23009 102ND PL W.PDF1111111111
195
23009 102ND PL W
NOTICE-
N'O ... w-ar,rant-Y..........a.. T . . . . . Y.
The inf'or . mation'shown on the attached
'led for use by the City 0�
map(s) was com ' pi
Edmonds, its.Empl-oyees and Consultants.
Th,.e City of �Edrn.onds does. not . warrant the
accuracy of anything set for.th on these
M a P ('s"). A n . y person or entity -requesting a
copy should conduct an.independent
i InfOrm'ation shown-c
Inquiry regarding the
I I
_tFe -M a P (S) / including, but not hrn'ted to
the lociation of any sew-er stub shown, Su(
sewer stubs may or may' not e.xist and ma�
or may not exist at the location shown.
y c f E d m On IrJ4 S. nor its
Neitheir t1he � I
e M 0-y e e-S o r o ff i -c e -r s -s h. a I- I l-`1 a. b-1--e
this Map(5), nor for
information g ven on
any one representation provided based
upon'sald map(s)�
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
Call 7-76-1107 for side sewer inspections BEFORE covering any Portion of the eonstruction.N
Inspection will be provided within 24 hours after request. No Sat., Sun., or holiday inspection.93
ADDRESS LOCATION OF CONSTRUCTION ............. 23009 - 102nd Place I -Jest
------------------ * ----------------- ---------------- -----------
PROPERTY LEGAL DESCRIPTION ...... Lot 5, Westgate Division Number 2 (Parcel A)
........................................................ ...............................................................
.................................................. . ................................................ ............................................................... .............................
B. L. Dempsey
-------------------------------------------------- ------------- OWNER AND/OR BUILDER_ .... ....................................................................
CONTRACTOR'S NAME & ADDRESS ---------------------- Oviner
Permission is gmntd ......... Apri 1 25 73 ----------------------- - --- ...................................................
--------------- ------------ --------------- 19 ......... for repair and/or connection of a side sewer to the city sanitary sewer
system In accordance with City of Edmonds ordinances.
PON IS CALLED TO THE FOLLOWING:
NO,� _No. I —The owners of the property may obtain a permit to construct sewer inside Property line. A licensed Side Sewer Contractor must be employed to construct
side sewer in street area. Do not cover any Portion of sewer before it has been inspected.
NOTE No. 2—All work performed in city right-of-way requires an Invasion Of Right-Of-WaY Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Top, of side sewer must have at least 30 inches coverage at property line and 12 inches inside property line; minimum grad
sharper than 'A will be permitted. e of 2%. No bends in grade
NOTE No. 5--Trenches in street must be water settled and surface of street restored to original condition. Contractors shall 'be responsible for failure due to improper
work which may develop within one year of completion.
NOTE No. 6—It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the main sewer Or its appurtenances except to in-
sert the pipe into the wye.
DIS. APPROVED E] Date ---- ----------------------------------- BY ---_---_---- Date ................................... By ------------_- Date .............. . ................... By ................
APPROVED
......................
Remarks:
.............................
............................................................... ..... . ................................. I ......................................................................................................................................... .........
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
------ �o -on;;-c eby certify that the side sewer insta,11ation constructed under this permit
V \,-.,istalled i�n",,r2_rrd?ce wi City of Edmonds.
LDated
-day of --------- ...................................................... 1 19 .........
V V Check BEFORE you dig for: Water Gas E], Telephone E], Power F], Sewer E], Other E] -%/ V
The City of Edmonds
APPLICATION
for
SEDE SEWER PERMIT
NEW CONSTRUCTION [:] REPAIRS
EASEMENT No . ..........................................
OWNER ....... Rurton Demnsey
.......................... I ....... . ................................................................... CONTRACTOR .................................................................................................. PERMIT No . ......................
ADDRESS ..... ?N09 --------- 102nd Place I -lest
. ........................................................................... LEGAJ, DESCRIPTION: LOT No - ---------------------------------------------- BLOCK No . ............................................
NAME OF ADDITION ....... Fanc!zl ...... A.'.'.--.o-f ... L.p t ---- 2 .... o-f ... t--J.es.t.g.a.t.e ... P.a.rk
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APPLICATION
for
The City of Edmonds SIDE SEWER PERMT
NEW CONSTRUCTION REPAI 0 EASEMENT No . ..........................................
0 Tit) lu CC nt 0 4 Ot,,x, P,57C /0"cz-
OV*rNER CONTRACTOR ....... E.!An",
-------------------------------------------------------------------------------------------------------------- - ............ PERMIT No
....... ............................................. -E ......... E-�Z R11 .......................... NREI- Itj
ADDRESS GAL DESC PTION: LOT No.... ................ BLOCK No . ............................................
...............
T5=
NAME OF ADDITION �Na!E�> ...................................................................................
