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City of Edmonds
Critical Areas Checklist
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 potent * ial
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 I 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
of the parcel with enough detail that City
staff can find and identify the subject
parcel(s). In addition, the -applicant is
encouraged to include any other pertinent
information 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:
Jvl'cr" J—.. sandeks
Narne
Title
4� 12 jV-07 A ve. N.
Street Address
EJ n o7n 9e o �;4' o
City, State, ZIP Phone
'771
SignaKue Z.4
Date
Applicant Representative:
Name
Title
Street Address
City, State, ZIP Phone
Signature
Date
Critical Areas Checklist STREET.FILE
Site Information
ProjectName: two ca�- '!RL1�-,-jg_,,_PermitNudiber:
'J
Site Location: 4/,7 -th Pve, M Property Tax Account Number: AJIA703-19-nilq-000.2
Approximate Site Size (acres or square feet): -7g- 4
Have you filled out a Critical Areas Checklist for a project on this site before? No
General Site Conditions
1. Has the site been cleared or logged? NO Date of most recent action:
Soils / Topography
2.. In the Snohomish County Soil Survey, what is the mapped soil �ype(s)? q cA %,/ r-
3. Describe the general site topography. Check all that apply. J
X 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 of horizontal distance.)
Steep: grades of greater than 30% present on site.
Comments
HydrologyNegetation
4. Site contains areas of year-round standing water: N c�
5. Site contains areas of seasonal standing water: NO Approx. Depth:
6. Site is in the floodway No floodplain___L�o of a water course.
7. Site contains a creek or an � area where water flows across the grounds surface? Noflows
are year-round? Flows are seasonal?
.8. Site is primarily: forested meadow —; shrubs mixed K
9. Obvious wetiand is present on site: No
10. Wetland inventory or map indicates wetland present on site: N-
11. Critical Areas inventory or map indicates any Critical'Area on site: t4o
...........
------- ------- For� City Us
e Only — — ------ — - — ------------------- — ---- - — ----
STUDY REQUIRED: Critical areas study is required.
CONDITIONAL WAIVER: Critical areas study not required if specified conditions satisfied.
t—� WAIVER: Critical areas study is not required.
Determination Number. Reviewer ti/A Aa-
Planner I a Date
Rev 3/27/92
STREET F:iLE
A-L
S.W
OE:CEIVED
MAY 1 9 1992
PERMIT COUNTER
xv
,,,
V j(Z"
IP'
17Z
OF 'PZ /IN
Z.// 7
A ve- Al
4 /'o A
S* NW
c'cl I r-
M I
A,
#0�
STREET FILE �
RECEIVED
AUG 12. 1993
ERMIT COUNTER
WIMP101 60
APPROVED BY PLANNING
n v--J WTI. P-0
W
Critical Areas Checklist
S T �_�; E � 1 E it I L E RECEWED
Site Information,
AUG 12 1993
Project Name: -Ew ca.#- Permit Number:
V_'/ _J R
Site Location: 09ve M Property Tax Account Number: A'tA703 -_2 q- 0002
Approximate Site Size (acres or square feet): -zo4z
Have you filled out a Critical Areas Checklist for a project on this site before? No
General Site Conditions
1 -. Has the site been cleared or logged? 0 Date of most recent action:
Soils / Topography
2. In the Snohomish County Soil Survey, what is the mapped soil type(s)? CZ I-,-, � 1'r
3. Describe the general site topography. Check all that apply.
Flat: less than 5 feet elevation change over entire site.
--Aolling: 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 of horizontal distance.)
Steep: grades of greater than 30% present on site.
Comments
Hydrology/Vegetation
4. Site contains areas of year-round standing water: N6
5. Site contains areas of seasonal standing water: N o Approx. Depth:
6. Site is in the floodway No floodplain No of a water course.
7. Site contains a creek or an area where water flows across the grounds surface? No -flows
are year-round? Flows are seasonal?
