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ADDRESS:
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TAX ACCOUNT/PARCEL NUMBER: SOS/3 / Os-b ®[ [ 0 O
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
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CRITICAL AREAS:- DETERMINATION:' ❑ Conditional Waiver Study Required Waiver
DISCRETIONARY PERMIT #'S: / lGl�`9D�✓D/ �L%/�//�' O<� Gt//�L��`'L
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DA'
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
6 -- 0/4 z ,
PLANNING DATA CHECKLIST DA
SCALED PLOT PLAN DATED: Q t
SEWER LID FEE $: LID #:
0 326
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #: 0 7
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED: jj
OTHER: �OekxM /J✓/�t- a ✓ OF G.Ei 4 L IYO-w
v/1/OV
LATEMP\DSTs\Fonns\Street File Checklistdoc
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,C,ITY of EDM"JIDS
For Inspection Call 771-3202
Address of Construction:
S.I q
SEWER PERMIT
PERMIT NOJy1�''v
LYNNW.00D LINE
Property Legal Description (Include all easements): �of�c�✓';.���{ �'t_.1� �°
Owner and/or Builder: ���%�-J=� p_-' y°v� �1 / ,�_
RECEIVED
Contractor & License No: >r9 r J..N !"'1gp5
PUBLIC WORKS
Single Family Residence
Multi -Family (No. of Units )
Commercial (No. of fixture Units )
Invasion into City Right -of -Way: No Yes (If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-55'55) before a'ny
excavation.)
Cross other Private Property: No �� Yes (If Yes, easement required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS LISTED ON THE BACK
I certify that I have read and shall comply
with the items listed on the back.
Date
----------
Permit Fee:
Trunk Charge:
Assessment Fee:
Issued By: (). i,r► �+�r;�t rC,�
Date Issued: ..2/
Receipt No.: 2 i
Partial Inspection:
Comments lc Date Initial
Final Inspection Approved: SE_
Date In 1—t A 1
Rejected:
Reason Date Initial
** PERMIT MUST BE POSTED ON JOB SITE **
Wh.ite Copy - File Green Copy - Inspector
Buff Copy - Applicants
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`890 19q-
CITY OF EDMONDS
250 - 5TH AVE. N.. EDMONDS. WA 98020 • (206) 77.1-0220 • FAX (206) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works • Planning . Parks and Recreation . Engineering
LETTER OF TRANSMITTAL
Date: April 19, 1995
To: Sky Young
2722 201st St. S.W.
Lynnwood, 14A 98036
Subject: Critical Areas Checklist
Transmitting:
For your information: XXX
As you requested:
For your file:
Comment and return:
Note attachments:
LAURA M. HALL
MAYOR
RIECiel r zo
MAY 2 4 1995
PERMITCOUNTER
Comments: Please briny in a copy of the Critical
Areas Checklist when applying for a building
permit.
Planning Division
cc: Sky.Young Diane Cunningham
• Incorporated August 11, 1890 r-
570 Sister Cities International — Hekinan, Japan
F
City of Edmonds
Critical Areas Determination
Applicant: [Sky Young Determination #: CA-95-59
Project Name: Permit Number:
Site Location: 1 16131 75th Place West Property Tax Acct #: 51310580110006
Project Description:
Non -Project Specific
Waiver Criteria (all criteria must be found to apply):
XXX There will be no alteration of the Critical Area or its required buffers;
XXX The development proposal will not impact the Critical Area in a manner
contrary to the goals, purposes, objectives and requirements of the
Critical Areas ordinance;
XXX The development proposal meets the minimum standards of the Critical
Areas ordinance;
XXX The above findings are based on the following conditions of approval:
1. All proposed development of the subject lot must meet the requirements
of Chapter 19.05 of the Edmonds Community Development Code.
2. All proposed development of the subject lot must meet Engineering Department
requirements for erosion control
0 Ct.*E NO. q5 5
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: 1(0131 i5-t-il pL W&-5r
2. Property Tax Account Number: $131OS- 80- ((000(o
3. Approximate Site Size (acres or square feet): 7 200 l f
4. Is this site currently developed? yes; no.
If yes; how is site developed? Ey 1-2n �Cn
5. 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-fed 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-fed).
Steep: grades of greater. than 30% present on site (a vertical rise of 10-fed over a
horizontal distance of less than 33feet)-
Other (please descxibe): ?
6. Site contains areas of year-mund standing water. (JO Appmx-Depth:
7. Site contains areas of seasonal standing water- ; Approx. Depth:
What seasons) of the yeaf? ... .
