23304 75TH AVE W.PDFlill 11111111
6010
23304 75TH AVE W
TAX ACCOUNT/PARCEL NUMBER: AN 87 1&6 Oq 0 06 W
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
f')
CRITICAL AREAS: DETERMINATION: E]Conditional Waiver nStudyRequired
,�yaiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):_
I
PLANNING DATA CHECKLIST DATEP:10-
SCALED PLOT PLAN DA
SEWER LID FEE $:
SHORT PLAT FILE:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT �:
WATER METER TAP CARD DA'
OTHER:
LID #:
LOT: BLOCK:
LATEMP\DSTs\Forms\Strcet File Checklist.doc
II
DATE RECEIVED
ID14-
I G+
[w' I PERMIT EXPIRES
CITY OF EDMONDS
USE PERMIT
ZONE
NUMBER
CONSTRUCTION PERMIT APPLICATION
JOB SIIITE/AFFr#
ADDRESS Q33�o —7,fj1fi2Li-e_\f4
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sjER NAMEINAME BUSINE," I
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PLAT NAMEISUBDIVISION NO.
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MAILING ADDRESS
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TIESCP Approv ad
RW Pennit Required 13
23304 75, P-1
4�d W
-
EXISTING - PROPOSED
DEDICATION___:� FT
Street U39 Permit Rsqd C3
Inspection Required CI
Sidewalk Required 13
Underground
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TELEPHONE
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_0740
REQUIRED
Wiring required 13
NAME
METER SIZE
LINE SIZE
NO. OF FIXTURES
RV REQUIRED
3
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3
5
ADDRESS
REMARKS
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OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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AREAS -7
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NUMBER
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DESCRIBE WORK TO BE DONE
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REMARKS
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PROGRESSINSPECTIONIS PER USC 1087 ISC1091 IRC1 09 FINAL INSPECTION REO'D
5
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VALUATION
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it City Surcharge
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PLAN CHECK NO: VESTED DAfE_ Base Fee
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Mechanical 4-p
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
It BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
X Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPUCATiON: 180 DAYS
IL PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
/fm
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
"APPLICAK ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposilt
IN INTEREST, AGREES TO INDEMNIFX DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
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 MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelinsp. Total Amt. Due
0 NOR LIMIT IN ANY WAY THE C17YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
xi
— Recording Fee Receipt #
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application Is not a permit until signed by the
CALL
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LA13OR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided.
WORKMEN'S C��SATION INSURANCE AND RCW 18.27.
LS SIGN#bRE ATE
SIGP*URK(OWNE DATE §IGNE)II (425)
ldlql lb&�,
1 f I 0�
771-0220
SED BY 4 Ar i
ATTENTION IV \j I / M 1333
IT IS UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTILAFINAL
INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU-
ORIGINAL -FILE YELLOW- INSPECT&
PANCY HAS BEEN GRANTED. UBC1 09 / ISCI 10 / IRC1 10.
PINK -OWNER GOLD -ASSESSOR
09/03 r%r%�C%^ L1 A r%r% %1^1 1 A 111711111 &M A WILI^ A
*ILE NO.- q,6 -so
Critical Areas Checklist -
SWD Information (soils/topog'raphy/hydrology/vegetation)
Z,,!S,3 p q - 7,5 7,vA,,W*j,,r 1-j"r- _r
1. 'Site Address/Locafion:, Pme, W-jr 9 Vall
2. Troperty Tax Account -Number: 8 eg - QQL/ - 006 - 0 16
3. Approximate Site Size (acres or square feet): /6 11800 S(�F
4. Is this site currently developed?
yes; no.
