17- 1,(,VF ii 6:�977�J N C4,A
Narne
L LCI
. k bsiy "41 -)-S- -1
Street Address
Gj A %ff 1/ (6 9
City, State, ZIP 'Phone
SigKa ?I Date
pl,
APPLICATION
for
The City of Edmond*,', SIDE SEWER PERNUT
4 — d,
NEW CONSTRUCTION 0 REPAIRS EASEMENT No . ..........................................
109-00400
OWNER............ 1M.11JAMA ...... UJOBbAra .................................................... CONTRACTOR .................................................................................................. PERMIT No . ......................
ADDRESS ........ ... 9Bth --- Ave....141 .......................... .............. LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
0
0
NAME OF ADDITION
Dye Tested On Sewer 1972
Approved:
DATE................................................ BY- ....................................................................
USE PERMIT
CITY OF EDMONDS ZONE NUMBER
CONSTRUCTION PERMIT APPLICATION joB
ADDRESS
OWNER NAME/NAME OF BUSINESS L DESCRIPTION CHFC 0. LIU NO,
LEGA
V
TESCP Approved 11
STREET 7MAP.
PUBLIC RIGHT OF WAY PER OFFICIAL 1 RW Permit Required 0
:�_ St
TELEPHONE NUMBER EXISTING _ REOUIRED DEDICATION Street use Permit Req*d 0
Zip inspection Required 0
<-- S. " 13
I G PROPOSED Sidewalk Required
11 3bz *
,IAME
ADDRESS
CITY
STATE LICENSE NUMBER
ption of Property -
NUMBER
EXPIRATION DATE
—7 -7
easements
P r 0 P Dr' y
1 Prope y
c 0 U n t
Tax Act: .. t
T a A C
CO
g
N 0
Parcel No.
P a r c e'
DE N T I AL
RESIDENTIAL
R ES I
PLUMBING
N E W
NEW
t
MECHANICAL
I T I 0 N
ADDITION
A
E C IAL
COMMERCIAL
C 0 M M
13 L D G
APT. BLDG.
A PT
El
SIGN
D E ,
REMODEL
Ft EM 0
GRADING
CYDS.
FENCE
I— x —FT)
REPAIR
L S
DEMOLISH
WOODSTOVE
INSERT
SWIMPOOL
HOT TUB/SPA
I
RETAINING WALL/
RENEWAL
ERGARAGE
C PC
CARPORT
ROCKERY
( fTY P 0 US Y) EXPLAIN:
TYPE OF USE. t3UZ1
N UMB'
U
DD WELL
W
N
NUMBER MBER OF CRITICAL
ELLING AREAS
OF ITS INUMBER
STORIES
PLAN)
DESCRIBE W�ORKTO BE DO E (ATTAPH PLO
V . -e- - " I C-t -
i i. -1 14 r k. ^A. t--I , L`V4 ..-- ta I
HEAT SOURCE:
�J—NESIZE I NO. OF
SEPA REVIEW
SIGN AREA
ALLOWED I PROPOSED I COMPLETE jEXFMPT
VARIANCE OR CU
SETBACKS — FEET
FRONT SIDE
YES 0 NO 13
�vIEWED BY
MrEwTED"By
lllmlll�
ADB NO.
4ORELINE#
EXP
PLANNIN REVIEW By DATE
REAR
'HECKED BY ' OF CON-1
SPECIAL INSPECTOR AREA
A
REOUIREiD 0 YES
HEIGHT I LOT COVERAGE
INSPECTIONS PER.UBC 305
FINAL INSPECTION REQUIRED
PLAN CHECK FEE
BUILDING
% PLUMBING
MECHANICAL
Plan Check No.
This Dermit covers worK 10 De do a on private property ONLY. GRADINGIFILL
Any construction on the public domain (curbs, sidewolks,
driveways, marquees, etc.) will require separate permission. STATE SURCHARGE
Permit Application: 180 Days STORM DRAINAGE FEE
Permit Limit- I Year - Provided Work is Started Within 180 Days
7�pplicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE
successors !in interest, agrees to indemnify , defend and hold
ton, its officials,
harmless th�e City of Edmonds, Washing
employees, and agents from any and all claims for damages of ----
whatever nature, arising directly or indirectly from the issuance PLAN CHECK DEPOSIT
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 enforce any ordinance TOTAL AMOUNT DUE
GLAZING
GROUP -7
OCCUPANT
LOAD
Z
provision." ........... that -the
hereby acknowledge that I have read this application
0
ATTENTION
APPLICATION APPROVAL
I
information given is correct; and that I am the owner, oi
I agree to comply with city and
THIS PERMIT
This application is not a perm it until
authorized agent of the owner.
laws regulating construction; and In doing the work authoriz-
AUTHORIZES
ONLY THE
signed by the Building official or his/her
are and receipt is
state bor
ed thereby, no person will be employed In violation of the La
Workman's Compensa-
WORK NOTED
Deputy; and fees paid,
acknowledged in space provided.
Code of the State of Washington relating to
INSPECTION
tion insurance and RCW 18.2
SIGNATURE (OWNER R A
UAI
DEPARTMENT
CITY OF
- RE ------6ATE
OFFIC, A rT_
c,
EDMONDS.
DATE
CALL FOR
RELEASE BY:
- VV%6---V1r% NOW
ATT,J�NTION STRUCTURE
INSPECTION
-
Insp ector
IT- IS7--UNLAWFOL TO USE OR OCCUPY A BUILD ING OR
BEEN MADE -AND APPROVAL OR
771 -0220
ORIGINAL — Fj-I- YELLOW —
UNTIL A FINAL INSPECTION HAS
CERTIFICATE OF OCCUPANCY HAS BEEN "GRANTED. UBC
"INK — Own er GOLD — Assessor
A
�GHAPTER 3.
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Actual
'6tba�ks
Front
Side§05
........ ....
Rear
"'Other
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