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24020 76TH AVE W
PLANNING DATA
NAME: -rim �Ilzrr,?t 6r0-'Sf"-e,.
SITE ADDRESS:-'-' 4o z-o - 16 DATE: 5-il3o
ZONING: PLANCHK#: 9-7-15-6
PROJECT DESCRIPTION:
CORNER LOT /�Io 5,-As r) (Yes/No)
SETBACKS:
Required Setbacks:
Front: Zf' Left Side: 7 Right Side: -7 Rear:
Actual Setbacks:
Front:--t'7' LeftSide: 1-7' RightSide: 49-' Rear: .3 4-
Street map checked for additional setback required? va, V4 —(Yes/No)
LEGAL NONCONFORMINGIAND USE DETERMINATION ISSUED M _(Y/N)
LOT COVERAGE: 1-7-300
%60-
Maximum Allowed: Actual:
BUILDING HEIGHT:
Maximum Allowed: 25' —Actual Height:
Datum Point: &,� I 2,4,iwA Datum Elevation-
A.D.U. CREATED?:
a Z, V
SUBDIVISION:
CRITICAL AREAS #: 9 -7 - �6 - Weuyt,, -
SEPA DETERMINATION: f*!nP�-
LOT AREA: q&60 0
OTHER:
Plan Review By:
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CA FILE NO.
Critical Areas Checklist
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Site Information (soils/ topography/ hydrology/ vegetation)
1. Site Address/ Location: '7 +
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? _�Zyes; no.
If yes; how is site developed? i r--,4� �-i
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 (lawn,shrubs etc) -,,,Z
11. Obvious wetland is present on site: 1--JO
---------- - ----- ---- For City-':Aaff Use
ite. is Zoned?
SCS mapped soil.type s ALP9&AM UM&t± LAPID e4rftgr - Z4.%
3. Wetland inventory or C.A. map indicates wetland present on site?
4. Critical Areas inventory or C.A. map indicates Critical Area on siteT
:5. Site within designated earth subsidence landslid.e ha.zard..0.r,e4?_
:;6. Site designated on the Environmentally Sensitive Areas* Map?.
,:DETERMINATION
STUDY REQUIRED
WAIVER
..Viewed by�6.
Planner
coNDiTibNAL WAIVER
'C�
Da tt
ACA —chk.doc; Rev 02/11/97
4 ",
City of Edmonds
Critical Areas Checklist
',7 C. I S 9 1.,
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 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:
t,1___fzK i 111t, F? �?o 0551:�� U
Name
15944 0
Street Address
City, State, ZIP Phone
Signature Date
Applicant Representative:
Name
Street Address
znc,7
Pholle
5iin6ture. Date
/,. 0 clb--.�e
APPLICATION CARD No . ........... ..........................
for
The City of Edmonds SEDE SEWER PERNOIT EASEMENT No . ......................................
. - 1�— UTSIDE INSIDE REPAIRS E]
------- T/ PERMIT
OWNER M6-�2 ................................... CONTRACTOR
------------------
STREET
HOUSENo.!��V VE E Lo ................................................................... BLOCK No . ............
........................... ...... A NU T 'No. ...
NAMEADD . .................. .......................................................................................................
,41
- V j V
Date
BACIMLL WORK ORDER ISSUED .................................... DEPOSIT, $ ..............................
SEWER WORK ORDER ISSUED ..........................................
J�- , I / -C;-/l
Approved:
DA TE . . ...... .... By
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 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
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).
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAM4EAME OF BUSINESS '00055EA U
—pi ,
M AILING ADORES
040W -7,g T)-4
_6_17Y ZIF—FT_ELEPHONE NUMBER
tFl_ C7�_40 �7 -75
NAME
ADDRESS
TELEPHONE NUMBER
CITY ZIP
30 505Z
)tj
<
ITN &P T, ON&INUIIE
'IX Cl 'D
MBE EXPIRATION
T
Nf�t�j _y
cis
Legal Des ription of Property - include all easements
Z oorzrotj 6F -r"r-^cT-
F1
JOB
A--s _1�c
I 1 70 j
PERMIT
NUMBER
(I SUBDIVISION NO.
0
i!) 7 :),,
P PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
UB LC RGH
TESCP A�proved '
0
.
RW Permit Required
0
EXISTING REOUIRED DEDICATION
""U" Req'd
Sln.pecll.n PR7.1ired
0
0
PROPOSED
Sidewalk Required
0
M R
ETER SIZE
LINE SIZE
FIXTURES,
PRV REQUIRED
rO..OF
YES 0 NO 0
S
REMARKS
-/
or ��OOL
r _rk-
M
LAJ
Property
Tax Account 000 oocl� 04570.5"
Parcel No.
EINEW
RESIDENTIAL
�BIN ECH
971
COMPLIANCE OR
OF USE
2SJADDITION
COMMERCIAL
CHANGE
APT. BLDG.
SIGN
REMODEL
GRADING
FENCE
Fn
REPAIR
CYDS.
I- x
D
WOODSTOVE
SWIM*POOL,
DEMOLIS.H
INSERT
HOT TLIB/SPA
FGARAGE
_1CARPORT
RETAINING WALL/
RENEWAL:
ROCKERY
01 jYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
ENGINEERING MEMO DATED
i REVIEWED BY
..Z.
