24103 101ST AVE W.PDF1111111111
115
24103 101 ST AVE W
-II.NIPERVIOUS SURFACE CALM--
Fxist Bld Pad: 1899 sf. (constructed prior to 1977)
Proposed Garage: 624 sf.
proposed Bedroom: 288 sf. t - — / —OL-) -r—k A—V 15, W—
proposed Driveway: 892 sf.
a it@ to 1010" �lope-west
ADD GUTTERS/DO'NNSPOUTS
� AND SPLASHBLOCKS
6-ARAGE HEIGHT CALCS 140 1-0 In
I. = +99'
2. = +99'
3, = +102'
&I = +101.75'
�,T GRADE = +100.e
.CTUAL +115'
,kxIMUM +11 5.eq
2 MER" HEIGHT CALCS
A=
+101.25'
1B =
+102.5'
c.=
+101.5'
D=
+101.25'
Ak7E GRADE = +101.6'
ACTUAL +114.11
mmimum +126.6'
LOT CDVERAGE
3?03 SQ.FT. (34.7%)
I- OT AREA
10,647 SQ.FT.
Tax account parcel #
OD0555000002400
PME7 20' FPOK-rlr�
DC-11Fc v::! -r�tE
To
W41E PhCAja)fg-r. <
L S easKVg- , f I
WT SLOPE: Plus or minus 3%
ks O�: due lot,=2-
141Egz
OF ae
REETPRI lue
LL
IgUrF-ACE
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mp�j 2 8 2C.02
MEMT SFR\IICES CTR-
DEIJELCOI�T'ly OF EDMONDS
r
Lkc -7-6 Fax, a I
[tMIJUKAhY L;UN,'j I HUL; I 1UN
ENTRANCE REQUIRED
r7f 7 7
'etc
25-0 a
A)
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2S,
A
01, I-C
C 10 , -0
,101
Tizko POSE6
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OWNERICOMCTOR IS RESPONSIBLE FOR
EROSION COWROL AND DRAINAGE
FI?O P0
FV i 5 71 �J
,Re .5 1
) 2./7 k
JM DRIVEWAY SLOPE
ALLOWED 14%
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-- b
j
+ ro /. 6
M,H. DVEP 4ED AS NOTED 30 0
b ENGINEERING
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2q103 1otsT-AVF— W
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41 1? C. 1 89�j
CITY OF EDMONDS
121 STH AVENUE NORTH - Edmonds. WA 98020 - (425) 771-0220 - FAx (425) 771-0221
HEARING EXAMINER
GARY HAAKENSON
MAYOR
FINDINGS, CONCLUSIONS AND DECISIOK,_
OF THE HEARING EXAMINER 1--,
CITY OF EDMONDS 9 2CU2
UP= MWENr sEAvIcEs CTR.
CITY OF E
APPLICANT: Suzanne Cancler represented by Harold Bacigalupo (Seeva"Itit
A, Attachment 2)
CASE NO.: V-2002-29
LOCATION: 24103 10 I't Ave W (See Exhibit A, Attachment 1)
APPLICATION: To reduce the required street setback bordering 1001h Ave W from
25 feet to 5 feet, to allow for construction of a garage..
REVIEW PROCESS: Hearing Examiner conducts a public hearing and makes the. final
decision.
MAJOR ISSUES:
a. Compliance with Edmonds Community Development Code
(ECDC) Section 16.20.030 (SINGLE-FAMILY
RESIDENTIAL - Site Development Standards).
b. Compliance with Edmonds Community Development Code
(ECDC) Chapter 20.85 (VARIANCES).
SUMMARY OF RECOMMENDATION AND DECISION:
Staff Recommendation: Approve with conditions
Hearing Examiner Decision: Approve with conditions
PUBLIC HEARING:
After reviewing the official file, which included the Planning Division Staff Advisory Report,
and after visiting the site, the Hearing Examiner conducted a public hearing on the application.
The hearing on the application was opened at 9:32 a.m., April 4, 2002, in the City Hall,
Edmonds, Washington, and closed at 9:35 a.m. Participants at the public hearing and the
exhibits offered and entered are listed in this report. A verbatim recording of the hearing is
available in the Planning Division.
Incorporated August 11, 1890
1;ictor (7itu - Hpkinan Aanan
Hearing Examiner Decision
Case No. V-2002-29
Page 2
HEARING COMMENTS:
The following is a summary of the comments offered at the public hearing.
From the City:
Kathleen Taylor entered the staff advisory report into the record (Exhibit A)
From the Applicant:
Harold Bacigalupo concurred with the staff advisory report and entered a letter from a
neighbor into the record (Exhibit B).
From the Community:
No one from the community spoke at the public hearing; however, one neighbor submitted a
letter in support of the request (Exhibit B).
FINDINGS OF FACT AND CONCLUSIONS:
A. SITE DESCRIPTION
1. Site Development And Zoning:
a) fAELs:
(1). Size: The subject property approximately 10,600 square feet. (See Exhibit A,
Attachment 4)
(2) Land Use: The subject property is currently developed with a single-family
residence. -
(3) Zoning: The subject property is zoned single-family residential RS-8. (See Exhibit
A, Attachment 1)
(4) Terrain: The site is relatively flat except that it slopes steeply to 100 th Ave W.
The slope is approximately 15 feet in vertical height, most of which is located in
the City's right-of-way.
