534 4TH AVE S.PDFlill 11111111
5084
534 4TH AVE S
0 0
ADDRESS: �5-3 Ll -`4 t-A fty-p- L-
TAX ACCOUNT/PARCEL NUMBER: 6 1 3
BUILDING PERMIT (NEW STRUCTURE): 40
/ L7 (Y�1!3
COVENANTS (RECORDED)
CRITICAL AREAS:- I q � 9 - w I (-V DETERMINATION: Ej Conditional Waiver Ej Study Required gWaiver
DISCRETIONARY PERMIT #'S:- I q b-1 - () 0 0 6 to - I I I I a J)
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):_ �p g (jEj y-e &aj� K ��zp 6
PLANNING DATA CHECKLIST DATED: 1/ju D-f-
SCALED PLOT PLAN DATED: 17, / Z,, q Al u
SEWER LID FEE S: LID #:
SHORT PLAT FILE:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR
LOT: BLOCK:
WATER METER TAP CARD DATED: ;� - 0 - I
LATEMP\DS'Ps\Fonns\Street File Checklist.doc
0 0
PLANNING DATA
SINGLE FAMILY RESIDENTIAL
STREET�FIL�E
Name:
Date:
Site Address:
, gA IS'
Plan Check #: accG i2oo
Project Description: _T_c3
c� on 4,e- c-�kex-rN 'ZZde_ cA Axe-
Reduced Site Plan Provided: NO)
\J
Zoning:
Map Page: 162
Corner Lot: (YES nNO
Flag Lot: (YES /0
Critical Areas Determination#: 1997,-00l1C
Study Required
waiver
SEPA Determination:
>f Exempt
El Needed (for 500 cubic yards of grading or site within 200 feet of Puget Sound or Lake Ballinger) _NIA
0 Fee 0 Checklist 11 APO List with notarized form
Required Setbacks
Street:
J!�
e,
Side(,
:lRear:,,
Actual Setbacks
Street:
0
aC
Side:&)
Side:
Rear:
El Detached Structures:
El Rockeries: Nc)c\e.
11 Fences/Trellises:
El Bay Windows/Projecting Modulation:3
0 Stairs/Deck: Ac., Q4,r_A- 6,mz, c_.,
I IJ �,Puildin Height
Datum Point: -T
c)o C�,.o wae._ meAex_
Datum Elevation: +
Maximum Height �llowed:
Actual Height: Iql 61q.o!) 24%1
Other
Parking Required:
I Parking Provided:
Lot Area: A
Maximum Lot Coverage: 35% Proposed: 30. co 7.
Lot Coverage Calculations: ao. G
ion,
ADU Created: (YES �N?))
Subdivision: 11 on Jrn, LA 1-,C;,
Legal Nonconform4g Land Use 'Determination Issued: (YES
CommenL5
Plan Review By:
Planning Data Form 04-11-06.doc
0 41
City of Edmonds
Critical Areas
"QC. IS91
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 pen -nit 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).
An applicant, or his/her representative, must
fill out the checklist, sign and date it, and
RSCEIVED
JAN -13 1998
COMMU
Checkll's't'""'
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.
With a signed copy of this form, the
applicant should also submit a vicinity map
orplotplan for individual lots of the parcel
with enough detail that City staff can find
and identify the subject parcel(s). In
addition, the applicant shall include other
pertinent information (e.g. site plan,
topography map, etc.) 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:
Ge"W A. 6jjzAJS
Name
;-IA<.7 �J-Vj. I-reftfl
Street Address
'5
16
City, State, ZIP Phone
--" A 3) ?7-
Signature Date
Applicant Representative:
Name
Street Address
City, State, ZIP Phone
Signature Date
CA FILE IVO._qA —1�2
tritical Areas Checkli*
----------------- ----------------------------------
Site Information (soils/topography/hydrology/vegetation)
St 3 -f �X, 4W
I . Site Address/Location: -9.
2. Property Tax Account Number: QjLo Qv/ 0 j
3. Approximate Site Size (ac res or square feet): 00 o
4. Is this site currently developed? yes; no.
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
X Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of I 0-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 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: /YL-10 _; Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year? �
8. Site is in the floodway _ 4Lo floodplain /V" of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? 4%-.4:3 Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow ishrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
.�SCSMa p�d� ' 'I
-P :sot. type
.3:.,. ::,Wefland;:inV-en'to C.A. �ifid'i atds;�w-etland:�preseftton,�site.
ry .:or :map:
4::: 'Ciftical A r
...eEts: inventory. or C.Amapindicates Critical: Area:on,site? A)a
art
ite,,within:desipatode
§t�: Sit.e,.:*�gnated�6h.:th, Jro�ine Ar. M: ?
en i
sit'
4p
IDEURMWATION
-62 C. 18 () 13
January 29, 1998
Gerald A. Girmus
2128 N.W. 199th
Shoreline, WA 98177
0 0
CITY OF EDMONDS BARBARA FAHEY
MAYOR
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works a Planning/Building * Parks and Recreation e Engineering - Wastewater Treatment Plant
Subject: Determination regarding Critical Areas Checklist # 98-16
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.
...................... . ..... . . :.... --
.. .......... I
.............
a 10TED.
... .........
.................. ........
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN g&MQNMjfflL6L CJJF-C&1S OR QBITIgAL AREAS S=Y,
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
omo, You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL -41111111111111
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
* Architectural Design Board
C:ReceptionUana\CRLTR.doc
Building Pennits;
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Thank you.
