533 HOLLY DR.PDFiiiiiiiiiiiiii
11722
533 HOLLY DR
0
CITY OF
EDMONDS
PUBLIC WORKS DEPARTMENT
TO:
SUSPENSE DATE:
0
#
DIRECTOR
Investigate
and Report
Take Appropriate
Action
ADMINISTRATIVE SECRETARY
BUILDING & GROUNDS SUPT
Prepare
CITY ENGINEER
letterimemo
for my signature
EQUIPMENT RENTAL SUPT.
For Information
STREET DIVISION SUPT.
LA%Musly Ref'd
WATERISEWER SUPT.
7atus of Action?
to:
TREATMENT PLANT SUPT.
49!1��71teturn
COMMENTS:
"01.14
e-
-Z A? 17
Ag— AA-
4—
&,1701-
1,,+ -AAx--
cost
6 7A. t-' A- -C,"i
1.4
FROM: LEIF' R LARSON, P.E. DATE:
PWA-WOI-11-78
191
ROUTING FORM
Contrador.4
P 0 BOX 216
778-0247 LYNNWOOD WA 98036 776-2829
MEMO DATE3/"D�
C,
1979
VL-n4
0,4
Ax-
%CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
Call 775-2525 for side sewer inspections BEFORE covering any portion of the construction.)
Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections.
AD6RESS LOCATION OF CONSTRUCTION...
........ . ............. ..................................
PROPERTY LEGAL DESCRIPTION ................ ....... ..........................................
. : -----------------
................... * -------- * ...... * ..... * - ---------- - ---- * -- - ---------------------- * -------------- * .... * ---------- * ------------------- *-"* ........ ** ...... ..... * ------- * ....... * ------------- * ------------------ ................
................................................................ OWNER AND/OR BUILDER ......... .. �zM��
I�A C: _ � -r� V \: - - t
CONTRACTOR'S NAME & ADDRESS ... . ............ ....
Permission Is granted ....... 1.0. 1 "7 -;:-? . . .....
.................... ......... 19 for repair and/or connection of a side sewer to the city sanitary sewer
Win accordance with Citylof Ediffo-nds ordinances.
TION IS CALI D TO THE FOLLOWING:
NOTE No. I —The owners of the property may obtain a permit to construct sewer Inside property line. A licensed Side Sewer Contractor must be employed to construct
side sewer in street area. Do not cover any portion of sewer before it has been Inspected.
NOTE No. 2—All work performed In city right-of-way requires a:n Invasion of RJght-of-Way Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtain full Information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 Inches inside property line; minimum grade of 2%. No bends in grade
sharper than % will be permitted.
NOTE No. 5---Trenches in street must be water settled and surface of street restored to original condition. Contraetors shall be responsible for failure due to Improper
work which may develop within one year of completion.
NOTE No. 6--It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the main sewer or its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVED E] Date By ................ Date ......... A�l ..... BY ................ Date ............... . ................... . By ................
APPROVED-fig—Date ..... ....................... By----.. ................... . .. . .. . .......................................................................................
Remwks: ....... . ................................... .. . .................................................................................................................. ....................................................
..................................................................... . .......................... . .............................................................................................................................................. .............
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
13 ......... wne-rof--C(-��' P ? ........ .... .... hereby certify that the side sewer installation'constructed under this permit
(8 ) ;J�iin�v: �i�Zk'��Ptforming Construction)
Arlstalled in accordance with all governing ordinances of the City of Edmonds.
Z- Dated this ............................ day of ................................................................. 1 19 .........
V N/ Check BEFORE you dig for: Water E], Gas E], Telephone E], Power E], Sewer [], Other C] V -V
PLANNING DATA
NAME:-To,q" Tqteck
SITE ADDRESS: 5_3'� DATE:
I- Z-'3 -77
ZONING: t5 -C —PLAN CHK#:_ 77-zi
PROJECT DESCRIPTION:
CORNERLOT 4/0 —(Yes/No)
SETBACKS:
Required Setbacks:
Front: 10 Left Side: 5- Right Side: Rear:
Actual Setbacks:
Front: 3 Left Side: Right Side: T07 Rear: (5
Street map checked for additional setback required? ?", —(Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED t/ (Y/N)
LOT COVERAGE:
Maximum Allowed: Actual: 57. V7.
BUILDING HEIGHT: $-Z-e 7
C-ry . 7
Maximum Allowed: Z.5' Actual Height: Iq
Datum Point: A/44�11 fSAc4tg ' Datum Elevation: +--toO
SUBDIVISION:
CRITICAL AREAS #: " - q6 - z6o
SEPA DETERMINATION: A/ - A -
LOT AREA:
OTHER:
Plan Review By:— 4:AK V �v ".7
Ad03 A113
APPROVED BY PLANNING
5s.
