22829 108TH AVE W.PDFlill iiiiii
502
22829 108TH AVE W
ADDRESS: Lbe,?Ilh 140�-
TAX ACCOUNT/PARCEL #: 0069 ?? 1? 1)6 0
BUILDING PERMIT (NEW STRUCTURE) #:
COVENANTS (RECORDED) FOR:
CRITICAL AREAS #: DETERMINATION: E] Conditional Waiver 0 Study Required
;xWaiver
CRITICAL AREAS #: DETERMINATION: Conditional Waiver El Study Required Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORD FOR:
PERMITS (OTHER — list permit #s): BZD 2-e�76?01,30 6o�e* aw
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:
SHORT PLAT FILE:
LOT:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE/ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
L:\TEMP\DST's\Forms\Jana's Street File Checklist 5-14-08.doc
�p
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS,WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
Expiration Date: 3/17/2 0 10
Parcel No: 00637800000400
PROPER-I'YOWNER APPLICANT CONTRACTOR
SHIRLEY HAMM SHIRLEY HAMM SHIRLEY HAMM
22829 108T HAVE W 22829 108TH AVE W 22829 108TH AVE W
EDMONDS, WA 98020 EDMONDS, WA 98020 EDMONDS, WA 98020
425-774-3959 425-774-3959 425-774-3959
LICENSE #: EXP:
JOB DESCRIPTION
COMPLIANCE PERMIT FOR AN ACCESSORY DWELLING UNIT.
VALUATION: $0
PERMIT TYPE: Residential
PERMIT GROUP: 19 - Compliance Inspection
GRADING: N CYDS: 0
T YP E OF CONST RUCT ION:
RETAINING WALL ROCKERY: N
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: N ( 0 X 0 FT.)
CODE: 06
OTHER: N ------- OTHER DESC:
ONE: RS-8
NUMBER OF STORIES: 0
VESTED DATE:
NUMBER OF DWELLING UNITS: 0
ILOT #� I
FXISTINA; ARF�k
IBASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
73
PROPOSFI)ARrk
ASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
13 RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER 0
GARAGE: 0 DECK 0 OTHER: 0
FRONT S LTBACK SIDESEFBACK RE4RSEFBACK
REQUIRED: PROPOSED: IREQUIRED: PROPOSED: REQUIRE PROPOSED:
HEIGHT ALLOWED:O PROPOSED:O IREQUIRED: PROPOSED:
SETBACK NOTES: * PLANNING DIVISION APPROVAL PURSUANT TO ADU-2008-76
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION 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 COMPENSATION INSURANCE AND RCW 18:27.
THIS APPLICATION IS NOT APERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HINfR DEPUTY AND ALL FEES ARE PAID.
" 61141,1,4w -Sh'rl��t 3-7,oj Em S!vz/��
- 6Sianature Print Name Date Released By 'Date
ATrENTION
IT IS UNLAWFUL T'O USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBC1091 IBC 110/ IRCI 10.
ARCHIVE APPLICANT ASSESSOR OTHER
A
Fri
1
20.0-
71
0
STREET FILE
'fs
A 07- 2
100
4996
le Aff, i
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&itical Areas Checklist 0
Le InfurmaLion ksods/ topography/ hyd rologyi vegetation)
1. Site Address/Location: -2 2-P2-1':P 20
2. Property Tax Account Number: L?6 C)
3. Approximate Site Size (acres or square feet): (D <n
4. Is this site currently developed? yes; no.
If yes; how is site developed?,-,J�-- 10 z!�/—b 02',g!27
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Rolling: slopeson site generally less than 1.5% (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
borizontal distance of less than 33-feet).
Other (please describe):
6. Site contains -areas of year-round standing water: Approx. Depth:
7. Site containsareas -of seasonal standing water: ,C/ U Approx. Depth:
What season(s) of the year?,
8. Site is in the floodway 1D 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 (lawn,shrubs etc) A
11. Obvious wetland is present on site: /4/0
For City Staff Use Only
I . Site is Zoned?
2. �CS mapped -soil type(s)?
3. Wetland inventory or C.A. map indicates wetland present on site? -1V0
4;.*-- :-..Critical Areas inventory or C.A. map indicates Critical Area on site? �94f 5��u e-
5.. 'Site within' designated earth subsidence landslide hazard area?
6. designated on the Environmentally Sensitive Areas Map?
DETERIVITNATION
"��UDYREOUIRED CONDITIONAL WAIVER
V
Reviewed by:
WAIVER
Z
Planner �/Ilr Date
P--v 01/04N4
0
. . . . . . . . . . . . . . . . . . . ...
Ali, RECEivED
AUG 2 8 1996
COMMUNITY SERVICES
City of Edmon&
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 todetermine 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 availableat
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.
