626 12TH AVE N (2).PDF1111111111
596
626 12TH AVE N
CITY OF EDMONDS
250 - 5TH AVE. N. - EDMONDS. WA 98020 - (2061771-0220 - FAX (2061771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works - Planninn * Parks and Recreation * En-ineerinn
.890- 1 9 C� -
Lh=ER OF TRANSAIMAL
Date: May 25, 1994
To: Nancy Edwards
626 12th Ave. No.
Edmonds, WA .98020
Subject: Critical Areas Checklist
Transmitting:
LAURA M. HALL
MAYOR
For your information: xxx
As you requested:
For your file:
Comment and return:
Note attachments:
Comments: Please bring in a copy of the Critical
Areas Checklist when applying for a building
permit.
Planning Division
Judy Kenney
Incorporated August 11, 1890
CITY OF EDMONDS
250 - STH AVE. N. - EDMONDS. WA 98020 - (206177.1-0220 - FAX (206) 771-0221
COMMUNITY SERVICES DEPARTMENT
lz� Public Works * Planninn * Parks and Recreation * Vn in—rin
9 0 C�
LEMR OF TRANSAffffAL
Date: May 25, 1994
To: Decks R Us
1030 164th St. S.W.
Lynnwood, WA 98037
Subject: Critical Areas Checklist
Transmitting:
LAURA M. HALL
MAYOR
For your information: xxx
As you requested:
For your file:
Comment and retum:
Note attachments:
Comments: Please bring in a copy of the Critical
Areas Checklist when applying for a building
permit.
cc: Nancy Edwards :
Planning Division
Judy Kenney
Incorporoted August 11, 1890
0 0 125.00 pL
ABOVE
ROOF
r (.Z I
PATIO POPOSED
AODITION
1288 SF
w
UJ OLJ
DE� 0
EXISTING �Jo
RESIDENCE VIA
q 2200 SF
FOOTPRINT
uj - t
5)
7
PATIO
0
cr w
125.00 PL
S 0* 10' 53'. E
R ECF.11 VE
AU G 16 1198r.
PERMIT COUNTER, -SiTE PLAN
SCALF- I I I A" '-0"
:9 -OF ..11 9.�!
City .,of Edmonds
.,.,.Cri.t.ical 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
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). I .
An applicant, or his/her 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 necessaryto complete a
development permit application.
With a signed copy of this form, the
applicant should also submit a vicinity map
or plot plan 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 thew preliminary
a ssment 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:
ID vi PK
Nam
Co 2, 4? 1 ) it" Ave, kD
Street Address 6 72,-q 7- -3
ZIP Phone
Date
Applicant Representative:
Name
tc)Zo 1(,q-(-'--4,Su
Address
3rG;"7
city, Ffift, ZIP
Phone
�r -� CK -I�y
Date
STREET FILE CA FILE NO. q4-1 C>6?
Critical Areas Checklist
Site InformaVion (soils/topography/hydrology/vegetation)
1. Site Address/Location:
2.
3.
4.
's.
Property Tax Account Number: �j L-76 - bcb 66 5- CC60 RECEIVED
Approximate Site Size (acres or square feet):
Is this site currently developed? t- y no. MAY 1 8 1994
If yes; how is site developed? PERMIT COUNTER
Describe the general site topography. Check �l that apply.
L.,-�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):
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?
8. Site is in the floodway floodplain of a water course.
9. Site contains a c r k or an area where water flow§, across the grounds surface? Flows are year-
? Flows are seasonal? (What time of year?
round.
10. Site is primarily: forested
1--A —A elk"Ihe AtA
m
eadow
u, ban bLdp k1a,"AlL, -
11. Obvious wetland is present on site:
; shrubs mixed i
RcV01/04/94
The City of Edmonds
APPLICATION
for
SIDE SEWER PERNaT
EASEMENT No.
NEW CONSTRUCTION REPAIRS E:]
OW`NER ---- ---- ...... ----- ........................... ........................ CONTRACTOR .................. ..................................... ......................................... PERMIT No.
c-
ADDRESS ........... ....... .../ ........... 12 .................................... LEGAL DESCRIPTION: LOT No . ...........
................................... BLOCK No . ............................................
NAME OF ADDITION .............. ........................................................................
,;" ..... — ------------- . 1-,z�-
0
Approved:
DATE................................ ............... By ......................................................................