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Approved:
DATE................................................ By ....... ..............................................................
STREET HLE
CITY of EDi'10, D' I'Ui�LJC
RoutinF of BUilding Permit Applications
Proposed Property Address oil Application: 23009 - 102nd Place West
'DE P A RT;V;':: 7
CO""ENTS
W A 'I
-77
S Y I I: L T
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2- u L. T
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OW-LDING DEPARTMENT Applicant Fill
PERMIT APPIOCATION Inside Heavy Linev
NAME 4011 NAME
MAILIN
z
UITY TELWPHONM NUMULR
2 7 7T -eZ-,f Y 2
NA61E
ADDRESS
IN KROLL MAP NO-: PXRMIT
/0' NUKDKR
JOB ADDRESS P
93 00,7- /0,,2- '1' 60.
SIDE YARD SETBACK
SITHEKT SETBACK
RNAR YARD SETBACK
UBE ZONE
LOT AREA
VACANT SITE
[3 YES [3 NO
fizzoirr
BUILDING AREA
NUMBER
PLOT PLAN APPROVED
STREET H/W
R/W FT DEFICIENCY THIS PROPERTY
CITY TIGLICIPHONX NUM13ZR
COMP. PLAN ST. R/W Irr Fr. —10
NANIXG
REMARKS
ADDRESS
2
CHECKED 13Y
CITY
TZLICIPBONE NUMBER
METER SIZE
SERVICE SIZE
'Y
a TATE LICENSE NUMBER
CITY LICENSE NUMBER
[CLEARANCE
LANAI Descriptio, of PropA,ty (Show S.I.,
or A,h Four copl,.)
REMARKS
11-7
TYPE CONNECTION
VERIFIED BY
PERC. TEST
PERMIT NUMBER
REMARKS
CvwrV
A
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
0 YEB [] NO
SPECIAL INSPECTOR FLEQUI RED
CCUPANCY GV.JF
GAB
RE., ...
0 YES 11 NO
NEW
T-A LINE
-
PLAN CHECKED By
ADD
NON -RESIDE SION
. ;' - 1111ITA.-N.
DEM.... WALL
REMARKS THIS SITE IS LOCATED IN THE
A �TER EXC . AVATE VENCE
CITY OP EDMONDS. LOCAL
OR FILL A
:E] PRE -MOVE SWIM
"ni I, n Q_j 31.041,
FIEPAii7t
INSP�. POOL
E]
NUMBER OP STORIES NUMBER 09
DWELLING
UNITS
valu.11�n
Ire.
ft'c'lpt NO,
FL— Check No.
0
BUILDINO
Vrouxu LION
PLUMBING
IdIcate Building, ..Ib-k.. butling �.tr*ot.)
11EAT A OAS LINE
FENCE
RECEIVED
SIGN
RETAINING WALL
DEC22 1972
SWIMMINO POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I to,. read U11. apD11"tina; that the In.
form Hart fflVon Is correct; Nolijbilt I am the Owner. or the duly author.
:gont
load Of the corner. I all?" 10 Comply with city and state lawsi rollu.
Isu"If "O"Ityll"Ifirti: and In doing 11111 Work Sulthblited thereby. no foram,
AMNTION
APPLICATION APPROVAL
Will be employed In V1018ttOn Of the Labor Code of the state ot�W"hInffton
TWO Pzni"
folatial; to Workmam's Camp-boatlon Umurso,ce.
This application Is not a perittilt until
NOTE: PermIt WWI , i no Year (Esc
0 opt DIIHOUTION"
AUTHOMZMB
ONLY 72M
signed by the Building Official or hill Dep-
which
shall be COMPIot*4 In alnety days; 111011MIN SVLLDING9 shall he W.-
WO1111 NOTI&D
uty; and fees are paid, and receipt is ac-
plated to six months.)
knowledged in spaco provided.
BIGRATURld (0,%yN9H Ott AGENT)
I DATZ-A�. H
INSPECTION
-111ONATURE
IS
DSPAR7UENT
DIRECTOR'B A
L
CITY OF
MMONDS
DATE
.717rlll":l'lll�-1711` MIT PIT
W
REC
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EC 22 1972
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STREET FILE'
Critical Areas Checklist
Of
Site Information ('OPC fc) C CJ
Project Name: .49,641PSeY Permit Number:
A0 * 9 -:- /VA `4 A - W - &7L)00q4 S
i e-Mocation: — Property Tax Account Number: J210*')-Qa2 -bo,5- - c,3c,
Approximiate'Site' Size (acres or square feet): 0.0 0
Have you filled out a Critical Areas Checklist for a project on this site before? A10
General Site Conditions
e-lel S -7-/,v G
1. Has the site been cleared or logged? Date of most recent action: 9
Soils / Topography
2. In the Snohomish Co'-anty Soil Suntrey,%vhatis the mapped soil type(s)?
3. Describe the general site topography. Check all that apply.
Z-�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 of horizontal distance.)
