22631 106TH AVE W.PDFiiiiiiiiii
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22631 106TH AVE W
STREET FILE
CAFILENO.
Critical Areas Checklist
Site Inform, -Won (sails!topography/bydrology/vegetatlOn)
1. Sitc Addrms/limtion:
2. Propeny Tax Account Number: fW 4: - QOO - 012 r- 0 1) '7
3. Approximati: Site Size (acrts or nuarc ftet), 4
4. U this site currently developW? - -,' y4n; _ nu.
If yc3; how iS 3itc doveJopcd? -/2 1*, Lf, - EAH . &&I C�f,
3. Dmr1be the general site topography. Check all dat apply.
Flat: less thmn 5-feet elev2tion change ovar entire site.
Rolling: slopes on site gemro)ly I= OM 15% (a vef%ical rise of '40-fea over a
110riZOntal di=MC of 66-fixi).
Hilly: sjoM presem on site of morc than IS% aW 1= than 30 S ( a vertical rise
of 10-FeA oves a harizontal distance of 33 to 6G-feet).
Steq: grades of greater dhan -10 % present on site (a vertical rise of 10-40 over a
huriz-ontal distance, of lCW *an 33-kct).
Other (please describe):--
6. Site contains areu of yeair-rouhd mading water: 90 Approx- Depth;
7. Site contains arew of senoW starWing wamr; 0.9 ;Approx. Dwth;
What season(&) of the year?
8. Site is in tht floodw3y_ flwdplain of a water Come.
9. Sito Contains a croek or an area where water flows across thegrounds surface? Flows are year -
I
round? NLo FloA-5 ac 3casocW? -1jo (What timc of yuae?
10. Site is primarily: fortsted meadow _; shrubs mixed
urban 1arxl3cV-ed (lawn,shfuts otc)
11. Obvious wfland 13 prestnt on she:
20d ZL-'q8 TZ9 90E 3NOHd SiMiTHDdd R)ER13Hd iNFID : W08J
44,
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City of Efton&
Critical Areas Checklist
The Critical Area Checklist contained on
this form is to be fillod out by any person
preparing a Development Permit
Application for the City of Edmonds prior
to histher submittal of a devclopment
permit to the City.
The purpose of the Checklist is to enable
Ckv itaff to determine whether any
potential Ntic2l Areas are or may be
present on the subject property. The
infomation needed to complete the
Checklist should be easily availablc from
observations of tbe site or data aveable at
City Hall (Critical Areas inventories, Map . 3,
or soil surveys).
An applicant, or his/her representative,
must fill out the checklist, sign and date it,
and submit it to the City.. Ile City will
rcvicw the chccklin, nu&c a puxurs'ory site
visit, and makc a detell"Mination of the
3ubsequent xteps n=c33&ry to cumplcw a
development ptrmis. aMlirAtion.
with a signed copy oIr this form, the
applicant should also submit a vicinity map
or plotylan for individual lots of the parcel
with enough detail that City staff can find
and idcntify thc subject pai=1(3). EM
additionp the applicant shall include
other pertinent information (e.g. sitf!
plan, topography snap, etc.) or studies in
conjunction with this Chccklist to assist
staff In completing their preliminary
awemment of the site.
I have completed the attached Critical Arm Checidist and attest that the answm provided are
hetual, to the best of my knowledge (fill cut the appropriate column below).
Owner / Appl"nt;
Name
Strod Addrew
City, State, 23P phMIC
3WAtM Date
Applicant RepresenL-ative-
LU 41g-f=
Nam
14tv; 50:7
Shwt Addtw
VJA I.Ls. Jaq
C' t talco Pbone
T�'
34pardre
W57-
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t-7 L,-E�
STREET FILE
PLANNING DATA
SITE ADDRESS:-2-,---7 U) ATE:
ZONING: PERMIT#:
PROJECT DESCRIPTION:
SETBACKS:
Required Setbacks:
Front: e2r; Left Side: Right Side: Rear:
Actual Setbacks: t I
Front: ft Side: Right Side: Rear:—�zi
.2 Le
FLOOR AREA:
LOT COVERAGE".
