21919 80TH AVE W.PDF111111111111
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21919 80TH AVE W
AG
STREET FILE RECEIVED,,.,.N
Critical Areas Checklist' J LIN 14 1993
Site Information PERMIT COUNTER
Project Name: '�;C," 0 YA Permit Number.
SiteLocation: 'a\(-\\Ck Ck
Property Tax AccountNumher. QQ2_- oil
Approximate Site Size (acres or square feet): 0 1 7 0
'Have you filled out a Critical Areas Cheddist for a project on. this site before?
General Site Conditions
L' Has the site been cleared or logged? -e S Date of most recent action: _0cA- f Vk 0
Soils /Topography &-4L_,—.'AC-'-.<\��
2. In the Snohomish County Soil Survey, what is the mapped soil typc(s)? 1, Y,
C�,
3. D7tgcnetal site topography. Check all that apply.
t:
less than 5 feet elevation change over entire site-
Iling: slopes on site generally less than 15% (a vertical rise of 10 feet over a
horizontal distance of 66 fceL)
IM13r. slopes present on site of more than 15% and less dian 30Vp a vertical rise.
of 10 feet of horizontal distance.)
Steep: grades of greater than 30% present on site.
Comments
Hydrology/Ve&tation
4- Site contains areas of year-round standing water-
5. Site contains areas of seasonal standing water-- Y'V-0—Approx. Depth:
6- Site is in the floodway . 1,n4 t floodpl ain , t\'� of a water course.
7. Site contains a creek or an area where water flows across the grounds surface? AL�Iflows
are yearround? —Flows are seasonal?
8. Site is primarily: forested meadow -shrubs mixed
---------------
9. Obvious wetland. is present on site:
10. Wetland inventory or map indicates wetland present on site:
11. Critical Areas inventory or map indicates any Critical Area on site: 111,
For,Gty -Use Onli
0
CitY of Edmonds
Critical Areas Chec* Mist
UC Critical Axcas ChmMist contained on
this form is to be filled oult 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.
Ile purpose of the Checklist is to cnable
CitY staff to determine v'vhcthcr any potcntial
Critical Areas am or may be present on the
subject property. Ite information needed to
cOMPIctc the Checidistshould be easily
available fiom observations of the site or
data available at City Hall (Critical Areas
.inventories, maps, or soil surveys).
An applicant� or his/her representative, must
fin out the C'hccldist- sign and date it, and
submit it to the city -Ihc Citywill review
the chocidist, make a precursory site visk
and a dammination of the Mbsequent
stcPs U==arY to complete a development
Permit application -
With a signed copyof this form, the
applicant should also submit a vicinity map
of the parcel vidi enough dctal that City
staff can f ind and identify the subject
parcel(s). In addition, the applicant i
Is
encouraged to include any other pertinent
information or saidies in con unction with
9
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
n�.k,, A n.--
Tide -
Street Address
Applicant Representative:
Name
Title
Street Address
(�7 6
City, State, Z�Ip Phone C't S zip
% , y, ale
Phone
Signature Date Signature
Date
PERMIT
CITY OF EDMONDS ZONE
CONSTRUCTION PERMIT APPLICATION Jul:$ NUMBER SUITE/APT
OWNER NAME/NAME OF BUSINESS ADDRESS
c <" z vv\ a h LEGAL DESCRIPTION CHECK SUBDIVISION NO. LID NO
MAILING A�CIR!S�. _ _ I
--) \ - III, C� T, , V�- V<- �&) - TPUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved 0
CITY NUMBER 0
T11.111111 :W Permit Required
7 -STING — REOUIRED DEDICATION ilreet U80 Permit Req-d 0
PROPOSED mpection Required 0
NAME Sidewalk Required 0 C
ADDRESS
-7 2, IS
ITELEPHO14E NU.BIER
NAME
\4 -T Ir\ ENGINEERING MEMO DATED REVIEW BY
ADDRESS
72--� (�A \ G, M ETER SIZE IBUILDING SUPPLY SIZE I NO. OF FIXTURES
<:�l - U ) (\ - -t -("L)4k-
I / ) (\ - / -1 -�
REMARKS
STATE LICENSE NUMBER EXPIRATION DATE
SIGN AREA
ALLOWED I PROPOSED
SEPA REVIEW
COMPLETE E . XEMPT
r�h
Legal Description of Pro - iincl 11 Its
_,party / We a easempn
7 (',So �� V\
81
It A
VARIANCE OR CU
PT7 G REVIEW BY
n H- a j- e -s,
SETBACKS - FEET
-
PRO I-'5!IOE-7 —CREAR
EIGHT
��7x7wcloun"H W (�- 6,02--
Parcel No.
