413 12TH PL N.PDF1111111111
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413 12TH PL N
ID:
Critical Areas ATAM
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Review Number:
t
Date Received:
Applicant:
fLonroe, James & Dorothy
Bldg Number:
1413
Street Name:
Suffix:
Dir: IN suite:
Int?.
El Streets:
PLANNING DATA
NAME: DATE:
SITE A DRESS: .4 13 - t2-` ft. IV, PLANCHK#: OZ-t'Zo
PROJECT DESCRIPTION:.
r"tau I (" 2-
REDUCED SITE PLAN PROVIDED?: (Y—�' � (k -/ 7,,
MAP PAGE: 2�04 CORNER LOT: (Yes / No FLAG LOT: (Yes No
ZONING: f-5-12- CRITICAL AREAS DETERMINATIONM le- 95'
U Study Required:
Waiver
Conditional Waiver
SEPA DETERMINATION:
0 Fee
U Checklist
L3APO list w/ notarized form
(Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger)
Exempt
SETBACKS:
Required Setbacks:
Street: IS' Left Side: 10' Right Side: 10' Rear: 2��'
Actual Setbacks: t. &"-
Street: 23,5 LeftSide: 17' Right Side: 14, Rear: 66'
Street map chocked for additional setback required? (Yes / No DN
U DETACHED STRUCTURES:
LJ ROCKERIES: V-,
13 FENCES/TRELLISES:
L3 BAY WINDOWS / PROJECTING MODULATION:
U STAIRS/ DECKS: 0 t,
PARKING: Required: VC Actual:
LOT AREA: 157Z-
BUILDING HEIGHT:
Datum Point:- IV A Datum Elevation:
Maximum Allowed: Actual Height:
A.D.U. CREATED?: (No / Yes Aj4
SUBDIVISION:
LEGAL NONCONFORMING LAND USE DE TERMINATION ISSUED: ffes lj&)
OTHER:
Plan Review By:
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RECEIVED
SENT BY: 3-18-BO ;11:00AM CITY OF EDMONDS-s ;# 7
MAR 2 4 1998
CAPILE IMA04-COUKEF
Critical Areas Chec'klist
------- ---------------------------------------- ---------------
Site Information (soils/topography/hydrology/vegetation)/-
I - - Site Address/Location- U-i --4 / -, , - - N 0-1-1,
2. Property Tax Account Number- 17 0 '1 a - 0 0- 0 - U Q Q
3. Approximate Site Size (acres or square feet): 1 x -1 0
4. Is this site currently developed? yes; _no.
If yes*�;* how is site developed?
S. 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 verfleal rise of I Meet over a
horizontal distance of 66-feet).
Hilly: 'slopes present on site of more than 15% and less than 309/9 ( a vertical rise of
I Meet over a horizontal distance of 33 to 664et).
Steep: grades of greater than 30% present on site (a verdral rise of 10-feet over a
horizontal distance of less than 33-feet).
Other (please desonI)e):
6. Site contains areas of year-round s=dingwaier: Approx. Npth:
7. Site contains areas of seasonal standina water: 0 Approx. Depth:
What season(s) of the year?
8. Site is in the floodway h�,� floodplain_ of a water co '"So.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? ty-O., Flows are seasonal? _ (What time of year?
10. Site isprimarily: forested meadcyw shrubs mixed
urban landscaped (lawn,shrubs etc) ' X
11, Obviou wetl4nd is present on site: fv--
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SENT BY:
; 3-18-98 ;10:59AM ; CITY OF EDMONDS-*
;# 6
City of Edmonds
CRITICAL AREAS CHECKLIST
The Critic.al 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 hiAer submittal of a development
permit to the City.
'ne ptupose of the Checklist is to enable City a I taff to
determine whether any potential Critical Arm are, Or
=y be, Present an the subject property. The
Information needed * to complete the Checklist should
be easily available from observations of the site or
data amfflable at City Hall (Critical Areas inv=tories,
maps, or soil surveys),
An aPPlicant, or hi"er representati-ve, must flU ou,
tbb Checklist, sign and date J� and submit it to the
City- The City Will re'view the checklist, make a
Pre=sory site vWt, and make a determinadon of the
Subsequent St6ps necessary to complete a develo'pment
permit application.
