602 12TH AVE N.PDFlill iiiiii
640
602 12TH AVE N
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
Cal .76-1107 for side sewer inspections BEFORE covering any portion of the construction
Inspleetion will be provided within 24'hours after request. NO Sat., Sun., or holiday Inspections.
ADDRESS LOCATION OF CONSTRUCTION ........... . ............................................................................................................................................................
PROPERTY LEGAL DESCRIPTION .................... ...............
.................................... I ...............................................................................................................
..................................................................... ................................................ ; .......................................................................................................................................
................................................................ OXVNERAND�OR BUILDER .............. : .............................................................. .......................................................
CONTRACTOR'S NAME & ADDRESS ..................................................................... .............
Permission Is granted ............................................................ 19— ..... . for repair and/or connection of a side sewer to the city sanitary sewer
system in accordance with City of Edmonds ordinances.
ATTENTION IS CALLFD 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.
,T7E No. 2—All work performed In city right,of-way requires an Invasion of RJght-of-Way Permit obtainable from the City Engineer's office.
0 No. 3—Obtain full. information regardifig Ordinance 11.16.030 and Regulations g . overning side sewers when you get permit.
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 'A will be permitted.
NOTE No. 5--Trenches in street must be.water settled and surface of street restored to original condition. Contractors sball be responsible for failure due to Improper
work which ma� 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 tb in-
sert the pipe Into the wye.
DISA-PPROVED n Date ......................................... By ................ Date By ..... zate ..............
.................
. .................. ........ ; .........
APPROVED' X Date ........................................................ ...... ji,
Remarks: .... ..... 4�� ........ . 2-7 .2' _.�T),i,/7
.............. .................. ................. * ..............................
...................................................................... ................................................. .........................................................................................................................
rmi
BOTH Pe,.7pieesMUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
I ........ . ... ......... . ............................. ... hereby certify that the side sewer installation constructed under this permit
,for
(gown of C tra ting Firm Performing Construction)
was installed in accordance with all governing ordinances of the City of Edmonds.
Dated this ..... / ................. day of—v4_47 ..........................................
_( A 61163� ul"ImnlDw, At- *--. XX7__ — --- — — . — — I - —
APPLICATION
for
The City of Edmonds E, SIDE SEWER PERYaT
GPTHT:P� Et"'b" EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS
ONVNER .... 4�.-e ..... e
.......... CONTRACTOR;;;�.,?,--,.'.'2.1,e�� z
jPERI= No.
ADDRESS ...... ... 7 .... Z�:�dc --- --- ........................... LEGAL DESCRIPTION: LOT No . ....... e� ............................ ... BLOCK No . ............................................
NAME OF ADDITION./�/`/�O��`�f
I.: , Ve-7-2�1—r ......... — -------------------------------------------------------------------
DATE................................................ By ......................................................................
APPLICATION EDINIONDS
for I TREATM Ell-,11T P1 ANTI
The City of Edmonds SII)E SEWER PER-111
EASEMENT No . ..........................................
Llt��W CONSTRUCTION REPAIRS
0 - o,5�c,-,--o
OWNER .......... ..... . ------_--___ CONTRACTOR
......... Z_,,t,..4-RMIT No..
ADDRESS ......... L�0_27 ..... .......................... ................... .... LEGAL DESCRIPTION: LOT No . .......... ............................ BLOCK No . ............................ ...............
NAME,OF _-.,,jvTiON ........... z �r
"!�; ef7l.7 . .......... .............. ...........................................
la /
/�,;7 9� _rl� 72.
70
Appro ed:
DATE .............. By<-�_
i
14
Critical Areas Checklist CA File No: I CF7
Site Information (soils/ topography/hydrology/vege7tati n)
1. Site Address/ Location: !�51 GLA:�,_ -Y) AA-
2. Property Tax Account Number: —7 0
3. Approximate Site Size (acres or square feet): 2— <-�
144jt06 V
4. Is this site currently developed? )L/ yes; _ no.
If yes; how is site developed?
5. Describe the general site topography. Gieck all that apply. U
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
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): C�p Q-
6. Site contains areas of year-round standing water: Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year? G-�� Y�-U�
8. Site is in the floodway — floodplain I of a wadr course.
9. Site contains a creek or an area where water flows across the grounds surface? Flow's are year-round?
Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow shrubs
mixed
urban landscaped (lawnshrubs etc)
11. Obvious wetland is present on site:
se
J�
IS 4.
..............
N ber'
tu�mm , . �, :# .1
S
t
Z
IQV�
c
"pin, dh!i0C a
7�
'h'
�§4gna
I 5-s'. ftp4eart
D
UDY;REO
ol
Critical Areas Checklist.doe/3.19.2001
ED
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
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 the application 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).