8. Site is primarily: forested meadow ;shrubs mixed K
9. Obvious wetland is present on site: N o
.10.- WetlAnd inventory or map indicates wetland present on site: N'_'
-11. Critical Areas inventory or map indicates any Critical Area on site: - t4o
For City Use Only
STUDY REQUIRED: Critical areas study is required.
CbNDITIONAL WAIVER: Critical areas study not required if specified conditions satisfied.
WAIVER: Critical areas study is not required.
�7' ". — /
Determination Number. - (2"'� Reviewer (QA ft Zt-
4f Planner o.t*e
Rey 3/27/92
-CITY OFEDMONDS
Permit No. a!Z 30Y
COMMUNITY SERVICES DEPARTMENT
RIGHT -OF I -WAYC I ONSTRUCTION . PERMIT STREET FILEls-sue bate
Z
U
A. 9 Owner: A16 I le AIACI:�l 6&OAI B. 9 Contractor
N a mie',� 17 1/,', A
Mailing- Address J�J5 9A 2- 0
City State Zip
-77-5 - 5(ol-4H
4 4t
C. e Address or Vicinity of Consf cti�n.-
Type of Work to be D, n 0
P"
D. 0 Work in Connection with:)�' &]��S%��4�of` lat
0 Commercial
E. 9 Pavement Cut: El Y El N F. 0 Size of Cut:
APPLICANT TO READ AND SIGN
�0&bs CUimhe_
Ngne,(
0
Mailing Address
I,VVA)�(002> W01-10?
City State Zip
72-79-3/7-4
License Number Telephone Number
�( Single Family
0 Multifamily
— X
M 0 PJ
El City Projects
El Utility
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds
harmless from any injuries, damages,, or claim� of any kind or description,whatsbever, for,seen or unforseen, that may
be made against.the City of Ednionds, or any of its departments or employees, including or hot limited to the defense
of any legal proceedings including defense costs, court costs, and attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE
YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK.
Estimated restoration fees will-lbe,h'eld untilithe final street patch is completed by City forces, at which time a debit or credit will be
processed for issuance to the applicant.
• A 24 hour notice is required for inspection; Please call Engineering: 771-3202
• Work is' to be inspected during progress And a . t completio'n
• Restoration to be in accordance with City Code.
• Street to be kept clean at all times.
Traffic Control to be in accordance with City regulations.
All street -cut ditches must be patched with asphalt or City approved material prior to end of working day;
NO EXCEPTIONS.
I understand the above and fhat thisA5ermit must be available at the job site for inspection purposes at all times.
C
Signature:
or Contractor
Date: P�
This Permit Must be Posted at the Job Site For Inspection Purposes
Call DIAL -A -DIG Prior to Beginning Work
A-PPROVED BY: PERMIT FEE: 0 0
Time Authorized: Void after —days.
Special Conditions:
RELEASED BY:
Restoration Fee:
Receipt No.: Z063.5-
Fund I I I Fee:
Street Cut Dimensions:
Date Cc /a 7/& 9 INSPECTED BY
T---V-
Date
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
19. -1. 11.1
FIELD INSPECTION NOTES
(Fund I I I - Route copy to Street Dept..)
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION El YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By:
FINAL APPROVAL BY:
Date:
Eng. Div. July 1985
OLDS OLYMPIC INC.
C�NNWOOD OFFICE SEATTLE OFFICE
P.O. BOX 180 OPERATING OLYMPIC PAVING 3400 STONE WAY N.
6016 204TH S.W. HEATING OILS * ASPHALT PAVING SEATTLE, WA 98103
LYNNWOOD, WA 98036 632-0450
778-3124 HEATING & AIR CONDITIONING
PROPOSAL SUBMITTED TO
PHONE
E
Muriel Mackinnon
775-5644
5-17-89
STREET ADDRESS:
JOB LOCATION
417 4th Ave. N.
