630 EDMONDS WAY.PDFiiiiiiiiiiiiii
11051
630 EDMONDS WAY
ADDRESS:
TAX ACCOUNTIPARCEL NUM13ER: 2103ze0eq /o/
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS:— DETERMINATION: E] Conditional Waiver 0 Study Required ;K/Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
I
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
Mines mo, amm. m
Romink 11 11412 60,
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $: . —LID#:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #-.
WATER METER TAP CARD DATED
OTHER:
LATEMP\DSrs\Fomis\Street File Checklist-doc
UILUING-. -A'pl. No. 7 ..... L ..........
APTLICATION im IRMITI
p
Ments
epart
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--is h a
onst'ruct, the:followin- work, -'�'acow.
ia iarice wi e� 666fii":.�
K ereb f6r,a.permit.to,c
y
pprovaj.
pany 11�? "d fkations., -Two sets are s6i6itt6d h&6�dth for a'
ing. p ,?p sped
Off'st.
.,yi
alter
new
r, -"`Wo-rki;'Pddn jepairi-..-.z ...... Parking ........ 1_1 .............
cu .......... Fir� zone.
pancyL., ...... ............. Const. type .................................. Usj;, zone.. .. ....... ..............
7.
41
.-Add*
.. ..... ................. ...... ............
0 ...................................... . ....... W -----_-_- .........
.......... I ...... Are . ........... . ......... . ...... ;.. Se�tic tanL.'.,e ......
ge ............ ....... ...
7
17 .71
Side ..... ............
Bldj. set�bach fronL: ......... rear ...... .............
......... . ... r. side.: ---------------------------- I
TeL. No... ...... ...
Add
-,2ress.-
........................... ............... 'Tel. N
j�
Builder ... . ...... ...... ........... Addrem..' ......... q..* .................... ......
................
7
......... Address ............................................. ..... Tel. i N6 .............................. ;)
by . .... .
...............................
.'..-R arks ...... .......................... ......................... ........................................................ .................
.......................... ........................................ ...........
... . . . .. . ..................................... .............................. .............. ...................
................. . . ..
......................... I ......................................................................... ..............................................................................
p igu ating,
I The ab&�e:is.i correct.statement, and I agree to comply with all. a plicable Codes and State li�is r
work.
Signed Ownei/4gena& Address ............................................ D a ti J_�
bje&, to above conditions, and -to c6m Iaix4e With'j;he
-'PERMff for the above work is hereby approved,-'gu the'
'thereon.
pi�� plans and specifications,. and. Building Department 'notations
Valuation Av...J ...... 'Permit fee� ............ Recd. .. ..... .....
................. ......
r
. ......... 6 . ..................... ..........
Building Dzpartment, By ...................................... ---'V -f ..... ... .......... Date.
This Permit does not cover Plumbing, Sewer or' Electrical installations.
STREET FILE*
Critical Areas C:hecklist.
Site Information
ProjectName: CaAlTe-11�01-IS,6CY perraitNumber-
Site Location: la Z 6--- d 5 k- 9- property Tax Account Number: S X1 12 3 0
Approximate Site Size (acres or square, feet): 5(2 5-6. 171,
Have you filled out a Critical Areas Chc . c1dist for a project on this site before?
General Site Conditions
1. Has tticsite been cleared or logged? Date of most reomit action:
Soils / Topography
2- In the Snohomish CountySoff Svrvcy�,vhat is the mapped soil qpc(s)?
3. Describe the general site topography. Chec.k 211 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-)
Mly: slopes present on site of more than 15% and less than 30Yp a vertical rise
of 10 feet of horizontal distance-)
itc.
_—.-$tccp: grades of gregtcr than 30% present on s
C�mmcnts
Hydrology/yegetation.
4- Site contains areas of year-round standing water:
S. Site contains areas of seasonal- standing water-- -Approx. Depth: Acc-
6- Site is in the floodway N\C— "'floodplain '6C ofawatcrcourse-
7- Site. contains a creek or an area whcre.water flows across the grounds surface? flows
arc year-round'? NC— 0ows are seasonal?