Date Received: 07-,
City Receipt *:_
Critical Areas File #:
Critical Areas Checklist Fee:. $45.00
Date Mailed to Armlicant:
A property owner, or his/her authorized representative,
must fill out the checklist, sign and date it, and 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.
Please submit a vicinity map, along with the signed copy
of this form to assist City staff in finding and locating the
specific piece of property described on this form. In
addition, the applicant shall include other pertinent
information (e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant staff
in completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information fin-nished by the applicant, his/her/its agents or employees.
By my signature, I cer* that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file thi pplic be mlf of the owner aslis77ow.
'T -7
/, Y
SIGNATURE oF APPLiCANVAGENT Q V %/L��ATE
Property Owner's Authorization /
By my signature, I cer* that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and nostin"tten s li ation.
I! IL6
SIGNATURE OF OWNER �620AQA—, ..... .. DATE ';� //7
V
Owner/A t:
pplican al Applicant Representative:
),, MJ�)
Name Name
;;e
&0)-
Street Address Street Address
r--7cwc*)u�
city State zip city State zip
Telephone:'��24---779-6W#q 1 Zoz� - ��*?> /I I Telephone:
Email address (optional):.Jh,0V,&,,,- R- wl-w-Email Address (optional):
Critical Areas Checklist.doc/3.19.2001
City of Edmonds
Critical Areas Determination
Applicant: J William Feldman Determination M CA-2002- I Ol
Project Name: Permit Number:
Site Location: 60212 1h Ave. N. Property Tax Acct M 1 4270-000-007-00
Project Description:
non -project specific
Determination: Study Required
A site inspection of the property has confirmed a lot developed with a single family residence.
The eastern portion of the lot slopes up steeply to the adjacent property to the east. Based on the
survey information submitted with the critical areas checklist and the inspection of the site it is
confirmed that the bank on the property slopes greater than 40%.
Based on the above findings, it is determined that there is a steep slope critical area on the site.
In this case, a Critical Areas Study is required to delineate the top and toe of the slope, the,
buffers and setbacks for a Steep Slope Area. For a Steep Slope Critical Area, which is defined as
any area with a slope over 40% and a vertical rise of over 20 feet, a licensed surveyor must create
a map of the site which indicates the top and/or toe of the slope. A 50 foot buffer is required
from the top of the slope and a 15 foot building setback from that buffer. The 50 foot buffer can
be reduced down to 10 feet upon the review of a Geotechnical engineer who will certify that no
additional potential for soil movement will occur with a reduction of the 50 foot buffer. No
permits will be issued for this site until the Critical Areas study has been completed. Also, tree
cutting, which would normally would be exempt from permits on a single family lot like this,
will require a permit and completion of the Critical Areas study.
If the property owner wishes to apply for a specific development permit which they feel would
not impact the Critical Areas located on the site, they may submit their proposal to the Planning
Department for review. If the Planning Department finds that the proposed development permit
will not adversely impact a Critical Areas or. - s buffers, a.'Gonditional waiver may be issued on a
project by project basis.
Steve Bullock , I (_ May 28,2002
Name SisCature Date
LAND SURVEYORS CERTIFICATE
THIS MAP CORRECTLY REPRESENTS A SUR)rqY MADE BY ME
AT THE REQUEST OF BILL FELDMAN IN �pbl 20101
----------
GU Y
It U-1A CERTIFICATE NO. 2953
0
z
t L
11/2412=
VOI 1
VERTICAL DATUM: ASSUMED
0 10 20 40 60
SCALE IN FEET
z 506a — 53%
43.7
TOE
506.5
C6
508.8
504.2
CA%
SOO 500.8
dp.�Nl 505.1 53t-,
500.3
48.5
8
50 .3
5
0
53�6_
— 4 8.5
498.9 5". T
0
499.81
503.8
511.7
49910 4__4
512.6
529.9
527.5
526.8
526.0
TOP SLOPE
0
FrOT.T. 0 a F. Pr.ra Wa7.Ti-.T-4l WAW^. lw?wq
VA M MW� M
AMKWAIA� M
0
pliAll
DEC-18-1998 04;44 CHICAGO TITLE
psi
Z..
z
0
z
0
2 z
Z'
0
pin
39
425 259 8242 P.02/04
L
ej
cf)
z
V
41 1
- rl
-Z;k
AD S .2
Z—:5— �_g
0111-1
ot,
V, zyz
ZONIE_
SETEACKb'.
