1010 SPRUCE ST.PDFiiiiii iiiiiiii
13289
1010 SPRUCE ST
TAX ACCOUNT/PARCEL NUMBER: 42� z6,-3WT/�,Iey
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS: 4A ''C,Qc�Z6 96' 7 DETERMINATION: ❑ Conditional Waiver ❑ Study Required aiver
DISCRETIONARY PERMIT
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS
PLANNING DATA CHECKLIST DATED: / A
SCALED PLOT PLAN DA'
SEWER LID FEE $:
SHORT PLAT FILE: LOT:
LID #:
BLOCK:
SIDE SEWER AS BUILT DATED: fC !9 SIDE SEWER PERMITS) #:
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED: ? (�
w
CITY OF EDMONDS
SEPTIC TANK APPROVAL
n
TO WHW IT MAX CONCERNs
This is to certify that the septic tank for
has been inspected and are according to City of Edmonds standards
DATE: L
r
Inspected bw_ .....
TREET FILE
•
0
CITY OF EDMO ET� ADDRESS F1� kARBARA FAHEY
MAYOR
7110-210TH ST.S.W. • EDMONDS, WA 98026 • (206) 771-0235 • FAX (206) 744-6057
COMMUNITY SERVICES DEPARTMENT - PUBLIC WORKS DIVISION
Est. 189v
April 18, 1997
R. D. Petersen
1010 Spruce St.
Edmonds, WA 98020
Dear Mr. Petersen:
On April 14, 1997, the Public Works Division performed a "smoke test" on the sanitary
sewer collection system in your neighborhood. It was found that the surface water drain in
your driveway is connected to the sanitary sewer system as opposed to a legal storm drain
or sump/drain field.
Please have this drain disconnected from the sewer system as soon as possible. We will
want to inspect the capping of this pipe before it is buried.
If you have any questions or if you are calling for the inspection, you can reach Everett
Akau or myself at 771-0235. Please respond by May 30, 1997.
Sincerely,
IzA
9w
Scott Highland
Acting Water/Sewer Supervisor
SH/lk
Attachment
cc: Everett Akau, Sewer Lead Person
Noel Miller, Public Works Superintendent
wordata\sewer\petersen • Incorporated August 11, 1890 •
Sister Cities International — Hekinan, Japan
18.10.020 •
•
years after the acceptance date by the city
council of the sewer subject to such agreement.
C. Restriction of Water Service. If a prop-
erty owner or owners within an area served by
sewerage systems of the city, including those
property owners on streets and alleys within
200 feet along which sanitary sewers have
been constructed, have not connected their pri-
vate sanitary drain and sewers with the city
system, the city may restrict water service to
the property to the minimum necessary to
insure health and safety of the inhabitants, or
where a health hazard exists or is threatened
the city may shut off the city water supply to
the premises.
D. Connection. The city council may order
connection to the sewer, and the director of
public works shall report to the city council as
soon as possible, an assessment roll showing
the description of the property connected, and
the cost of each connection.
E. Hearing. The city clerk shall notify the
owner of each property as in the case of a local
improvement district of such proposed assess-
ment, and that the council will hold a hearing
on a certain date upon the roll and will hear
protests at such hearing against the assessment
roll. The city council shall, at the hearing, by
ordinance, assess the cost of making the con-
nection against the property connected. The
assessment shall become a lien against each
property, and shall be collected in the manner
provided by law for the collection of local
improvement assessments, and shall bear
interest at the rate of interest established by
ordinance from the date of the approval of the
assessment.
F. Permit Required. It shall be unlawful for
any person to make any sort of connection to
the city sewer line without a permit from the
public works director.
18.10.020 Prohibitions.
A. Injuries. No person shall injure, break or
remove any portion of any manhole, lamphole,
flush tank or any part of the trunk or lateral
sewer of the city of Edmonds.
B. Obstructions. No person shall deposit
any garbage, rubbish, dead animals or any sub-
stance or thing having a tendency to obstruct
the flow of any sewer in any manhole, lamp -
hole, flush tank or sewer opening.
