19402 82ND PL W.PDF11111111111111
15345
19402 82ND PL W
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: DETERMINATION: 0 Conditional Waiver E] Study Required [] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR: I
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #: /,Q 7
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: 9-6113
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
OTHER:
LATEMP\DSrs\Fomis\Street File Checklist.doc
Also'see
19400
19401
19402
19403
CA FILE No
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: -17YOa P1. W. ) Ej,,,j,,_426 5910-2C
2. Property Tax Account Number: 6 -3 q? - OD (D - 06R- 00 0 5? RECEIVED
I Approximate Site Size (acres or square feet): / 4., 3 75 P� 2-
4. Is this site currently developed? -*" yes; — no. MAR 2 3 1995
If yes; how is site developed?- *b Lkm I CY, PERMIT COUNTER
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-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: —A)C> Approx. Depth:
7. Site contains area-, of seasonal standing water: 40 Approx. Depth:
What season(s) of the year?
8. Site is in the'floodway c) floodplain NO of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? t\) 0 Flows are seasonal? Ajo (What time of year?
10. Site is primarily: forested ;meadow _;shrubs mixed
urban landscaped (lawn,shrubs etc) law A
L .. E
LICENSE NO.
ITY 0
-ERAIFIFILICATION
CITY of EDMONDS A NE,S-S-&ICr:KIS
aton
Civic Center - Edmonds, Washin"'�� 10
9 k2O
City Clerk Phone 775-2525 ANNUAL FEES PENALTY AFTER FEB. 15
El HOME OCCUPATION
INSTRUCTIONS: CLASS I YEAR I LIC. E:FFEC. DATE JREASG. LIC. NO.JSPEC $10.00 (A) ADDITIONAL $5.00 El
• All items must be completed - 6 *79 1 1 1 1 1 .1 A_SMALL BUSINESS
or application will not be ac- HECEIPT . NO. PAID PRINT'X' $15.00 (B) ADDITIONAL $7.50 0
cepted. IN SPEC. BOX
FOR ISSUE OF 0 Business with 10 or
FEE PAID
• Sign and return application PENALTY PAID CORRFCTeD more employees ADDITIONAL $25.00 0
C
LICENSE WITH
with fee. Renewals received 'LC'ACTION. $50.00 (C)
after February 15 must pay
penalty in addition to fee. W APPLICATION (LA)
0 RENEWAL (LB)
NEW BUSINESSES AFTER 0 CHANGE (LC)
JULY 31, 112 FEE. (PLEASE MAKE ANY NECESSARY CHANGES) 0 DELETE o n�
N
BUSINESS PHONE
NO. OF EMPLOYEES
MAILING-ADDRES'S' NATURE OF BUSINESS
[Itt-5 1417o ot
/01- 1�_
0 BUSWESS ADDRESS INDIVIDUAL PARTNERSHIP CORPORATION
6� Z/- 0_�, — 0 2- F2 1116 VI/ =1 (S) (P) P
OWN ERS-NAM E--- H
A V-4-f6- "J�� OME ADDRESS
(0
f2t cul 16; 0
HO 'PHONE DATE OF BIRTH PLACE OF BIRTH SOCIAL. SEC RITY NUMBER
7 7 Y! 02 9 -z— 1) r-- c, 2-1 1 z Lonli ma,
EMERGENCY NOTIFICATION: '(1) NAME & TELEPHONE
(PLEASE LIST TWO) (2) NAME & TELEPHONE
WASHINGTON STATETAX NO.
APPLICANT'S SIGNATURE
DO NOT WRITE BELOW THIS LINE
STAFF REVIEW: FILL IN LAND USE CODE, LIFIR NUMBERS, ZONING, ETC. CHECK APPROVAL OR
DISAPPROVAL, DATE, AND SIGN. IF DISAPPROVAL, PLEASE COMPLETE "COMMENT"
SECTION. ROUTE TO NEXT DEPARTMENT ON LIST.
PLANNING DEPARTMENT DATE a 1_2-Z LAND USE CODE ZONING CODE
E'APPROVE 0 DISAPPROVE
SIGNATUREY) I nI 17
CONDITIONAL USE PERMIT
COMMENTS
B)ALDING DEPARTMENT DATE 2 Buildi�g
APPROVE 0 DISAPPROVE 0 Hotel/Motel
SIGNATURE Permit Apt. Bldg. (A)
1713
0 Office Bldg. (0)
Occupancy 0 Restaurant (R)
COMMENTS: Group El Hosp/Nurs Home (H)
CAPACITY: (NO. LTNITS, APTS., OFFICES, 9EATS", BEDS, STUDENTS) GR]3] 0 School (S)
FIRE DEPARTMENT DATE U. F. 1. R.
