23011 102ND PL W.PDFiiiiii lill
197
23011 102ND PL W
- -7,
77
rl
City of. Edmonds.
RIGHT-OF-WAY CONSTRUCTION
PERMIT
Permit Number- 4?5�- 9 *7 �-
Issue Date: 0/'J
Al
A. Address or Vicinity of Construction: Z3o)( 0 Z tL . i"'I.
7819��o W19 1� B. Type of Work (be specific)- 7-0 -S /-�o /Z /t-/
C. Contractor: 74-kri?Ake4lt "feikerva 4rr Contact:
Mailing Address: 7S-05-;3 Po&y-L-4*t� )" Phone: S'VC-36Af)-3
I
StateLicense#: 37J7-519 Ta---0*'"'rLia rilityInsurance: Bond: $
/A
D. Building Permit# (if applicable):_ , Side Sewer Permit # (if applicable):
E. F] Commercial 0 Subdivision [-] City Project [-] Utility (PUD, GTE, WNG, CABLE, WATER)
F] Multi -Family Er Single Family EJ Other
INSPECTOR: 4LC I INSPECTOR:
F. Pavement or Concrete Cut: 0 Yes ANO G. Size of Cut: x H. Chargc�,$ X"
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signatureto this application, agrees to holdthe CityofEdmonds harmless from injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any Of its departments or
e�ployees, including or not limited to the defense ofany legalproceedings including defense Costs, and attorney fees by reason ofgranting thi8permit.
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 TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THEAPPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
Ihave read the above statements and understand thepermit requirements and thepink copy of thepermit will be
available on sit Vall times for inspection purposes.
Signature: Date: z 0 - 47s-
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
�APPROVED,BY RIGHT OF WAY DEPOSIT
TIME AUTHORIZED- VOID AFTER 150 —DAYS DISRUPTION FEE/FUND 111.
SPECIAL CONDITIONS:
COMMENTS:
I?ATE:
RESTORATION FEE:
PERMIT FEE:
TOTAL FEE:' -3
490 C-,d- Z
RECEIPT,FEE:--
ISSUED,IiY::-,
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. 1994
.:1 . I � ix , I . . . I . �
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.)
Comments:
I Diagram.:
CONTRACTOR CALLED FOR INSPECTION El YES El NO
,Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
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9303080123
CITY OF EDMONDS
RECORD;'O �SHOR _�SUBffVISION
n the attached map (Exhibit
This is to certify that the properties as shown o
kA") and described.as follows: REC
See Exhibit "B"
nce JUN
ions of the Edmonds Subdivision Ordina
have been divided underthe provis
s 22.1o) File No. s-9-90 subject to the following co nditions and PERMIT
ec. I
reauirements: C ti-mb
Exhibit HCR Hold Harmless Agreement
e
2. An on-site'turn-around is r quired on lot 2 a : long with a building permit
on Lot #1-
as built drawings for
3. -Underground wiring, an.on-site drainage system$
all utilities, and excavation -and grading to conform to the Uniform
Building Code Chapter 70 is required with a building permit on lot 2.
9 plan shall be submitted to the City for review and
4— A, tree. cutti n!
approval.prior to issuance of any development permits. Care shall be
as many trees as possible by careful siting of the road,
taken to preserve ld-
utilitiesand bui. ing..
I/we verify that I/we Are the legal owner(s) of the property described
tthat�all representations are true and correct and
above. I/we warran
ntation or failure to comply
understand that in the event of any misreprese
ons set forth herein, the City of Edmonds
with.the conditions and regulati
hat subdivision.void and record a statement
...shall have the right to declare t of the Snohomish
.''.to that effect in the Grantor-Grant6e's Index in the office
County Auditor.
SIGNED. et,
RECEIVE
D
�cl C).
JUN 0 7 1994
00
C—� rtKMIT CoUlyTER
EDMONDS
CITY OF
W P,w. DEPT. ENGINEERING DIV.
rXA!A1:'LD
DAT�
CY
REMARKS
STATE OF WASHINGTON)
ss:
COUNTY OF.SNOHOMISH)
4
On this day personally appeared..before me 19
. .... . .. ............... ..... .......
... ...... . ...... ....... . ..... ecuted the within
ibed in and who ex
0 m;; . ........ - ........ .................. .... b tile i n i vi dual T—descr
t 113101.11111 to."le , iat signed the.
and foregoiny instrument, and,acknowledged 0 the u . ses and
free and voluntary act and d-eZetd/�,--
same as
tr
p seslthgerein m
pur 0 en ioned.
day of 6L 19iel—
and official seal thisd
Given under my hand
he State
r t
Notary u ic in an f
. ............ of Washington residing At
AUTHORIZED
R. ECO
W
RDING
FOR
COMMISSION EVIRES 3-1.93
"fl L
E
DMOND'
.........
y
LPAGE Or—
ABE 1716
VOL. 2694P
ownership
--an a
Owners,, d 11persons having any present.or. subsequent
i ntirest`-� 16 *t these lands i *- and the. *succes sort: and assigns of owners or
st "hereby-agre
other''parties_hdving.ahy said intere e that the City
rom any and all
.of.;,,:Edmond _"' hall- be.,held._harmless in 11 respects f
s s
A iges',for-,-,injunctive -relie; which may be
occasioned, now
"th .' utur
..N.in �_ e�f i e'.to.adjacent land or improvements' byreason of:the
'.operation and'maintenance of.the drainage system and
n
er:by -,�-waive -and �releaS6 'the City of Edmonds from'any and all claims
-'�exc u
-damages's . .1 ding damage causid.solely by'an,act or omission of
or,'
'4City 'and 'Anjunctive..'relief ',which the owners, or.their
said
i is,.may themse
tucc6ssors.or ass gi Ives have',now or in the future by
eison'-1of the construction, maintenance and operation of said
rainag'eI',sy's*tem.'..
