638 PINE ST.PDF11111111111111
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638 PINE ST
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ADDRESS:6349 &� :�7r,
TAX ACCOUNT/PARCEL, NUM13ER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: �M Z— J20 t� — DETERMINATION: E] Conditional Waiver 0 Study Required Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:--&2-/,02--, AVI-71-7,560k`
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED: 2j, jqj SIDE SEWER PERMIT(S)
t I
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED: 47// 47 / /
OTHER: &W qr -
LATEMP\DSTs\Fomis\Street File Checklist.doc
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PLANNING DATA
NAME: &ArPK f- 77�� rA f DATE: 9'/ 1 lo2-
SITE ADDRESS: & 3 k A-h't S�-' —PLAN CHK#:-o 7- - 3
PROJECT DESCRIPTION: ~-e-b-A g b"-L- t- LvL-4e 6e4mw-� et-t tW Abj��
14 e2f4 -
REDUCED SITE PLAN PROVIDED?:
MAP PAGE: 15-3 CORNER LOT: FLAG LOT:
ZONING: Ps - t' CRITICAL AREAS DETERMINATIONM 02-11E'
0 Study Reguired:
U�Walver
L3Conditional Waiver
SEPA DETERMINATION:
UFee
U Checklist
L3APO list w/ notarized form
VU eaded for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger)
Exempt
SETBACKS:
Reguired Setbacks:
Street: 7-o' Left Side: 5' Right Side: Rear: 5
Actual Setbacks: 4-
Street: 3b' Left Side: 15.1s, Right Side: Rear: 3
Street map chocked for additional setbaci required? (Yes I Wol DNA)
DETACHED STRUCTURES: A- f" pyd� 14�y -
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ROCKERIES:
U FENCEsrrRELLISES:
[J BAY WINDOWS/ PROJECTING MODULATION: &,atkj.6�
LJ STAIRS/ DECKS:
PARKING: Required: 2- Actual: Z
LOT AREA 2,S7
LOT COVERAGE
Calculations: aj S 7P 3
BUILDING HEIGHT:
Datum Point: Datum Elevation: 99
7,10
Maximum Ailowed: Actual Height:
A.D.U. CREATED?: Yes) 0��,
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SUBDIVISION: —
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: (Yes / No
k be A 10' 4frV% �-�44� -K,4� 06-e
Plan Review By.
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NewBPPlanningDataForm.DOC
CA File No: OD, - it
Critical Areas Checklist
Site Information (soils/ topography/ hydrology/vegetation)
1. Site Address/ Location: ( --5 9 R Qe %
2. Property Tax Account Number: G 19LA -005- 010 - Q 109
3. Approximate Site Size (acres or square feet): 0 K
4. Is this site currently developed? )4- yes; — no. -- — ----
If yes; how is site developed?
A . -
5. Describe the general site topography. Check all that apply.
Y, 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).
I -My: slopes�present-or.-siie 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 lesg than 33-feet).
Other (please describe):
6. . Site contains areas of year-round standing water: W6 Approx. Depth:
7. Site contains areas of seasonal standing water: '''No Approx. Depth:
What season(s) of the year?
8. Site is in the floodway WO floodplain — of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
00 Flows are seasonal? (What time of year?
10. Site is primarily: forested 06 meadow ;shrubs mixed
urban landscaped (lawnshrubs etc)
11. Obvious wetland is present on site: V113-
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Critical Areas Che�klist.doc/3.19.2001
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City ofEdmonds
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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 fromobservations of the site or data aVailableat
City Hall (Critical areas inventories, maps, or soil
surveys).
-ateRecem: 5/30(oZ,
,13
City Receipt Ft'
#:_ 64V
CriticalAreas File M
CIriticalAreas Checklist Fee: $45.00
'Dite Maiiiied-to Applicant:
A property owner, or his/her authorized representative,
must filf.out th6 checklist, sign and date it; and submit it
to theCity. 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
spicific - piece of propert�' described 6h 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 Edin�6nds 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 furnished by the applicant, his/her/its agents or employees.
By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file this application on the behalf of the owner aslisted below.
SIGNATURE OF APPLICANVAGENT 0_
DATE
Property Owner's Autborization
By my signature, I certify that I have authorized the above Applicant/Ag t to apply for the subject land use application,
. �� f
and grant my permission for the public officials and the staff of the City " f Edmonds to enter the subject property for the
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purposes of inspection and posting attendant to this application.
