22022 92ND AVE W.PDF111111111111
8943
22022 92ND AVE W
ADDRESS:
TAX ACCOUNTIPARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS:— 29 7- 7 DETERMINATION: 0 Conditional Waiver 0 Study Requireq�`Waiver
DISCRETIONARY PERMIT ft'S--
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHE
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:_(,21 ffl I Z�--T-
SEWER LID FEE $:
SHORT PLAT FILE: LOT:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) M
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:
LID
BLOCK:
LATEMP0Srs\Fotms\Street File Checiclist.doc
11
MCMAME TIGHTL %
STREET FILE i "APPROVED BY UkNNING
MATENAL
I 3DR 35
dNowng in this permit approval process :-:hall bo
Ifitorpret alloydng -tbe
on a C of any cirrently existing illegaL '-MRWHANCOR
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116ftconfijrr�. rig or urperm.4t.7,4,buft—r* tNdm
or hite condi w1hi& 's oi-,, r�Aide scope of the
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-Hn't fi zticm, regardless of whether such 11)
E,eTld! app 11de-re or condition is shown on the
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BUILDING DEPARTMENT
C+va
SITE INFORMATION PRbVAEPff'vCUT FILL: EXCAVATED SOIL TO 81
+0 OWNER AND '5COF1, USED AS BACKFILL
DRAWINGS.
+ MATERIAL$ AND
UTILITIES INCLUDE: r'4?.?Lj6, FEATHERED OUT FROh
4 ABLE & PHONE
J+ao.,PUBLIC POWER, C THE RESOENCE 20'ma
SERVICE.
lop, 4
0, 119AJf—STOCK PILE AND COVER EXCAVATED F'ILJ— 4t) eYr----.>
MA% 100- 1 Z57-4- Z91 ('Z57-12-5- "
SOILS W/IN 24 HRS W/ BLACK PLASTIC. t4
PROVIDE DOWNSPOUT EXTENDERS -
UNTIL VEGITATION ADJACENT TO IMPERVIOUS SURFACE AREA:
RESIDENCE IS REESTABLISHED.
PROVIDE SILT FENCE AT DOWN HILL
v SIDE OF AREA OF CONSTRUCTION.
4v, (:i
K
STREET FTLEr. LANNING DATA
GLE FAMILY RESIDENTIAL
I =FILE
Name: Ahdo
Date: s7-1V -a?
Site Address: - q2-inaf Ay
W
Plan Check #:,WV-7,0qe13
Project Description: SFP- AW66,
Reduced Site Plan Provided (YOE / NO)
Zoning: P��
Map Page: /,�
Corner Lot: (YES
Flag Lot: (YES 16
Critical Areas Determination #:.2-001-4749-57
11 Study Required
>ewaiver
SEPA Determination:
>*xempt asre-q�
Needed (for over 5b6 cubic yards of grading)
0 Fee El Checklist 0 APO List with notarized form
Required
Street: t
Side:
Side:
Actual Setbacks
Street:
Side:
'7o
0 Detached Stru
11 Rockeries:
El Fences/Trellises:
El Bay Windows/Projecting Modulation:
El Stairs/Deck:
Height
"Datum Point.) May, e
Datum Elevation: -+-
Maximum Height Allowed: Zl,;7
1,2
Actual Height:
Other
Parking Required:
Parking Provided:
Lot Area: q 0 -7 6
Maximum Lot Coverage: 35% Proposed:
5qo
Lot Coverage Calculations:
TS;'
ADU Created: (YES
Subdivision:
Legal Nonconforming Land Use Determination Issued: (YES C60)
Comments
Plan Review By:
- 61
Planning Data Form 04-11-06.doc
#P20
,4C. 1%9�
City. of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
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 the application 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--infor-mation
-fide-de-d-fo—com--pli5t�-d-di-e--Ch-eckli§t -.should- be �sily
available from observations of the �,te[or*ta-available-4
City Hall (Critical areas inven ones; maps� i6f�-sbil
P
surveys) -
A P 2007
PERMIT COUNTER
Date Received: -
City Receipt#: 0 �Ll 0-1 L4
Critical Areas Fae M C/P-A 1,0 D+ - 6T
Critical Areas Checklist Fee:. $135.00
Date Mailed to Applicant:
A property owner, or his/her authorized 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.
