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24132 106TH PL W.PDFiiiiiiiiii 428 24132 106TH PL W ADDRESS: TAX ACCOUNT/PARCEL NLTM13ER: BUILDING PERMIT (NEW STRUCTURE): COVENANTS (RECORDED) FOR: CRITICAL AREAS: 4�� —,!? o3 — DETERMINATION: [:1 Conditional Waiver [] Study Required [Z�eaiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED PERMITS (OTHER): PLANNING DATA CHECKLIST DATED SCALED PLOT PLAN DATED: x/AZ SEWER LID FEE $: LID #: SHORT PLAT FILE: LOT: BLOCK: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: SOILS REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: WATER METER TAP CARD DATED: OTHER: LATEMPOSTsTonnAStreet File Checklist.doc PLANNING DATA NAME: AIA, I Mickde khn�it--qrj DATE: q /1q /0 q SITEADDRESS: a'413X WM 01'Lce . wtiz — ' PLAN CHK#: 0 - to -- —T0,rKrQ— CAJ'J�,"�-ff- 'M PROJECT DESCRIPTION: ko' Y- X5' C 50LI 5-�) jVejrdj),--, A_GT 5 L-, - REDUCED SITE PLAN PROVIDED?: MAP PAGE: 003 CORNER LOT: FLAG LOT: ZONING: CRITICAL AREAS DETERMINATION M. 0 q Ll Studv Reauired: Waiver Conditional Waiver SEPA DETERMINATION: Ll Fee 13 Checklist L3APO list w/ notarized form (Needed for 500 cubic yards of grading, Shorell no Area- site within 200 ft. of Puget Sound or Lake Ballinger) Exempt SETBACKS: Required Setbacks:/ -7, 5 " Street- Left Side: 'f�l!h 7.5 Rear: . LSl�e: Actual Setbacks: e - . 11 1— Y Street: Left Side:7- Right Side: tear: d" Street map chocked for additional setback required? (Yes I No DNA DETACHED STRUCTURES: 0 V - v41--E '&'rdj?qtd ROCKERIES: 0 V - N4 pliaf c� r- d FENCES/TRELLISES: f all BAY WINDOWS / PROJECTING MODULATION: STAIRS / DECKS: A4,-� 0, � - PARKING: Required:P/A Actual:/V# - Nd—, --PF'J LOT AREA- q q 5"o 5 F LOT COVEkAur-': C Calculations: )qq1q'q56 = A�0/0 % qllollf- 0,K, BUILDING HEIGHT - Datum Pol�t: 0 0, 0 - too, dP' � 0 � Datum Elevation: 100-0 Maximum Aflowed: 9L- Actual Height: 1q, 5 / - A.D. U. CREATED?;((No) Yes) Wd(od-- I 6-T�f(;d, 0A dl- -rK5 LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: OTHER: t I R SeTL�� '-ewr4 V^1� " S�Je SaLcg) '/' ex; T-1-7 1'rrvc-iVrf cArp I P&,, I I., irA— - — I PlanReviewBir �� 6-cA NewBPPIanningDataFormD0C v fl�A c �'X'! t:�! 5- V�i A rl[)l -,"'N 50 FIT 2 0'/ -'! /e4 5- 0 Tlo TOTAL IMPERI�,OCL 15 r I -, -1 L�; CALC. 1;11 :LLDIN I ; �U - - -1 IG 5 TIR CTUIRE5 A,5 N"--"'T:-:D A50VF= DRIVEI,AAY AF',EA= 350 5Q. FT. I 50iO TC�AIL iMPERVIOU-5 ARfA= 2444 SQ. F7. m il�f; !6 AURM 251-04 ALL EXPOSED SURFACES TO --- — ------------ BE COVERED WITHIN 2 WS ROPOSEE DITION GUUMSDOWNWWlb o CONNECT TO SM. SYST LA- LU LU cr. SITE PLAN L 934 SCAM 'I ff 0 W-W MOAL MSCIUMON 44' APMVED BY PLANNINU �/jj lo q 5NICE cr C., ,Z6-0�1 WA75> Mff r i a Q�- ,K* t" - w 3: Receiver) MAR 2. 