16233 72ND AVE W.PDF16233 72ND AVE W
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW
COVENANTS (RECORDS
m
CRITICAL AREAS: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMITS) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR: G�
WATER METER TAP CARD DATED:
OTHER:
LATEMP\DST's\Fonns\Street File ChecklisLdoc
DATE RECEIVED
PERMIT EXPIRES
CITY OF EDMONDS � PERMIT
CONSTRUCTLCN PERMIT APPLICATION ooREss su1TE/APT#
OWNER NAME/NAME OF BUSINESS 4��k II
,r"�
�` ' /e r +� o G P e C -(J yy. Gs PLAT NAME/SUBDIVISION NO. LOT NO. LID NO.
Y MAILINGADDRESS
t W LID FEE $ 13
O �% Q y,. ' �, PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved
4
RW Permit Required 0 CITY ZIP TELEPHONE EXISTING JPROPOSED N % Street Use Permit Required O
? ! Inspection Required 0
Sidewalk Required'11 El
�-7 ICATION FT Underground C3
Wirin re uire0
NAME E LINE SIZE N0. OF FIXTURES PRV REQUIRED
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ADDRESS C
cii �i REMARKS W
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V `� oo STUDY 13 f�' F �� . 1 r
NEW RESIDENTIAL LOT COVERAGE
a PLUMBING / MECH REQUIRED SETBACKS (F .) PROPOSED SETBACKS (FT.)
OWED PROPOSED FRONT SIDE _FRONT ..`UR SIDE REAR
❑ COMMERCIAL
❑ ADDITION ❑ ❑ COMPLIANCE OR 'LJ7 f �T l� , j f, 4 �� _
MIXED USE CHANGE OF USE ��, I /S� _ f
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❑ REMODEL: ❑ MULTIFAMILY ❑ SIGN REO'D RPIROVNG IDED JLOTAREA PLANNING REVIEWED BY DATE g
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❑ REPAIR i 2 (U lE Cyr
CYDS FT.) REMARKS
❑ DEMOLISH ❑ TANK 0 ER
GARAGE RETAINING WALL ❑ FIRE SPRINKLER
o CARPORT ❑ ROCKERY FIREALARM
i _,(TYPE OF USE„BUST SS OR ACTIVITY) EXPLAIN:
m TYPE STRUCTION CQDEE OCCUPANT
GROUP
o NUMBER f
UMBER OF l/� j
m OF WELLINGSPECIAL INS CT10N CONSULTANT OCCUPANT
O STORIES rJ NITS LOAD
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REMARKS
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VALUATION
ul#,Ve lyDfl $
LZ- LTY Description FEE Description FEE
Plan Check (/ State Surcharge
HEAT SOU C LOT SLOPE % VESTED DATE. _
Building Permit City Surcharge f� .
PLAN CHECK NO:
"• Plumbing "` ' Base Fee 4:2V '
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Mechanical
tj BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBIC
J DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading
I.- SEPARATE PERMISSION.
m
W PERMIT APPLICATION: SEE ECDC:19.00.005(A)(5) Engr. Review
a PERMIT LIMIT: SEE ECDC 19.00.005(A)(6)
r. SEE.9ACK OF PINK PERMIT,FOR.MORE INFORMATION EngL InSpeC1100
y 'APPLICANT, ON BEHALF OF.'HIS OR HER SPOUSE* HEIRS, ASSIGNS AND SUCCESSORS Fire Review °
� IN INTEREST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF - plan Chk. Deposit
i EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY Fire Inspection Receipt #
G FROM THE ISSUANCE OF THIS PERMIT. 'ISSUANCE.OF'THIS PERMIT SHALL NOT BE
O DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp.' Total Amt. Due 02 = NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.*
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION Recording Fee I Receipt #
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC• CALL This application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and
WORKMEN'S COMPENSATION INSURANCE AND RCW 16:27.
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR and
receipt is acknowledged in space provided.
I LS SIGNAT ATE '
SIGN TUR (OW E OR AGENT): DATE SI NED (425)
1D
771•1-0220 REHESED BY DAT
ATTENTION EXT.1333
IT IS UNLAWFUL TO USE OR OCCUPY,A. BUILDING OR STRUCTU, .E UNTIL
°`A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- 106 .r..
FICATE OF OCCUPANCY 1. HAS BEEN GRANTED. UBC109 / IBC110 / IRC110. hill$ $iL (}JL 1��3 0� ORIGI Al - ILE YELLOW-- INSPCTOR
10/04 ���.�„� ^' „�„ - �_ _ _ _ _ _ r _ PIN NER • GOLD - ASSESSOR
r
ATE RECEIVED
f
1
PERMIT EXPIRES
CITY OF EDMONDS
PERMIT
NUMBER
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CONSTRUCTION PERMIT APPLICATION
JOB
SUIITEE/�T#
ADDRESS
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OWNER NAME/NAME OF BUSINESS
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PLAT NAME/SUBDIVISION NO.
LOT NO.
LID NO.