If yes; how is site developed? Z-Arp"r
5. Describe the general site topography. Check all that apply. JUN 0 2 1995
v"" Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than . 15% (a vertical rise of MeMERNMR
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: gr ades of greater tha n 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 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 Qawnshrubs etc)
11. Obvious wetland is present on site:
Rxv OV0494
RECEIVED
J U N o 2 1995
PERMIT COUNTER
9 0 . ,
'99-
City of Edmon&
Cti' I Areas Checklist
The Criti z
WlAx af Checklist contained on
is "C616i 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,
RECEIVED
MAR 2 7 1995
MMMUNITY SFAVW
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
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
&cttW, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant:
Applicant Representative:
Nam Nam
q -TS t/4r
Street Ad&�w Street Addim
C-ppmr,ep-s "A, ftU 1_17+?�ao)
Cifty, State, ZIP Phone
Signature Date
Qty, State, ZIP Phone
Signature : .. -
Date
0
PLANNING DATA
NAME: tfferq DATE: 10/ 1 V10 I
SITEADDRESS: I jT_?oq 7q';�' 40. W. PLAN CHK#:_ Oq - 'i b 6'
PROJECT DESCRIP71ON: Addirlo^ ro shed — arki 5z-ze = %1-7 0
REDUCED SITE PLAN PROVIDED?:
MAP PAGE: CORNER LOT: OLes FLAG LOT: es
ZONING: CRITICAL AREAS DETERMINATION #: qS 5o
LJStudv Reauired:
aWaiver
L3 Conditional Waiver
SEPA DETERMINATION:
Ll Fee
UCheckllst
L3 APO list w/ notarized form
L) (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger)
Exempt
SETBACKS:
Required Setbacks: , " a r it
Street, a-9 Left Side: 7 RightSide:_ 7 Rear:
Actual Setbacks- ol
Street- �AW Right Side: 6
ikeft Side: Rear -
Street map checked for additional setback required? (Yes / No DN wl_ rkw" )ar
LJ DETACHED STRUCTURES: - Sked 7_�P -,J;rrtr, tv 5-W A
11Y I OT. ,I s4j 0Z e
L1 ROCKERIES: - IVIA
L3 FENCEsrrRELLISES: /V/4 0.
Q BAY WINDOWS I PROJECTING MODULA71ON: A/
STAIRS I DECKS: A//4
PARKING: Required:_X Actual: X
LOT AREA: 10 , 6 C) I
LOT COVEFU%E--.'
Calculations: 5 0 t 0 (0 1 0/0
BUILDING HEIGHT:
DatumPoint: Datum Elevation: too
Maximum Allowed: Actual Height: I V
LEGAL NONCONFORMING LAND USE DETERMINATI ON ISSUED: (Yes No
OTHER:
Plan Review By. Kec k�
NewBPP]arufingDataFornLD0C
LEON MARIA PALOMA Et RAFFETY BRIAN
23304 75TH AVE W --- EDMONDS, WA 98026
Tax Parcel No: 0048 880 040 0601
Height Calculations
A 108'
B 108'
C 108'
D 108'
432' / 4 = 108'
108' + 15'=
max. height 123'
Soil Classification '
Sandy gravel (GW)l
" GUTTEKW11NM%1)rV
mo mAMOCKS
ALL EXPOSED SURFACES TO APPROVED AS NOTED
13Y ENGINffRING
gE COVERED WITHIN 2 DAYS r
T 6 min. side
setback
0INNER/CONTRACTOR IS RESPONSIBLE FOR
muoium cui 1 1,IUL ANQ DRAUNIAGE
108'
PL-
17'-3"
3"
9
Et 100'-0"
Datum point at
2'-7" 9. bo 104'6" T
C,
base of
All 08' 01 108' o"
T
telephone pole.
P se Existing Existing
5' min. rear 0 6'
F
setback for d ti Shed driveway
detached ig Garage 725 sq. ft.
210 sq. ft
[20'� f
20'-6"
outbuildings 408 sq. ft. L
M///
less than
108' 0";
600 sq. ft lo'Ce
108'0"
D 108'0"
9
roof 1 1 19
overhang
Existing House J
90'-0" 1522 sq. ft.
PL PL
Existing Existing porch
deck
Ln
—126.Lq.jt�.
532 sq. ft.
13'-0"
Existing 105"-3"
deck
C
LA
17 sq
8 ft
NINING
91-01.