REMxA
NEW
ADDITION
PLUMBING
MECHANICAL
#
ElREMODEL
SIGN
FENCE
CHECKED BY
TYPE OF CC
GRADING
L-J REPAIR Li CYCIS. Li , X—
I
--V/- - /J I
q1
1 zs-,
DEMOLISH OOD$TOVE $WIMPOOL
INSERT HOT TUB/SPA
1:1 1:1
SPEC INSPECTOR
AREA
OCCUPANCY
OCCUPA NT
1
.
Oultli.
.6 ED C3 YES
GROUP X^
\
LOAD.
0 AR AGE RETAINING WALL/
CARPORT RENEWAL
MARKS
. ..
ROCKERY
k c
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN
PROGRESS INSPECTIONS PqR VBC 305 z
M&f1IAL-Z(-U11-
NUMBER OF STORIES
NUMBER OF
DWELL NG
0
UNITS
DESCRIBE WORK TO 13E DONE (ATTACH PLOT PLAN)
v-,e Ir(jt---
INAL INSPECTION
REQUIRED
\r, (-)o Y-Y, L (I u v, c ri n t 0
VALUATION
FEE
Ck
PLAN CHECK FEE
0
c� (A rA (A C 0
HEATSOURCE* GLAZING
BUILDING
--.)
C—
PLUMBING
Plan C.heck No. �7
97. 1.7--,
MECHANICAL
This Permit covers work to be done 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
Permit Limit: I Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse. heirs, assigns dird
ENG. INSPECTION FEE
successors in Interest, agrees to Indemnify, defend and'hold
harmless the City of Edmonds, Washington, its officials,
2
employees, and agents from any and all claims for damages of
�<
whatever nature, arising directly or Indirectly from the issuance
x
of this permit. Issuance of this permit shall not be deemed 0
t
PLAN CHECK DEPOSIT
modify, waive or reduce any requirement of any city ordinance
ox
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
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
:uthorized agent of the owner. I agree to comply with city and
THIS PERMIT
tate laws regulating construction; and In doing the work authoriz.
AUTHORIZES
This application is not a permit until
ad 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 Com
WORK NOTED
Deputy; and fees are paid, and receipt is
Von Insurance.
INSPECTION
acknowledged In space provided.
III U E,(OYVNER OR AGENTI DATE SIGNED
DE PARTMENT
C1
CITY OF
S NATURE
L' TE
EDMONDS
711011-3
ATTENTION--
CALLFOR
INSPEC
FIE 1:!'A DATE
IT S UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
771-0220
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
ORIGINAL - File YELLOW - inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN 'GRANTED. USC
CHAPTER 3.
PINK - Owner COLD - Assessor
coo
CITY OF EDMONDS
250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 774-0220 FAX (206) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public orks * Plannina * Parks and Recreation e Ennineerinn
go
LETTER OF TRANSMITTAL
Date: June 14,, 1993
To:
Karl Schorzman
21919 80th Ave. W.,
Edmonds WA 98026
Subject: CRITICAL AREAS CHECKLIST
Transmitting: CA-93-158
For your information:
As,you requested:
For your file:
Comment and retum:
Note attachments:
Con ments:
x
**YOU MUST BRING A COPY.OF�YOUR CRITICAL
AREAS CHECKLIST WHEN YOU SUBMIT YOUR
BUILDING PERMITAPPLICATION**
Planning Division
Cindi Cruz, Planning Secretary
LAURA M. HALL
MAYOR
e Incorliorated August 11, 18§0 0
Sister Cities International,— Hekinan, Japan
9 9
CitY of ]Edmonds
Critical Areas Checklist
ne- Crifical,&Cas Checklist contained on
this form isto be filled out by any person
pi paring a MvelopmCnirermh
Application for the City Of Edmonds prior
to his/her submittal of a development permit
to the City.