2. Neighboring Development And Zoning:
a) Fact: The adjacent properties are zoned RS-8 and developed with single-family
residences.
b) Conclusion: Construction of a detached garage is consistent with the zone and the
adjacent properties.
B. STATE ENVIRONMENTAL POLICY ACT (SEPA)
1. Fact: The proposal does not require SEPA review.
2. 'Conclusion: The applicant and the City have complied with SEPA regulations.
Hearing Examiner Decision
Case No. V-2002-29
Page 3
C. EDMONDS COMMUNITY DEVELOPMENT CODE (ECDC) COMPLIANCE
1. Zoning Standards
a) Facts:
(1) ECDC 16.20.030 states the development standards for RS-8 zoning. The required
setbacks are as follows: 25 feet from the street property line, 15 feet from the rear
property line, and 7.5 feet on all other sides.
(2) The subject property fronts on both 10 Is' Ave W and I 00th Ave W-,. its setbacks' are
as follows: 25 feet from both street property lines, and 7.5 on the north and south
sides.
(3) The applicant may request a variance from the required setbacks through the
variance process. Refer to ECDC 20.85.
b) Conclusion:
The applicant submitted a variance request on February 6, 2002.
2. Compliance with requirement for a Setback Variance
ECDC Chapter 20.85 (Variances) states an applicant may request a variance from the
standards of this Chapter pursuant to the procedures set forth in ECDC Chapter 20.85.
Chapter 20.85 of the ECDC also sets forth the mechanism whereby a provision of the
Codem'ay be varied on a case -by -case basis if the application of the provision would
result in an unusual and unreasonable hardship.
a) Facts:
(1) ECDC Section 20.85.010 establishes the decisional criteria with which a variance
request must comply in order to be granted by the Hearing Examiner. These
criteria include the following: a special circumstance 'must exist; no special
privilege may be granted; the proposal must be consistent with the Comprehensive
Plan and the Zoning Code; and the proposal can not be detrimental; and it must be
the minimum necessary.
(2) Applicant's response
Refer to the applicant's response in Exhibit A, Attachment 3, plans in
Attachments 4 - 7, and photos in Exhibit A, Attachment 8.
(3) ReMonse and additional information:
a. A one-story single-family residence exists on the property. The residence
appears to have had an attached garage with a carport. However, the garage
was converted to living space. As a result, there is not a garage at the site,
merely a carport that does not provide sufficient protection for the applicant's
vehicles or adequate storage space.
b. The positioning of the existing residence limits potential development for a
garage. Refer to site plan in Exhibit A, Attachment 4.
Hearing Examiner Decision.
Case No. V-2002-29
Page 4
c. As, stated in- section C.L(a)(2) of this report, the property has a required street
setback from I 00th Ave W. Although it is has a stre * et setback, it functions as
the rear of the lot. ECDC 16.20.050 allows for a rear setback to be reduced to
5 feet, for accessory buildings that cover less than 600 square feet of the
property.
b) Conclusions:
(1) Special Circumstances
Special circumstances exist in the location of the property, because it lies
directly between two streets - I 00th Ave Wand 10 1 s'Ave W. However, the
lot can only take access from 10 Is' Ave W, due to the existing topography.
(2) Special Privilege
The applicant would not be granted a special privilege in being allowed to
construct a garage on the site. The neighboring property to the north has a
shed on the property line, which has been there for many years. Refer to
Exhibit A, Attachment 8. Also, properties in the vicinity are allowed to
reduce their rear setback to 5 feet, as allowed by ECDC 16.20.050. Although
it functions as the lot's, rear, the Cancler property technicaNy does not qualify
for ECDC 16.20.050, since it does not have a rear lot line, as defined by
ECDC 21.85.010.
(3) Zoning Code and the Comprehensive Plan
The lot is zoned single family and is designated single family - small lot on the
comprehensive plan. Construction of a detached garage is consistent with
both.
(4) Not Detrimental .
The proposed variance request does not appear detrimental. The location of
the garage will not create site distance problems for neighboring properties.
And since the garage will be located approximately 15 feet up from 100th Ave
W, it Will likely not be visible from 100'h.
(5) Minimum Required
The requested variance appears to be the minimum necessary to adequately
move a vehicle around the residence to access the garage.
D. TECHNICAL COMMITTEE
1. Facts: Review by City Departments: The application has been reviewed and evaluated by
the Fire Department, the Public Works Department, the Parks Department, and the
Engineering Division. The Engineering Division requires the access width to be at least
12 feet from the property line. No access will be allowed from 100 th Ave W. No other
comments were received.
Hearing Examiner Decision
Case No. V-2002-29
Page 5
2. Conclusions: The site plan indicates that there is 12.5 feet from the north property line to
. . accommodate vehicular access, and the applicant will not be taking access from I 001h.
DECISION:
Based upon the foregoing findings and conclusions, the request for the requested street setback
variance is approved, subject to the following conditions:
1. The setback is only applicable to the property line along I 00th Ave W.
1. The setback reduction is only to allow for a garage.
2. The applicant must obtain proper building permits prior to construction.
3. Access will not be allowed from I OOh Ave W.
4. The applicant must pave the first 20 feet from the property line, at least 12 feet in width.
5. This application is subject to the applicable requirements contained in the Edmonds
Community Development Code. It is the responsibility of the applicant to ensure
compliance with the various provisions contained in these ordinances.