E E
0�
PL
go.-
�5 -'e Cor
er _A/
Flag A108' I
Zone --------
Setba_cks
—
Cl
ed
LSY--17re
Actual
L �_--
Cd �'
Front
a-5 (0 tof
---�-7 �6`
Sides
4TREET
Rear
Jle-r�j�,weji,
mvcr. 4
other
Iql
He __
light
5TivW-10
FILE
WATER & SEWER
WSPECTIONS REQ'D
Qkl 425-771-OM
Site Plan N
SCALE 1" - 20' +
E)(T. 132-6
100'-0"
RFcFiVED
OCT - 4 2004
PERMIT COUNTER
0
0
0 0
RECEIV-ED
Project Address / Owner C'r"T - 4 2004
LEON MARIA PALOMA & RAFFETY BRIAN
23304 75TH AVE, EDMONDS, WA 98026 PENi
425-771-0760 (home), 206-771-0972 (Brian Raffety, work —contact number during p-e (TCOUNTER
Tax Parcel No: 0048 880 040 0601
Parcel Legal Description:
LAKE BALLINGER LAND CO SUBDIV 1 BLK 004 D-01 - N1/2 LOT 6 LESS W 118.5FT THOF
Zoning: RS-8
Scope of Project:
Extend existing 210 sq. ft. unheated detached shed/workshop by 237 sq. ft., and improve existing
shed/workshop by adding a slab concrete foundation.
Lot Size: 90' x 117' 9" (average of 115' and 120' 7") = 10,601 sq. ft.
Lot Coverage:
Existing
Original residence 1,065 sq. ft. (constructed in 1948)
Detached shed 210 sq. ft. (constructed in 1948)
House addition 457 sq. ft. (constructed in 1995)
Attached garage 408 sq ft. ((constructed in 1995)
Front porch 126 sq ft. (constructed in 1995)
Total existing coverage = 2,267 sq. ft.
Proposed
Addition to detached shed 237 sq. ft.
Total proposed coverage. = 237 sq. ft.
Total existing and proposed lot coverage = 2,503 sq. ft.
% coverage: 2,503 sq. ft. / 10,601 sq. ft. = 23.6%
Heat: Proposed shed addition is unheated.
Contractor: Owner/builder
Impervious: ,
Original residence 1,065 sq. ft.
Detached shed 210 sq. ft.
Gravel driveway and walk ways 900 sq. ft.
Total pre-1977 impervious = 2,175 sq. ft.
Existing residence addition 457 sq. ft.
Existing attached garage 408 sq. ft.
Existing decks (178 sq. ft. + 532 sq. ft.) 710 sq. ft.
Existing front porch 126 sq ft.
Total Existing post-1977 impervious = 1,701 sq. ft.
Proposed addition to detached shed 237 sq. ft.
Proposed concrete landing at detached shed doors (30 sq. ft.)
Total Proposed post-1977 impervious = 267 sq. ft.
Total post-1977 sq. ft. = 1,968 sq. ft.
% impervious: 4,143 sq. ft. / 10,601 sq. ft. = 39.1%
Grading: Zero
Height Calculations:
A = 108'
B = 108'
C = 108'
D = 108'
432 / 4 = 108'
108'+ 15'= 123'Max. Height.
Datum point: Base of telephone pole on NE corner of lot.
Design Loads:
Dead:
Dead load: 15 pfs x 273 = 4095 lbs.
Snow: 25 lb x 306.75* = 7,668.75 lbs.
Concrete slab 66 (perimerter footing @ 12" x 12") * 80 lbs + (68.31 (207 sq ft. interior @ 4"
deep) * 80 lbs 10,744 lbs
Total: 11,763.75 lbs (dead + snow loads) + 10,744 (slab concrete foundation) = 22,508.55
lbs or 82.45 psf
*Note roof horizontal sq. ft. = 273 sq ft horizontal floor space + 33.75 sq. ft. overhang = 306.75
sq. ft.
Rafter span calculations (used span calculator found at http://Www.awc.or-q )
Horizontal span = 12' max, Snow load = 25 psf, Dead load = 15 psf, Deflection limit = L360
Spacing = 24" o.c., Species: No. 2 Douglas Fir or No. 2 Hem -Fir
Rafter size: 2x8 (13 ft. max. span with a minimum bearing length of 0.49 in. required at each end
of the member.)
