629 ELM PL.PDFIIIIIIIIIIIIII
11159
629 ELM PL
ADDRESS:
TAX ACCOUNT/PARCEL
BUILDING PERMIT (NEW STRUCTURE) #:
COVENANTS (RECORDED) FOR:
CRITICAL AREAS DETERMINATION: 0 Conditional Waiver 0 Study Required NWaiver
CRITICAL AREAS #: DETERMINATION: 0 Conditional Waiver 0 Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORD FOR:
PERMITS (OTHER — list permit #'s):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID
SHORT PLAT FILE:
LOT:
SIDE SEWER AS BUILT DATED: / 2,�-
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE/ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DATED:
OTHER:
L:\TEMP\DST's\Forms\Jana's Street File Checklist 5-14-08.doc
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Critical. Areas Che . cklist CA File No:. 0S I
Site Information (soils/ topography/ hydrology/vegetation)
1.. Site Address/LDcation:
2. Property TaxAccount Number:
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? A' yes; no.
If yes; how is site developed?.
5. 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).
Hilly: slopes present on site of mor
44
over. a horizontal distance of 33 t6o
AM I 10 �1 1A
A
�56 1h
-ite vertic 10 v rifortud
Steep: grades of greater than 30% present 9 't, 01 07 4M
lrti L
g
distance of less than 33-feet).,ow-_4�,
Other (please describe
6. Site contains -areas of year-round. st - anding water. -;Apprpx.'Depth.
7. Site contains areas of seasonal standing water: 1'-07' Appro?(.,De
pt.h
What season(s) of 'the year?
8. Site is in the flood-.4ay -IzO floodplain OEO of a watercourse.
9. Site contains a creek or an area whereWater flows across the grounds surface? Flows are year-round?'
Flows are seasonal? (What time of year?,
10. Site is primarily: forested meadow shrubs— mixed -e<
urban landscaped (lawn, shrubs etc)
Ar _Oeo
-VIVele- f x ee- -le e-,, r-,
11. Obvious wetland is present on site:
po
For City Staff Use Only
1. Plan Check Number, if applicable?
2. Site is Zoned?. P;2- D - I C1 19 zo - 0 1
I SCS mapped soil type(s)? _6aM&U W6LAM Q-9+ -b
.P0JV k Ot' kAjt/YtAr 4yaAZag6:4 CA/vl LI'M -2" '5'LV 12 ee'�L,
�j . I Ij
4. Critical Areas inventory or C.A. map indicates Critical Area. on site? NQVX5h0VJn M-Giff.
5. Site within designated earth subsidence landslide hazard area? w:onesV1oWy1joLA* RLAftCAtnq
0 �fj c.� a I -M m a fm a i dvftym� Yi a-h om
DETERMINATION
STUDY REQUIRED
I—
WAIVER
0 #P-20
9
14 C., 1%9V
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 Appli cation.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
. +_+� I f�_;+; A---
Date Received: L�Z '2� / 41'
City Receipt#: 7e�1,47
Critical Areas File M
Critical Areas Checklist Fee: $135.00
Date Mailed to Applicant: X—,2_3-26ac
A property owner, or his/her authorized representative,
must fill out the checklist, sign and date it, and submit it
to the City. The Cit� will review the checklist,.make a
precursory site visit, and make a determination of the
subsequent. steps necessary to complete a development
permit application.
detratnuie aILY FU a %, are, or
may be, present on the subject property. The information Please submit a vicinity map, along with the signed copy
needed to complete the. Checklist should be easily of -this form to assist City staff in finding and locating the
a s ific piece of property described on this form. In
C
sV
I "M
ddition, the applicant, shall include other pertinent
f f
01
ormation (e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant staff
Q,,Lcornpleting their preliminary assessment of the site.
-APPLICAMN PIC
'fhe undersikrio applicant, and histher/its heirs, and. assigns, in consideration on the processing of the application agreqs
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 mi; fraction. based in whole or part upon false, misleading, inaccurate or
incomplete information. ftimished by the applicant, his/her/its agents or employees.
By. my signature, I certify that, the iaormation 'and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to, file, this application ont4e behalf of the owner as listed below.
SICNATURE OF APPLicANT/AGENT DATE
1_40�- eA
Property Owner s Authorization
By my signature, I cer* that I have authori zed 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 posting attendant to this application.
Owner/Applicant-
Name
Street Ad&ess
AI/P
City� -:State Zip,
Telephone:
Email address (optional),: _ AA
Applicant Representative:
Name
Street Address
City State zip
Telephone:
Email Address (optional): 1,e 4V
Z-,e;* e-oV-7,'
lqr
00
C)
CITY of EDIVIODS
For Inspection Ca'l.l 771-3202
"-ddress of Construction:
E�L.Property Legal Description
(Include all easements):
SORE SEWER PERUIT
PERMIT NO. 07901
: L o 7- 00N -r o P7 L-2-nA
Owner and/or Builder: k4-6 f_�7 0�_ 11-1'J /�4� Kk? A-)C,
Contractor & License N.o: /4 o 4 14 '/L� k
Singl:e Fami I y, Residence
Multi -Family (,No. -of Units
YIA EDMONDS WAY
TRUNK LINE
Commercial (No. of fixture Units
Invasion i nto City Right -of -Way: No Yes (If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No Yes (If Yes, easement required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS LISTED ON THE BACK
t7f
I certify that I have read and shall comply Date
with the items listed on the back.