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MAILING ADDRESS
le Ild
LID FEE $
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1 • 0 �o X ' `
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCPApproved O
RW Permit Required 13���
CITY ZIP
TELEPHONE
EXISTING
PROPOSED
Street Use Pemut Required
�� �� I�&
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REQUIRED DEDICATION
FT
Inspection Required'. O
Sidewalk Required"s
underground O
Wirin required �
NAME
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METER SIZE
tl
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LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
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YES
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ADDRESS
REMARKS
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17 '! 4,10?1
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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/ INS
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VARIANCE OR CU
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REQ'D
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T E LICENSE NUMBER EXPIRATION DATE
CHECKED BY
L L 3 i3 6AUL
O YES
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-C V
PROPERTY TAX ACCOUNT PARCEL NO,
CA# 47—!�2
ZONE
SIGN AREA
HEIGHT
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Q O
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Qj 177�000no oo
WAIVER 13
STUDY I3
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ALLOWED
PROPOSED
ALLOWED
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PROPOSED
JAI '6i
NEW
RESIDENTIAL
))Q PLUMBING / MECH
T�
LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SETBACKS (�jF ) PROPOSED
FRONT SIDE FRONT
SETBACKS (FT.)
,,. BUR SIDE REAR
❑ADDITION
❑ COMMERCIAL
COMPLIANCE OR
El
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17
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❑ MIXED USE
CHANGE OF USE
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: L0
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❑ REMODEL
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DATEREPAIR
FENCE
� I
2
1 4p
yD
SC7� CYDS ❑
( X FT.)
REMARKS
❑ DEMOLISH ❑ TAN�-K++�,� ❑ OTHER
GARAGE RETAINING WALL FIRE.SPRINKLER
CARPORT ❑ ❑I
Z
O
r-
ROCKERY' FRE ALARM
(TYPE OF USE„BUST SS OR ACTIVITY) EXPLAIN:
Q.
TYPE Vf5STRUCTION
CDDE
OCCUPANT
GROUP
cNUMBER
f
NUMBER OFOF
'
m
O
STORIES
STORIES
DWELLING
UNITS
SPECIAL INS ECTION
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PANT
REQUIRED YES
LOAD
DESCRIBE WORK TO BE DONE
REMARKS
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GEOTECH POT
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VALUATION TION
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$
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Description
FEE
Description
FEE
Plan Check
/ State
Surcharge
��I HE T SOU�tC
F;,',
LOT SLOPE%
VESTED DATE.-
Building Permit
_ City
Surcharge
�� y
PLAN CHECK NO: l
Plumbing
— Base
Fee
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY'CONSTRUCTION ON THE PUBIC
7
DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES,"ETC.) WILL REQUIRE
Grading
SEPARATE PERMISSION.
W
PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
Engr. Review
_
IL
PERMIT LIMIT: SEE ECDC 19.00.005(A)(6)
Engr. Inspection
"
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
DD
W
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS
Fire Review
Plan
Chk. Deposit
Uj
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
FOR
Fire Inspection
Recei
p t #
¢
=
ALL CLAIMS 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
Landscape
^
ANY REQUIREMENT OF ANY CITY ORDINANCE
Insp.
Total
Amt. Due
p(6.
=
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.*
Recording Fee
Receipt
#
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION
APPROVAL
GIVEN IS CORRECT; AND THAT 1 AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
This application is not a permit until signed by the
TION;
AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
Building Official or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
receipt is acknowledged in space provided.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
I LS SIGNAT ATE
SIGN TUR
(OW E OR AGENT):
DATESI NED
(425)
771 -0220
RE ED BY DAT
ATTENTION
'A
EXT.1333
IT
IS UNLAWFUL TO USE OR OCCUPYBUILDING OR STRUCTURE UNTIL
A
FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI-
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / IBC110 / IRC110.
oRlcl AL - ILE - YELLOW - INSP CTOR
4n1AA
PIN NER - GOLD - ASSESSOR
.... .
0- •
PLANNING DATA
NAME: or, vC-,if" DATE: 1 /20 /os
SITE ADDRESS: I & 7-1 A 29 P1, W, 1 ['70'- PLAN CHK#: aq -4-/s-
PROJECT DESCRIPTION:
eta -cam 15 °
REDUCED SITE PLAN PROVIDED?:(Ye / No)
MAP PAGE: 5a7 CORNER LOT: es / FLAG LOT: Yes
ZONING: RS - 12 CRITICAL AREAS DETERMINATION #: 199 -7 - 04-0
❑ Study Required:
Q Waiver sr. -,,,A A sw? f co( Cn'Trtk A tm Art'w.0 Y Rnq , VR IZO 4" qPn 'A -4, V - 0413
"% J fianAh^Y `,hum ije,w, F[ccty .%°.+� �2",�W„ P ! ' , 72" (,r,ccti.:� eca,u.H•.
❑ Conditional Waiver fj t-, Ko sMc, 30' ti F,o4u.L.. NPorr
SEPA DETERMINATION:
❑ Fee (Na SW4
❑ Checklist
❑ APO list w/ notarized form
❑ Needed for 500 cubic yards of grading, Shoreline Area- site within �=Puget Sound or Lake Ballinger)
Exempt
SETBACKS:,.. LS'
Required Setbacks: t , !
Street: Z5' Left Side: 10' Right Side: 1 O Rear: 30'
Actual Setbacks: 101 / u ,&— Se+i,,."
Street: 25' Left Side: Right Side: 7 CRear: 3o'
Street map checked for additional setback required?
