23705 78TH PL W.PDFlill iiiiiiii
6782
23705 78TH PL W
0 0
ADDRESS: c9 3 2�25� �29 Kla�W
TAX ACCOUNTIPARCEL NUMBER: 64&9ME-&)6-a2
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS:
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN D.K
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:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
OTHER:
DETERMINATION: [] Conditional Waiver 0 Study Required F] Waiver
LID #:
LOT: BLOCK:
LATEMP\DS'Ps\Forms\Street File Checklistdoc
PLANNING DATA
NAME: 04n 2, C&I-111 S,'1VV-r1'Vt4 DATE: 71w-5'
SITE ADDRESS: 2--370S - 'J79- Q- -4 PLAN CHK#:- C757 2!�-3
PROJECT DESCRIPTION: j94pyz-.- /'.9 ZZ t-
REDUCED SITE PLAN PROVIDED?: oe/ No)
MAP PAGE: 006 CORNER LOT: (YesA!�N@ FLAG LOT: 0)
ZONING: CRITICAL AREAS DETERMINATION #: ?,co,; -
LlStudv Reauired:
ljJ Waiver
L3 Conditional Waiver
SEPA DETERMINATION:
LI Fee
L3 Checklist
LJAPO list w/ notarized form
Ll (Needed for 500 cubic yards of grading, Shoreline Ared- site within 200 ft. of Puget Sound or Lake Ballinger)
Ld'Exempt
SETBACKS:
Required Setbacks:
Street: 2-!�' Left Side: -7,5" Right Side: -7, 5-' Rear: f -5'
Actual Setbacks: 1.
Street: - 15 2-' Left Side: 1-7' Right Side: .5 oo' Rear: 312'
Street, map checked for additional setback required? (Yes / No 05'NM
LJ DETACHED STRUCTURES:
ROCKERIES:
FENCES/TRELLISES:
Ll BAY WINDOWS / PROJECTING MODULATION:
LY STAIRS / DECKS:
PARKING: Required: 7 7� Act * ual: ' Z- '
LOTAREA: IfLIS a
LOT COVERAGE &0 Z ---1- 31.2
Calculations: - 8'-h 3
BUILDING HEIGHT:
Datum Point: Prb1-n,0-*vA4 41-OvA Datum Elevation: vo. 0'
Maximum Allowed: (I L2 _-7&'IActual Height: i3. 75 clis"00
A.D.U. CREATED?: o Yes)
SUBDIVISION:
LEGAL- NONCONFORMING LAND USE DETERMINATION ISSUED: aes /If
2)
OTHER:
Plan Review
NewBPP1anningDataForrn.D0C
MAY-12-2005 09:39 P.03/03
#P20 CA File No:
Critical Areas Checklist
Site Information (soils/ topography/ hydrology/ vegetation)
L. Site Address/ Location; 2:17 0 15 -7?�!i� F�L - M, 1 402 OZ�O
2. Property Tax Account Number 0 0 C � 14 - � a 0 0 0 o 0 (0 0 e 9
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? /- yes; — 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 y less dun 15% (a vertical rise of 10-feet over a horizontal
distance of 0-
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
distatice of less than 33-feet),
Other (please describe):
6. Site contains areas of year-round standing water Approx. Depth-
7. Site contadns areas of seasonal standing water Approx. Depth:
What seawn(s) of the year?
8, Site is in the floodway f� 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?
. �,Q_-- - Flows are seasonal? _ (What time of year?
10. Site is primarily: forested ; meadow shrubs mixed
urban landscaped 0awn, shrubs etc)
11. Obvious wetland is present on site;
For City Staff Use Only (2-00(0)
1. Plan Check Number, if applicable? 05-7-13 -3 -
2. site is zoned? ELS-9.
3. SCS mapped soil ty"s)? (0* A-1ACyWQ0cj V t- u ana LAm ol Co yvi IQ 15
4. Critical Areas inventory of C.A- map indicates Critical Area on site? —W 0 VIC., SY10WV1-
5. Site within designated earth subsidence landsfide hazard area? WO. BLAitGA(ne� DffiUal i-D
61 a k-c-, :fi yx o, I (A t,,tz,,4y-m in A-h ovi
DETERMINATION
STUDY REQUIRED
1p—A�AA I—P
WAIVER
Date! ov ( �4 1 /WL) 6 TOTAL P.03
MAY-12-2005 09:39
P. 02/03
ED
C' of Edmonds
ity
IMDevelopment Services Deparunent
Planning Division
Phone: 425.771.0220
90 Ift Fax: 425.771.0221
is
The Critical Areas Checklist contained on this form is to
be filled out by any person preparing a Development
Pemit Application for the City of Edmonds prior to
his/her submittal of the application to the City.
