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10704 244TH ST SW11111111111111 16203 10704 244TH ST SW 0 0 ADDRESS: TAX ACCOUNT/PARCEL NUMBER: f '% ���`� / COI 034 cna BUILDING PERMIT (NEW COVENANTS (RECORDED) CRITICAL AREAS: liq - Iq3 DETERMINATION: ❑ Conditional Waiver ❑ Study Required lKwaiver DISCRETIONARY PERMIT DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: PERMITS (OTHER): PLANNING DATA CHECKLIST DATED: I SCALED PLOT PLAN DATED: SEWER LID FEE $: SHORT PLAT FILE: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: SOILS REPORT DATED: STREET USE / ENCROACHMENT PERMIT FOR: WATER METER TAP CARD DA ►w m� LID LOT: BLOCK: LATEMP\DSTs\Forms\.Street File Checklist.doc CA FILE NO. 41tical Areas Checklist -------------------------------------------------------------- Site Information (soils/topograp//''hy/hydrolog'�y/��/dvegetati`�o}n) 1. Site Address/Location: 7p �i ? �� 5��� V \ L k �J N (— �-D V1 A0 i ,j (Ja q 6ZL; 2. Property Tax Account Number: _50H r9 0q0 103 y CD0 9 — 3. Approximate Site Size (acres or square feet): 4. Is this site currently developed? yes; no. If yes; how is site developed? i—io�hC 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: ; Approx. Depth: 7. Site contains areas of seasonal standing water: ---C — ;Approx. Depth: What season(s) of the year? 8. Site is in the floodway 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? (What time of year? ). 10. Site is primarily: forested ; meadow ;shrubs ;mixed _ urban landscaped (lawn,shrubs etc) K3 11. Obvious wetland is present on site: --------------------------- --- - =----- ------ For City Staff Use Only-------- ----------------- ------------ ------ 1. Site is Zoned? SCSmapped'soil type(s)� rt/l h3? C�f.r.1 ,t.P fit: ��' ;l i Y� (t: f)?,Off /.. t 3. Wetland inventory or C.A. map indicates we land pres on site? 4. Critical Areas inventory or C.A. map indicates Critical Area on site9 ti, f7 ;3; Site within designated earth subsidence landslide hazard areal_ 6: Site de§ignated`on tlie`EnvironmentallySeristtive Areas Map? `DETERMINATION `STUDY REQUIRED CONDITIONAL WAIVER WAIVER Reviewed by:s`. �, ti�lf G Iq l/ PlaVr pa j i ^ce chk,doc; Rev 10/03/97 � i REECEIVED % JUL - 1999 City of Edmonds PERMIT COUNTER 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. 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 assist staff in completing their preliminary assessment of the site I have completed the attached Critical Areas Checklist and attest that the answers provided are factual, to the best of my knowledge (fill out the appropriate column below). Owner/Applicant: G I c n n, Le u t-r\- Name i01�-oy 24 3r 1' Fi 5.b-) Street Address qU City State Zip 2CC� 5 L4 L. - 1-� D21-1 Telephone Signature Date Applicant Representative: � L-t-- t-A Name Street Address AA..., (,,A A, City State Zip -70-22 Telephone Signature -7I Z/ '1,a, Date execeptionljanakad doc (over) r 901 4 SEC. 36 T.27N.E.A. 003 �A Zone � S / , R.3 E. j a n ��"Nj 23420 23405 2�4031tMATE0 NOTTINGNAM g 23411 d i �BPuEER \ 4 m Fz' 23497 y,GR_E WrcN iI34� 0 -$1- 2364 43- NN lOjCOMAI $i.�NU. I3b 10 v N l68 $ Roo T 235nyj H Ln lASEBAtIV �FORESS 23614 1036/3 23d PL. 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W. �+! 4017 oo sti1o25 3 c 4022 a N m 24 D20 240102 e c �. g 4029 ` o 'o a c P26 027 �A024 24/ C 24032 3 9031 — 3 2403 24108 74103 24104 24103 24104 3 24107 24108 41e7 4101 p 1� a o32 4103 24109 24//O 241a9 2g1l0 241/3 3 41ob lag o N a 3 y910 L4114 3 24.114 4115 4111 v O�`0 �: o 0 o a 91/o C /IS T9122 24115 24/16 ;24117 2g118 4 119 24120 glss PL. S.W 4125 177 .24125 24123 ?A128 24123 24114 24126 29/2 ; 4/2q YI?02 24131 24132 V 13/ 24132 2420/ 24202 /29 Q M o_ 132 !27 0 0 0 St 8 126 24205 p4zoB d 24203 24204 �. c O 4207 2g208 �° c �, c 9205 24I t2q C 24 N to 24211 24212 N, 42ds' 24216 421f p� o e 4208 242 �B a . qjI o $ a 24216 24217 242/8 242 P(. a 217 J 4213 I(0 A. N .o ?21 24222 6v N ' w �Z PL. S.W. 24224 ►o N 4225 — o o aD P20 29T25 226 In 1� 423p ` M O o N N N 3 4221 g$ 22Y 0 Y4232 93 24233 o C No 0 228 > o l 231 24232 024229 InPh ICE �+ n (3I 305 306 4305 0 c 24305 0- e a c 24302 4301 o a o 4T32 24yy3 "� PL . S b�. 