CITY OF EDMONDS
R W. DEPT. ENGINEERING Div.
'EXAMU40
By ATZ� /-/57 g.:)
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CITY OF EDMONDS 00
P.W. DEPT. ENGINEERING DIV.
BY C -DATZ
7- a-1 -
N89046'32"W 90.77'
10,26'
lf�kll 1-7
L - - - - - - - XISTING 11" I.P.
30.0c. 4.88!
4.16E'
N89046 32"W 202.8S
PROPOSED INGRESS, EGRESS, UTILITY EASEMENT
30 ct Water and Sanitary Sewer EXISTING CASEDMONUMENT.
service available in Right -of -Way 0 SET REBAR W/CAP N0.7892':
�0
S -T SPIKE W/WASH.ER NO.7892.'
E
jol
EDM.ONDS: SHORT PLAT S7.9-90
Scale:l"=30'
SHORT PLAT
Nort DOUGLAS AND JUDIE . AARDAHL
0 15 30 60
in the HE 114. NW 114, S*C 36. T27K'M WAL
Snohondsh County. Wnhington
LEGAL DESCRIPTION
t9WI 33rd AY& W. SL4@ 301
Zone':'RS-8
4W.0K WA 0306-6635 -
Area: 20,753 Sq.'Ft. Lot 19,'Block 2. Division No. 2 of Wes-IUM0 Park &cc*"ibV 10 00 PISt
thereof recorded In Volume 13 of Pkft, poges 40 and 41, records of the
0.48 Acre Snohomish County;
W. .""1 0... 1 54.
EV'SO 5-17-90 CHANGED FRONT SETS SMw RLS 13-5-901 r.52 /47_1.. I"- 3d.
ACK EXCEPT On East 250 feet Ow &of.
SEAD 4-18 - 91 ADDE D SURVEY DET
Al LI!
FOR FINAL:SUBMITTAL
.4-
ity of,Edmo ngton, commonly known as 23015
property in the Ci nds, Washi
Block 2,.
..102nd Pl. W., the legal descri.ption of which is Lot 191
Park, according to the plat thereof,
Ui—Vislon.No. 2, of Westgate
dod in volume 13 of plats,' pages 4 0 and 41,.records of Snohomish
recor
County, Washington, except the Eas t 250 feet thereof and,
WHEREAS, each lot of Shor n s-9-90 will have an
t Subdivisio
impa ct on the street system and each will specific ally benefit.from
the construct ion of sidewaTks and,
WHEREAS, as a condition of short subdivision approval owners
:icipate in a focal ImprovemeRt District as
shall agree to parl walks for
35.43.046 for construction of side
horized by RCW
—fu—ture,
....aut
pedestrian safety when one is formed in the
NOW, THEREFORE, it is hereby agreed. as follows:
1. owners acknowledge that state and City law prov ides that the
City may require certain real property improvements be made by owners
to effects of development, and further
..as conditions of, and mitigate
a cknowledge that the consideration for this agreement shall be approval
of this development without requiring owners t o make such improvements.
2. owners acknowledge that each lot within the S -9-90 would be
specially benefited by sidewalk construction and agree to participate
in any Local Improvement District �Ihich is formed for the purposes of
providing such.
3. Owners waive their right to protest the formation of any such
test the method
LID, provided that owne rs shall retain the right.to con
of calculating the assessment and amount thereof.
4. This agreement shall be a covenant running with the land and
sessor and
shall be filed and recorded with the Snohomish County -As..
their
shall be binding upon the owners a nd subsequent property owners,
successors in interest and assigns.
DATED this day -of ex "r � I
OWNERS
'720
ot. 2 6". .9 4 phrur, 11
'9 S 13:11 U J.
`AUTHORIZED
FOR RECORDING
CITY OF,.EDMONDS
PAGE OF._C__
DOUG AND JUDIE AARDAHL SHORT PLAT LEGAL DESCRIPTIONS
EXISTING PARCEL
Lot 19, Block 2, Division No. 2 of Westgate Park, according to the plat thereof reco rded in
mi hington;
Volume 13 of Plats, pages 4.0 and 41, records of Snoho. sh County Was
EXCEPT the East 250 feet thereof.
PROPOSED LOT I
Lot 19, Block 2, Division No., 2 of Westgate Park, according to the plat thereof recorded in
Volume 13 of Plats, pages 40 and 41, records of Snohomish. County, Washington;
EXCEPT the East 364.00 feet thereof;
ALSO EXCEPT the South 15.00 feet thereof
TOGETHER WrM an easement for ingress, egress and utilities over, under and across the
South 15.00 feet of said Lot 19, less the East 364.00 feet thereoL
PROPOSED LOT 2
The West 114.00 feet of the East 364. . 00 feet of lot 19, Block 2, Division No. 2 of
Westgate Park, According to the plat. thereof recorded in Volume 13 of Plats, pages 40 and
41, records of Snohomish County, Washington;
TOGETHER WITH the South 15.00 feet of said Lot 19, less the West 364.00 feet thereof.
