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22228 95TH PL W
NOTICE.
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formation*shown on the ktached
The in -tY 01
map(s) was com ' piled for use by the C1
Edmonds/ its Empl-oyees and Consultants.
Th,..e City of 'Edm.onds does. not . warrant the
n these
accuracy of anything set for.th 0
M a P (s). A n . y person or entity -requesting a
copy should conduct an.independent
Orm'atlon shown-c
Inquiry regarding the *nf' I 'ted to,
-tF�� -Map(s),, including, but not J mi
the location of any sewer stub shown. SU(
sewer stubs may or may- not exist and ma�,
t the location shown.
or may not exist a
Neitheir the �jty of Edmon(JAS/ nor its
ff i-cers sha-H be l--`1a-b-11--e for th
'emPio-yee-s Of 0
information given on this map(s), nor for
rovided based
any one representation P
upon said. map(S'
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PLANNING DATA
NAME: :�)2 1pmbr4 M\e_br,�U el
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SITE ADDRESS:-ZZZ 4- 9��- P1, 0. —DATE: 573017-2
ZONING: PLAN CHK#:
PROJECT DESCRIPTION: 6",-
CORNERLOT P —(Yes/No)
SETBACKS:
Required Setbacks:
Front: 7,5' Left Side: 7,zl-' Right Side: _7$!�,' Rear: 15—
Actual Setbacks:
Front:-79" Left Side: 65 Right Side: T,_' ''Rear: 7 7
Street map checked for additional setback required? Ara - 7P (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED IV (Y/N)
k3,�7, - ?,& -7 5- 17,
LOT COVERAGE: 3 j 640
Maximum Allowed: Actual:
BUILDING HEIGHT: z5-,
Maximum Allowed: le" (-ey2=) ActualHeight:
Datum Point:
Datum Elevation: 100'
A.D.U. CREATED?: . W
SUBDIVISION:
CRITICAL AREAS #:
9-7-54
SEPA DETERMINATION: Ex4n,,4r
LOT AREA: 16 1 6 kb a
OTHER:
Plan Review By:
cAfileApermit\�p1andaLdoc
CITY OF EDMONDS
USE
ZONE PERMIT
NUMBER
-CONSTRUCTION PERMIT APPLICATION
OW14ER NAMEINAME OF BUSINESS
APT 4
ADDRESS Z Z zz
—r, In rit
L EGAL. . DESCRIPTION CHECKISUBDIViSION
NO.' LID
NO.
MAILING ADDRESS
0 q 5i�
09e W10-
PUBLIC RIGHT OF WAY PER OFF ICIAL STREET'MAP. TESCP
RIN
A'pPt"d -
D
P.1.11 4qyuid E3
CITY
�g
,ZIP .3TELIEPHONENUMBER
Fj
A
EXISTING REOUIRED 1EDICAnO Street
Un Pe-11 Rql'd
NAME
In
PROPOSED Z� SSPWion
Required
deenitit Required
METER SIZE
LINE SIZ E
149. OF FIXTURES
PRV REOUIRED
.0 ADDRESS
C?dlv-�� c+,
YES NO O_
Z
REMARKS
CITY Zip
ITEI�EFjO� NUMBER
KAI.
19>7, 1_7
0-y I, V4,t� S La I,, i I
NAME
kv f,'q 6, vem Ce.
ADDRESS
LP) que -1 -Y,
ENGINEERING MEMO.OATED REVIEWED BY
91
m CITY ZIP LEPHONE NUMBER
Z
'0
IT —7-7k /0 10
FIRE MEMO DATED REVIEWEDBY,
STATE LICENSE NUMBER EXPIRATION DATE
SIGN AREA
SEPA REVIEW
ADB NO�
Legal Description of Property - include all basements
ALLOWED
PROPOSED
COMPLETE
2 J, 0 4- a-, ALK I
i
1EXEMPT
SHORELINE#
6t
EXP
VAR JANCE OR CU
PLANNING REVIEW By
DATE
VOL
7Y 1 /? 7
sETBACKS FEET
HEIGHT
LOT COVERAGE
I Property
FRONT 7-5- SIDE 7A REAR
39-07,
Z
Tax Account
MARKS
rc. .0.
NEW RESIDENTIAL :LUMBING/MECH
OMPLIANCE OR
El ADDITION 0 COMMERCIAL CHANGE OF USE.
REMODEL APT. BLDG. SIGN
___CONSTRUCTION OCCU A
El REPAIR GRADING C,.S. FENCE CHECKED BY ITYPE OF: GRO P
x_FT) . —v—
E]OEMOLISH WOODSTOVE SWIMPOOL a ECI /V
�IAL IN PECJR AREA.
INSERT HOT TUB/SPA RPEG RED ZAWX"_W
WARAGE R ETAINING WALIJ S
CARPORT ROCKERY RENEWAL REMARKS.
