22728 105TH AVE W.PDFlill iiiiii
322
22728 105TH AVE W
iding Permit
STR= F.
Ap
.Plica*ion C.
920780%1x; Dat e
i I-, e A t 1 d r es s . . .
2 2 7 28 10 55 v 4
St, Name .......
Shc)enaut�r
�!ani e ...........
Ross & Srtarcrj
ATAO 6104 DOC; ;-'-�9
........
22728 -1 05th kve 5,A�
L.
—ty,/St�/Zip ....
-12C,
Ectmonds, WA. 14K.4-
'io-
-ite Phone.
Wor.K
cont.Laf 4-Or lrjfc�'rmaticn
..........
.ont
C S-, t.--A Z
Phone.
kr-��litect Ifftorwation
...........
No Architect Assigned
Arch
Address ........
cil:y./state/Zip.
Contact ........
. Phone...
Engineer information ----------
— -- — ----
V.X ............
No Engineer Assigned
Engr # ...
Address. .
City/state/zip.
Contact. .
Phone...
ani Zord-ag Data
Lot Coverage
Height
Front..
Side..
Rear..
2.
3.
4.
Addition.,. X Alteration.... Repair ..... Heat ..... 0
Nati=e of Work. -
Swroca addition 235 SqWe feet
Occupancy Group.
- - - - �- Occupant Load..
Building Type Code. dost/84ft .......
$65.12
Basement
ist, Story 137.15 2nd Story
3rd Story
Over 3.-
Gar4p- Decks....
Shell.... Y
Total Sq.Ft. 237.5
Bldg Value 12,372-80
Total
-Review Fee
78.98 Permit Fee 121.50
Fe�-_s
This Permit covers work to be done an private property OWLY. Any construction on public domain will require
separate permission.
Hold 4araless: Applicant, on -hehalf of his or bar spouse, heirs, assignes and successors -n interest, agroes to
indemnify, defend and hold harmless the City of Edmonds, Washingtor, its officials, employees, and agents from any
and all claims for damages of whatever nature, arising direlctly or indirectly from ' the issuance of this permit.
Issuance, of this permit &hall not be deemod to modify, waive or raduco any requirement Of any city ordinance nor
limit -in any way the City's ability to enforce any ordinance provision.
I hereby acknowledge that I have read this application, that tAe information given is correct, and that I an the
owner, or the, duly authorized agent of the owner. I agree to comply with city and state laws regulating
constraction and in doing the work authorized thereby, no person will be amployeed in violation of the labor code
Of the state Of Washington relating to Vorkman'st Compensation Insurance
Owner/Agl!��— 64 Data Issue Date Expiration Data 77-
LE
STREET* �' Critical Areas Checklist
Site Information
Project Name: i&)JO 41WK Permit Number:
Site Location: W-1 fAmkroperty Tax Account Number. le 1 D46 on 01 01ZO
Approximate Site Size (acres or square feet): t�(o �e
Have you filled out a Critical Areas Checklist for a project on this site before?
General Site Conditions
1. Has the site been cleared or logged?
YW
Date of most recent action:
Soils / Topography
2. In the Snohomish County Soil Survey, what is the mapped soil type(s)? 15114VIAft"
,J
3. D the general site topography. Check all that apply.
7P70at: less than 5 feet elevation change over ent ' ire site.
-Rolling: slopes on site generally less than 15% (a vertical rise of 10 feet over a
horizontal distance of 66 feet)
lhlly-. slopes present on site of more than 15% and less thari 30% vertical rise
of 10 feet of horizontal distance.)
- Steep: grades of greater than 30% present on site.
Comments
Hydrology/Veg ; etation
4. Site contains areas of year-round standing water
.5. Site contains areas of seasonal standing water N P ---.Approx. Depthi:
6. Site is in the floodway 90 floodplain 0 of a water course.
7. Site contains a creek or an area where water flows across the grounds surface? flows
are year-round? Flows are seasonal?
8. Site is primarily: forested meadow shrubs mixed
9. Obvious wetland is present on site:
10. Wetland inventory or map indicates wetland present on site:
11. Critical Areas inventory or map indicates any Critical Area on site:
For City Use Only
STUDY REQUIRED: Critical areas study is required.
CONDITIONAL WAIVER: Critical areas study not -required if specified conditions satisfied.
WAIVER: Critical areas study is not required.
Determination Number. Reviewer
Planner Date
Rey 3/27192
,Y -go -.199 -
Ciq of Edmonds
Critical Areas Checklist
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 a development permit
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).
An applicant, or his/her 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.
Mrith a signed copy of thi's form, the
applicant should also submit a vicinity map
of the parcel with enough detail that City
staff can find and identify the subject
parcel(s). In addition, the applicant is
encouraged to include any other pertinent
information or studies in conjunction with
this Checklist to assist staff in completing
their preliminary 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:
Applicant Representative:
[A E14� ' StA& 5., 5-.4 OWS
Narne k
— W4 J2 "A � &-vw-
Title' Title I
76-71,5 10 G1,114 AV - 9 -
Street Address
�Pk) 77 � -J�Oqb
J�AMMA& � JffA L%2-0
City, State, ZIP Phone
Signature
Date
1% t -A N - � -
Street Address
City, State, ZIP Phone
r , �- C, 1,96d. / /IP—
,�ignIf - —/ EWC
ature
lor-ILth A1\1 W.
, k'
IN
OWNER & ADDRESS
Ross & Sharon Shoenauer
22728 105th Ave. W.
Edmonds, WA 98020
Tel: (206)776-5898
TAX ACCOUNT NUMBER
#61040000090201
LEGAL DESCRIPTION
Westgate Estates Blk 000 D-02 - Lot 10 & E 5ft
of Lot 9
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STREET FILE