C. Connections and Smoke Testing. No
person shall connect, permit the connection, or
allow to be maintained any connection, any
downspout drain, storm drain or drainage of
any kind or description whatsoever other than
sanitary sewerage connections as authorized
by the city of Edmonds into the sanitary sew-
erage system of the city of Edmonds. The pub-
lic works director is authorized to conduct
smoke testing of the city sewer system to
detect illegal connections to the city sewerage
system.
18.10.030 Unlawful connections. .
A. Notice. If any land or structure contains
an unauthorized connection to the sewerage
system as prohibited by this chapter, the same
shall constitute a misdemeanor subject to the
penalties provided in this code. In addition,
and not by way of limitation, the public works
director may send notice to correct such viola-
tion to the owner of the premises addressed to
the street address of the premises. Where the
records of the water/sewer department show a
different address for the owner, a copy of the
notice shall be mailed to that street address.
B. Charge. If the condition has not been
corrected within the period specified by the
public works director, not less than 60 days
from the date of mailing of the notice, there
shall be added to the utility bill prescribed by
the Edmonds City Code for that premises, an
additional charge of $1.00 for each month of
violation after the expiration of the specified
period. The additional charge shall continue
and be collected until such time as the owner
of the premises corrects the condition.
18.10.040 Defective private drain pipes.
A. Notice. If any private drain pipe con-
nected with the trunk and lateral sewer
becomes obstructed, broken or out of order,
18-8
SITE PLAN
Fite 9011021 •
Address 1010 SPRUCE STREADMONDS, WA 98020
Date of Insp: 11/19/90
, - I W!" mv,
` Em
0 R �D S
1" D RAND;VIEW A I
A, ;l/I
AMP
h-S
. . . . . . . . . . . .
du
-4
C E D A R S T
wD
iNji
9,
V Mr, v
I"% c\l A
;SPRUCE
An
4 A3
'LEANNE
4
1 3'17—
LAU LAN
M) "03 LA
10' 10
'0.4
"Ol �
.4oar w
14.
IT L^
S,4
-e'
14�7,`
or r,
R
go E
LAUR
f ski
11C
�aQ
A
6_os9`j oho. Ito1'
A SAD
W-1
Mkz
LAWYERS TITLE COMPANY OF WASHINGTON
ALTA Commitment, Page 2
Order No. 98804
SCHEDULE A
LEGAL DESCRIPTION
PARCEL A:
That portion of the Northwest quarter of the Northeast quarter of Section 25,
Township 27 North, Range 3 East, W.M., described as follows:
Beginning at a point 626 feet South and 720 feet East of the North quarter corner
of said Section 25;
Thence continue East 130 feet;
Thence South 110 feet;
Thence West 130 feet;
Thence North 110 feet to the point of beginning.
PARCEL B:
An easement for ingress and egress and for road and utilities over and across
that portion of the above said subdivision, described as follows:
Beginning at a point 388 feet South and 820 feet East of the North quarter corner
of said Section 25;
Thence East 30 feet;
Thence South 238 feet;
Thence West 30 feet;
Thence North 238 feet to the point of beginning.
Situate in the County of Snohomish, State of Washington.
10 SPRUC
U ' h'
T UNION
SAD
� � n, l �- vz z l o l ., I •� -- --!
�
1
— i I r- 0 34
- 0 31-1 �'
.0�� 1 1 1-033
-- -- - -- -1 1 - O 3 G
I 1-03Z /C'
f-U4r i �
/ I 2
�L E'ANr
s \ 5
1-025
3
LAUREL LANE
LAIVI
�- 0 3 1
11-v3o 49�.�
047 ! I-04F. ( I I( I I o
vso i-o49
rj
11
)5Z 1-053 I^ I n I I 1 1
�_5GS I i
A
•
81
9
The City of Edmonds
APPLICATION
for
SIDE SEWER PERMIT
OUTSIDE ❑ I'NSIDE ❑ REPAIRS ❑
CAMDNo . .................. ................... :
EASEMENT No.
