591 12TH AVE N.PDF1111111111
639
591 12TH AVE N
PLANNING DATA
SITE ADDRESS:-5q/ DATE: .,4�ljz /,"P/
ZONING: PERMIT#:
PROJECT DESCRIPTION:
SETBACKS:
Required Setbacks:
Front: 0 Left Side: Right Side:. ire Rear:
Actual Setbacks:
Front: :--1 Left Side: Right Side: Rear:
FLOOR AREA:
LOT COVERAGE: 40Ac,
Maximum Allowed:. :Z ual:
X
BUILDING HEIGHT:
Maximum Allowed: -LW, Actual Height:
SUBDIVISION:— --'
CRITICAL AREAS #: CA - 1 -3 � �W — L c�,,-1v:, - uA,\YV�2-
SEPA DETERMINATION: Jr eE2") -
LOT
OTHER:
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STREET FILE
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
USE PERMIT
ZONE
NUMBER
0
Z
0
Jo 6 SUITEIAPT
ADDRESS
A,"
L EIAL IDIS.FIFU.11 1. ECKI
S NO
LID NO
MAIL I'D �OPqESS
iEc\ \
PU13LIC RIGHT OF WAY PER OFFICIAL STOEET MAP
EXISTING — FEOUIFE0 DEDICATION _.
-POSED
TESCP APPIOved 0
RW Pe —I Reqed 0
Siteei USff Pefmit Req d 0
I`..,Pw:on Requ.,ed 0
SIdewa k R eQui,ed 0
C)
11LEPIONE N MEER
E��c � I- \ C
NAYE
C\
METER SiZE
LINE SIZE
NO Of FIXTUPES
PPV 11COUiRED
YES 0 NO 0
ADDRESS
R F ARKS
�Ay
(D
1-01,E 1,., BE-
NAME
(7
ADDRESS
ENGINEERING MEMO DATED EVIEWED BY
A
CITY ZIP TELEPHONE NUMBER
FIRE 1AEM0 DATED REVtEWED BY
STATE LICENSE NUMBER EXPIRATION DATE
SIGN AREA
ALLOWED � PROPOSED
SEPA REVIEW
COMPLETE EXEMPT
E. P V
ADO NO
Legal Description of Property - inciuci7aii eaKments
S k O�7) NX_
VARIANCIiI 9R,CU
PIA�AINCYOVEW` B]Y
if _DAI(�
nj Property
Taic A n,
COO"
a .0.
NEW
RESIDENTIAL
PLUMBING
(2�
El
ADDITION
C OMMEACIAL
MECHANICAL
ElREMODEL'
F� APT. BLDG.
SIGN,-
[] GRADING F_1 FENCE
CHECKED BY
TYPE OF CONSTRUCTION I
CODE
JOCCUPANT
C'OUP
REPAIR CyDS. 1— x _FT)
V��/
� 41. ,
f__21
DEMOLISH WOODSTOVE E] SWIM POOL
INSERT HOT TUBISPA
SPECIAL INSPECTOR _7AREAA<.
REOUIRED
OYES
IWI_
2-
JOCCUPIINT
LOAD
GARAGE RETAINING WALL/
911166111mr ROCKERY RENEWAL
REMARKS
Z
0 (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
Z
PROGRESS INSPECTIONS PER UBC 305
P.
NUMBER NUMBER 0* C.'
0 OF
D ELLING ARETASCF&—-7
STORIES 402
,jt�IC
UWNITS
DESCRIBE WORK TO BE DONE (ATT
.�F,,PLOT �AN)
e^, ic,,E� Q_
FINAL INSPECTION
REQUIRED
VALUATION
FEE
PLAN CHECK FEE
BUILDING
HEAT CE:
GLAZING
0/0
PLUMBING
Plan Check No.' -
MECHANICAL
This Perm it covers work to be done onfirALZRIB property ONLY.
GRADINGIFILL
Any construction on the public domain (curts, sidewplks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
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
5 whatever nature. arising directly or Indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
in odify, waive or reduce any requirement of any city ordinan
C:
—
i
nor limit in any way the City's ability to enforce any Ord nanC
TOTAL AMOUNT DUE
7,1'
provision."
I hereby acknowledge that I have read this application; that the
ATTENTION
APPLICATION APPROVAL
information given is correct; and that I am the ow ner , or the duly
authorized agent of the owner. I agree to Comp) y with city and
THIS PERMIT
This application is not a permit until
state laws regulating Construction: and in doing the work authoriz-
AUTHORIZES
THE
signed by the Building Official or his/her
ed thereby, no person will be employed in violation of the Labor
Code of the State of Washington relating to Workmen's Compensa.