Property
Species
Grade
Size
Modulus of Elasticity (E)
Bending Strength (Fb)
Bearing Strength (Fcp)
Shear Strength (Fv)
Value
Douglas Fir -Larch (North)
No. 2
2x8
1600000 psi
1348.95 psi
625 psi
207 psi
Ceiling joists
Horizontal span = 12' max, Dead load = 10 psf, Deflection limit = Ll 80 (no attic)
Spacing = 24" o.c., Species: No. 2 Douglas Fir or No. 2 Hem -Fir
Joist size: 2x6 (13 ft. max span with a minimum bearing length of 0.28 in. required at each end of
the member.)
Property
Species
Grade
Size
Modulus of Elasticity (E)
Bending Strength (Fb)
Bearing Strength (Fcp)
Shear Strength (Fv)
Value
Douglas Fir -Larch (North)
No. 2
2x8
1600000 psi
1345.5 psi
625 psi
180 psi
Lumber:
All framing shall be 2 x 4 stud grade or better. All sill lumber in contact with concrete slab shall be
pressure treated. Wall and roof sheeting shall be 7/16" OSB with a span index of 24/16.
,tic. 1 S9-
Address of
PERMIT NO: 9888
City...of Edmonds PIRES
PERMIT EX
SIDE SEWER PERMIT .
Property Tax Account Parcel No. 009 -*m ip
Attach copies of all access and utility easements Verified and Approved b
nd/or Contractor:
Contractor License #: Building Permi,t
D4ingle Family
E] Multi -Family (No. of Units
E].Qjmmercial (No. of Units
Pub1ic -A
Invasion into City *Right -of Way: El Yes FrNo
*RW Construction Permit #
Cross other "Private Property: El Yes eE]'K"
*"*Attach'iegal description. and copy of recorded easement.
Owr�er or jqontra�i� ature and acknowledgement statement:
`1"ty signing for this permit I certify that I have read the City's public handout entitled
ide Sewer'Specifi cations, and shall comply with all City requirements outlined therein.
Datj
W, CALL DIAL -A -DIG (1-8004,2��_,at-5555) BEFORE ANY EXCAVATION W
W FOR INSPECTION CALL 425-771-0220 extension
24 HOUR NOTICE REQUIRED FOR ALL INSPECTION REQUESTS
City Permit Surcharge Feq
Total Fees
L. J4
NOTE: IF JOB SITE IS NOT READY'.FOR INSPECTION WHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION FEE WILLBE CHARGED.
Job Site Ready YES NO —Date: I.nitial:
Partial Inspectiow. Date: Initial: -
Partial Inspection:' —Date:— Initial:
FINAL INSPECTION APPROVED: Date: A24 le ..i- lnitial:,�,� As -built to Street File:
'M PERMIT MUST BE POSTED ON JOB SITE.t-
White Copy: File Green Copy: Inspector Buff Copy: Applicant
L;temp;bldg;forms;sspermitjlg4/00
E.D.,�_
75 AVE W
CITY OF EDMONDS SIDE SEWER AS- BUILT
ADDRESS SCALE
23304 - 75 AVE W NTS
HOMEOWNER 7CONTRACTOR
-KAFFETY
DATE DRAWN PERMIT
02/15/2005 0 SIBREL NO. 9888
LEON MARIA PALOMA Et RAFFETY BRIAN
23304 75TH AVE W --- EDMONDS, WA 98026
Tax Parcel No: 0048 880 040 0601
Height Calculations
A 108'
B 108'
C 108'
D 108'
432' / 4 = 108'
108'+ 15' =
max. height 123'
Soil Classification
Sandy gravel (GW)
108'
Al 8
5' min. rear
GM for
detached
outbuildings P20�'- 6�"
less than
600 sq. ft .
ALL EXPOGED SURFACES TO
BE Cd-VtAlEb 'WITHIN 2 DAYS
T 6 min. side
setback
APPROVED AS NOTED
BY ENGINEERING
0 IN N E R/foe 1%, -r M-, - C- : TIr$71 /S-AL - 0/- a
ES13ON-SIBLE FOR
EROSION CONTROL AND DRAINAm:
120'7"
— PL
1773
17'-3"
f(D 108' 0" 9. 91 104'6"
60 T
106
6
0.
M 4 _ Q
Iff I — - — - I- T
6' Existing
Existing driveway
Shed
20,
108'0"
- - - - I I ----------
(D
D 108' 0"
61-0 - 11:
9 9
roof 10 'T
overhang
Existing House
90'-0--
21'-0"—
PL 11 1
Existing I Existing porch !
deck 48'-0" - — - — - — - — /
20'-0"
81-01, - I 1 1 '-6"
J,--�J g16
13'-0"
105"-3
Existing
I deck
ING
91-0..