OWNER-.......1..:"I17...✓......?!.Y..I C .............. CONTRACTOR ...........0.4 W//� ........................................................... PERMIT N�� .�1.....��`
J f� l• STREET
HOUSENo........ CJ V---------............................................................................ AVENUE LOT No. .......... .C�--------= C- ........ BLOCK No. ...............................................
NAMEADD......................................................................................
Date
Approved:
ek
PQ�
F
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ ................................... ..........
SEWER WORK ORDER ISSUED ............................................. DATE ..... .... .................. t....----- By ..'.. ... ... ....... .:�.�-z �..............
Y
1�
10 1 u -spruce
`
Di 1,F,-
PLANNING DATA
NAME: 00�4 yewla- DATE: 1 Z/ Z b /.I
SITE ADDREM: 10 / o Spn.4ce 5r. PLAN CHK#: OL. -S4 9
PROJECT DESCRIPTION: 5 8ce6c
REDUCED SITE PLAN PROVIDED?: Yes / No)
MAP PAGE: 1 q'4 CORNER LOT: Yes / FLAG LOT: Yes / & - e"— �---� �• +
f jvvr �.tn b I nr.
ZONING: 125—ft CRITICAL AREAS DETERMINATION M o L - 226 l; o L - Z2 7
❑ Study Required:
LdWaiver
❑ Conditional Waiver
SEPA DETERMINATION: elx-e-y.-
❑ 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)
Or Exempt
SETBACKS:
Required Setbacks:
Street: 2-51 Left Side: 7. 5 ' Right Side: 7, 5' Rear: / s '
✓ ? Actual Setbacks: + &va0o^&
�j Street: 75, Left Side: +/' Right Side: (y9' Rear:
Street map checked for additional setback required? (Yes / No / DNA)
Ll
DETACHED STRUCTURES: ru^' " n4 o+wr�"Qi4A
ROCKERIES: r+F^t- fh,",,, " I}'"''"'"''
FENCESITRELLISES: �� s,-- 8 _ ,,, � fv-,
BAY WINDOWS / PROJECTING MODULATION:
STAIRS I DECKS: ,,, J;.-
b�
PARKING: Required: 2 Actual: 2 ; 1 to k (3c) - 14, 3OZ - l �,30)= 13,6A-o
LOT AREA: —(1 ° t - o i 13 0,
LOT ERAGE-
Calculations:ns: (1-4X7-4) /-r35'-4sl k ziL()3 4) r iZ1.13) 64-20) = 1?95
576 4QA i rL deb
BUILDING HEIGHT:
Datum Point: runWk Datum Elevation: /w'
VV Maximum Allowed: 4-*4+-A Actual Height: 12'
A.D.U. CREATED?: N / Yes)
—� SUBDIVISION: toz 4 SR^ru. - S'191,1,'3 1 o 2, Spr", % 5-11 14 ; �uOk (n a.0 Aa ^-1-%^ irbM.>
L-L 0 3 - q 3 (ar7 .
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: Yes / No
a
OTHER:
Plan Review By: �1�
NewBPPlanningDataForm.DOC
0/9, 4
91'
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation
1. Site Address/Location: e 5 ,/.
VIA- a� +
CA File No:
Q - aa-1
2. Property Tax Account Number: D 3 L 7v3 7,
3. Approximate Site Size (acres or square feet):.' -
4. Is this site currently developed? Ives; no.
If yes; how is site developed? ` 2 In-
5. Describe the general site topography. Check allat 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 604eet).
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 les's than 33-feet).
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 season(s) of the yearn?�,
8. Site is in the floodway _,'- i22 floodplain i of a water course.
9. Site contains reek or an area where water flows across the grounds surface? Flows are,year-round?
Flows are seasonal? (What time of year? ).
10.
11.
Site is primarily: forested _ : meado -shrubs : mixed
urban landscaped (lawn,shrubs etc)
Obvious wetland is present on site:
Critical Areas Checklist.doe/3.19.2001
City 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 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).
Date Recued• 111;2 '
City Receipt#:�2'J 4
Critical Areas File #: ,
.Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant:
A - property owner, or his/her authorized 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.