13 o g � S 710 $ 8 8 43a4 Op O244 ~ ST. e"' PL. S. 24316 a ao 3/e .O TN S. m—AW49 W r241Z7af N 3 0. i3I 2ofm sr. H.W. 04- aL _ _ li �NI a4 CITY OF EDMONDS 121 5TH AVENUE NORTH - EDMONDS, WA 98020 • (425) 771.0220 • FAX (425) 771-0221 DEVELOPMENT SERVICES DEPARTMENT Planning • Building • Engineering July 23, 1999 Glenn B. & Rebecca A. Levin 10704 243rd Place S.W. Edmonds, WA 98020 Subject: Determination regarding Critical Areas Checklist # 99-193 Dear Applicant: BARBARA FAHEY MAYOR Enclosed please find a copy of the Critical Areas Checklist you submitted. The "DETERMINATION" reached by the City is located on the reverse side of the form (bottom of page). It is very important for you to retain a copy of this Critical Areas Checklist "DETERMINATION" for your records. ... ............ ......... IMPORTANT INFORMATION TO BE NOTED: PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTAL CHECKLIST OR CRITICAL AREAS STUDY. The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a project -specific determination. You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED. 40 Permit applications include the following: Building Permits Conditional Use Permits Subdivisions Variances Applications to the ADB• Land Use Applications Any other development permit applications. c: Bill Miller Enc: Critical Areas Determination * Architectural Design Board C: R eceptionWna\C R LTR.doc Thank you. Sharla Graham Planning Secretary • Incorporated August 11, 1890 • Sister City - Hekinan, Japan • PLANNING DATA NAME: STREET FILE SITE ADDRESS:1 . : ' .S DATE: 1l I ZONING: �SJ0 lqq PLAN CHK#: �� CORNER LOT (Yes/No) FLAG LOT I V (Yes/No) SETBACKS: Required Se bac s: Front: ' Left Side: —Right Side: _Rear: Actual Setbacks ` Front: !o LeftSIde:tqftRight Side: q Rear, �Z Street map checked for additional setback required? (Yes/No) LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED N (YIN) LOT COVERAGE: jb Maximum Allowed: 7;-bActuai:✓ BUILDING HEIGHT: Maximum Allowed: �� Actual Height: 7 Datum Point: �,HYkn LoCDatum Elevation:_ A.D.U. CREATED?: SUBDIVISION:_ MIA CRITICAL AREAS # -UA --I`I," SEPA DETERMINATION: LOT AREA: q OTHER: RECEIVED I (� CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS MAILING ADDRESS tc) CITY ZIP TELEPHONE NAME CITY ZIP NAME �. (( 22_-1 " PERMIT EXPIRES ! - 2- — 2 ` I USE PERMIT 'C ZONE 39 0 ,37 NUMBER JOB""' RIIITF/APTN ADDRESS r ,^ PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. dKSC11KVeL 4 r—f_TLP-7_ LID FEE $ /4 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Approved RW Pe Approved yam" p Required'yE-S _ EXISTING -"^ PROPOSED Street Use Permit Req'd �O InspectioSidewak REQUIRED DEDICATION •� FT RequuirredjV O Undergrequheround Wldng d rj METER SIZE LINE SIZE RE NO. OF FIXTUS PRV REQUIRED YES O NO �dl' ADDRESS r' CITY ZIP TELEPHONE �Y `�� ` ". �_�-� ll �f'� '•hi) 'lam b' r<��� STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY PROPERTY TAX AC OUNT PARCEL NO. c)'�:) 'tit : ' _ i 1�3t a NEW (%I RESIDENTIAL IX I PLUMBING / MECH AUDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL ❑ APARTMENT C3 SIGN REPAIR GRADING CYDS FENCE X FT) ❑ DEMOLISH TANK OTHER ❑ GARAGE CARPORT RETAINING WALL RENEWAL (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN ui NUMBER NUMBER OF to OF DWELLING OSTORIES UNITS DESCRIBE WORK TO BE DONE REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE .�/r7 //✓C C'�-:.! ^(fir � ti S l�� l.. i r J rl/ .�C .'