Steep: grades of greater than 30% present on site. X
Comments 17 /Z A AM T -r -604-7- 4N A0 s 46o . -w.*y r 7-o B vlz-� 4
1 - P.,"VW4
Hydrology/Vegetation
4. Site contains areas of year-round standing water: 41b
5. Site contains areas of seasonalstanding water: NO --Approx. Depth: 0
6. Site is in the floodway No floodplain__&O of a water course.
7. Site contains a creek or an area where water flows across the grounds. surface? 610 flows
are year-round? 6LI�--Flows are seasonal? /W
8. Site is primarily: forested NO meadow WO shrubs -S 0A,02- mixed '/f/O
9. Obvious wetland is present on site: /YQ
10. Wetland inventory or map indicates wetland present on site: /V6
11. Critical Areas inventory! or map indicates any Critical Area on site: . NO
For City Use Oniy
&90 . L94 -
City 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).
RECEIVEE)
--i" 1 1 1993
PERMIT COUNTER
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
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 th.e best of my knowledge (fill out the appropriate column below).
Owner Applicant: Applicant Representative:
46.4
Name Natne
Title
23009P
Street Address
Title
Street Address
4dWaYMOS, klIV- 9 8'0-W 7 73' '?0/
City, State, ZIP Phone City, State, ZIP
R, A , W �
Date Signature
Phone
Date
'r 3 E Wm
W�V.
\1
PL. W,
qsa:Lo
2
9 WO A0 WA
1-110 sq#voz-
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STREET FILE
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
,8, /_ , ?.9 F y
MAILING ADDRESS
IV-4
CITY ZIP ThLEPHONE NILMBER
L _7 7e
;AME
A
NAME
ONE NUMBER
E NUMBER
STATE LICENSE NUMBER EXPIRATION DATE
Legal uescription oT eroperty - incivae all easements
WFJrrC4 Td y6W Q;JV,
__1V1V'2
141
LL
34 7-
Lu
a
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< ZN,9. CoV1,17y,
_j Property
Tax Account
Parcel No.
1:1
E]
NEW RESIDENTIAL
PLUMBING
ADDITION COMMERCIAL
MECHANICAL
APT. BLDG.
El
REMODEL
SIGN
GRADING
FEr
REPAIR CYDS. .
FT)
WOODSTOVE
DEMOLISH INSERT
SWIM POOL
HOT TUB/SPA
GARAGE RETAINING WALL/
CARPORT ROCKERY
RENEWAL
Z
0- (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
rL
a I't?l Ph C
05 NUMBER
Lu
NUMBER OF
CRITICA
0 OF
DWELLING
I
AREAS
INUMBER
0 STORIES
0
UNITS
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
01-0 A',1-72� & 1 _),14 IL e-
ZONE
PERMIT
NUMBER
V JuD
ADDRESS 7M9
EGA;L;DE!CCR41PT1ON CHECKI SUBDIVISION NO. ILID NO,
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCP Approved
13
AW Permit Required
C3
EXISTING — REOUIRED DEDICATION
Street Use Permit Req'd
C3
Inspection Required
I
Sidewalk Required
REMARKS
Lu
Z
a
z
UP
DATED
BUILDING SUPPLY SIZE
SIGN AREA SEPA
ALLOWED I PROPOSED I COMPLETE
REVIEW BY
NO. OF FIXTURES
Lu
EW I ADS NO
I I EXP I
VARIANCE OR CU PLANNING REVIEW BY DATE
SETBACKS —FEE - T HEIGHT LOT COVERVE
FRONT SIDE REAR'
BY ITYPE OF
SPECIAL INSPECTOR
AHEA
OCCUPANCY
OCCUPANT
REQUIRED E3 YES
GROUP
LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC 305
Z
FINAL INSPECTION REOUIRED
VALUATION
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 (curbs, sidewolks,
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
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
successors in interest, agrees to Indemnity, defend and hold
harmless the City of Edmonds, Washington, its officials,
E 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
PLAN CHECK DEPOSIT
modify, waive or reduce any requirement of any city ordinance
nor limit In any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
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
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
ed thereby, no person. will be employed In violation of the Labor
ONLY THE
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
Lti n' nsurance. INSPECTION
S_IGN_A_ DEPARTMENT
/11:1,) CITY OF
.. I EDMONDS
TURE (OWNER OR AGENT) DATE SIGN
CALL FOR
ATTENTION INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-0220
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC
r,WAPTFR .1
11
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his/her
Deputy: and fees are paid, and receipt is
acknowledged in space provided.
ICIR*S SjGlJATUF4A DATE
RELEASED BY:
DATE
ORIGINAL — File YELLOW — Inspector
PINK — Ownpr 11,01. r) — Assessor