0 APPROVE 0 DISAPPROVE SIGNATURE
MENTS:
PUBLIC WORKS DEPARTMENT 17
B-APPROVE El DISAPPROVE DATE '3111-2 SIGNATURE
COM
RECEIVED
14AR 2 3 1995
PERMIT COUNTER
LE4A,
JAmr:5 A, K&Y-ommy
4:�� 151 HA�-rftegll
1'75CO I-7TH
L*111WOOP \A/A
ArPRCIVEO By PLAl`J'AjjNG
flL. %jl.
9002-6
L6yT '8,
SaU4EVEP 44
-56. or mrw- !3-4., -mc4)a>-s
M-3 fNO*' THIS SITE'PLAN*18 FOR ORIENTATION PURPOSES ONLY.,
AND NOT FOR CONSTRUCTION. ALL SITE PLAN DIMENSIONS,
MEETS & BOUNDS, AND FLOOR ELEVATIONS MUST BE
VERIFIED BY A PROFESSIONAL LAND SURVEYOR TO ASSURE
COMPLIANCE WITH LAND USE CODES.
-MAVTj
S, 'PER,
CITY'DFIE N,
C.
"SEW _MEFARTME$ItII
%WATER.
44 13.
.""p "M
ER
Call 7.76-1-107 for side sewer Inspections BEFORE',cavering, tion the construction.
(,,j..pectlori -will he provided' within
24,,hours; after request. 0"' sat�,. Su�;,�,,or�hollday' i�spection��
0� 19.4 8).� 6 d P'l ace 146�
V - .19400
ADDRE OCAMOYOF CONSTRUI CTI ................ . . .................... ............................... .
, $SL .................... ......... ...........................
'F—
PRt)PERt,:Y:.L-EqAL,DESCRIPTION ..... .... Lot 8 Map ewT6d
.... .................... w ...................... .......... .......................... ...... ? ........... ........... .........
.................................................. ........................ ....................................... I ............. ................ ......... ......................... ................................ .................
d Hama�
Nor
............. ...................... ........... OWNER AND/0R,BUILDER .......................
.................. ............................... ! ...................... ............................ ........................
'Russ Johhson .�S,&er' & PI umb.i n. 16009 North - meadowdaTe 'R6�d
'T
CONTRAC .01USNA—MR& ADDRESS ................................. ..................... .........................
................................. w ...... .........
7 ......
Irppyossion.,ts-granted ........... 1 1 ..... July 18.- 73
. 19� ......... for,repak and or,connectim of ',a sewe Ii-.4hevel ry
.......................................... r o ty, sanifa :s'ewer-,
'Syst'e,m��ili�l'a�c,c,o,rd,&Tibe,4�with, City,,of Edmonds, ordinances.
\TibN; is
CAILLED� TO, THE FOLLOWING:
ei�
,Zo. I�The�'-ownersl of -the �property may- obtain a permit' to,con6truct -sewer, Inside'-property'lin : A. license&SIde, Sewer :Contractor musf be.einployedl;to construct
side sewerl.in. street area. Do; not:,cover any portion 'of. sewer before' it has been"inspect. tl_
-of',RJ ghtwofw:
NOTE:,No. .2�AIII;� work,., performed Anilcity right-of-way, require ,an' Invasioir, Way -erriiii �obtdirrablb, from, the City, Engineer.s, office;
NOMNo., 3� Obtain full�informatiorf,:regarding.,Ordinarice I'l),I��'030,:�nd�'R'�egul'a�ions. governing. a] permit.,
140TE. No.-.4�'Top� of�,sld,e,.s6wer, must;have at least 30,�Jn6he� covergge,,:af, property line- an .12,'�Inche�Ansiile)� ropert,ytjine;� mffilmurrf �gradb of`2 T.: '7'N'o blend's, in, grade.
t T
han"& %', will; �bie pe ltted�
rm
NOTE*, No: :5,--Trenthes in'��s'tre'et'rnust the, water,iettledi and, surface of, street"restor,s&- to original' confdition'� Cc,ntracfo a, sball ibe,xesponsible' for failure, -due to Arnlrqpe'r -
workwhich may.develop within,.one year of compl' fion�, .. .....