C
b
E
9 E
PL
Zone Comer Al- FTag Al 10'. TTr%VL;n at QG1VCn
INSPECTIONS REQD
,�—ctbacks Rec CK-1 425-7171-022-3 EXT. 1326
juired Actual
Front -k 5 q'A'
r-l' 71",
-7
;;�'Sides
Rear copy
Other --M" ric(ell.
Height -if 0—&� - iq
it
rFR-ZVD(" S
Am SPOUTV
Site Plan N
SCALE 1 " - 20' +
PL
El 100'-0"
Datum point at
base of
telephone pole.
t;
Ln
901-01,
109-0"
RECE:IVED
C L' I
"T - 4 2004
PERMIT COUNTEII
.91
'low
J '
CA FILE NO--26 - E210—
Critical Areas Checklist -
Site Informition (soils/topog�aphy/hydrology/vegetation)
7,!5,3oq 757-0AVZ__&Mr k�r rZmo;;�14& 9V4Zj
1. 'Site. Mdrdss/Ucafion:
2. -Propeqy Tay, Account Number: a CA - 00&/ - 0 0 (0 0 16
3. Approximate Site Size (acres or square feet): /01,600 SaLF
4. Isthis site currently developed? _"Vy --no.
If yes; how is site developed? Z-Acp"nn 4ys6l, S#eb RECRIVEL)
5. Describe the general site topography. Check, all that apply. JUN 0 2 1995
v"*'Flat: less than 5-feet e*levation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feid
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 floodplain of a water course.
9. Site cont;fms 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 Qawn,shrubs etc)
11. Obvious wetland is present on site:
RevOl/04194
RECEIVED
J U N 0 2 1995
PERMIT COUNTER
6190 -199-
City of Edmon&
fitical Areas Checklist
The Cri,"� Checklist contained on
abAhligib be filled out by any person
preparing a Development Permit
Application for the City of Edmondspnior
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,
RECEIVED
MAR 2 7 1995
COMMUNITY SEW"5
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.
Wlith a signed copy of this form, the
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 shaH 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
factnial, to the best of my kpowledge (fill out the appropriate column below).
Owner / Applicaub
Nam
-7S.T7J t/4-r
Street Addr6si
rm ro -s t,4A- M24 I- -?7q-W)
City, State, ZIP Phone
3
Signature JJAW,
Applicant Representative:
Nam
Street Addrew
City, State, ZIP Phone
. Signature
Date
3HN3AV SL
WOL;V jgl�'�42iZS 4SAVd jO--j—,q3-
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....... .. .
sole Sol v
APPROVED EBY PLANNING RECEIVED
JUN 2 6 1995
PERMIT
715i"i
,70
RECEIVED
JUN 0 2 `1995
'CITY -COPY
PERMIT COUNTER
B 109'
10,15 L:
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D AS /VOTE,
d PERMIT EXPIRES
DATE RECEIVED 61IS101
USE
ZONE PERMIT
12S
CITY OF EDMONDS NUMBER ZYJ
JOB SUITE/PPT#
r DRESS
CONSTRUCTION PERMIT APPLICATION AD
OWNER NAME/NAME OFILISINESS see
Mrivr PLAT NAM E/SUBDI VISION NO. LOT NO. LID NO.