With:a signed COPY of this form, the
applicant should also submit a vicinity map
or plot plan fbirindividual lots of theyarcel
with enough detail that City staff can find
and identify the subject pancet(s)_ in
addition, the 2 ' PPlicant shill include
otherpertinent infonnation *(e.g. :site
Plan, t9POgraphy -map, etc.) 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:
J
Name
2,2_ ?Z7
Street Address
City, Stat IP �FF_62_0 Phone
Signature
7 //6—ate
Applicant Representative:
Street Address
City, State, ZIP Phone
Signature Date
7-6—ITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME NAME Ul' UV—...
�v 1,11144,1 51,egy), .4 7'114"�l
MAILING ADDRESS— xaza 4p,-- �j
LEPHON NUMBER
CITY
,e- P/,j 4 0177 Y
r-A
9/ -57_
�14�y ZIP T NONE NUMBER
179---252-
STATE LICENSE NUMBER
A14—Y . J,, _1.7t:
Legal De =115 �10.--Of 1`10�5.dy - include all easements
&) 0 oZi W.A y /1-1
C4 000 — 0
_svle_r Er.5c- —rz), 1p,/6
r- §)u 4 1 q,& zi F Az� 77- /,V -7*1.4*
/I rc'e -5 /F 0.4 a
USE PERMIT
ZONE NUMBER
Joe
ADDRESS P 62 AO 8-
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MA.P.RES
po'�"d
TESPC.P,.A ,I R.I.wed
0
0
EXISTING � REOUIRED DEDICATION
St,sej Use Pe-il Re , Q-d
Sin d
=Onziuze
13
0
0 E
METER SIZE
TER S'.7
T
No. OF F,.W
LINE SIZE NO. OF FIXTURES
LINE SIZE
PRV REQUIRED
PFIV REQUIRED
'0 No 0
YES C1 NO 13
Tam A ccou"'
&044-p- I
L/L.116-10' /
Pa..
NEW
RESIDENTIAL
ElPLUMBINGIMECH
ADDITION
COMMERCIAL
COMPLIANCE OR
CHANGE OF USE
REMODEL
APT. BLDG.
C1
SIGN
REPAIR
G—ING CYOS
PENCE
I x —FTI
DEMOLISH
OODSTOVE
WINSERT
SWIM POOL
HOT TUB/SPA
GARAGE
CARPORT
r7
"
RETAINING WALL]
ROCKERY
RENEWAL
S ON AREA
I COMP
ALLOWED I PROPOSED LETE
EXP
ADB NO.
�PLANNNING _REVIEW BY DATE
��LOT COVERAGE
rSETBACKS - FEET HEIG
CI YES SQ TaIr
WNEWA-R—KS
I PROGRESS INSPECTIONS PERUBC 108
a
NUMBER
OF
NUMBER OF
DWELLING
CHITIUAL - :
=R
UNITS
O;Z
-2TORIES
OESCRIBj WORK TO BE 60NE
(A TTACH PLOT PLAN)
.
FINAL INSPECTION REQUIRED
VALUATION
FEE
417
a Q 0 AI -I>
PLAN CHECK FEE
BUILDING
HEAT SOURCE.
GLAZING %
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curn. sidewpike.
'56
driveways, marquees, etc.) will require separate permission.
STATESURCHARGE
Permit Application: 180 Days
STORM DRAINAGE FiE
Permit Limit: I year - Provided Work Is Started Within 180 Day$
"Applicant. on behalf of his or her spouse. heirs, assign5 and
ENO. INSPECTION FEE
successors 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
whatever nature. arising directly or Indirectly from the Issuance
Issuance of this permit shall not be deemed
to
PLAN CHECK DEPOSIT
of this permit. 1
modify, waive or reduce any,requirement of any City ordinance
In any, way the City a ability to enforce any ordinance
TOTAL AMOUNT DUE
-7k5012JIS
nor limit
provision."
I hereby acknoviledde that 1.1have read this application; that the
ATTENTION
APPLICATION. APPROVAL
IRformatign given Is com that I am the owner, or tha duly
.plf"biId
authorized agentf�of J��wner. I agree to comply with city and
THIS PERMIT
This application i's not a permit until
state laws rag ulall nq�constr tion, and In doing the work authoriz-
uc
AUTHORIZES
ONLY THE
signed by the Building Official or his/her
ad thereby, no porson will be Orn�loyed in violation of the Labor
Statel.of Washington relating to Workmen's Compensa.
WORK NOTED
Deputy; and fees are paid, and receipt Is
acknowledged In space provided.
Code of the
tion insurance and RbW 18.27.