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, topographymap, 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 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 application on the behalf of the owner as listed below.
SIGNATURE OPAPPLICANT/AGENT _
Property Owner's Authorization
By my signature, I certify that I have
and grant my permission for theppb11
purposes of inspection and po , g,4
SIGNATURE OF OWNER _I
Owner/Applicant:
this
Name
-.. I0(0
Street Address
Ed L(YAO(Js
City ' State Zip
Telephone:
Email address (optional):
Critical Areas Checklist.dod3.19.2001
DATE
've Applicant/Agent to apply for the subject'land use application,
staff of the City of Edmonds to enter'the subject property for the
DATE /04
Applicant llepr..esentative:
Name
Street Address
City State Zip
Telephone:
Email Address (optional):
0Criticai Areas Checki*
CA File No:
Site Information (soils/topography/hydrology/vegetation
1. Site Address/Location: _ l d�21 i /2 S
2.
3.
4.
5.
Property Tax Account Number: D n Z S 4
Approximate Site Size (acres or square feet):
Is this site currently developed? _Yyes; no._
If yes; how is site developed? �/A / 4) ( � e
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
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:
7. Site contains areas of seasonal standing water: ; Approx. Depth:
What season(s) of the year?
8. Site is in the floodway 1V-0 floodplain of a water course.
9. Site coma' reek or an area where water flows across the grounds surface? Flows are year-round?
i Flows are seasonal? (What time of year? ).
10. Site is primarily: forested ; mead o ;shrubs ; mixed
1 urban landscaped aawn,shrubs etc)
11. Obvious wetland is present on site:
Critical Areas Checklist.doe/3.19.2001
City o�!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 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).
Date RecdWd: /,�< U
City Receipt #: olzmx
Critical Areas File #:
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant:
A property owner, or his/her authorized 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.
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.
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 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 application on the behalf of the owner as listed below.
SIGNATURE OF APPLICANT/AGENT
DATE
Property Owner's Authorization
By my signature, I certify that I have au z eYabe Applicant/Agent to apply for the subject land use application,
and grant my permission for the 1c o ci s dtaff of the City of Edmonds to enter the subject property for the
purposes of inspection and pong d thiscation. /
SIGNATURE OF OWNER
Owner/Applica t•
Name
Id(O Spruce, 6r
Street Address
� 0Q i
City State Zip
DATE /
Applicant Representative:
Name
Street Address
City State Zip
Telephone: Telephone:
Email address (optional): Email Address (optional):
Critical Areas Checklist.doc/3.19.2001
CALCULATIONS::, SUMMARY LIVING AREA CALCULATIONS
SiZe:. : Totals. Breakdown Subtotals,
Fi,rsr::�toor::•• 659s00 ;.659:00. > 5:00 , X 14.00 490.00
;� %GW►2 <,! ;; Seconii l odr :. 576 00 576 00'• 22.00 X 6.00 132.00
!-BSFI
E', .`: `' Yet•:;: ;.0:. , 5018X 2.00
i::.;; ::.
- �%S � n��Fil�it/f.,C lc.�.:�: er,9ye{:�:•;-r::•�'. 2:73.bOa..�•. 2T3:00'-.;, -24.00 X 24.00 -5
n d 1
yf,:T FIL%WqD
ZONE
SETBACKS:
FRONT
SIDE
REAR
OTHER
HEIGHT
r
Ca tex C 1•at /
o
^Ilr i
�� � REF7
fah--y ---�
dew
�M�.ef�v�vaS Su��a ry-
���sr���
�yiVG 1160
APPROVED 13Y PLANNING
—. Z� ���is-��3
sdc 0, "-o3 93
SeewlL
9 f �
4 �
f !
f
1,✓l � �I��_ it ,f
uVVl/ l/ v v v v kx L/ l./ v " Wr -.Vw �T'vp�w
p� i ��� v <J •V� f
%d1 • •
DA Zone G N.E. 1 /4, SEC. 25 T.27N.9 R.3 E.W.M. 154
m a 9535 3
�11 1ALDER ST I 'ale
O
4o10
Mp-
�L05S
c
CAM a
Q
l
Al
a
415
o
p
o
a
.
