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15824 70TH AVE W.PDF111111111111 5508 15824 70TH AVE W r; City of Edmonds R�' Critical Areas Determination APR 2 2 1996 Applicant: Donald J. Kennedy Determination '#: CA-96-55 Project Name: Permit Number: Site Location: 15824 70th Avenue W. Property Tax Acct #: 5133 000 036 0106 Project Description: I Non -Project Specific Determination: Study Required: 1C C During review and inspection of the subject site, it was found that the site appears to contain and/or is adjacent to a Steep Slope Hazard Area pursuant to Chapter 20.15B of the Edmonds Community Development Code (ECDC). To determine if a Steep Slope Hazard Area does exist, a topographic survey prepared by a Licensed Land Surveyor delineating Steep Slope Hazard Areas must be completed. Any slope over 40 % with more than 20 feet of rise will be classified as a Steep Slope Hazard Area. A 50 foot buffer is required from both the top and toe of the slope. A 15 foot building setback is required from the 50 foot buffer. For development of any kind which is proposed within the critical area, 50 foot buffer or 15 foot buffer setback, it must be shown that the development will not adversely impact the Critical Area or its buffer, by doing one or possibly both of the following depending on the outcome of the study: For development proposals which will occur within the 50 foot buffer, but no closer than 10 feet from the top or toe of the slope, the 50 foot buffer requirement may be reduced to 10 feet if a study is completed by a licensed geologist or geotechnical engineer which clearly demonstrates that the proposed buffer alteration will have no adverse impact upon the site, the public or any private party. All Critical Area Studies must be completed under a three party contract where the City hires the professional required, and the applicant pays for the study (pursuant to ECDC Section 20.15B.150). 2. If development must occur within the critical area, buffer, and/or buffer setback, and is not identified as an exception per ECDC Chapter 20.15B, a Reasonable Use Exception and Variance must be obtained pursuant to ECDC 20.15B.180A and 20.15B.040C. All proposed development of the subject lot must meet the requirements of Chapter 19.05 (Building Permits - Earth Subsidence and Landslide) of the Edmonds Community Development Code. If the property owner wishes to apply, fora specific development permit which they feel would not impact the Critical Areas located on the site, they may submit their proposal to the Planning Department for review. If the Planning Department finds that the proposed development permit will not. adversely impact a Critical_ Areas or its buffers, a conditional waiver may be issued on a project by project basis. Name Date 2 The City of Edmonds Side Sewer Drawing EASEMENT NO- ------------- ------------------------------- NEW CONSTRUCTION ❑ REPAIRS ❑ LID NO. Z- 0._---.- ASMT. NO- ------------------ OWNER.L-_11t.�-.�_)....... ... CONTRACTOR ._....._.. PERMIT NO.5� JOB ADDRESS..`__�Z._'Y........ __......... V_. ........ Vli_-....... LEGAL DESCRIPTION: LOT NO.S_-.-_------- BLOCK NO------------------------------------- ------------------------------- ---------------------------------------------------------•--------------------------------------------------------------_._.-_...-- NAME OF ADDITIONS _ -• ME-.i TQ----bS�.: �►+?!�tJlg�}... LYNN ell OOD LINE I (e b�vE\Al. t PWW 0001 11/75 (REV.11/78 DATE`?.-.L.IA.�� ----- B�^� Y Zr1s'4eua9 �jy IZ, N�t(�U.� The City of Edmonds Side Sewer Drawing EASEMENT NO- -------------------------------------------- - MG.A0. C-,Ct4". nn NEW CONSTRUCTION ❑ REPAIRS ❑ LID NO. 2.10 ------- - ASMT. NO. ____________-____ OWNER MULFORD ----- 01-AP ,Tt.m -------------------------------------------- CONTRACTOR ---------- -------------- ----------------------------------------- PERMIT NO. -U592- JOB ADDRESS -1-5-S-2-4 ---------- --A)M2-NV.i ------------- LEGAL DESCRIPTION: LOT NO. ----------- BLOCK NO. ------------------------------ -------------------------------------------------------------------------------------------------------------------------- LLYIYNWoop NAME OF 11 ADDITION.. ----------------------------------------------------------------- r - ....... - ------------------ — �7o 15824 '70 W. f Wc e It, R." 4"c-o.w3E 14 V, -PIFW - \ ` �, Y+ GRINtWA; IT* u PM4 P CPACU VALVE rk Approved: PWW-0001 -11/75 (REVA 1/78) DATE By f- ,R8---------- 1" . - -W/// N STREET FILE MEMORANDUM March 6, 1986 TO: Ilene Larson ' FROM: Bobby R. Mills SUBJECT: Acct. #301-22200 - Conni Martin - 15824-70th Ave. W. Per my conversation with Conni Martin, this leak was not the result of frozen pipes, but a normal leak which occurred in an old pipe. Please adjust this account to reflect the average plus the City cost of water. BRENA T MA DT c r �r DIVED February 2, 1986 PUBLIC ,WOR,KS Mr. Bobby Mills Public Works Superintendent City of Edmonds Water Department 501 Bell Street Edmonds, WA 98020 Dear Mr. Mills: This letter is to request that you consider making an adjustment to our water bill. During the period of unusually cold weather in November, an outdoor pipe near the edge of our property broke. The pipe is located a good distance from the house and is hidden under some trees. We did not know of the leak until our. neighbor noticed it and brought it to our attention. We hack a plumber come and repair the leak on the same day that we were told of it. There was obviously a lot of water lost before we were aware that there was a problem. Our normal water consumption over the last year averaged 13 hundred cubic feet per billing period. The current billing period shows 380 hundred cubic feet consumption. Since the loss of the water was not due to carelessness or negl.ience on our art and ein m e Eery wnen . vL.P cegame avaA , adjustment to the bill. Thank you for your consideration. Sincerely, Connie Martin 15824 70th Ave W Edmonds, WA 98020 Account number 301-22300 W —1'e�lt (,23-666ro CITY OF EDMONDS-UTILITY BILLING ACCOUNT NUMBER / 301-01300 301-22300 SERVICEADDRESS ► 15824 70TH AV W MA MARTIN CONNIE NAD A 1 D MLR ENS GS TELEPHONE / 743-4433 METER SIZE► 3 /4 NO. OF UNITS) { 1 SEWER CHARGE �38 WATER BASE ► jQ/j CONNECTED ►? G� f / N 6 SUPPLIER ► A CODING ► Q W lJ R j�►d- Adi14r tY l A METER NO. ► 4148 LOCATION J�OGUN i3.�N>� DATE READ CONS. NOTE DATE READ CONS. NOTE { 'al 15, (� b� c741 �� j 0 T� `err /7o�l. 3� < < 4, 03f( g 30 N' ;2 o12 IE �., 0505 68 i RLE CITY OF EDMONDS DEPARTMENT OF PUBLIC WORKS 250 Fifth Avenue North, Edmonds, Washington SEPTIC TANK INSTALLATION PLAN (Submit in 'Triplicate) ADDRESS OF PROPERTY ..... 15§4.7 ..V�4--W.: ........ ...... ................... Lot No.----- ............ Permit No ...... /2..16..... .... Owner. RM -... Be=ett Address _.1Jr' 8- ...-.. th �. Fsdmonds... .. Phone. 'J-0850... Builder ..n..-.... n Address - - n ............. .. p--------- ----- Phone... n DesignerM.$..-Meyrring------------------- ----------------- Address --- 200.19_Hiway--�% --- Lynnwood......... Phone.