11C Purpose of the Checklist is to enabic
City staff to dcterminc whether any potential
Critical Areas are or may bc; present on the
subject property.'1he information needed to
complete the Chccidist should bc easily
available fiorn observations ''of the sitc, or
data,Aywilableat City Hall (Critical Areas
inventories, miaps-,or soil surveys).
An applkan� or his&cr representative, must
—f ill -*ut.thc.ch-=Mist,- sign- and date
kand
submit it to the City. The City Will review
the cheddist, make a precursory site visit�
and make a determination 'of the subsequent
steps necessary to complctc a development
permit application.
With a signed copy of this form, the
applicant should also submit a vicinity map
of the parcel vith enough debul that City
staff can find and ideatify the subject
pareel(s)- In addition, the applicant is
encouraged ' to inclu& any other pertinent
information 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
:facbW, to the best of my knowledge (fill out the appropriate column below) -
Owner / Applicant:
Name
Title
c', A
Street Address
Applicant Representative:
Name
ritle
Street Address
W cp-617 6
/v I Y,
Uty, State, Zip
Phone City, State, ZIP
Phone
Signature Date Signature
Date
RECEIVED
Critical Areas Checklist JUN 14 1993
Site Information. PERMIT COUNTER
Project Name: 0 (-?,MGL pi Permit Number
Site Location: .a'\C-\ \ 6� Property Tax Account Number. 0 2- -0 j
.C-- CX vv--, a
Approximate Site Size (acres or square feet):
lUvc you filled out a Critical Areas Checklist for a project on this site before?
General Site Conditions
1. Hm the site b= cleared or logged-? \, I - '� 0
-es Date of most recent action: -Pot V
"Y P-- V11 a- \-N 0 11) 5sle- V01 Cks
Soils /Topography
2- In the Snohon2ish County Soil Survey, what is thcmapped soil typc(s)? A Y�'ucc"�
3. D!71WI'd ha \�
��gcneral site topography. Chacball t t apply. C '--C� C,'
C'-
less than 5 feet elevation change over entire site-
L
Rolling: slopes on site generally less than 15% (a vertical rise of 10 feet over a
horizontal distance of 66 feet-)
Ifilly.- slopes prcscnt on site ofmort d= 15% and less thatt 30'0/,p a vertical rise
of 10 feet of horizontal distance.) RECEIVED
Steep: grades of greater than 30% present on site. JUN 1 7 ISS3
Comments
PONT CoUNTeg
Hydrology/Vegetation.
4. Sitecontains areas of year-round standing water:
5. *Site contains areas of seasonal standing water V\--0 Ap rox- Depth:
6. Site is in the floodway 1,!!� b floodplain t\ � of a water course.
7- Site contain - s a creek or an area where water flows across the grounds surface? h-�'Aows*
are year-round? Flows are seasonal?
8- Site is primarily: forested meadow ;shrubs mixed
9. Obvious wetland is present on site: C)
10- Wetland inventory or, map indicates wedand present on site:
11. Critical Areas inventory or map indicates any Critical Area on site: VIV
APPLICATION
The, City of Edmonds for EASEMENT NO . ............................ -- ---------- -
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS 7 L I D N 0. A S M T. N 0.
OWNER -TCD
------------------------------- .................................................... CONTRACTOR P-)
---------------------- --------------------------- PERMIT NO.