8. Site is in the floodway )JO floodplain W of a water course-
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? MO Flows are seasonal? W (What time of year? )....
10. Site is primarily: forested ; meadow. ; shrubs ; . mixed ;
urban landscaped (lawn,shrubs etc) ✓' .
11. Obvious wetland is present on site: NO
RevO110094
"ga_199—
City of Edmonds
Critical AreasChecklist
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 histher 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 ots of UFe parse
with enough detail that City staff can find
and identify the subject paroel(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,( out the:appropriate.00lumabclow).
Owner / Applicant: y Y Applicant Repcseutative:' 3i:• �" '","; _ ,'
5Ky YOURXI _i• �';�sr N�. l w,y.i{T J� s'4'.: �il� . I� , n! ?1s1�f ' . .
'y Name - ., '� - a . _�,��t-,• rf »-', Name
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04TY' CLERK i — sus►.o►N�
GITY'OF EDMONDS 505 BELL STREET NOTIFICATION OF COVENANT AUG 2 81995
EDMONDS, WA 98020 INDEMNIFICATION & HOLD HARMLESS
Under the review procedures established pursuant to the State Building Code, incorporating
amendments promulgated by the City of Edmonds, and as a prerequisite to the issuance of a
building permit for the construction of a residential structure and attendant facilities, the
C undersigned OWNERS of property do hereby covenant, stipulate and promise as follows:
1. Description of Subject Property This covenant of notification and indemnification/hold
harmless relates to a tract of land at the street address of L13(
Edmonds, Snohomish County, Washington and legally described as
i�
L ATT-6C-116:0
. STREET FILE
2. Notification and Covenant of Notification. The above referenced site (hereinafter "subject
site") lies within an area which has been identified by the City of Edmonds as having a potential
for earth subsidence or landslide hazard. The risks associated with development of the site have
been evaluated by technical consultants and engineers engaged by the applicant as a part of the
process to obtain a building permit for the subject site. The results of the consultant's report and
evaluations of the risks associated with development are contained in building permit file number
on file with the City of Edmonds Building Division. Conditions, limitations, or
prohibitions on development may have been imposed in accordance with the recommendations of
the consultants in the course of permit issuance. The conditions, limitations, or prohibitions may
require ongoing maintenance on the part of any owner or lessee or may require modifications to
the structures and earth stabilization matters in order to address future or anticipated changes in
soil or other site conditions. The statements and conditions proposed by the -OWNERS'
l emp:forms: nidcov.doc:2/95 VOL. 3 O 5 3 P A G E 17 73 1
�y
geotechnical engineer, geologist, architect and/or structural engineer are hereby incorporated by
reference from the contents of the file as fully as if herein set forth. Any future purchaser, lessee,
lender or any other person acquiring or seeking to acquire an interest in the .property is put on
notice of the existence of the content of the file and the City urges review of its contents. The file
may be reviewed during normal business hours or copies obtained at the Planning Division, City
of Edmonds, 250 5th Avenue North, Edmonds, Washington 98020.
3. Indemnification and Hold Harmless. The undersigned OWNERS hereby waive any and all
liability associated with development, stating that they have fully informed themselves of all risks
associated with development of the property and do therefore waive and relinquish any and all
causes of action against the City of Edmonds, its officers, agents and employees arising from and
out of such development. In addition, the OWNERS on behalf of themselves, their successors in
interest, heirs and assignees, do hereby promise to indemnify and hold harmless the City of
Edmonds, its officers, agents and employees from any loss, claim, liability or damage of any kind
or nature to persons or property either on or off the site resulting from or out of earth subsidence
or landslide hazard, arising from or out of the issuance of any permit(s) authorizing development
of the site, or occurring or arising out of any false, misleading, or inaccurate information provided
by the OWNERS, their employees, or professional consultants in the course of issuance of the
building permit.
4. Insurance Requirement. In addition to any bonding which may be required during the course
of development, the Community Services Director has/has not specifically required the
maintenance of an insurance policy for public liability coverage in the amount and for the time set
forth below in order to provide for the financial responsibilities established through the
indemnification and hold harmless agreement above: (insert insurance requirements/time period)
Ltemp:forms:mdcov.doc:2/95 2
r� d) VOL. 305 3 PAGE 17 '7 4
5. Covenant to Touch and Concern the Land. This covenant of notification . and
indemnification/hold harmless touches and concerns the subject tract and shall run with the land,
binding, obligating and/or inuring to the benefit of future owners, heirs, successors and interests
or any other person or entity acquiring an interest in property, as their interest may appear. This
provision shall not be interpreted to require a mortgagor or lender to indemnify the City except to
the extent of their loss nor to obligate such persons to maintain the insurance above required.
