647 9TH AVE N.PDF9880
647 9TH AVE N
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ADDRESS:
TAX ACCOUNT/PARCEL NUMBER:2WZZ4X2/q&0,Q
BUILDING PERMIT (NEW STRUCTURE):/ftPD595
COVENANTS (RECORDED)
CRITICAL AREAS: DETERMINATION: 0 Conditional Waiver [-] Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DA
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS
PLANNING DATA CHECKLIST DATED: —
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORT PLAT FILE:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
� -I "LATAXOTAr" r1fiff"Afto
LID #:
LOT: BLOCK:
FOR: I
WATER METER TAP CARD DATED
OTHER:
LATEMP\DSTs\Fonns\Street File Checklist.doc
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PLANNING DATA
NAME: bo_4 r= -, ' q ki -yr i r., Q P_ -DATE: 'R- I Q - 0 D_
SITE ADDRESS: LQ Ll -I 00:H A144 tQ - PLAN CHK#:.(3a - No-[
ZXXIC-`,� -00 SrEL
PROJECT DESCRIPTION: D_�,to 'EVE20-14 NX
REDUCED SITE PLAN PROVIDED?t�5 I �No W77S -
MAP PAGEQ 5.;5 CORNERLOT: (Yes FLAG LOT:
ZONING: -L- CRITICAL AREAS DETERMINATION #: Kk
EJ Studv Reauired:
Waiver
Conditional Waiver
1"T fa. V2-S
SEPA DETERMINATION:
Ll Fee
Ll Checklist
U APO list w/ notarized form
U (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft.of Puget Sound or Lake Ballinger)'
JA Exempt
\ 1.1__
SETBACKS,717- 'P-00- "C>U5E 'EY-1-15Ttr-AG C-A::w_k=1Cg
Required Setbacks:
StreetOW Left Side: 10' _ �iqht§lde:_ Rear: ak'
Actual Setbacks: 1 (.0, m9pa-
Street:Q;,; I' Left Side: '116MRIght Side: Rear: -7.2
Street map checked for additional setback required? (Yes / No DNA)
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A ROCKERIES: 95. 1 -T
a-AJ
U FENCES/TRELLISES:
BAY WINDOWS / PROJECTING MODULATION: 0 C4 C I
->4STAIRS / DECKS:
PARKING: Required: Z Actual:,?
2--7C>
BUILDING HEIGHT:
Datum Poini
Maximum A]
A.D.U. CREATED?: (
SUBDIVISION:
Elevation:q'i - JE-) 1 11
Height: a&A - 25 1
NONCONFORMING LAND USE DETERMINATION ISSUED: (Yes No
N907 e�a�� R_j� �Zjj
Plan Review
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City X-`Edm`0-a
Developrnen�2SIO-rVieesDe -arltinq�tl.�--,Ilav,�
Planning �Pivipiqr�-,
Fax: 425.77.1t.'0221
MII!
11M,
1 1 tf%j ;J .1 IJ
The Critical Areas Checklist contained,,qiL, form is. to,
or.,,his/h, Jauthoriied4i
r _presentative,
be filled out by' any'pefisdri 'preparing a Develdpmefit' fill out the checklist,, sig�i:afid,.date it, and� submit it
* F t fl , '., , � . I 'Ji.'t.' , ", , " �1. � ",
Permit Application for the City of Edmonds pri6rto'�� the 'City... Mi.; City thi,pl,,666kilsi; T�ake -a
his/her submittal of the application to the City. pr�cursory site., visit, and,.: make' a determination of the
nt -steps necessary to complete
sul5s'e q�u' e, a.' eve merit
The purpose of the Checklist is to enable City staff to application.
determine whether any potential- Critida I I Areas are,or per-mi
may be*, present on the subject property. The informati Ti-eaie-subrn�iva,-vicinit copy
or y�mgp alqrig--*iih ihemped
needed to -cqm
plete the Checklist sh d.b&�--,*easilyj�, - 'of� s' and"1oQclt igi� th
fo tb:)assisV-Cit W;
e
6ific:. piqcq this; In
available from observations of the site or data aya�ft.at!i� -spe of p,io, ` `ii �W
pert ei6rib�ed on
City Hall (Critical areas inventories, maps, addition, the applicant shall, include othei pertinent
A-1 I, . i � i -1 , " I
surveys).
"dohfidti6n,
si e p, ani. tbpogriph�. map
etc.) or
oe njtmctidh.-' *itlitthi'sChecklist to assistant staff
completing their prelimiaryassessment of the site.
The undersigned applicant, and. his/her/its heirs, and,.kss'igns,`-in -consideration on theprocenin&o6he application agrees
to release, indemnify, defend and hold the City of Edmonds harnile, ss froml any and all damages, including reasonable
p 1. � :. - i. - :". t
attorney's fees, arising from any action or infraction bikd in 01.e-.,or art upon't sd;! 0 mg,�maccurae or
incomplete information furnished by the applicant, his/her/its agents or e , Ii ' . ". I .1� . 1 �. '.. '' :
By my signature, I certify that the information and exhibits, herewith submitted areitrue. and correct: to, the best of my
knowledge and that I am authorized to file this appliciiion on -the b i�lfi f the owner as listed below,.
SIGNATURE OFAPPLICANTIAGENT DATE
Property Owner's Authorization
By my signature, I certify -that I have authorized the above Applicant/Akent tol 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 an4,MtinMttendant to this application.
SIGNATURE OF
OwnerApplkap�
A�A ele7 ,�
Name
0. 36V- * S5 G -3 IS
Street Address
50e F11..TT
City State zip
Telephone:
Email address (optional):
CLEARI - Y
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Narhe
i oc-�;l- 8,-:� PD kviF EA s-r
Street Address'!
el? �1 T L r1- WA
Zip
City., - St at 0.