-PRi..8-3.10.1 Installer.No-rth--End---Se-pt-ie ... Tank ----------_--- Address. 19704.. Aurora -Av9•..Sea.--- j.3...... Phone..;j..2-2222 I hereby certify the accompanying drawing is an accurate representation of the system installed at the listed address. I also certify all recommendations and restrictions (concerning plumbing stub elevations, maintenance of grades, fills surface drains, etc.) listed by me on my sewage disposal system permit application dated ................ .._....... ..% $�65------------------have been complied with. v wa Signature of esi ner Date TO BE FILLED IN BY CITY ENGINEER ONLY Accepted ................. ........ Date ....... t'1Z_.4.:�....... NotAccepted ............. ................................ .... a _.......__........ Signature of of Fi Tr ----------------- .......... ..-------- .... ........ .... -------------------- -_ --- Remarks:.... INSTRUCTIONS: Use the reverse side of this form for the drawing. Use a scale which will permit the greatest detail and still contain the entire site on one page. ATTENTION HOME OWNER: Your septic tank has limitations! It was designed and installed to care for an average -size family. Over- loading the septic tank or disturbance of the drain -field may seriously impair satisfactory operation. Points to remember: 1. Have your tank checked periodically to see if pumping is necessary (2%2-3 years). 2. Do not channel ground water, surface water, footing drains or downspouts into the tank or drainfield. 3. Do not excavate, fill, place a structure, driveway or- patio in, on, or over the drainfield. 4. Limit toilet fixture disposal to sanitary wastes and toilet tissue. 5. Detergents and bleaches used in normal household quantities will not harin the action of the septic tank and disposal field. As ® Built Sketch /0 R .M. BE TUETT Por. Lot 36 P,badosrdale Beach S170 CC. AM ST 1965 Permit No. 216 Owner: R.m. Bennett 15824 0 70th W. WASH. Edmonds, Wanh. Designer: isv ta_.—I -- 99 sh. ICOO gal. S. T. Installer: 3 ft. Trench. North End Septic Tank 532 sq. ft. 19500 Aurora Ave. Seattle 33, Wash. ?`OVyp,,g Survepor°s In I.;,na a ocd, i,ash,, h 10_ • C .5ng Le / "-20' SEWAGE DISPOSAL PERMIT fi4-'._..gals. CITY OF EDMONDS Septic Tank ....----.. .. - ,, Department of Public Works Disp. 'Field -------- <�r� j: s9 ft. Other----------------•--•-----------------------•----- _..._ is hereby authorized to install/ ,, r .r.%--- repair sewage disposal system at -- --- .. p g P y • Name---------------------�-f ff _1...---._.-__--_---_---_-----------_...._-_----_-_-_-__-_-_-_-_-_---_--_-----__.......___. S Date issued on ----------------- -,,_..... - j Permit expires one year from date of issue DO NOT COVER BEFORE APPROVED BY DESIGNER OR SANITARIAN li supervision and control and complies with all provisions of the City I hereby certify this system was installed under my of Edmonds Resolutions. ----•---•--•---•-• ............... Date.--•---•-----•----- Signature of Installer--------------------------•-----• •-------- Approved .❑ Disapproved ❑ Date ------- ------ By ---------------------------------------- Remarks:------ ----------•----- ----------•--..... --------•--•------------------ Date ----------------------------------------------------------- SANITARIAN OR DESIGNER_________________________ __ • - - - • inspection has been completed. This permit shall be posted in a reasonably conspicuous place on the job until ------------- a CITY OF EDMONDS DEPARTMENT OF PUBLIC WORKS 250 Fifth Avenue North, Edmonds, Washington APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT (Submit 3 Copies) Permit to be issued to: ...... R.M.- Bennett . E For installation at: (street address) -------- 15✓ ..-....' .P. k ...... rc�...LU......... --------------- ----- --e... ........... ... - fee descr: ��on-back Addition or Subdivision...... Po.r.- Mead!?wdale..Beach....................... ........:...... .. Lot.. ......... Block ................ Type of Building: New .... X..... Existing.... . Single family residence . X . Number of bedrooms 4 ............ Other: (specify type or use) ------------------------------------------------------------------------------------------------------------------ -------------------------------•--- Builder. RR#:.B-enpett---....................... -- '------- ----- ----- Address...15M. "_-70th'-.W._.Edmonds .............................. Designer .... R.H...Meyring------.------- --------------------------- ---- Address- -..20019--- Hiway..-9.9..Lyn nw.gn.d........................... Soil Log Hole No. 1.---- ----...0.4"----to-psai-1--1--4-60"- sandy -clay-loam. ...- .................................... . SoilLog Hole No. 2---- ------ Same-------------------------------------------------------------------------------------------------------------------------------------- Elevation of Water Table, if encountered. (Distance from ground surface)............vimi.e................................................. Corrections to control surface water if needed ........................................... nine Specify if any removing or grading of topsoil in field area .......... ........... nnne.............. ................................ ....... ................. ------- ------------- Percolation : Test Hole No. 1 'Average Rate .......... T.@..30............ (Fall in minutes/inch-bottom 6" test hole) Test Hole No. 2—Average Rate .........6............................................ (Fall in minutes/inch-bottom 6" test hole) Test Hole No. 3—Average Rate ......... 6..... .................................. (Fall in minutes/inch-bottom 6" test hole) Average percolation rate on which to base drain field design...............7...................... . Date Taken ...... 6129165 Septic tank requirements based on present rules and regulations: Septic Tank Size.....'�".4.Oli.gallons. Amount of Square Feet of Disposal Field....532 4q...ft.......4 bedrooms Signature — Designer...... 1.3.-------- --- ... .. ......... ...... Date ----------- 6/30/65...................... DO NOT WRITE BELOW THIS LINE6/be compVted by Issuing Agency) Permit issued (date)..................7.y. 4 .s................ Permit Number .............. l.C...........---- Remarks:..................................................................................................................... . Beginning at a point on the East line of_said„Tr. 36. Megdowdole Beach. Supplemental Plat. Ihich is 471.11 ft. Nmrth of the SE corner.therrf; thence cnainuing_Nlortherly ol^rg said East lire 190.19 ft. more ^r less. do tr'he' F� corner of said Tr. 36; thence West along the Nn,rth line of .. said Tr. 36 f-r a distance of 365.40„ft; thence Southerly 276.11 ft. t^ a paint which is 376.21 ft. West of the East line of said Tract; thence ,Fast M ft.l t°; a_. print which is 336.21 ft. West of the �a.st lire f..r'racti 36; thence:Nnrtherly 10 ft. to a paint which_is_.-335.82 ft. West of said East,, lire; • shence-Nnrtheest.e#y; 340 eft..