Entered this 5th day of April 2002 pursuant to the authority granted the Hearings Examiner under
Chapter 2 0. 100 of the Community Development Code of the City of Edmonds. -
Ron McConnell, FAIC�
Hearing Examiner
RECONSIDERATION AND APPEAL
The following is a summary of the deadlines and procedures for filing reconsideration -and
appeal. Any person wishing to file or respond to a recommendation or appeal should contact
the Planning Department for ftirther procedural information.
REQUEST FOR RECONSIDERATION
Section 20.100.010.G allows for the Hearing Examiner to reconsider his decision or
recommendation if a written request is filed within ten (10) working days of the date of the
initial decision by any person who attends the public hearing and signs the attendance register
and/or presents testimony or by any person holding an ownership interest in a tract of land
which is the subject of such decision or recommendation. The reconsideration request must
cite specific references to the findings and/or the criteria contained in the ordinances
governing the type'of application being reviewed.
ERVIOUS SURFACE CALCS
Exist Bld Pad: 1899 sf. (constructed prior to 1977)
Proposed Garage: 624 sf. t
Proposed Bedroom: 288 sf. / 0 0.
Proposed Driveway: 892 sf.
4" to 10'0" slope -west
GARAGE HEIGIff CALCS k10 I -oft
1 = +99, TEMPORARY CONSTRUCTION
2 = +99' ENTRANCE REQUIRED
3 = +102'
4 = +101.75'
AVE GRADE +100.3' ;rgq
ACTUAL NTRACT . OR IS REMSIBLE FOR
M
Axjfvm
+
ON CoNTROL AND DRAINAGE
BEDROOM MIGHT CALCS
A = +101.25'
B = +102.5'
C = +101.5!
D, = +101.25'
AVE GRADE = +101.6'
ACTUAL + 114. 1 1
MAXIMUM +126.6'
LOT CDVERAGE
3703 SQ.FT. (34.7%)
LCT AREA
-qq"
10,647 SQ.Fr. APPROVO AS NOTED
BY ENGINEERING
Tax account parcel
005550000024OLr--
.12 oi—
Date. (0
LOT SIDPE: Plus or minus 3%
STREET FILE
prop. line
jZECSj,VaD
5t,,VICES CTR-
DEVELOIPMeml Et)
CTy OF MONDS
r -r nLj
ay, sr(REE:T
APPROVED BY PLANNIPG
10 �/ .
77/
w
GhRAB F_'
bpq C31
ADD GUTTERS/DOWNsPOUTS
AND SPLASHBLOCKS
11
,�,
P/?C, P0
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25-0
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t F NtE
2_1 k
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FOR
C) --,4%1 0o
'LO I S T,
AV E. W,
214103 foisr-AVe W
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PLANNING DATA
NAME: e_- f DATE: &7-7 / ---I
SITE ADDRESS: �2� i Q'_", — 10 7�7V W i PLAN CHK#: 0.2- tL'E��
PROJECT DESCRIPTION: A 4t A10W Aaff_2��
REDUCED SITE PLAN PROVIDEDTzjLes.A0
j
MAP PAGE: CORNER LOT: OLe�o FLAG LOT:
ffqs—&o!,)--/77rw 1,-;4
ZONING: CRITICAL AREAS DETERMINATION #:,0;-7
Study Required:
liver
Conditional Waiver
SEPA DETERMINATION: isflA
UFee
13 Checklist
IJ APO list wl notarized form
U (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger)
vi�rExempt
SETBACKS: 2- — 2-cl
Required Setbacks- f
Street: 2��Le%Side: Right Side: Re r:
Actual Setbacks: 4t t/�)" t
Street-AJV eAWeft 1.5; Right Side: Rear:
Street map checked for additional setback required? (Yes No DNA)
A2--DETACHED STRUCTURES:
L3 ROCKERIES:
U FENCEsrrRELLISES:
U BAY WINDOWS / PROJECTING MODULATION-
U STAIRS /DECKS:
PARKING: Required: Actual: 'z"MI
LOT AREA: 10 -7
Z (eg
LOT CO firt ;,q _t 12--7
Calculati ns:
BUILDING HEIGHT:
Datum Point: M"'k_ 0 -Datum Elevation:
Maximum AJlowed* 'Actual Height: /91 (e
A.D.U. CREATED?: (No Yes&_n'"_
SUBDIVISION:
LEGAL NONCONFORMING LAND USE DETERMINATION.ISSUED: (Yes / No
NewBPP1amingDataForm.D0C
.". 15-7
City of Edmonds
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 s
determine whether any potential CriticailApxel
may be, present on the subject property. B ILI
needed to complete the Chh#eckkl�ist- hn'
available from observations of the ail
City Hall (Critical are4as ma
surveys).
Date Received: cc
City.Recelpt
Critical Areas File #:
Critical Areas Checklist Fee: $45.00
Date Mailed to ADDlicant:
A property. owner, or his/her authorized representative,..
Must af] I ut the checklist, sign and date it, and submit it
t�o i� The 11 re e he he�k t ' make a
ty* . v City w' m v' w t c li� he
isit' and ake a determmatlon of t
s ss ry to compl t I
Oqu "i J�ep nece a e e a deve opment
i p along with the signed copy
ta in nding and locating the
s Pb 0 this form. In
oa v*c nir
t assist C
s
recific pirece of property descn ed n
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 applio Mis/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, d%l 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
incomplete information furnished by the applicant, his/her/its; agents or employees.
By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file is application on the behalf of the owner as listed below.