DONE this L67—_dayo , 19 Sr
OWNERS)
By: _ .
- IK "14- 4�'
By:
STATE OF WASHINGTON )
ss)
COUNTY OFJ�2'� '
I certify that I know or have satisfactory evidence that &tMGQ.m K 9 our signed this instruineuit`and
acknowledged it to be (liis/luer) free and voluntary act for the purposes mentioned if/this instrument..'
DATED this _ L I� day of , 19ltr. V
OT Y PUB IC y commission expires: 6—V416
STATE OF WASHINGTON) _a
ss)
COUNTY OF )
I certify that I know or have satisfactory evidence that signed this instrument and
acknowledged it to be (his/her) free and voluntary act for the purposes mentioned in this instrument.
DATED this day of
19
NOTARY PUBLIC
My commission expires:
1: temp: forms: mdcov. doc:2/95
VOL. 3 0 5 3 PAGE 177 a
LEGAL DESCRIPTION
MILLS
LOTS 9, 10 AND THE SOUTH HALF OF LOT 6, BLOCK 58, MEADOWDALE BEACH, AS PER
PLAT RECORDED IN VOLUME 5 OF PLATS, 'PAGE 36, RECORDS OF SNOHOMISH COUNTY,
WASHINGTON, EXCEPT THAT PORTION TH EREOF CONVEYED TO THE CITY OF
EDMONDS FOR 75 th PLACE W. BY DEED RECORDED UNDER RECORDING N0.90101 10 126
TOGETHER WITH TH AT PORTION OF TH E WEST HALF OF VACATED 74 th PLACE W.
ABUTTING SAID LOTS 9.10 AND THE SOUTH HALF OF LO T 6 AS PER SAID DEED
RECORDED UNDER RECORDING NO. 9010110126
ALSO, TOGETHER WITH THAT PORTION OF THE WEST I I FEET OF THE EAST HALF
OF SAID VACATED 74th PLACE W. LYING BETWEEN THE EASTERLY PROLONGATION
OF THE NORTH LINE OF SAID SOUTH HALF OFLOT8 AND THE SOUTH LINE OF SAID
LOT 10 AS PER DEED RECORDED UNDER RECORDING NO. 9010120365.
MILLER
LOT 11, BLOCK 58, MEADOWDALELIEACH, ASPER PLAT RECORDED IN VOLUME 5 OF
PLATS, PAGE 38, RECORDS OF SNOHOMISH COUNTY, WASHINGTON, EXCEPT THAT
PORTION THEREOF CONVEYED TO THE CITY OF EDMONDS FOR 75th PLACE W. BY DEED
RECORDED UNDER RECORDING NO. 9010110125
TOGETHER WITH THAT PORTION OF THE WEST HALF OF VACATED 74 th PLACE W.
ABUTTING SAID LOT AS PER SAID DEED RECORDED UNDER RECORDING NO.9010110125
ALSO, TOGETHER WITH THAT PORTION OF THE EAST HALF OF SAID VACATED 74thPLACE W
. AS PER DEED RECORDED UNDER RECORDING NO. 9010120363.
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BASIS OFBEARINGS:
RECORD OF SURVEY, VOL. 18, PGS. 102 8 103 VOL. 00 53PAGE17 77
May 28, 1996
Ron Kirkendorfer
PO Box 6816
Lynnwood, WA 98036
To: Ann Bullis
City of Edmonds
Building Division
Re: Permit # 950326 Phase One
Sky Young
16131 75th Place West
Edmonds, WA 98020
Dear Ann:
RECEIVED
MAY 311996
COMMUNITY SLKVIC;ES
Per you letter of May 3, 1996, I have attached the responses and required documentation concerning
occupancy of a portion of the above referenced project.
1. A signed letter from the property owner acknowledging the ordinance in the Edmonds Community
Development Code that prohibits a second kitchen is attached. This kitchen will be eliminated at the time of
occupancy of phase two, and will revert to it's original permitted use.
2. All of the conditions for occupancy have been met. (See attached)
3. See attached letter from the structural engineer.
It is my understanding that the letter of acknowledgment from the Owner concerning a second kitchen will
eliminate the need for a conditional use permit, or the need to modify the phase one or two drawings since the
phase one kitchen will be eliminated at the time of occupancy of phase two.
Sincerely,
Ron Kirkendorfer
City of Edmonds
250 5th Avenue North
Edmonds, Wa. 98020 B U I L D I N G
MAY 3 1 1996
Re: Phase One Permit #950326
16131 75th Place West
Edmonds, Wa. 98020
To Whom It May Concern:
I am the owner of the property referenced above and hereby acknowledge that the
Edmonds Community Development Code prohibits two kitchens in one Single Family
Residence.