SIGNATURE OF OWNER ���a, acIrLent DATE 5/2(9/0 a
Owner/Applicant: I -, 7 1
Wav-d .4, The-res a- For re-,11
Name
6- 1
� S TP'n e S -f
Street Address
Gj� ryi o n d WA 9 80 Zo
city State Zip
Telephone: Li 2. r3 - -� -15 - 6 1-11
Email address (optional):
Critical Areas Checklist.doc/3.19.2001
AppHcant Representative:
Name
Street Address
city State zip
Telephone:
Email Address (optional):
t
STSEtt"HLE
CITY OF EDMONDS SIDE SEWER PEBMIT
PERMIT
8 9 1 4 C, 1 828
Address of Construction: C,�_3 F 7 e- 4 ill Z
,rpan
Property Legal Description (Include all easements): Yosir 11-45,r AWal xi�q Aw- o,,e-ZWeyave2�-
61-k-, 00,5- weir ya Z-O/- /V
Av -<-I- /fd
EDMONDS
Owner and/or Contractor: MC. Al2 ef Ce
State License No.
t4 Single Family
0 Multi -Family (No. of Units-)
0 Commercial
E3 Public
JAN 2 8 1991
PUBLIC 1NOR"kS
Building Permit No.
Invasion into City Right -of -Way: 10 No 0 Yes
RW Construction Permit No.
Cross other Private Property: W No 0 Yes
Attach legal description and copy of recorded easement
�rtify that I have read and shall comply with all city requirements
indicated on the back of the Permit Card.
/ - /-if- %�
Date
* CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION *
Permit Fe
OFFICE USE ONLY
FOR INSPECTION CALL 771-3202, PUBLIC WORKS DEPT.
Issued Bv
Trunk Charge: &Q42112--
Assessment Fee:
Lid No.: 7_�t
Date Issued:
Receipt No.:
Partial Inspection: Date -Initial
Comments
Reason Rejected:
Final Inspection Approved:
Date:2-(4/ lnitiaL-�7'
I
Date -Initial
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Green Copy: Inspector Buff Copy: Applicant Revised 3 90
Side Sewer Drawing
The C' ity of Edmonds EASEMENT NO - ---------------------- ---------------------
NEW CONSTRUCTION [j REPAIRS Yfl� LID NO - ------------------ ASMT. NO - ------------------
........ 0 Z'�-�CL - ---------------------------- PERMIT NO. 0-11� ---- -----
OWNER ------------------------------------------------------------------------------------------------ CONTRACTOR ----------------
JOB ADDRESS --6e .. 3 --- ------ - - ------------------------------------------------ LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
--------------------------------------------------------------------------------------------------------------------- -- ---------- EVNIOVJ)S� ----------
NAME OF ADDITION ---------------------------------------------------------------------------- �l TREATMEN-F PLANT
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PWW-0001-11/75 (REV.11/78)
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Approved:
DATE.!9=-/ ............ ............. �.,. By ------------------------------------------------ ...........
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'CI* OF EDMONDS
COMMUNITY SERVICES DEPARTMENT
RIGHT-OF-WAY CONSTRUCTION PERMIT STREET FILE
A. 9 Owner: Washington Natural Gas Company B. Contractor:
N19,%ercer Street
Mailing Address
Seattle WA 98111
City State Zip
W
Permit No. 90 - 5_9Q
issue Date � ;L - 9, 4 - 3 D
Name
Mailing Address
City State Zip
State License Number Telephone Number
C. * Address or Vicinity of Construction: 638 Pine Street
Type of Work to be Done: Install New Service
D. 0 Work in Connection With: 0 Sub or Plat 0 Single Family 0 City Projects
El Commercial 0 Multifamily 9 utility
E. 0 Pavement Cut: El Y Od N F. 0 Size of Cut: — X — No Cuts
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds
harmless from any injuries, damages, or claims of any Vnd or description.,whatsoever, forseen or unforseen, that may
'r& 0 .9
be made against the City of Edmonds, or any of its dwr Pe or empl yees'ilICIUAiR or not limited to the defense
of any legal proceedings including defense costs, court-00 ,
ji atjrne�fees by reason of granting this permit.
