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7115 181ST PL SW.PDFiiiiii iiiiii 1301 7115 181 ST PL SW ADDRESS: "7115- 1914�r -PL 9u) TAX ACCOUNT/PARCEL NUMBER 05Dz)t& ©OODD I Dv BUILDING PERMIT (NEW STRUCTURE): COVENANTS (RECORDED) CRITICAL AREAS: ADD D©(/ O DETERMINATION: ❑ Conditional Waiver ❑Study Required Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: PERMITS PLANNING DATA CHECKLIST DATED SCALED PLOT PLAN DATED: SEWER LID FEE $: LID #: SHORT PLAT FILE: LOT: BLOCK: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMITS) #: SOILS REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: FOR: WATER METER TAP CARD DATED: OTHER: LATEMPOSTsTormAStreet File Checklist.doc Critical Areas Checklist ite Information (soils/topography/hycl ology/vegetation) Site Address/Location: I j 5J 1 q) PL, s W _ 2. Property Tax Account Number: CA File No: D CG 1 5014( P 000 .or) ( as 3. Approximate Site Size (acres or square feet): `tea I 4.1 Is this site currently developed? yes; no. If yes; how is site developed? ST 5. Describe the general site topography. Check all that a ply. 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 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 less than 33-feet). Other (please describe): 6. Site contains areas of year-round standing. water: • Approx. Depth: 16Site contains areas of seasonal standing water: ; Approx. Depth: What season(s) of the year. Site is in the floodway floodphdn of a water course. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round? Flows are seasonal? (What time of year? ). 10. Site is primarily: forested ; meadow • shrubs ; mixed urban landscaped wn, shrubs etc) 11. Obvious wetland is present on site: 1. 2. 3. 4. 5. DI.— ('{.n..L A vl, hor if annlirahla7 STUDY For City Staff Use Only DETERMINATION Reviewed Critical Areas Checklist.docl4.22.2003 City oTEdmonds 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 from observations -of the site or data available at City Hall (Critical areas inventories, maps, or soil surveys). R E C51 V 5 D. jAN 2 0 2004 Date Received: I— oL(-)— ( 3 -[ City Receipt #: Critical Areas File- :-' Critical Areas Checklist Fee:_ $135.00 Date Mailed to Applicant: A property owner, or his/her authorized representative, must All 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. Please submit a vicinity map, along with the signed copy of this form to assist City staff in finding and locating the specific piece of property described on 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. P lT .The undersigned applicant, 10Ys/her/its heirs, and assigns, in consideration on the processing of the application agrees 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 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 mo knowledge and that I am authorized to file this app ' ation tify on the behalf of the owner as listed below. 4 /q SIGNATURE OF APPLICANT/AGEN DATE 0) B"� Property Owner's Authorization By my signature, I certhat I have authorized 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 atten t to this application. QSIGNATURE OF OWNER401? Aft DATEd W-1`o/ PLEASE PRINT CLEARLY Owner/Applicant: ��rfi LSs� ��Je,es� Name ?ll J5- S (,.) Street Address City State Zip Telephone: 2r— 67 Email address (optional): Applicant Representative: Name Street Address City State Zip Telephone: • Email Address (optional): Critical Areas Checklist.doc/4.22.2003 Property Owner t+tme .