.
—
—
rew+ls POST MEMORIAL ',
w LNUT SIT. PARS a
IZ
Ln
0 21201, 120 n
6 E
5 a a a h A L4 `Z 2 0 21202 21211
o' p s. 21214 3 21209 a m
N CEO $ o. Eo R PL. 12 2 a 21220 3 +YI nn
601 0, o• 0�'. a o. a $ I$ 2; J c M h o 0 0
G00 4i c to N a 21222 a , /21
o M a N Qp• v o o 0 0 0 o a p21218 OU 1230
LIO Q O, O� P O+ O. O V� O 8 vl Q IZ.3Z h
'dL
PRUCE ST. 2 122 0 21224 2
21301 1 130N1315 a
16 TV 721 7l7 7/0 C 707 o �Nw $ oa. t1327 213(5 21312 SO9 21309
7!4 7!1 0 P 21320 tt 2/323 91! N a
c N. -UREt- 2141� 0.J 21401 21326 21329. 21t18 21 z1316 P
731 725 719 21900 c w ,°p o 141 ~ 21420 21411 P1406 • 1403 21824 ( 213211403
21goB
;;= IT.. ---w-110 8 SO S 21320 2132 14
MI o. 21419 0 y912
06 C% 803 21412 21419 ^ ^ ' `Igl2 2N24 214 A 40y 2M1
c o 0 0. o, a o+ 2N2t, 21423 ZIAI . 2141 o a 5 10 214PL. S. 0o4vI N
21423
8
all
,
2
s rm sr.
2
12
17
411
yo9
905'
P
a
ON
a
;16
�►
21522.
3
T
P
M
°
1_
a
21524
PINE
ST.
110
1009
N
N
N
rNn
..m
215l1
21506
21515
2/525
Z152L
524
21522
P
P
z1415
. a
214
2142$01
I
N
m OM.
b
S'
�215j0
215
21509
�
a
$
a
m
�
215f8
21513 '
p4`,
1^
N
P
v
pp�'•
M
1�`n
P
21522
2151
3
Z
Q�
Q�
A
P
O,
P
O,
p.•
P
P
O�
21
TM
7.
W.
16
1607
N
VM
N
a
M
O
m
N
m
N
01
21Nb
0, P O, 2/606 2161" PL. O• P � P
21611
24 1013 1015 2/628 0.�°�T. ti: nxT M
36 W 11033 1017 2/630 W 2/629 2(626 21627 21628 0` 217 rr S T 51 216
1037 21702 � 2170/ 21704 21703 21700 j 21701 N b o N p to -O N V m
Q 1035 Q g 217/0 711 In1� N N N 2170_
8 21708 21707 21110 2►709 2170G Q 21705 21714 3 0. o
,y
217/5 211/4 j 217/9 21716 17 21717 07 M c o H 2n14 Will
54 1051 g:�6 21716 Q 17Y3 217j5 722 ul 21729 rN� ° P a 0� C4 21 2
21726 2171E 21720 �� 217r/1 0 724 17, 1
o.