SUBJECT TO an'easement for ingress, egress and utilities over, under and across the
South 15.00 feet of. said Lot 19, less the Fast 364.00 feet thereof.
Situate in the City of Edmonds, Snohomish County,'Washington.
CITY OF E D,%,,'O N D S
P. 17. DEPT. ENGINEERING -DIV
h AdoOsOaardahl.sm w
1001 A?rd Avr. IV., Suitt- K11
Po. rt^�
WA J:�Zlx, Ot,M'
8 0
AMMUicu
PATZ
-9 g ti A na 17 1 .1
TUL.
Agreement to Waive Protest to LID.
Pag4.2
t -City of Edmonds
Acqept6d by . he
2-
B BY
Y
STATE OF WASHINGTON
ss.
:COd'NTY OF SNOHOMISH
0 ppeared before me
;On* this day pers nally a
tome known fo be the i ndi vi dual (s)
yhe
described, j n and who executed within and foregoing
instru mant, and
adknowledied -tha signed.the
same as*
AA free a6d vo Tu-ntary act and deed
for the
n
uses and purpos�s therein.me tioned*.
_L�d6y
GIVEN, nnder my hand and official seal this a
19
of
r
AUTHORIZED,..
F AECORDING
OR
�_,,CIT Y:0F1. EDMONDS
2 "L,
0 39,�81 0 1
NOTARY PUBLIC in and foof the..State
of Washington, residing at
My COMMISSION EXPIRES 3-1-93
VOL.. 26' .9 4
rz
9303080123
CITY OF EDMONDS
RECORD-W SHOR VISION
This is to certify that the properties as shown.on the attached map (Exhibit
"IA") and described as follows:
See Exhibit "B"
vision ordinance
have been divided underthe provisions of the Edmonds Subdi
owing conditions and
(Sec.12.10) File No. S-9-90 subject t . o the foll
requirements:
e s Agreement 2 along with a building permit
1. Exhibit "C" Hold-Harml ss
on -site turn -around i required on lot
2. An
on Lot #1. drawings for
-Underground wiring, an on -site drainage system, as built
3.. and grading to conform to the Uniform
all utilities, and excavation
B ilding Code Chapter 70 is required with a building permit on lot 2.
U
cutting plan shall be submitted to the City for review and
A.tree. of any development permits. Care shall be
approval,prior to issuance as possible by careful siting of the road,
e,as many trees
taken to presery
utilities and building..
I/we verify tha . t I/we are the legal owner(s) of.the*property.described
t that�all representations are true and correct and
above. I/we warran ly
ntation or failure to comP
'understand that in the event of any misreprese
f City of Edmonds
orth herein, the
with.the conditions and regulations set
t to declare that subdivision.void and record a statement
shall have the righ
-Gr . antee's Index in the office of the Snohomish
that effect in the Grantor.
County
Auditor.
C_: 2
U_J CITY OF EDMONDS
CC
P. W. DEPT. ENGINEERING DIV
EX AN. I N
�4kV DATZ
y
STATE OF WASHINGTON)
ss:
COUNTY OF.SNOHOMISH)
before me
On this day personally appeared.,
... ........ ..
... ..... ...... . . .. .. .. .. .... ......... ekecu ted the within
to me known tZ Be the individua s es-1 ined il�l and yanc signed the
and foregoinp instrument, and..acknowledged that
s e free and voluntary act and deed, �the uses and
am
o:es-6h`e�rein meMtioned.
pu.rp
19i
and official seal this*,LtL day of
Given under my hand
for t e State
Notary 146 i �ci n
........ of Washin-gton residing at
ED
AUTHORIZ
.1 ...........
16- W COMMISSION EVIRES 3.1-93
CITY C4 EDMONIC.-
ay�
oe
PAGE_J
vot. 2 69 4 pw 17 16.
d 11 p rsoniftving any present or subsequent. ownership
rs,,,an a a
i nti�est.,A61hise'l and' , �:and the. successors:and assigns of owners. or
sai ..the City
thei : ii
par is hav ' ing any d interest,-'her0y agree that
all be.'held harmless in ill�respects:frtm any and all
now
-liimsjoi damages" for"injunctive 'relief which may be occasioned.
c
-the
)r An',"the"future to adjacent land or improvements by reason.ofs
C
system
and
on and maintenance'of the drainage
construction; operati
'ive'*.a A relea- 6 'the City 'of Edmonds from any and al I claims
hereby we n s
of
','for,.Aa'mages, excluding damage caus�d solely by an act or omission
said �,City ' an " injunctive.. relief ' which the owners or their
d
. ..,succ6iiors.or assigns : may themselves have'nowor in the future by
ation of said
.-reason" :of ' the construction', Maintenance and oper
d ra
inage.system.
IZED
AUTHOR
Fzc; R
0 DIN
i.,.,C1Ty'QF.-:EDM0N7
My,
49
'-OF
pA
CITY OF EDMON M
P. W. DEPT. ENCINEERING DIV.
DATZ:
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BULDING SETBACK LINE
L
N89046'32"W .90.77
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11, 400 t Sq Fit., Net 8
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Fornily
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CITY OF EMIONDS 00
P. W. DEPT. ENGINCE. rZING DIV-
,y 11L
[)ATZ )-)!'
Cq
EXISTING I"I.P.