ir MAILING ADDRESS LID FEE $
W
z 7 TESCP Apprwed 0
3: 75 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required 0
0 ;- —�� 4 Street Use Permit Req-d 0
CITY ZIP TELEPHONE EXISTING — PROPOSED Inspection Required 0
Sidewalk Required 0
REQUIRED DEDICATION— FT Underground
(q,5)77q-�5301 , - Wiring required 0
NAM E METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
`A YES 0 NO 0
v r.-, I
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ADDRESS REMARKS z
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAG. z
z
W
0
W
CITY ZIP NE 4 5q*x61,ocrf1_
NAME
rew Pew IV^gy
0-- ENGINE9�,,,5;r, 1d*0,;V REVIEWED/DATE
cc ADDRESS
0
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cc FIRE REVIEWED By DATE W
"- CITY ZIP TELEPHONE
z S
0 U.
U I I I
STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY VARIANCE OR CU SHORELINE OR ADB# INSPECTION IPBOND
REQjNO OSTED
YES
SEPA REVIEW SIGN AREA HEIGHT
-4 PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE I EXEMPT ALLOWED PROPOSED ALLOWED , -'PROPOSED
0 R )< 151
W 1-1 Ss q . 006 - 010q. P — I —
EX 1 22 Z4.9'
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
NEW NI"O'RESIDENTIAL �<:P:LUM:BINGI ECH ALLOWED ROPOSED FRONT SIDE REAR FRONT URSIDE RE
F-i COMPLIANCE OR
02�ADDITION 0 COMMERCIAL 19% 'ZS' 71/7,1 15' z
CHANGE OF USE ;V I z
PAF IN LOT AREA PZ�WEW�)yy DATE
REMODEL 0 APARTMENT C] SIGN REDID tGOVIDED 0.
F-1 REPAIR Ej GRADING E] FENCE X
:CYDS FT)
DEMOLISH TANK OTHER
GARAGE ROETAINING WALL RENEWAL
z CARPORT R CKERY
i= (TYPE OF USE. BUSINESS OR ACTIVITY) EXPL61N-
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cc
w NUMBER 4UMBER OF CF"T'CAt_6._,__7
OF DWELLING AREAS AREA OCCUPANT
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IV 7-o re *G-a REMARKS 0
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VALUATION FEE
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AIR. o C) -7 BUILDING I_ZP�
PLAN CHWKNO:— VESTED DATE PLUMBING 00
CMECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE GRADING/FILL
SEPARATE PERMISSION.
STATE SURCHARGE
cc
W PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DA . YS ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
"APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS ENG. INSPECTION FEE
LU IN INTEREST, AGREES TO NDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
_j LANDSCAPING
2 EDMONDS, WASHINGTON, �TS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
cc INSPECTION FEE
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE RECEIPTI
PLAN CHECK DEPOSIT
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
RECEIPlelt, 47
1
I HEREBY A I CKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION TOTAL AMOUNT DUE
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL Building Official or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided,
WORKMEN' CQUEENSATION INSURANCE AND RCW 18.27.
I - 3NATURE, DATE/
SIGN WN 0 DATE71GNI (425)
771-0220 RELT9 DAA
j.Ej(T,T333
IjT7
T'
S - I JFA W FIL RA 4. 041&61p*� gui �0'
LDIM �STAUCTURE UNTIE 11b
INS oe
A FIN INSP C Idk HAS 9EN MADE AND APPROVAL OR A CERTIFI- 771 -0221 1
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 T ,ORIGINAL -FILE YELLOW - INSPE(P.TOR X
FAX PINK -OWNER GOLD - ASSESSOR
5/98
CITY OF EDMONDS
USE
ZONE
PERMIT
NUMBER .9-50,334
CONSTRUCTION PERMIT APPLICATIOW
JOB
SUITE/APT#
OWNER NAME/NAME OF'BUSINESS
AUUMLZOZ _e
.7' "4111114, WC C r 2
Ale A/ r 8e P z) og
LEGAL DESCRIPTION CHE
1
ISION NO,
LID NO.
uj
Z
3:
MAILING ADDRESS
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7
0
Z3304i 4-Vrjrvar_
PtjaLIC*AIGMT OF WAY PER OFFICIAL
STREET MAP.
TESCP Approved 0
CITY ZIP
TLUPHUNt NUMBER
30)
EXI�TING AEOUIRED
%,
DEDICATION
RW Permit Required . 0
Street Use Permit Req'd 0
Required 0
PRO�OSED
Inspection
Sidewalk Required 0
IAME
1
r
METER SIZE
NO, OF FIXTUR PRV REQUIRED
ADDRESS
[=E
YESO N 013
I
REMARKS
L)
CITY ZIP
TELEPHONE NUMBER
w
NAME
�-JomrowNCIZT Vknt W 7
M
0
ADDRESS
711--IC,4 7Z4 a/,) �4e
1JQ 42 (2/0
ENGINEERING MEMO DATED
FIEV�IEWEDBY
(,C—
CITY ZIP
TELEPHONE' NUMBER
Z
FIRE MEMO DATED
REVIEWED BY
W
0
L)
EXPIRATION DATE
STATE LICENSE NUMBE%.,,.,..,,.;
M
SIGN AREA
SEPA REVIEW
ADB N
Ltal Description of Property - include all easements
ALLOWED
PROPOSED
COMPLETE
EXEMPT
Z
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LOT & a LOCA q wr & L41,V6ca- JA ND (4'� P0 T, 5" -
#
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REMARKS
Paricell No.