TeI6�hone:,: `4Q(e
Ern�ail. Addriess (ootional)';
Critical Areas Checklist.doc/3.19.2001
0 IV -IQ
C-r A File No:
ifica 1: Areas.Chepki i;st.,,
I 1 -1 i `3
Site Infor�"in�"('Soils'/, egetafdon).,
Wrolo
-rFP, 0, i - gy/V WA C119 C5AO
1. Site Address/Location: (o4l;' -,C1114 AVr_ 4012,Tli-) C-DHOKIOSS
2. Property A" uhtNtimb r
..Tax cco e n -S
3. A�pioidj&iAte�$itoSiiL-'(a�r6iois'quaref"i
4. lslhls�sitk currently ddvel6'�, �d? kyek no.
P
Ifye'g;',,ho'w"i's,'s'l"W"!-d6veid�ed? 6jOrALE-_,,1pAV1AtLY,1 Ew"
5. Describe the general'.-'s"lte'�t.-opography. C-heck;all.-that, a plye
P
Flit: less than 546et! el6vati6ri'chai'nige over entire site.
Rolling: slopes on site I generally less than 15% (a vertical rise of 10-feet over a horizontal
distmce.of-66--feet-).
�sdnt Ion sibe. of iiibre th An' -15 % land'Iess than 30 % a vertical rise of 10-feet
Hilfy:� sl6Pes,,PrL
di6taiii"..- f
o'Ver a horizontal ce, o 33 td 6&feet).
Steep: grades. of , greater tha� , 3.0% pr6'se'n`t on site (a vertical rise of 10-feet over a horizontal
dis6n�e of, le�'�s than -3&feL
!Other (please ddscribe):'i
6. Site contains areas of year-round staridifitwatei: 4-10 Approx. Depth: Qj h
eas ""a standing, w`a' tien.' th: N1 Pr
7. Site con a�r 1"of se.asonE Approx. Dep
!j
What season(s) of the year?
8. Site i's in theflo"odi4av-440 flood p'liin" of 'a water course.
1: j
9. Site contains a creek or an area wherewater "flows across the grounds surface? Flows are year-round?
Flows are s6a's6 44D '(What time -of year?
01 Pr
10. Site is primarily: forested meadow shrubs mixed
urban landsc aped (lawnshrubs etc)
11. Obvious' wetla'n'd is prese . nt on site: 140
Critical Areas Checklist.doc/3.19.2001
7',
City of Edmo, nds
SIDE SEWER PERMIT
PERMIT NO: '9722
PER MIT EXPIRES
\ A ess of Construction: Aj LID'#
ddr 42
Property Tax Account Parcel No. 9 70 3 4�2- 0 - 00 /'9X0 0
Attach copies of all access and utility easements , 6& Verified and Approved by— X?Ae�
Owner and/or fitractor;.-,� 17,911,U
r CQto — IN
Contractor License#: —Building Permit #:
,K'Single Family Invasion into City *Right.of Way: El Yes __NONO
F� Multi -Family (No. of Units *RW Construction Permit
E] Commercial (No. of Units Crosiother "Private Property: Elyes N_-No
'E] Public "Attach legal description and copy of recorded easement.
(Ownerontractor
dwriefor c(�nfractor signature and acknowledgement statement Date
By signing for this permit I certify that I have read the City's. public handout entitled.
ide Sewer Specificatioins, and shall comply with all'City requirements outlined therein,
9 CALL -DIAL-A-DIG (1-800-42f,4-,5555) BEFORE ANY EXCAVATION 9
.19TOR INSPECTION CALL 425-771-0220 extensio '3z'
T
24 HOUR NOTIdE REOUIRED'FOR ALL- INSPECTION REOUES S
NOTE: IF JOB SITE IS NOTREADY FOR INSPECTION WHEN
INSPECTOR ARRIVES A $45 RE-INSPECTIO.N FEEWILL BE CHARGED.
Job Site Ready YES NO --Date: .'-Initi al: —
Partial Inspection: Date: Initial:
Partial Inspection: Date: Initial:
FINAL INSPECTION APPROVED: Date: NA-103. Initial:--V( As -built to Stre
et File:
"'*.',PERMIT MUST BE POSTED ON JOB SITE I A
White Copy: File Green Copy: Inspector Buff Copy� Applicant
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CITY OF EDMONDS SIDE SEWER AS- BUILT
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:::� ADDRESSi
tA 647 9TH AVE N
HOMEOWNER:
DATE: DRAWN
3/25/03 BY: I, ABILA
SCALE
NTS
CONTRACTOR:
HELLUND BUILDERS
PERMIT
NO. 9722
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An
,-Side Sewer Drawing
The City of Edmonds EASEMENT NO . ...................... ------ ..............
216-05050 NEW CONSTRUCTION Ej RE13AIRS LID NO . .................. ASMT. NO.. ..... ..........
OWNER ......... RALPH D. LAURIDSEN
............................ ............ -------------------------------------------- CONTRACTOR ---------- ............... ------------------------------------ .................... PERMIT NO . ....................
JOB ADDRESS ........ 6.4-7 ... :n ... 9-TH..AVEN.UE ... NORTH ............... LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO - ------------------------------------
..................................................................................................................................................................
NAMEOF ADDITION .......................................................................................................................
11
0
DYE TESTED ON SEVIER
Approved:
PWW-0001-11/75 (REV.11/78) DATE ...................................... —... By ........ .................................
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