- m-re ^r less - to the point nf_heginning. Except the North 1.25 ft. there^f; and,- pept the East!:2Q ft. theremf for read; Situate in the County d'f Snohomish. Wash. Septic Tank G Drainfield Design vner: P-r. Let 36 Mead^wdal Beach R.". Bennett- 15824 — 70th 14. SNU. Cv. WASH. .dmvnds, Wash. JUNF 1965 j . t4 p Y 0 i �- a AZI A1eyr.inq Survey^rs4 Inc.. .% Lynrnv—da Wash. PR 8-3101 .N CITY OF EDMONDS 250 STH AVENUE NORTH, EDMONDS, WA 98020 (206) 771-3202 RCW 197-11-970 Determination of Nonsignificance (DNS) DETERMINATION OF NONSIGNIFICANCE eu/i b4NG APR 3 0 19,96 Description of proposal: Construction of a 20-foot by 30-foot, 3-car carport (City of Edmonds Plan Check #96- 70). Proponent: Donald J. and Yvonne V. Kennedy Location of proposal, including street address if any: 158247 70th Avenue W., Edmonds, Washington Lead agency: CITY OF EDMONDS The lead agency for this proposal has determined that it does not have a probable significant adverse impact on theA environment. An environmental impact statement is not required under RCW 43:21.030(2)(c). This decision was made after review of a completed environmental checklist and other information on file with the lead agency. This information is available to the public on request. XX There is no comment period for this DNS. This DNS is issued under 197-11-340(2), the lead agency will not act on this proposal for 15 days from the date below. Comments must be submitted by .1996. Responsible Official: Jeffrey S. Wilson Position/Title: Current Planning Supervisor, Department of Community Services - Planning Division Phone: (206) 771-0220 Address: City of Edmonds, 250 5th Avenue North, n A 98020 Date: �Tq6 Signatur Yam_ You may appeal this determination to Robe Chave, Planning Manager, at 250 5th Avenue North, Edmonds, WA 98020, no later than Robe. . 1996, by filing a written appeal citing the reasons. . You should be prepared to make specific factual objections. Contact Jeffrey S. Wilson to read or ask about the procedures for SEPA appeals. XX _ Posted on q 3� q6 , 1996, at the Edmonds Public Library, Edmonds Community Services Building, and the Edmonds Post Office. XX Distribute to "Checked" Agencies below, along with a copy of the Checklist. Mailed to the following along with the Environmental Checklist: XX Department of Ecology Environmental Review Section P.O. Box 47703 Olympia, WA 98504-7703 XX Applicant/Owner: Donald J. and Yvonne V. Kennedy 15824 - 70th Ave. W. Edmonds, WA 98026 PC: File No. Plan Check #96-70 SEPA Notebook Paul Mar, Community Services Director Robert Chave, Planning Manager PC9670EN/4/23/96. SEPA Page I of 2 MEMORANDUM CITY OF EDMONDS PLANNING DIVISION 250 5TH AVENUE NORTH, EDMONDS, WASHINGTON 98020 TO: FILE NO. PLAN CHECK 96-70 FROM: Meg Gruwell, Code Enforcement Officer DATE: APRIL 23, 1996 SUBJECT: ENVIRONMENTAL DETERMINATION FOR CARPORT FOR KENNEDY RESIDENCE, FILE NO. PLAN CHECK 96-70 I have had the opportunity to visit the site, review the environmental checklist, and review the building permit documents. A copy of which are filed in the official file for this permit. Based on my review of all available information and adopted policies of the City, I recommend that a determination of nonsignificance be issued. Erosion control measures will be addressed by the Engineering Division in their review of the building permit. Should you have any questions concerning the information in this memo, please feel free to contact me. Review by Responsible Official: I concur I do not concur Comments: Jeffrey S. Wilson, AICP Date Responsible Official Attachments PC: FILE NO. PLAN CHECK 496-70 Robert Chave, Planning Manager Page 2 of 2 PC9670EN/4/23/96. SEPA CITY OF EDMONDS ENVIRONMENTAL CHECKLIST APR 2 2 19(; 9 19 9 - PERMIT COUNTER Purpose of Checklist: The State Environmental Policy Act (SEPA), chapter 43.21C RCW, requires all.governmental agencies to .consider the environmental impacts of a proposal before making decisions. An environmental impact statement (EIS) must be prepared for all proposals with probable significant adverse impacts on the quality of the environment. The purpose of this checklist is to provide information to help you and the agency identify impacts from your proposal (and to reduce or avoid impacts from the proposal, if it can be done) and to help the agency decide whether an EIS is required. Instructions for Applicants: This environmental checklist asks you to describe some basic information about your proposal. Governmental agencies use this checklist to determine whether the environmental impacts of your proposal are significant, requiring preparation of an EIS. Answer the questions briefly, with the most precise information known, or give the best description you can. You must answer each question accurately and carefully, to the best of your knowledge. In most cases, you should be able to answer the questions from your own observations or project plans without the need to hire experts. If you really do not know the answer, or if a question does not apply to your proposal, write "do not know" or does not apply". complete answers to the questions now may avoid unnecessary delays later. Some questions ask about governmental regulations, such as zoning, shoreline, and landmark designations. Answer these questions if you can. If you have problems, the governmental agencies can assist you. The checklist questions apply to all parts of your proposal, even if you plan to do them over a period of time or on different parcels of land. Attach any additional information that will help describe your proposal or its environmental effects. The agency to which you submit this checklist may ask you to explain your answers or provide additional information reasonably related to determining if there may be significant adverse impact. Use of checklist for nonprojeet proposals: Complete this checklist for nonprojeet proposals, even though questions may be answered "does not apply." IN ADDITION, complete the SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (part D). For nonprojeet actions, the references in the checklist to the words "project," "applicant," and "property or site" should be read as "proposer," and "affected geographic area," respectively. A. BACKGROUND 1. Name of proposed project, if applicable: Q, 2. Name of applicant: �a 3. Address and phone number of applicant and contact person: 4. Date checklist prepared: Page I .of 22 CKKLT/1643-91MASrER 5. Agency requesting checklist: City of Edmonds. 