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PLUMBING
R`ADDITION
0
[?"MECHANICAL
COMMERCIAL
APT. BLDG.
SIGN
REMODEL
GRADING FENCE
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ECKED BY
TYPE OF CONSTRUCTION
1
:CODE
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REPAIR __,CYoS. _FT)
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1-1 . ... 0
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I Al
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OCCUPANT
LOAD
13 YES
5b 0
J
GARAGE RETAINING WALL/
CARPORT RQCKERY RENEWAL
REMARKS
Z
9
TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
PROGRESS INSPECTIONS PER. UBC. 305
Z
rL
cc
CRITICAL
M44 ML
M4 110564. 4-13 VIAS,
u,
a
NUMBER
OF 2
NUMBER OF
DWELLING
AREAS
co
0
STORIES UNITS
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLANI-06L
NUMBER f
CAIA 6 E'
A p D I rl 0 4 - 4 OL),'ff6 A ;W )e Z-0 70
FINAL INSPECTION
REQUIRED
VALUATION
FEE
,rh S r fID)5 Or' jJda�r, VCtj 4 mgpua <7-pay 1,I-gisour.
PLAN CHECK FEE
/-10
Aget'ACS I
!-(.qV of -
BUILDING
76
HEAT SOURCE:
GLAZING
r_AjSj-jrv& 1$0000 61M GAj%F,A.rvfeAA0j
12P h
PLUMBING
Alsom4ir
Plan Check No. 4n e—
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewpiks,
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 6f his or her spouse, heirs, assigns and
ENG. INSPECTION. FEE
Z0
,n
successors in interest, agrees to indemnify, defend and hold
'Lnu
harmless the City of Edmonds, Washington, its officials,
2
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 I o
PLAN CHECK DEPOSIT
_j
modify, waive or reduce any requirement of any city ordinance
0
nor limit in any way the City's ability to enforce any ordinance
I
TOTAL AMOUNT DU'E
-provision."
I hereby acknowledge that I have read this application; that the
ATTENTION
APPLICATION APPRdVAL,.-'
information given Is correct; and that I am the owner, or the duly
.authorized agent of the owner. I agree to comply with city and
THIS PERMIT
This appli . cation is not a permit until
-state laws regulating construction; and In doing the work authoriz-
AUTHORIZES
signed by the Building Official or his/her
ed thereby, no person will be employed In violation of the Labor
ONLY THE
WORK NOTED
Deputy; and fees are paidi and receipt Is.
Code of the State of Washington relating to Workmen's Compensa-
acknowledged in space provided.
tion Insurance and RCW 18.27.
INSPECTION
ER OR AGENT) DATE SIGNED
DEPARTMENT
S ATURE
F &/
CITY OF'i
W110 ,
EDMONJPS
ATTENTION
CALL FOR VEL"s
INSPECTION,
DATE
6. 50,
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
HAS BEEN MADE AND APPROVAL OR
771'-0220
ORIGINAL — File YELLOW — Inspec
UNTIL A FINAL INSPECTION
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
n
/7_jc�: 6 -2-
PINK — Owner GOLD — Assessor
10247
'CITY COPY
t,� Az5t:e� (D)� LN
1016
ry; ST.
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CD&c or PAV[p �,kfr-r Dl-
7 5 AVENUE L,/.
App D AS NOTE:,
RECEIVED
JUN 0 2 1995
PERMIT COUNTEF1
e, log' I
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6.A
61
RECEIVED
MAY 2 1 2001
BUILDING DEPT.
APPROVED AS NOTED
GINEERliNG
Date:
'100,
oql
YbP
B 109
CIO.
