22110 98TH AVE W.PDF111111111111
9685
22110 98TH AVE W
CA FILE NO. 00 - / 6 -7
Critical Areas Checklist
---------------- ---------------------------------------------
Site Information (soils/topography/hydrology/vegetation)
7-11 6 V N
1. Site Address/Location: .2-22/c)- 9L
2. Property Tax Account Number:
3. A pproximate Site Size (acres or square feet):
4. Is this site currently developed? yes;
If yes; how is site developed?
— I _. f- , I .- if '. I I I -
no.
Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
C-11
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 3 0% ( a vertical rise of
I 0-feet over a horizontal distance of 33 to 66-feet).
Steep: grades of geater 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):
Site contains areas of year-round standing water: Nc-.) _; Approx. Depth:
Site contains areas of seasonal standing water: 4(c_j) _; Approx. Depth:
What season(s) of the year?
8. Site is in the floodway JJ 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? . IVO (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc) IX
11. Obvious wetland is present on site:
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-r-n i=r-- -r-- t5UILUIINIV UCT- I -
STREET FILE
APPLICATION
for
The City of Edmonds
r SIDE SEWER PERMT
NEW CONSTRUCTION C] REPAIRS E] EASEMENT No . ..........................................
400-04500
OWNER ........... Tho.m.as....
.. . .. .. .... .. .....
.......................................................... CONTRACTOR .................................................................................................. PERMIT No . ......................
ADDRESS ...... 221.10 ... 98.th ... Avenue --- W- .............................................. LEGAL DESCRIPTION: LOT No . .............................................. BIA)CK No . ............................................
NAMEOF ADDITION .........................................................................................................................................
Ll
0
Dye Tested On Sewer 1972
Approved:
DATE................................................ By .................................................................
CAFILENO. 00-15-7
Critical Areas Checklist
--------------------------------------------------------------
Site Information (soils/topography/hydrology/vegetation)
I. Site Address/Location: )/C) 9 �� 7-)4 �6 V I--=-
2. Property Tax Account Number: _ (a n :2 ) — 0 0
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? yes; no.
If yes; how is site developed? Lin AfA
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 IS% (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 3 0% ( a 'vertical rise of
I 0-feet over a horizontal distance of 3 3 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: Nc--.) - ; 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- XC-) 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? - NO (What time of year?
10. Site is primarily: forested meadow :shrubs mixed
urban landscaped (lawn,shrubs etc
11. Obvious wetland is present on site:
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E 10)
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
Critical Areas File #: (OC— 16-7
Critical Areas Checklist Fee: $45.00
Date Received by Dev. Serv. Dept:
City Receipt No: /
Date Mailed to Applicant:
CRITICAL A'XDV"xvJAS- 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 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 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 Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
PLEASE PRINT CLEARLY
Owner/Applicant:
F--) � /- 7— al�S�4 S-tr<J'�ZA
Name
Street Address
JIM C>
City State Zip
Telepho,pe
9 �'�
MI. ","I '
Date
Applicant Representative:
Name
Street Address
City State Zip
Telephone
Signature
Date
d:receptiorbiana/CACLHandotd.doe Revised 411 Gt2OOO
NOTICE
-a.cr.
-N 0*'*w.a r-r a n y...
The -information shown on the attached
map(s) wa-s cOm ' piled for use by the City 01
Edmonds/ its Empl-oyees and Consultants.
Th,.e City of *Edm.onds does. not. warrant the
accuracy of anything set forlth on t ' hese
M a p (S). A n . y person or entity -requesting a
copy should conduct an �independent
inquiry regarding th-e infOrm'ation shown, c
tFi-�� -map(s),, including, but not Jimited to/
n of any sew-er stub shown. SU(
the locatio
-not exist and rna�,
sewer stubs may or may
or may not exist at the location shown
r-ity of Edmo-n(JAS/ nor its
Ne-1-their the I,_,
e M pli-0-ye e-S 0-r officers -sha-H be 11 a-b-1--e for -41-h
I n on this map(5)) nor for
information g Ve ion pr 'ded based
any one represe.ntat' ovi
upon*said map(s),
'DATE RECEIVED
PERMIT EXPIRES
CITY OF EDMONDS
USE PERMIT
ZONE
re
FCONSTRUCTION
N U M B E R
_3
PERMIT APPLICATION
JOB
SUITE/APT#
ADDRES:"
Aeo
OWNER NAME/NAME OF BUSINESS
PLAT NAME/SUBDI VISION NO.