LJ DETACHED STRUCTURES: ;At-1-C fK"
Ld ROCKERIES: aL- ;►, P-1,� ; ,n 70'.,P1. SPw-it '"* 0-(P417 h t1614 a c, _ 540. _ ok
❑ FENCES/TRELLISES: Inc. (hel ,
rLa BAY WINDOWS / PROJECTING MODULATION: Sha,.,n ors S,m 104,^ - M—ij X4+.-W4
-� STAIRS / DECKS: -fir a-,i fd-n 0— ' �j, KFrw►� P,w /,,,. r,,M,; 14.,,�� �- �a ti «r K..k
PARKING: Required: 2 Actu�fl
LOT AREA: 12_90 0
LOT COVERAGE o
Calculations: �Z� 990 %, °
BUILDING HEIGHT:
Datum Point: 4.— baca SW Datum Elevation: 2 70, 3(0
Maximum Allowed: 2 5' ( ?t$ ZjB. 75')Actual Height:
A.D.U. CREATED?: No / Yes _ yu<rr Soldti
L�H SUBDIVISION: t x-tikwq-- VAw 2 j I aF
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED:
OTHER: N64i, for UFre e►s haNarts 16 of - 70' Pt- r t.v •nr ..w f*�„6wc S S �+5�'c la <<fuv�v�
30' o' . ,2pe , I�w
Plan Review By:
NewB P P lanningD ataForm. D OC
_ _
'VA
�,,�.1, is Gay v�«•., —
na.li (,as..� oG .
_
r
ti 3a ' IrLN s •
oi` ?y
I
HRE VID AM ADDRESSIMM MMM
AgIguired Actual
I
GRADING QUANTITIES:
CUT: 350 cu yards
FILL: 12 cu yards
TIGHTLINE DOWNSPOUTS e
AND AREA DRAIN TO 30" 0
x 18' DETENTION PIPE,
CONTROL MANHOLE LID at
262.0 OUTLET INVERT at
258.3', 3/4" ORIFICE, TO
Y OF EDMONDS
NDARDS _ I
ti
T. E. S. C.
-FILTER FABRIC FENCE--,
- BAG EXPOSED CB's
- SEED DISTURBED EA ;
ASAP
- ROCK CONST.
ENTRANCE AS REQ'D
FOOTING DRAWS o l
TO BE TIED INTO
d�TION SYS M `D
co
rn
o
U)
261.5 \
280.5
282.5
+ 270.5
= 1095
/4
vg elev = 273.75
+ 25
lht limit = 298.75 50 /
l
F=t
swe
Rw
odw
Hewn
APPROVED BY PANNING o3�b
,380.5
OWNER/CONTRACTOR IS RESPONSIBLE FOARIG;iT 07-7'AY CGtrS?Ft'CTIGN PERM
EROSION CONTROL AND DRAINAGE AND iASPECTI(M hEOURED
APPROVEI'`AS IVOTEI)'
BY I�INEE�ING.
70th Place West -
O S� S.99
DC.
`
/ /2 p ,
(280 _ \ 282.
(275L
6 .5 co - - — 0
5' ETBACK N rea Drain
\ p Rim:267.0
i t' CB 2 N Invert: 265.5
i : 261.46 m�\ 30' ASPHALT
1 v rt:254.4 .� -DRIVEWAY
6" CO w/ LOCKING
\ PHOLE C VEl
exi B �\
QQ
m: l
north - 1" = 20' 2/10/05
0
bs
1,0
—t—= v --
(270 w
o w
0
N O
to
270.50o0 11, 2„
- l cn TO GRID 8
exist'JI CB 1
o Rim: 70.36
Yi% Inve :259.7
WATER
14
M METER/ **DATUM**
1 — —
WATER SERVICE LINE
(5' MIN. FROM SIDE 72nd Avenue We
SEWER)
SURFACES 0
BE 00VWb W11THIN 2 DAYS
NOV-39-04 11:21 AM 4252590799
STANDARD DRAINAGE DETENTION SYSTEM
WORKSHEET
P. 07
owmmLLG -r ConISTLi I0r4
ADDlk=S i'• o . �o x l 2 I FROM : v2 2 � _ ¢
I?_o
f,v 'DATE: i 2 ' ° ¢ -
• • •"DESIGN DATA 40"s
IMPERVIOUS AREA PIPE DIA PIPE LG ORIRCE
tt ik
r
n MWM PIPS LOWN 1.ra "ma
j �ro
rna�
•
or
,ass to I; am �e A
' Calilml ,
NIN. •� �
UPPER CATCH BASIN ow'
CONTROL CATCH BASIN
SYSTFA! CROSS SB'CTIDN 0 20%
' R
PERMIT COUNTER
INxax6• .�. 4-6• >Xua M DUAL_
h
/Rat CatMa C� !'1t rx 0' i". 3,4' tea Imp= tattoo aluot
nm Comm mu an
• AIAW 00nff 1 1� vAs N0L1t
RUNOFF S,PBBADEA. TRENCH
E00WNG DRAINS SUALL NOT•,RB CONNECM 2V DE77JMON SYS=
L c Au 8%Ww ag Dividfa tr17l4m liar a tipltmm and dataaban sysba'"No b"
befoteand far and inepeatiooe.