INSPECTION
DEPARTMENT
SI N TURE JOWNER OR -AGENT) IGNED
DNA Alt
CITY OF
EDMONDS
:F �FA F
T
CALLIFOR
E EASED BY:
L
ATTENtION
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
HAS BEEN MADE AND APPROVAL OR
771-0220 ORIGINAL - File YELLOW - inspector
UNTIL A FINAL JOPECTION
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC
PINK - Owner GOLD - Assessor
SECTION 109
10247
.. : "a - O%MW -RW-
i� CITY OF EDMONDS -
COMMUNITY SER,,41faTTFILE
RIGHT-OF-WAY CONSTRUCTION PERMIT
Z
U
A. * Owner: Washington Natural Gas CqTpauy
�TT'mewcer street
Tea ail i n
t&Address
e WA 98111
City State Zip
0 e -
� CellfeD Permit No. 67 1 _d ff)
J U L 15 1991 IssueDate 2 6� /
B. * Contractor:
Name
Mailing Address
City State
State License Number Telephone Number
C. * Address or Vicinity of Construction: 22829 108 Avenue West
Type of Work to be Done: Install 1 1/4" PE IP Main in 108 Avenue West from centerline of
108 Avenue West to 25' East of centerline of 108 Avenue West at
2471 North centerline of 229 Place Southwest. Per Attached
D. 0 Work in Connection With: 0 Sub or Plat El Single Family El City Projects
0 Commercial El Multifamily El Utility
E. 0 Pavement Cut: 0 Y 0 N F. 0 Size Of Cut: — X — Drawing: 9 10-098 (IR 604
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature. to -this application, agree to ihold the City of Edmonds
- �rescription whatsoeve -, forseen of upforseen, that may
harmless from any injuries, damages, or claims of any kind o�
be made against the City of Edmonds, or any of its dep d g or nohimited to the defense
g m-ents or employees, includin
of any legal proceedings including defense costs, court feb sts,'an�attor fees by reason of granting this permit.
L - rj�_ I I
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE
YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK.
Estimated restoration fees will be held until the final street patch is completed by City forces, at which time a debit or credit will be
processed for issuance to the applicant.
• A 24 hour notice is required for inspection; Please call Engineering: 771-3202
• Work is to be inspected during progress and at completion.
• Restoration to be in accordance with City Code.
• Street to be kept clean at all times.
• Traffic Control to be in accordance with City regulations.
• All street -cut ditches must be patched with asphalt or City approved material prior to end of working day;
NO EXCEPTIONS.
I understand the above and that this permit must be available at the job site for inspection purposes at all times.
.;s
Signature: MeMvtz�� Date: JUIV 8. 1991
Owner or Contractor
This Permit Must be Posted at the Job Site For Inspection Purposes
Call DIAL -A -DIG Prior to Beginning Work
APPROVED BY: Bw
Time Authorized: Void after I N4!4-.f' —days.
Special Conditions: N o e_vTA -
RELEASED BY:
Date 77 - /:i- , /
PERMIT FEE:
Restoration Fee:
Receipt No.:
Fund I I I Fee:
Street Cut Dimensio_31�M
INSPECTED BY
Date
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. March 1989
Eng. Div. July 1985
EX/577 E.O.AA. -Zo/i--/V
-E REDUCSR
'At 9 MT
4-4 - 1O'W
v
20 1 ESM7.7
N
5/9" 117'tY w
1187 W
> 00
< 0
Co �j rn
C) klw
501,
A/w
2-2-cl PL
60,
A/W
NO i
DESCRIPTION
REVISIONS
el
NOTES:
I.
FIELD LOCA-rE ALL U-rlLl-r't,,E5
CIALL 1-900-4.Z.+-5-5.55
49 HOURS BEFORE 0166/A/S
Z.
LAY DETffC7- WARIVING WIRE OVAER
ALL PE 0/)REC-r BURIAL PIPE
3.
ItVS-T-ALL CAIjE RQUAID AAIOCE' F'OR
EVE*RY 1000' OF LOCA-rINU WIRE
4-.
SURVEY REQUIRED
NO-r/F=*Y SNOHOMISH COUA/Ty 1AjSREr-7-0,q
48 HOURS PRIOR 710 COAlS7-Rucr1oA.1
A7- Z59-7464-
10
-7T 1114-" PE C-A P 52:- 630
7 -2f )c, V/4" RE REDUCER 7Z- 4-00
6 14-81 TF14-GAUGE DE-FE.C7- W/RE 85- 94-0
5 - SDR-11 RE PIPE -70- 170
1 Z!, RE CA P 52-- 9.50
2" PE 7-E E 79-363
4-6' 14- GAUISE DE-FECT- WIRE 95-940
46' Z!'5DR-n r-E PIPE O-Z60
ITEM QUANT DESCRIPTION STOCK NO.
BILL OF MATERIAL
PERMITS: SNOHOMISH COVA17-Y 1/4 SEC: NE 35-Z7--3
EASEME'At7- PLAT- 166.65
OP MAP: /G 4-. G Z
AREA: Z4-1
TAX CODE:
SEQ. NO:
Gm
GR-
II/W' 50R- 11 PE IP MAIN EXT
TO: Z2-82-9 /08 AV W
I
DWN L. HIR SCH G //a 11 cri IR G 0 4-3
I iJOB cTIO-OcIS
DATE E3Y I APP'D CHK'D.
DRAWING
SCALE: -50, 9/0 - 0 17 8
.4pp. K/*U—