1061 6 .j 922 21728 21729 2f72c 1723 1727 1730 Q 2081
Q 21727' 21728 Z O v
21804 / 21 21802 21807 2160c 21 p1802 218rM PL. o� N � 2reo1 zleo2 = I
917 9IB 80 80 180 8 = s7 .3
a8 1109 ti 5 7 x 07 21810 r w"p d. 21a05 n N 8
—" a 9/6 21812 - 1' 21619 2/81c tell g 21812
: 1123� 915 Go z18+7 2/814 T �p 2 2181 71e11
M O� 9 10 21810 Q: 21819 21818 a y819
36 Q) M � 2/620 Ol 2/823 2(824 11 15
1125 z � v: 2/e21 2(822 � ,h 2l826 trl 21e21 21822 2l821
0
, W a" o.� 21 21813 91899 21826 0)21e27 21
/n 2 21824 21829 1926 21823 817 21
131 2
� � o $T. 2 21900 19jj > 21901 21e32
1 21910 21911 2/900 F90) 21+10`i9 91821 2/W tl9
19161904 2f98
41 0 $21920 21919 a0 a a 21909 9/0 r+ 21g2021�3 219os 2t9/
x 2l916
1926 H 1 p N N h O O yI^ 1139 21925 O O ^I �, h 92s ^ M M IM M In O p� 0� 00 ap b I n 1915 p N
O� O-
220 7H S T S. i1/ ?O t1+ S7 S.1✓ 20
o05 _ y1
22 wa Q 006 2a011 wErSrG�rE 14n L� iL 0 0^� o� e°'
4 '� L?LM• $CN.Q = a �, 0: � 9, Z � o' o, z 1
x z2oi4 w 2o(S 0/1 /s v14 Zoll a a 12 N l7 �t a joi4 Z°IB /6 7
�t�q4
22oza C' 22024 17 ozz w at _ 22022 `►s
Ch 2027 22030 29027 4 22020 a15I
• DATE RECEIVED/ D
PERMIT EXPIRES
CITY OF EDMONDS
ZONE USE PERMIT n `h
NUMBER
JOB UITE/APTN
CONSTRUCTION PERMIT APPLICATION
ADDRESS
OWNER NAME/NAME Oi-BUSINESS I
/� ✓
PLAT NAME/SUBDIVISION N0.
LOT NO.
LID NO.
D i
r /� IF I✓
LID FEE $
W
MAILING ADDRESS
PUBLIC RIGHT OF WAY PER
TESCP
/ 0 / S
S K,� C- VVV
OFFICIAL STREET MAP
Rw Perm tRquired
G
�J
_meµ---
EXISTING PROPOSED
Street Use Permit Req'd
Inspection Required 13
Sidewalk Required 13
CITY ZIP
TELEPHONE
/ 10 ' O�U
y L — �� �. l - y
K7 Q V
_
REQUIRED DEDICATION FT
r°md O
Widnp
Wiring
NAME
METER SIZE LINE
SIZE
NO. OF FIXTURES
PRV REQUIRED
� A
A
Id
YES 13 NO 1
_
W
ADDRESS
REMARKS
=
2
=
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
a
Jf S I MS 3►v
CITY ZIP
TELEPHONE
N 'L
NAME
CB q
ENGINEERING REVIEWED BY DATE
ADD
C
(LgEr— n
-3
FIRE REVIEWED BY DATE
tu
CITY ZIP
MOO o s R ��
TELEPHONE 'l
ldk�+10 3,3
cc
V
VARIANCE OR CU
SHORELINE OR ADS
INSPECTION
REQ'D
BOND
POSTED
STATE LICENSE NUMBER EXPIRATION DATE
C ECKED BY
0
—
—
OYES LBfJO
$ --
I
SEPA REVIEW
COMPLETE EXEMPT
SIGN AREA
ALLOWED PROPOSED
HEIGHT
ALLOWED PROPOSED
PROPERTY TAX ACCOUNT PARCEL NO.
�J 7 p�
70 �� ��� b' OG 7v�l� �C/ f%
�
Q
' Z r
EXP
�1
❑ NEW RESIDENTIAL ❑ PLUMBING / MECH
LOT COVERAGE
REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS (Fr..)
LOWED PROPOSED
ALCOMPLIANCE
FRONT SIDE REAR
FRONT UR SIDE REAR
OR
❑ ADDITION ❑ COMMERCIAL ❑
F USE
�+�
2 5• 7.51 �
4+ % Z I
Z
CHANGE
❑ REMODEL ❑ MULTIFAMILY ElSIGN
PARKING
REQ'D PROVIDED
LOT AREA
-PLANNING REVIEWED BY DATE
Z Z
1 aCL
FENCE
❑ REPAIR C'A< 1 0 CYDS ❑ ( X FT)
REMARKS
4a OAS.,
OTHER
❑ DEMOLISH TANK ❑
GARAGE RETAINING WALL FRE SPRINKLER
CARPORT ❑ ROCKERY ❑ FIRE ALARM .