0 .0%�,
�.e
,;o
Dil e
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ow
6,
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NZ
A�
A-
3-75-
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77-6
b:P. + loo
+1OLLY--bRIVE. -R.O.W.. 6L
APPROVED BY PLANNING
7/7-
Is
I
18
19
ju�
44
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A�
-7
13
i D 7-
25' '3
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776
STREET FILE
4;
4 The City of Edmonds
Side Sewer Drawing
EASEMENT NO . ..... ....... ........... .....
NEW CONSTRUCTION E REPAIRS LID NO . . .... ........... ASMT. NO. � ----- ........
OWNER ------ ---- -- ---------- CONTRACTOR KA ----- PERMIT NO.
JOB ADDRESS --- ------
it
11
PWW-0001 - 11/75 (R EV. 11178)
LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - --------------------------------
T E��
..... Z17 ........ F ..... V ... . ... ..... -- -----
V—�. <=)V= T-,A .,,� . t/,et- J,�A . W. �1,6_
..................... ............................................................
Approved:
DATE --- W7`/7'-;3- ----------- By ------------------
�A
-At) 8 ��4
R -Elt
E C ED ZN
OT
'DECII 1996
W
CUMMUNITY UNCES.,
Ci 4
Critical Areas eck
The Critical Areas Checklist contained on -and submit it Wiffie -City. The Ci 'ill
tywi
this forra. is to be filled out by any person review the d=klist, make a precu site
preparing a Development Permit rsory
visit� �a4d uxaki'a detiiinimffi6nof the
Application for the City of Edmonds prior subsequent steps necessary to complete a
to his/her submittal of a development development ppli tion
permi a ca
permit to the City.
With a signed copy of this form,.. the
Ile purpose of the Checklist is to enable,. applicant should also submit a vicinity map
City staff to determine'wheth er any or plot plan.for individual lots of the parcel
potential Critical Areas arebr may be vvithegiMbdetail that City staff can find t.-
presenton the subject property. - The and -Weidfy the subject parcel(s)_ 1.1,
information needed to complete the additioi; the applicant shall inclu&
Checklist should be easily available ftom., other pert� info ite. fj&�'
t�nafion (eg. si
observations of the site or data available at plan, topography amp, etc.) or studies in
City Hall (Critical Areas inventories, Maps, conjunctioi -with * thiks Checklist to assist
or soil surveys). staff in completing their preli in"Inary
assessmentof the site. -
An applicant, or his/her representative,
must fill out the' checklist, sign and date it,
I have completed the attached Critical Area Checklist and attest that the answers provided are
factual, to the best of m. y knowledge (fill out the appropriatepolumn below).
Owner I Applicant:
Appricant Representative:
Nam
Narne
-oV VC
Street Address
street Addrew
-7
20& -
city, state, ZIP ty, S
Phone Ci tate ZIPJ
Phone
Signature U
gn lure,_ fl.��!�V.
V
"2'
3.
5.
Ar-, J -1 : -,�t Yr jl�;r - , - I . %*,.�
. P, �q, %l t � I L
pro 7K Q-1
pe ty,, :�dittit Number'. i5 D- 77
Site,Size (acres or square feet): -010 N E
Is this site currently developO? DO.
�:_yes
If yes; how is site develope47_` F �J-
T.,
Describe the gen6ra1site topograph�j-'Check all that t
p y-
':.1%i-,;Pt .5
.>< . Fiat less than chanki oVd entire site.
Rolling: slopes on site geneially less dian 15% (a vertical rise of 10-feet -over a'
horizontal distance of 66-feet)-
Hilly: slopes present on site of more than 15% and les's than 30 ayertical 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-feety.
Other (please describe).-
6. Site contains areas of year-round stkWing water. Ap&ox..1) . epth:
7. Site co�tains areas of seasonal staleing water':
Approx. Depth:
What season
(s).-of the year?
B.- Site is in the floodway '-�.,.�floodplam a water course.
9. Site contains a creek or an area wherei�ater'.flaws across the grounds surface?. Flows are year- .
round? Flows are seasonal? _IJ'O (What time of year? NQ
10. Site is primarily: forested ;meadow _;shrubs mixed
urban landscaped Oawnshrubs etc)
11. Obvious wetland is present on site:
City Staff Use Only
1. Site is Zoned?
.0
%2- ks mappedsoil typ-,(sr L -
3. Wedand inventory or C.A. map indicates wedand present on site?
4.,- !',Critical Areas inventory or C.A. map indicates Critical Area on site?