2. aapa WMIY fbr opeazdm and tmlialammos of &Wup wjW= on p bafs PIWNIY b &D
s�r of dopeopeetar owner. Maoeeial aeaated is tbs ato�M�e pdps eamt b0 Am
ou and. mm l'iva 60 ukh wam to allow P wor "wWa L 1Lo aodd oontd arras
3nn
a2 i f`il i K
L1�' 304N12 =0.s0g
J Q' _J
C8 1-TYPE 1L
W/ FRAME & Oci(1,#6 L//J
RIM= 2(91.0
IE=11 fig_ 6
DETENTION TANK
N.T.S.
—CONTROL STRUCTURE
SEE BELOW
CB#2^-TYPE 1L
CONTROL STRUCTURE
W/ SOLID LOCKING LID
RIM= 262,0
IE= 25'9.S-
OE=2&49-d.
SOLID—\
LOCKING �--RIM=
COVER \ /
6" MIN. CLEARANCE FROM OVERFLOW
OE= 160. C?T TO BOTTOM OF RISER
T 8"CMP RISER
'3U "' IN
_8"CMP OUT
IE= z. 3
9" MINT �
ORIFICE DIA.=3/4" DRILLED
INTO SOLID PLATE
CONTROL STRUCTURE
TYPE 1L CATCH BASIN
N.T.S.
0
•
RECEIVED
JAN 12 2005
PERMIT COUNTEP
WM
x
13'
• 5' bend
3' deep X
11'
0' bend going down
1 � 4' deep
Back of the House
1'—Y4"PVC
SCH 40
370 psi
Back of the House
NOTICE: NO WARRANTY OF ACCURACY. The information shown on the attached map was compiled for use
by the City of Edmonds, its employees and consultants. The City of Edmonds does not warrant the accuracy of
anything set forth on the map. Any person or entity requesting a copy should conduct an independent inquiry
regarding the information shown on the map, including, but not limited to, 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 City of
Edmonds nor its employees or officers shall be liable for the information given on this map, nor for any oral
representation provided based upon said map.
72ND AVE W.
�� of ED�ro� CITY OF EDMONDS WATERLINE AS —BULL
4S d ADDRESS SCALE
16233 72ND AVE W NTS
HOMEOWNER CONTRACTOR
HILLCREST HILLCREST
DATE DRAWN PERMIT
3/1 /2006 BY �I. ABILA NO, 2005-0179
FIRE AND AID ADDRESS SW REMNO VUNtH/UUN I HACTOR IS RESPONSIBLE FOP, KIUH'I--Oj..V.AY CONSMMOTION PEROT
EROSION CONTROL AND DRAINAGE AND 11ASPECTItX! [,.EQLq[ ELp
2011a p- -;I- Corner Flag gr"d -W
GRADING QUANTITIES:
Front
CUT: 350 cu yards
Sides
FILL: 12 cu yards
Rear
Other
TIGHTLINE DOWNSPOUTS
I Hei&t
AND AREA DRAIN TO 30.. 0
.
Y 10, r)cTcK1T1r)K1 010c
Reguired Actual
D Ao I
CONTROL MANHOLE
OLE LID at AppROVE BY VLT"q""
262.0 OUTLET INVERT at / '
9 3', 3/4" ORIFICE, TO
'Y- OF EDMONDS
STANDARDS
T.E.S.C.
- FILTER FABRIC FENCE---\
- BAG EXPOSED CB's
- SEED DISTURBED RHEA
ASAP
- ROCK CONST.
ENTRANCE AS RE 'D
FOOTING DRAIN
1fo BE TIED T
29�
DETENTION SY
00
261.5
280.5
282.5
+270.5
1095
/4
vg elev = 273.75
+25
B
jht limit = 298.75 250 Ri
.1
ENTRIN!
4-
Z-K
'K
100
"10
9
' 6 .5
—
Drain
IT n
Rim: 267.0
2
i t' CB 2
i t, C B
Invert: 265.5
.5
6
i : 261.46
61 - 4
30'ASPHALT
rt 4 4
I I v rt: 254.4
2
-DRIVEWAY-
J�
6 6" CO w/ LOCKING " CO w C NG
VER PHOLE C ER
rRucmoN
APPPiOVEO"trAS.,'-'!NO,T,�,P....�
loth PlacEBv#e GI RING
"4 H,
0 h Pl"*' a'-
cq 0 9
99
0e..
:3 w
10 -
o
L6
I
p (
u,
N
O
Acn
M
-4
270.5
M
:n
0
Td'ID 8a 5 fp
0
_ i
CB 1
� =3
9
Z . 70
exist'
Rim: ?70.36
Invert: 259.7
co WATER
**DATUM
METER/ **
WATER SERVICE LINE
(5- MIN. FROM SIDE 72nd Avenue We
SEWER)
-ALL- UP6860 SURFACES M
Mai`;-108-06 08=34A ROB '',T N. PARNELL, PE 425 41-5095
1,
P.02
PRE -DESIGN REPORT
SANITARY SEWER GRINDER PUMP
CHARLOTTE GARDENS
EDMONDS, WA
FOR RECEIVED
JON KVERNMO
HILLCREST CONSTRUCTION CO., INC MAR - 9 2006
P.O. BOX 3121
EVERETT, WA 9812.3 BUILDING DEPT,
425 259-2775
0
BY
ROBERT N. PARNELL, PE
RN PARNELL CO
4422187T" PLACE SE
ISSAQUAH, WA 98027
(425) 643-3560 aJ"
MARCH 7, 2006
Mar-08-06 08:35A ROT N. PARNELL, PE 42E41-5095
1•
P.03
PRE DESIGN REPORT
CHECK LIST
SINGLE FAMILY
Qualifications of Enaineer: Robert N. Parnell, PE is a civil engineer registered
in the State of Washington, license # 19775. He has designed simplex and duplex
sanitary sewer pump stations with force main conveyances as well as gravity sanitary
systems.