PROGRESS INSPECTIONS PER LIBC 108
0 (TY3;i�PE. OR ACTIVITY) EXPLAIN:
NUMBER NUMBER. OF FCRITICAL
0 OF DWELLING JAR
STORIES LIN TS NUEMABSER
DESCRIBE WORK TO BE DONE JATTACH PLOT PLAN)
66M,_� m cr Let-j4y Ally FINAL INSPECTION REOU . IRED
.4, EEEa VALUATION FEE
PLAN CHECK FEE
BUILDING Z
HEAT SOURCE' GLAZING
PLUMBING,
Plan Check No. MECHANICAL
ON 'A�
.R. a
_ j
oc-F`Aivr�
L Lo .
OAD
tFEE I
q77/5-2— ------------
This Permit covers work to be done on private property ONLY. GRADINGIFILL
Any ron3tructlon.on the public domain (curbs, sidewpiks,
driveways, Marquees; etc:) will require separate permission. STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: 1. Year -provided Work: Is Started Within 180 Days STORM DRAINAGE FEE
"AppliCant, on behalf of hl:ioroa a Irs, 838191`15 and. ENG. INSPECTION FEE
'sp 5
successors In interest, agn nde% defend and hold
harmless the City of -Edhiog , da, Washfn , to Its officials;
employees, and agents from.ahy and .311 claoinitTioir damages of
whatever nature, arising directly or indirectiV. f ro m the issuance,
of this permit. Issuance of this permit shall not. be deemed to PLAN CHECK DEPOSIT
modify. waive or reduce any requirement of any city ordinance
0
.1 nor limit In any Way the City's Ability to enforce any o rdinance TOTAL AMOUNT DUE
provision." MENOMONEE
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'
authorized agent of the owner. I agree to comply with city and THIS PERMIT
state laws regu let Ing.construct Ion; and In doing the work authoriz. AUTHORIZE This application is not a permit, until
'S
ad thereby, no person. will be employed in violation of the Labor ONLY THi sligned.by the Building Official or histher
Code of.the State of Washington relating to Workmen's Compensa. WORK NOTED Deputy: and foes -are paid. and recelptJ's
tion Insurance and FICAM-t$427. INSPECTION acknowledged in space provided.
M[—siGNATURE JOWNER OF AGEN7)j DEPARTMENT
1;1:a ;Li,"
JDATE SIGNED F ;F WCS IONATURE DATE
'27-7- EDTY 0 S
?2 CIMOND
CALL FOR ELE4 B DATE
ATTENTION INSPECTION 7- -L
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
.UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR. 771-0220 ORIGINAL —()I. YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN �GRANTED, USC
SECTION 169
PINK — Owner GOLD — Assessor
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APPROVED BY PLANNING
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APPROVED BY PLANNING
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PERMIT
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The Critical -Areas Checkbst-,toiitaffied-�.,*.-"",�
-,',thd-*subr'ruit-it i6 the City., -.'The Ci
ty
on this form is tG be filled Out by any,,,. review the", c ecklist;'mak6' i".
person preparing a Development Permit,','," �T.l precursorl visit, and make
Application for the City of Edmonds determination *of the subsequent ste s
P
prior to his/her submittal of a necessary to complete a development
development permit to the City. permit application.
The purpose of the Checklist is to enable
of this form, the
City staff to determine whether any
applicant should also submit ' a vicinity
potential Critical Areas are or may be
map 6i plot pld?i for individual lots of
present on the subject property. The..
the. parcel with enough detail that City
information needed to complete the
staff can find and identify the subject
Checklist should be easily available
.pa�cel(s).. In addition, the applicant,.
from observations of the site or data
shall include othir pertinent
available at City Hall (Czitical Areas, -
Info; on'(e.g. site Plan, topography
inventories, maps, or soil, surveys).
mapi etc.) or:studies in conjuncti
with this Checklist to assist staff in
An applicant, or his/her representative,
completing their preliminary
must fill out the checklist, sign and date
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-'
Street Address
Applicant Representative:
Name
Street Addresi ii,
to
;;CheWiS7'
.616gy, 6gethfibn),
YD4 a
V -0
sit
/Location:
C
N. � .1 -
r co
2." P 8pe er'
A:
wall-,
3 Ap r i'( cies 6r s 4 r
i L quarefeet):
4. Is this* site.." qy de,veloped? yes; -..no.
if yes;' how is site__developed?.
]n,
5. Des� th� geperal site topo hy.. Check all that apply
grap
T at a
l l6s�. than 5-feet -elevation change, over 'entire site -
'Rolling: , 'slopes on site generally less than 15% (a vertical rise of 10-fee'i over a
0 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-fe�t)_
Steep:,;. grades of greater than 30% present on site (a Vertical rise of 10-feet over'
-feet).
a horizontal distance of less than 33
Other (please describe):
6. Site c6ntaini area's of year-round standing water: �kppiox. Depth.
7. Site c'ontains areas of seasonal standing waten' AppFox. Dept�:
WhAt,q�asqn(s) Of the year?,.-
8. Site is in th . i I flooaway floodplain 011,_ of a water course.'
. . .. � -7"P� 1
9. Site contains a &e& 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) k
11. Obvious wetland is present on site: