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7117 176TH ST SW.PDFiiiiiiiiiiii 1152 7117 176TH ST SW STREET F-14E Critical Areas Checkis Site Information Project Name: IS- C— c- T L--<_o P E (-, Permit Number: RECEIVED APR 3 0 1992 PERMIT COUNTER Site Location: I 1 ^j I -7C� ` �S v� Property Tax Acc unt Number�t X ( O © c? 14-3 Approximate Site Size (acres or square feet): Have you filled out a Critical Areas Checklist for a project on this site before? K') <�) General Site Conditions 1. Has the site been cleared or logged? S Date of most recent action: Soils / Topography 2. In the Snohomish County Soil Survey, what is the mapped soil type(s)? � Z-7 8`y�p 3. Describe the general site topography. Check all 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.) 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 1='0 ;r't C7 [fir, L- P 1r--A C_ 1 N GT .4' N C-5'4 l5 i— Hydrology/Vegetation ®-ris cz- 10 4. Site contains areas of year-round standing water: q a 5. Site contains areas of seasonal standing water: t,� Approx. Depth: 6. Site is in the floodway I c-,) -floodplain of a water course. 7. Site contains a creek or an area where water flows across the grounds surface? flows are year-round? Flows are seasonal? 8. Site is primarily: forested ; meadow ; shrubs ; mixed 9. Obvious wetland is present on site: 0 O 10. Wetland inventory or map indicates wetland present on site: �o 11. Critical Areas inventory or map indicates any Critical Area on site: _ 0 o 'go -19y 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 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: E C-2. -T— L Name Title 4 -0 ,.A,,t o .c9 ti>-!o IZ- `71 1 7 , l 'l 6 ,::� - LV - Street Address Applicant Representative: &YV [,aK) U�t��IS Name i 6r r ) A 7— Title Street Address L—C'pIJ 45L.Po— E<QM'lM,9�S �hov\� p i�o�5-��3 793v .1�a fii- l �ZZ City, State, ZIP Phone Cit State, ZIP / O ci- Phone Signature Date Si lure Date 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). •• - =� APPLICATION � 1..�......_..`dAAOf� for �...,.....,. . The City of -Edmonds SWE SEWER PERMIT ^ / LASEME o........................................... NEW CONSTRUCTION U REPAIRS ❑ l6 rs 1 OWNER, C .. CONTRACTOR ..-Ll.................................................................... ....:-..:..Lr�.! PERNIIT o. ADDRESS,. ....... ........................................... LEGAL' DESCRIPTION: LOT No. ........................... �... f BLACK No. .................... ,.............. .....,.,. /wr /�3 -off u,l�ae &acc,..5 iao' 0A NAME OF ADDITION T .....L- ,?...... ..-..-G r -. 1.-.-.fl ......m....... €' cc T7t- Th 1�4�Y �,- u Approved: l re�c dIN1 E 1 1971 CITY OF EDMONDS - SIDE SEWER PERMIT _. WATER -SEWER DEPARTMENT PERMIT (Inspection 7.761107 for side sewer inspections BEFORE covering any portion of the construction. l \Inspection will be provided within 24 hours after request. NO Sat., Sun., or holiday inspections./ ADDRESSLOCATION OF CONSTRUCTION_ ..................................................................................... ! ................................................................................ PROPERTYLEGAL DESCRIPTION...............................................................................:....................................................................................................... �' � ��..PP... ................................................................. .OWNER AND/OR BUILDER............................................................................................................................. .... ✓.s�� �6�••• .................................................................................................................................. CONTRACTOR'S NAME & ADDRESS.................................................................................................:....:............................................................................. Perinissiori is granted............................................................ 19....----, for repair and/or connection of a side sewer to the city sanitary sewer system in accordance with City of Edmonds ordinances. ATTENTION IS CALLED TO THE FOLLOWING: NOTE No. 1—The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct side sewer in street area. Do not cover any portion of sewer before it has been inspected. I-E No. 2—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office. NdTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit. NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 inches inside property line; minimum grade of 2 J . No bends in grade sharper than 1/s will be permitted. NOTE No. 5—Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper work which may develop within one year of completion. NOTE No. 6—It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the main sewer or its appurtenances except to in- sert the pipe into the wye. DISAPPROVED ❑ Date ... .. .............................. By ................ D .... ................. .... B �......... Date .................................... BY ................ --- ell APPROVED Da .......