APPLICATION;
Edm'bnds'- RAF
SIEDE SIEWE t
RlVHT'
ASEMENT No.� .......... ...... .....................
NEW CONSTRUC
ITI N'�'aw:,- RERkIR9 Ej
r
F:F
NA4 %A -A
bArNER4q.t ..................................................................................................
TGR� ...... ..............
......... CON-T-R-AG IM-P
........ ERIYHT7?�� .................
,.EI37A:L-�DESCR,I-PTION,:-LOT-N . ............................. ...... _..:77:::777:��DDCK-N6 . . ..........................
_L
UN-
ADDRSS .............................................................................................. ...........
....................... W ................................... ... .....
NAME OF ADDITION
Id
VMS
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lu
1p
kv
'14
Approved:
-DATE
y
XV
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4�
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-- - --------
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CITY OF EDMONDS SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PEI
IMIT
STREET FILE
Call 7�76-1107 for side sewer inspections iEFORE covering any portion Of the constru tion.)
Inspection will be provided withizi 24 hours after reques . NO Sat., Sun., or holiday
t Inspections.
ADDRESS LOCATION OF CONSTRUCTION 626 TwWth Pve. No.
t
PROPERTY LEGAL DESCRIPTION ............... Lo 5, Higgins AdOtion
........................... ............. * ---------------------
---------------------------------------------------------------------------------
................................................... . .......... . .......... . ........................................................................ . ............... ............. ..................... . ..................................................
------- I ------------------------------------------------ OWNER AND/OR BUILDER ........ A-mcconnachie
.............................................................. . .......................................................
REss. Bob Wir-,
CONTRACTOR'S NAME & ADD ackhoe Svc, 006 - 92nd Rest, Edmonds, Wash. 98020
..................................................... ..................................
. .............................. . ... ... ...................................................
td ... May 17
Permission is gran ......... ................................ . .. 73
......... 1 19 for repair and or
/.,, �bonnection of a side sewer to the city sanitary sewer
sYsbqn in accordance with City of Edmonds ordinances.
AT�_ ION IS CALLED 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
side sewer in street area. Do not cover any portion of sewer before it has been inspected. to construct
NOTE No. 2—All work performed in city right-of-way requires an Invasion of Rlght-of-Way permit Obtainable from the City Engineer's office.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations
4
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 rade
sharper than % will be permitted. 9
NOTE No. &--Trenches in street must be water settled and surface of street restored to original condition. Contractors 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 .................. .................. By ............. :... Date ..... By ...............
............ . ....................
APPROVED 3!y... �7
ig . ......................................... I - TE ....................................
Remarks: ....... . ...................... ............ --------------------------- -------------------------- — ------------- ...
--------------..........
............. — ....... 7 ..........................................
a
..................................................................... . .............................................. ........................................ .
..........
..... . .................... .......................... .........
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing: onstrucii6fi, PRIOR
C To Request For Inspection
----------------------------------------------------------..... ... hereby C ertify, thAt.Lthe� side's6werinstallation constructed under this permit 7
6wner of Contracting Firm Performing Construction)
installed in accordance with all governing ordinances of the C ity 0
.............................. .............................. .. ....... �:..;.:.'
Dated this ............ L6 day of--- j?
V V Check BEFORE you dig for: Water [j, Gas [:1, Telephone E], Power 0, Sewer Othe r 77 �7—
VA
t.71
rrZI
?v
ivc:l 00
HOU5E'-
lf/--*�N T
u ul
.p
ZONE
SETBACKS: ol
FRONT -:>eS
SIDE /,C-
REAR
OTHER
MEIG�T'
CITY OF E[
BUILDING DEPA-Rjr,,,�
WORK —Di�C—he
Annpr--q-z
<F,771-
V y _W, 07,
STREET,q LF
— -----
CITY OF EDMONDS
U S E
Z 0 N E
ZONE PERMIT 94o�339
'ADDRESS
NUMBER
J
CONSTRUCTION PERMIT APPLICATION
C;�
J 0 B
JOB SUITE/APT
AD 0 SS
#
OWNER NAME/NAME OF BUSINESS
NANC A I I AA1 F—DW A QQ S
FRE
LEGAL DESCRIPTION CHECK SUBDIVISION NO. LID NO
4
MAILING ADDRESS
62-(o hvll:�
C
A/
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP, TESCP Approved
U LI R T 0
CITY ZIP TELEPHONE NUMBER
RW Permit Required 13
EXISTING REQUIRED DEDICATION Street Use Permit Req'd 13
NAME
....... Inspection Req
PROPOSED uired 0
Sidewalk Required 0
'REMARKS
ADDRESS
Z
LU
Zip jTGrePMQa&.�U�BER
NAMbus —lio C,
l"ENGINEERING MEMO DATED REVIEW BY
a
'C-i
At
ADDRESS
I D:� 0
:11vIETER S1ZE_____'BUILDiNG SUPPLY SIZE NO. OF FIXTURES
CITY ZIP TELEPHONE NUMBER
0%
Lu
0
_7 -71-3 7-
11/1 V1 I.A.) 0 0 D Cf
REMARKS
____4
STATE JCENSE NUMBER EXPIRATION DATE
I o(o L rZ _51y
I
Le a[ Description of Property - include all easements
AREA— SEPA REVIEW NO.