4.16E
N89046'32"W 202.8S
PROPOSED'INGRESS, EGRESS, UTILITY EASEMENT ..a
30 Water and Sanitary Sewer EXISTING CASEDMONUMENT. Q*
service available in Right -of -Way
10 SET REBAR W/CAP NO. 7892
SET SPIKE W/:WASHER NO.7892
301 EDMONDS:'SHORT PLAT.'S .9-90
Scale:l"=30' SHORT PL . AT . FO
pmmml. . R.
Nort
0 15 30 60* DOUGLAS AND JUDIE AARDAH�� 41;l
VbA
In tM HE 114, NW 1/4, S" 36.'"
Snohomish Cout". Washingun'.."-..
pro
LEGAL DESCRIPTION
Zone: RS-8 1901 33'd m. W. &a.
4=�ood. WA 93OU-11418
Area* 20,753 Sq. Ff. Lot 19,*BIock 2, Division No. 2 of Westgate Pmi4 WCWdIng to ilhe Plat 3m/ns-34u
thereof morded In Volurto 13 of Pigs, p"n 40 and 41. lemills of the
0.48 Acre Snohomish County;
EXCIEFFT the East 250 feet thmeof. 2.89-054,
BACK S -1 S 13-5-901 652/471 1"-- 36
REV'SO 5-17-90 CHANGED FRONT SET MW
FIEVSD 4-18 ' 91 ADDE 0 S U R VE Y DETAI LS
FOR FINAL -SUBMITTAL,
dN
AGREEMENT TO WAIVE P ROTEST TO LID
Judy ardahl are Owners of real
WHEREAS Douqlas.Aardahl and ardahl
p roperty in i1ij City of,R[monds, Washington, commonly known as 23015
2,.
102nd Pl. W., the legal description of which is Lot 19,.Bl.ock
Park, according to the plat thereof,
on..No. 2, of Westgate
recorded in volume 13 of plats, pages 40 and 411 records of Snohomish
County, Washington, except the East 25 0 feet thereof and,
WHEREAS, each lot of Short Subdivision s -90 will have an
impact on the stree st will speci ally benefit from
t sy em an each
the construction of sidewalks and,
WHEREAS, as a condition of short subdivision approval owners
shall agree to participate in.a Local Improvement u1strict as
authorized by RCW 35.43.046 for con struction of si dewalks 'or
'75
edestrian safety when one is.formed in the ture,
NOW, THEREFORE, it is hereby agreed. as follows:
owners 6cknow ledge that state and City law provides that the
City may require certain real property improvements be made by owners
of development, an d further
a s conditions of, and to mitigate effects
sideration for thi proval
acknowledge that the con s agreement shall be ap
of this development without requiring owners to make such improvements.
2.* owners acknowledge that each lot within the S-9-90 would be
I te
specially benefited by sidewalk construction and agree to partic pa
in any Local Improvement District which is formed for the purposes of
providing such.
3. Owners waive their right to protest the formation of any such
the method.
-LID, provided that -owners shall retain the right.to contest
of calculating the assessment and amount ther . eof.
4. This agreement shall be a covenant running with the land and
shall be filed and recorded with the Snohomish County -Ass essor and
their
shall be binding upon the owners and subsequent property owners,
successors in interest and assigns.
19
DATED this day of
OWNERS
AUTHORIZED..2*.
FOR RECORDING
OF EDMONDS
't(BY
AG;; OF--L-
720
V o L 2 ti .9 4 PA'ru r, I i
. 'AUTHORIZED
FOR RECORDING.
CITY OF..EDMONDS
BY
PA6E--4-,-- OF. -6 --
. DOUG AND JUDIE AARDAHL SHORT PLAT LEGAL DESCRIPTIONS.
EXISTING PARCEL
Lot 19, Block 2, Division No. 2 of Westgate Park, according to the plat thereof recorded in
Volume 13 of Plats, pages 4.0 and 41, records of Snohomish County, Washington;
EXCEPT the East 250 feet thereof.
PROPOSED LOT I
Lot 19, Block -2, Division No..'2 of Westgate Park, according to the plat thereof recorded in
Volume 13 of Plats, pages 40 and 41, records of Snohomish County,'Washington;
EXCEPT the East 364.00 feet thereof,
ALSO EXCEPT the South 15.00 feet thereof.
TOGETHER WrM an easement for ingress, egress. and utilities over, under and across the
South 15.00 feet of said Lot 19, less the East 364.00 feet thereof.
PROPOSED LOT 2
The West 114.00 feet of the East 364.00 feet of lot 19, Block 2, Division No. 2 of
Westgate Park, according to the plat thereof recorded in Volume 13 of Plats, pages 40 and
41, records of Snohornish County, Washington;
TOGETHER WITH the South 15.00 feet of said Lot 19, less the West 364.00 feet thereof.
SUBJECT TO an easementfor ingress, egress and utilities over, under and across the
South 15.00 feet of. said Lot 19, less the East 364.00 feet thereof.
Situate in the* City of Edmonds, -Snohomish County, 'Washington.
h.Ndoc\sv\aardahl.smw
01
1001 A�rd Ave. IV, Suilk- K
r. 0. IL, r-v _,,x
V�A
co) 03 8 01,-
CITY OF EDNIONDS
PT.
P. W. DE ENGINCERING DIV..
PATZ a
. nt 9 14 ti A PArx 17119
r
Agre - ement*to Wai ve Protest to LID..�
Page. 2
h of Edmonds
Accepted by t e'City
By �2
�'STATE OF WASHINGTON
ss.