Maximum Allowed:. -�Z-745,q��1�6/Ltual: Zn -7 L612—/O)
BUILDING HEIGHT:
Maximum Allowed: (a Actual Height: 12 61 -75
SUBDIVISION:
CRITICAL AREAS #: C A7-9.q -�z
SEPA DETERMINATION:
LOT
OTHER:
Plan Review By:
Date: January 10, 1994
To: Lee Kirk
1425'4th AVe. #307
Seattle WA
Subject: CA-94-4
Transmitting:
For your information:
As you requested:
For your file:
Comment and retum:
Note attachments:
Comments:
STREET FILE
CITY OF EDMONDS
250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771-0220 - FAX (206) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works a Plannino * Parks and Recreation a Ennineerino
9 0 C�
T 1791"IrWID "117 '11"ID A'hT4ZAA1r9FwrAT
If% r. k-. r. 1 V r- U
JAN 1 8 1994
PERMIT COUNTER
R,
LAURA M. HALL
MAYOR
Please brin-g in a copy of the Critical
Areas Checklist when applying for a building
perm it.
Planning Division
Di ane Cunni'.ngham, Planning Secretary
Incorporated Au_qust I 1 1890
If W-'
'go-10
City of E&non&
Critical Areas Checklist
ne Ctitical Areas Checklist contalne:4 on
this form is to be filled out by any per3on
preparing a Development Permit
Application for the City of Urnonds prior
C_,,Cj,0pMCnA
to his/her submittal of a d
permit to the City.
The purpose of the Checklist is to enable
City staff to dotermine whcther any
potiential Nitical Areas are or may be
present on the subject prop". The
Information needed to complete the
Checklist should be easily available from
observations of the site or d ata 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.. 71he City will
mvicw the checkliat, nmir_ a procurwry site
visit, and makc a deterimination of the
subicquent. 3tep,3 nc=s&ry to compictu a
developmeent pexmill AMlication.
With a signed copy of this form, the
applicant should also submit a vicinity map
or plotylan for individual lots of the parcel
with enough detail that City staff can find
and identify the. subjcut pancl(s). In
additionp ithe 2ppliCan.t Sh2H inClUde
other pertinent information (e.g. -site
plan, topography map, etc.) or studies in
penjunction with this CheMist to amist
staff In completing their prelindnary
am-essment of the site.
I have. completed the attached CridcaJ Artm Checidist and attest that the answers provided are
factual, to the bw of my knowledge (fift out the appropriate column below). '
Owner / Applicant;
Nam
SttW Addrm -
city, state, zip PhCMV
31pature Date
Applicant Represenutive:
La
Nmw
14-LG
Stnxt AddrM
/-7 fA -r r VJA
tatc zip phone
C L"ft , Y i J, Ilt-14:
34pulure I - , Nte
208 2!29e 129 SW : 'ON =_N0HcA S�aIHDNU NDSN94al INI-10 : t-IMU
�N
CA FILE NO..
Critical Areas Checklist
Ske Information (sails!topography/hydrology/vegetatton)
1. Site Addrws/Locatioa: tlk 1 10 A"s,
2. Propeny Ux kcoount Number: L) 000 - QQ n 0 07
3. Approximate Site Size (atres or square, fed): MR
4. Is thk site currently developed? ot' v"; _ nu.
If yc3; how is 3itc doyclaped? -1E71*4&F, - PAW. F_j&lVF,!AC,(,
DeScribe the general Site toPograPhy. Chmk W1 dot aPPlY,
Flat: less than 5-fed elevation change over entire site.
Rolling: slopes on site gatorally lem Own 15% (a vertical rise of 104�a over a
horizontal distance of 66-Aa).
Hilly: slopes present on site of more than 15 % and 1= than 30 % (a vertical rise
of 10-fed ovei a horizontal distance of 33 to 66-feet).
Steep: grades of groater dhan 30% present on site (a vertical rise of 110-foo over a
huriznntal distarce of few *An '13-&A4,),
Other (please describe):
6. Site Contsin3 are" of year-round 3tanding water: go ; Appro-x- Depth;
7. Site contains araas of smono] standing waWr; hLe Approx. DWth;
What season(&) of the year?
8. Site is in the flowdwsy_ flc*dplain of a water wur.5c.
9. Site *ontains a cro-,k or an area whera water flows across the grounds surface? Flows aft year-
round7 �d — FlOA-5 arc 3C.&WEW? 1jc (What timc of yum?