5 04' "'A 04, fA 0A, 0A, 0A, 05 0A, 0A, S A A' W_R� 05' 05, 'A
Permit Fee: XZ67 /VP Issued By:
Trunk Charge: Date Issued: A 9/'
, -A
Assessment Fee: Receipt No.: _e 'D' Y2�'?
Partial Inspection:
Comments
Final Inspection Approved: M/_
" 4 e_'1'
Date I ia lJ
Rejected:
Reason
** PERMIT MUST BE POSTED ON JOB SITE **
Date Initial
—Ta—te —T—nitial
W.h.ite Copy - File Green Copy - Inspector
Buff Copy - Applicant
Tl%,m r; 0%; cA*"0%V%A
Side Sewer Drawing
m
EASEMENTNO - --------------------- ------ ------------ --
NEW CONSTRUCTION REPAIRS LID NO - ---------------- .- ASMT. NO - ------------
'--81.
OWNER AOMELA ------ �.A -0 M -G--, I.NC --------------------- CONTRACTOR, -------------------- PERMIT NO.
JOB ADDRESS -G-2,13 ------- ..... P-A�-P<�F — ----------------- LEGAL DESCRIPTION: LOT NO. -A-S -------- ------------------- BLOCK NO - - - - - - - - - - - - - - - - - - - - - - - 7
X- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ---
r
PWW-0001 -11/75 (REV. 11178)
NAME OF ADDITION -------- E L- P.A -------- P-%--A-,C-E
mg, m
1*0 SURFA"
4!DP. , i
W'C�c V.C.
C�*.C*�p r
Approved:
DATE;61�01'1'.. ------- -------
Ej
L11
% '; ;I
SHEET I OF
Sr ELM PLACE
A PLANNED RESIDENTIAL DEVELOPMENT
POR. OF NW 1/4 SYJ 1/4 S E C. 25, T. 27 N., R. 3 E.,W. M.
DEDICATED AS R/W EDMONDS, WASHINGTON
5 as-D'27"E NE CORNER
r ik--S r
-------- NE 1/4, NW 1/4,
0
209 64
I SW 1/4
ci TRACT 102 0
30.00 93.94
,1 32.62
.16 20 0
21 4 1
19 'Ef X C r P
TION.
So.
29 0 22
a 84*31,27" C
"0"
46.00
sea-312,
%
T, al c
28 Ilk
IN 17
10. 1j -
/01 4 + 19.
o"'
�O PL.
o
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S 9",71 26
33.2. 32 33 06
+
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36 �s,.26 tLM TRACT103
12 So
9
12 10
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ve
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TRACT 103
a S0.00
.00
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4
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'101
10,
-100 , , it. -* t. - 2 �
S 84'00'13't
jo.
TRACT
102 16
!a
NOTES:
L EASEMENT 3 AFFECTING THIS PRO ARE AS DEPICTED IN THE
DECLARATION OF COVENANTS, CONDITIONS AND RESTRICTIONS SCALE 1' 50*
AS FILED UNDER A.F NOL
2. SETBACK$ HAVE BEEN SPECIFICALLY DETERMINED AS 10 FEET
A
FRONTYARD AND ZERO FEET SIDE AND REAR YARDS WITH THE
I
APPRO%AL OF P.R.D. NO. 1-83 BY THE CITY OF EDMONDS.
SAN
UTILITY
EASEMENT
' . iNfED* TY -THE
XCITY OF EDMONDS
j'a OLYMPIC VIEW
-WATER DISTRICT.
IS 09-00,1?" It -
TRACT 102
b EXCEPTION
�-i- 29 ILI
s do-30*11"t 54 ai - -
P A r? A D I
L A tq E'
VE DATA
DELTA
PAD! US
LENGTM
CURVE
DELTA
RADIUS
LENGTH
35*57' 17*
133.43
83.71
Z3
26*41 '56'
17.00
7.92
90:00:DO:
00
26.70
24
23:06:23:
44.SD
7.95
I 1 01 11
"7:00
5.08
25
53 07 45
44.50
4 1. 26
". 4 6.,9.
28 . CO
35.08
26
33 . 0 1. 33
10.00
1.76
22*17 . 54
103.15
40.;4
??
26:44:37
0.00
�7.00
4.67
90*00 .0 0
1O.D0
15 "
?a
49 08 1 1:
1 4.53
64. 4 S 05
11.50
'3:'
29
43 25 .5S.
so 00
37 9,9
08625 so
Ill. 1 2
17 . 28
310
10 50 52"
.19 78
:
N1
90*00 00
1.60
7 . 07
31
26 24 45"
99.78
46.00
38.59.45
33.00
22 46
32
77:15:36:
17 00
22.92
47*42 34-
7Z.28
: 9
113 1
33
24 00 00
455:00
190 59
17,33 30*
77.50
2 .15
34
138 59 56
0 00
�7
24 26
$2,00 00,
77.50
70 . 34
35
44 51 32
. 00
13.31
27. 41,
ol:".