While Phase Two of this project is being completed a certificate of occupancy is necessary
for 1/3 of the lower floor. A kitchen is required for this occupancy.
When Phase Two is complete, the kitchen will be eliminated to comply with current code.
If you have any questions, or need additional information please contact Ron Kirkendorfer
or me.
Thank You,
Signed and Acknowledged:
i
Sandra K Young D e
JOHN S. APOLIS, P.E.
Consulting, Structural Engineering Services, Inc.
6311 17th Avenue NE, Seattle, WA 98115
(206) 527-1288
To: May 20, 1996
Mr. Ron Kirkendorfer
Pacific Resource Group
P.O. Box 6816
Lynnwood, WA 98036
Subject: The Sky Young Residence structural design Job No. 95065
Site visit and letter regarding occupancy
Dear Ron:
. At your request, I made a site visit to the Sky Young residence, currently under
construction, for the purpose of inspecting the structural components of the home to
determine whether occupancy of a portion of the lower floor is safe. The area to be
occupied is the only area of the home which currently has finished gypsum wallboard
walls, and occupies approximately one third of the lower floor.
During my site visit, I observed that the major structural components of the home
are in place, as set forth in the structural plans. Since construction is continuing, and
construction equipment and materials are present, the occupant and visitors should, of
course, use reasonable caution in entering and leaving the occupied area, and a sign should
be posted indicating that construction is underway.
With this proviso, it is my opinion that the finished area on the lower floor is safe
for occupancy.
Please call if you have questions regarding the subject of this letter, or require
further information.
Respectfully,
John S. Apolis, P.E.
Consulting Structural Engineering Services, Inc.
BURDING
MAY 3 1 1996
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May 16, 1996
CITY OF EDMONDS
250 5TH AVENUE NORTH • EDMONDS, WA 98020 • (206) 771-0220 • FAX (206) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works • Planning • Parks and Recreation • Engineering
Ron Kirkendorfer
P.O. Box 6816
Lynnwood, WA 98036
RE: 16131 75th Place West
Building Permit # 950326
Property Owner: Young
Dear Mr. Kirkendorfer:
BARBARA FAHEY
MAYOR
This morning I left a message on your voice mail at your request, since you were leaving on vacation, in response
to your most recent phone call regarding the property owner needing to occupy the single-family residence at the
above referenced address. The following is the letter I read on to your voice mail:
The following requirements must be met in order to obtain occupancy approval for the lower portion of the
building:
1. Provide the Building Division a letter from a Structural Engineer licensed by the State of Washington that the
structural integrity of the building is suitable for habitation based on his/her site inspection.
2. Provide the Building Division a letter from the property owner (with her signature) that she understands that
due to the single-family residential zoning of the subject property, the Edmonds Community Development
Code prohibits a second kitchen in the subject single-family residence, and that she can only have a second
kitchen if she first obtains a conditional use permit from the Planning Division.
3. Phase 1 work must be completed before occupancy will be granted, and occupancy will only be granted on the
first floor. Compliance with the UBC for an R-3 occupancy is required and includes but is not limited to: .
occupancy separations, smoke detectors, light, ventilation, heat, exiting, sanitation, 1 full bath, 1 sleeping
room with egress, 1 kitchen, and in addition one room that is at least 120 sq.ft., and insulation of all
conditioned spaces from unconditioned spaces.
Please note that an "efficiency dwelling unit' as defined in UBC 310.7 is only allowed in R-1 occupancies, for
which the property is not properly zoned.
Should you have any questions, please contact me at 771-0220.
Sincerely,
�Za_
Ann Bullis
Plans Examiner
Building Division
• Incorporated August 11, 1890 •
Sister Cities International — Hekinan, Japan
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City.of Edmond
RIGHT-OF-WAY CONSTRUCTION
PERMIT permit Number. - C 9
Issue Date• „ l S 2q4t_
A. Address or Vicinity of Construction: 16131 75 Pl W (4612018)
B. Type ofWork(be specific): lnatal l Service
C. Contractor: Washington Natural Gas Contact: Mariamne Kingsbury
Mailing Address: 1122 75 St SW Everett Phone: 356-7500 X7596
State License #: 98203 Liability Insurance: Bond: $
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. ❑ Commercial ❑ Subdivision El City Project W Utility (PUD, GTE, WNG, CABLE, WATER)
❑ ..Multi -Family ❑ Single Family ❑ Other .