DATE
SIGNATURE OF APPMANVAGENT
Property Owner's Authorization Cl/
By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the su*,6�lpfopeft` or the
y-f
purposes of inspection and posting attendant to this application. DEVELOPMENT �E
Y
SIGNATURE OF OWNEZ__� —DATE k — -, _6�
Owner/A.pplicant: App�icpnt , Representative:
Name Name
J 7- 144,-0, PP
.Street Address Street Address
n, \A) c�ZD-,�,Q -5,-7ko 12maA1292
city State zip city State zip
Telephone: 2-ACC -�- !S-\ C-iff�-Z. -'-i Te.lepho'ne:
E . mail address (optional scg_,,\ftytQ_ e.,,��\. , Email Address (optional): Rap
Critical Areas Checklist.dod3-19.2001
CA File No:
Critical Areas Checklist
Site Information (soils/ topography/hydrology/v* egetation)
1. Site Address/ Location: 4�� NO LIT— AV6, U/
2. Property Tax Account Number:
3. Approximate Site Size (acres or squ are eet): /a 6
4. Is this site currently developed? _4 yes; no.
If yes; how is site developed? 13 7 / -�7 0,A//-
5. Describe the general site topography. that apply.
Flat- less than 5-feet elevatio ver entire site.
RoUing-. slopes on site erall -s a vertical rise of 10-feet over a horizonta'
distance of 66&- e
Hilly: slopes present site of ' e than 15 s. - an 30% ( a vertical rise of 10-fee:
over a horizontal distance of'��Lo 66-WI,
Steep: grades of greater than 30% presen ve 0-feet over a horizonta-
distance of less than 33-feet). Wy,&, , -
.1
7.
91
Other (please describe):
Site contains areas of year-round standing water: Approx. Depth:
Site contains areas of seasonal standing water: — ; Approx. Depth:
What season(s) of the year?
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 (lawnshrubs etc). 'I(
11. Obvious wetland is present on site:
Critical Areas Checklist.doc/3.19.2001
�C. 167-
City of Edmonds
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 s
determine whether any potential Critical Are I
may be, present on the subject property. B III.
needed to complete the Chh#eckl�ist- W,
available from observations of the
City Hall (Critical areas ma
surveys).
Date Received
City Receipt #: t q0ci—_6
Critical'Areas File #:
Critical Areas Checklist Fee: $45.OQ
Date Mailed to ADDlicant:
A property. owner, or his/her authorized representative,..
must,W1 ut the checklist, sign and date it, and submit it
W to i� ne City will make a
visit' and of the
q s s ry
. �ep nece sa opment
i along with the signed -copy
f i! indin and locating the
s Pi
Y % g
s oa vic ni �
t assist C
recific Wpiece of property des bed 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 applid Wis/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, d%l 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
incomplete information finmished by the applicant, his/her/its agents or employees.
By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file is application on the behalf of the owner As listed below.
SIGNATURE OF APPLicANT/AGENT DATE
Property Owner's Authorization
By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
OwneF/AppUcant:
Name
DATE k — _c_:;X� - -
Appl c�Rnt'Representa ve:
Z, Iva
Name
-Gk�-k\ C�:Es J01,S7-
Street Address Street Address
\A)
W,4
city State zip city State Zip
�elephone: Z)OC 1� - Gf�� -:4 Telephone: g206-
tmail address (optional):
,..,,Email Address (optional): Rap
Critical Areas ChecklistA60.19.2001
j
CA file No:
Critical Areas Checklist
Site Information (soils/ topography/ hydrology/vegetation)
1. Site Address/ Location:
,Q 400 to I S'T- 4 LIE. Ul
2. Property Tax Account Number:
3. Approximate Site Size (acres or squarleet):
4. Is this site currently developed? Y yes; no.
If yes; how is site developed? 1,3 7 '�7 �OAIC- V A?05 122,9 AIC r
dthat a
5. Describe the general site topography. pply.
v tire s
Flat. less than 5-feet elevatio, ver entire site.
r I
Rolling: slopes on site 'ge n e r jaH yje Fs s (a vertical rise of 10-feet over a horizonta"
. . - 05�.,
distance of 66-feell-to., & ..
Hilly: slopes present on. site of ?We than 15%WIAI
ov o 616- 't
er a horizontal distance of"' 0 "W
Steep: grades of greater than X - pprSsen
distance of less than 33-feet). ;*
30% ( a vertical rise of 10-feet
0-feet over a horizontal
Other (please describe):
VY '7
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 watercourse.
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 (lawnshrubs etc). Y,
11. Obvious wetland is present on site:
Critical Areas ChecklisLdoc/3.19.2001
EXEMPTION FROM CONTRACTOR REGISTRATION
VERIFICATION FORM
The undersigned property owner or contractor has applied for'a building nit from the City of
permi
Edmonds and claims that he/shelit are exempt from providing contractor registration in accordance with
the,provisions of RCW 18.27. The property owner, by their signature below'hereby verifies to the City of
Edmonds that:
0 Value of work under $500.00. The aggregate contract price of labor and materials
and all other items required for the project is less than $500-00 and is not part of a larger
opertation to be undertaken on the property. The person employed to do this work has not
advertised nor otherwise put himself forward to the permittee to be a contractor or
qualified to engage in the business of a contract. RCW` 18.27.090(9).
Work performed personally on own property. The undersigned verifies that all work
done under this permit will be done by the permittee personally on his/her own property
and that the improvements constructed on the property are not being undertaken with the
intention and purpose of selling the improved property.
