24024 84TH AVE W (2)1111111111117988
24024 84TH AVE W
STREET
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAA1 rNAME OF BUSINESS
'D (z . %c-" S k' A--
MAILING ADDRESS
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CITY ZIP TELEPHONE NUMBER
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NAME
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ADDRESS( h
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CITY ZIP TELEPHONE NUMBER
n 77q
oa
STATE LICENSE NUMBER EXPIRATION
Legal Description of Property include all easements
Property `fbS6-o�-f----
Tax Aogount y 3, O 1' 00 1- O 000
.Parcel No.
NEW
RESIDENTIAL
PLUMBING
ElADDITION
® COMMERCIAL
MECHANICAL
ElREMODEL
O APT.BLDG.
SIGN
GRADING
FENCE
❑
REPAIR
O CYOS.
i x_FT)
DEMOLISH
a INSERT
SWIMPOOL
HOT
HOT TUB SPA
WALL/
CARPORT
II ROCKERY
❑ RENEWAL
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
If / o i4 C7—G Cfr' C'!-
NUMBER
NUMBER OF
CRITICAL
OF
DWELLING
AREAS
STORIES
UNITS
NUMBER qq,_
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
zor +E / PERMIT NUMBER 946538
JOB �7 /JUITE,APT e
ADDRESS C� OCK �i'r (Cl � (l 16F
.EGAL DESCRIPTION CHECK SUBDIVISION NO LID NO
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved ❑
RW Permit Required ❑
EXISTING REOUIREO DEDICATION Street Use Permit Req d ❑
PROPOSED Inspection Required O
SidewUk Required ❑
«
u
METER SIZE I LINE SIZE I NO, OF FIXTURES PRV REQUIRED C
YES O NO ❑ 3
i MEMO DATED
SIGN AREA SEPA REVIEW
ALLOWED PROPOSED COMPLETE E%EMI
EXP
VARIANCE OR CU PLING REVIEW BY
W. .(
SETBACKS -FEET EIGHT
FRONT I � SIDE / OEAR ,'iC G 7 R
CHECKED BY
TYPE OF CONSTRUCTION
CODCEJ
- /),V
/
SPECIAL INSPECTOR AREA
REOUIREO
❑ YES
' m
(J�V
MARKS
PROGRESS INSPECTIONS PER
UBC 305
FINAL INSPECTION REQUIRED
ADS
PUN CHECK FEE
/
C =
G
BUILDING
HEAT SOURCE:
GLAZING
D/o
El�et 7—%�
PLUMBING
Plan Check No. - S
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGWILL
Any. construct ion on the public domain (curbs, sldewelks,
driveways, marquees, etc.) WIII require separate permission.
1xO0
STATESURCHARGE
Permit Application:180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
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 IssuancePLAN
of this permit. Issuance of this permit shall not be deemed tomodify,
CHECK DEPOSIT
waive or reduce any requirement of any city ordinancenor limit in any way the City's ability to enforce any ordinance
AMOUNT DUE
provision."
TOTAL
/G�y
I hereby acknowledge that I have read this application; that the
ATTENTION
APPLICATION APPROVAL
Information given Is correct; and that I am the owner, or the duly
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
This application Is not a permit until
state laws regulating construction; and in doing the work authoriz•
AUTHORIZES
THE
signed by the Building Official or his/her
ad thereby, no person will be employed in violation of the Labor
Code of the State of Washington relating to Workmen's Compensa•
ONLY
WORK NOTED
Deputy; and fees are paid, and receipt is
Aiiao Insurance and RCW 18.27.
INSPECTION
acknowledged in space provided.
SIG R GENT) DATE SIGNED
DEPARTMENT
CITY OF
0 IA 'S I TUBE DATE
1 L51
EDMONDS
CALL FOR
RELEA DATE
ATTENTION
INSPECTION
) ��-
IT I S UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
- ORIGINAL - File YELLOW - Inspector
7710220
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
PINK - Ow,er GOLD - Assessor
•
"go-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
or plot plan for individual lots of the parcel
with enough detail that City staff can find
and identify the subject parcel(s). In
addition, the applicant shall include
other pertinent information (e.g. site
plan, topography map, etc.) 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:
�2 c L-k 1< 14 a> Y2'
Name
Zyozy - �'- y a'L Arv-e- .(J
Street Address
City, State, ZIP -77 & • yaZI Phone
1 zZ�t-�y
Signature Date
Applicant Representative:
Name
Street Address .
City, State, ZIP Phone
Signature
Date
• STREET FILE CAWLENo CN-,�o
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: Z y o "Z y- is `i Z- A�--- w • -
2. Property Tax Account Number: 9 4c, 33 - 0 l - t c / _ o co
3. Approximate Site Size (acres or square feet): 7 Soo s h- f f .
RECEIVED
4. Is this site currently developed? x yes; no.
If yes; how is site developed? 1100 .5 MAR 1 5 1994
5. Describe the general site topography. Check all that apply. PERMIT COUNTER
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 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: ,J o ; Approx. Depth:
7. Site contains areas of seasonal standing water: 00 ; Approx. Depth:
What season(s) of the year?
8. Site is in the floodway N z floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? Flows are seasonal? N J (What time of year? ).
10. Site is primarily: forested ;meadow ; shrubs a ; mixed
urban landscaped (lawn,shrubs etc) V--- .
11. Obvious wetland is present on site: v o
Rcv MUM