22220 93RD PL W.PDF111111111111
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22220 93RD PL W
ADD GUTTERS/DOWNSPOUTS
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CiUTT SPOUTS
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APPROVED AS N TED
BY ENGINEERING
Al-lx
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Date:
4(.o' P LAN
-7. RECEIVED
REAR
OTHER- MAY 1 8 2001
HEIGHT
BUILDING DEPT.
F I EET X.N.b.'
SITEm-PLAN' t:PR0JElCdr-."lN*lF
FIUL��
LA
PLANNING DATA
NAMED,4-r-
SITE ADDRESS: a,9,9,1pC> PL \x
�,.DATE: G1 ?>i / c>
ZONING:---- 122) - F) PLAN CHK#: a - LQ� �:)
PROJECT DESCRIPTION: v4Q-u-.> -i r5n
CORNER LOT Yes4qO) FLAG LOT. dye:��Wo)
SETBACKS:
Required S tbacks:
Front: -7. �-->'Left Side7l - 2)' Right Side: -7. -5 1 Rear: -7. f
Actual Setbacks:
rl
Front: � (D' Left Side: -7 - 2' Right Side: 10 Rear: -7 - 's
Street map checked for additional setback required? t�IA —(Yetq!,o)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED ff"
LOT COVERAGE:
Maximum Allowed:_ ?>roe-1>,10 --.Actual:
BUILDING HEIGHT:
Maximum Allowed:— Actual Height: �
Datum Point: —Daturn Elevation:
A.D.U. CREATED?: r-40
SUBDIVISION: T?
LA-r :2z- PW,1!�Z
CRITICAL AREAS #: Q N- C-)i - -7"
SEPA DETERMINATION: \
LOT AREA: 10, Qr7-) hn
OTHER:
Plan Review By:"-' A i e—
cAftleAperiniMplandadoc
ED
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
/�C. 1 Fax: 425.771.0221
The Critical Areas Checklist contained on this form is to
be filled out by any person preparing a Development
Pen -nit 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
City Hall (Critical areas inventories, maps, or soil
surveys). -
Date Received: G-Jlele /
City Receipt#: — 0(2A��'
Critical Areas File 4: Cyh -7 L/
Critical Areas Checklist Fee: $4500
Date Mailed to Applicant:_ -5' -.2-1- 6 /
A.pi�operty 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
ol'this form to assist City staffin 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 infon-nation fumished by the applicant, his/her/its; agents or employees.
By my signature, I certify that the infon-nation 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 APPLICANVAGENT \JflSZ-LJ 12 DATE 571
Property Owner's Authorization
By my signature, I certify 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 posting attendant to this application.
SIGNATURE OF OWNER 'h-rl a.,,, -P blw'
Owner/Applicant:
MAt4uV
&ame 1
2 -7—;�- 2-0 R44 Eff L(ekl-
Street Address
City State Zip
Telephone: 4Ab
;3 3
Email address (optional):
DATE �r— /1? - '�� r, I .
Applicant Represe�
, �flve:
Name
Street Address
City State Zip
Telephone: S f � 0
Email Address (optional):
Critical Areas Check I ist.doc/3.1 9.2001
Critical Areas Checklist CA File No: C-4 - o 1, -7 q
Site Information (soils/ topography/ hydrology/ vegetation)
1. Site Address/ Location: :?
�Z -7-7— C)
OOD- 4::D
2. Property Tax Account Number: 6 0 �74 00 P-PIC4_1
3. Approximate Site Size (acres or square feet): /1), !Y,00
4. Is this site currently developed? )�_ yes;
If yes; how is site developed?
no.
5. Describe the general site topography. Check all that apply..
Flat: less than 5-feet elevation change over entire site.
C� RoHing: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal
distance of 66-feet).
f) HiRy: 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): L,6'-VU�e_ V4964ZE-
04 V
t4 bl# Af-
,9 C.
6. Site contains areas of year-round standing water: 0 Approx. Depth:
7. Site contains areas of seasonal standing water: go Approx. Depth:
What season(s) of the year?
8. Site is in the floodway 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? (What time of year?
10. Site is primarily: forested meadow shrubs L-"' mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
1.
2.
3.