0 Commercial property exemption. The p6mlittee is the owner of commercial property
and the owner's own employees will perform all maintenance, repair and alteration work
on the property.. No work will be done by contract under the permit. RC!W` 18.27.090(13).
0 Licensed architect, engineer, electrician or plumber. All work performed under this
permit will be performed by an architect, civil or professional engineer, licensed electrician
or licensed plumber operating within the scope of his or -her license. RCW 18.27.090(14).
13 General Contractor. The owner is the General Contractor for the project and is required
to hire a minimum of two licensed subcontractors (unrelated building trades or crafts). The
general contractor is responsible to verify all State licenses of subcontractor. RCW`
18.27.010
THE UNDERSIGNED PROPERTY OWNER HEREBY VERIFIES THAT ALL
INFORMATION PROVIDED ON THIS FORM IS TRUE AND ACCURATE TO TIRE BEST OF HIS
OR HER KNOWLEDGE AND ACKNOWLEDGES THAT IF ANY OF THE INFORMATION
PROVIDED ON TEIS FORM IS FALSE, HE OR SHE UNDERSTANDS THAT THE BUILDING
PERMIT WILL BE IMMEDIATELY REVOKED AND ALL FEES PAID FORFEITED.
Dated this QE; day of 4 , 20 C>
PROPERTY OWNER/PERM1TTEE
WITNESS:
A
LA7EMP\BU1LD1NG\F0RMS\c=W cmunctor mos wrif fWmdoc03tn/01
Critical Areas Checklist CA File NO: 0 Z-7-q
Site Information (soils/ topography/hydrology/vegetation)
1. Site Address/ Location: --'24//p 3 to 1:5*1— ALI-E. Ul
2. Property Tax Account Number: goo
3. Approximate'. Site Size (acres -or squ;eTeet): 6 XV 7
4. Is this site currently developed? no.
Z yes;
If yes; how is site developed? 1,3 -7 PAl Alc F7
5. Describe the general site topography. . �tffihat apply.
Flat: less than 5-feet elevatibA Wver entire site.
Rollin : slones on site erallv e;s*t'h - a. vertical rise of 10-feet over a horizontal
%
distance of 664;e%�It� OW
U 20 - dkh�
Hilly: slop�s present on site of Wthan!15
'o 66
over a horizontal distance of "W
Steep: grades of greater than 30% present
distance of less than 33-feet).
30% ( a vertical rise of 10-feet
Other (please describe): if �F^ -
44WOE
7
6. Site contains areas of year-round standing water: Approx. Dep
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.
over a horizontal
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 (lawnshrubs etc)
11. Obvious wetland is present on site:
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Critical Areas Checklist.doc/3.19.2001
-.1. 10'
City of Edmonds
Development Service.sPepartment-
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
Date Received: Co - 0 Q
Cit e t
. . _y Rec i pt. #:
Critical Areas File, #:
Critical Areas Checklist Fee: $45.00
Date M ailed to ADDlicant:
The Critical Areas Checklist contained on this form is to, A property
,owner, or his/her authorized representative,.,
be filled out by any person preparing a Development'.2' must fi ,
,Wl ut the checklist, sig'n and 6te it, and submit it
0 ,
Permit Application for the City of Edmonds prior to, to 4. Jbe City will review the checklist, make a
his/her submittal of the application to the City. visit, and make a determination of the
The purpose of the Checklist is to enable City s
determine whether any potential Critical Are
po'enua' '_
may be, present on the subject property.
i
needed to complete the Ch#eckdli�t h
available from observations of the d ail
City Hall (Critical ar mapA%
eas
surveys)..
qup6tKeps�necessary'to complete a development
s a vicinity map, along with the signed copy
1. to assist City staff in finding and locating the
ecific ppieice of,property described on this form. In
Ic
t
'JXdcitlion, 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 appli Wi%fflits heirs, andassigns, in consideration I on the processing of the application agrees
to release, indemnify, *d� 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
incomplete information furnished by the applicant, his/her/its agents or employees.
By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file s application on the behalf of the owner as listed below.
SIGNATURE OF'APPLIcANT/AGENT
.2 DATE
V
Property Owner's Authorization
By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
Owner/A plicant:,
p
Name
DATE _k 0
Ti*cant'Representative:
pp
a J 4
Name
7-
Street Address Street Address
WA
City State Zip city State Zip
Telephone: _c_3kQC -3 - 'S-\ Telephone: 74,
I
Email address (optional): sc,,\,rCp) p,�\. -.,Email Address (optional): 1Q0 0,qo_,'00Ab17,_1W4 t?ow
Critical Areas Checklist.doc/3.19.2001
'24103
101st ave.west
Richmond Park Homes
"TREO"'
AL'
/00-r� 14 V6. w
roposud
A
rag
1:
- �f t
F, R rT
RECEIVED
FEB G 8 2r'!
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
LOT COVERAGE
LOT AREA
10647 sq.ft.
1
Z"
opos
Tax account parcel
#
L
r
2k8q.
ft.
00555000002400
6p, 141�11
44
LOT SLOPE:
1371 sq.ft.
res idenc,
existin residence
gistin
'FCAU
LTMO!
prop. line
jF)(. CAR extend d.r.30 sq.ft.
307S
q010,
"
101st ave.west
=PV
Critical Areas Checklist CA File No: 0 2--?-q -
Site Information (soils/ topography/hydrology/vegetation)
al. Site Address/Location: Z11D 10 T_
2.