- klArt &- Li eweese • R E C E t V E Property Address: 7115 18-1 sr P , Edmonds, WA 98026 Tax Account Parcel t: 00504600000100 ZONE 2S' JAN 2 0 2004 SETBACKS: FRONT 25 PERMIT COUNTER �Et�'f CALCS REAR s SIDE -7.9 APP�R®VE® �V P�A�iVII�C A 96,,6' n B= +89.6, drL OTHER Zi7io9- C= +940 Sy�v t+`i +95.6' +94 38 HEIGHT 2� 92 ` + ' , D= +98.8 0� t ' inn r%T? lMa/nrtix99ecni rra +89.4 AVG GRADE= +94.2' ACTUAL = +107.3' MAXIMUM = +119.2' Got Co Mr,_a _ 2583 SO. FT. (21.5%) a Lat'Ares: A� 12a19 SO. FT. .28 Acre c6. O Lot Stoj: r" - to % APPROVED AS OTED , r BY ENCA Date: b +9b;st� PmWe f Line +10G.8' AND SPLASHELOCKS ER/ C0hTK - I OR IS I1c�,, tFI IISIBLE F0 3 EROSO4 OUTRCI. AM) CPA AGE existing T� rockery / B ---------------------- . +89.6' 3 existing Concrete Patio (432 sQ-tt) ---- _ >- -t ---------------------------------------------------------------- . overhang ME �l Q (2Ww. n) y ll� i4'- ---------- --- --- -- ----------- --- --- ----------------------- -- b s in eoxcisktien�g� r +� . a s 5 �AWftDdvemw +98' +96' W -E 181 ST. PL. SW S ` / Top of SS Mmhoie Cover Scale: I" = 2(r +94.8' PLOT PLAN Pags 1 PLANNING DATA NAME: K <-Ir )- L- SA LAW0(,c DATE: Z /0- t 7/2=4 SITE ADDRESS: --705_ S ► " S•. PLAN CHK#: -o/4 PROJECT DESCRIPTION: AA&�a A 1 G' X Zo 3Zo I-) r►. b e D k--e-r.. �. REDUCED SITE PLAN PROVIDED?: 6/ No MAP PAGE: 3S -7 CORNER LOT: es FLAG LOT: es / o ZONING: P,S' $ CRITICAL AREAS DETERMINATION #: 4 -0 ❑ Study Required: Waiver ❑ Conditional Waiver SEPA DETERMINATION: ❑ Fee ❑ Checklist ❑ APO list w/ notarized form ❑ (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger) Ef Exempt SETBACKS: Required Setbacks: Street: ZS• Left Side: 7,5 Right Side: -7, S Rear: / Actual Setbacks: ++ �� + Street: -+91 Left Side: Z / Right Side: -7i ' Rear: 43 ' 39' Street map checked for additional setback required? Yes / WN DNA ❑ DETACHED STRUCTURES: 0 ROCKERIES: ❑ FENCES/TRELLISES: U. BAY WINDOWS / PROJECTING MODULATION: n P�•l or STAIRS / DECKS: PARKING: Required: 2 Actual: 2- LOT AREA: 2 01 LOT COVERAGE9 Z10 73 BUILDING HEIGHT: Datum Point:__ la P oA SS nw koli hr.. h 19Y"R. Datum Elevation: ob' Maximum Allowed: ZS ' Actual Height: p 2' LS. & - A.D.U. CREATED?: / Yes SUBDIVISION: LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: OTHER: Plan Review By. / .� NewBPPlanningDataForm.DOC Critical -Areas Checklist CA File No: Site Information (soils/topography/hydrology/vegetation) 1. Site Address/Location:og 2. Property Tax Account Number:D G 56,4�005 .b� UD 3. Approzunate Site Size (acres or square feet): �0.. . 4.. Is this site currently. developed? ,.yes; rio. If yes; ;how is site developed? 5. Describe the general site topography. Check all that a ply. Flat: less than 5-feet elevation change over entire site. i 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 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 less than'334eet). Other (please describe)": • 6. Site contains areas of year-round standing. water: • Approx. Depth:. 7. Site contains areas of seasonal standing water: ; Approx. Depth: What seasons) of the year? , Site is,in the flood' ay floodplain of a water course. �1 Site contains a creek or an area where water flows across the grounds'surface? Flows are year-round? Flows are seasonal? (What time of year? ). 