6. Proposed timing or schedule (includine uhasina. if aaalicable): (STAFF COMMENTS) 7. Do you have any plans for future additions, expansion, or further activity related to or connected with this proposal? If yes, explain. n (STAFF COMMENTS) 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. fVDYU�' (STAFF COMMENTS) 9. Do you know whether applications are pending for governmental approvals of other proposals directly affecting the property covered by your proposal? If yes, explain. P�1 a (STAFF COMMENTS) 10. List any government approvals or permits that will be needed for your proposal, if known. (STAFF COMMENTS) Page 2 of 22 CKKLT/1425-93.MAS'ER 11. Give brief, complete description of your proposal, including the proposed uses and size of the project and site. There are several questions later in this checklist that ask you to describe certain aspects of your proposal. You do not need/ two repeat those answers on this page. 12. (STAFF COMMENTS) Location of .the proposal. Give sufficient information for a person to understand the precise location of your proposed project, including a street address, if any, .and section, township, and range, if known. If a proposal would occur over a range of area, provide range or boundaries of the site(s). Provide legal description, site plan, vicinity map, and topographic map, if reasonably available. While you should submit any plans required by the agency, you are not required to duplicate maps or detailed plans submitted with any permit applications related to this checklist. (STAFF COMMENTS) TO BE COMPLETED BY APPLICANT B. ENVIRONMENTAL ELEMENTS 1. Earth a. General description of the site (circle one): Flat 'rolling, hilly, steep slopes, mountainous, other: (STAFF COMMENTS) ha4 a 5dcto Stet a,, Wem- S,dc3 o k-,,. Sc I a , kL 5 (gu s q t6 7o ^^ Avi 0 b. What is thae�teepest slope on the site (approximate percent slope)? A pr r e 7 0 10 `7 ye,Yye (STAFF COMMENTS) � S � I rw. = q % 010 3 (woe_ aCU,r�ha h � a�.�raot, . e1AXA . C. What general types of soils are found on the site (for example, clay, sand, gravel, peat, muck)? If you know the classification of agricultural soils, specify them and note any prime farmland. Page 3 of 22 CKKLT/10.25-93.MASM cce- w) (STAFF COMMENTS) (,trbx., LA -A f or•�l Z_ $2m (,6T t A I ALrLft A tr ar c1� 25 -7o °l.� sw, s Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe. (STAFF COMMENTS) e. Describe the purpose, type and approximate quantities of any filling or grading proposed. Indicate source of fill. lJ t (STAFF COMMENTS) f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe. (STAFF COMMENTS) Or*Ab re s-PL be A iLo+n % blap WA"yck:ail d."s6,Ar5 lit t -l't dnV-�, T.n -Yhc rmSi--U-- eWA �1- �S -Nab gL.41 -0.* r..X CIMsf � ik G1rnn g. About what percent of the site will be covered with impervious surfaces after project construction (for example, asphalt or buildings)? CO_r- PGyt k 6-S ci iA-Je- 0 or. (STAFF COMMENTS) aftA Ct� 1-d4 .,r-Arnl% Page 4 of 22 CHKLT/1425.93. MASTER h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: . (STAFF COMMENTS) 2. AIR a. What types of emissions to the air would result from the proposal (i.e., dust, automobile, odors, industrial wood smoke) during construction and when the project is completed? If any, generally describe and give approximate quantities if known. (STAFF COMMENTS) b. Are there any off -site sources of emissions or odor that may effect your proposal? If so, generally describe. , (STAFF COMMENTS) C. Proposed measures to reduce or control emissions or other impacts to the, if any: (STAFF COMMENTS) 3. WATER a. Surface: (1) Is there any surface water body on or in the immediate vicinity of the site (including year-round and seasonal streams, saltwater, lakes, ponds, wetlands)? If yes, describe type and provide names. If appropriate, state what stream or river it flows into. (STAFF COMMENTS) CHKLT/10.75-93.M ASTER Paae 5 of 22 (2) Will the pr(kject require any work over, in, or.adjacent to (within 200 feet) the described waters? If yes, please describe and attach available plans. 00 (STAFF COMMENTS) (3) Estimate the amount of fill and dredge material that would be placed in or removed from surface water or wetlands and indicate the area of the site that would be affected. Indicate the source of fill material. , (STAFF COMMENTS) (4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. (STAFF COMMENTS) (5) Dom the proposal lie within a 100 year floodplain? If so, note location on the site plan. (STAFF COMMENTS) (6) Does the proposal involve any discharges.of waste materials to surface waters? If so, describe the type of wa�st)e and anticipated volume of discharge. t�d�� (STAFF COMMENTS) Page 6 of 22 CHKLT/ 10425.93. M AJTB R b. Ground: (1) Will ground water be withdrawn, or will water be discharged to ground water? Give general description, purpose, and approximate quantities if known. (STAFF COMMENTS) (2) Describe waste material that will be discharged into the ground from septic tanks or other sources, if any (for example: Domestic sewage; industrial, containing the following chemicals...; agricultural; etc.). Describe the general size of the system, the number of such systems, the number of houses to be served (if applicable), or the number ok animals or humans the system(s) are expected to serve. (STAFF COMMENTS) C. Water Runoff (including storm water): (1) Describe the source of runoff (including storm water) and method of collection and disposal, if any (include' quantities, if known). Where will this water flow? Will this water flow into other waters? if so, describe. 0 0 �tl f e, Y- D k) Gil GL ►�� e� c1. r CA-V e- C— 0 V e- '0eI di it v- )e 1 A lR (STAFF COMMENTS) (2) Could -.Naste materials enter ground or surface waters? If so, generally describe. (STAFF COMMENTS) Page 7 of 22 CHKLT/10.75A3. MASTER d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any: {STAFF COMMENTS) 4. Plants a. Check or circle types of vegetation found on the site: deciduous tree: alder, maple, aspen, other: evergreen tree fir, cedar, ine other: shrubs grass pasture crop or grain .vet soil plants: cattail, buttercup, bulrush, skunk cabbage, other: water plants: water lily, eelgrass, milfoil, other: other types of vegetation: (STAFF COMMENTS) b. What kind and amount of vegetation will be removed or altered? Uo roc - (STAFF COMMENTS) -c. List threatened or endangered species known to be on or near the site. - V t, k) Q— "t, L 4-rt 1- Cam, vvt G- t.J e."- r E? a (STAFF COMMENTS) d. Proposed landscaping, use of native plants, or other materials to preserve or enhance vegetation on the site, if any: Page 8 of 22 CHKU/10.25-93.MASfER S. (STAFF COMMENTS) Animals a. Check or circle any birds and animals which have been observed on or or near the site: C,,1 ' Y- birds: hawk, heron, eagle, songbirds, Sher: mammals: deer, bear, elk, beaver, other: fish: bass, salmon, trout, herring, shellfish, other: (STAFF COMMENTS) b. List any threatened or endangered species known to be on or near the site. (STAFF COMMENTS) C. Ls the site partofa migration route? If so, explain. (STAFF COMMENTS) d. Proposed measures to preserve or enhance wildlife, if any: 0 �j (STAFF COMMENTS) 6. Energy and Natural Resources the site or are known to be on Page 9 of 22 CKKI T/IP?5.93.MASTER a. What kinds of energy (electric, natural gas, oil, wood stove, solar) will be used to meet the completed project's nergy needs? Describe whether it will be used for heating, manufacturing, etc. 0 PJ (STAFF COMMENTS) b. Would your project affect the potential use of solar energy by adjacent properties? If so, generally describe. Ook (STAFF COMMENTS.) C. What kinds of energy conservation features are included in the plans of this proposal? List other . proposed m4surps to reduce or control energy impacts, if any: (STAFF COMMENTS) 7. Environmental Health a. Are there any environmental health hazards, including exposure to toxic chemicals, risk of fire and explosion, §pill, or hazardous waste, that could occur as a result of this proposal? If so describe. (STAFF COMMENTS) CW U/IQ'3-93.MASrER Page 10 of 22 (1) Describe special emergency services that might be required. (STAFF COMMENTS) (2) Proposed measures to reduce or control environmental health hazards, if any: (STAFF COMMENTS) b. Noise. (1) What types of noise exist in the area which .may affect your project (for example: traffic, equipment, op (ration, other)? (STAFF COMMENTS) (2) What types and levels of noise would he created by or associated with the project on a short-term or a long-term basis (for example: traffic, construction, operation, other)? Indicate what hours noise would come from the site. (STAFF COMMENTS) (3) Proposed measures to reduce or control noise impacts, if any: (STAFF COMMENTS) Page 1 I of 22 CMCLT/ 10.25-93. M ASPER 8. Land and Shoreline Use a. What is the current use of the site and adjacent properties? (STAFF COMMENTS) b. Has the site been used for agriculture? If so, describe. -F ; (STAFF COMMENTS) c (STAFF COMMENTS) d. Will any structures be demolished? If so, what? (STAFF COMMENTS) e. What is the current zoning classification of the site? 9►lue,. CC; - (STAFF COMMENTS) �-5 - IL Page 12 of 22 CI OCLT/ I0.2S93. M ASTER f. What is the current comprehelan designation of the site? (STAFF COMMENTS) g. If applicable, wh t is the current shoreline master plan designation of the site?. A. (STAFF COMMENTS) h. Has any part of the site been classified as an "environmentally sensitive" area? If so, s ify. CL, v-- et- roo a- a (STAFF COMMENTS) uz; -- if S,?=&i_6 ►g; & IA -AS (.-A' ke ZLa A , i. Approximate2yow many people would reside or work in the completed project? (STAFF COMMENTS) j. Approxim tely how many people would the completed project displace? PS Yl l e (STAFF COMMENTS) Page 13 of 22 CHKLT/1425.93.MA5rER k. Proposed measures to avoid or reduce displacement impacts, if any: (STAFF COMMENTS) 1. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if any: I l (STAFF COMMENTS) 9. Housing a. Approximately how many units would he provided, if any? Indicate whether high, middle, or low-income housing. i (STAFF COMMENTS) b. Approximately how many units, if any would be eliminated? indicate whether high, middle, or low- income housing. k) (STAFF COMMENTS) C. Proposed measur to reduce or control housing impacts, if any: (STAFF COMMENTS) Page 14 of 22 C W CLT/10.25-93.MAS1'ER 10. Aesthetics a. What is the tallest height of any proposed structure(s); not including antennas; what is the. principle exterior building material(s) propd?('M V-C- ff o u e. cx (STAFF COMMENTS) b. What views 11 in the immediate vicinity would be altered or obstructed? e ..� (STAFF COMMENTS) C. Proposed measures to reduce or control aesthetic impacts, if any: 1— 6- vJ A S C a-12 ))k L� (STAFF COMMENTS) 11. Light and Glare a. What type of light or glare will t e proposal produce? What time of day would it mainly occur? M / A. n v- No fU c, , (STAFF COMMENTS) b. Could fight or glare from the finished project he a safety hazard or interfere with views? (STAFF COMMENTS) CKKLT/ 10.25.93.MASCCR Pap 15 of 22 C. What existing off -bite sources of light or glare may affect your proposal? (STAFF COMMENTS) d. Proposed measuj•e_c to reduce or control light and glare impacts, if any: (STAFF COMMENTS) 12. Recreation a. What designated and informal recreational opportunities are in the immediate vicinity? OnA)e_ (STAFF COMMENTS) b. Would the proposed project displace any existing recreation uses? If so, describe. (STAFF COMMENTS) C. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the pp ject or applicant, if any: (STAFF COMMENTS) Page 16 of 22 CHKLT/10.75.93. MASTER 13. Historic and Cultural Preservation a. Are there any places or objects listed on, or proposed for, national, state, or local preservation registers known to be on or next to the site? If so, generally describe. (STAFF COMMENTS) b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural importance known to be on or next to the site. (STAFF COMMENTS) C. Proposed measures to reduce or control impacts, if any: (STAFF COMMENTS) 14. Transportation a. Identify public streets and highways serving the site, and describe proposed access to the existing street system. Show on site plans, if any. a , ct d C—' -5 (STAFF COMMENTS) b. 'Is site currently served by public transit? If no, what is the approximate distance to the nearest transit - stop') ) Page 17 of 22 MIKU/10-25-91MASTER (STAFF COMMENTS) C. How many parking spaces would the completed project have? How many would the project eliminate? r-I ,r- nn«T 1J ). H �Va1/e. -�? -c,-,1::pQ,C_P_S �_n1ievI (STAFF COMMENTS) d. Will the proposal require any new roads or streets, or improvements to existing roads or streets, not including driveways? If so, generally describe (indicate whether public or private). (STAFF COMMENTS) e. Will the project use .(or occur in the immediate vicinity of) water, rail, or air transportation? If so, eenerally describe. (STAFF COMMENTS) f. How many vehicular trips per day would he generated by the completed project? If known, indicate when peak volumes would occur. (STAFF COMMENTS) CHKLT/1045-93. M ASTER Page 18 of 22 g. Proposed measures to reduce or control transportation impacts, if any: (STAFF COMMENTS) 15. Public Services a. Would the project result in an increased need for public services (for example: fire protection, police protection, health care, schools, other)? If so, generally describe. (STAFF COMMENTS) b. Proposed measure, to reduce or control direct impacts on public services, if any: (STAFF COMMENTS) 16. Utilities a. Circle utilities currently available at the site< electricity, natu�' ralg , water, refuse service, telephone, sanitary sewer septic system, other: -7-V (STAFF COMMENTS) Page 19 of 22 CHKU/10- 591MASTGR b. Describe the utilities that are proposed for the project, the utility providing the service, and the general construction activites on the site or in the immediate vicinity which might be needed. (STAFF COMMENTS) C. SIGNATURE The above answers are true and complete to the best of my knowledge. I understand that the lead agency is relying on them to make its decision. Signature of Proponent Date Submitted CFOCLT/10-25-91MASrER Page 20 of 22 NAME �Q.�Ic;/JNeN JOB SITE/ADDRESS _' 5t/Z Y�PP W FJ�,M.O9015 LAM ' 864 ► TAX NO. LEGAL DESC 616 Laurel Drive PACIFGI088JN Everett, WA 98201 (206) 259-1311 PACIFIC GARAGES. INC. "The Wood Frame Specialists" j I rQ ,off RECEIVE, CA A ; ► oo v 'APR 2 2 1996 g 106 . PERMIT COUNTER /�)'u c 100.o z.S- 00 Arrult- S LA?3 I �1f)�� ACA M za�b ACV ' ! j `8\ ; ,a ► , i I cJ Yh,rr, rc� to f I I 1�p.1D 20 �ioh A�1'NA`T P 1? N TS j� iG 70: i I �4/,4/49p 890 -,99.- STREET BILE CITY OF EDMONDS 250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771-0220 - FAX (206) 771-0221 COMMUNITY SERVICES DEPARTMENT Public Works • Planning . Parks and Recreation . Engineering June 1, 1993 LAURA M. HALL MAYOR M. Mulford 15824 - 70th Ave. W. Edmonds, WA 98026 This letter is to inform you that you are served by a city maintained grinder pump system. This system pumps your sanitary waste to city gravity sewer lines as your house was too low to obtain gravity flow when city sewer mains were installed. I hope to inform you of the.basics of how these pumps function, who to call should you experience alarms, and what precautions should be taken to prevent damage to your home. 1. The grinder pump was originally installed by the homeowner, but the hardware was purchased by the c-ity of Edmonds' Lid Bond that paid for the sewer project in your area in 1985. These pumps are float activated to cycle the one pump to take your sewage up to where gravity flow can be obtained. 2. The following precautions must be adhered to prevent damage to your home: A. Do not dump any nonbiodegradable products down into the pump tank. VIA your drains in your house. B. Minimize the amount of grease disposed down your drain. This may cause problems with the float operations. C. Do not empty pools into the tanks without a restrictor approved by the city of Edmonds. D. Do not attempt to access tank or electrical cabinets. Should you have a pump failure from any of the above mentioned items, the homeowner will be held responsible for damage. Incorporated'August 11,,1890. Sister Cities International — Hekinan; Japan 3. The city of Edmonds Sewer Section will maintain the pumps .every three (3) months to ensure.the proper operations: We will also clean, operate and check all components to ensure proper working status. A separate log is kept to your pump that will reflect any maintenance done. We can track reliability and the need for upgrade or repairs when a chain of failures start to occur. Crews will require the use of your water so the tank can be washed down and we will always try to notify you of their presence when they arrive on the site. 4. Should you experience any problems with the pump, there are two alarms that will indicate failure. One alarm is located within your home and has a black push button to reset to silence. There is also a visual alarm located on the electrical box outside your home. When this occurs, please call us at 771-0235 immediately to investigate any problems. Our office hours are 8:00 AM - 5:00 PM Monday Through Friday: Should an alarm occur after hours, weekends, or holiday, contact 911. There is a 24-hour call person on duty to be dispatched. We do carry parts for al.l of these systems and should be able to correct most problems within a reasonable amount of time. If you have any questions or concerns, please contact Everett Akau or myself at 771-0235, extension 349. Sincerely, Ron Holland Water/Sewer Supervisor cc: Everett Akau RH/lk -k PERMIT APPLICATION REQUIREMENTS To: Applicant From: Lyle Chrisman, Engineering Inspector Q Owner.. ill Plan C heck No. / /4, —76 Address: l �� 16✓� Date:_ _-571-16 Zjl After review of the subject permit application, the following requirements must be met: 1. Construction hours are: WEEKDAYS — 7:00 A.bL-10:00 P.M.WEEKENDS/HOLIDAYS —10:00 A.bL-6:00 P.M. 2. A separate RIGHT-OF-WAY CONSTRUCTION PERMIT is required for all work on public property. (ECDC 1&60) 3. Truck haul route plan must be submitted and approved prior to permit issuance. 4. BuildWowner is responsible for containing all temporary nmoff and erosion control on site. (ECDC 1830.030d) S. NO WORK SHALL BE DONE WITHIN IS FEET OF STREAMS OR 10 FEET FROM ANY CLOSED DRAINAGE FACUM Y. BUILDER/OWNER 1S RESPONSIBLE FOR IDENIV YING CONDITIONS ON THE DRAWING. (ECDC 1830SOG) 6. FILTER FABRIC FENCE SHALL BE INSTALLED AND INSPECTED PRIORTO CLEARING AND CONSTRUCTION. (ECDC 1830) 7. INSPECTIONS ARE REQUIRED ON STORM DRAINAGE SYSTEMS, TIGHTLINES AND CATCH BASIN INSTALLATION. INSPECTIONS ARE REQUIRED PRIORTO BAC KFUIMG. (ECDC 18.30) L Repair or replace aU defective existing quit, gutter and ddewalk adjaoetrt to dw property. tf= won is lnvoli ed, a handicap tamp mq► be required. Contractor shall tact with the Cky EaSkmering staffto detemhre the exomt of repair prior to issuance of the pmWt. ("Mc 18 90) 9. Driveway slope shall not exceed 14% without a waives. Every attempt should be made to keep fire slope below 14%. Waiva granted to S6. (ECDC 1&OU60D) , 10. Driveways must be paved f to m p Wcdy No to Cky RIGHT-OF•WAY. A separate penult is tequked. (ECDC IUO.060C) 11. INSPECTIONS ARE REQUIRED ON DRIVEWAYS AND SIDEWALKS PRIORTO AND AFTER POURING. (ECDC 18.30) 12. No burning of construction refuse without a penult frost the Fire DeparmwIL 13. Oomodon to City water system is required. There is a separate charge for the water meter. (ECDC 7.20) 14. Aback water valve is required if downstaits plumbigg is below the elevadoa of opst<+ea:rt mantrol&. (BCDC 7.20) lS. Wooer and sewer main Han Mould be separated by 10 feet minimuxm. (ECDC 1&10) K COMOction to the City sanitary system is enquired. A separate permit is ragWh& HE` T E T ,.F H Fan paid: Yes No—_ amp (ECDC 1&10} i 17. UndUFound wiring is requited ou all trees cousttuctim and for add 1=6 afteniflon16 and repairs that exceed 50% of the total assessed value of the strut tune. (M=1890) l8. A FINAL ENGINEERING INSPECTION IS REQUIRED PRIOR TO Tim BUILDING DIVISION GRANTING OCCUPANCY OF THE BUILDING OR STRUCTURE. (ECDC I&") A � . i -P-PROVED CITY OF EDMONDS LAURA M. HALL 250 - 5TH AVE. N. EDMONDS, WA 98020 (206) 771-0220 FAX (206) 771-0221 MAYOR COMMUNITY SERVICES DEPARTMENT I p Public Works • Planning. • Parks and Recreation • Engineering 890_l.q December 29, 1994 Mr. & Mrs.Ford Martin 15824 - 70th Ave. W. Edmonds, WA 98026 Dear Resident: I have reviewed your account and will allow a credit to your account in accordance with our City policy for the billing period August 22, 1994 through December 22, 1994.. The policy states that the customer will be billed at the retail rate based upon the average water consumption for the same period'during the previous year. In addition, the excess water lost from the leak will be billed to customer at the City's wholesale rate with a 15% surcharge added for administrative cost. Only one leak credit will be granted in any three year period. I would like to add that city crews did leave a door hanger and provided you with a letter to insure you were notified of a possible leak (see attached). I feel this is an adequate response to assist our customers. In the future you might think about having your water shut off at the meter by the water department. at no charge to you and therefore, eliminating any bill for the time you are gone. Should you have any additional questions after you receive your new billing, please contact Ilene Larson, Utility Billing Clerk. Sincerely,. Ron Holland Water/Sewer Supervisor RH/lk cc: Ilene Larson Utility Billing Clerk wordata\water\#303225 • Incorporated August 11, 1890 • Sister Cities International — Hekinan, Japan December 23, 1994 Mr. Ron Holland Water Superintendent City of Edmonds 501 Bell Street Edmonds, WA 98020-0908 Dear Mr. Holland: RECEIVED DEC 2 7 1994 PUBLIC WORKS DEpl I am writing to ask you to consider reducing the amount of both our current and our upcoming water bill due to a leakage problem that went undetected for a long time. I am enclosing a copy of our current overdue water bill, which shows the extremely high usage of 648 units during the period 8/22/94 to 10/22/94, when the meter was last read. As of today, the meter reads 137, which represents further high usage of 774 units since the reading on 10/22/94. I would like to explain the circumstances. I believe we have behaved in a responsible manner and deserve your consideration for some relief in payment for this usage. On 10/16/94, our family left home on a driving trip back east to visit family. We returned from that trip on 12/4/94. During that time, a friend stayed at our house to take care of our dog and watch the house. Apparently, the water leak developed near the time we left and was undetected the entire time we were gone. As we later found out, the leak was in the line between the meter and the house. There was no indication of a leak in the house or on the grounds of the 'property (no puddles, sprays, running water sounds, or even.soggy ground that would be an indication of a leak). Apparently the water -was entirely absorbed into the ground, which in this area is very sandy. The only way to have known that water was leaking would have been to read the meter. When we returned home on 12/4, I found the extremely high water bill. The next morning, 12/5/94,. I called the water department and spoke with Eileen. She got in touch with Terry, who came to our house later that morning to help investigate the problem. He and I experimented with various shutoff valves and isolated the location of the leak. We also shut off the water at the meter to stop the leaking right away. At that point, the meter reading was 130. T then contacted Earl Basim at Allied Backhoe who indicated he could come the next day to dig up the line and make the repair. The next day the roads were icy, so.he delayed a day and came Wednesday 12/7. He and I worked together and fixed the leak by about 1 PM, then turned the water back on after Scott came from the water department to inspect the work. During the time from Monday morning to Wednesday afternoon, the water remained off at the meter and we lived at the house without water, which is not easy with a 2 year old child. I have enclosed a copy of the statement from Allied Backhoe so that you could see the expense of fixing the problem. I received that statement in the mail today. Additional expenses included $30 for two brass connectors with compression fittings for the two ends of the pipe, plus $10 for a tracer wire. Page 1 It is a shame the leak was not -remedied around the time. of the 10/22/94 meter reading. Eileen told me the meter reader noted that a message had been. -left on our door to notify us of a leak. Unfortunately that message never got to us; our housesitter says she never saw that notice. I don't know who is right in this case, but the result was that we knew -nothing about the problem. I realize that since the.leak was between the meter and the house, we as homeowners are responsible for this loss of water. However, I am asking you.to consider that we didn't know about the leak for a long time, and that -as soon as we did know about it, we shut off the water and got the problem repaired. I also ask you to consider whether the water department could have made a stronger effort to convey the information they had as of the 10/22 reading -- namely, that a very serious leak existed. I am enclosing. a $250 partialpayment of the current bill in good faith and hope that will suffice until_ a final amount can be determined. Lwould appreciate any help you could offer us in reducing the the amount of the current and upcoming bills. Thank you very much. Sincerely, r• � Ford Martin Account number 303225. Enclosures: Copy of current water"bill from City of Edmonds. Copy of repair bill from Allied Backhoe. Partial payment of $250 on account 303225. Page 2 t a �T bA r NALLIED SACKHOE 22821 85th PL W. EDMONDS, WA 98020 PHONE 206-774-1206 CUSTOMER'S ORDER NO. DEPT. NAME ADDRESS 9156 OUAN,� �;• d-- ,fir' � �DESCR`IPTI,ON' y,�l��'. +. '� ' r e �® a �o e �� a REC'D BY t,C/r'20 KEEP THIS SLIP _ FOR REFERENCE:.. CITY OF EDMONDS ? WORKS DEPARTMENT FOR INSFECTION CALL Permit in , SIDE SEWER PERMIT 775--2=525- Ext. 2-2`0_ Issue Date i J /r g h `p * PERMIT MUST BE. POSTED ON JOB SITE 1. � 2. 3. Single Family Residence ►,' Multi -Family No. of Units E U H a a a r� ca w H w a a z 0 U w as 0 E+ b w w Address of Construction 95,IIZ4 70 A,(o W, Property Legal Description (include all, easements) Commercial 4. Owner and/or Builder 5. Contractor & License No. jd)Y7Pr 6. Invasion into City Right -of -Way: No ✓ Yes (If Yes Right-of- way Construction Permit Required - Call Dial Dig V1,44A$'3,4,4& before excavation). 1-800-454-5555 7. Cross other private property: Yes No V111 Easement required - attach legal description and county easement number. READ THE FOLLOWING AND SIGN: a. Property owners must obtain a permit to install side sewers on their property. A licensed side sewer contractor must be employed to construct side.sewers in the public right-of-way. b. The side sewer contractor assumes full repohsibility for each installation for one year. C. Commercial establishment requires a minimum of a six inch (6") side sewer line. d. Side sewers may not be installed closer than thirty inches (30") to any structure. e. Side sewer lines must be laid at a minimum grade of 2% (1.150) and maximum grade of 100% (450). f. No turn in side sewer greater than 45° (1/8,bend) is allowed between cleanout. All 90 turns must be constructed of a 450 (1/8 bend) and Wye with removable cap. g. No down spouts, footing drains or floor drains can be connected to side sewer system. h. Pea gravel is required for bedding when installing sewer lines through other than granular soil. i. Cleanouts are required at 30"-60" from each plumbing exit line and at minimum intervals of 100' along sewer line run. j. Trenches within City right-of-way must be restored to original conditions. Contractors shall be responsible for right-of-way failure due to poor compaction of fill. k.. Side sewer must be left uncovered until inspected and approved by the City. 1. Inspection during normal working hours only. Two (2) working days notice required. DATE: It1)9I?4 r I certify t at I have read and shall comply with the above PERMIT FEE: 30.00 hok rih t4rge 2T 30 CONNECTION FEE: * PERMIT DISAPPROVED By: Date: 4tj_B Date: _ APPROVED By. : Date: T BE POSTED ON JOB SITE The r;fw of l:j4r"o%,%Ac Water Service Drawing EASEMENT NO. ... ...... . ....... .. . .. .......... NEW CONSTRUCTION ❑ REPAIRS K/ LID NO . .................. . ASMT NO. .............. OWNER ...... Plq4FO.R.0 ........ MAS.RTO-4 .... : ................................... CONTRACTOR .................................................................................... PERMIT NO. .................... JOB ADDRESS 15B-Z.4 ......... ...... W, .......... LEGAL DESCRIPTION: LOT NO ....................................... BLOCK NO. .................................... I — New V, 2.00 mi. P. E. vaiscopipe W/TRhc,eR Is, t2"FIR TREE P rh PWW-0001 -11175 (REV. 11178) NAMEOF ADDITION ........................................................................................................................ 2-4"CeDAR a V&%sT 1&4 Cy Plfr, x % sT. VALVE F&UCCT Approved: DATE'DcaG.:... By . ....... (� . ...... ... .... —* ........... f aJ' _•.F. � 'r"'" �w, '`F� �tl•¢.--..a t`+i:t�- 1 F '��i}'iti � ..r{... _ X,Y�..�� r f�-ir.trun''` ^f w i' .-i T,�'•T1-. .r ... . �:lt� ,. is -..._ .r a. '.� Y'.... ..r L a ... . • -„ City of :Edmonds HT -OF -WAY CONSTRUCTION .. � . � IT ET :F6 Permit Number - Issue Date: A. Address or Vicinity of Construction: 15824 70 AV V ( 0513621 ) 18 o B. Type of Work (be specific): Install New Service 90-.19 C. Contractor: Mailing Address: 1122 79 Ct SH Averett State License #: 98203 D. Building Permit # (if applicable): Contact: Fr -pal- Swan Phone: 447-3284 Liability Insurance: Bond: $ Side Sewer Permit # (if applicable): P E. ❑ Commercial ❑ Subdivision ❑ City Project EJ Utility (PUD, GTE, WNG, CABLE, WATER) ❑ Multi -Family ❑ Single Family ❑ Other INSPECTOR: INSPECTOR: F. Pavement or Concrete Cut : ❑ Yes WNo G. Size of Cut: 115;x H. Charge $ APPLICANT TO READ A f IGN INDEMNITY: Applicant understands 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 ''�c[iossts, and attorney fees by reason of granting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PRIOD OF ONE YEAR O LOrWIN��7�HE 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.01 tim r Inspect' n urposes. ec Signature: ✓�� (/Q/ Date: A-3-95 (Contractor or Agent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR CITY USE ONLY APPROVED BY: �1�1�tcv TIME AUTHORIZED: VOID AFTER DAYS RIGHT OF WAY DEPOSIT DISRUPTION. F"MUND 111: SPECIAL CONDITIONS: VA RESTORATION FEE: 2 (� PERMIT FEE:: ..�! TOTAL FEE: COMMENTS: RECEIPT FEE: -- DATE: ISSUED BY: - a — NO WORK SHALL BEGIN PRIOR TO PERMIT ISSqJ.4NCF, Eng. Div. 1994 FIELD INSPECTION NOTES Comments : _ Diagram (Fund 111 - Route copy to Street Dept.) CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO Partial Work Inspection by P.W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: WNG to window Watermain depth 'Tb IbP Llp per Ov V4T2. VA4-VrL To gas main Addendum to: City of Edmonds Right of Way Permit Application Submitted by: Hariamne Kingsbury Engineering Aide Washington Natural Gas 1356-7500 X7596 Icbg24 - --FO .*v W %30e) qS 1 ►11c$ eJ-LTIb Key: -W Water --G- Gas -SS- Sewer & Water hydrant p Water valve Washington Natural Gas Company 1122 75th Street S.W.. Everett. Washington 98203, (206) 355-3331 WNG to window Watermain depth wA,►z 'M ¢ibP wo -orc Ot: V4TP-• To �E'�utiNm: ��T«d • C�1tY� gas main Addendum to: City of Edmonds Right of Way Permit Application Submitted by: Mariamne Kingsbury Engineering Aide Washington Natural Gas 1356-7500 X7596 N 4 1e--JIS24 - --f-o -A,%-v W .doe) 9513 CoQLA Key: -W Water -G- Gas -SS- Sewer -& Water hydrant p Water valve Washington Natural Gas Company 1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331 Addendum to: City of Edmonds Right of Way Permit Application Submitted by: Mariamne Kingsbury Engineering Aide Washington Natural Gas 1356-7500 X7596 ti 4 1 ,24 - -11-0 -AVv W Joe, CIS 13 Cowl ►•l, e,-LT'S WNG to window Key: -W- Water Watermain depth "14^4� 'b ¢bP -G- Gas t✓ID OC•F of;: WTF-- VAA-Ve. To -SS- Sever TMIN+�t�T� • ��.QY� 8. Water hydrant gas main p Water valve Washington Natural Gas Company 1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331 CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS w MAIUNG,,;AODRESS 1156 �` ANIp- W CITY ZIP TELEPHONE NUMBER i r�MbNj)ce 797 ewz NAME w ADDRESS U a CITY ZIP TELEPHONE NUMBER NAME ADDRESS (o 16 u IBC. 2 ¢ CITY ZIP TELEPHONE NUMBER E,4F_ke-rr WA 982s> I jzog. Z-59;-1// STATE LICENSE NUMBER _PIyTION DATE PACA9 61 0aB3-J Legal Description of Property - include all eascrments Tax Parcel No. Account 1133; 000 036 010 (o *NEW Li RESIDENTIAL PLUMBING ADDITION 1:1COMMERCIAL El MECHANICAL REMODEL 1:1APT. BLDG. El SIGN GRADING FENCE REPAIR CYDS. (x_FT) DEMOLISH ❑ WOODSTOVE INSERT.HOT SWIM POOL TUB SPA r—lArAAGE ❑ RETAINING WALL/ CARPORT' ROCKERY RENEWAL (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAINf' NUMBER NUMBER OF CRITICAL OF STORIES DWELLING r UNITS i AREAS (''�,Q Q fir' NUMBER""* f �.7� DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) .e . �:gxoC� . c�ar.,•r . USE ZONE PERMIT Z NUMBER ADDRESS 9ro',j At- SUITE/APT HT. OF WAY PER OFFICIAL STREET MAP. TESCP Approved ❑ RW Permit Required ❑ REQUIRED DEDICATION Street Use Permit Req'd ❑ Inspection Required ❑ LREMARKS Sidewalk Required ❑ ZE LINE SIZE NO.OF FIXTURES PRV REQUIRED YES NO A iJ' iPi�% 1P 1 MEMO DATED ), REVIEWED BY SIGN AREA SEPA REVIEW ADB NO. ALLOWED PROPOSED COMPLETE EXEMPT ----°�"' "s - --.., SHORELINE EXP `j/le( Aj VARIANCE OR CU PLANNING REVIEW BY DATE . .!yrI� 5 6A-- �� J �, •LTf SETBACKS — FEET HEIGHT LOT COVERAGE FRONT 7-S' SIDE I0' REAR I4jrj REMARKS W,t . rtr -9` r �' • { •..,ti, S • . r+. 7d, i .. a2_,ir ., i, CHECKED BY TYPE OF C� ON UCTION CODE OCCL GROL SPECIAL INSPECTOR AREA OCCU REOUIRED LOAD ❑ YES REMARKS PROGRESS INSPECTIONS PER UBC 305 FINAL INSPECTION `hE0yIR PLAN CHECK FEE BUILDING HEAT SOURCE: GLAZING PLUMBING Plan Check No. MECHANICAL This Permit covers work to be done on.private property ONLY. GRADINGWILL Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE ' Permit Application: 180 Days T 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 y successors in interest, agrees to indemnify, defend and. hold W harmless the City of Edmonds, Washington, its officials, f 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 PLAN CHECK DEPOSIT -..... omodify, waive or reduce any requirement of any city ordinance x nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE pia L 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 ATTENTION APPLICATION APPROVAL 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 InsUWce and RCW 18.27. INSPECTION acknowledged in space provided. SIGN E j E OR AGE ) DATE DEPARTMENT `d �_ CITY OF OFFlGf/1 IGNA DATE 1 p+ EDMONDS ATTENTION CALL FOR INSPECTION RELE ED BY DATE -- IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE � UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR �� O��O ORIGINAL — File YELLOW — Inspector A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC CHAPTER 3. �1 ��,;� 10247 �f PINK — Owner GOLD — Assessor �+' 0 Z z Z 5 a nN'p NAME bpi 616 Laurel Drive PACIFG1088JN JOB SITE/ADDRESS ' �J�� ` 7® a 1!y Everett, WA 98201 (206) 259-1311 �r�MOnsOS 1,c�A 48d2 PACIFIC GARAGES, INC. TAX NO. S 193'3 000 tps (o W N-0 "The Wood Frame Specialists" LEGAL DESC RECEIVE- -APR 2 2, 1996 PERMIT cobNE � = 100 0 i p 1001D _ _....._ _ 00. _1 /.�-- t?- _ O` • • _apao�t. YH 0D �p ; APnno • 1 i