22422 96TH AVE W.PDF1111.11111111
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22422 96TH AVE W
NOTIC�:'
ran;�.y ... oT
N
formation shown on the attached
The in
Hed for use by the UtY 01
map(s) wa-S COM ' P1
Mpl,oyees and Consultants.
Edmonds/ its E
Th,.e City ofEdrn.onds does - n ot. warrant the
accuracy of anything set for,th on t. * hese
r entity -requesting a
Map(s). Any person o I
copy should conduct an independent
rm-ation shown, c
Inquiry regarding the info'
1mited to,
t� Map(s)/ including, but not H
the lociation of any sew-er stub shown. SU(
sewer stubs may or may- not exist and rna�,
or may not exist at the location shown
Neltheir the �jty of Edmo*ndlq nor its
emp`oyee-s o ff ic e,r s -s. h. b e b-1--e o th
information given on this map(5), nor for
d
any one representation provided base
upon said map(S'.
oWNER/CONTRACTOR IS RESPONSIBLE FOR OTED
EROSION CONTROL AND DRAINAGE APPROVED AS N
BY ENGINE ING
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Ta Ls P;l oc STREET FILE
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0 CE 00' 14- s %cl-11 MAY 0 9 2002
rA \J,� 0 Qcw/)-j 300.0 q-7-7 DEVELOPMENT SERVICES CTR.
A C-r%AAC, 14.715' NE W CITY OF EDMONDS
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PLANNING DATA
NAME: L-A -r-r Lr4_ DATE: 3 1 - <=> -
SITE ADDRESS: Q a L'k 9'a C� U-TIA 10, 1 , 0 PLAN CHK#: Oa - SLA Ot
PROJECT DESCRIPTION:
REDUCED SITE PLAN PROVIDED?i��/ No
MAP PAGE: 10 LJ CORNER LOT: (Yes Nb FLAG LOT: (Yes
Z,ONING:- CRITICAL AREAS DETERMINATIONM
UStudv Reauired:
ZIWaiver
L) Conditional Waiver
SEPA DETERMINATION:
U Fee
Ll Checklist
L3APO list w/ notarized form
L3 (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger)
Exempt
SETBACKS:
Required Setbacks:
Street: Left,Side:7. Right Side: -1 - 5' Rear:
-*Actual Setbacks: ( F=.=— e-p
C
Street: —7 (6 ' Left Side: -7 Right Side:- _1=t Rear:
Street map chocked for additional setback required? (Yes No DN
DETACHED STRUCTURES:okc.,�r_ c?r_
co
ROCKERIES:
FENCES/TRELLISES:
BAY WINDOWS / PROJECTING MODULATION:
STAIRS/ DECKS:
PARKING: Required: Actual:.�> 2—
LOT AREA: -_�_T 5 t)o
I nT MV RAM- 'a-q,
C .. ;v- -Z -!, e;' -t- ':FXfaT j':r_0 C--4--4 0- r-4& 9_�
BUILDINGHEIGHT: OR%%- %t.4 I
DatumPoint: Datum Elevation: I C)b
Maximum Allowed: l,Z->' V_-) Actual Height: 1 t L4 . 'I Y� 10
A.D.U. CREATED?: ft/ Yes)
SUBDIVISION:
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: Ms
OTHER:
Plan Review By: -1.
NewBPPIann.ingDataForm.D0C
Critical Areas Checklist CA File No: (DO-1
Site Information (so'ils/ topography/ hydrology/ vegetation)
1. Site Address/ Location: 96-"-,4Vf- W,
2. Property Tax Account Number: 00 S 5 () 0 C)O,-,)- 0 0 rd 00
3'. Approximate Site Size (acres or square feet): -794 1
4. Is this site currently developed? ZYes; _ no.
If yes; how ' is site developed? b aise (fz e c, i d cnrriN)
5. Describe the general site topography. Ch eck 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 Iesslhan 33-feet).
Other (please describe):
6. ' Site contains areas of year-round standing water: A10 Approx.,Depth:
7. Site contains areas of seasonal standing water: Wo Approx. Depth:
What season(s) of the year?
8. Site is in the floodway L 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?
1-j 0 Flow's 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: AJ 0
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Critical Areas Checklist.doc/3.19.2001
OV ED&
City of Edmonds
Development Services Department,
Planning Division
Phone:. 425.771.0220
.11, C. 1 9 ri 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).
Pate Re ' ceived: L/
City Receipt#:
Critical -Areas File:#:
Critical Areas Checklist Fee: $45.00
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 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 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.
SIGNATURE OF APPLIcANT/AGENT
DATE
Property Owner's Authorization
By my signature, I certify that I have authorized the above ApplicanVAgent 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
PLEASE PRINT CLEARLY
Owner/Applicant:
e-�� S-r c
Name
2, 0 q6
Street Address
03 44�-
City State Zip
Telephone: C -7- -, s') , -5 3 c) i o
11. -
Email address (optiona.1):.