417 4th Ave. N. Edmonds
CITY, STATE, ZIP
Edmonds, WA 98020
A S Tl-tle/M.5 "Six-c i-eH
4,
4, z�
41afA_( 6�?p 'L� (I �r) L( 'L
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K
(I 0
APPLICANT AUTHORIZES OLDS-OLYMPIC, INC,_
ju RIANE INQUIRY' OF FINANCIAt AND REM17!iii
MATTERS FOR THE PURPOSE OF GRAN!'ING GRE-bl-, ALL PRICES PLUS TAX
A late payment charge may be made on any past due balance, which the law calls
"FINANCE
AUTHORIZED
a CHARGE", and it is computed at a monthly rate of 11/2% (ANNUAL
SIGNATURE 7
PERCENTAGE RATE OF EIGHTEEN PERCENT). It is agreed that in case suit is
instituted to collect amount due on this contract or any portion thereof, reason-
THIS PROPOSAL MAY BE WITHDRAWN BY US IF NOT ACCEPTED
able attorneys fees and court costs may be added to this contract.
WITHIN 30 DAYS
Permits, if required, will be the owners responsibility.
We shall not be liable for damage to or breakage of septic tanks, underground pipes, andor conduits not visible from the surface of the ground nor for any
damage to approaches (including sidewalks) from the street to the property line.
We cannot be responsible for sub grade failures or settling of subgrade material which was not installed under the above agreement.
Soil sterilization (weed killer), if included in contract, will be applied at rates specified by manufacturer. Olds Olympic Inc. will not be responsible forany subse
quent growths of horsetail weed, morning glory, deep rooted ferns, or perennials, which have not reached maturity prior to application.
All material is guaranteed as specified. All work to be completed in a workman -like manner according to standard practices.
Olds Olympic Inc. accepts no responsibility for any work other than that specifically described above. Any additions to or alterations of the above work -will be
executed only upon written orders and may become an additional charge.
All agreements are contingent on strikes, accidents, delays of carriers, and other delays unavoidable or beyond our control.
ACCEPTANCE —YOUR SIGNATURE ON ONE COPY, RETURNED TO US;
WILL MAKE THIS A LEGAL CONTRACT PENDING ACCEPTABLE
CREDIT APPROVAL. CUSTOMER COPY ACCEPTANCE BY DATE
/O,V 0- k /,Vijo J
A),
-rl
�rt
Z-1
IA
4o
14.
I
i
APPLICATION
for
The City of Edmonds SWE SEW= PFX3=
EASE39ICNT No . ..........................................
NEW CONSTRUCTION REPAIRS 0
113-OZOOO
OVVNER ........... W. B. Pearce . .........................................
.................................... .............................................................. CONTRACTOR --------------------------------- ........................ PER� No . ...................
ADDRESS ........ 4.17 .... 4.th .... Ave ....... N ...................................................... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
.. ...... ......... .
NAMEOF ADDITION .................................................................................................................. :.
Dye Tested On Sewer 1972
Approved:
DAIS........................................ I ....... ft ......................................
APPLICATION
V-% , for
The City of Edmonds SThEET FILE SEDE SEWER PERNEIT EASEMENT No... ........................................
NEW CONSTRUCTION REPAIRS 0
OWNER ................................................ . 42��
r ............... ............................ ............ CONTRACTOR ........................................... ...................................................... PERMIT No<� ......
ADDRESS ......... 14#7 ............... J;wl -------------------- A-4 ......................... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
V
9
a
0
NAMEOF ADDITION ......................................................................................................
Approved:
C 9
DATE .... ............ BY
APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS EASEMENT No . . ...... Z . ........................ . ........
OW-NER - ------- ;.Fl - --------------------------------- CONTRACTOR ... F=.I.LJ;5� ........
...... . PERMIT No . .........
`177 .4rm N-4a. N.
ADDRESS-------------------------------------------------------------------------------------------- LEGAL DESCRIPTION: LOT No . .............................................. BL4C)CK No . ............................................
TION ....... N NC-HSO
0
z
.41 c�
Ya EMMN.Tn,
(411 MA�)
&E34 o
V7
i
Approved:
'p
DATE ... .. ....
. .... ..... B
. ............................ ...............
7 T`
MWATEW�E
A0 I -
-CITY�0
WEN. Eim�A NT'�
p
MIT
EIR
43'8'9":
d.