�.. ICJ �, !K 'Z:� 1 C hf r: r> r - .glfa Al- l`..r"m. r /LKlI%P ili / t;r tJ.r i V �d c7 Z 2 w z z a z w NGINEERING REVIEWED/DATE I E REVIEWED BY DATE w Lr U. OR CU SHO/R/EL NEE OR ADB# INSPECTION BOND VARIANCE O'O PL�/ D J 4 / 1 ❑ YES IM SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMP ALLOWED PROPOSED ALLOWED PROPOSED I IV P 2 S- EXP LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED -'7 CZ FRONT SIDE REAR FRONT UR SIDE REAR r, ,y q 2 CAT4 1 z PARKING LOTAREA PLAN NINGAVI EWED BY DATE REO'D PTOVIDED /% a CHECKED BY CRITICAL AREAS G l J SPECIAL INSPECTOR NUMBER REQUIRED YES HEAT SOURCE LAZING % LOT SLOPE PLAN CHECK NO: � vESTED DATE °rr �.: . THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 180 DAYS PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION "APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS 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 ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION." I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE 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 STATE LAWS REGULATING CONSTRUC- TION; AND IN DOING',IHE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENISATION INSURANCE AND RCW 18.27. DATE SIGNED ATTENTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 5/98 OCCU OCCUPANT J I LOAD REMARKS d r, PROGRESS INSPECTIONS PER UBC 108/1FINAL INSPECTION REQ'D o - 15 VALUATION I FEE PLAN CHECK FEE BUILDING PLUMBING MECHANICAL GRADING/FILL STATE SURCHARGE ENG. REVIEW FEES ENG. INSPECTION FEE. .�`+� ••' LANDSCAPING INSPECTION FEE PLAN CHECK DEPOSIT RECEIPT _ TOTAL AMOUNT DUE . , RECEIPT/(.) r •' / L. � APPLICATION APPROVAL CALL This application is not a permit until signed by the Building Official or his/her Deputy: and Fees are paid, and FOR INSPECTION receipt is acknowledged in space provided. (425) OFFICIAL? SIGNATURE r DATE 7.1 -0220 REL ASEC B I, DATE EXT 333 ij�l 771-0221 ,w FAX ORIGINAL -FILE • YELLOW- INSPECTOR PINK -OWNER GOLD -ASS ESSOR City of Edmonds -OF-WAY CONSTRUCTION PERMIT /► A. Address or Vicinity of Construction: / V 7/) S ki B. Type of Work (be specific): Permit No: 17' Issue Date: C. Contractor: �L�—� Ld�1��-•►_��0�� Contact: _)_21 L E:t( Mailing Address:1?26_20 old <_*w E12Q P.0 Mok"Phone: 7:=2�C7 G(-A (k,45 State License #:P= 1.Gam( C 1-70 n Liability Insurance: Bond: $ D. Building Permit # (if applicable): Ti n VS3:7 Side Sewer Permit # (if applicable): E. ❑ Commercial ❑ Subdivision ❑ City Project ❑ EUC (PUD, GTE, PSE, CHAMBERS, OVWD) ❑ Multi -Family '© Single Family ❑ Other INSPECTOR- F. PAVEMENT: ❑ YES ❑ NO G. SIZE OF CUT X H. Charge: $ CONCRETE CUT: ❑ YES ❑ NO APPLICANT TO READ AND SIGN IDEMNITY: Applicant understands by his/her signature to this application he/she holds 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 but not limited to the defense of any legal proceedings including defense costs 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. ♦ Traffic control and public safety shall be in accordance with City regulations as required by the City Engineer. Every flagger must be trained as required by (WAC) 296-155-305 and must have certification verifying completion of the required training in their possession. ♦ Restoration is to be in accordance with City codes. All street -cut trench work shall be patched with asphalt or City - approved material prior to the end of the workday — NO EXCEPTIONS. ♦ Three sets of construction drawings of proposed work are required with the permit application. t I HAVE READ THATIMU,1 Signature: STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE 'PINK COPY OF THE PERMIT AVAILABLE ON SITE AT ALL TIMES FOR INSPECTIONS '21 (Contractor CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK FOR CITY USE ONLY Approved Right -of --way Fee: �--- Time Author' ed• Void After 11dl9 Disruption Fee/Fund 111: Special Conditions: Aw Restoration Fee: Total Fee: f?_ .... csi 14 ., _ UPON COMPLETION OF PERMITTED WORK, AN ENGINEERING FINAL INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE EDMONDS COMMUNITY DEVELOPMENT CODE. FINAL APPROVAL OF PERMITTED WORK: INSPECTOR'S SIGNATURE.. DATE: For inspection requirements 'see hngineering4nformation Handout. NO WORK SFIALL BEGIN PRIOR TO PERMIT ISSUANCE