INSPECTOR: INSPECTOR: ; }
F. Pavement or Concrete Cut : ® Yes ❑No G.. Size of Cut: I x H. Charge $
_kcut ) 7
APPLICANT TO READ AND SIGN""
INDEMNITY: Applicantuh&e tands and by his signature to this application, agrees to hold the City of Edmonds harmless from injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its departments or
employees, including or not limited to the defense of any legal proceedings including defense costa, and attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering: Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and understand the permit requirements and the pink copy of the permit will be
available on site at all times for inspection purposes.
Signature: Date: 4-1 A-96
(0yractor r Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: LA �� RIGHT OF WAY DEPOSIT
JV^G 3a +ti 19�10
TIME AUTHORIZED: VOID AFTER -k / _ DAYS DISRUPTION FEE/FUND7 I 11:
SPECIAL CONDITIONS: AVOID ipC 101 Dt'El1.. RESTORATION FEE:
iNATE►t i P &53A 9(-!- PERMIT FEE: Ord
Pvs� S�✓r c t-- '� ' UJc�- �� d i G�TI ' TOTAL FEE -
COMMENTS: � RECEIPT FEE: 4—
DATE:.
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. 1994
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AVA%hhgtcnEr"WCcnvany' Addendum to: Cilty of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
1356-7500 X7596
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-W- Water
Watermain depth -G- Gas
-SS- Sever
�" gas main �- Water hydrant
p Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331
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^"'"E"'Corip8"'' Addendum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Marianne Kingsbury
N Engineering Aide
Washington Natural Gas
i 1356-7500 X7596
Watermain depth
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Key:
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-G- Gas
-SS- Sewer
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p Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331
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Addendum to: City of Edmonds
Right of Way
Permit Application
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Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
1 1356-7500 X7596
Watermain depth
_ZL" gas main
13 I- s p L- v\1
ST C
Key:
-W- Water
-G- Gas
-SS- Sever
e Water hydrant
p Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331
' Nn'�f JN IJ.q` V 4 V.sy ..n�..11.+..:tN t..^I :.,� J'Tt:.lr`f.�'Y-.I?.+�„t,rT , .x�A... .a. �f�1y t.. � �tM .-..vv ..y.- .IY yr •. :'ln<... .-r ,.jl �'r 4.li��.,.;,tY �llv._...� u Z %h'i✓'•}7+�:..� r
City of Edmond
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number: 9
a Issue Date: 9/' .
R
~ A. Address or Vicinity of Construction:
18 9 0 1 9 B. Type of Work (be specific):
C. Contractor: Contact: 2C- 1� �Gl (� j inn
Mailing Address: 2D L Phone: �Z7
State License #: " "' - Liability Insurance: Bond: $
D. Building Permit # (if applicable): `� j ���% Side Sewer Permit # (if applicable): _
E. ❑ Commercial . ❑ Subdivision ❑ City Project ❑ Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family Single Family ❑ Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut : ❑ Yes �PNo G. Size of Cut: x H. Charge $
APPLICANT TO READ AND 4GN
INDEMNITY: Applicant understands and by his signature to this application; agr to Kih� City,.%Edmonds harml, ss f_Lerom injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may 6e ma against the City of Edmonds, or any of its departments or
employees, including or not limited to the defense of any legal proceedings including defense costs, and attorney fees by reason ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOW N(6 THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with Ci,y�r g�llations as require(1434 the City Engineer.
All street cut ditches shall be patched with asphalt or City approvelmaterial prior to thle end'of the working day;
NO EXCEPTIONS.
I have readd e a ove tatements and understand the permit requirements and the pink copy of the permit will be
available on sit at , l-times for inspection purposes.
Signature: Date: _ (-
(Contractor or Agent)
CALL DIALrA=DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY:,, ;�� RIGHT OF WAY DEPOSIT
TIME.AUTHORIZED: VOID AFTER / { D,A�YrS'.