COUNTY OF SNOHOMISH
o-this day personally be
n appeared fore me
be the individual (S)
to me known fo
ant, and
t and foregoing instrum
wi hin
described in and who executed �he
signed.the same as
owled ed tha
ackn t
free aa v
f AA-
oluntary act and deed for the
. ......... :-
e tioned.
uses and purposes therein m n
official seal this day of
GIVEN pnder my hand. and
19
-Ro-TARY PUBLIC in and fooF the State
of Washington, residing at
. .... . .. .. ....
-1-93
My COMMISSION EXPIRES 3
1,
AARDAHL/TXTFORKS
VOL. 26 9 4 Pin 2 1
... 03 0.8 012fl
STRE�T FILE
CA FILE NO. Clq_tj L
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetafion)
-4 P -
1. Site Address/Ucation. 230'.1W/Oac e rLJ. —
2. Property Tax Account Number: WC-1-07-002--o19-0202
3. Approximate Site Size (acres or square feet): 6006
4. Is this site currently developed? -yes; _2�no.
If yes; how is site developed?
5. Describe the general site topography. Check 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 less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth: _
What season(s) of the year?
8. Site is in the floodway A10 floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? 'V/,4 . Flows are seasonal? (What time of year?
10.
Site is primarily: forested
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
; meadow ; shrubs ; mixed *
RevOIA)4194
690 -199-
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 Edmondsprior
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.
With a signed copy of this form, the
applicant should also submit a vicinity map
or plot plan for individual lots of the parcel
with enough detail. that City staff can find
and identify the subject parcel(s). In
addition, the applicant shall include
other pertinent information (e.g. site
plan, topography 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:
Z5�y-rl-w- 1',Lfr'
Name
-7-3-3
Street Address
Applicant Representative:
d�e
Name
Street Address
City, State, ZIP Phone City, State, ZIP
Signature �Ijate
Signature
Phone
Date
77
REET FILE
127 Z,
CA FILE NO.- 9LI-1 I L
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
I. Site Address/Location: 23o-YX' Pe r, uj.
2. Property Tax Account Number: 6'107-002_-01Q-0,'_122
3. Approximate Site Size (acres or square feet): 6006"
4. is this site currently developed? �es;
If yes; how is site developed? —Y —L(nb. on
5. Describe,the general site topography. Check all that apply.
X, 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 less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: i6kc.-I—ne- Approx. Depth:
7. Site contains areas of seasonal standing water: lVonr_ ; Approx. Depth:
What season(s) of the year?
8. Site is in the floodway 4/0 floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? IVA - Flows are seasonal? - (What time of year?
10. Site is primarily: forested meadow ;shrubs ;mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
RM01/004
090 -19,1-
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 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.
With a signed copy of this form, ' the ' -
applicant should also submit a vicinity map
or plot, plan for individual lots of the parcel
with enough detail that City staff can find
and identify the subject parcel(s). In
addition, the applicant shall include
other pertinent information (e.g. site
plan, topography map, etc.) or studies in
coidunction with this Checklist to assist
staff in completing their preliminary
assessment of the site.
I have �,ompleted 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:
e'--I'v"Ie�ee-cr'zo zSV-r/-R- Xfr'
Name
Street Address
Applicant Representative:
Name
Street Address
1-�'4 771-4pos;—
City, State, ZIP Phone I city, state, ZIP
a 0, 2��' �V 4//,
Signature. Date
Signature
STREET FILE
PLANNING DATA
SITE ADDRESS:-95011 10'2WP A . 5W ATE: &1/ 1,
/ f - -
FLAf� 'v/4F
ZONING: 48RONW:
PROJECT DESCRIPTION:
SETBACKS:
Required Setbacks:
Front: ;* Left Side:_21& Right Side: Rear:
Actual Setbacks:
Front: Left Side: Right Side: Rear:
FLOOR AREA: 3.14 -6 6,
LOT COVERAGE:
Maximum Allowed: Actual:
BUILDING HEIGHT: f
Maximum Allowed: IV-29> ��') Actual Height:
SUBDIVISION: Is- 9 - 9 0
CRITICALAREAS#: L74-116
SEPA DETERMINATION:
LOT AREA:
OTHER:
L
ST REET FILE
CITY OF EDMONDS
USE .,:;'PERMIT
ZONE 0 < NUMBER
40 4Z7
CONSTRUCTION PERMIT APPLICATION
JOB
-30//
OWNER NAME/NAME OF BUSINESS
ADDRESS ;
Z,..1,%jA,�P6A4 Ce^lf
LEGAL DESCRIPT ON CHECKI
;
SUBDIVISION NO.
—,.q
LID NO.
a.
MAILING ADDRESS
,40;r
I?
5 �i
-7.3-3 x/.
TESCP Approved 0
0
PUBLIC RIGHT OF WAY PER OFOICIAL STREET MAP.
CITY ZIP
C?80201
thLhFHUNENUMBER
77/- 54 0 5-
EXISTING — REOUIREO DEDICATION
RW Permit Required 0
Street Use Permit Req'd 0
Inspection Required 0
PROPOSED
Sidewalk Required 0
NAME
W
METEW
IZE
NO. OF FIXTURES
P V R QUIRED
wo
uj
ADDRESS C
P�641e/bw (4 za
77.
NO
Z
REMARKS
L)
m
CITY ZIP
.f
TELEPHONE NUM85
NlpAj� 4_01%k !;W
'Z
<
14s6
Aff?5-V,171 Jry-5 h0S1'VeC,7rV-J
NAME
cove.