Date Received:
City Receipt M
Critical Areas File M 0 M_
Critical. Areas Checklist Fee: $135.00
Date Mailed to Applicaft
A property owner, or histUr authorized represcntativc,
must fill out the checklist, sign and datc it, and submit it
to the city. The City will review the checklist, make a
precursory site visit, and make a determination of the
&*.keA 1.�# "A^Ae t^ ^^ lAta a AAuAl —A"t
'Me purpose of the Checklist is to enable City staff to %t awra
determine whether any potential Critical Areas are, or permit application.
may be, present on the subject property, The information Please submit a vicinity map, along with the signed copy
needed to complete the Checklist should be easdy of this Zone, to assist City staff in finding and locating the
_avai
CM sc this form. In
;M specific piece of property de ribcd on
s
s
11addition, the applicant shall include other pertinent
information (e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant staff
APPUCATION PIC t�JSLI.29& ompleting their preliminary assessment of the site.
The undersigned applicant and hisl=/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harinless from any and all damages, including reasonable
attorney's lees, arising from any action or infraction based in whole or part upon false, misle2ding, inaccurate or
incomplete information furnished by the applicant. hisi(herlits agents or employees.
By my signature, I certify that the information and exhibits herewith b itted are true and correct to the best of my
)Ppl beha
knowledge and that I am authorized to owner as listed below.
SIGNATUR13 OF APPLICANVAGENT DATE
Property Owner's Authorization
By my signahm I certify that I have alonze4e �Rbove Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the !ta m
,ff of the City of Ed onds to enter the subject property for the
purposes of inspection and posting attendan 0 this tion.
p
�r --
SIGNATURE OF DATE -!� —/,) 77
Owner/Applicant:
Name
Strect Address
L�,- 2
City State zip
Telephone:.
Applicant Representadve:
Name , - -
Street Address
city State Zip
Telephone:
Email address (optional): Email Address (optional):
X,ITY�o 4t* �711 ;7 1,Pd
CITY of EDMONDS BUSIN& LICENSE APPLICATION DATE 1_16�ENSE NO.
Civic Center - Edmonds, Washington 98020
City Clerk Phone 775-2525
INSTRUCTIONS: CLASS
• All items must be completed RECEI 1
or application will not be ac-
cepted.
• Sign * and return application L4EE F
with fee. Renewals received
after February 15 must pay
IEW BUSINESSES AFTER
ULY 31, 112 FEE.
ANNUAL FEES
PENALTY AFTER FEB. 15
FWF-"P N-911 00
0 OME OCCUPATION
C
0
=JE 0. SPEC.
$10. 00 (A)
ADDITIONAL $5.00 0
LT I I
0 1:1 SMALL BUSINESS
S
DATE PAID
$15.00 (B)
ADDITIONAL $7.50 0
PRINT'X'
-1
IN SPEC. BOX
rA
1:1 Business with 10 or
FOR ISSUE OF
PENAL Y PAID CORRECTED
!t
more employees
ADDITIONAL $25.00 0
LICENSE WITH
'LC' ACTION.
$50.09 (C)
NEW APPLICATION (LA)
• RENEWAL
(LB)
• CHANGE
(LC)
EASE MAKE ANY NECESSARY CHANGES) 0 DELETE (LD)
NAME OF FI M BUSINESS PHONE NO. OF: EMPLOYEES
M-AILING A LDRESS
NATURE OF BUSINESS
vylo �s
-2
BUSINESS ADDRESS
2 2 '7 a J_ 7Y -i�4 'a - ZO
OWNERS NAME
"Izo (_ _!s Is
MONE_ FATE OF
�f
EMERGENC`t ION:
(PLEASE LIST TWO)
WASHINGTON STATE TAX N
gI,ND VIDUAL
(S)
HOME ADDRESS
'7
IRTH
7— ,
(1) NAME & TELEPHONE
(2) NAME & TELEPHONE
APPLICANT'S SIGNATURE
PARTNERSHIP CORPORATION
= (P) = (C)
Db NOT WRITE BELOW THIS LINE
t4o er /V
S C
��C I A ;E?UTITY- NUM BER
STAFF REVIEW:- FILL IN LAND USE CODE, UFIR NUMBERS, ZONING, ETC. CHECK APPROVAL OR
DISAPPROVAL, DATE, AND SIGN. IF DISAPPROVAL, PLEASE COMPLETE "COMMENT"
SECTION. ROUTE TO NEXT DEPARTMENT ON LIST.
