630 GILTNER LN.PDF11111111111111
11396
630 GILTNER LN
CITY OF EDMONDS
8 9 0 1 q,
Address of Construction:
SIDE-. SEWER,�
PERMIT
�PER MIT
Property Legal Description (include all easements): 1�nE-t U, 7 1992
PUBLIC WORKS DEPT,
Owner and/or Contractor: 4-'6
14
StateLicenseNo. OFINAL 14K- JLI'LOS�-Building Permit No. A/A
2--Single Family
El Multi -Family (No. of Units—_
Commercial
Public
Invasion into City Right -of -Way: 11 No 1A Yes
RW Construction Permit No.
Cross other Private Property:,x No El Yes
Attach legal description and copy of recorded easement
I certify/Pat I have read and shall comply with all city requirements
as indigated on the back of the Permit Card.
1,2-- Z-
Date
CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
OFFICE usEJONLY
*FOR INSPECTION CAL PUBLIC WORKS DEPT.
Permit Fee: 30. 77 -629112d
ill By
Trunk Charge: AIA Date Issued: 2-
Assessment Fee: Receipt No.: 9 z 5po
Lid No.:
Partial Inspection:
Comments
Date -initial
Reason Rejected: I Date —Initial
Final Inspection Approved: DateZ--�Z-�.I.Initierf-& .
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Green Copy: Inspector Buff Copy: Applicant Revtsed 3190
Side Sewer Drawing
The City of Edmonds EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION REPAIRS [I LID NO - ------------------ ASMT. NO - ------------------
OWNER.......... ------------------------------------------------------------------------------------- CONTRACTOR ------------------------------------------------------------------------------------ PERMIT NO.
JOB ADDRESS .-�. 3 0 Ct ;-L�: - ------- LEGAL DESCRIPTION: LOT NO - ------------------------------- ------ BLOCK NO - ------------------------------------
- ---------------------- ------------- --- ...............
A
li
PWW-0001-11/75 (REV.11/78)
NAMEOF ADDITION -----------------------------------------------------------------------------------------------------------------------
�os
va
Approved: 61,��
DATE-------------- B�� .......................... -----------------------------
STF-iEET FILE
6, -go - 19 "
City of Edmonds
Critical 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).
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 necessary to complete a development
permit application.
With a signed copy of this form, the
applicant 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
information or studies in conjunction with
this Checklist to assist staff in completing
their prelimdnary assessment 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:
Ofk�-k(- 40r--Q
Narne
Title
9219 :2 2 ci S S LJ
Street Address
JS P, qyoLo
City, State, ZIP Phone
Signature
Date
Applicant Representative:
� A Yl-*xp—.% M - D A sk—
Nwne
Title
Street Address
7d- Z Y?f
Phone
Sign4e Date
JI
Site Information
Project Name:
Critical Areas Checklist
Permit Number:
Site Location: 63 0 &1 &V,- 1A Property Tax Account Number:
Approxi mate Site Size (acres or square feet): __40Q0 10
REET FILE
Have you filled out a Critical Areas Checklist for a project on this site before? 4>6
General Site Conditions
1. Has the site been cleared or logged? �
Soils / Topography
Date of most recent action:
2. In the Snohomish County Soil Survey, what is the mapped soil type(s)? _5 csa
3. Describe the general site topography. Check all that apply.
X —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 th an 30% ( a vertical rise
of 10 feet of horizontal distance.)
Steep: grades of greater than 30% present on site.
Comments
Hydrology/Vegetation
4. Site contains areas of year-round standing water: A)
5. Site contains areas of seasonal standing water: A-) 0 —Approx. Depth:
6. Site is in the floodway /U 0 floodplain- 1U of a water course.
7. Site contains a creek or an area where water flows across the grounds surface? 4J0 flows
are year-round? Flows are seasonal? P 0
8. Site is primarily: -forested meadow shrubs mixed
9. Obvious wetland is present on site:
10. 'Wetland inventory or map indicates wetland present on site: V0
11. Critical Areas inventory or map indicates any Critical Area on site: A2 1)
For City Use Only—
PERMrr "PLICAUON RE 41 "F-L I riLr.
QUUMM24
TO: Permit Coordinator, Building Division
FROM: Lyle Chrisman, Engineering Inspector
OWNER: 6e211AJ,-50,-J - PLAN CK #
ADDRESS:- -5C' 555A::-7A-Z5�- 6^) DATE:
After review of the subject permit application, the fbIlowing raqWrementf mustbe met.