-74 2-
JQB ADDRESS ...... 7. C73.CD ------- . ....... NN4!— LEGAL DESCRIPTION: LOT NO - - ------------------------------------ BLOCK NO - ------------------- ------------
r2-1 C�)p t-�4 Cl> I <=*=- �—C) -V I �
---------------------------------------------------------------------------------------------------------------------------------------
NAMEOF ADDITION ........ ------------------------------------------------------------------------------------------------------------
J7
17—' , o-
Approved -
DATE
By- ---------------- -----------
C . I
A nni 10' 71^M
for
'Th'6 City of Edmonjs SIDE SEWER PERMIT
NEW CONSTRUCTIONg REPAIRS 0
OV*rNER . ...... ---------------- .......
D
ADDRESS ..... ....... .. .
.. .... ....... .. �; ........ I
RECEI.Vp
JUN 11,-"" 79,
EASEMENT No . ..........................................
— �- j 0 /�,z N)
CONTRACTOR
----- -- PERMIT No.
/Y-
LEGAL DESCRIPTION: LOT' No . ...................................... ....... BLOCK No . .......... ?;z . .......... ..............
.. ...... ..... ...........................................
I ON .......... i"'. 7?
NAME OF ADDIT .............................. . ..... I -
Approved:
DATE.... ........................................... By ......................................................................
NOTICE:
No warranty of accuracy.
The information'shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of �Edmoncls does not warrant the
accuracy of anything set for ' th on these
rnap(�-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
"----fh-e -map(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may, not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
emplo-yees or officer-,-) Shall be liab-le for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
r
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
Call 775-2525 for side sewer inspections BEFORE covering any portion of the constru tion.
Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspecetions.)
'519 - CoSth �xalu 1,10st
ADDRESSLOCATION OF CONSTRUCTION -------------- ............................................................................................ . .......................................................
72' pj' S q? Lot 11 � 13-x-c% 2� NaQnv'r� .....................
PROPERTYLEGAL DESCRIPTION ------ ----------------- ! ........................................................................................................................................
.................................................. . ...................... . ........................................................................ ................ ......................................................................................
................................................................ OWNER AND/OR BUILDER __-_ Scc-u-ri-ty --- Savc-sc-a --------------------- I ---- - ---------------------------------------------------------
_avawn . 21S Pppioy Rozd � SoNM I � tla 91"T 1
CONTRACTOR'S NAME & ADDRESS --- ...... E.Y':�t .................................. ---------------------- - ------------------------------- --- --- --------------------------------------------
I, - lAssion is granted ............... U ............... - ----------- 1 19..&, for repair and/or connection of a side sewer to the city sanitary sewer
system in accordance with City of Edmonds ordinances.
A77TION IS CAT I D TO THE FOLLOWING:
N, No. 1—The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct
1�� side sewer in street area. Do not cover any portion of sewer before it has been inspected.
NOTE No. 2—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Tap of side sewer must have at least 30 inches coverage at property line and 12 inches inside property line; minimum grade of. 2%. No bends in grade
sharper than % will be permitted.
NOTIE. No. 5--Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper
work which may develop within one year of completion.
NOTE No. 6--It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the main sewer or its appurtenances except to in-
sert the pipe into the wye.
B, ...............
te ....
DISAPPROVED E] Date --- - ---- --------------------------- --------- ------ Da . e ............. BY ---------------- Date ............... . ................... By.
.......................................................
By ......... ... ............. . .. . ..........................
APPROVED Da;te...- --- -------- X ------- ... IZ
...........
V e I V/ . ..........
Remarks: ....... . . --_-------------------------- . ....................................... ................... . ....................... -------------- - --------------- ---------------------------------------------------
..................................................................... . .................................... ................................................... . .................................. . .......................................... ..
BOTH P rmit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
I_ '('0 _w, _n -------- i ---- - ------- hereby certify that the side sewer installation constructed under this permit
Co ctin
er 0 i g Firm Performing Constr ion)
wp-- ristalled in accorda ce with all governing ordinances of the City of Edmonds.
Datedthis ................ ........... day of ................................................................. 19 .........
Check BEFORE you dig for: Water E], Gas Ej, Telephone E], Power [:J, Sewer E], Other E] -V