10. Site is,primarily: forested. ;meadow • shrubs ; mixed ; uibait aandscaped awn, shrubs etc) 11. Obvious wetland is present on site: For City, Staff Use Only. 1. Plan Check Number, if applicable? 2. Site is Zoned? — e Pih�"7 3. -SCS mapped soil type(s)? 4. CritieaY Areas inventory or C.A. map indicates.Critical Area on site? kt dwcajled OYt .S 5. Site within designated earth subsidence landslide Bazar area? CL Laga�H�v(S CoVV4A.. 73Gu ldl`i c I DETERMINATION STUDY SQUIRED' WA IVER Reviewed bv: Date: Te,?`� Critical Areas Checklist.doc/4.22.2003 // 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 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 irifotmation 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). E CE ��,/ E D JAN 2 0 2004 Date Received: City, Receipt;#:���� Critical Areas;File-#: -Critical,-Areas Checklist Fee: $135.00 Date Mailed to Applicant: ' A property. owner;, or his/her authorized representative, must ,fill put the ;checklist, sign and date it, and submit it to °the City. The City wilt 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 vicini map, along with the s ty p, g gned copy of this form to assist ,City; staff' in finding -and locating the specific . piece of .property described on 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. FR%J The undersigned applicant,paltd'liis/her/its heirs, and assigns, in consideration on the processing of the application agrees 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 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 app ' ation on the behalf of the owner as listed below. `` SIGNATURE OF APPLICANT/AGEN DATE 0) /A / Property Owner's Authorization By my signature, I certify that I have authorized 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 Cityof Edmonds to enter the subject property for the purposes of inspection and .posting attendagt to this application. t ' SIGNATURE OF OWNER 14mr—'am, ..— , v/1", I - —Ifflismi uwner/Appticant: k-uyt A3eese- Name ?11 Is614s, P) S W Street Address 1 ` cdwolvll City State pp Zip Telephone: Email address (optional): Applicant representative: Name Street Address City State Zip Telephone: Email Address (optional): Critical Areas Checklist.doc/4.22.2003 NOTICE: No warranty of accuracy. The information shown on the attached map(s) was compiled for use by the City of Edmonds, its Employees and Consultants. The City of Edmonds does not warrant the accuracy of anything set forth on these map(s). Any person or entity requesting a copy should conduct an independent inquiry regarding the information shown on the map(s), including, but not limited to, the location of any sewer stub shown. Such sewer stubs may or may not exist and may or may not exist at the location shown. Neither the City of Edmonds nor its employees or officers shall be liable for the information given on map(s), nor for any one representation provided based upon said map(s). �+.a:�,w,,.;ggr�: .y s�lli, ,y� 7n r:.+7c�-:,.v',. � �-i ��j�ti•-R',i .. .. _. .. -. c l�n �r ". �:�<0^' t^".. C�-�'.�"'.7i.;."t�- : i.T[,F�'•_..._.. 