ADDRESS
-33
ENGINEERING MEMO DATED UVI EWED BY
IrL 41
Z
'CITY ZIP
qgoZ
TELEPHON� NUMPER
1771-L52�0s
W
FIRE MEMO DATED REVIEWED BY
8,
STATE LICENSE NUMBER EXPIFIATION DATE
61 k go 11MM511
SIGN AREA
SEPA RE IEW
0 -
7. Mm
ALLOWED
PROPOSED
COMPLETE 1EXEMPT
SHOqELIt4E#
Z
,�LegahDescript' n of Property - include all easements
S_q_9D'W1`A "d/
0
t
. . .
07 lj,.elook ZD/tA0&/ 0
E�P,, A A
�VARIANCE�f
BY
DA
W
I _j
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-61
"teal-* Pat-/< % ]Lsro.
Z
SI:7
/21195
HEIGHT IL
OT CbVER My
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P( 46 -.1 1
7TOPACC..n
FRONT s IDE REAR
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Nc?;.k
EN EW
KRESIDENTIAL
PLUMBING
El,
ADDITION
COMMERCIAL
MECHANICAL
EIREMODEL.
PT� BLDG.
13(A
SIGN
GRS" FENCE
EIREP"AIR C212t!h- CYDS. I— x _FT)
CHECKED BY
40A
TYPE 0 CONSTRUCTION
CODE
OCCUPANT
G R Wid
3
_�v
wc� SWIM POOL
[]-6EMOLISI! INSERT HOT TUB/SPA
SPECIAL INSPECTOR JAREA
REQUIRED
13
i
� &z— km=
OCCUPANT
LOAD
rill GARAGE.. C RETAINING WALL/
j&j OARP ROCKERY RENEWAL
YES
,
REMARKS
0
(TYPE OF q§EjUSINESfjOR ACTIVITY) EXPLAIN:
PROGRESS INSPECTIONS PER.UBC 305
Z
9
8
NUMBER. CRITICAL
NUMBER OF
Z;�Vsmt_ /I,?/ IW i1w,
W
0
OF.
DWE�LING
/
AREAS
NUMBER9�'
00
0
STORIES
UNITS
�Z2
t Oft r &-SIM � A Y J?W V RAL& PAC
DESCRIBE WORK;T�BE D07NIIATTACH P T PLAN)
FINAL INSPECTION
REQUIRED
VALUATION
FEE
PLAN CHECK FEE
CC
TGLAzlNG
BUILDING
00
HEAT SOURC
.4
1
PLUMBING
//q
Plan.Check NO.
94 — //
MECHANICAL
This Per mit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewpiks,
4 -50
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
STORMPRAINAGE FEE
—30
Permit Limit: I Year - Provided Work is Started Within 180 Days
"Applicant, on behal . f of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
-30
grees AD indemni y,, 71. e n
successors in interest, a d f d and hold
21
harmless the City of .oAno6o, Washin�t' its officials,
5
employees, and agents from.any and all claN'6�6 darriages of
whatever nature, arising directly & Indirectly from the Issuance
of this permit. Issuance of . this permit shall not be deeme . d1d'
P�A� ��HECK DEPOSIT
0
I
modify, waive or reduce any requirement of any city ordinance
nor limit In any way tl�i.qlty's ability I enforce any ordinance
TOTAL AMOUNT DUE
It
provision."
I hereby acknowledge that I have read this application; that the
Information given is correct; and that I am the owner, or th.e duly
ATTENTION
APPLICATION APPROVAL
authorized agent of the owner. I agree to comply with city and
state laws regulating construction; and In doing the work authoriz-
THIS PERMIT
AUTHORIZES
This application Is not a permit until.
signed by the Building Official or his/her
ed thereby, no person will De employed in violation of the Labor
Code of the State of Washington relating to Workmen's Compensa-
ONLY THE
WORK NOTED
Deputy; and fees are paid, and receipt is
tion Insurance and RCW 18.27. 1
INSPECTION
acknowledged In space provided.
SIGNATURE (OWNER 08 AGENT) DATE SIGNED
DEPARTMENT
I DATE
0 F Cl L'S GNATURE
CITY OF
EDMONDS
CALLIFOR
INSPECTION
DATE
(RELEASED V "74-
7- _t
ATTENTION
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
STANDARD DRAINAGE DETENTION SYSTEM
gn!!rmacl! C11 G WORKSHEET
Ovalim CALC BY: 5-.
ADDRESS 73 3 PHONE: 774/-/0,32
DATE:
*****DESIGN DATA
IMPERVIOUS AREA PIPE DIA PIPE LG ORIFICE
6--XD SV 7/8
DETENTION PIPE LENGTH WASHED GRAVEL
OUTFLOW TRENCH, MIN IV LONG
TOP AND 4"PERF PIPE TO BE LEVEL
9 L?. G'Min SPACE
CMIN COVER FROM
RIM ELEV 2-MAX COVER RIM ELEV CONTROL
40 'OUTLET
4-0 NUN T 4'PERFPiPE W/CAPS
.51/. - rl. SLOPE 4' 0 PIPE MIN.
r
ORIFICE 314 If RUNOFF SPREADER
(0. OUTLET
INV ELEV C16. 3
INV ELEV
LoFFeR "rCH CONTROL CArCH
SA SIN BASIN
2'. 2'r G" DEEP, 4'- 6' QUARRY SPALLS
x2lxY DEEP, 3 /4"CRU SHED ROCK
1
SYSTEM CROSS SECTION
FROM CONTROL
OUTLET
RIPRAP OUTLET
RECEIVED
JUN 0 7 1994
PERMIT COUNTER
FOOTING DRAINS SHALL NOT BE CONNECTED TO DETENTION SYSTEM
NOTES.-
1. Call Engineering Division (771-0220) for a tightline and detention system inspection
APPROVED BY
before backfilling and for final inspections.
d5 -w Me/
2, Responsibility for operation and maintenance of drainage systemwas ogn . h
440/#/
kvatq
ToMlbie
responsibility of the property owner.'Material accumulated Qtfe- p b, ushed
DATE
out and removed from the catch basins to allow proper operaan. e ou et control orifice
e ou e
must be kept open at all times.