77.50
36 . S&
36
87 42 34
10 . 00
15.31
51*28
47.50
42 . 68
37
48 59 56
10 . DO
8.5 S
21.28145*
76.00
28 . 12
38
90.00:00:
20 00
321.42
60*00 . 00,
17.00
11 . so
319
41 00 04
17:00
1 . I I
38-59 .4 51
17.00
11.57
40
to S. 19:111:
0.00
38
92,00 . 00'
17.00
27.)D
41
60, 4
11
9.92
'4 48
22*17:54'
114.15
44.42
42
142:0�:112:
50.DO
12 .
3.94
71* 39"
f
17.00
2 -
21-30
11 no
4 3
52 0 2
15.00
13 62
SO'
SURVEYOR'S CERTIFICATE
1, LeRoy F. Midditton. Registered Land Surveyor, do herwisy
certlfy,that this plat Is based upon an actual su "or and
S ubd vi I on of Section 25, T?7N. R3E. W.M., and that mnw-
inents have been set and lot corners Staked on the qr�nd
as S h own he reon.
L4100
e 1�0114'�d A�oto. ko.
R istertd Land Surveyor 0
Rold, Middleton A Associates, Inc.
LEGEND
9) EXISTING CASED MONUMENT
+ EXISTING CONCRETE MONUMENT
0 SET CASED MONUMENT NO. 4561
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
HOMELAND HOMES. INC.
NDS
DESIGN CONSULTANTS
TO OR _ESS
903 -
1< CITY
MUKIL
NAME
HOMEL
ADDRESS
CITY
EDMO
STATE LICEI
xxxx
5-
E NUMBER
- AI;A
NUMBER
A
HO ME LHI"'174KE
Dn of Property - Include all easements
attach four copies)
18, Plat of Elm Place
4pt I I L_ LM NWPERMIT
WR
JOB
ADDRESS
629 Elm Place
LEGAL DESCRIPTION CH UBDIVISION NO.
4;r /,* 7 /a- '7-,F_3 � 2
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING PEQUIRED EDICATION—
PROPOSE6?����7,2�RD
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED 0
STREET USE PERMIT REQUIRED 0
SEE ENGINEERING MEMO DATED
SIZE IBUILDING SUPPLY SIZE
REMARKS
UNITS
0
Z
cr
LU
Z
SIGN AREA
ALLOWED PROPOSED
ENV. REVIEW
COMPLETE iPT
ADB NO. r—'
I _
SHORELINE#
I
VARIANCE OR CU,
PLANNING REVIEW BY
DAT
L9
YARDS
FRONT
SIDE REAR��
HEIGH7
LOT COVERAGE 9
Z
Z
REMARKS
M
r
EJ
�i
NEW RESIDENTIAL PLUMBING
F
ADDIALTER COMMERCIAL MECHANICAL
D El
I
REPAIR RETAINING WALL SIGN
CHECKED BY TYPE 0
EXCAVATE FENCE
El
DEMOUSH OR FILL x _FT)
PRE -MOVE 1143PJ swim SPECIAL INSPECTOR
REMODEL 9OMKIANPE INSP. REQUIRED
WOOD STOVE/ 0 YES 0 NO
INSERT APT. BLDG RENEWAL REMARKS
IQ
NUMBER OF STORIES r—NUMBER OF
Two 1DWELLING
Single
UNITS
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
Construct sinale family dwelling
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit be done
covers work to on private property ONLY. GRADING/FILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission. STATE SURCHARGE
Permit Application: 180 Days
ENERGY CODE
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
lo
successors In Interest, agrees to Indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
J
employees, and agents from any and all claims for damages of
whatever nature, arising directly or Indirectly from the issuance
of this permit. Issuance of. this permit shall not be deemed to PLAN CHECK DEPOSIT
1_1
modify,. waive or reduce any requirement of any city ordinance
0
Jx
nor limit In any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE
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
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
ed thereby, no person will be employed In violation of the Labor ONLY THE
Codeof thq State of Washington relating to Workmen's Compensa- WORK NOTED
tIQ /111 zf INSPECTION
SI T (OWNER OR A9t A DEPARTMENT
]DATE SIGNED
CITY OF
EDMONDS
771-3202
ENT
Mlk �OROCC�UPY
;,j UNLAWFUl A BUILDING OR STRUCTURE
!NTIL A FINAL IN�PECTION HAS BEEN MADE AND APPROVAL OR
CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
1,1-11�1.PTER 3.
-02.74
GROUP
VALUATION
OCCUPANT
LOAD
FEE
W
111112�1�
APPLICATION APPROVAL
This application Is not a permit until
signed by the Building Official or his
Deputy; and fees are paid, and receipt Is
acknowledged in space provided.
OFFICIAL'S SIGNATURE DATE
RELEASED BY:
DATE
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
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