-T lease- ' submit -a vicihity� map, -along- with -the -signed copY___
of 'this form -to -dssist City staff in findinp� 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 Checklist to assistant staff
in completing their preliminary assessment of the site.
The undersign ed applicant, and hislhff/its heirs ' and assigns, 'in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City'.of Edmonds harniles's from any and all damages, including reasonable
attorney's fees, -arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information fumished'by the applicant, his/her/its agents or employees.
By my signature, I cer* that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file this application on the behalf of the owner as listed below.
SIGNATURE OF APPLIcANT/AGENT
DATE
Property Owner's Authorization
By my signature, I cer* that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and"sting attendant to this application.
.SIGNATURE OF 61W?�i
PLEASE PRINT CLEARLY I
Owner/Appficant:
9Z0W46/ AkPIP
Name
A -e
g
Street Address
city State Zip
Telephone:
Email address (optional): 5,r&AW4A:>
Applicant Representative: -
Name - - -
Street Address
City State
Zip
Telephone:
Email Address (optional):
#P20
Critical Areas Checklist
Site Information (soils/ topography/hydrology/vegetation)
1. Site Address/ Location: /A er:
2. PropertyTaxAccount-Number:
3. Approximate Site Size (acres or square feet)-
4. Is this site currently developed? yes; no.
CA File No: CaA,20D-T ()0,5 -7
If yes; how is site developed? At-
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: //0 Approx. De pth:
7. Site contairL§ areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway floodplain 4-10 of a watercourse.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
'yo 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:
For City Staff Use Only Max Q. 10q
1. Plan Check Number, if applicable?
2. Site is Zoned? - 9
3. SCS mapped soil type(s)? S_ - Cr__,�
4. Critical Areas inventory or C.A. map indicates Critical Area on site? cg:�, cl\c-
4" k % I A--
Q. MO.
5. Site within designated earth- subsidence landslide hazard area?
DETERMINATION
.STUDY REQUIRED —WAIVER
Reviewed
#P20 CA File No: OA'ZOD-T coS -7
Critical Areas Checklist
Site Information (soils/ topography/ hydrology/vegetation)
1. Site Address/ Location:
2. Property TaxAccount Number: /7,00
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 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: A/0 Approx. Depth:
7. Site contains areas of seasonal standing water: ft Approx. Depth:
What season(s) of the year?
8. Site is in the floodway //0 floodplain A.,Io of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
/uo 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:
---------- For City Staff Use Only
1. Plan Check Number, if applicable? —NL
2. SiteisZoned?
3. SCS mapped soiltype(s)?
G — N ckrczr�--
4. Critical Areas inventory or C.A. map indicates
— J-- -- -L -\-- -- 11
M.
I %
Area on site? —E-2AP,
\1j.
5. Site within designated earth subsidence landslide hazard area?
DETERMINATION
STUDY REQUIRED
Reviewed bv.
WAIVER
#P20
loc. 1 %9'*,
City, of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
'Me 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 the application 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 siter.or -av4�lable-at
City Hall (Critical areas invenWieR,*- 16f-��sbil
surveys), I . I
APR " 3 2007
PERMIT COUNTER
Date Rec!ived:
It. I L&
City Receipt
Critical Areas File #- C/P-A —1,�a D+ - 6
Critical Areas Checklist Fee: $135.00
Date Mailed to Applicant:
A property owner, or his/her authorized 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.
P lease ' 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 Checklist to assistant staff
in completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns,:in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information furnished by the applicant, his/her/its agents or employees.
By my signature, I cer* that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file this application on the behalf of the owner as listed below.
SIGNATURE oF APPLicANT/AGENT
I
DATE
Property Owner's Authorization
By my signature, I cer* that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection andppsting attendant to this application.
SIGNATURE OF
PLEASE PRINT CLEARLY
Owner/Applicant:
S�Zwle�6/ Apo
Name
ZWZ-Z, '�FZ-
Street Address
6WCW,W-r , cc,20
city State zip
Telephone: ?Z
Email address (optional): 5'My&oW&I�>
DATE
Applicant Representative:
Name
Street Address
City State Zip
Telephone:
Email Address (optional):