SPECIAL CONDITIONS: are
t7 Cd � INStI>D(c
hoItiwtJ t9P Ate! T _VO PING
1PL<.K--Mor1 p PdcF �
COMMENTS:
DATE:
DISRUPTION FEE/FUND Ill
RESTORATION FEE:
PERMIT FEE:
TOTAL FEE+
RECEIPT FEE: _
ISSUED BY:
sf ,_
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. 1994
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STREET FILE 9 9 5 0 6 2201#4 RECEIVED
STATEMENT ON ACCESSORY DWELLING UNITS J U N 2 2 1995
Property Address: 16131 75th Place West Edmonds. Washington PERMIT COUNTER
Tax Account Parcel No.: 513105 80 110006
Legal Description: LOT 11, BLK 58, MEADOWDALE BEACH, AS PER PLAT RECORDED IN
VOL. 5 OF PLATS, PAGE 38, RECORDS OF SNOHOMISH COUNTY, WASH. EXCEPT THAT
PORTION THEREOF CONVEYED TOTHE CITY OF EDMONDS FOR 75TH PLACE WEST BY
DEED RECORDED UNDER RECORDING NO. 90110110125. TOGETHER WITH THAT PORTION
OF THE WEST HALF OF VACATED 74TH PLACE WEST ABUTTING SAID LOT AS PER SAID
DEED RECORDED UNDER RECORDING NO 9010110125 ALSO, TOGETHER WITH THAT
PORTION OF THE EAST HALF OF SAID VACATED 74TH PLACE WEST AS PER DEED
RECORDED UNDER RECORDING NO.9010120363
I have read the requirements for accessory dwelling units contained in Chapter 20.21 of the Edmonds
Community Development Code and understand that an accessory dwelling unit, including a second
kitchen, is prohibited for two years after occupancy by the current owner is granted and until after a
conditional use permit has been approved by the City of Edmonds Hearing Examiner.
I also understand that approval of a conditional use permit is subject to a public hearing, and neither
this statement nor the issuance of a building permit shall act to limit the discretion of the City review
in the review of any application for a co0dgional use permit.
Property Owner Signature:
Sky Y
Date: V V
STATE OF WASHINGTON )
COUNTY OF SNOHOMISH)
I certify that I know or have satisfactory evidence that Sky Young signed this instrument and acknowledge
it to be her free and voluntary act for the uses and purposes mentioned in this instrument.
Dated: tO
Signature of
s, x Notary Public-7-7—
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ry ram- n -
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.• V� �, My Appointment
Expires:—Q�
THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR
9506220 RECEIVED
IVED
STATEMON ACCESSORY DWELLI
E UNITS
J U (d 2 1 1995
Property Address: 16131 75th Place West. Edmonds. Washington PERMIT COUNTER
Tax Account Parcel No.: 513105 80 110006
Legal Description: LOT 11, BLK 58, MEADOWDALE BEACH, AS PER PLAT RECORDED IN
VOL. 5 OF PLATS, PAGE 38, RECORDS OF SNOHOMISH COUNTY, WASH. EXCEPT THAT
PORTION THEREOF CONVEYED TOTHE CITY OF EDMONDS FOR 75TH PLACE WEST BY
DEED RECORDED UNDER RECORDING NO.90110110125. TOGETHER WITH THAT PORTION
OF THE WEST HALF OF VACATED 74TH PLACE WEST ABUTTING SAID LOT AS PER SAID
DEED RECORDED UNDER RECORDING NO 9010110125 ALSO, TOGETHER WITH THAT
PORTION OF THE EAST HALF OF SAID VACATED 74TH PLACE WEST AS PER DEED
RECORDED UNDER RECORDING NO.9010120363
I have read the requirements for accessory dwelling units contained in Chapter 20.21 of the Edmonds
Community Development Code and understand that an accessory dwelling unit, including a second
kitchen, is prohibited for two years after occupancy by the current owner is granted and until after a
conditional use permit has been approved by the City of Edmonds Hearing Examiner.
I also understand that approval of a conditional use permit is subject to a public hearing, and neither
this statement nor the issuance of a building permit shall act to limit the discretion of the City review
in the review of any application for a conditional use permit.
Property Owner Signature:
Sky Y
Date: to6? V V
STATE OF WASHINGTON )
COUNTY OF SNOHOMISH)
I certify that I know or have satisfactory evidence that Sky Young signed this instrument and acknowledge
it to be her free and voluntary act for the uses and purposes mentioned in this instrument.
Dated: %
Signature of ,
s, X Notary Public
Title.
s:
My Appointment��
Expires:
THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR
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`----------------------'-- MetroScan/Snohomish
)wner :MILLER DALE E
:oOwner .