41, C. 18UV City of Edmonds PEITT NO: 9379 PERMIT EXPIRES SIDE SEWER PERMIT �11� Address of Construction: 72 &5" lfl Et` A s'l-✓ LID # C!V Property Tax Account Parcel No.d��d Attach copies of all access and utility easements Verified and Approved by, Owner and/or Contractor: n, i v 4j it I l c-t pl-_4 zt 11 * C I c a [i 4' f , Contractor License #:&j4L- 0D a fl-Oa3 O Z- Building Permit #_ Single Family ❑ Multi -Family (No. of Units ❑ Commercial (No. of Units ) ❑ Public Invasion into City *Right -of Way: ❑ Yes �o *RW Construction Permit # Cross other **Private Property: ❑ Yes g4No **Attach legal description and copy of recorded easement. Owner or contractor signature and acknledgement statement: j `4-,By signing for this permit I certify that have read the City's public handout entitled 1 � ide Sewer Specifications, and shall comply with all City requirements outlined therein. CALL DIAL -A -DIG (1-800-425-5555) BEFORE ANY EXCAVATION W " W FOR INSPECTION CALL 425-771-0220 extension`s /_&24o; `�` 24 HOUR NOTICE REQUIRED FOR ALL INSPECTION REQUESTS N Date FOR OFFICE USE ONLY Permit Fee $ Repair Fee $ Issued By: / Trunk Charge $ Date Issued: Assessment Fee $ Receipt No: _ lv City Permit Surcharge Fee $5:00 Total Fees Paid $ .� NOTE: IF JOB SITE IS NOT READY FOR INSPECTION WHEN INSPECTOR ARRIVES A $45 RE -INSPECTION FEE WILL BE CHARGED. Job Site Ready YES NO Date: Initial: Partial Inspection:. Date: Initial: Partial Inspection: Date: Initial: FINAL INSPECTION APPROVED: Date: 11b Initial'_As-built to Street File: 15, PERMIT MUST BE POSTED ON JOB SITE t White Copy: File Green Copy: Inspector Buff Copy: Applicant L;temp;bldg;forms;sspermitj lg4/00 N 3 w Q i" 26' 17' C/❑ 11' CITY OF EDMONDS SIDE SEWER AS -BUILT ADDRESS 7115 181ST PL S,W, PERMIT NUMBER 9379 HOMEOWNER CONTRACTOR C❑NTRACT❑R AAA WILLIAMS DATE 06/01/01 BRAWN ISMAEL ABILA /e/s-7- P/ Sh/. r vw l0.- ao PLO c=� O Ald9 Z)WO ;w 55 N lki 6 10 IV 11308 4- Ile 7719 a2 (Q, 4�5 &95 Pz. sw ---------- -cy &76 /96 6 '0 1 0. 0ay L- :10 >. = n — — — o of �, 0 .17 16 ooj/ or,,/ rn 4.01 1,12,v-' 106 '41poomzs �-1�011771f 16d Ord 010pr011ed 614,5_ 00 abv 0/� Cy- - 4 M ��- r, n - . . A n., I-AIRAff-fRS CIRT Transit Measurement Raw Tansit Relative Relative Datam Location Point Measurement Height Offset Datum Pt Pt. (feet) Datum Pt. A 11' 51711 V 5" 931711 93.6 Point A 13' 9' 7" -5' 7" 4' 0" 89' 7" 89.6 Datum Pt. C 10' 8" 5' 7" 5' 1" 94' 11" 94.9 Datum Pt. D 6' 9" 6711 1" 2" 98" 191 98.8 JA%2U2'v�a PERMIT COUNTER Propertr -owner-N PravarLy. A 7.115 ISI. sr PI SW,­.,Edmcnds-, ; FAA' -900261 ftz AcComt Parcel.#1­0050460000010cZONE P_S_ R SETBACKS: FRO,NT, SIDE HEIGHT CALLS REAR t;., A-- +966 OTHER B-- +89.6! HEIGHT C— +9CW +94' +929—., Ear- +98:8' ��"► ow kVG- GRADE=-+9.4.2- ikCT-.UAL=+1:07.,3?--- kL4XJMUM- +119-7- Lot-Covem9e 2583-SO.-PT. (21.5%)- Lot-Ama: 120.19-SQ.-.-FT. 28-Adre, LatSfoRl; 10-%_ b - 06-, APPROVE[YuMMM? BY ENGINEERING Date: �4 q 107' RECEIVED JAN 2 0 2004 PERMIT COUNTER APPROVED BY PLANNING 7,19. +go'-- +89 GtTTERSIDOWNS S MISIBLE FO'l NER,' CONTRk"-"rNrl ZcV, ANDI SPLASHBLOCKS M VQ DRAWN147r: existing - roc". ---------------------- ------------- --------- -------------------- Existing-concrete Patio q (43Ztq1Q. r ---- Z=azzzz - ------------------ ---------------------- Existing Hotm (20W sq; It.)- c- -- --------------------- ------- ---- ------- - --- ---------- +ba- Rri existing-- +96. Existing_ Aspait - Wvemy-+ ----------------------------------------- -------------------------------------------------------------------------------------- N S- E L = aDATUMPT. -+-IW- Top-cf..SS Manhote Cover.. Pap 4