9 2Wj a, PERMIT ColjNTEI, APPROVED AS NOTED v -4-- %=er-t -f V� 17, —t- A- D R E S- S Ll C, Cit-*, 4 S Q- E 24132 106t-� Plac-a 'Aj- *�BIYEJNGEERING WA Dab: Iti �171 FILE CMM/OaN I rA'. i i6 REMSME IKA'sTREET EROSION M.) DRAWAGE r -A OV ED& OL City of Edmonds Development Services Deiartment Planning Division Phone: 425.771.0220 40c. I %91� 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 subm ittal 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 inventories, maps, or soil surveys). ,Date.,Receiv,ed: U4�ZQ��L-��>ZQVOV City '. R , eceipt#.: �2_75U IT Critical Areas File M Areas Checklist Fee: $135.00 Critical 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, inden ' inify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable attorney's fees, anising 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 this 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. SIGNATURE OF OWNER DATE Owner/Applicant: Alarl Acke le- /� //,�n Name ------PLEASE PRINT CLEARLY Applicant Representative: Name Z q 13 7- Street Address Address 'C' c� V), o Ad .3 co 4- 9 5oz 0 City State zip - city State zip Telephone: 2o(, 53 3 -,59 21 Telephone: Email address (opt ional): Qrn Email Address (optional): Critical Areas Check] ist.doc/4.22.2003 CA File No: Critical Areas Checklist Site Information (soils/ topograph y/hydrology/vege.tation) 1. Site Address/ Location: 2_q1*5Z loc, ,A - P/. U-) 3. ?gtzo 2. Property Tax Account Number: 0 Ibb oo-L 0 1 C1 00 15(00 m 1 0 1,1 00 C) 3. Approximate Site Size (acres or squ are feet): V 5- 6 -s (::4 4.. Is this site currently.developed? � yes; no. If yes; how is site developed? Pe 5 I'dkolo 4, .5. Describe.the generalsite topography. Check all that apply. Flat: less than 5-feet elevation change over entire site. Rolling: slopes on site generall . y less than 15% (a vertical rise of 10-feet over a horizontal distance of 6.6-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: /164- 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? 6/,4 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 onsite: i Llf 1. 2. 3. 4. — ------ - For City Sta.ff Use. Only Plan Check Number, if applicable? Site is Zone d? SCS mapped s ,r_ 1 1 ­14 _�Dzn 1 Critical Areas inventory or C.A. map indicates Critical Area on site? t\_� 0 5. Site within designated earth subsidence landslide haz_ardai6a?.6,'),0+ �,S�a g - C4 C-1, 4 DETERMINATION STUDY REQUIRED I. Reviewed WArVER Critical Areas Check] ist.ddc/4.22.2003 1 ")Vr DULD�NG 5Q. L U D I N C, i ST. H 0 U 5 ff. 5 h. t= I'D - N IfW A () D I T 10 N -"U SQ. im-1f, 20e4 /9450= . �- 9 : .. . Z. --T TOTAL UPERVIOU5 CALC. DUILDING STRUCT URf5 AS NOTED AbOVE=20e4 SQ. f7. DRIVEWAY AREA= 350 SQ. f7. D�15TING NEW IMPERVIOUS= 500 SQ. F-T, TOTAL IMPERVIOU5 AREA= 2444 SQ. f7. B Lu T Z0 APPROVED BY PLANNING Von aj4l— q11 mo y W(Dpr\ 5h0p NORM alsi RZ51 [ )EN CE 5 i �-(Dli 2 5-0" 24 -0' 3 5-0" LL EXPOSED SURFACES TO E COVERED WITHIN 2 DAYSbi GUTTERS/DOWNSPOUTS ROPOSED DDITION 0 CONNECT TO EXIST. SYST.1 �Dj F= 1= I Uj LM -_j 0 CM 'C'-'-3' S I T E P LA N < :Z SCALE: I I' = 20'-Ovv LEGAL DESCRIPTION 0 C1 C-) —. C'i; CO 00.2- La- SEE ATTAC"HED APPROVED AS NOTED BY ENGINEERING SITE ADDRESS: 24132 106th Place W. Edmonds, WA Date: Zu. h-.1 " WATER M ffr ff R RECEIVED 6w 1 MAR 219 2004 PERMIT COUNTER r= st -0 �Mt �O'O - C�) AU0C RAY-, - F, MQ*— tAi AM- C?,JNER/C0?4TF-',A,rJG'R IS RESPQNSKE FQ9 t JL AL E9080 Cv.)ZIRUL AM) DRY49.AZE CITY CO'Pv CA File No Critical Areas Checklist Site Information (soils/ topography/hydrolo '/vegetation) gy 1. Site Address/Location: .2-cli 3, Z- le)(- A P/. U). ft bZ0 2. Property Tax Account Number: 0 0 00'L 0 19 00 1509 MI 0 1 Cl oo C) 3. Approximate Site Size'!