3.
4.
Property Tax Account Number: 00,
-_ :;e
Approximate Site Size (acres or squ
W54
I /a 6,V7 Z71
is this site currently developed r j yes; _ no.
If yes; how is site developed? 1.3 7 / 17 0 F-
5. Describe the general site topography.
Flat less than 5-feet ele,
9
0 7.
8.
Rolling: slopes on site
distance of 66-j
Hilly: slopes present on site of M
over a horizontal distance oi
Steep: grades of greater than 30%
distance of less than 33-feet)
Other (please describe):
apply.
wer entire site.
a vertical rise of 10-feet over a horizontal
than 15 S 30% a vertical rise of 10-feet
0 o616- t
sen ve 0-feet over a horizontal
Site contains areas of year-round standing water: Approx. Depth:' -
Site contains areas of seasonal standing water: ; Approx. Depth:
What season(s) of the year?
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:
Critical Areas Checklist.doc/3.19.2001
'C. I b-7-
City of Edmonds
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 s
determine whether any potential Critical Are I
may be, present on the subject property. ,lire
needed to complete the Chh#eckh��St, hn'
0 s 0�t
c 1� d
available from observations of the aill
City Hall (Critical ar ma
eas
surveys).
a SIX
rt*
Date Received: ';k - Co - 0 Q
City Receipt #: t U105E
Critical Areas File #:
Critical Areas Checklist Fee: $45.00
Date Mailed to ADDlicant:
A property owner, or his/her authorized representative,
must,W1 ut the checklist, sign and date it, and submit it
to z e "y will make a
t' and of the
C
visl
Nqu t*. eps necessary opment
i p along with the signed copy
ta i in riding and locating the
s Pb 0
oa v'c nir
t assist C
s
I"
Pecific piece of property descri ed n 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 appli Wis/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, 10 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
incomplete 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 application on the behalf of the owner as listed below.
SIGNATURE OF APPLIcANT/AGENT DATE
Property Owner's Authorization
By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendantto this application.
SIGNATURE OF
OwneF/Appficant:
Name
\QAS::� k�aQ- \A1
Street Address
-E \,,. , �, \4 N --F�,-7 � C)
city State zip
DATE \ .
Applicant Representative:
;4� ZF 4 4 a pe
Name 9
J 016 7- 195��eO,
Street Address
city State ZIP
Telephone: 'c->� , - !S Telephone: 1>�e 4P
Email address (optional): Alf .
mail Address (optional): Rop 64y-,'P,4/�,4�4 1 60
Critical Areas Checklist.doc/3.19.2001
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PERMIT EXPIRES
sessions
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CITY OF EDMONDS NUMBER 6C4::�141
CONSTRUCTION PERMIT APPLICATION: SUITEtAPT#
ADDRESS -7 r
OWNER NAME/NAME OF BUSINESS
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MAILING ADDRESS LID FEE$
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Aw is
V '7' Av lr�5 Street Use Pennh
CITY ZIP TELEPHONE EXISTING — PROPOSED inspection Required
Sidewalk Reclutrad
;> Undergmund
,6 g __ q�2 .16 -,?Z REQUIRED DEDICATION— FT
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NAME C METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIR:K z
YES 13 NO
ADDRESS REMARKS z
x OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
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VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND
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0 GRADING I =4
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Fri REMARKS �.i I
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0 DEMOLISH 0 TANK OTHER VN1tqG 6 . WL�
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(rYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: CHECKED BY I TYPE OF CONSTRUCTION OCCUPANT
FE I IOU
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NUMBEFV NUMBEI(OF CRITICAL
OF DWELLING AREAS SPECIAL INSPECTOR AREA OCCUPANT
STORIES UNITS NUMBE REQUIRED 0 YES LOAD
DESCRIBE WORK TO -BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REO'D
Aj
v
V
4
VALLIATION $ 'P0220�;L W119__
Description FEE Description FEE
Plan Check 7to 1
HF,A,TSOURCE GLAZING %
LOT SL Building
PLAN CHECK NO: -z u4 VESTED DATE Plumbing
Mechanical
Tmis PERurr AUTHORIZES ONLY THE WORK NOTED. THIS PERurr COVERS WORK TO
BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC
2 Grading
DOMAIN (CURBS, SIDEWALKS, DRiVEWAM MARQUEES, ETC.) WILL REQUIRE Recording Fee
SEPARATE PERMISSION. Engr. Review City Surcharge
PERmrrAPpLjcATiom isoDmi
AL PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Traffic Mitigabon Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF:
a EDMONDS, WASHINGTON, ITS OFFICIAL% EMPLOYEES, AND AGENTS FROM ANY AND Fire Review Receipt #
IALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
!3 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF my CITY oAotNANcE Fire Inspection Total Arnount Due 41CA
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
x Landsc r ape Insp. Receipt #
I 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 Isnot 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'S COMPENSATION INSURANCE AND RCW 18.27.
OF*IALS SIGNATURE DATV
SIG TURE (OWNFR OR ;fiENn) DATE SIGNED (425) /�&y
I ;?. � - I wal6c, 1
771-0220 IRE By DATE
ATTENTIdN EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 771-0221
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 ORIGINAL -FILE - YELLOW- INSPECTOR
10/01 FAX PINK - OWNER - GOLD - ASSESSOR
"')FTE RECEIVED
5,j
L5 0? IT WIRES
FERM
P
USE PERMIT
CITY OF EDMONDS ZONE NUMBER
CONSTRUCTION PERMIT APPLICATION JOB
ADDRESS
OWNER NAMVK49E OF BUBINE8',
Q44nf( dhak
, A %AT NOVAFJSUBDP41SION NO. LOT NO. UD NO.