10. Site is primarilly:. forested meadow shrubs mixed
urbaii landscaped (lawn,shfubs otc)
11. Obvious waland 13 present on she:
20d ZZqB TZ9 9OF : 'ON 3N0Hc1
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FILL
ALq C>/- 757
A c-jvA I - 19J-S-
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Al
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STREET
FILE
GA/
CITY OF EDMONDS
USE
ZONE
e15 4"DNIUMBER
PERMIT
CONSTRUCTION PERMIT APPLICATION
ILEGAL
joB
OWNER NAME NAME OF BUSINESS
ADDRESS
16-
�1_7 /.7
1 ('7- Ae Cit 6-11, V
DESCRIPTION CHECXI
SUBDIVISION NI
0 c� L71 Aig" tA-,)
CITY TELEPHONE NUMBER
9,zs�,PVQ 17 7- 5 5-S
NAME
W ADDRESS
1
FE
0 / qc�S 41 '4' A kF-
a: CITY ZIP IT &d, E NUMBER
/01 ELEPHON
NAME
Noll P C A
M ADDRESS
0
0
;%I FITV ZIP I TELEPHONE NUMBER
STATE LICENSE NUMBER' PIRATION DATE
NOR-114 C G 0tT0H e gbdl�.41
Leoal DescrIDtion of ProDertv - include all easements
Z
2
0.
Cr E�
(/0 E"&T G
r )ts-t
Uj
0
_j
_j Property
Tax Acco�nt
60164 —onn—n"n'<
—nc—)
ParQ No.
FINEW
RESIDENTIAL
PLUMBING
1:1
ADDITION COMMERCIAL
MECHANICAL
91EMODEL APT.BLDG.
El SIGN
GRADING
FENCE
REPAIR — CYOS.
(_ x _FT)
WOODSTOVE
DEMOLISH
SWIM POOL
INSERT
HOT TUB/SPA
GARAGE RETAINING WALL/
CARPORT ROCKERY
RENEWAL
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
Lu NUMBER
0 OF
NUMBER OF
DWELLING
CRITICAL
AREAS
INUMBER
CC STORIES
UNITS
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
0
940nes
SUITE. APT
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP,
TESCP Approved
0
RW Permit Required
0
EXISTING — REQUIRED DEDICATION
Street Use Permit Req'd
0
Inspection Required
0
PROPOSED
Sidewalk Required
0
Cr
METER SIZE
I
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
uj
YES 0 NO 0
REMARKS
Z
W
W
Z
ENGINEERING MEMO DATED
REVIEWED BY
0
Z
SIGN AREA
SEPA REVIEW
ADS NO.
ALLOWED PROPOSED
COMPLETE
MPT
jEXE
SHO�EINE 0
EX?
VARIANCE OR CU
P 'i
,rN)NlNG PEVIEW BY
OAT
SETBAC�p — FEET
HQGHT LOT
0
COVER�GE, Z
C/
FRONT SIDE
REAR
Z
REMARKS
CHECKED BY TYPE OF CONS UCTION coo OCCUPANT
7 GRO
I -,a 1 91
SPECIAL INSPECTOR S JAREA OCCUPANT
REQUIRED 13 YE LOAD
EMARKS
PROGRESS INSPECTIONS PER UBC 305
f101.070— W.SF-6-
FINAL INSPECTION REOUIRED
VTU'ATION
PLAN CHECK FEE
BUILDING
HEAT SOURCE:
GLAZING
0 %
PLUMBING
Plan Check No.94 — zz-7
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewplks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
11 Applicant, on behalf of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
su ccessors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
PLAN CHECK DEPOSIT
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
nor limit in any way the City's ability to enforce any ordinance
provision."
TOTAL AMOUNT DUE
I herebv acknowledne that I have read this annlicationp that the
FEE
) O'��
. /-4y—
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 regulating construction; and In doing the work authoriz-
AUTHORIZES
T his application is not a permit until
ed thereby, no person will be employed in violation of the Labor
ONLY THE
.
signed by the Building Official or his/her
Code of the State of Washington relating to Workmen's Compensa- i
WORK NOTED
Deputy; and fees are paid, and receipt is
tion Insurance and RCVV 18.27.
INSPECTION
acknowledged in space provided,
SIGNATURE (OWNER OR AGENT) DATE SIGNED
DEPARTMENT
CITY OF
OFFI S - SIGNA RE DATE
EDMONDS
ATttNTION
CALL FOR
INSPECTION
VELEASEYEW DAT 1. E
C.
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220
ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
PINK — Owner GOLD — Assessor
10247