5.. *Site withir designated earth mbsidence landslide hazard area?
6. ''tith des,ignated on the Environmentally Sensitive Areas Map? 4110
.DMRMWATION
REOUIRED
CONDITIONAL WAIVER
WAIVER
Reviewed by:
Planno�-
7,PwOti%"4,04�
:7 V
77
Date
j,
CITY OF EDMONDS*
PUBLIC WORKS DEPARTMENTj ENGINEERING DIVISION
APPLICATIO[A FORRIGHT-OF-WAY CONSTRULTION PERMIT
THIS PERMIT MUST BE AVAILABLE AT THE JOB SITE FOR INSPECTION PURPOSES
Applicant to Complete Parts A and B
A, Permit to be issued to:
lei
1,4 2; 4_:f4::R 2=-�5' C;R6_sZ Q
_ _ _ e _t
For Work at:(address.or vicinity) zzg�=' - C.,
Type.of Work to be done: -1-4
(attach drawing when applicable)
Time Required Start: Zz� Finish:
Owner:
Name
J
Mail d ess
State Zip
Contractor:
Name
Mailinj Addr&ff
110111"4
City State Zip
STREET FILE
Telephone Number
State License Number
T�lephone Number'
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE **
B, INDEMNITY: Applicant understands and by his signature to this application, agrees -
to hold the City of -Edmonds harmless from any injuries, damages, or claims of any
kind or description wh * atsoever, foreseen or unforeseen, that may be made against
the applicant or the City of Edmonds, or any of its departments or employees,
including or not limited to the defense of any legal proceedings including defense
costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and
materials for a period of one year following the final inspection and acceptance
of the restoration by the Engineering Division.
Funds held from the Security Deposit'(estimated restoration fee) will be held until
the final street patch� is completed, at which time a debit or credit will be
processed for issuance to the applicant.
Work is subject to inspection and restoration in accordance with City Code. A
24-hour notice is required for inspection by Engineering. Call 775-2525, ext. 220.
I understand that this permit must be available at.the job site.for inspection
purposes at'all times.
Signature:K&-i Date :_/2
Owner 6r Agin-t
A TO BE COMPLETED BY ISSUING AGENCY:
Date Issued: Permit No. Fee:
S e c u r i t y B o n d ex &
Time Authorized.:- 09
APPROVE . D BY_/4 Date
L9
52�
I
March 13, 19-79
11EMO TO: Art Housler, Director
Finance Department
FROM: Leif R. Larson
Director of Public Works
SUBJECT: BILLING FOR ADDITIONAL EXPENSE - STREET CUT SECURITY
DEPOSIT - ORDINANCE #1935
ft/W 'CONSTR. PER141T NO. : 78-265
DATE ISSUED: 10'-23-78
LOCATION OF WORK: 533 Holly Drive
SECURITY DEPOSfT UNT: None
RECEIPT NO. & DATE:
COMPLETION Dt. OF REFAiK: 1--L/-/9
Please bill the below mentioned company for $ 83.25 to cover
additional.expenses incurred by the St'reet.Division w en accomp-
lishing the subject'work:
B & M. Contractors
P.O. Box 216'
Lynn.wood,.WA 98036
The total of the Sec-urity.Deposit including this billing, will
be $ 83.25 to be deposited to Street Division Revenue Fund
111-0-0-0--0-00-F-7-8-9.10, under the above mentioned R11q Permit.
1V
Street Supt.
Dt. Acm /Dt.
11EM0 TO
FROM
0
March 13, 1979
Art Housler, Director
Finance Department
Leif R. Larson
Director of Public Works
a
STREET FILE
SUBJECT: BILLING FOR ADDITIONAL EXPENSE - STREET CUT SECURITY
DEPOSIT - ORDINA14CE #1935
R1W CONSTR. PERMIT NO.: 78-265
DATE ISSUED: 10-23-78
LOCATION OF WORK: 533 Holly Drive
SECURITY DEPOSIT AMOUNT: None
RECEIPT NO. & DATE:
COMPLETION DT. OF RFPAIR_-._I_-_1,7-7q
Please bill the below mentioned company for $ 83.25 to cover
additional.expenses incurred by the Street Division when accomp-
lishing the subject work:
B & M. Contractors
P.O. Box 216
Lynnwood, WA 98036
The total'of the. Security Deposit including -this billing' will
be $ 83.25 to be deposited to Street Division Revenue Fund
111-0-00-0.00-389.10, under theabove mentioned R114 Permit.