'ih6;,,con t
1'�, .764I07!*for'4ide, 'sewer jnspeddionso,BEF RE',:cc_rv`er!':
d:
ng �any '06rtlon��,of.
Inspectlq� 1111 with .24 Uurs I :'a ter reqtiest�- 8 ru�tlon..)',
lid*
1h6 ay- nsPections:
MDDRESS1 M C AnON`OF�iC6N5tRtjCT1bN.' % ",-bPrO `Av*En6& -Nort
411 "P. h
................
.................. ........ m .......
...... ......... ...... ......
..................
ON...
............................
................... ... ... .......................... ........ �.: ..............
.........
................... . ..
....... ... ....... ..
.................
, , _'. . ;��, . f:,� , , , 2.
. ........................... .....
........... ........
..........................
7
umb,E*
. ......... ......... 'QWNER.
. ......................... ............ .... -kNUIO PL
R.,B am
. ............... ..............................
. . .............. ...........................................
.............
':CONtRAiDTORIS� Us S. JollnsoRi,� 1,600-9. N:.- -mead '6fiiodds �_.Jja-s:� 97
NAM -Et& ADDRESS:.*-..'..'..R
..............
.......... ................................. ...... h 8C120
Svg-ran'to-od' JL'1h .. ........................... .........
e 25'. w —, . _t. . ! : 1. - 1. 1 It . _.11.*. I
.......................
........... - t n 'tO
lo
U Edimi-onds' di 7 dty'��s�'nit
ty., ar seiyer
1.�r Tan-ces..
T1014.: ISJC'A,LLED�:TO, THE' FOLLOWING:
,�.Tiie 2owners -of'-the Property. ma
: . Y%obtafn Perrniv*to,,construct s�wer.,instae�:pr�p�ity'.1i'n"'-',
side:,sewer lh;�stre6t -area. Do; notcovei .'a' Sid
any-.139 e;_A*,licenseV e Sewer'Contractor.-must. b
N*�OT�E., rtion,.,of-.�sewe'6before �ft has.�.beeni Inspected,- ,�,,eMPI
�OY�d! tdeconstruct,...
,N6.,"'�—A]B�work Perf�nedt li� City right-ofway;reciulres a 'of
or
ni.- nvaslon�7.
tainable,
-NO'fE;-N t of�Wmy� Perailf. oh -frorri the. Ci.tyEngineer!B� office'.
0.,3-. lfornia[tlon reg�rding.:Ordin"c6:1,1*"16"6*36k.aii-�,.iieg6i*aiib
06tdirittull! jj
NOTE*. No. . se'wer.' must hav ns: 94B ou�.gbt: p4rinit
t i �
4—Top, (Yf*;side I e,at,lcasi �ZiO Jn"��s' �co-vemge. a �Property and, 1214richl 1. . I
:sharper tham!/8 w ll"b6 permitted. - ` ' - , I .. '1� .. : - b nlgrade-
es lnsld4,iprPperty I ne;.,1rnlnl!n�rni grade :of '2 �Nol
NOTE' No: 5--Trenches�lnf! ends 01�
street- must be watirrsettledvandsurface of.'str-e'e"t rest6red, �to: orjglh�i�,,c6n'dit I ton.*. , Contmctors� shalll!be, r�sponisl
work:-which.may develop. n. ble'for, failure Aue,
NOTE),'N ..,6L)t . within ons� Year of.?compi6tio
0 lis,uniawful to,,alter or do any!oth
an Is,.provi ed, for�.ln �the,�eiml�..or'
:sertJhe:iplpe into,the �r',work 'th'
�Nyye; . , 6'do'.�ny. work -,on the, m&,n,-sewer-or �tts
fappurtenan�esi(excepf to� 'in*-"
D
ate! .. ..................................
......... .
& . 041. ....... ........
..�,PPROVE'
. . ............ ......... ..................
ei)cj j r
PWil a rks . . . . . . . ... . . . .. . .
7: ... ............................. 6_
............
......................... .................. .