1. Construction hours art.- WEEKDAYS .......... 7:00 A.M.-10:00 P.M. WEEKENDSMOLIDAYS ..... 10:00 A.M.-6:00 P.M.
2. A separateRIGHT-OF-WAY- Construction Permit is required for all work on Publicproperty. (ECDC 18.60)
3. Truck haul route plan must be submitted and approved prior to permit issuance.
4. Builder/Owner is responsible for containing all temporary ruzioff and erosion control on site. (ECDC 18.30.'030d)
5- No WORKSHAU BE DONE MTRINZS FEET OF STRE"S OR 10 FEET FROMANY CLOSED DRAINAGE FACIL,
ny. DuaDERlowNER is REPsminkpoR mENT1Fy11VG coNDHTONs ON THE DRAy NG. (FCDC18.30.50G)
a
6. FzTER FAB= FENcE sHALL BE iNsTALLED AND iNSPECTED PPUOR TO CLEARNG A*D CONSTRUCTION.
(ECDC 18JO)
7. INSPECTIONS ARE REQUIRED ON STORM DRAINAGE SYSTEM, TIGHILINES, FOUNDATION DRAINS, AND
CATCH BASIN UWALLATION. INSPECTIONS ARE REQUIREI) . PRIOR TO BACKFILLING. (ECDC 18.30)
8. Repair or replace all defective existing curb, gutter, and sidewalk adjacent to the property. If an intersection is involved a
handicap ramp may be required- Contractor shall meet with the City Engineering Staff to determine the extent of repair prior to
issuance of the permit. (ECDC 18.90)
Driveway slope shall not exceed 14 % without a waiver. Every attempt should be made to keep the slope below 14
W�iver granted to_%. (ECDC 18-80.060D)
10. Drivewayi must be paved from property line to City RIGHT-OF-WAY. A separate perimit is required. (ECDC
18.80.060C)
11- INSPECTIONS ARE REQUIRED ON DRIVEWAYS AND SIDEWALKS PRIOR TO AND AFrER POURING.
(ECDC 18.30)
12. No burning of construction refuse without a permit from the Fire Department.
13. Connection to City water system is required. There is a separate charge tor the water meter. (ECDC 7.30)
14. Aback, water valve is required if downstairs plumbing is below the elevation of upstream manhole. (ECDC7.20)
15. Water and sewer main lines should be separated by 10 feet minimum. (ECDC 18. 10)
16. Connection to the City sanitary system is 'required. A separate permit.is required.
LID#- 5-1 Feespaid: Yes NO- Charge (ECDC18.10)
17. Underground wiring is required on all new construction; and for additions, alterations, and repairs that exceed 50% 'of the total
assessed value of the structure. (ECDC 18.05.010)
18. A FINAL ENGINEERING INSPECTION IS REQUIRED PRIOR TO THE BUILDING DIVISION GRANTING OCCU-'
PANCYOF THE BUZLDING OR STRUCTURE. (ECDC18.90) -
19.
20. liz-
Critical Areas Checklist STREET FILE
Site Information
Project Name: Permit Number:
Site Location: 63 Q &i AA v/, JA Property Tax Account Number:
Approximate Site Size (acres or square feet): �Oc)()
Have you filled out a Critical Areas Checklist for a project on this site before? X,) 0
General Site Conditions I
1. Has the site been cleared or logged? Date of most recent action:
Soils / Topography
2. In the Snohomish County Soil Survey, what is the mapped soil type(s)? SkA 4L
3. Describe the general site topography. Check all that apply.
X 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 of horizontal distance.)
Steep: grades of greater than 30% present on site.
Comments
I
Hydrology[Vegetation
4. Site contains areas of year-round standing water: A-) 0
5. Site contains areas of seasonal standing water: A-) 0 _Approx. Depth:
6. Site is in the floodway /U 0 floodplain A) 0 of a water course.
7. Site contains a creek or an area where water flows across the grounds surface? 4)0 flows
are year-round? Ju 0 Flows are seasonal? X 0
8. Site is primarily: -forested meadow -;shrubs mixed
9. Obvious wetland is present on site: A2 0
10. Wetland inventory or map indicates wetland present on site: VQ
11. Critical Areas inventory or map indicates any Critical Area on site: A) 1)
... ....... ..
..........
..........
—For City Use Only---- ......
STUDY REQUIRED: Critical areas study is required.
CONDITIONAL WAIVER: Critical areas study not required if specified conditions satisfied.,
WAIVER: Critical areas study is not required.
Determination Number.— Reviewer
Planner Date
Rev 3/27/92
890 .199-
City of Edmonds
Critical 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).
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 necessary to complete a development
permit application.