Designs include a duplex sanitary sewer and force main for an office building serving
100 people for Weyerhaeuser Company, Enumclaw; several individual single family
residences serviced by a 2" PVC force main collector line discharging into a gravity
line within the Sammamish Plateau Water and Sewer District; an EPA grant design
for simplex grinder pump and force main collector serving multiple single family
residences due to failed septic systems along Puget Sound within the Ronald Sewer
District; and a duplex grinder pump 2" PVC force main system that discharged into a
8" DIP main line sanitary sewer force main for the Washington State Patrol Station,
Marysville, WA
Experience includes design for domestic and fire water, sanitary sewer, and storm
water systems for single family, multifamily, commercial, and industrial use.
Topographic Services Area Map:
Topographical limits of pump station service area. The attached map provided by
Hillcrest Construction Company, Inc. illustrates the residential lots to be served by the
grinder pumps, force mains to serve lots, and the location of the gravity system. Each
grinder pump lot, Lots #3, 4, 5, & 6 have individual 2" HDPE force mains that
discharge into the 8" gravity sanitary sewer. Length of force main varies from 36 feet
to 155 feet.
Property boundaries. Each lot with property boundary is shown on the map.
160 Year Flood Plain line. The site is outside the 100-year flood plain line
Location of nearest sewage collection system piping. Location of 8" gravity
sewer main is shown on the map and is the manhole located within the 5-foot wide
utility sewer easement on lot #3.
Location of sewer stub that the force main will connect to. This location is the
manhole located within the 5-foot wide utility sewer easement on lot #3 and then
discharges into SSMH#2.
Location of water service to the house(s). Water meter locations are shown on the
map. Sanitary sewer force mains (7' dia. HDPE) will be under the water meters and
home service lines. Location of house(s) with water service lines and side sewers to
be provided by contractor. Separation of water and sanitary sewer lines to meet
health department codes such as 10-foot horizontal separation and sanitary sewer
line to be under the water line by at least 18" when crossing.
ECEIVE®
MAR - 9 2006
BUILDING DEPT.
Mar-08-06 08:35A RO T N_ PARNELL, PE 42!*41-5095 P.04
Design Calculations
Present, design, and ultimate water fixture counts and their associated flows.
Each new single family home is assumed to have three bathrooms totaling three
toilets, four bathroom sinks, three showershubs; kitchen with sink, .dishwasher,
garbage disposal, and laundry room with clothes washer. Outside hose bibs will not
be connected to sanitary sewer system. Associated flows indicate bathroom units are
8 gpm, kitchen sink with food grinder is 3 gpm, dishwasher is 2 gpm, cloth washer 2
gpm. Maximum peak sanitary sewer flow is estimated at 3 x 8+3+2+2 = 31 gpm.
Average daily flow from a typical residential dwelling is about 50 gals/capita/day. For
a family of four, an estimate of volume is 200 gallons/day per residence.
Proposed grinder pump curve and system curve. Hydromatic curve for HPGR is
attached.
Pump station hydraulic computations: (see attached calculations)
Pump cycle time ( minimum twice daily)
Wet well capacity (165 gallons)
Flushing velocity (2.5 ft/sec min)
Force main hydraulic losses (various based on static head and FM losses)
Minor Hydraulic losses due to valve and fittings (Assume 2 foot head loss)
Net positive suction head (Yes vacuum not created)
Sump basin anti -flotation calculations Provided by manufacture
Soil Bearing pressure: Assume 2000 psf
Electrical Power Requirements 230 volt single phase 15 Amp dedicated circuit
Other applicable calculations (Provided as requested)
Additional Submittal Requirements checklist
Manufactures data, drawings and details for preassembled grinder pump
station and instrumentation clearly indicating compliance with all specked
requirements. (Catalog cut sheet attached)
Documentation of source of supply and or repair located within 24 hour
delivery time. ( Supplier name )
Drawing showing location of pump station, discharge line, connection to sewer
main, cleanouts, fittings, and alarm panel '(audio and visual) etc. (see attached
site map provided by developer/contractor) Grinder pump to be located at least 5 feet
away from structure and within 15 feet of a home hose bib. Alarm panel to be located
outside of home along side of home visible from street. Power from home electrical
box on dedicated 120 volt 20 amp circuit with buried line located in non-metallic
casing. There will be a 4" clean out between home sewer line and the grinder pump.
The 2" HDPE force main is already in place and is shown on the site map adjacent to
the road within a 5 foot sanitary sewer easement.
