23329 76TH AVE W.PDFlill 11111111
6419
23329 76TH AVE W
TAX ACCOUNTIPARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: --a7- DETERMINATION: F] Conditional Waiver [-] Study Required Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR: —
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE
SHORT PLAT FILE:
SIDE SEWER AS BUILT DATED: ")A/,
SIDE SEWER PERMIT(S).#:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
LOT�
Up]
BLOCK:
LATEMDS'PsTomis\Street File Checklist.doe
#P20
CA File No:_C"ftr700CZ5
Critical Areas Checklist
Site Information (soils/ topography/ hydrol /vegetation)
1 1.. Site Address/ Location: * Z-3,� Z-q 7 6'M 4X 05 6611wyd's Pf 2'� 4
2. Property TOxAccount Number: OD 4"ot+M-ID3
3. Approximate Site Size (acres or square feet): PV!�'12�1
4. Is this site currently developed? yes; no.
If yes; how is. site developed?. !S KI &S j�
5. Describe the general site topography. Check all tkajt 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 are as of year-round standing water: 0 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 (lawn, shrubs etc)
11. Obvious wetland is present on site:
For City Staff Use. 6dy
1. Plan Check Number, if qpficable?
2. Site is Zoned-
3. SCS mapped soil type(s)? S-- A uvwoni UrLei lc,,162.� K g rlwk
4. Critical Areas inventory or C.A. map indicates Critical Area. on site? - 4 A-
5. Site within designated earth subsidence landslide hazard area?.
DETERMINATION
STUDY REQUIRED WAIVER
Reviewed by: Date:A(1 6 / -,I o-7
#.P20
0
City, of Edmo*nds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
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 the application 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 . nventories, maps, 'or soil
surveys).
&Db ),x1-()(d)q
Date Received: i a --/-
City Receipt#:_ A-0
Critical Areas File M CUTS
Critical Areas Checklist Fee: $135.00
Date Mailed to Applicant:
A property owner, or his/her authorized 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.
Please submit a vicinity map, along with the signed copy
of this form to assist City staff in finding and locating the
specific piece of property described on this form.. In
addition, the applicant. shall include other pertinent
information .(e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant staff
in completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns, 'in consideration on the processing of the application agrees
to release, inddinnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomple te information furnished by the applicant his/her/its agents or employees.
By my signature, I cer* that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file thi lication oR the behalf of the owner as listed below.
SIGNATURE oF APPLIcANT/AGENT
7" DATE
V
Property Owner's Authorization
By my signature, I cer* that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for thS bli fficials and the staff of the City of Edmonds to enter the subject property for the
_p,ul ic o .
purposes of inspection andWsting Attendant to this application.
SIGNATURE OF
Owner/Applica t:
o �i
I 4'ajm e
Z, � 5 Z,9
Street Address
icdwk�g
city State Zip
Telephone:L4 �10 121301
DATE -
Applicant Representative:
Name
Street Address
City State Zip
Telephone:
Email address (optional): - Email Address (optional):
APPLICATION
for
The City of Edmon& SIDE SEWER PERMIT
OUTSIDE 0 INSIDE 0 REPAIRS 0
OWNER ........ .......... ................ .................. CONTRACTOR,,.25�a-
HOUSE 7 STREET 3-7
:� . . ..... --( . .......... . ... . ............. I .................................. AVENUE LOT NoZ� ............. , ........................
m
BACKFILL WORK ORDER ISSUED — ......................................... DEPOSIT, $. ..........
SEWER WORK ORDER ISSUED ................... -- .... ...... .............
BLOCK No. -# ......................................
F.
NOTICE:
No warranty of accuracy.
The information shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of Edmonds does not warrant the
accuracy of anything set forth on these
map(s). Any person or entity requesting a
copy shoul ' d conduct an independent
inquiry regarding the information shown on
the map(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
employees or officers shall be liable for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
1 0
PLANNING DATA
SINGLE FAMILY RESIDENTIAL
'FILE I
Name: C
Dat =2
( I - /, , -7 7
Site Address: Z 342-Y -7� 0" 11V-P— 641
Plan Check #: c97
Project Description: j cof npol-t
10 0 5-f-)
Reduced Site Plan Provided: & NO)
Zoning:
Map Page: (9 S 6
Corner Lot: (YES /00
FFIag Lot: (YES
Critical Areas Determination #: �ZQ07-6?0<_3—
Study Required
Waiver
SEP� Determination:
34-Exempt
Needed (for over 500 cubic yards of grading)
0 Fee El Checklist El APO List with notarized form
Required
S treet:
Side: :7,
Side: 7,S-
Rear:
Actual Setbacks
Street:
Side:
Side:
Rear:
El Detached Stru'X're'��'
11 Rockeries:
El Fences/Trellises: A*
El Bay Windows/Projecting Modulation:
El Stairs/Deck:
Height
Datum Point: q0r\�,, co r
Datum Elevation: 00,
Maximum Height Allowed:
Actual Height:
Other
Parking Required: 2-
Parking Provided:
(P-ef- CefymtAt)
Lot Area:
Maximum Lot Coverage: 35% Proposed: 2
Lot Coverage Calculations: 0 5t (WI dd T�i m
t
ADU Created: (YES /(9
Subdivision: /V��
Legal Nonconforming Land Use Determination Issued: (YES
Comments
aA� t e? Ce �(.AIV CCVS
Z CAA �1
OJ, -JJ4 -&/-T'�7
Plan Review By:
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HOME DESIGN @wi net
"Nothing in this permit approval process shall be
interpreted as allowing or permitting the APPROVED AS NOTED
maintenance of any currently existing illegaL BY ENGINEERING
nonconforming or unpermitted. building, structure
or site condition which is outside the scope ofthe
e!mit application, re-gardless of whether such
uilding., stnict-ure or condition is shown on the Date:
site plan or drawing. Such building, structure or _4
condition may be the subject of a separate BY PLANNING
enforcement action.". OWNERMONTIRACTOR IS RESMOBLE FOR
22,'310N CONTROL AND"