?lease it a ':
SlIbm vicinity map along with the sline4_
COPY Of 0313 form to assist City stiff in finding and
locating the specific piece of property described on
this fann, In addition, the applicant shall include
other pertinerit information (e.g., site plan, topography
map, etc.) or studies in conjunction with this ChecUst
to assist staff in completing their prel"
iminmy
assessment of the site
I have completed the arached Critical Arm Checklist and attest that t1le answers provided are factual, to the
b"t Of mY ImOwledge (fill out the appropriate colurnia below).
Owner/Applicant:
kre�1121RA WA
3 91WIR
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@mw,PficnVaxAcao1.daa
Applicant Representative:
Nome
Street Address
city state zip
Telephone
Date
(over)
I"? C . 1 S () 13
April 6,1998
CITY OF EDMONDS
BARBARA FAHEY
MAYOR
121 STH AVENUE NORTH - EbMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221 ,
COMMUNITY SERVICES DEPARTMENT
Public Works - Planning/Building, 9 Parks and Recreation o Engineering * Wastewater Treatment Plant
James & Dorothy Monroe
41312 th Place North
Edmonds, WA 98020
Subject: Determination regarding Critical Areas Checklist # 98-85
Dear Applicant'
Enclosed please find a copy of the Critical Areas Checklist you submitted. The "DETERMINATION" reached by the City
is located on the reverse side of the form (bottom of page).
It is very important for you to retain a copy of this Critical Areas Checklist."DETERMINATION" for your records.
IMPORTANT INFORMATION TO BE NOTED.
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCHASAN ENVIRONMENTAL CHECKLIS OR REAS STUDY,
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
YOU must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.,
Permit applications include the following -
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Thank you.
Sharla Graham
Acting Planning Secretary
Enc: Critical Areas Determination
Architectural Design Board
C:Reception\Jana\CRLTR.doc
Incorporated August 11, 1890
Sister Cities International — Hekinan, Japan
APPLICATION
for
FILE
The City of Edmondo- SEDE SEWER PERNaT
EASEMENT No . ..........................................
NEW CONSTRUCTION E] REPAIRS E]
120-07500
OWNER............ ......................................................... CONTRACTOR ............................................................................................ ----- PERMIT No . ......................
ADDRESS ....... 41.3 12th Place N.
............................................................................................ LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
0
0
NAMEOF ADDITION .........................................................................................................................................
Dye Tested On Sewer 1972
Approved:
DATE................................................ By ......................................................................
APPLICATION CARD No . .......................................
for
The City of Edmonds T EET FILE SIDE SEWER FERNaT
�,R INSIDE EASEMENT No . ......................................
OUTSIDE Ej REPAIRS 0
OWNER ... .. ................ x t ...........................
------ CONTRACTOR 4 �4 ---- ..... 01 . ......... 1.i� ..................... ........ . PERMIT No.
STREET &r
HOUSE No*. -- — - — -------- ................................... AVENUE LOT No . ...... 40 ........................................................ BLQCK No . ..................... fu ---------------
All
NAME ADD . ....... 0_aoo.� .... P_A�� ............... �.040 ir ....................
k-
'APPROVED
OCT 2- 1866
- - -- -------
Date Approved:
w
10-- r -" _�- 0
Z) Aj S- �;7 c.-i C:�
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ .............................................
C=; —
SEWER WORK ORDER ISSUED .......................................... DATE ..... gr?� ..... . ..................... 17... By ............................................................