MAR - 9 2006
BUILDING DEPT,
Mar-08-06 08:35A ROB N. PARNELL, PE
42E*41-5095 P.05
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Mar-08-06 08:35A RO T N. PARNELL, PE 42 41-5095 P.06
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MAR •- 9 2006
BUILDING DEPT.
Mar-08r06 08:36A ROf ,N. PARNELL, PEN`J 425W1-5095 P.07
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MAR — 9 2006
BUILDING DEPT.
sosL-ess (osel
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Mar-08-06�08:36A RO N. PARNELL, PE �. 42 41-5095
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RECEIVED
MAR - 9 2006
BUILDING DEPT,
OIT;" JD Li uer
Mar-08-06 08:36A ROB T N. PARNELL, PE 42 41-5095
P . 10
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CNAWL, CWE COAT, AIR DRIED,
MAXIMUM LIOUlb 140"F
MAXIMUM STATon
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PAGE 06/13
RECEIVED
MAR - 9 2006
BUILDING DEPT,
o, aa�aer EH e T "I T 9D / i uer
DWELLING
5' MIN
2'
-+ C
GRAVITY FLOW
FROM DWELLING
PROPERTY OWNER PUBLIC RIGHT-OF-WAY
PUMP CONTROL
PANEL PROPERTY LINE
/— LOCKING 1 AMPHn1 r rnvco
GRINDER PUMP
ASSEMBLY
FINISHED
GRADE
3' MIN COVER
FORCE MAIN
2' IPS POLY HI-MOL PIPE
(200 PSI)
GRINDER PUMP SERVICE LINE NOTES
12" PVC SLEEVE
6" RISER
6' WYE AND 45'
AND 1/8 BEND
�I
I
TYPICAL SIDE SEWER
SEE DETAIL 'A'
I FOR CONNECTION
IN THIS AREA
ROADWAY
GRAVITY SEWER MAIN
I
PROPERTY OWNER I PUBLIC RIGHT-OF-WAY
GLUED
MAINORCE _\ f 6' SDR 35 PIPE
I. WRAP AND TAPE 12 GAUGE TRACER WIRE EVERY 10' TO THE FORCE MAIN.
2. THE LOCATION OF THE STUB SERVICE TERMINATION SHALL BE MARKED BY
THE CONTRACTOR WITH 2' X 4' TIMBER EXTENDED VERTICALLY FROM THE
PLUG END TO A MINIMUM OF 3' ABOVE THE GROUND SURFACE. A 12-GAUGE
GALVANIZED WIRE SHALL BE ATTACHED TO THE TIMBER FROM END TO END.
NEITHER THE WIRE NOR THE 2' X 4' SHALL BE ATTACHED TO THE SEWER
PIPE OR PLUG. THE EXPOSED PORTION OF THE 2' X 4' SHALL BE
PRE -PAINTED TRAFFIC WHITE WITH THE WORDS 'GRINDER PUMP SEWER
CONNECTION' STENCILED ON WITH BLACK PAINT. THE END OF THE 2' X 4'
SHALL BE PRE -MARKED IN PERMANENT INK WITH THE LENGTH OF THE
TIMBER INSTALLED.
3. GRINDER PUMP VENTILATION SHALL BE CONNECTED TO THE HOUSE
SEWER VENTING SYSTEM, PER NFPA CODE.
IC90-199IJ
6' SDR 35 SPIGOT (W/ 6' GASKET)
X 4' SCH 40 HUB
/4"' X 2' SCH 80 SLIP
X THREAD BUSHING
2' BRASS MIP X IPS COMPRESSION
FITTING WITH STAINLESS STEEL INSERT
DETAIL 'A'
CITY INSPECTI❑N
REQUIRED PRI❑R
TO BACKFILL
C-1-TY D:F:..-E-D:M:O:.N�D.
REVISIONS STAN DAR D DETAIL
APPROVED BY DATE
A GERM 6/16/03 GRINDER PUMP SERVICE CONNECTION TO GRAVITY SEWER MAIN
A GEMT 6/23/03 DATE SCALE DWG NO.
5/9/02 NTS E6.9
G-itical Areas Checklist 9-7
Site Information (soil
sltopography/hydrology/vegetation) ?' �L
i. Site Address/Location: ,AW645Kr qD • 10209 - 10ft- W • tVMOMV7, �'(PD2-6
2. Property Tax Account Number:. 6+15 000 - 004 -00 - of
3. Approximate Site Stze'(acres or square feet):
13, 6,00 ew
4. Is this site currently developed? yes; no.
If yes; how is site developed?
5. Describe the general site topography- Check all that apply.
Fiat: 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: NO ; Approx. Depth:
7. Site contains areas of seasonal standing water: No ; 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? t/ Flows are seasonal? (What time of year? ).
10. Site is primarily: forested ; meadow ; shrubs ; mixed ✓
urban landscaped (lawn,shrubs etc) _
11. Obvious wetland is present on site: .
p For City StalT Use Only
1. Site is Zoned? R s— I ti
2. SCS mapped soil type(s)? �„/o� 1 Ur�o��i✓ 4,4k-/d+
3. Wetland inventory or C.A. map indicates wetland present on site? Al 6
4: -- :-..Critical Areas inventory or C.A. map indicates Critical Area on site?