Site Addr:16131 75TH PL W EDMONDS 98026
rail Addr:16131 75TH PL W EDMONDS WA 98026
Zec Date Deed
?rice Loan
wd Fee #: Ln Amt:
�ctualUse: Lender:
lest Type: IntTyp:
3ldg Name:
---------------------- - - - - -
*
RTSQ :04E-27N-05-SW
APN:5131 058 011 00 06
Struct:$46,800
Land :$140,000
Total :$186,800
LevyCd:00217
1995Tx:$2,164.73 -
Phone :206-743-0063
%Owned:
Vol:5 Page:38
,and Use :11101 RES,SGL FAMILY RES,DETACHED,l UNIT Easement:
ibJ. %a e : 52o
toning :RS-20000 ZoningRest:
tub/Plat :MEADOWDALE BEACH
,egal :BLK 058 D-00 - LOT 11 TGW TH PTN
--Census--
Tract:502.00
Block:2
;edrooms :3
Bldg SF:2,176
LotAcre:
Year B1t:1910
;ath F3H :1
/ /1 1st SF :1,216
Lot SF :
EffYrBlt:
stories :1
2nd SF :
Heating:BASEBRD
B1dgGrad:AVG
'ireplace:
3rd SF :
Roof :COMPOSITIONB1dgCond:GOOD
;pa
4th SF :
View :GOOD
WaterSrc:PUBLIC
inits :1
BsmntSF:960
WtFront:
Sewer :SEWER
PHOTO DOCUMENTATION
OF LEGAL NON -CONFORMING BUILDING
16131 75TII PLACE WEST
PROPERTY OWNER: SKY YOUNG
PHOTOGRAPHS TAKEN 6/14/95 BY ANN BULLIS
PHOTO DOCUMENTATION
OF LEGAL NON -CONFORMING BUILDING
1601 75TH PLACE WEST
PROPERTY OWNER: SKY YOUNG
PHOTOGRAPHS TAKEN 6/14/95 BY ANN BULLIS
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CITY OF EDMONDS
COMMUNITY SERVICES DEPARTMENT
250 5TH AVENUE NORTH, EDMONDS, WA 98020 (206)771-0220
1 � ►�__1� 1 � 1 � 1 � 1 �U � _: � 1
PROPERTY ADDRESS: 16131 75th Place West -Edmonds. Washineton. 98026
TAX ACCOUNT PARCEL NUMBER: 5131 058 01100 06
LEGAL DESCRIPTION: BLK 058 D-00 - LOT 1 l TGW TH PIN
It is hereby determined that pursuant to Chapter 17.40 of the Edmonds Community Development Code the
property identified above contains a nonconforming (check only = of the following):
USE BUILDING XX LOT SIGN
Description of legal nonconforming use, building, lot or sign (describe in detail): Property is currently
designated as Low Density Residential on the Comprehensive Plan, and within the Single -Family Residential Zone
(RS-20) on the Zoning Map There is curre tly a single-family residence on the 12rgpeM built in 1910 according
to MetroScan records. The code defines the lot as a corner lot_ The existing south street setback is 1'-6" where
25' is currently required; the existing west street setback is T-2" where 25' is currently required. It is likely that
there were no setback requirements under county regulations when the structure was built, therefore, the structure
is legal nonconforming.
This determination was made based on the following information and documentation:MetroScan records
show that the structure was built in 1910 Accoring to the fro_ ep�- ,y owner. it used to be a "general store" in the
early 1900s. Site plan shows setbacks referenced above Photographs of the site taken 6/95
Date Annexed: August 1, 1963 Date Constructed: 1910
Zoning at Time of Annexation Residential Occupancy Group: R3
No. of Stories: 2 No. of Units
This determination is made, with the understanding that the status of the parcel may be altered by
amendments to the Edmonds Community Development Code (ECDC) adopted subsequent to the issuance of
the determination and provided that the City shall not be liable for damages for its action to amend the
ECDC affecting this determination. This determination shall be null and void if any activity, action, or
omission as listed in ECDC Chapter 17.40 occurs which would terminate the nonconforming status. This
includes, but is not limited to, alteration to the nonconforming use, building, lot or sign not in accordance
with the requirements of the Edmonds Community Development Code, including required approvals and
permits.
List Attached Documents: Site plan dated received 5/24/95, MetroScan printout dated April 28, 1995
photographs taken 6/95.
Owner of Record: Sky Young
(NAME) (SIGNATURE) (DATE RECEIVED)
Issued by:
(SIGNATURE)
TE)
Supervisor Concurrence: Jeffrey Wilson Current Planning Supervisor
�1 A e _ (NAME) (TITLE) _I _ / _
(SIGNATURE) (DATE)
NOT AUTHORIZED FOR RECORDING
in 40
USE
CITY OF., EDMONDS ZONE
CONSTRUCTION' PERMIT APPLICATION JOBS -Po
OWNER NAME/NAME OF BUSINESS ADDRESS
w MAILING ADDRESS
o a7
CITY ZIP
TELEPHONE NUMBER
LYlVNW o0D WA 98M,46
NAME
1A N 5LYCK_
4D' S.