(acres or squi are feet): 9 V5 �!s? 4.. Is this site curr . entlydeveloped? yes; no. if yes;how is site developed? e 5 .5. Describe. the general site topography, Check all that apply. Flat less than 5-fe'et elevation change over entire site. Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal distance of 6646�1:)., 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 contgns areas of year-round standing water: A Approx. Depth: 7. Site contains areas of seasonal standing water: Approx. Depth: What season(s) of the year? 8. Site is.in the floodway flolodplain of a water course. 9., Site contains a creek or an area where water flows acr6ss the grounds surface? Flows are year-round? 1A 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 onsite: :j L./f For City Staff Use Only 1. Plan Check Number, if applicable? 2. Site is Zoned? I SCS mapped soff type(s)?)_-7-1 I 'NA 1 \1 r", C-) — 4. Critical Areas inventory or C.A. map indicates Critical Area on site? 5. Site within' designited earth subsidence landslide haiaird'ai&? U4 0 r rkn I r I I-- IV2 .9 4 DETERMINATION StiUDYREOLTIRED. WArVER .. Reviewed V� Critical Areas Checklist.ddc/4.22.2003 City of Edmonds Development Services Department Planning Division Phone: 425.771.'0220 1pays Qr% mi ni,)i 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 inventories, maps, or so'il surveys). Pate, Received:'���—,�� City Receipt#: Critical Areas File M Critical -Aiea ' s Checkliit Fee:, Date'Maile"d Ito App1,ippnt:, A prope�� owner, 'or � his/her, authorized representative, must fill out the.checklist, sign and date it,.and subnidt it to.the City. The City will review,the che�klist, 'make a precursory site visif,'iand make a 'determination o . f the subsequent steps necessary to complete . a development permit application. Please submit a' vicinity map, alon .g with the signed copy I of this form to assist City staff in finding and 1�cating 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, indemnify, defend and hold the City of Edmonds harmless from any and all dami es, including reasonable 9 attorney's fees, anising from any action or infraction based in *whole or part upon false, misleading, inaccurate or incomplete information furnished by the applic.ant,.his/he���/its'agents or employees. By my signature, I certify that the information and exhibits herewith subrmitted are true'and correct to the best of my knowledge and that I am authorized to file this aipplication on the behalf of t:he owner.as listed below. SIGNATURE OF APPLIcANTIAGENT 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. SIGNATURE OF OWNER ��f DATE Owner/Applicant: Navi 0 IX�c ke le - Name \J Z 4 f 3 /C>6"J, pt- . - U), Street Address r� 41 od 3 CL) aa-0 city State zip Applicant Rlepresentative:. Name Street Address city State zip Telephone: 2o r, 5-3 3 -8� 9 2 Telephone: Email address (optional): Ool AZt,*104--5woe7w Email Add ress (optional): '2-a, 4. /Z Critical Areas Checklist.doe/4.22.2003