LID FEE $
MAILING 0ORM ?W TEMW Approvad
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW F0 PA*drod
gJ4103— /01-57- 0.) Sod Un Pom* Rwffl
Cnry z'P ITELEPHONE I EXISTING — PROPOSED rAqum I
REQUIRED DEDICATION_ Fr yr4KW&jnd
edtv#05; 07 0 yu - 50 z - &91??, wwq A 13
NAME METER SUE LINE SIZE I NO. OF FWUREB PRV REQUIR%D
YES 13 NO
ADDRESS REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLJORAINAGE
CITY ZAP TELEPHONE 113 "WORN I JR!% D I G) GRO r- WtJ rl NA L_
NAME
REVI
ENOPEERIK k1m BY DATE
0 1-
ADDRESS
FIRE- REVIEWED BY DATE
CITY TELEPHONE
mmoict. Do,
SHORELINE OR AD
INSPECTION
BOND
POSTED
TE F"ECKI
STATE LICENSE NUMBER EXPIRATION m By
$
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13 COMMERCIAL
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t: BE DOW ON PRIVATE PROPERTY ONILX ANY OONSTRUCTION ON THE PUBLIC
2
Gmding
3 DORM (CURBS. SIDEWALK% DRIVEWAY% MARQUEM ETC4 WILL REQUIRE
SEPARATEPERMISSION.
Engr. Review
"5-
PERAUTAPPLICATION: 190DAYS
Engr. Inspection
06 PMUW LIMM I YEAR - PROVIDED WORK 18 grrARMD WITHIN 180CAYS
SEE BACK OF POK PERMIT FOR MORE INFOPJAATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTERES'r. AGREES TO INDEMN" DEFEND AND HOLD HARMLESB THE CITY OF
EDMONDS. WASHINGTON. ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
Fire Inspection
Receipt # X92.6
ALL CLAIM FOR DAMAGES OF WHATEVER NATURE ARISING Dw=w OR iNDIREfrLy
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF T106 PERMIT SHALL NOT BE
DEEMED TO MODIF% WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Be"
La . nd Insp.
Total AmL [)us KQb
NOR LIMIT IN ANY WAY THE CIT" ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee
Receipt 0
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
OMEN 0 CORRECr AND THAT I AM THE OWNEP, OR THE DULY X)THORIZED AGENT OF
APPLICA FA_PPfi0V_A_L
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
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TIOK AND 01 DOING THE WO )RIZED THEREBY. NO PERSON WILL BE EMPLOYED
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IN VIOLATIO N OF THE ME OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
BWWbV OftW or NOw DVW: and F*n we pold, XxI
WOW Is admawledged In spece puMed.
WORKMENS COMPENSK AND ROW 16.27.
'j
I
(425)
0 DATE
8 SIGNATURE
WAY
771-W20
WREEMAS!
ATTENTIM -V
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A I;ERTIFI.
CATE OF OCCUPANCY HAS BEEN GRANTED. LIBC SECTION 109
ORII�I YELLOW - INSPEc16
��&Rl
PINK. GOLD -ASSESSOR
04102
PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACOOUunNu
ZE ;EC EIVED
PER.mrr r;KPIRE6
CITY OF EDMONDS
us E. PERMIT
ZONE
NUMBER
CONSTRUCTION PERMITAPPUCATION
JOB SUITEIAPT*
ADDRESS
W
OWNER NA MMWE OF 04MM
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METERiIZE:
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ADDRESS
REMARKS
OWNERICONMCTOR RESPONSIBLE FOR EROSION CONTROIAMNAGE
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CITY ZIP
TELEPHONE
NAME
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ENGINEERING . REVIEWED/DATE
ADDRESS
k
FIRE REVIEWED By DATE
CFTY ZIP
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STATE LICOW NUMBER EXPIRATION DATE
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..
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NUMBER
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SPECIAL INSPECTOR
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REMARKS,
PROGRESS INSPECTIONS PER UBC 10WRNAL-INSPECnON.RECM'
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n
FEE
Doomption"
"FEE
Plan Cheri
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PLAN CHECK NO: VESTED DATE pil
umbing,
Mechanical.
WOMOUPOWAMPROMUYOMXAWCOMMMMON-ONTMPUMC'
DOWN MUM% SIDEWALTW DRIVEWAVS, WkRQUEM ffFC4 WILL REQUIRE Grading Recording Fee
SEPARATEPER111.118101L.
Engr. Review
P1111MMAPPLWATea 60.� Ctty.84fchargs.
