22205 96TH AVE W.PDFiiiiiiiiiiii
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22205 96TH AVE W
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ADDRESS: zllzz�57 - C16! 01 Pvz 6u
TAX ACCOUNT/PARCEL NUMBER:-040 MI 0c;0 06
BUILDING PERMIT (NEW STRUCTURE)
COVENANTS (RECORDED)
0
CRITICAL AREAS:-' DETERMINATION: Ej Conditional Waiver Ej Study Required Kwaiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS (OTHER): ZZLO -
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DA
SEWER LID FEE
SHORT PLAT FILE:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DA
OTHER:
LID
LOT: BLOCK:
LATEMP\DSrs\Fomis\Street File Checklist.doc
0
Siff- plan
"u5c 19411,4
sarA 54 5-14 0 ' \
5iw 4 tun- Z av IP
PARKING: Required: Actual:. 7, 5" C. tl'-4 - 1 -.3� a IP
LOTAREA: 1(0,(V0;5G�(qiVC41)
LOT COVERAGE (
Calculations: � r- -aE51- 0r1r 1 to I to D5
BUILDING HEIGHT: 1001046
DatumPoint:--S Y'A0kVlV101e- 01 Wr" —Datum Elevation:
,q e4 *f- AdRj—'j'r&1
Maximum Allowed: 1, 51 ( I I's, - -Z' Actual Height:_ 14-410, (111,40
A.D.U. CREATED?:
41,14P'
4. 1�p 51. 0
A* qjjj,'
51 1119141,
CA 'qr""
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?, %-ir. (0 (V * 4 :-
SUBDIVISION: P ( Vl,& A L rt�, - I Qj- '2,3 LI'j. Z'
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: ffes Q Ok if C-A 5 F,
OTHER:
PLANNING DATA
NAME: -C
it1t66LA 81,-roe, Ck1rj*5f-1*CLn -DATE: 0611012,006-
SITE ADDRESS: 1,2, Z-05 41,0111 Anrf..o W PLAN CHK#: 05- 1 Sr
PROJECT DESCRIPTION: !Ze 661 (Q] 1'-H Qf] 4&rl I d V- e IE411
and, -emC'L'06-& C'jIlQ20
REDUCED SITE PLAN PROVIDED?: 6FNTo�- 15"X I '�*
MAP PAGE: 10 CORNER LOT: FLAG LOT: (Yes
me—s 0 3No
ZONING:- P-59 -CRITICAL AREAS DETERMINATIONM CA. 7,005. 00 Co(v
LlStudv Reauired:
Waiver
Conditional Waiver
SEPA DETERMINATION: f,)(f'YKPt
Ll Fee
LJ Checklist
Ll APO list w/ notarized form
Ll(Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget -Sound or Lake Ballinger)
Exempt * styur-jur%
Vn -e.Arwt par4- bf-
SETBACKS: OLP""Ale) 0 LA+Vl P`r'0Pe.*-*Y 410 r%04-
Required Setbacks: q
Street: 7.6' LeftSide: -1-51 Right Side: Rear: ,P- +Av 4 c*.s
Actual Setbacks:
Street: 7,15' Left Side: 24'3" RightSide: 9101, Rear: (05' f-b C, X vi GL
V-11*&reet map checked for additional setback required? (Yes / No
L3 DETACHED STRUCTURES: *
L] ROCKERIES: non-t d5VIown 0,n evii-r- plavj
13 FENCEsrrRELLISES: V% 0 V1 4 6 V1 0 V-'V% VY%
Ll BAY WINDOWS / PROJECTING MODULATION:
0 STAIRS/DECKS: *-)(Qt"fV1j3 oltcy mtt*5
ma)( allDVIX4
+
Plan Review By: OW6AZ
of
0 a ro Aji- A Ad it"aA
NewBPPIanningDataFornLD0C 14. .9 0 1 01s.lo)
_V. 157
0 #P20
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 information
needed to complete the Checklist should be easily
available from observations of the site or data available at
RC w
rIkIN
UM, u non i IMN
a sagas @Aft aw2^12 Mft M 0�5_ IRAM _-k
Date Received: �911(21(Jtp
City Receipt#:. lle?lvf-�39 �3
Critical Areas File#: ?,,D0&5-0(v49
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.