I t
8- Site is pnimanily: forested meadow AL shrubs mixed
9- Obvious wetland is present on site:..
10. Wetland inventory orniap indicates wetland present on site:
11- Critical Areas inventory or map indicates any criticiLk Area on site- N C
-0i
aty Use nl�.
R ar!eas stu'��,,'.-ts-�Veqqtrf-�
d
Rev'3127192
CitY Of Edmon&
Critical Areas Che'
cklist
ne Critical Amn Checklist contained on
this form. is to be f Mad cut by any person
prqmiqg a Dcvclopment permit
Application for the CitY of FAmonds prior
tO his&cr submittalof a demopmcat permit
to the City- .
The purpose of the ChecIdist is to able,
CitY staff to determine whether my pot=tW
Critical Areas are or may be present on the
subject property
. Ihe information uoo&d to
cOmPlete the Chadkiist should be easily
avaiiable fi-omobservati ' ons; of the site or
data available at (Nty 11all (Critical Areas
inventories, maps, or soil surveys) -
An applicant or his/her rcpresentative. must
fill out the chocIdist. sign and date itand
submit it to the City. 1he City Will leview.
the chedlist, a precursory sftc visit
and a dammfimfion of the MbseVent
stcps u0CCSSarY to complete a development
Permit application -
With a signed copyof this form�, the
3PPlicant should also submit a vicinity map
of the parcel vith enough dctail dw City
staff can find and identify the subject
parcel(s)- In addition, the applicant is
encouraged to include any other pertmcnt
infonnation or sbidics in conjunction with
this Chcddist to assist staff in completing
their preliminary assessment of the site.
I have completed the attached Critical Area Cheddist and attest that the answers providedare
factual, to the best of my knowledge (fill out the appropriate column below) -
Owner/ Applicant:
Name
Title
: Street Address
City. State. Zip Phone
Signature Date
Applicant Representative:
k,51 IVlk(4 T
Name
fg)E5 LdL2!-f� IT 0 L.Z,-AIE t2-
Title
Street Address
City, State, Zip
Phone
Sti�ature Date
APPLICATION
for
The City of Edmonds SEDE SEVOM PEBBM
OUTSIDE E] INSIDE REPAIRS
CARD No. ...
EASEMENT No . ................ ..............
, jo � /
OWNER.JqA.AYc--.-z# HAAl.AUXlP.AJ ............................................... CONTRACTOR .... R 4
.................................................................................... PERMITNo.
HOUSE No..6--..Tg .... STREET
VJA V
.......... I ............................................ AVENUE WT No . ...................................................................... BWCK No . ....................
NAMEADD . ................................................................................................................................
1%
U-1
BACKIFILL WORK ORDER ISSUED .......
SEWER WORK ORDER ISSUED .............
rA
-rc Lu
Date Approved:
......................... DEPOSIT, $ .............................................
........................ DATE ...... ......... ---------- By
fixlrr%
JAY, 2 8 1963
STREET FILEP'
CITY OF EDMONDS HARVE H. HARRISON
MAYOR
CIVIC CENTER EDMONDS. WASH114GTON 98WO (206) 775-2525
-.Red--Snapper-Seafood & Steak House
6301LEdmonds-Way
Edmonds, Washington 98020
Dear Sirs:
The City of Edmonds Public Works Department, Sewer Division,
has informed this -office that the kitchen in the above
establishment is not equipped with a grease interceptor, as
required by the Uniform Plumbing Code,and City policy.
Lack of an interceptor on kitchen waste lines is imposing
maintenance problems on the sanitary sewer serving the
building.
Please take action within the next thirty (30).days to
provide an interceptor in accordance with code requirements.
Very truly yours,
JOHN B. MITCHELL
.,Acting Public' Works Direc.tor
Enclosure (2)
CC: Building Division