1V
Street Supt.. Dt. Adm- Dt—.
I i i
�' I I I k-- �11 k I I i I I -, '
PUBLIC '*KS DEPARTMENI, ENGINEERI�6DIVISION
APPLICATIOH FOR RIGHT-01 -UW FRNSTPUFTM71 PFRt`1T J
THIS PERMIT MUST BE AVAILABLE AT *1 HEI JOB SITE FOR I NSPEICTI Oil: PURI SFS
Applicant to Complete Parts A and B
A Permit to be issued t o
For Work at :(address or vicinity)
Type of 1,,'ork to be done:
(attach drawing when applicable)
Time Required Start: Finish:
Owner:
Name
41
Ma i
I�ing Address
State Zip Telephone Number
Contractor: ZZ,
Name
crr,
Mailing Address'/
Ci ty SL-te Zi 1)
State License lNumber
I
Te I e 1) 11 o I 10. 0; t Im. ") e r,
NO t-MRK TO BEGIN PRTOR TO PERHLT ISSUANICE
B, INDEINNITY: Applicant understands and by his signature to thi,� appl.ication, agrees
to hold the City of Edmonds harmless from any injuries, da;:inges, or claims of any
kind or description whatsoever, foreseen or unforeseen, that may be r-,,ade against
the applicant or the City of Edmonds, or.any of iLs departments or emmployoes'
including or not limited to the defense of any legal proceedinps including defense
costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workri:inship and
materials for a period of one vear following the final inspecLion and accuptance
of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until
the final street patch is compA.eted, at which time a debit or credit will be
processed for issuance to the applicant.
Work is subject to inspection and restoration in accordance with City Code. A
24-hour notice is re(ILli-red for inspection by Engineering. Call 775-2525, clx.t. 220.
I iinderstand that this permit must be available It the job site for inspection
purposes at all times.
Signature:, Da Le
Owne r or Agent
TO BE COMPLETED BY ISSUING AGE'NCY:
Date Issued: Permit �Io.
e e
Security Bond
Time Authorized: �A
.APPROVED B Y
D a t e
'W /*
Co Rwr,,;I�
M
� . .- 0
CITY OF EDIVI11NDS
200 DAYTON ST. -EDMONDS. WASHINGTON 98020-(206) 775-2525
DEPARTMENT OF PUBLIC WORKS
�oeoBfi�_c
n ra tors
21400 Highway 99
Edmonds, WA 98020
Dear Mr. Belt:
March 29, 1979
SUBJECT: INVOICE 90005
HARVE H. HARRISON
MAY68
STREET FILE
You requested that we check out the charges on invoice
90005. As we explained to you on March 27, 1979, you made
A street cut without posting the street repair deposit. The
charge is not an additional assessment, but the total charge
for restoring the street. We consider it to be very reasonable.
FFH:kjr
Dt.
Yours very truly,
VFRED F. HERZBERG, P I E.
City
City Engineer
P.W. Dir _r Dt.
I ; 4
0
INFOICE
CITY
'OF
EDMONDS
Edmonds, Washington,
Sold To
Invoice No. RS 90005
B&M
CONTRACTORS
Job No.
P.
LYNNWOOD,
0. Box 216
10ASHINGTON
Date MARCH 20, 1979
98036
Your Order No.
BILLING FOR ADDITIONAL EXPENSE - STREET CUT
Additional expenses incurred by the Street Division S 83.25
when accomplishinn work at.531 Holly Drive
R/1-1 rons.truction Permit Mo. 78-265
TOTAL DUE THIS INVOICE 83.25
PLEASE REMIT TO EDMONDS CITY TREASURER, STREET FUND.
THANK YOU
DATE CUE7-
FIEN�LTY CHAIRGED
ALL BiLLS
C, 4 L,;.
; � <) REEFERRED
-T
PA;4
.OiM
CITY OF EDMONDS
USE
ZONE PERMIT
-NUMFkF:I
CONSTRUCTION PERMIT APPLICATION
jos UITIE/APT #
ADDRESS
53 4 )qotLy 091 V,6s.-
OWNER NAME/NAME OF SUSINESS�
!S� CJ VW 7-S C �A
LEGAL DESCRIPTION CHECK
SUBDIVISION NO.
LID NO.
tr
ui
MAILING ADDRESS
Z
0
4
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCP.Approved 0
CITY ZIP
11FL) LAI t<,I
TECEPIjONE NUMBER
EXISTING REQUIRED DEDICATION
PROPOSED
RW Permit Required 11
Street Use Permit Req'd 0
Inspection Required
A�
1
NAME
010eWRIK Required
METER SIZE
LINE SIZE
NO. 0 F FIUURES
PRV REQUIRED.