PEAW LIMM I VIM -t 6pkOVID1oWOffiK IS 111TARTED.1111THIM In DAYS .000,
t.-.-ttL--4WBI*M(WgW.P=WfongDWWMIWATICO, 8418Surcharge
'APPLICANX ON.BEHALP OF HIS OR HER SPOUIK HEIRS. ABSKIN Traffi M111006n Plan Chk Deposit
IN , . 6 AM SUCCE8086 C 02
WFEMEIrr. AGREES TO INQEMNIF% DEFEND -AND HOLD HARMLESS THE CITY OF -
EDmONDS-wASH*4roN- n9OFFOAS-EMKOVEMANDAGENTSFROm ANYAND' 'Fire Re 'view Pt
ALL C1,A1MB FOR ES OF WHATEVER NATURE, ARISING OIRECTIY OR INDIR[ECTLY Recel
RMIr ISSUANCE OF.THIS PERMIT SHAM NOT 13E
REQumEmw OF ANY CITY oRDwANcE Fire Inspection Total Amount D6e
ENFORCE AW ORDINANCE PROVISION'
Landscape insp. Recelpt III
I-HERESVI THAT I HAVE READ-THIR APPLJCXTKft- THAr-THE INFOFMATION
.GIVEN. THAT I AM THE OWNER OR THE DIXY. AITIMORIZED MEW OF, APPUCATION APPROVAL
THE 4Z= To COUPW WPM CITY AND STA7E LAWS REGuLATING coNMUC- - , . w . d
TiON; AND IN DOM US WORK AUTHORIZED THEREfff, NO PERSON WILL BE EMKOYED - ZALL TW @PObftn Is not a Pmm wd dor by 'he
BWWQ O"W Or hWher Dqkft; end Fen we peld. wW
IN VIOLATION OF THE LABOR. CODE OF THE STATE OF WASHINGTON RELATING To FOA INSPECTION rewWIsa*wwWQodw*p=
WO"E" COMPENSK _jLWURANCE prowed.
TION AND RCW 1827.
OF � So
RE I OVRE DATE SIGNED ItIJONATURE DA
(425)
771 i-0220 REMASED BY 7-1- M-Ai�
AM"Oh v
M 1333
IT Is UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL jY7J
A'FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CgRTA- '771-6221:
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 ORIGINAL YEwmf - idipEcrro'R
FAX PIN.K-;:V- GOLD-ASSEBBOR
* Permit No: IV _40F
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION PERMIT -Issue Date:
A:- Address or Vicinity of Construction: 1�4103 1 o I eSr
B. Type of Work (be specific):
C. Contractor: I lmmm-i-1 - PIURA" Contact: lAtd W. S44ou&,
Mailing Address LqwKwaod Phone: J-11S -7-715 3)1�Lwr
State,Li66nse #: �N�m P-gZ.- 0 'M Lb .Liability Insurance: Bond: $
D. Bu,ildiifg,Permit # (if applicable): Cft71_2-e" Side Sewer Permit # (if applicable):
E. n Commercial EJ Subdivision [:1 City Projec"t E:1 EUC (PUD, VERIZON, PSE, AT& T, OVWD)
Multi -Family XL Single Family 'Other
INSPECTOR:
T
F. PAVEMENT CUT: El YES NO G. SIZE OF CUT X
CONCRETE CUT: El YES tO
V
IND EM1#TY. K , '.,4 Ipplivant understgn"ds by h ' is/her signature to this application helshe holds the City of Edmonds harmless from
. . 1. A i b�. any kiq'4-1�rl �escription whatsoever, foreseen or unforeseen, that may be made against the City -of
injuries, -hamag& or cl�Kml
Edmon& or any ofits,departments A;�ployees, including but not limited tothe defi�nse of any legal proceedings including defense
costs anaAtor_ni�yees byreason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MAJERJALS.FOR A PERIOD OF ONE YEAR FOLLOW[NG THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES KILL BE HELD UNTIL THE FINAL STREET PATCH IS
COMPLETED BYCITYFORCES, AT WHICWTIMEA DEBITOR CREDIT 9ILL BEPR6CESSED FOR ISSUANCE TO THEAPPLICANT,
Traffic control and public safety shall be in accordanc*Pkiwith City regulations as required by4he City Enginee�. Every
flagger muist be , trained as required 'by (WAC) 296-155-k5*and must have certification verifying completion of the
require4lirainingl in their possession.
Restoratioj� is"to be in accordance with City codes. All street -cut trench work shall be patched with asphalt or City -
approved material prior to the end of the workday - NO EXCEPTIONS.
Three sets of construction drawings of proposed work are required with the permit.application.
CALL"DIAL-A-DIG (1-900-424-5555) PRIOR TO BEGIN.NING WORK ---
IRAVEREAD THE ABOVE STATEMENTS AND UNDERSTAND THE -PERMIT -REQUIREMENTS AND ACKNOWLEDGE
THATIMUSTMAKE THEPINK COPYOF THEPERMITAVAILABLE ON SITE A TALt-TIMES FOR INSPECTIONS
Signature: Date: 0 ;1,
(Contractor or ARent)
Approved by:
Time Authorized: Void After t-YFIFr< 1) /v.
Special Conditions: nV(LA,A1'1/ �
y
Right-of-wayFee:
Disruption Fee/Fund 111:
Re storation Fee:
To6l Fee,:'�'. -75`�'
Receipt, No:
Issued bv*, zw�,/Lll
UPON COMPLETION OF PERMITTED WORK, AN ENqINEERING FINAL
INSPECTION IS REQUIRED PER CHAPTER-18.00 OF THE EDMONDS
COMMUNITY DEVELOPMENT 'CODE (Phone 425-771-02.20, Ext. 1326)
FINAL APPROVAL OF PERMITTED WORK.- - F1.1rn DATE: 40 103
Inspector's Signature
For
equirements see Engineering Inspe,
IZK SHALL lll,(;IN 111Z101ZT0 11t
�D:\My Documents\Forms\Engrtmg\ROWpermit Am