5..' Site within designated earth subsidence `landslide, hazard area? /1/D
6. Site designated on the Environmentally Sensitive Areas Map? Ygs, S� tep S�opes
DETERMINATION `
`STUDY REOUIRED
WAIVER
Reviewed by:
Plan&r
CONDITIONAL WAIVER
03
Date. ,
S'FPA w� �l be r�a�,red .r 0S,+ ,4,0"e,✓4
0
City of Edmonds
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 Ball (Critical Areas inventories, maps,
or soil surveys).
An applicant, or his/her representative,
must fill out the checklist, sign and date it,
•
RCCEIVED
MAR 17 1997
PERMIT COUNTER
and submit it to the City. The City will
review the checklist, make a precursory;site
visit, and make a determination of the
subsequent steps necessary to complete a
development permit application.
With a signed copy of this form, the
applicant should also submit a vicinity map
or plot plan for individual lots of the parcel.
with enough detail that City staff can find
and identify the subject parcel(s)_ In
addition, the applicant shall include
other .pertinent information (e.g. site
plan, topography map, etc.) or studies in
conjunction with this Checklist to assist
staff in completing their preliminary
assessment of the site_
I have. completed the attached Critical Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant:
pw �MAz1I-YN 7D-
Name
KO *111Y AcvvO� � - APJ44g - TV
IIo20Q - 70'V •PL,. .1Av
Street Address
I�VwmpD ' VWNC �SOLb
City, State, ZIP Phone
Signature
Date
Applicant Representative:
40VW W_ I tuap Law
Name
lbZOZ - 7LND AJ9 • W.
Street Address
t5pMoNp'51, u1k G A92-6 - 746--bf-"
City, State, ZIP Phone
e� 3. /7. '
4Sia+tur Dale
CITY OF EDMONDS
121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771-0221
Website: www.d.edmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
In C. 1890 Planning • Building • Engineering
July 18, 2006
Mr. Wayne Lennstrom
16233 72nd Ave W
Edmonds, WA 98026
RE: Remove fence from around the on -street turn around on 72"d Ave W
Mr. Lennstrom;
GARY HAAKENSON
MAYOR
This letter is a f6llow up to our conversation a few weeks ago with regard to the fence
you installed around the on -street turnaround on 72nd Ave W. The turnaround, located
within the City right-of-way is for vehicle turn around only, and as such, the fence will
need to be removed to allow full unrestricted use of the turn around. Please remove the
fence around the turn around by July 28, 2006.
It is my understanding that some residents in the area are using the turn around as a trash
pick up point. Appropriate signage will be added to indicate the turn around is for turn
around purposes only.
Thank you for you cooperation. If you have any questions, please call me at 425-771-
0220 ext 1324.
Sincerely,
4tfi Chrisman
Engineering Program Manager
Cc: street fide
ike Thies, Code Enforcement
V:\letters\Lennstrom-tumaround fencing.doc
0 Incorporated August 11, 1890 0
attached man j.
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11'
1'
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.4
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--90' bend going down
4' deep
1—Y4" PVC
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370 psi
Back of the House
72ND AVE W
m
A/
�� of Eqo� CITY OF EDMONDS WATERLINE AS —BUILT
O ADDRESS SCALE
16233 72ND AVE W NTS -
m
HOMEOWNER CONTRACTOR
HILLCREST HILLCREST
DATE DRAWN PERMIT
3/1 /2006 BY I. ABILA NO, 2005-0179
InC.1890
Oct 13, 2006
CITY OF EDMONDS
121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771-0221
Website: www.ci.edmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
Planning • Building • Engineering
Mr. Wayne Lennistrom
16233 72nd Ave W
Edmonds, WA 98026
GARY HAAKENSON
MAYOR
RE: Recycle/trash enclosure fence in the City right-of-way at 16233 72nd Ave W
Mr. Lennistrom;
This letter is a follow up to our issue with the trash enclosure in the City right-of-way
there on 72nd Ave W. As you know, initially we required you to remove the recycle/trash
enclosure, but after some confusion, delay and discussions with the staff members, our
latest position is, the enclosure may remain as located. However, you will be required to
obtain an encroachment permit since the fencing and curbing is in the City right-of-way.
You can pick up an encroachment permit application here at City hall. One of the permit
requirements the permit is to obtain insurance, and the permit will be recorded against
your property.
Please submit the encroachment permit by October 23, 2006.
Although the encroachment permit allows you to leave the fence and curbing within the
right-of-way, if it becomes a safety issue or is not properly maintained, the City can
revoke the permit at any time.
If you have any questions, please contact me at 425-771-0220 ext 1324.
Sincerely,
Lyle Chrisman
Engineering Program Manager
Cc: street file
Mike Thies, Code Enforcement
V:\letters\Lennstrom-encroachment fence permit.doc
Incorporated August 11, 1890
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ENGINEENNG HLE COPY
24 HR. NOTICE REQ.
FOR INSPECTION
D AS NOTED
APPROVE
'BY ENGINEERING
ate: �� O�
0 10
-Traffic control set-up for minor encroachment
PROJECT'S TIMELINE AND PROPOSED HOURS OF OPERATION:
• Timeline - Up to 30-days past the issue date.