`� • F,>� Relnarlcs:................................................................................................ BOTH Permit Copies Z41111 Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection -- hereby certifythat the side sewer installation constructed under this permit �I1 G1! .. .....G Y I,• � Owfir•-- of (Owner of Contracting Fir Performing Construction) was installed in accordance with all governing ordinances of the City of Edmonds. Datedthis............................day of ................................................................. 19......... J J Check BEFORE you dig for: Water ❑, Gas ❑, Telephone ❑, Power ❑, Sewer ❑, Other ❑ J J STREET HLE PZ5 - t Z -0 T-" P -r ly Water Service Drawing The City of Edmonds EASEMENTNO . ..................................... . NEW CONSTRUCT14DN ❑ REPAIRS ❑ LID NO . .................. . ASMT. NO.................. OWNER....................................... .....................................CON'I'I'.AC1'OR................................................................................... PERMIT NO. Z01 00 JOB ADDRESS ...�. \ \1.........i ZG................................ LEGAL DESCRIPTION: LOT. NO. ..................................... BLOCK NO. ................................... Go ob OD 100o n�� a ow. gs li to 8 am itm Z. Ic _8or19 3Q .Or 5 �a•-,-?T 3� 3-SL r� a�'�' as A S.. � s� m aMLF40 �Igi 40 80'QQa Amin via% p� �C »8 #>� a S. NAMEOF ADDITION ............................................. ...... -t NVN4-00u1.11175 (REV.11178) llA1'E .... 0'.7-U.-.00............... Dy .. M. ..................................... USE PERMIT CITY OF EDMONDS ZONE NUMBERCJ��t1J CONSTRUCTION PERMIT APPLICATION joB SUITE/APT# OWNER NAME/NAME OF BUSINESS ADDRESS // e5 d l� LEGAL DESCRIPTION CHECK SUBDIVISIO 0 Z MAILING ADDRESS / j f "t r -' 1 ( qj , TESCP Approved ❑ O r CITY ZIP TELEPHONE ��� ��1y NUMBER PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. EXISTING REQUIRED DEDICATION RW Permit Required ❑ Street Use Permit Req'd ❑ ❑ S PROPOSED Inspection Required ❑ NAME Sidewalk Required v 1 REMARKS z w w ADDRESS o Z l!r w U a CITY ZIP T LEPHONE NUMBER NAME 1 M �� {'! �, ENGINEERING MEMO DATED REVIEW BY cc ADDRESS Q 1A',: ( r"� `�' METER SIZE BUILDING SUPPLY SIZE NO.OF FIXTURES U Q CITY ,. s I� TELEPHONE NUMBER W z" U REMARKS 3 STATE LICENSE NUMBER EXPIRATION DATE 1 A-5 B SIGN AREA SEPA REVIEW ADB NO. L. Legal Description ko�fProperty - include all easements ALLOWED PROPOSED COMPLETE EXEMPT z SHORELINE # 0 F EXP a 2 VARIANCE OR Cu ANNING REVIEW BY DATE U N W O � t7 z SETBACKS — FEET HEIGHT LOT COVERAGE a w Property Sr FRONT (SIDE t REAR E z Tax Account ,��" 1 ,q� C� 5 No. @� U Q I 'L...+ Parcela REMARKS— NEW RESIDENTIAL PLUMBING ADDITION COMMERCIAL MECHANICAL ARC LDG. E] 9a REMODEL SIGN GRAISING. // FENCE REPAIR C�lDSt,,,_ I x_FT) CHECKED BY TYPE OF CONSTRUCTI N CODE HEIGHTi ., f WOODSTOVE r SWIM POOL '® DEMOLISH INSERT j HO.T,TUB/SPA ��•. (Q� SPECIAL INSPECTOR AREA GROUP GROUP OCCUPANT t,a REQUIRED AYES LOAD GARAGE RETAINING WALL/ RENE AL REMARKS ROCKERY 0 (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: PROGRESS INSPECTIONS PER UBC 305 NUMBER OF STORIES NUMBER OF / E %� {� L M coW G y �* 6` DWELLING m0 A 1 UNITS DESCRIBE WORK TO BE DONE (A TACH PLOT PLAN) rn FINAL INSPECTION REQUIRED A r o b7 VALUATION FEE PLAN CHECK FEE /L/ ` HEAT BUILDING Z)� 2 2 7 . SOURCE: C— Q I I,A �'Rc 15 At rj.G+ GLAZING % PLUMBING Plan Check No. / MECHANICAL This Permit covers work to be done on private property ONLY. GRADINGIFILL Any construction on the public domain (curbs, sidewpiks, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE Al- Permit Application: 180 Days Permit Limit: I Year - Provided Work Is Started Within 180 Days STORM DRAINAGE FEE "Applicarilt, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE successors in interest; agrees to indemnify, defend and hold J harmless the City of Edmonds, Washington, its officials, Q employees, and agents from any and all claims for damages of i whatever nature, arising directly or indirectly from the issuance of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT q t 0 waive or reduce any requirement of any city ordinance` 0modify, x nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE provision." I hereby acknowledge that 1 have read this application; that the ATTENTION APPLICATION APPROVAL information given is correct; and that 1 am the owner, or thikuly authorized agent of the owner. I agree to comply with city and state laws regulating construction;gnd in doing the work authoriz- THIS PERMIT AUTHORIZES This application is not a permit until ed thereby, no person will be employed in violation of the Labor ONLY THE signed by the Building Official or his/her Code of the.51ate of Washingt� relating to Workmen's Compensa• WORK NOTED Deputy; and fees are paid, and receipt is ° j�� acknowledged in space provided. tin -. INSPECTION SIGN RE (OW OR AGENT),. � DATE SIGNED DEPARTMENT CITY OF EDMONDS OF 1 IAL'S GNATURE DATE 5� 92 ATTE N CALL FOR IF RELE D BY: TE INSPECTION 2— IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE 771-0220 UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW — Inspector A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC 3. PINK — Owner GOLD — Assessor \CHAPTER 102.87