J_t _I 4�ATERIALS FOR A PERIOD OF ONE
THE CONTRACTOR IS RESPONSIBLE FOR WOR94AI HIP AN
YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK.
Estimated restoration fees will be held until the final street patch is completed by City forces, at which time a debit or credit will be
processed for issuance to the applicant.
• A 24 hour notice is required for inspection; Please call Engineering: 771-3202
• Work is to be inspected during progress and at completion.
• Restoration to be in accordance with City Code.
• Street to be kept clean at all times.
• Traffic Control to be in accordance with City regulations.
• All street -cut ditches must be patched with asphalt or City approved material prior to end of working day;
NO EXCEPTIONS.
I understand the above and that this permit must be available at the job site for inspection purposes at all times.
Signature:
Date: December 120 1990
Owner or Contractor
This Permit Must be Posted at the Job Site For Inspection Purposes
Call DIAL -A -DIG Prior to Beginning Work
APPROVED BY:
Time Authorized: Void after days.
Special Conditions:
PERMIT FEE: :? U�'�
D Pn 14 �):& (�J
Restoration Fee:
Receipt No. - —
Fund I I I Fee: APPOMOM
Street Cut DimenlomQu - S
RELEASED BY: Date12 -a(A- �O INSPECTED BY Date
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
tng. ujv. marcn iwsv
7
FIELD INSPECTION
Comments:
Diagram:
(Fund III - Route copy to Street Dept.)
CONTRACT(JR CALLED -FOR INSPECTION 0 YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. July 1985
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Addendum to:
City of Edmonds
Permit Application
Engineering Aide : Kerry Walsh
Washington Natural Gas
622-6767 x 2588
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4eA1159- MAIN VaFr4
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e %� I S-r I t-4 ca� eAS AAAO,
PFOPO-SED
3
KEY:
-as- sanitary sewer
-s- storms
-w- water
0 water valve
wOAF
ul Rd
U
Z
Street Right -of -Way Existing REQD
Access Easements Existing REQD
Utility Easement Existing ------- REQD
Lot per Subdivision Plat Assessor Map NW IJ4�,
Site Plan Checked for Accuracy -!-X -7 /7 L�,'
Underground Wiring Reqd.
Check Accuracy of Legal Description
Environmentally Sensitive Area
Environmental Checklist Reqd.
Flood Hazard Zone
U Shoreline Management Area
Z Slope, Soil, Vegetation
Stream, Creek, Drainage Basin
Existing Zoning Per Code
Amenities Design Board Approval Reqd. ADB # Approval
Board of Adjustment Approval Reqd.
Review By- Date: :ffZ=IZ2�
Existing Water Main Size
Water Main Reqd.
Service Line Reqd.
Hydrant Size Existing
Hydrant Reqd. Per Fire Code
Detector Check Meter Reqd. .
Cross Connection Inspection
Fire Department Camients
Water Meter Charge Reqd.
Review by: Date:
Septic Tank Permit Reqd.
Sanitary Sewer Availability
Drawing No.
Side Sewer Availability
Sanitary Sewer Connection Fee Reqd.
Review By:
Size
L)ate:
Permit No.
Proi -
File No.
Date:
�ss
*0 , 00
Open Ditch
Culvert Reqd. Size
Catch Basin Reqd. Indicdte on Site Plan
C4
0
Shoulder drainage naintain collection o"n-'swale open runoff
H
En !,lu-ffiole reqd. Indicate on Site Plan
Soil Conditions and Grow -id Water Field Checked
Rexriew by Date
Street Paving Reqd.
Curb and Cutter Reqd.
Sidewalk Reqd.
Curb Cut for Driveway Reqd.
P� Right -of -Way Construction Permit Reqd.
Bond Reqd. for Public ImprovaTents
Street Name Sign Reqd.
Other Sip-iing Reqd.
Pre Permit Site Inspection made on �117-7
0
F-A BY: MIER
WATER.
STREET
ENGINEERING
AL AL M' M AL AL M W M W W W M
Special Require=,ts listed in mew to Communit-y Development Depart:ment,
Building Division
BY Date
o
All items filled in on Building Permit Application
W-
BY Date
P4
Drawings Stamed and Notations Made
BY Daite
,,jApproved
w Mr
by Public Works DeparbTunt
3C
Revised: 1v 10-1977