LOT NO.
LID NO.
LID FEE $
Elizabeth Strash
W
w
MAILING ADDRESS
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Appmed
RW Permit Required
z
22110 98tb Ave W
0
EXISTING - PROPOSED
Street Use Permit Req'd E3
Inspection Required 0
CITY ZIP
TELEPHONE
Fdraonds 9802
778 5685
REQUIRED DEDICATION- FT
Sidewalk Required 0
Underground
Wiring required 0
NAME
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
YES 0 NO 0
M
ADDRESS
REMARKS
z
. .............
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
z
CITY ZIP
TELEPHONE
NAME
Same
ENGINEERING REVIEWED/DATE
ADDRESS
z
FIRE REVIEWED BY
DATE
W
E
CITY ZIP
TELEPHONE
0
N EORCU
SHORELINE OR ADB#
INSPECTION
REO'D
BOND
POSTED
STATE LICENSE NUMBER EXPIRATION CAT E
CHECKED By
0 YES (:] NO
SEPA REVIEW
COMPLETE EX
SIGN AREA
ALL�WED PROPPSED
HEIGHT
ALLOWED PROPOSED
PROPERTY TAX ACCOUNT PARCEL NO.
w
-00602100102100
EXP I :�T
M/A
2.61 10
,
NEW RESIDENTIAL PLUMBING / MECH
LOT COVERAGE
ALLOWED OPOSED
REQUIRED SETBACKS (FT.)
FRONT SIDE REAR
PROPOSED SETBACKS (FT.)
FRONT L/ Sl E REAR
AUDITION 0 COMMERCIAL COMPLIANCE OR
*5SZ
I , I
I 1
1+ 15
3
z
CHANGE OF USE
REMODEL C3 APARTMENT SIGN
z
PARKAG
R�9'1) I P4071DED
N/A
LOT AREA I
9
P%rED' 1`1 -DATE
zo
A6
FENCE
0 REPAIR C] GRADING CYDS X FT)
REMARKS
F1 DEMOLISH 0 TANK OTTER
eck,
z
1:1GARAGE 0 RROETAINING WALL
CARPORT CKERY RENEWAL
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPUMN�-.
CHECKEDBY
TYPE OF CONSTRUCTION
COD
119
OCCUPANT
Tti
residence
GROUP
NUMBER
NUMBER OF
CRITICAW6%/ F
SPECIAL INSPECTOR JAREA
OCCUPANT
a
OF
DWELLING
AREAS -15
0
2
2
TORIES
UNITS
NUMBER
REQUIRSD E] Yrq
K-�Qw
LOAD
DESCRIBE WORK TO BE DONE
rebuild deck
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL
INSPECTION REG D
z
5
VALUATION
FEE
PLAN CHECK FEE
HEAT SOURCE GLAZING % LOT SLOPE
BUILDING
PLAN CHtCK NO: VESTED DATE
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADINGIFILL
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
STATE SURCHARGE
W
PERMIT APPLICATION: 180 DAYS
�zfza
PERMIT LIMIT. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG..REVIEWFEES
5d
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
"APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
ENG. INSPECTION FEE
W
-i
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
LANDSCAPIN7
2
Ir
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
INSPECTION FEE__
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
x
0
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
PLAN CHECK DEPOSIT
RECE71PY,�&p
e?y
-i
0
NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.,
RECEIPT
TOTAL AMOUNT DUE
I
HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
This application is not a permit until signed by the
CALL
TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
Building Official or his/her Deputy: and Fees are paid. and
IN
VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION receipt is acknowledged in space provided.
WORKMEWSC� �PNSATION INSURANCE AND RCW 18.27.
SIGNAT
OWIPERIOR AGENT) DATE SIGNED
OFFI�11�1S SIGNATURE q
(425)
DATE
771-09220
RLLEASFE) BY
DATE I
ATTENTION
EXT 1333
�)/S
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORIGINAL -FILE
FAX PINK - OWNER
YELLOW - INSPECTO�
GOLD - ASSESSOR
5/9a