"-- n /nn Page 6 of.6
-------------
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STANDARD DRAINAGE DETENTION SYSTEM
WORKSHEET
%If I I ILMLM I I ILULM
OWNER AIC CALCBY-
ADDRESS 73 3 PHONE: 774/-/0,32
DATE: 7—2,3 /9,9,V
'"DESIGN DATA*****
IMPERVIOUS AREA PIPE DIA PIPE LG ORIFICE
-3
42' 14
(5z; 1
DETENTION PIPE _LENGTH WASHED G'— L
U � W TRENCH MIN IV LONG
`�OUz -
P D 4'PERk PIPE TO BE LEVEL
OP AN
0
RIM ELEV I'PMN COVER VMIK SFACE
2*MAX COVER RIM ELEV FROM
CONTROL
40 4L OUTLET
4'
4� PERF'PIPE W.ICAPS
SLOPE 41 0 Pule MIN.
E ci -3 RUNOFF SPREADER
/4 "
OUTLET
INV ELE INV ELEV
t#FCR CA rCH CONram CAY04
BASIN BASIN
"0'2 Z'c G* DEEP, 4"-6*OUARRY SPALLS
x2*x3- DEEP, 3/4'CRUSHED ROCK
SYSTEM CROSS SECTION
Co;�FROM NTnoL
OUTLET
R RAP 0 LET
ACCEPTABLE TIGHTLINE MATERIAL
N-12 ADS
Sch 40 PVC
SDR 35 (ASTM 03034)
FOOTING DIWNS SHALL NOT BE CONNEUED TO DETENTION SYSTEM
NOTES:
1. Call Engineering Division (771-MO) for a tightline and detention system inspection
before backfilling and for final inspections.
APPROW BY
11" AA91%--0
2, Responsibility for operation and maintenance of drainage systems on private property is the
2x) /,Fir
responsibility of the property owner.'Material accumulated in the storage pipe must be flushed
out and removed from the catch basins to allow proper operation. 'ne outlet control orifice
DATE
must be kept open at all times.
I I
1 57/
Z3015
r
A/ A
7Ur17 - a- /10 C/11
1? 2
(2 A. c.
14-0)
4:::� Re M 0 v C.4
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-------WEPTABLE TIGHTLINE MATERIAL
-12 ADS
Sc If
SDR 35 (ASTM�DW�4).
4
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IC' I Z0711-e;l
'y
1-002-019
eroSlov) can/ro/.
PERMIT APPLICATION REQUIREMENTS
To: Applicant
From: Lyle Chrisman, Engineering Inspector
Owner:
STREET FILE
Plan Check No: qV-111
Address:_ 134114 Date: ZA�?,/
— — — ------- - — — — — ------ — ---------- — ------ — - — ---
After review of the subject permit application, the following requirements must be met:
1. Construction hours are:
WEEKDAYS — 7:00 A.M.40:00 P.M.WEEKENDS/HOLIDAYS — 10:00 A.M.-6:00 P.M.
2. A separate RIGHT-OF-WAY CONSTRUCTION PERMIT is required for all work on 'public property. (ECDC 18.60)
3. Truck haul route plan must be submitted and approved prior to permit issuance.
4. Builder/owner is responsible for containing all temporary runoff and erosion control on site.
(ECDC 18.30.030d)
5. NO WORK SHALL BE DONE WITHIN 15 FEET OF STREAMS OR 10 FEET FROM ANY CLOSED DRAINAGE
FACILITY. BUILDER/OWNER IS RESPONSIBLE FOR IDENTIFYING CONDITIONS ON THE DRAWING. (ECDC
18.30.50G)
6. FILTER FABRIC FENCE SHALL BE INSTALLED AND INSPECTED PRIOR TO CLEARING AND CONSTRUCTION.
(ECDC 18.30)
7. INSPECTIONS ARE REQUIRED ON STORM DRAINAGE SYSTEMS, TIGHTLINES AND CATCH BASIN
INSTALLATION. INSPECTIONS ARE REQUIRED PRIOR TO BACKFILLING. (ECDC 18.30)
8. Repair or replace all defective existing curb, gutter and sidewalk adjacent to the property. If an intersection is involved, a handicap ramp
may be required. Contractor shall meet with the City Engineering staff to determine the extent of repair prior to issuance of the permit.