Lu
YES 0 NO 0
ADDRESS
REMARKS
<
V;JQ V-me_o k�kic 94titcp, 411�
cc
W
CITY ZIP
TELEPHONE NUMBER
0
NAME
cqw
cc
ADDRESS
ENGINEEPINp MEMO DATED REVIEWED , BY
9-7
0
oci
cc
3/1(/
CITY ZIP
TELEPHONE NUMBER FC,
Z
qef 62-& 1
77? 7057
FIRE MEMO DATED REVIEWED BY
Lu
0
0
tr
STATE LICENSE NUMBER EXPIRATION DAT
?56N L)o 715S 12-2— Q #, A)o e,
ol SIGN AREA
ALLOWED PROPOSED
SEPA REVIEW
COMPLETE EXEMP
ADS NO.
—
Legal Description of Property - include all easements
Z
- I I
IT- Or- 'As 4). 40 OF4 10
SHORELINE#
o
EXP
5
W, o F)illte Ny, W - OF JC4 2S_ I'U'
VARIANCE OR Cu
PLANNING REVIEW BY
DATE-
:5
N. Kq AJ64C 3 & - (k fil
SETBACKS - FEET
HEIGHT
LOT COVERAGE
Z
2
<0
is W. 54 uF L41A 5NAA 6 46A.)
uj
FRONT U, 616E REAR
'3
Z
Property
REMARKS
Tax Account
31- -0oo
rcel No.
NEW RESIDENTIAL XGDECH
COMPL ANCE OR
F
ADDITION COMMERCIAL CHANGE OF USE
APT_ BLDG.
REMODEL SIGN
CHECKED BY
STEILICTION
TYPE OF -CONS
CODE
OCCUPANT
.
GR!�N[b FENCE
EIREPAIR
C S
YD . I x _FT)
GRVA
DEMOLISH WOODSTOVE SWIM POOL
1:1 INSERT HOT TUB/SPA
_1=1T
SPECIAL INSPECTOR JAREA
OCCUPANT.
-JCA
REQUIRED
0 YES
_yg L5.
LOAD
FGARAGE. RETAINING WALL/
RENEWAL
REMARKS,
PROGRESS INSPECTIONS PEWUBib 108
Z
ROCKERY
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
Lu
&Ili, nr V
NUMBER
NUMBER OF
CRITICAL
0
OF
DWELLING
r,1V
Zo
CD
0
STORIES
UNITS
N
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
T
MOM 0
'A D Q 1Y i b Al 41) kf51 191es-
FINAL INSPECTION REOUIRED"
VALUATION
FEE
PLAN CHECK FEE
/A_
BUILDING
71
HEAT SOURCE:
GLAZING
A14
PLUMBING
Plan Check No..
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINOIFILL
Any construc tion on the public domain (curbs, sidewplks,
STATE SURCHARGE
+1
driveways, marquees, etc.) will require separate permission.
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
Cn
successors in interest, agrees to indemnify, defend and hold*'
'Its
20
harmless the City of Edmonds, Washington, officials,
2
employees, and agents from any and all claims for damages of
cc
<
whatever nature;'arising directly or indirectly from the Issuance
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
01
modify, waive or reduce any requirement of any city ordinance
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNTDUE
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 APPLICATION -APPROVAL
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 This application Is not a permit*until
ed thereby, no person will be employed in violation of the Labor ONLY THE signed by the Building Official or his/her
Code of the State of Washington. relating to Workmen's Compensa WORK NOTED Deputy; and fees are paid, and receipt is
tion Insurance and RCW 18.27. INSPECTION acknowledged in space'provided.
SI ,OWNE�OR AGENT) DATE SIGNED DEPARTMENT
VNATLI
Cl OF IG DPE
ITY OF
.1
j EDMONDS
CALLFOR 51
��ELEXASE '716 ATE
A TIY- N T I &N INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVACOR �RIGINAL`I— File YELLOW
77-1 0220
— Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC
SECTION 109 PINK — Owner GOLD — Assessor
1" 69
propasao AbD!4--ilum WAS:
Lek 10 �44) -3 2 -7 2.
=---Mob 9
13
S 2-1
0
-10 OU.
c I.A- 1,
19
11
a. L/
vap
eOLLY-1kIVE - -k O.W. a .
RECEIVED
MAR - 7 iq97
pERMIT COUNTER