VOTV N& -BL-It W�unlawfdll to, alter -or do; ELny/, other work tham,js �,provlde'd, -,for Am the peimif_ or to Ao�..any, --mork; on the main.,sewer, o�, its, �appurtenances �excep�,,to� in--
'.D t . e,
',Ej� Date.,— ...... .............. By/ ..............
ATPROYED ............... .... Date . ............ ....... ........... . 'By ... ............
�,,PPR Y.
OVED n; Date . ......... B . .... .............................................................. ..............
;,or
Romars: . ............ .......................................... ............... ........................ .................... ....................................................
............... ............... ...... ................... ..... : ................ ..... .. ............. ............... ......
. ...... . .............. 7 ............ ........ ........
us. Be, glned�,By Own er�7�,ofiPlirrn'L
BOTH ��peif6rrriin-g��C��.gt-rilcti*oji-;-P.RIOR-Td, Request. For Insp6ction
.0.0.
..... ........ ........................... ..... 'h�rppy �certii� installati6n, coi�strudeffundiar' thi's permit
g�11( I �_,ner,�of,%Cont g,-Oirm,�Performi
-AO
I'v--sta &,!in, accord al g�or inaiicestof-��th.e!Cit-�,:'�of��Edi nds
................................................. .......
9
ted his! ....... ......
e fo iher,,E]'! -jPV'
E)
!Dhec� BEIFORE� you- dig.:for: Water-,E3� Gas-.:[L—] S wer
CA FILE No_
—q5 S—
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: 1?Y0a Fa P L W - , EA mc,,�A 4�6 5,90-;2
2. Property Tax Account Number: 6 3 q ? 01) 5 — 00F — 0 0 0 9 RECEIVEo
3. Approximate Site Size (acres or square feet): 14,375 A�2-
4. Is this site currently developed? v'*' yes; — no. MAR 2 3 1995
If yes; how is site developed? b L&m I ey, — PERMIT COUNMR
5. Describe the general site topography. Check all that apply.
Flat:' less than 5-feet elevation change over entire site.
Rolling: slopes on site geiierally 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 contain . s a I reas . of year-round'standing water: 40 Approx. Depth:
7. Site contains areas of seasonal standing water: 40
Approx. Depth:
What season(s) of the jear?
'Site is in the'floodwa� 0 , flood lain NO of a water course.
p
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? tj 0 Flows are seasonal? go (What time of year?
. . .. ........ %
Rev 0912"
4Wqd:-, 99-
co ty.
of Edmonds
Critical Areas --Checkfist-
The Critical Areas Checklist contained on and submit it to the City. - The City will
this form is to be filled out by any person review the checklist, make a precursory site
preparing a Development Permit yisit, and make'a determination of the
Application for the City of Edmonds prior , subsequent steps*'necessary to complete a
to his/her submittal of a developmen't development permit application.
permit to the City.
ith a-signed,copy of this,form, the
The purpose of the Checklist is to enable FlflO.. ;applicant should -also submit a vicinity mLp
City staff to determine whether any or plot plan for individual lots of the parcel
potential Critical Areas are or may be"-'- * ------- j�itfi-en"ough detail that City stiff 6in_ find
present on the subject property. 714i and'identify the subject parcei(s). in
�"the applicant :shill in . d'u'-die
information needed to c6m plete the addition"s,
Checklist should be easily available from other pertinent informatioij (e�g.* Site
observations of the site or data available at plans topography'!nap, etc.) oristudies in
City Hall (Critical Areas inventories, maps, conju , nIction With this Checklist to asea
or soil surveys).
staff in c;ir�pletin �ir lin�i
g th pre inary
assessrnentvofthesite�
An applicant, orhistherrepresentative,....,,-il,.;
A—.
must fin out the checklist, sign and date.it
I have completed the attached Critical Area Cljdc-)&j that the answers Vrovided
`Wtual,- tolhe b�st -bf -6y '16ib7wfia&_(f HCSrt ffi-e'--.
appropriate column' §09yo
Owner Applicant-
ApplicantAepreseitaii
ve:
V
Nam
'0�
rryrd IMA
It
S
Street Addrew.-
tie-4-Midirew
"Ct
diij.�Statle. VtAv
one.:, City, Swc� ZIP
P116
7, V
777
-4
Signature, Date Signature_;_,r.,- W&
NOTICE:
N'o war-ranty..'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 �Edm.qnds does not - warrant the
accuracy of anything set forth on these
map(�_)- Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
I ited to
tF e -map(s), including, but not Hm*
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 (_-.ity of Edmonds nor its
. h. a. I. I b e 1`1 a. b.-Ife f o r il- h e
ernp-to-yee-s o-r office,rs,S) I
information given on this map(s), nor for
ion pr 'ded based
any one representat' ovi
upon I said map(s).