PLANNING DEPARTMENT
'?"174
�r APPROVE. 0 DISAPPROVE
DATE
LAND USE CODE
4=11
ZONING CODE
SIGNATURE 7
CONDITIONAL
USE PERMIT
COMMENTS
BUILDING DEPARTMENT
DATE
Building 0
Hotel/Motel (L)
19-APPROVE 0 DISAPPROVE
SIGNATURE JA - uAtN-12-1
Permit 0
Apt. Bldg. (A)
COMMENTS:
CAPACITY: (NO. UNITS, APTS., OFFICES, SEATS, BEDS, STUDENTS)
FIRE DEPARTMENT DATE /0 - S 0
10, APPROVE 0 DISAPPROVE SIGNATURE 53= C740O.—
COMMENTS: oeo-ye owl4oeov.
LICE DEPARTMENT DATE SIGNATURE
APPROVE 0 DISAPPROVE U
COMMENTS:
PUBLIC WORKS DEPARTMENT
0 APPROVE 0 DISAPPROVE , DATE SIGNATURE
I I I M E3 Office Bldg. (0)
Occupancy 0 Restaurant (R)
Group 0 Hosp/Nurs Home (H)
0 School (S)
COMMENTS:
PLEASE RETURN TO CITY CLERK
APPLICATION CARD No . ...........
r
The City of Edmonds SIDE SEWER PERMT
fo
S91DE INSIDE E] REPAIRS E] EASEMENT No . ...........
OWNER--- ------- At ......... ................................................... CONTRACTOR ............... ........................................................... PERMIT No.
STREET
............ UE LOT No . ..........................................................
HOUSE No...,.5q.X7P6 — ----------------- 71 . ........................... ..... AVEN ............. BLOCK No . ....................
NAMEADD . ..................................................................................................................................
Date
BACKFILL WORK ORDER ISSUED ......
SEWER WORK ORDER ISSUED .............
N
lE-
Lg
APpROVE0
:-, tA),F
Approved:
...... DEPOSIT, $ ...........................................
............ B3, ...............
I
2q
�4
k-1
HSU
n r3�-
-% wr%e
6.1 ritET FILE
-7
C) V1
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 for ' th on these
map(s). Any person or entity -requesting a
copy should 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
empl-oyees o-r officers shall be lia-bl-e for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
APPROVED BY'PLANN I IN
U
I I L
Zone P-S-8 Comer
Setbacks
Required
Front
2.51
Sides
715'
Rear
Other
Height
�0
5T
--- _-E44-V �,57 5ci4
F0UTLfQ5.(cowtTIt-,j
co-p 57K...Iq 1161)*
Y� rbT I HG COYMED _F01ztV1
Aw)
--F.f--,0P0_5ED ^-DDITIOH
TOTAL 1H�_PYj0QE) .5URFACIS IAFr-^
V I c
ya M
N0 RT H
—Fla&_
Actual -i.*4sA,,
5 2-'
5f
390
IMMMEM-11
119
Z\V<
. 51 wqop
P p- N HIer-p-
v
540
290
6560. _.
flu"'
"im\'L . rr
'to - floue)e:
522 50 R
ECEIVED
I Mee" M ;WATK
5-F_ ftV-e_A JUN 2 0 2005
BUILDING DEPT.
D E
IT ff L/1� kJ
STREET'FI,LE '11 "201
rA ;-:,n
-4 1 W3, 0
c 105.00
__D + 10-1.15 0
0
�AMAGa 9"Oc tol - 24�
;ACT.UA I.
M U M
01. -r
100 00
=! 0
T7
APPp,011ED AS NOTED
By ENGWEERIN G_
io
_J
cl
0
ADD GUTTERS/DOWNSPOUTS
AND SPIASHBLOCKS 71
r
'OR IS RESPONSIBLE
FOI` i EROSION CONTPOL AND DAMAGE
+
0.0
b T'H
- 'PL A%C, E- 1_� E b T
LU
,.Luc)
'1101 W OF KEF Err,
LL
C)
f012. 5ITS:&K4.Drr_ r=LBVATI0q5
CATY OF--:F-DM_0WP5
1N*.WWWD tTAJI40 PIFIE: eAt)_e__