For City Staff Use Only -AD 0LJ
Plan Check Number, if applicable?,
Site -is Zoned? -19
SCS mapped soil type
m 1X i n17 P_ k-jo c_iD r ,a c j, -a r-* -) Q inb. � L C -V
4. Critical Areas inveltory or C.A. map indicates Critical Area on site? N 0
5. Site within designated earth subsidence landslide hazard area? t4o
DETERNENAnON
1 .0 X61 I
Reviewed bv:
31MM
VATI�
Critical Areas Check] ist.doc/3.19.2001
Critical Areas Checklist CA File No.
Site Information (soils/ topography/ hydrology/ vegetation)
Site Address/ Location: RACE-.
0. ODC- U,
2. Property Tax Account Number: 0
3. Approximate Site Size (acres or square feet): 6 C) '52-Z.,
4. Is this site currently developed? )�_ yes; — no.
If yes; how is site developed?
Lo 7
5. Describe the general site topography. Check all that apply..
Flat: less than 5-feet elevation change over entire site.
C� Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal
distance of 66-feet).
b 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): L.6-1- Is L-ig-VETe- 1j/A(9�_zR_-EF-
a
6. Site contains areas of year-round standing water: 0 ; Approx. Depth:
7. Site contains areas of seasonal standing water: N Q Approx. Depth:
0 What season(s) of the year?
8. Site is in the floodway 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? (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawnshrubs etc)
11. Obvious wetland is present on site:
For City Staff Use Only P. � OE-4
1. Plan Check Number, if applicable?..,.
2. Site is Zoned? P-5- 9
3. SCS mapped soil ")? & QC e-"Cx�r> Qz>._k4-� I
4. Critical Areas inver(tory or C.A. map indicates Critical Area on site?
5. 'Site within designated earth subsidence landslide hazard area?
DEI MNffNATION
Reviewed bv:
Critical Areas Check] ist.doc/3.19.2001
D
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
City Hall (Critical areas inventories, maps, or soil
surveys).
Date Received:_ 16,'1161,e
I
City Receipt#: 4 ?,�� -9
Critical Areas File i:' - 0 /--,-To 7
Critical Areas Checklist Fee: $45.o6
Date Mailed to Applicant: -T--2-1—C) /
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
ofthis form to assist City staffin finding and lo cating 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 f�om any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate Ore
incomplete information furnished by the applicant, his/her/its agents or employees.
By my signature, I certify 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.
<,�- �, . V
SIGNATURE OF APPLICANVAGENT, —DATE
T
Property Owner's Authorization
By my signature, I certify 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 posting attendant to this application.
SIGNATURE OF OWNER a,� bi
Owner/Applicant:
MAtwl-F-Rmur- DIAZ-
f4ame
Street Address
Lmuom L24 C9 M),2_0
City St�fe Zip
Telephone: 4Ab�
Email address (optional):
DATE ��— /1? — ')-6
Applicant Represe'
,� ive:
�tive.*
r�, A, I
Name
Street Address
City State t zip
Telephone: 0
Email Address (optional):
Critical Areas Checklist.doc/3.19.2001
06
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22304
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ADDRESS: 222-20 qg,'A 1?.
TAX ACCOUNT/PARCEL NUMBER: nL k)LA-k-ZA--k-J
BUILDING PERMIT (NEW STRUCTURE): I q
COVENANTS (RECORDED)
CRITICAL AREAS:- pt - c* — DETERMINATION: E]Conditional Waiver OStudyRequired Q CWaiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS (OTHER):20010445(CIOW.-t);20C)4C%q(&geLD)
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DA
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED
LATEMP\DSTs\Fomis\Street File Checklist.doc
F)r_
DATE RECEIVED
."j
/AX
PERMIT EXPIRES
CITY OF EDMONDS
USE
ZONE
PERMIT
NUMBEF&V4
CONSTRUCTION PERMIT APPLICATION
JOB
ADDRES�"
SUITE/APT#
�OZ
OWNER NAME/NAME OF BUSINESS
PLAT NAM E/SU BDIVI SION NO.
LOT NO.
LID NO.
0%1� A N LL 0 4, r Rp, t-i Cei D �'_ 1% 'z�-
LID FEE $
M
MAILING ADDRESS
W
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10
7— -2
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved 0
RW Permit Required 0
2-0
Street Use Permit Roq'd 0
CITY ZIP
TELEPHONE
EXISTING —
PROPOSED
Inspection Required 13
Sidewalk Required 0
L-7bW\nNAf wo, q&or?