UTILITY SERVICE ORDER
Tqday's Date Account Number Pulled Meter Meter WMeiy By
-ZT7el ReqiTested By
Service Address PL UJ
Water Service Date Turn -On— Turn-off — C/B Read �Reread Reread
Location of Meter 1; Leave D_/H Edit/Cust
Current Read Date, Current Read Previou� Read Date Previous Read Consurnotibn
Keaa by uate
Notes W3T5o04-_
TM
Closing Bil s Sent
Name J
... Y2.
Street
Address+ A��r P14 CA. Wes
City 2516-umXs StateZ-e;yl Zip 9T'49, a L
Da+'te New Meters Installed
Size
Lock Uhlockqd�
Residential
Apartment,
-Units
Office,
Units
commercial
Units
pn r
Sprinkle
Other
Sew er Avail.
Unavail .
Meter+Charge 7=0
FS Connection
$
H20 Connect
$
Streit Cut
$
Total+
Receipt c)l
Permit
Screen 1 ***Tenant Inf6rmation*** ***Owner Information"*
01Name
09Name
02 Care of
10 Care of
03 Addr 1
11 Addr I
04 Addr 2
12 Addr 2
05 City
13 City
06 State 07 Zip
14 State 15 Zip
08 Phone
16 Phone
33 Meter #:
36 Acct Setup.Date
34 Location
Screen 2
**Misc Codes"
***Rate Codes***
**Units**
01 Status
14 Water
15 0.00 23 Meter #:
02 Type
16 Surcharge TAX
17 0.00 25 Type M A
03 Cycle
18 Sewer RSEWR
19 0.00 26 # Readings
04 In/Out
27 Meas. Code HCF
07 # Tenant
28 Install Dt.
08 # Owner
30 Route
09 Respon?
31 Sequ.
32 Codes
Mutisvordhvord
;11
RECEIVED
MAR 2 3 1995
PERMIT COUNTER
LEAA, o"m
JAMr:5 A,. ��OOCT_y
'lm
1-75W 1-7TH
I
mom
APPROVED BY PLANNING
pv= __easm M. va.
lZrT
pjw�j
rF
-6 _4��
44
I
ZONING = RM-3 (NO*: THIS SITE -PLAN -IS FOR ORIENTATION PURPOSES ONLY I
'AND NOT FOR CONSTRUCTION. ALL SITE PLAN DIMENSIONS.
'MEETS & BOUNDS, AND FLOOR ELEVATIONS MUST BE
VERIFIED BY A PROFESSIONAL LAND SURVEYOR TO ASSURE
COMPLIANCE WITH LAND, USE CODES.
APPLICATION
EET FILE for
The City of Edmond IR. SIODE SEWER PERMT EASEMENT No.
NEW CONSTRUCTION REPAIRS 0
la� -tl C���lxr=-
OWNER ..... KA�-Km ....... ..................................... CONTRACTOR ..... F25Ll-.c=l%s ..... ............. I PERMIT, No-44134.44-1 7-
............. .............. .................. . .. ... . ..... .. ....
LEGAL DESCRIPTION: LOT No. -.77.4, 414�.
ADDRESS .11>44> 44 .... ........ ...... &J* ........... ... ............. ...... ......... BLOCK No . .... .............. .....................
NAMEOF ADDITION.. .......................................................................................................................................
Ll
DATE � ............ ............ V.V.
r
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NANIE/NAME OF BUSINESS
f
j*M6_S A , &1-SA,.,`
uj MA LING ADDRESS
Z
3 ; -1-5-110 /7-"/ .40e_ ttk -s
0
CITY ZIP TELEPHONE NUMBER
Z_v rl ri woo �e -3 1 17
NAME
L
ADDRESS
t
x
U g8ezl q7_'5 A/
Cr
< CITY ZIP TELEPHONE NUMBER
M c) 7 5
AJORESS.
a --) 1,2, _ Aoe7 u)
70( 0
CITY ZIP I TELEPHONE N
t, 19`l`ATVL*IrI?NSEWI,1MQ6W_
EXPIRATION DATE
PLZ_
L I;k
Legal Description of Property - include all easements
Z
9
cc 11,)o 1 3 3
Pjcj-Pex:;iIIL
3Y
>
4 Sr'01"
('OJA� 4 14)14
LD
Property
TaxAccount L'z4/7-000-0off
_60t?�
Parcel No.