(ECDC 18.90)
9. Driveway slope shall not exceed 14% without awaiver. Every attempt should be made to keep the slope below 14%. Waiver granted to
%. (ECDC 18.80.060D)
10. Driveways must be paved from property line to City RIGHT-O&WAY. A separate permit is required. (ECDC 18.80.060C)
11. INSPECTIONS ARE REQUIRED ON DRIVEWAYS AND SIDEWALKS PRIOR TO AND AFTER POURING. (ECDC 18.30)
12. No burning of construction refuse without a permit from the Fire Department
13. Connection to City water system is required. There is a separate charge for the water meter.
(ECDC 7.20)
.14. A back water valve is required if downstairs plumbing is below the elevation of upstream manhole. (ECDC 7.20)
15. Water and sewer main lines should be separated by 10 feet minimum. (ECDC 18.10)
16. Connection to the City sanitary system is required. A separate permit is required.
LID# Fees paid: Yes— No— Charge (ECDC 18.10)
av W-T5.7-
17. Underground wiring is required on all new construction, and for additions, alterations, and repairs that exceed 50% of the total assessed
value of the structure. (ECDC 18.90)
18. A FINAL EN * GINEERING INSPECTION IS REQUIRED PRIOR TO THE BUILDING DIVISION GRANTING OCCUPANCY
OF THE BUILDING OR STRUCTURE. (ECDC 18.90)
PRMMEQP-DOT
REET FILE
8 C) Q5
f Edmonds
City 0
RIGHT-OF-WAY CONSTRUCTIOW
PERMIT
Permit Number.
Wue Date:— .9
A. Address or Vicinity of Construction: 23011 102 Pl SW , #9503351
.'', I
B. Type of Work (be specific):' Install New Service
C. Contractor: -Washington Natural Gas Co. . .
Mailing Address: 815 Mercer St. Seattle,WA
nili
State License
VERBAL PERMIT SK -PER ROY WRITTCUTT
Contact: Vrank Swan
Phone: 224-2278
Liability InsuiTance: Bond: $
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. F-1 Commercial E] Subdivision [:1 City Project K] Utility (PUD, GTE,-WNG, CABLE, WATER)
E] Multi -Family 6 Single Family F1 Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut Yes /MNo G. Size of Cut: x H. Chargc�_$
APPLICANT TO IIEAD ANJJSIGN
INDEMNITY. Applicant understands and by his signature to t�ii application, agrees to Xk City of Edmonds harmleslfr& iljLite� Ca2dorp1gag'es, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against Me City ofl�dmonds, or any of its departments or
employees, including or not limited to the defense ofany legal proceedings including defense c�*sts,4nd attorney fees by reason ofgranting thispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FPR A PERIOD OF ONE YEAR FO LOWING THE FINAL
;;,,BE HELD UNTIL TH, kVII(STRE PA TC. H
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATFDRFSTORATIONI�rF,—','�-ri�
IS COMPLETED BY CITY FORCES, -A T WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TOT[ MIT
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineei Usi�eA-02�a�-,-
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordAnce with City regulations as required by the, City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
Ihaue read the above statements and understand thepermit requirements and thepink copy of thepermitivillbe
auailable on site at all t*mes-for inspection purposes.
Signature: Date: November 14, 1994
(Contractor or ALeWt)"-
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: I-WL'i
TIME AUTHORIZED': VOID AFTER S4 JffA DAYS
SPECIAL CONDITIONS:
COMMENTS:
RIGHT OF WAY DEPOSIT
DISRUPTION FEE/FUND 111:
RESTORATION FEE:
PERMIT FEE:
TOTAL FEE:
RECEIPT FEE:
W
DATE:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. Div. 1991
FIELD INSPECTION NOTES
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION
Partial Work Inspection by P.W.:
Work Disapproved By:
FINAL APPROVAL BY:
(Fund 111 - Route copy to Street Dept.)
El YES
Date:
Date:
El NO
Addendum to RUSH
City Of Edmonds
. ul� Right of Way
Permit Applicaiion-,
--Pubmitted by: lj�TCHELL S.-LANKFORD.,.
Engineering Aide
Washington Natural Gas
#'-521-�5246
WNG to window
W depth
gas main
NOV 11 1894
(C:4
Y�,
Key: _w- water
-9- gas
-ss- Bawer
19-- waterhydrant
0 water valve
815 McMcr St- MO. box 1869), Scstdc, WA 98111 (206) 622-6767
\A/A-rEA SGRVtCe
The City of Edmonds �z - 8 p - p I Drawing EASEMENT NO . ..... ----------------------------
NEW CONSTRUCTION 0' REPAIRS F-1 LID NO - ------------------ - ASMT. NO - ------------------
OWNER ------------------------------------------------------------------------------------------------ CONTRACTOR ------------------------------------------------------------------------------------ PERMIT No9 417
--------------
- ----- ----
JOB ADDRESS ..Z30-0 ---------- �.0.2 -------------- pl, --------------------- LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
------------------------------------------------------------------------------------------------------ ...........................................................
NAMEOF ADDITION -----------------------------------------------------------------------------------------------------------------------
- --- � T �--"
10 1 N" PL.
PWW-0001-1 1/75 (REV.1 1178) DATE Va54 ........ B,
,4&-4 ------ --------------------
NOTICE:
-N'o ... w-a r-r a. n ty ... ot—ac-C-9-17--.
The -information shown on the attached
for use by the City 0:
map(s) was com ' piled
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 (sl A n . y person or entity -requesting a
copy should conduct an.independent
i orm . ation shovvn-c
Inquiry regarding the inf'
t-Fe -M a P (S) / including, but not hm'ted to
the loc'ation of any sewer stub shown, Su(
sewer stubs may or may' not e.xist and ma�
or may not exist at the location shown.
r—ty of Edmon(JAS nor its
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