L ADDRESS
/23 C.A�E �r���r
0
So • #/Z�
• EITY, ., ZIP
TELEPHONE NUMBER
RAW
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1ls,
Q ADDRESS
o�/�3_r ��/s"f, ,
- -
PERMIT
NUMBER
, / IN SUITE/APT It
DIVISION NO. LID NO. .
PUBLIC'RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCP Approved
0
RW Permit Required
0
EXISTING REQUIRED DEDICATION
Street Use Permit Rep'd
0
Inspection Required
0
PROPOSED
Sidewalk Required
01.
DATED
NO 13
REVIEWED BY
2 CITY ZIP
TELEPHONE NUMBER
FIRE MEMO DATED
REVIE
/-�Ti 9814:9
3,93--7g1
8
STATE LICENSE NUMBER
EXPIRATION DATE
EXPIRATION
SIGN AREA
ALLOWED PROPOSED
SEPA REVIEW
COMPLETE EXEMPT
ADS
9AX5V Io�,S' QR 3-3 -
Legal Description of Property - include all easements
0 . AC N5
EXP
SHORE
/
a
VARIANCE OR CU
REVIEW BY
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SETBACKS —FEET
FRONT SIDE io'REAR
HEIGHT
LOT COVERA
✓O,?�
Property
TeX Account r 3105 ^ "
Parcel No. � 000(a
MA
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+t� NEWI&S RESIDENTIAL PLUMBING
® ADDITION COMMERCIAL MECHANICAL
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. GRADING FENCE
El REP 'IR CYDS. L_x_FT)
SWIM POOL
MOLISH INSERT HOT TUB/SPA
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CHECKED BY
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NWOODSTOVE
CODE
A421.94—
SPECIAL INSPECTOR
IRED
/� wQ
YES �/ v
CARPORT ROCKERY RENEWAL REMARKS
m (TYPE OF USE. BUST ess OR ACTIVITY) EXPLAIN: PROGRESS INSPECTIONS PER UBC 305
ix-
+. NUMBER r NUMBER OF CRITICAL 0/4M•G-/ U41 L illy✓VyW 7, , 1
O OF ' •• 3 DWELLING / AREAS
CO STORIES UNITS NUMBER /�� `
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) AL • U* C.
1 N �IZ102 ZpTlb/�S FINAL INSPECTION REQUIRE6
M.4 ]A- d R I� X� jC VALUATION
�NVe-egCA 0 K�f
PLAN CHECK FEE
BUILDING
HEAT SOURCE:
67> s A M
GltA7rING '
��. O. %
PLUMBING
MECHANICAL
'Plan Check No.
GRADING/FILL
-This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks,
3
driveways, margµees, etc.) will require separate permission.
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STATE SURCHARGE
Permit Application:180 Days
r`
Permit Limit* 1 Year - Provided Work is Started Within 180 Days "'
STORM DRAINAGE.FEE
h '
ENO. INSPECTION FEE
"Applicant, on behalf of his or her spouse, heirs, assign�a nd
successorA;jn interest, agrees to indemnify, defend a9d hold
harmless the City of Edmonds, Washington, its/officials,
/
employees, and agents from any and all claims forPamages of
/
whatever nature, arising directly or indirectly from -the Issuance;
of this p?rmit. ,Issuance of this permit shall not -`be d9emed ttpp
modify,'waive or reduce any requirement of any city ordinapce
PLAN CHECK DEPOSIT
• r Nm r1 tan 1N _I'�J u; p'' y; a�y.the City's•a4�jity,to enforce any ordinance
TOTAL AMOUNT DUE
provision."`' / • r. : • _.. .. ;
I d II ti ' th t th
OCCUPANT
M
infhereby acknowledge I. at ave rea s app ca on, a e
ormation given is correct; and.that I am the owner; or the duly
ATTENTION
APPLICATION APPROVAL
authorized agent of the owner. I agree to cpmply 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
ed thereby, no person will be employed in violation of the Labor
ONLY
WORK NOTED
Deputy; and fees are paid, and receipt is
Code of the State of Washington relating to Workmen's Compensa-
tiQajosurance RCW 18.27.
INSPECTION
acknowledged in space provided.
IG UR NER O AGENT) DATE SIGNED
DEPARTMENT
9_/3,95
CITY OF
0 I
I NATURE ATE
EDMONDS
3
CALL FOR
ELEASED GY: DATE
ATTENTION �..-' '
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION -HAS BEEN MADE AND APPROVAL OR
��� .rLL OwwO
ORIGINAL — File •YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS 4EEN GRANTED. UBC
CHAPTER 3.
PINK — Owner GOLD — Assessor
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