With a signed copy of this form, the
applicant 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
information or studies in conjunction with
this Checklist to assist staff in completing
their preliminary assess mient 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:
ORvA(- 4orn-a-s Let(-
Nwne
Title
q 219 '9- 2 C/ K 'S 'S Li
Street Address
City, State, ZIP Phone
Signature Date
Applicant Representative:
-� A Y"Ics A
Nwne
F-C
Title
I/
Street Address
7d- Z Y-af
Phone
Signa�fe Date
TREET FILE
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNE5 N_VEINAME OF BUSINE�6
/I/` 41.lel<
Z MAILING ADDRESS
� /
0
CITY ZIP TELEPHONE NUMBER
-7 -7 6 C -Z
NAME
ADDRESS
L)
CITY ZIP TELEPHONE NUMBER
7
-:70
NAkFj
N
R UC I-YllrV
CITY ZIP TELEPHONE NUMBER
,7 . f— 17,�_ -
Xw'-u, 7-F-0 7,!s- 1 , ,_, P 1�
STATE LICENSFNVMQgEL— EXPIRATION DATE
0*"'l
C_ /< /Y 16 C, (1) /-/9-95
Legal Description of Property - include all easements
F&SIM: A - F&II LLO IA&
Property
T Account
P'ax�el No.
5;�NEW
RESIDENTIAL
F71
�N PLUMBING
ADDITION
COMMERCIAL
MECHANICAL
EIREMODEL
APT.BLDG.
SIGN
0
GRADING—
FENCE
D
REPAIR
�a �L— CYOS.
( x —Fr)
DEMOLISH
WOODSTOVE
SWIM POOL
INSERT
HOT TUB/SPA
IGARAGE
M
ETAINING WALL/
F� T.......
F-1
00d~T
TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN
Z6;E PERMIT
& NUMBER 9-30363
JOB
ADDRESS SUITE/APT #
WCOVIMIr I IUN t1MtUKI
4"" Z'
SUBDIVISION NO.
-5-
LID NO,
-
1 4 - '71
57/
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCP Approved (3
EXISTING REOUIRED DEDICATION
RW Permit Req ired
Street Use Permu ' )51
it Req'd 13
Inspection Required
PROPOSED
Sidewalk Required
REMARKS
4/U`j0_9s W r, -
W
W
Z
ENGINEERING MEMO DATED RIEVIEW BY
MM
METEZ01ro IBUILDING SUPPI�YISIZE
. /1 1 NO. OF FIXTURES
R F EMARKS
SIqN AREA
'
SEPA REVIEW�'
ADS NO.
ALLOWED \
PROPOSED
COMPLETE
E
I 7
SHORELINE N
IFRONT
EXP
VARIANCE OR CU
INING REVIEW BY
�ATE
SETBACKS — F&P
I HEIGHT
I LOT COVERA FT
<_
REAR
_7_0_7SDE
REMARKS
CHECKED BY
TYPE OF CONSTRUCTION
I
CODE
I
HEIGHT
A)
e7/
2S4
SPECIAL INSPECTOR
REOUIRED
OCCUPANT'
13 YES
_t2
2 MA�?
LOAD
REMARKS
PROGRESS INSPECTION
S PER uBC inn
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
- I f 7-.-
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
,,fC I LMI tAl INSI ECTION REQUIRED
VALUATION
-V-0104 OF I -Or 3 % .
PLAN CHECK FEE
BUILDING
HEAT SOURCE:
GLAZING
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewialks,
driveways, marquees, etc.) will require separate permission.
GRADINGIFILL
STATESURCHARGE
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 an
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
whatever nature, arising directly or Indirectly from the Issuance
of this permit. Issuance of this permit shall; not be deemed to
modify, waive or reduce any requirement of *any city ordinance
nor limit In any way the City's.ablilty to enforce any ordinance
provision."
ENG. INSPECTION FEE
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
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
state laws regulating construction; and In doing the work authoriz-
ed thereby, no person will be employed In violation of the Labor
Code of the State of Washington relating to Workmen's Compensa.
tion Insulance.
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
SIG T OR ENT) I NSPECTION
E (OWN! DEPARTMENT
�E DATE SIGNED
CITY F
ODSI
EDMON
ATTENTION CALL FOR
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE INSPECTION
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-0220
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UEIC
CHAPTER 3.
102-87
91
CC)
/P'43— V�4�'4/�.,
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his/her
Deputy; and fees are paid, and receipt is
acknowledged in space provided.
OF L' SIGN RE DAPE
hELEAS— %;:.-
E
DATE
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
x
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City of Edmonds Building Division
APPROVED PLAN
)tain E I eckcal Ae-rmitfrc
State Labor & Industries
ApPROV�E�,L
FIRE DEPARTM C""')
CITY OF. EDMONDS
BUILDING DEPARTMENT
WORK
ADDRESS C-VL44L'Z'� Ltj
OWNER
FPPROVED DATE:
B G.
LD OFFICIAL A -
PERMIT NUMBER
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