Critical Areas Checklist.doc/3.19.2001
DATE
.App1icant Representative:
Name
Street Address
City State Zip
Telephone:
Email Address (optional):
DATE RECEIVED
CITY;OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
.W
ER NAMEMAME OF BUSINESS
0 A LIF I I _rTI C
MAILING ADDRESS
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CITY ZIP TELEPHONE
Cl t 0 2-0 1 �1170'5 -7
NAME
t ADDRESS
x
CITY ZIP ITELEPHONE
q /0?_,, 7 (S I PERMIT EXPIRES
I USE PERMIT
ZONE Oe�-
1 1-1 (-/ % NUMBEIte/
JOB
ADDRESS
PLAT NAME/SUBDIVISION NO. LOT NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING - PROPOSED
06q7 REQUIRED DEDICATION- FT
Ij METER SIZE I LINE SIZE I NO. OF FIXTURES
NAME 6�'trt 4 (1-6-S e -r(- , Is
ic ADDRESS
0
0
CITY zlp� TELEPHONE
0
0 1 �AL_ C4 9,+,1 16,q3� �gcj A I
SUITE/APT#
LID NO.
LID FEE $
TESCP Approved
RW Permit Required
Street Use Permit Req'd
Inspection Required
Sidewalk Required
Underground
Wiring required
PRV REQUIREA
YES 13 NO I
IREMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
&SeMna0c, RMn -. 0 ElVetatJ M FWA L
ENGINEERING
4.� - %-Al I - 46.-
FIRE REVIEWED BY
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W
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0
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W
REVIEWED/DATE
DATE W
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: I
STATE LICENSE NUMBER
G,ct n A,6-6 -1 o,,,%
EXPIRATION DATE
-3
CHMBY
. . VARIANCE OR CU
SHORELINE OR ADB#
INSPECTION
REQ,D
0 YES [3 NO
BOND
POSTED
z
CL
SEPA REVIEW
COMPLETE EXEMPT
EXP
SIGN AREA
ALLOWED PROPOSED
HEIGHT
ALLOWED PROPOSED
PROPERTY TAX ACCOUNT PARCEL NO.
0o f>-�s q 0 oo-a' 003 00
NEW RESIDENTIAL.. 0 PLUMBING MECH
COMPLIANCE OR
ADDITION 0 COMMERCIAL HANGE OF USE
C
REMODEL APARTMENT SIGN
GRADING FENCE
REPAIR C YDS X. FT):
0 THER
DEMOLISH TANK
GARAGE RETAINING WALL
CARPORT 11 ROCKERY . 0 RENEWAL
LOTCOVERAGE
ALLOWED, 'PROP 6SED
AtQUIREDSETBACKS (FT.)
FRCINT� SIDE REAFt,/
PROPOSED SETBACKS (Fr.)
FRONT LJR SIDE REAR
C,—
PARKING
P R(
RE )VIDED
�2 1-7
LOT AREA,
&�D
P
��NNING REVIEWED BY DATE
&L0
REMARKtV51
(TYPE OF USE, BUSINES OR ACTIVITY) EXPL&W:
.
CHECKED
TYPE OF C014S TRUQ ION
OCCUPANT
GROUP
z
NUMB ER
OF
STORIES
NUMBER OF
DWELLING�
UNITS
CRITICAL
AREAS
NUMBER
SPECIAL INSPECTOR:,,:
REQUIRED YE 8
AREA
OCCUPANT
LOAD
DESCRIBE WORK TO BE DONE
9
REMARKS
PROGRESS INSPECTIONS PER UBC.108/FINAL INSPECTION ncu-10
23 4 C _rAltl It'
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURRS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
t:
Ix
uj PERMIT APPLICATION: 180 DAYS
IL PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
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
12 NOR LIMIT IN ANY WAY THE CnYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
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-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATIO NCE AND RCW 18.27.
ass
SIGNATURE (0 ER 0 AGENT) DATE SIGNED
Zi!�
A17ENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109,
10/01
VAWATION
/q
Description AE
Plan Check '
,Building
,Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Traffic Mitigation
Fire Review
Fire Inspection
Landscapelnsp.
CALL
FOR INSPECTION
1%, 4. —9 5)
771-0220
EXT 1333
771-0221
FAX
FEE
Recording Fee
City Surcharge
State Surcharge
Plan Chk Deposit
Receipt #
Total Amount Due
I Receipt #
APPLICATION APPROVAL
This application is not a permit until signed by the
Building Official or his/her Deputy: and Fees are paid, and
04 receipt Is acknowledged In space provided.
FF)EJALS SIGNATURE DATE
-M C- - A - 11
RELEASED BY DATE if 9
ORIGINAL - FILE YELLOW - IINAPE&OR
PINK - OWNER GOLD - ASSESSOR