ONLY
WORK NOTED
Deputy: and fees are paid, and receipt is
tion Insurance and RCW 18.27.
INSPECTION
acknowledged in space provided.
SO T"" WNE- 0- -ULNII DATEPIGJED
DEPARTMENT
PffICIAL'S SIGNATA� DATE
L
CITY OF
EDMONDS
CALL FOR,-'_'�
_RELIT DATE
ATTENTION
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A F:NAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220
ORIGINAL — Pde YELLOW — Inspector
A I OCCUPANCY HAS BEEN GRANTED. UBC
FfF��F.CATE OF
STREET FILE
City of Edmonds
Critical Areas Determination
Applicant: I Michael Miller I Determination #: I CA-93-74
Project Name: Per it Number:
Site Location: 591 12th Ave. N. Property Tax Acct #: 5489-000-024-05
Project Description:
Waiver.criteria (all criteria must be found to apply):
xx There will be no alteration of the Critical Area or its required buffers;
XX The development proposal will not impact the Critical Area in a manner contrary' to
the goals, purposes, objectives and requirements of the Critical Areas ordinance;
xx The development proposal meets the minimum standards of the Critical Areas
ordinance;
xx The above findings are based on the following conditions of approval:
1. The applicant must comply with any requirements the Building Official
might call for due to construction on steep slopes (ECDC title 19.05, 19.00-
UBC chapter 70).
2. The applicant must follow the requirements of the Engineering Division for
erosion control (ECDC title 18).
Based on the above findings and conditions, the requirement for a Critical Areas Study
associated with this development permit is hereby Waived, as authorized by Chapter
20.15B. 150 (B) of the �dmonds Co4mmun* y Development Code.
Stephen F. Bullock
Name Si ature E/ate
9
City of Edmonds . I
Criti 0 cal Area's' C'hec'kl['*st
'Me Qitical JALreas ChwHist co,
this f ntained on
arm 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.,Checidist is to enable
City staff to determine "whether any potential
Clitical Areas are or may be present on the
subject PrOPertY. The information needed to
COMPlete the ChIcddist should be easily
'labic fi*Om Observations of the site or
aval
data available at City Hall (Critical Areas
inventories, maps, or soil survcys).
An applicant. or his/her represetativc. must
fill out the checld'st, sign and date it, and
submit it to the City- The City will review
the checidist, make a precurwry site visit�
and make a determination of the subsequcnt
steps necessary to complete a development
Permit application.
With a signed copy of this forrri, the
aPP"cant 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
informationor sttidics in conjunction with
this Chcckl I ist to assist staff incompleting
their prelirninary assessment of the site.
I have completed the attached Qitical Area Checklist and attest that the answers provided -are
I facttial, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant:
("*'xa---\ -9 --
Title -------------
c�,c\ \7
Street Address
Applicant Representative:
Name
Title
Street Address
'hone City, State, Zip
I Phone
I S?
Date
Signature
Date
Critical Areas Checklist
Site Information
Project Name- Permit Number
Site Location- Property Tax Account Number.6�-Vq -00MJ- -OT+ -0
Approximate Site Size (acres or square feet):
Have you filled out a Critical Areas Checklist for a project on this site before?
General Site Conditions
1. Has the site been cleared or logged?
n cz. -
Date of most recent action:
Soils / Topogriphy 4U'r
2- In the Snohomish County Soil Survey, what is the mapped Soil t1p #.. C44,
3- 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 vertical rise of 10 feet over a
horizontal distance of 66 feet.)
�Iilly.- slopes prcscnt on,site of more than 1�% and less thari, 30%p ( a vertical rise
of 10 feet of horizontal distance.)
Steep: grades of greAter than 30% present on site.
Comments
Hydrology/Vegetatiort
4. Site contains areas of year-round standing water:
5. Site contains areas of seasonal standing water Approx. Depth:
6. Site is in the floodway Pup floodplain-0 c> of a water course.
7. Site contains a creek or an area where water flows across the grounds surface? V'\ flows.
are year-round? C��Flows are seasonal? n
8- Site is primarily: forested meadow shrubs mixed
9. Obvious wetland is present on site:
Rey3f27/92
7
CITY of EDMUND,-) t5U%Z)IIN4t:.-30 L U
DAifikj.5.�� LICENSE NO.
Civic center - Edmonds, WashinI;
"AL
City Clerk )ton OSTREET
Phone 775-2525
,tt . TYP F BUSINESS ANNUALFEE AFTER FEB. 15
INSTRUCTIONS:
All items must be completed
or application will not be ac-
cepted.
d, Sign and return application
with fee. Renewals received
a fter February 15 must pay
penalty in addition to fee.