ALLOWED COMPLETE EXEMPT
---
- _*
/A
4;OPOSED
SHORELINE
.Z,C) o
Elp, A
6r
VARIA7/41.1
Njj�VIEW BY DATJ
A A"NU11
u�
SETBAC § F LOT
u.,
Properly
F _�.HELGI
RONT ��STIDE REAR /4� �1 ��/a
Z
Z
I
Tax Account
'12:70-000 -Q05'-000(D
'REMARKS
Parcel No.
20'RESIDENTIAL
PLUMBING
VADDITION MECHANICAL
COMMERCIAL
AA 60-"
Qh"r--� BLDG.
APT.
REMODEL SIGN
GRADING FENCE
'CHECKED BY YPE OF CONSTRUCTIOWTCODE EIG.T
T-A I?
REPAIR — CYDS. (_ x _FT)
DEMOLISH WOODSTOVE SWIM POOL
INSERT HOT TUB/SPA
SPECIAL INSPECTOR JAREA OCCUPANCY OCCUPANT
REQUIRED GROUP LOAD
ES F23
.F�GARAGE RETAINING WALL/
CARPORT ROCKERY RENEWAL
'REMARKS
Y
(TYPE OF USF. Bust ESS 01LACTIViTY) EX�eAIN:
�PROGRESS INSPECTIONS PER UBC 305
D
16
NUMBER OF STORIES NUMBER OF
u
I�
DWELLING
UNIT
DESCRIE,WORK To BI DONE bTACH RLOT PLAN)
FINAL INSPECTION REQUI-REP
11wit""j. S(d e,
I VALUATION FEE
�PILAN CHECK FEE
�BUILDING
HEAT SOURCE: I NG.
%
PLUMBING
:Plan, Check'No.
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL,
Any construction on the public domain (curts, sidewalks,
'STATE
driveways, marquees, etc.) -will require separate, permission.
SURCHARGE ZA-5
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Starled Within 180 Days
I STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENG. INSI��CTION FEE
successors in interest, agrees to indemnify, defen. an.
ow
harml6ss. the City� of Edmonds, Washington, its officials,
2
employees, and agents from any and all claims for damages of
X
�x
ly or indirectly from the issuan
whatever nature, arising direct ce
r
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
D
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
r
provision."
I hereby acknowledge that I have read this application; tha tthe
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
state laws regulating construction; and In doing the work authoriz-
THIS PERMIT This applicatio4n is not a permit until
AUTHORIZES
ed th person will be employed in, violation of the Labor
ereby, no
ONLY THE signed by the Building Official or his/her
WORK NOTED Deputy; and fees are paid, and receipt is
Code of th St te of Washington relating to Workmen' . s Compensa-
' ;1-717
acknowledged in space provided.
tiojn InsurteK -x
INSPECTION
SIGNATUME N E %�Mf E DAT I NED
DEPARTMENT
OFFJ4:IAL'S SI NATURE
CITY OF
EDMONDS
OFRIELEA46 DATE
LIALL FOR �,7
J N T I ON
INSPECTION Q
0—
11 ' IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
771-0220
UNTIL A FINAL INSPECTION iHAS BEEN MADE AND APPROVAL OR
ORIGINAL — File YELLOW — Inspector.
Al, CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
01HART-ER-3.
PINK — Owner GOLD — Assessor