. . .. .......... ...........
. . . ..............
.............. ........ ...... ....... .............. .
...............
.. .. .. .........
.. . . . . ..... . . . . .. . . . . . ... . . . . . . . . . . . . . . .
. . . . . . . . . . . .
. . . . . . . . . . . . . . .
ei tl;Copie Be';Si* ei�'By Ow-`
BO
gn d.. ner -of: Pfr'iriil�.,Fierfw�ln bristructiorr.p
g,*;C R1OR:.,'rV:k6queSt;Y jn�ct
.......................... .
..............
ra ng ...... ...... a ion',:6onitruc
-4seWer"i'fist fl, t'd&dnder 'this Te'rm it,
wner,of Co i Firml*Perfcr�ning nstmiction-)'.'
W
W ls�alM ntaccor� 60, 'th-all:govdr i
-o the.'CitY.; 'Of-:Edrnon&,
n n rdirialices f
q
7
... 1C.2L
youi..digjor:�M
-elepholl jr'i.. Other
B ater iE];
he'ek,- EFORI
c E
APPLICATION
for
The City of Edmonds SrDE SEWER PER*lT
NEW CONSTRUCTION REPAIRSk
EASEMENT No.
... ...............................
Tr-P,q-(R- (nA)Ly ,
OVITNER V 7-
A
. ......... / .... 611* - ------------------------------------------------- CONTRACTOR ...... L . .. ......... PERMIT No.
ADDRESS ..... ........... ZI.1�7 ... . .................................. LEGAL DESCRIPTION: LOT No . .............................................. BL40CK No . ............................................
T.
NAMEOF ADDITION ............. /32 ... .................................. . .............................................................
JUN 9 5 1973
0
5,6 to
Approved:
DATE................................................ By ......................................................................
INTER -OFFICE COMMUNICATI.OKS
DATE s- 19
TO FROM
FOR. 41 LITYLE'S
SUBJECT:
FOR GOOD AND VALUABLE CONSIDERATION, the Grantor, Merlb L,.. Carpenter,
a widow, owner of the following described tract of land,.,Islituat ed in Snohomish
---County, Washington, to wit:
Commencing at the southwest corner of tract cohveyed to Me ' rle
L. Caroenter from R. J. Huston, which point intersects Third
Street at the northwest corner of alley immediately north of
Lot 38, Block 119, in the City of Edmonds,, Washington as the
T--- Point of Beginnina: runnina thence'easterly along the
Notherly l'ine of said alley a distance of 135 feet; thence
running al- right angles northerly a dis tance of 90 feet,, more
or less to the northerly line of tract conveyed to Merle L.
Carpenter,from Meda Waggoner, widow, said deed dated August 15,
1936, recorded August 24, 1936 under File No. 583095, page 420,
Volume 275, records of Snohomish Coun ty, Washington; thence
running westerly parallel with northerly line of said alley to
easterly line of Third Street; thence running southerly along
the easterly line of Third Street, to the Point.of Beginning.
DO HEREBY GRANT AND CONVEY unto the Owners, William B. Pearce and
Ellen DeEtte Pearce, his wife, and to the future owner, heirs and assigns,
of the following described,tract of land, to wit: -
"Parcel B"
Beginn.ing at the northeast corner of -Block 119, Plat of City of
Edrrionds;'thence northerly along west side of 6th Street, 15 fee * t;
thence angle left 90' for 335.46 feet to the Point of Beginning;
thence north along w'est side of High School Tract to intersect
with 4th'Street; thence northwesterly along westerly line of'4th
Street to a point 90 feet north of alley norl -h of Block 119;
thence west parallel to said alley, to an intersection with
easterly.line of 3rd Street; thence southwesterly along easterly
line of said 3rd Street to an intersection with north side of
alley no*rth of Block 119; thence east along north line of said
alley 227.5 feet to the True Point..of Beginning, LESS alley off
south side and 'LESS the west 135 feet, as measured along, north
line of alley in, Section 24, Township 27 North, Range 3 East,
situate'in the County of Snohomish, -State of Washington.