NEW BUSINESSES AFTER
JULY 31, 1/2 FEE.
I-) (A) HOME OCCUPATION $15.00 $ 22.50
BUSINESSWITH $20.00
1 TO 3 EMPLOYEES
(c) BUSINESSWITH $22.00
4 TO 9 EMPLOYEES
(D) BUSINESS WITH 10 $75.00
OR MORE EMPLOYEES
0 NEW APPLICATION
0 RENEWAL
0 CHANGE
(PLEASE MAKE ANY NECESSARY CHANGES) El DELETE
NAME OF FIRM BUSINESS PHONE NO. OF EMPLOYEES
III vej�r"r. V%f, I" r- e- 0 �: 0 e A tw e- 77(,,- �1_3oo ;7 /
, 44��
MAILING ADDRESS NATURE OF BUSINESS R-[C E IV ED
es - Re C. -)
M A f � 163 -11 `9 U J
BUSINESS ADDRESS INDIVIDUAL PARTNERSHWIVION k-Jb0PtfR_WdN
F__71 (S) (P) (C)
OWNERS NAME HOME ADDRESS
6, 9 4 0,67-
L, I S /W a te'_ h e Oi�i*e_ 4, 0L.,)e,.,j
HOMEPHONE DATE OF BIRT PLACE OF BIRTH SOCIAL SECURITY NUMBER
30 u 7- r4
EMERGENCY NOTIFICATION (1) NAME & TELEPHONE Ll 1-t (2 3
(PLEASE LIST TWO) (2) NAME & TELEPHONE c_ A^,4 C
WASHINGTON STATE TAX NO. e- 3 1 "Y APPLICANT'S SIGNATURE
DO NOT WRITE BELOW THIS LINE
FILL IN LAND USE CODE, LIFIR NUMBERS, ZONING, ETC. CHECK APPROVAL OR DISAPPROVAL, DATE, AND
STAFF REVIEW. SIGN. IF DISAPPROVAL, PLEASE COMPLETE "COMMENT" SECTION. ROUTE TO NEXT DEPARTMENT ON LIST.
PLANNING DEPARTMENT DATE LAND USE CODE ZONING CODE
j4 APPROVE El DISAPPROVE W if
_S
SIGNATURE IL
U
CONDITIONAL USE PERMIT
COMMENTS
CLASS
I Y,
LIC. EFFIC, III IREASG.
LIC. NO.ISPEC.1
RECEIPT NO.
DATE PAID
PRINT'X'
I
Pi / 4q 83
IN SPEC. BOX
1,6q7l I
I
FOR ISSUE OF
CORRECTED
FEE PAID
PENALTY PAID.
1!2 10 jo
I
I
LICENSE WITH
'LC' ACTION.
BUILDING DEPARTMENT DATE 3-1-5-83
I', -
I? APPROVE 0 DISAPPROVE SIGNATURE
COMMENTS:
E�� CAPACITY: (NO. UNITS, APTS. OFFICES, SEATS, BEDS, STUDENTS)
FIRE DEPARTMENT DATE
KAPPROVE El DISAPPROVE SIGNATURE
COMMENTS:
POLICE DEPARTMENT DATE '-3_1743 SIGNATURE
'1;�-�PPROVE 0 DISAPPROVE
COMMENTS:
PPLIC WORKS DEPARTMENT
9 APPROVE 0 DISAPPROVE DATE
$ 30.00
$ 33.00
$112.50
(LA)
(LB)
(LC)
(LD)
Building
EJ
Hotel/Motel
(L)
Permit
El
0
Apt. Bldg.
Office Bldg.
(A)
(0)
Occupancy
El
Restaurant
(R)
Group
0
Hosp/Nurs Home
(H)
El
School
(S)
U. F. 1. R.
ED�eo LO I
IL
SIGNATURE
Ile-
COMMENTS:
PLEASE RETURN TO CITY Cl...ERK
APPUCATION
The City of Edmonds for
EASEMENT NO - ------------
E sim sEvm Pmmff
,.,ONSTRUCTION n REPAIRS LID NO - ------------------ - ASMT. NO - -------------
OWNER--------- --------- ................. ---------------------------------------------------------- CONTRACTOR -------- --------- ----------------------------------------------------------------- PERMIT NO - --------------------
JOB ADDRESS --j5-'7
.-/ ------- ......... ------ -----------------
4� ..... -- LEGAL DESCRIPTION: LOT NO - -------------------------------- ..... BLOCK NO - -------
.................. --------------------------------------------------------------------------------------------------- -------------------------------------
NAME OF ADDITION
Approved:
DATE............................. .............. By ..............