SIGN AREA
SEPA REVIEW
ADB NO.
ALLOWED PROPOSED
COMPLETE EXEMPT
SHORELINE#
EXP
VARIANCE OR CU
PLANNING REVIEW BY
DATE
ACKS — FEET
HEIGHT
CO
Z
FRONT Z5 * SIDE_7�t!
REAR7-5
]LOT
7-5
Z
3
REMARKS
CHECKED BY ITYPE OF
SPECIAL INSPECTOR
REQUIRED .5q
13 YES
REMARKS
PROGRESS INSPECTIOMS PER.UBC 108
y
f�S NUMBER
W
a OF
cc STORIES
NUMBER OF
DWELLING
UNITS I
A
CRITII IC
AREX
I NUMB "
tX1 h - t— a
IF,
DESCRIBE WORK TO BE DONE (Al I ACH PLOT PLAN) Tr6Q
P::A-I-1IL`r 900"A4
q �_, #-- st
FINAL INSPECT104 REQUIRED
U
VAUJATION
PLAN CHECK FEE
val Io
BUILDING
HEAT SOURCE:
GLAZING
%
PLUMBING
Plan Check No.
MIECHANICAL
!. GRADINGIFILL
This Permit -_ covers work to be done on pr vate property ONLY.
Any construction on the. public domain (curts, sidewplks,
driveways, marquees, etc.) will require separate permission.
STATE SURCH . ARGE
Permit Application: 180 Days
Permit Limit: I Year -provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
ENO. INSPECTION FEE
"Appli . cant, on behalf of his or her spouse, h . eirs, assigns and
in successors in interest, agrees to.indemnify, defend and hold
Tn harmless. the City Of Edmonds, WashingtofiN its officials,
m employees,and agents from any.andtall,clalms-for damages
arisi - hg direct , -or Indirticily fromr�he lssuanc&.
whatever nat6te iy,�
4 It I�suance of this permit shall,not tie deemed
erm
t
of
tot 10 , LAN. CHECK DE POSIT
04CCUPANT t
LOAD
0 0 F, any city ordinance
-i modify, waive or reduce any requirement of
0 1 provision." ce any ordinanc
:r nor limit in any way the City's ability to enfor
e
TOTAL AMOUNT DUE
loso lit -4t
I hereby acknowledge that I have road this application; that the
ATTENTION
APPUCATION APPROVAL
information given is correct; and Ithat I am the owner, or thp duly
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
This application is not a permit until
state laws regulating construction; and in doing the work authoriz.
AUTHORIZES
signed t)y t he Building Official or his/her
ed thereby, no person will be employed in violation of thii'Labor.
Code of tho State of Washington relating to Workmen's Compensa-
ONLY THE
WORK NOTED
Deputy; and fees are paid, and receipt is
acknow ledged in space provided.
tion Insur6nce'and RCW 18.27.
1 NSPECTION
JWSIJ�NATURE JO�NER OR AGENT) GNED
1— 9
DEPARTMENT
CITY OF
EDMONDS
0 FICIA S IGNA11pAE DATE
CALL FOR
E LEASED BY DAJ�,
ATTENTION
INSPEPTLPN
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. USC
PINK — Owner GOLD — Assgssor
SECTION 109
RECEIVED
Was�
Nattzra=3�
AVvbstvxjbn ErerW Company
COMMUNITY DEVELOPMENT
CIVIC CENTER
505 BELL STREET
EDMONDS, WASHINGTON
Gentlemen:
STRE67 IrILE
DIVISION
afflowl
OCT 15 1981
Dir. ot pubijc ,,t�,.Ks
Washington Natural Gas Company hereby applies for permission to:
Permission is requested to install +/- 54' of 14" Plastic Main in
76th Avenue West. Approximately 183' North of the cneterline of
241st ST SW.P4-" Main to enter 151 Easement 30' West of the centerline
of 76 Avenue West.
Per Attached Drawing: 813-156
We would like to be. in construction about Oct 81 and will require
approximately 9T— days to complete the work. If we have your
approval to proceed, please sign and return the original of this form*.
(Please enter any special conditions.)
Application Date Oct 14, 1981
WASHINGTON NATURAL GAS CO.
Tony P. Tessitore
Distribution Engineer
Eastern Division
Washington Natural Gas is hereby authorized to perform the work
described above in accordance.with their franchise responsibilities
and are further subject to all applicable federal,state,county and/
or municipal ordinances and specifications.
W4 0 WIN
Approval Date
805-I%th Avenue North EasL Beftvw. Wnhinstort "W Tdepbow (206) 28"101
Z171Z
A�Z
OCT 1 3 1981
NO. I DESCRIPTION
REVISIONS
-A/�7�EL.g ----
CALL 48 HOURS
BEFORE YOU DIG
1-800-562-6478
4�
7
IT-7-m I OLIANT.1 DESCRIPTION STOCKNO..
BILL OF MATERIAL
6 WASHINGTON NATURAL GAS COMPANY
PERMIT
D. G. R.
PERMIT
1/4 SEC.
PERMIT
OP. MAP
TAX CODE
PLAT NO.
AREA
SEQ. NO.
DWN.
DATUB Y [��d C H K'D
SCALE
I R R R
JOB
DRAWING
APP I D
c, Ag &;�5