An easement for the installation, operation and-malintenance of a sanitary
sewe'r a nd"water line . over across, through, under and upon that certain
tract described above as Parcel A, said easement more particularly described
as fol lows:
-d to
Commenc,ing atthAftouthwest. corner of the tract.cMgeyc
Mer'le L. CarpenlWfrom R. J. Huston, which poiniWtersects
3rd Street at the northwest corner of alley immedlately north
o.f- Lot 38_,�B.I.oc k-.- 1-1 9,,__I_n_the _('i ty—of _.Edmond.s_,,_.'��ash i naton.
being �the True Point of Beginning of this description; thence
i
east I erl'y al,ong t northerly line oil said alley a istance of
1 '00 -ly.a ance.of
,35 feet; thEjW at right angles northei
5.00 feet; thence ,�iesterly'parallel w i th the norther I'y ' I i n'e of
said �alley a di . stance of 92.63 feet; thence alonq a line drawn
perpendicular with the easlerly mardin of 3rd Street a distance
of 29.57 feet to an intersection with a line drawn parallel wit/
and 5.00 feet souiheasterly of the easterly margin oil said 3rd
re tic theasterly along s.aid parallel line a d1stance
Si et; I ,nce nor
of 4"'.00 -rl- rirhT anglc�� north,,-icstprly a distance
of 5.00 feel- to an intersecl-ion with -1-I)c easlerly margin of
said 3rd Street, thence southwesterly along said easterly ma.rgin
to' -the True Poini- of Beginning.
41
7 'T- -7
7
rig i na I
THE GRANTEES hereby agree to restore to substantial ly 'he o,
condition such improvement�,,,as�,..�b,rei d i stuqbedj,,,, Uri ng the construction
maintenance and repair of said sanitary sewer.and/or wat6r* line.
-is
VN WJTNESS WHEREOF we hereunto set our seals and signatures..th
i973-.
d�ay of
CA,�
_11�,O_PIS ep"� ff.j g
P,
Cl/
STATE OF,,WASHINGTON)
ss-
..COUNTY OF SNOHOMISH)
-ay persdrial I y appeared before me Nlerle,L. Carppr�ter,� a
On this d'
w 1 dow- to me known to be the ind4vidual descri-bed- -i n and wl�o executed-
the� with -in and foregolng instrument, and acknowledged that she signed
the sameas her -free and voluntary act and deed, for the uses and purposes
therein mentioned.
�OTARY IC in and fol/The S,*7ate o
Washing on, residing ai.
C:) 3j
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>:
P_
t�8
C:) PL- Lai
01 CL
.7P'30G7S0
�m
4
STREE"'i, FILE
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
All rS 6t 17
MAILING ADDRESS
4/17
CITY zip TELEPHONE NUMBER
J--� /I
C: 01A 9
ADDRESS
4 "If ZIP ITELEPHONE NUMBER
NAME
L 49 -IL? plo-,, C
ADDRESS
0 / o o 7 117 014 05�, - _�r
CtTY ZIP TELEPHONE NUMBER
QO 1_1S_5",_q3qA�,
007//e // r-O 0'a I I
STATE LICENSE NUMBER EXPIRATION DATE
Z,nor 0 c * 11-1k) - �/
Legal Description of Property - include all easemehts
.J rFOPUFIY
Tax Account -032--06
2AZ7
_4_%
I-Ou
Parcel No.
1:1 NEW
ESIDENTIAL
PLUMBING
r7-V
'PI ADDITION
COMMERCIAL
MECHANICAL
REMODEL
1:1 APT. BLDG.
El SIGN
GRADING
FENCE
REPAIR
CYOS.
I X_ FT)
DEMOLISH
WOODSTOVE
INSERT
SWIM POOL
HOT TLIEI/SPA
GARAGE
RETAINING WALL/
CARPORT
ROCKERY
RENEWAL
V/?" W 0 0 M _gcz _rx-
NUMBER NUMBER OF CRITICAL
OF DWELLING AREAS
a I ove I CA 9.�-
STORIES UNITS NUMBER
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
v4 Q AAA
IF qs- g 0 Alykaaoln ��Wlval*
Ubt E
ZON PERMIT
'�3o&jc
NUMBER
/?