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEWME OF BUSINESS
j a 11 if's H 01 t V oe,
MAILING ADDRESS A/ 12
CITY'1W
ZIP TELEPHONE
41) 6
NAME
P/A
ADDRESS
CITY ZIP FTEL7PHONi
NAME
bavc-I Kleuell I 'I C1Ker(,4'�k'rf)
ADDRESS
CITY TELEPHONE
L V/ b OJ zip q2-5 74 1 - ?Y�2,5-
STATE LICENSE NUMBER EXPIRATION DATE. Q
of . _2to /o2—
PROPERTY TAX ACCOUNT PARCEL NO.
000 C)I 0 00
W NEW _�RESIDENTIAL 0 PLUMBING / MECH
ADDITION 0 COMPLIANCE OR
OMMERCIAL CHANGE OF USE
0 REMODEL APARTMENT 0 SIGN
REPAIR GRADING CYOS 0 FENCE X FT)
[3 DEMOLISH 0 TANK 0 OTHER
o GARAGE RETAINING WALL
CARPORT . ROCKERY RENEWAL��:
UWE OF USE. BUSINESS OR AgTIVW4 MLAJN:
N BER I
�T LLI
NUMBER NUMBER OF CRITICAL. C/
DWE NC AREAS
STORIES UNITS NUMBER
OF DWELLING
10
0
DESCRIBkWORK TO BE DONE
wo
H FAT
GLAZING %,�� I LOT
PLAN CHECK NO- VESTED DATE
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, FTC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: 160 DAYS
IL PERMIT UMrP I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS.
IN INTEREST, AGREES TO INDEMNIFY, DEFEND� AND HOLD HARMLESS THE CITY. OF,
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROMANY AND.
IALL CLAIMS FOR DAMAGES OF WHATEVER NATUREi ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CRYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.*
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
THE OWNER * I AGREE TO COMPIY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE. OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATIONJOSIAMCE AND RCW 18.27. 1 .
DATE SIGNED
.4,(-
1 9 - ev
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCU,PANCY HAS BEEN GRANTED. UBC SECTION 109
10/01
:A
�'PERMITUPIRES
Us PERMIT av --p-
ZONE NUMdiR k0j
JOB UITE/APT#
ADDRESS A
New A)
PLAT NAME/SUBDIVISION No. LOT NO. LID NO.
I LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP jeSCP Approved
RW Permit Required
SUM Use Permit "
EXISTING PROPOSED inspection Required
Sidewalk Required
REQUIRED DEDICATION— Fr Ur4arground
Wiring required
METER SIZE LINE SIZE OF FIXTURES PRV REQUIRED
YES E:1 NO 13
REMARKS Z
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE Z
REVIEWED/DATE
FIRE REVIEWED BY DATE
ir
VARIANCE OR CU
SHORELINE OR ADB#
INSPECTION
BOND
REO'D
POSTED
.....
[3YES 1214-0
SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWED PROPOSED
__XP ",000"e.
,
LOT COVERAGE
REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS (Fr.)
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT UR SIDE REAR
57-7 /V4
2-51
1�/
73 14
Z
PARKING
LOT AREA'
PLANNING REVIEWED BY DATE
REO'D I PROVIDED
A -
I
1
L IV(_
17- 1&0
,
+/.0,
REMARKS
CHECKED BY ITYPE : =R
/PT 'OCCUPANT
GROUP
SPECIAL INSPECTOR rREA OCCUPANT
REOU IRED [:] YES LOAD
REMARKS I
PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D
0
VAWATION $
.. FEE .. 1, Description I FEE
Plan Check
Building
Plumbing
Mechanical
Grading
Recording Fee
Engr. Review
City Surcharge
Engr. Inspection
State Surcharge
Traffic Mitigation
Plan Chk Deposit
Fire Review
Receipt #
Ar -_3 v
Fire Ins pection
Total Amount Due
Landscapainsp.
Receipt #
APPLICATION APPROVAL'.
CALL
This application Is not a permit until signed by the
Building Official or his/her Deputy: and Fees are paid, and
FOR INSPECTION
A reCelpt"aCknovAedged In space provided.
OFF DATE
A[Ai� SIGNATURE
1A0
/77
771 %
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EXT 133
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