0
NEW
RESIDENTIAL
PLUMBING
21
ADDITION
COMMERCIAL
MECHANICAL
1:1
APT. BLDG.
REMODEL
SIGN
1:1
GRADING
El CYOS.
FENCE
REPAIR'
—
11 x_ FT)
DEMOLISH
W OODSTOVE
INSERT
SWIM POOL
HOT TUB/SPA
GARAGE'
CARPORT
RETAINING WALL/
F7 RENEWAL
ZI
ROCKERY
0
�j (TYPE OF USE. BUSINESS OR_ACTIVITY) EXPLAIN
N u NUMBER OF CRITICAL
MBER
OF DWELLING AREAS
STORIES UNITS NUMBER
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
ALAA SV\u-jt-., 4o e-xi's4k,
USE
ZONE PERMIT
NUMBER 950143
JOB SUITEIAPT
AUUHtbb LJ A
�EGAL DESCRIPTION CHECK[ SUBDIVISION NO. ILID N3
!A4tt
PUBLIC RIGHT OF WAY PER OFFICIAL STREET
EXISTING —REQUIRED DEDICATION
PROPOSED
METER SIZE LINE SIZE-7—NOOF F
KS
ENGINEERING MEMO DATED
TESCP A��roved 0
c-
RW Permit Required 0
Street Use Permit Req'd 0
Inspection Required 13
Sidewalk Required 0
cc
RES
PRV REOUIRED
Fw
YES 0 NO 0
9
Z
US
ul
9 *
0
Z
W
REVIEWED BY
SIGN AREA
SEPA REVIEW
. ADB NO.
ALLOWED I PROPOSED
COMPLETE EXEMPT
0 let lvt;
7
SHOJELINE
EXP ,
4
VARIANCE OR CU
P:MF
EVIEW BY
-DATE
SETBACKS — FEET
FRONT /4 SIDE RE
-AR
EIG �_R
IT COVERA.9E I
V
4-
JR.AreAl (ee&&.)L moo", &..# fo
ID 041kS Ot14-ri: H ra
CHECKED BY TYPE OF CONSTRUCT ON C DE
I lz--
SPECIAL INSPECTOR AREA
REQUIRED 0 YES
REMARKS
PROGRESS INSPECTIONS PER UPC 305
FINAL INSPECTION REQUIRED
I f 1 dQ 174AU I 1-1V A-Z
- 4Af=i
PLAN CHECK FEE
M
BUILDING
HEAT SOURCE:
GLAZING
%
PLUMBING
_34-
Plan Check No.
_-2 62
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADING/FILL
Any construction on the public domain (curbs, sidewalks,
STATE SURCHARGE
driveways, marquees, etc.) will require separate permission.
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
w successors in interest, agrees to indemnify, defend and hold
2 harmless the City of Edmonds, Washington, its officials,
m employees, and agents from any and all claims for damages of
a: whatever nature arisinn directl or indirectl from the issuance
0
OCCUPANT
LOAD,_----�
(9
Z
M
of his permit, Issuance of this permit shall not be deemed to
modify, waive or reduce any requirement of any city ordinance
0
1 nor limit in any way the City's ability to enforce any ordinance
PLAN CHECK DEPOSIT
-7
TOTAL AMOUNT DUE
provision."
1 hereby acknowledge that I have read this application; that the
information given is correct; and that I am the owner, or the duly
ATTENTION
APPLICATION APPROVAL
AL
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
state laws regulating construction; and in doing the work authoriz-
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 State of Washington relating to Workmen's Compensa-
WORK NOTED
Deputy; and fees are paid, and receipt is
tion Insurance and RCW 18.27.
INSPECTION
acknowledged in space provided.
SIG ATURE 0 ER T) DATE SIGNE;D,,
DEPARTMENT
70G
CITY OF
OFFICIAL*S SIGNATU5��-� DATE
EDMONDS��;
.24—
(AfTENTION
CALL FO
INSPECTION e'-
RELEA B UAII:
—
2vd, j
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
C'(
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
171-01220
ORIGINAL —"File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
PINK — Owner GOLD — Assessor
102-87
W