Sharla Graham
Acting Planning Secretary
0 Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
APPUCATION -BUILDING PERMIT. Appl. No. . . .................
I .0F EDMONDS Building Department Permit limit, one year
'i'g
ICATION is hereby made for a permit to construct the following work, in accordance with the accom-
panying plans and specifications. Two sets are submitted herewith for approval.
new "�'a'lter Off -St.
Workaddn repair .................. ............................ - ......................................... Parking ......... . ...........
Occupancy ................................ Const. type-,.,._..,..,. U83 zone .... Fire zone..: ......... ...............
Address.... ............................................... Lot ........ Blk ........................ Addrie
...........
... 1� e
Lotfrontage ....................................... Arm ........................................... Septic tank..... ................................
Bldg. set -backs — front .....................
....... r. 'id . ................. 1. side ................. rear ...........
Owner. ....... ...... Ad ........ . ..... 7el. Nd-JD
... .........
Builder ....................... !t__
.......................................... Address. .......... �/ ................................... Tel. No .............................
Plansby ................................................. ............... Address .................................................... Tel. No .............................
Remarks......................................... .......................................... ............................................................................................
nle above is a correct statement, and I agree to comply with all applicible Codes and State laws regulating this
work
Signed Owncr/Agenr�V" J:!;� .......... Address ........................................... Dat.....
PERMIT fo, :,ic abovc work is heieby approved, subject to the above conditions, and to compliance wi/th' e ap,
t
proved plans and specifications, and Building Department notations thereon.
Valuation ................ Permit fee ...... ............ Recd. by— ......
Building Department, By ................. /A1.7 . ....................... ..... Date 6.0 ............... . ...............
... ......
INSPECTION1 RECORD
Fdn, OK ............................................ Frame, OK .................................................... Final, OK . .......................................
This Permit does not cover Plumbing, Sewer or Electrical iristallations.
APPLICATION
for
The City of Edmonds SIDE. SEWER PERMIT
EASEMENT No . ...................... .............
NEW CONSTRUCTION cl REPAIRS 13
100 Q&700
..... Wern.qw,.�knald ..............................
'NER ......... PERMIT Mo..� .....................
OW .......... CO NTRACTOR ............ -------- ------- ........... -------- ---------------------
........................ LEGAL DESCRIPTION: LOT No . ........... .................................. BLOCK No....
.ADDRESS ........... ................ I ..................... I., ...................
NAMEOF ADDITION ............. . .......................................................................... ....................
uj
DAYTON ST.
HOWELL WAY
EDMONDS cd
CITY PARK w
ca
w
HEMLOCK WA'
PINE ST.
VICINITY MAP
Zone �ZEa-rp Corner
.&,6 Fla&_.&(_c.
Setba Actual
Front<6):
Sides6�/-S)
Rear 30
Other
Heiek
Ln
N
Q�
Ln
IIVIPERVJOU�5 OAL n
t6(tt avu 0, &-tt)toot� LOT 61ZE- 512-2- 6q. ff-F.
too i- too 4� tGO 4-0o 0'4 PROP06EP APPITION- '900 6q- ff-F-MV
ACCEPTABLE yjaffTLW�. mk(!� tlQw ts - t Its OVERHAN06- 151.5 6q. ff-F.-/vtw
MR 25 MATEM 60NORE-FE PAT 10- 15 6q. ff-F.- P, 6W
mm 40 i� A6PHALT PRIVEWAY- (000 6'q. F=-F..- "1w.
N-12
Few mwm LOT 60VERAaE ---v50A% TOTAL— 171(a'Z5 6q. ff-F. OM go -W11J.466
OWNER & 61-FE APPRE66
LOT 61ZE- �512-2� 6q. f=-F.
f�LUEPRINT MANAaMENT IN6.
5'�)4 4TH AVE 6. EX16-FINO HOU6E-- 1510 6q. fz-F.
WoRr\ �36OPE
FPMONP6j PROP06EP APPITION- 9(a'�3 6q, 1`77- TO ( ,011\16TRU6T A WOOP ffRAMEP A 6INaLE 6-FORY
TOTAL- 247�? 6q. ff-F.
WA6HINOTON 5�502-0 APPITION
Z47�)/ 512-2- 1- 24 HR. NOTICE REQ. W/ ATTA6HEP, �Z 6A'R OARAaE W/ PE61<, AREA Af�OVE
FOR INSPECTION
wry"
V�> -70EXIS-r.
kL0 vf%v
Ty� 1, it 16YST. Ln
�,O"fto�J Ot A70610tJ
C-1
�0'
CAll 0.4 f
6&u
4. 4 "t., . PROPOSED 60 Now
.: . . . , . �4 sovrh ?�V.
ADDITION Nat) Fech't lot-0
. �l
'.NEW 20'WIDE we (1 0
m ,;(Ab e tot
ASPHALT DRIVEWAIr OA (Ate
amm
rATM
6.4. Ot dt FAIU
A
cl 13
r ...... ... 00
V Im Ln
V.
qm
17.92
OWNERMONTRACTOR IS RESPONSIBLE
I — - -- - --t I — h /it- I nO An
Emm mom WESSEEM
APPRO\tED BY PLANNING
(IN F EE T)
LEGA'L. DESCRIPTION
1 in ch 10 f t'-'
NORM
,�b �P/"
13
,o lyeIV7 / /Ll
STREET FILE
JAN 2 3 2007 AV 182007
8u,"11,113
BUILDING DEPARTMENT CITY Op"SeDMOWSENT
CITY. OF EDMONDS