JOB 04 7;L-
ADDRESS
A Vt /ry SUITE/APT #
4
W7771
LEGAL DESCRIPTION CHECK
SUBDIVISION NO.
LID NO�
PUBLIC RIGH T'OF WAY PER.OFFICIAL STREET MAP.
TESCP Approved
13
RW Permit Required
0
EXISTING -REQUIRED DEOICATION
Street Use Permit Req'd
C3
Inspection Required
0
PROPOSED
Sidewalk Required
C3 0
ENGINEERING MEMO DATED
METER SIZE IGUILDING SUPPL
REVIEW BY
NO. OF FIXTURES
SIGN AREA
SEPA REVIEW
ADS NO.
ALLOWED PROPOSED
COMPLETE
EXEMPT
/.j
SHORELINE 0
/V/
EXP
VARIANCE OR, CU
P N I N�JA,
IEW BY
/V/
1 11. 2,��
1. �12117E
SETBACKS - FEET
HEIGHT
LOT 6OVE��GE
FRONT 21 ) SIDE REARI �_l
oln
CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT
I __ Z 7_/ 1 q) 2_5'
SPECIAL INSPECTOR AREA OCCUPANCY' OCCUPANT
REQUIRED CIYES GROUP Rs LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC 305
FINAL INSPECTION REQUIRED
PLAN CHECK FEE
BUILDING
HEAT SOURCE:
GLAZING
IFEA A/1,1111"'
W%
PLUMBING
Plan Check No. 93-1111
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADING/FILL
Any construction on the public domain (curbs, sidewalks,
STATE SURCHARGE
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the Issuance
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
modify, waive) or reduce any requirement of any city ordinance
nor limit In any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
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
ATTENTION
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
state laws regulating construction; and in doing the work authoriz-
AUTHORIZES
ed thereby, no person will be employed In violation of the Labor
ONLY THE
Code of the State of Washington relating to Workmen's Compensa—
WORK NOTED
tion Insurance.
INSPECTION
DEPARTMENT
5IGNA URE (OWNER OR AGENT) DATE SIGNED
CITY OF
IeA, er. EDMONDS
CALL FOR
ATTENTION INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771 -'0220
wr
e-
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his/her
Deputy: and fees are paid, and receipt is
acknowledged in space provided.
F URE . I DA T E
q/ow/��5
DATE
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
M
W
0
Z
2
Z
CIL
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
102-67
WE
USE PERMIT
F1
CITY OF EDMONDS 111E NUMBER
CONSTRUCTION PERMIT APPLICA110,111 joe -71
OWNER NANIE/NAME OF BUSINESS ADDRESS ql
T. S LEGAL'DESCRIPTIuN CHECKI SUBDIVISION NO.
MAILING ADDRESS
4L 1 7 LL -N) PL, I,
t)e A/1
311111111111
-I LID NO,
%igz I PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
CITY ZIP TELEPHONE NUMBER
EXISTING — RtOUIRED DEDICATION
E8monA,s PROPOSED
ADDRESS
TELEPHONE NUMBER
NAME
L D+DC0,i JfZvj#�OA Ce.!5!2,
ADDRESS
:2 10 0 -7 q 7 A Or.
CigT ZIP
C
I � , I,TELEPHONE NUMBER
02 L - qlqq
STATE LICENSE NUMBER
EXPIRATION DATE
LOD 6 o C -)p IS -el I(A) _�- Z q3
Legal Description of Property - include all easements
-�LJJ-'g W.Aq Sec. c�q
T,*�7N R-3E-
Property
Tax Account 2q,�?`
P.rcel No.
EINEW
DRESIDENTIAL
PLUMBING
1:1
'COMMERCIAL
ADDITION
MECHANICAN
DREMODEL
APT. BLDG.
El
SIGN
GRADING
F� 0
FENCE
0
REPAIR —CYDS.