=
F
(TYPE OF USE, BUSINESS OR ACTNITY) EXPLAIN:
BY
TYPE O ST UCTION
CO
OCCUPANT
DC
/ /) LL a� MCHECKED
G7 • �(i/Q
GROUP
ER
0
MO
NUMBER
OF /
NUM OF
DWELLINGS
CRITICAL
A
SPECIAL INSPECTION
AREA
OCCUPANT
STORIESUNITS
REQUIRED ❑ YES
LOAD
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D
9
N,5 ,- 6 W
t- e,
m
VALUATION
$
—
Description
FEE
Description
FEE
Plan Check
—''
State Surcharge
HEAT SOU E GLAZIN % LOT, SLOPE %
Al � N{ Building Permit City Surcharge
PLAN CHItCK NQ� VESTED 6ATE C� Plumbing
_
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMR COVERS WORK TO
t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review � •"
Iu PERMIT APPLICATION: 180 DAYS
d PERMIT LIMIT. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection .�
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
D
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE �•
9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due J
= NOR LIMIT IN ANY WAY THE CITY S ABILITY TO ENFORCE ANY ORDINANCE PROVISION '
Recording Fee Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT; AND THAT I AM THE OW R, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CrTY ND STATE LAWS REGULATING CONSTRUC- CALL This application is not a permit until signed by the
TION; AND IN DOING THE WO"AUTHORIZOD THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and
IN VIOLATION E LAB CODE OF HE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided.
WORKMEN' OMP NSAV7TI NSURANC AND RCW 18.
OF S TUR DATE
SIG R DATE SIGNED c
(42J)
//qi-
ILL Z 771-0220
ELE SED BY D E
ATTENTION M 1333 -
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI
ORIGINAL -FILE YELLOW - INSPE oR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK -OWNER • GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN -ACCOUNTING
City Clerk
City of Edmonds
121 — 5"' Ave. N.
Edmonds, WA 98620
003050m�26r�1 PGR�t
SNOHOMISH COUNTY. WASHINGTON
STREET FILE
NOTIFICATION OF LOT AGGREGATION
Property Address: le S% Tttc e
Edmonds, Washington
Legal Description of Both Parcels:
Assessor's Parcel Numbers: 176-'073 a-boa/o3�o�
WHEREAS, the owner of the above lots has applied for a building permit to erect a structure across
the internal lot line between said lots, violating allowed use provisions established by City ordinance;
and
WHEREAS, the owners desire to aggregate said lots into one building lot in order to remove side yard
setbacks and receive a building permit.
NOW, THERERORE, the undersigned property owner, as owner of the above lots, in the city of
Edmonds, Washington, do hereby aggregate said lots into a single building parcel. This notification is
being recorded in order to confirm the aggregation so that a building permit may be issued by the City
of Edmonds to construct a building across said lot lines, without the imposition or requirement of
normal setbacks.along,the.common border of the lots. The City will apply setbacks to the newly
aggregated lot only along the perimeter of the newly aggregated lot in accordance with current
ordinance. By this notification, the owners bind themselves, their successors, heirs and assigns to
treat the above lots as one lot and to commit to re -subdivision of the lots in accordance with the
provisions of law and ordinance prior to any future sale of less than the entire newly created parcel.
DONE THIS day of , 20e�;5,
Property Owner Signature:
STATE OF WASHINGTON
COUNTY OF SNOHOMISH ) l _
I certify that I know or have satisfactory evidence that eo &4 Pee rs e/t
signed this instrument and acknowledge it to be his/her free and voluntary act for the uses and
purposes mentioned in this instrument.
Notary's must be smudged. Dated:--O 3
\PC�P%N' f4, ,Signature of:
Og��s`' xAi9� Notary Public:-
0 o-fARY 0'/
0 N Residing at: S11yh 0 z
PURL Z My Appointment
IN 4.30-2005
�� �0 Expires: ok go -0�
DF WPS�\
THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR.
W