0
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TH AVENUE
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AND SPLASHBLOCKS
APPROVED AS NOTED
By INEERIN
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Date: ztegtj cz,
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CITY COPY
ST.
RECEIVED.
JON 0 2 1995
PERMIT COUNTER
40.0 Slog'
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1004,
EXIST
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RECEIVED
JUN 2 6 1995
PERM
PLANNING DATA
SITE ADDRESS: a-�i96� 1441r�:JDATE:
ZONING: es -C") PLAN CHK#:— 15- - S?IF
PROJECT DESCRI
SETBACKS:
Required Setbackp:
Front: 'y7 �� Left Side: Right Side: ±17'Rear:
Actual Setbacks:
Front: -7 Left Side: 1 �5 Right Si ear:
CORNERLOT �C)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED /in
LOT COVERAGE:
Maximum Allowed:'5 -7D I 25*-Octual:
-Fc�p job
BUILDING HEIGHT
Maximum Allowed:-L31J9 (25-') Actual Height:
SUBDIVISION: I
CRITICAL AREAS #: 'FS-- 5-D
SEPA DETERMINATION:
LOT AREA:
OTHER:
Plan Review By:
u J�
The City of Edmoids-
APPLICATION
for
SIDE SEWER PERMIT
OUTSIDE A INSIDE 0
OWNER ....... E ............ b. D. ss i s 7/—
.. . ... ....... ...... ... .. .......................................
sc)
HOUSENo . ...................... ... ...... ..........................................
0
le
� 140
,;.r—:
E
LM Z�,pDo ZZ
CD
Z'
n=
EJ
--5
CARDNo . ..... ......... ....... ..................
EASEMENT No . ....... ......... ........... ............
REPAIRS 0
ID 1AV
CONTRACTOR ... 40.'pL-./9 ........ .... .... ....... .... ..... ..... ... .. PERMIT No.(
STREET
AVENUE LOT No. .... 7 0 /,x BLOCK No. ... ......
..........
NAME ADD ............ ....a4V11.4%1�7FeR ...... .... ..... ........... .............. .........
APpRoVeo
OCT 2q 1982
-----------
Date Approved:
BACKFILL WORK ORDER ISSUED ............................................ DEPOSIT, $ ...................................................... In
.............................
.. ..... . ..
SEWER WORK ORDER ISSUED ................................................ DATE ... ..... BY
...............
CA FILE NO. Cj
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
Z,�,3oq 757-o#vg*Mr
1. Site, Addrdss/Locafion: LDMd;i.-' "A- ff'4ZJ/
2. Property Tax Account Number: Iq 00q - 0 0 0 16
3. Approximate Site Size (acres or square feet): /0,
4. Is this site currently developed? ',�ves- no.
y
If yes; how is site developed? .2 -bro4orn W"stc. Me�p
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 — 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 Qawn,shrubs etc)
11. Obvious wetland is present on site:
Rzv0l/0"4
& 90 .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 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. Ilie
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,
RECEIVED
MAR 2 7 1995
COMMUNITY SOW"
and submit it to the City. 71be 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
TeETW������
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 shaH include
other pertinent information (eg. 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:
Nam
Applicant Representative:
Name
-7 4�rwe - 1:/4-r
Street Address Street Address
rm rio -s "A 9%024 1- -17q-L3o)
City, State, ZIP Phone
Sigfiature Date
City, State, ZIP Phone
Signattm
Date
NOTICE
THIS SKETCH IS FURNISHED BY FIRST AMERICAN TITLE INSURANCE COMPANY AS
k-COURTESY ONLY, AND IS NOT A PART OF ANY TITLE COMMITMENT OR POLICY
OF TITLE INSURANCE.
THIS SKETCH IS FURNISHED SOLELY FOR THE PURPOSE OF ASSISTING IN
LOCATING THE PREMISES AND DOES NOT PURPORT TO SHOW ALL HIGH—
WAYS, ROADS OR EASEMENTS AFFECTING THE PROPERTY. NO RELIANCE
SHOULD BE PLACED UPON THIS SKETCH FOR THE LOCATION OR DIMENSIONS
OF THE PROPERTY AND NO LIABILITY IS ASSUMED FOR THE CORRECTNESS
THEREOF.
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