(—,, —FT)1
WOODSTOVE
DEMOLISH 0 INSERT
SWIM POOL
HOT TUB/SPA
[2rccGARAGE RETAINING WALL/
E]
RENEWAL
ARPORT ROCKERY
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
PC 1* 50,1 C4 C OS e-
NUMBER OF STORIES
NUMBER OF
OAe
DWELLING
UNITS
ONC,
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
C' C,,t r
e
CP LO 4-eA C ff'0 M r4fs ;6r?"1C4L
REMARKS
TESCP Approved 0
RW Permit Required 0
Street Use Permit Req'd 0
Inspection Required 13
Sidewalk Required 0
WA(W-7 Apa?b
ENGINEERING MEMO DATED REVIEW BY
I I I I �/// � � A��
SIMMMI11111
R SZ FBUIL
rMECTER SIZE DING SUPPLY SIZE I NO. OF FIXTURES
F1
LLI
Lu
Z
Z
w
a:
REMARKS
SIGN AREA- SEPA REVI W ADB NO.
ALLOWED PROPOSED COMPLETE
EXEMPT ------ —
._SHORELINE 0
Y
......... .
EXP
VARIANCE )R CU
PLPNNING REVIEW BY
DATE
-,5. :;? 7
SETBACKS — FEET
Q 00
HEIGHT
/
0
LOT COVERA E Z
Z
Z
s
FRONT 0 IOE REAdS
REMARKS
ACCES-SO RNI 12:6 LES,!�
r A
V1 I T-t+1 /Ij
rz ----------
v- -
T�ILIAJII—b:r
CHECKED BY TYPE OF CONSTRUCT N
i6w
iCODE HEIGHT
'
I
66
SPECIAL INSPECTOR
REQUIRED 0 YES
JAREA
140w5elkl
OCCUPANCY
GROUP
OCCUPANT
LOAD
PROGRESS INSPECTIONS PER UBC 305
FINAL INSPECTION REQUIRED
'PLAN CHECK FEE
HEAT SOURCE: BUILDING
PLUMBING
Plan Check No.64,—.1-
MECHANICAL
GRADINGIFILL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks,
C
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, -heirs, assigns and
ENG. INSPECTION FEE
successors in interest, agrees to indemnify', Jdefend and hold
harmless -the. City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
modify, waive or reduce any requirement of any city ordinance
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
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
ATTENTION
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
state laws regulating construction; and in doing the work authoriz-
AUTHORIZES
ed thereby, no person will be employed in violation of the Labor
ONLY THE
Code of the State Of Washington relating to Workmen's Compensa-
WORK NOTED
tion Insurance. I m
I NSPECTION
5IGNATURE JOWN A OR G T)
DA E SIGNED
DEPARTMENT
CITY OF
EDMONDS
CALL FOR
ATTENTION INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-0220
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED, UBC
CHAPTER 3.
ow
APPLICATION APPROVAL
This application ii; not a permit until
signed by the Building Official or his/her
Deputy; and fees are paid, and receipt is
acknowledged in space provided.
FFI I L'S SI N URE DATE
tL E A S DATE
A? — �,Z-
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
84.82'
R o 0
0
T 6
H
Q)
92.G3'
34.35 7- —.7`77--;77'77� =,7----
U) 135,00'
-- P U B L I-C-A-L L E-Y
/1, 1�714orlhj 17ine ol BI
loc,
r I Ir—'s 'N 1/ 4 4
L
t, r
"I T Y I C LJI VI I L.',.o
?o
r
A, 0
Daley Street
0 INSLTALLED IRON PIN
REID, MIDDLETON
&
ASS'OCIATES9-INC.-
CONSULTING ENGINEERS & LAND SURVEYORS
EDMONDS
& EVERETT. WASHIPskGT ON
DESIGN'
DAA�WN
CHECKED
DATE
FIELD BOOK
SCALE
FILE No-. 444W
G. W. L.
G-21 -73
31 1, p. 16
1 40'
SHEET� I dir . -