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 pertment
information (e.g. site plan, topography map, etc.) -or
studies in conjimction 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
mcomplete information ftimished 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 flu�j:lication on the behalf of the owner as listed below.
SIGNATURE OF APPLICANTIAGENT DATE Li — C)
Property Owner's Authorization
By my signature, I certify that I have authorized the above ApplicanttAgent 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 posting attendant to " application.
SIGNATURE OF OWNER 9,-L,4 DATE S,& LOS
ft I � 91
Owner/Applicant:
15 0 SA 1-4 4 _rQE k 1,
Name
Applicant Representative:
T'8- CA C-- 0 *4 �) F—S ( C. t-4 Z go L Lb - F> t L UJADU
Name - -
7, 0,57
Street Address Street Address
Eldowr> uiA * q6020- YSZ8
city State zip
Ktet,j lqeD LAJA q802_R_
city ' State zip
Telephone: q �_ E; —7YLI -- IS 5-1 Telephone: 20(, — 7 7 9 — 4 10 (7
Email address (optional): Email Address (optional):
16 1 L(§ 67AeA r. 0" Z�6 S- t 1:�. IV - SO I I- b � C-3 1-4
0 0
#P20
Critical Areas Checklist
CAFileNo: D5-qe
Site Information (sofls/topography/hydrology/vegetation)
1.. Site Address/ Location: X Z 2-E)5- 4,, 4 L/, LAJ ao
2. Property Tax Account Number: -5- Ll 9 7, 0 0 10 Z 3 C>0 6
3. Approximate Site Size (acres or square feet)- Z-0,zZYD
4. Is this site currently developed? Xyes; _ no.
If yes; how is site developed?. :5 1 �-k G LF— EA'tj L L- Lx) e— LL- I L'4 r.,
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). 4� , .- .. too-
Y I I N
rise of 10-feetj
Hilly: slopes present on site of more thi%m;i 161 V
over. a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% present on sQaUcal rif ook
ffeej fo;�;-a VoUz
distance of less than 33-feet). WA*Mi&VPWMM
- Other (please describe):
6. Site contains areas of year-round standing water: J\( Q Approx- Depth:
7. Site contains areas of seasonal standing water: IV 0 ; Approx. Depth. -
What season(s) of the year?
8. Site is in the floodway a 0 floodplain — of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
.44 D 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: n
For City Staff Use Only Ll R� I
1. Plan Check Number, if applicable? 05 - 19 (0
2. Site is Zoned? P-,5'9
3. SCS mapped soff type(s)? 5- AIA"Wood-LAvloam Laod WwPIP-9 61ipac-5
4. Critical Areas inventory or C.A. map indicates Critical Area on site? N
5. Site within designated earth -subsidence landslide hazard area?. N 0
DETERMINATION
STUDYREQUIRED -WAPVER
Reviewed br. /,P I AnM;C, Date. 05 1,3 PiP o 5
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JOSEPH
22205 964. AVE. W
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PAXCE4 54+200/02300OG'
OWNER/CONTRACTOR-IS RESPONSIBLE
FOR EROSION AND DAMAGE PROPOSED DRIVEWAY4-60D'
PXOP6550 +WALXWAy /59 0'
.. ...... . ......... . 4-0-rCOVERAGE ISC6 tu NW10
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JUN 7 2005
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�DING DEPARTMENT
F EDMONDS— .50,
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APPROVED AS NOTED
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A— MAY 10 2005
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ND INSPEC110N REQUIRED
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APPROVED BY PLANNING
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