FRONT—_
SIDE
REAR_��'
OTHER-
HEIICHT
4yi
r
OwEA
UNA
1p'MISR,
Ad"A0 ---j "o
__Z-��12 T-
14 1
mJ4
P0:5'
I t-i m-W� r_VE.Or
et��FL— WIU—
LAI MFLJ6f—, 0 0 Fjt. I
F-r-MD'j (:�
,'�vp E;ir�r- to r;f-- =yl c
C\j
p7r, Ps-Fmpt__p
- FT
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME I(ME OF E1U5INt:b*
L (0
MAILING ADDRFbb N
W ? — I �7,-r I J-�-j i\Jo
CITY ZIP ?0 TELEPHONE NUMBER
SIAME
c"i:10 1 100
Ao� SS
0 L,*k
TELEPHONE UMB
)kLjArn
NAME. —
ADDRESS
CITY
�_o 0
STATE LICENSE NUMBER
Leg
— -k-j'Vj1A-j (_, /C
`T44`D_T 'S-LIJ
TELEPHONE NUMBER
EXPIRATIFN DATh
("I
Olt— i�_
,ronertv - incilide all easements
i5—rop—erty
TaxAccount 410-000-oo-4 -00016
Parcel N 0.
1 USE PERMIT
ZONE NUMBER -95 O(C66
JOB SUITE!APT #
-w-1- Ale Mat/H —
IVI
Li
M NEW
LrJ RESIDENTIAL
PLUMBING
ADDITION
COMMERCIAL
1:1
MECHANICAL
APT. BLDG.
El
SIGN
REMODEL
GRADING
REPAIR CYDS.
FENCE
I— x _FT)
WOODSTOVE
DEMOLISH INSERT
El
SWIMPOOL
HOT TUB/SPA
MGARAGE RETAINING WALL/
RENEWAL
CARPORT ROCKERY
�T—y p FINESS OR —ACTIVITY) EXPLAIN:
yd�? WvSe,06W
NUMBER
OF
NUMBER OF
DWELLING
AREAS
STORIES
UNITS
NUMBER
7CR BE WORK TO BE DONE (ATTACH PLOT PLAN)
01 1 Lo 0
.EGAL DESCRIPTION CHECKI
SUBDIVISION No
LID NO
AV
I
RIGHT OF WAY PER OFFICIAL STREET MAP.
ESCP Approved 13
PUBLIC
W Par." R.q
R uired 0
EXISTING _ AEOUIAED DEDICATION
'real Use Pe; A 0
Sin
'P.,"o R u�IrAeq
L
n 'd 0
PROPOSED
Sidewalk Required C3
METER SIZE
NO. OF FIXTURES
PRV REQUIRED
YES 13 NO 0
REMARKS
cc
Lu
0
Z
DATED REVIEWED BY
SIGN AREA SEPA REVIEW
P
ALLOWED ROPOSED COMPLETE EXEMPT
EXP, A X
IARIANCEMA. I 'P R Y
I T LOT
3ETBAC7
T AFES HEIGHT
FRON IDE j C) REAR`2A
5'H—ECKED BY
TYPE OF CONSTHUQ1IUN
a6vtip
^_3
TP—ECIAL INSPECTOR
AREA
OCCUPANT
REOUIRED 0
1
LOAD
PROGRESS INSPECTIONS PER USC 305
FINAL INSPECTION REWIRED
PLAN CHECK FEE
BUILDING
—
7,30
HEAT SOURCE: GLAZING
IN) - — —
PLUMBING
_Z_
Plan Check No.
MECHANICAL
GRADINGIFILL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewpiks,
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
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
whatever nature arising directly or Indirectly from the issuance
of this permit . 1�suance of this permit shall not be deemed
modify, waive or reduce any requirement of any city ordinance
nor limit in any way the City's ability to enforce any ordinance
ENG. INSPECTION FEE
of
to PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
provision."
1 0
Z
Z
CL
I hereby acknowledge that I have read this application; that the
ATTENTION
APPLICATION APPROVAL
Information given is correct;.and that I am the owner, or the duly
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
This application Is not a permit until
state laws regulating constructl on; and In doing the work authoriz-
AUTHORIZES
ONLY THE
signed by the Building official or his/her
ed thereby, no perso 11 be employed In violation of the Labor
WORK NOTED
Deputy; and fees are paid, and receipt is
Code of the State of rasCrigton relating to Workmen's Compensa-
acknowledged in space provided.
tion Insurance and, $18.27.
SIG RE iOWNER 07R&_N I
INSPECTION
DEPARTMENT
CITY OF
-----------
OFFICIAL*S SIGNATURE DATE
�I
Al,
EDMONDS
4E
CALL F01I
RELEAS�b BY: _DATE
L S�o
Al
ATTtNTION
INSPECTION
BUILDING OR STRUCTURE
IT IS UNLAWFUL TO USE OR OCCUPY A E AND APPROVAL OR
HAS BEEN MAD
771-0220
ORIGINAL — File YELLOW — inspectbr
UNTIL A FINAL INSPECTION
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
. I
PINK — Owner GOLD — Assessor