9 s �?v
REQUIRED DEDICATION— FT
__;��S
Underground
Wiring required 0
NAME
METER SIZE
LINE SIZE
PRV REQUIRED
T
6L
I
YES 0 NO 0
IM
W
ADDRESS
REMARKS
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OWNER/CONTRACTOR
RESPONSIBLE FOR EROSION CONTROUDRAINAGE
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0 FI 14L S-17
ITY ZIP
TELEPHONE
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NAME
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ENGINEERING REVIEWED/DATE
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ADDRESS
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FIRE REVIEWED BY
DATE
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CITY ZIP,
TELEPHONE
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VARIANCE OR . Cp,�,
:SHOR \1NE OR ADB#
INSPECTION
RES
BOND
POSTED
STATE LICENSE NUMBER EXPIRATION DATE
CHECKED BY
r]YES NO
SEPA RLVIEW,..
�':'S[619 AREA
HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO.
COMPLETE
ALLOWED, PRkPOSED
ALLOWED PROPOSED
_j
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NEW RESIDENTIAL PLUMBING MECH
ERAGE
ALLOWED PROPOSED
.,REQUIRED SETBACKS'(FT.)
FRONT Sl . DE - REAR
PROPOSED SETBACKS (FT.)
FRONT UP SID� REAR
1:1 ADDITION 0 COMMERCIAL El COMPLIANCE OR
7
-7 ;c)
V17 '7,
CHANGE OF USE
PARKING"-',
REQ'D PROVIDED
LOT AREA
PLANNING REVIEWED BY DA1E
APARTMENT
REMODEL 0 SIGN
REPAIR GRAPDING FENCE
CYDS X- FT):
REMARKS
DEMOLISH C] TANK F-1 OTHERI:
-Nn-GARA
z
,al [3 RETAINING WALL, REN4.
_TA_RPOAT E L .
ROCKrRY
(TYPE OF USE. BUSINES R ACTIVITY) EXPLAIN:,
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Q=5TRUCT�
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77 . I I .
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11
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70CCUPAN-
GROUP
NUMBER
NUMBER 'OF
CRITICAL W,+ t
00
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SPEC AL NSPECT67R'
' __
T:,AFREA.-OCCUPANT
on
OF
DWELLING
AREA '24
o
STORIES
UNITS
NUMEVA191--24
:Y ES,
LOAD
DESCRIBE WORK TO E+
DONE
tA j)
REMARKS
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PROGRESS:INSPECTIONS,PER.UBC
108/FINAL INSPECTION REQ
v U 9 + bt 0
DVqE k
Ec, 0-fi N Q T-0 L-1) F::'G, U t�,b P t10
'\t- -&70 S J_P
VALUATION
FEE
PLAN CHECKFEE'
HEAT SOURCE GLAZINJ% LOT SLOPE %
-,t-
:BUILDING,
U ?d
No Ll IN L F-4p
PLAN CHECK NO: VESTED DATE
PLUMBING
6j— / T_ a
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADING/FILL
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
D
SEPARATE PERMISSION.
t Mp/
t
STATE SURCHARGE
A
ui PERMIT APPLICATION: 180DAYS
11. PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
so
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
0 "APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
V)
ENG. INSPECTION FEE
W IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
_j
LANDSCAPING
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
INSPECTION FEE
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
RECEIPT —
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
PLAN CHECK DEPOSIT
7, 6 Z 42 Or- IS
0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
R CEIPT
TOTAL AMOUNT DUE
17M6
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
This application is not a permit until signed by the
TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
Building Ofticial or histher 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.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
111�1111
0 0 E
SIGNATUR E (OWNER OPKGENTYI DATE SIGNED
(425)
V, VC
>
9- 1,!�Oo 1
I 1
771-0220
),tC-N SEDBY
A17ENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
L)
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE - YELLOW - INS'PEC/OR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
98
FAX
PINK - OWNER - GOLD - ASSESSOR
4
ra
ADD GUTTERSIDOWNspOUTS
AND SPLASH13LOCKS
GUTTERS/DOWNSPOUTS
TO CONNECT TO EXIST. SYST.
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APPROVED AS NOTED
ENGINEERING
Date:
Ll
11
RECEIVE
MAY 1
AP/Yeld
c 9,V
STREET FILE S TR
t: k: I- FIL Le
RECEIVED
MAY 18 2001
BUILDING DEPT.
CITY COPY
F�-