• Work Hours -The entire project area will be conducted from 7:00 AM tr
as specified by the Inspector. v- (pfv---- Ali) Q L) 1-0
ND KDE-e-A-L ACOLI-54,
Traffi
c Control Plans OOZ A
1 The standards and "bidgif6f-the latest version of the MUTCD or as set-up per 1 4
Code shall be folloWe&VA'11.1times.
2. A copy of the Permit arid -Traffic Control Plan 'shall be on -site with all "X
contractors during the'--Ir6'Jqc*t.-,;
3
3. All contractors will aV:*6`id,-1Ygiking on sidewalks and shoulders and will take the
3 lane and follow the pr6p&!tfAffic control set-up for the given situation.
A Pedestrian access snalli
sites. 'S A FC-
CY
5. Please find attached;
, th4
sites that will be encobA
AS
6. Flaggers will be usedoh
inadequate to warn and
the project.
7. If situations occur whiffi-i
solution will be deteffiiiiii
and the Inspector.
If curb and gu I ieo
• Filter bags will be pla,
• Small check dams of,
gutter upstream of the
comcas.
Lamed through or detoured around all work
tic control plans for the various types of work
kduring our project.
,,n all other methods of traffic control are
drivers. Only licensed flaggers will be used on
3 arise about* proper traffic control set-up the
field with the Cbmcast Construction Rep.
ject area:
sins downstream of work site, and
d sandbags will placed within the
()euo!1do)
M or
Truck Mounted
Attenuatot
)optional)
.,�w,Traffic control set-up for lane closure
lit
100,
Buffer space
FLAGGER STATION
0
•
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L.J
0
9
Depth, Cleaning, Containment;
Compaction, and Restoration
Depth
♦ 36-inch minimum
♦ Compatible w/
other utilities
♦ Shoring required
at 4-ft +
Pavement Cuts = :.
♦ T-cut 1-ft wider
than trench
♦ Neat -line saw -cut
or jackhammered
edge.
■► All trench backfill shall be mechanically
compacted to 95 percent of maximum density
using 1-ft loose lifts with, whacker or 2-ft loose
lift with:a hoe pack
♦ If proper compaction ta' nn6f lib kfiiev'edv with the ~
native material, new import material is required at
the 95 percent rate.
■► As an alternative, CDF can be used in a design
mixture approved by the Engineer.
Ccomcast
CLEANING: All Streets and roads are required to
be cleaned and swept both during and after the
installation work.
♦ Mechanical Vacuum is preferred method
CONTAINMENT: All un-restored shoulders or
material storage areas are required to be contained
with reflective barricades.
All disturbed areas shall be restored to
existing or better conditions ! ! ! ! ! ! !
Trench parallel to road:
♦ Shoulder - Match existing surface conditions
!► : Pavement - 6 1/2 inches of crushed surfacing material
and asphalt concrete Class B at 2- inches minimum or
same -thickness if greater..
Trench across road (immediate cold mix patch):
♦ Asphalt - Permanent hot mix patch at same thickness
or 2-inches and sealed within 30 days.
♦ Concrete,- saw cut and pored with mastic joints, eight-
sack.mix; either type II of III cement, within 30 days.
y
City of Edmonds Permit No:
RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date: % �064
A. Address or Vicinity of Construction:
B. Type of Work (pe specific): Ci"` O& ,SD i h A I t 4 -e47 l Ynl 011d b ,,r_
Q C. Contractor: COM 4F1_C1'JC— "A / L L
Mailing Address:
:..� ... CLV e rYTr r w14 cl oZ 03
Sate License #:
City Business License #:
Contact: IK elrr I&M- GY`
Phone:
Liability Insurance: Bond: $
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. ❑ Commercial ❑ Subdivision ❑ City Project XEUC (P COMCAST, 4fl)
❑ Multi -Family ❑ Single Family ❑ Other
"`'=`INSPECTOR:
F. PAVEMENT CUT: ❑ YES NO G. SIZE OF CUT X
CONCRETE CUT: ❑ YES MNO
G. 34 Mail Approved Permit ❑ Call for Pickup
INDEMNITY. 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 tothe 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 EXCEPTIONSt-
♦ Three sets of construction drawings of proposed work are required with the permit application.
CALL DIAL -A -DIG (17800-424-5555) PRIOR TO BEGINNING WORK
I HAVE READ THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE
THAT I MUST MAKE THE PINK C Y F THE PERMIT AVAILABLE ON SITE AT ALL TIMES FOR
, INSPECTIONS
Signature: Date: t/o,ff/- 09
or Agent)
FO CITY' USE'ONLY ;
<Approved;by: f r rwt..�:ac�. _ Rlgfit of way Fee �JQ'J[�/^/�e
Time Authorize Void'After / : /' �O DisruptionFee/,Fun'dll`,191
Special Condition nspechon
T0ta1Fee: 2 7
:- Receipt-N6Q,
Issued'by: -
tom.
1.
REQUIRED INSPECTIONS: 6,) rz.� P .C'1
all 425-771�0220, Ext 326 for a 24-hour voice -recorded ins ection request line. crI
FINAL P QF P T D WORK: _ DATE:
snector's Sign re
M
NO WORK SHALL
BEGIN
PRIOR
TO PERMIT ISSUANCE
CADocuments and Settings\CurtisNy Documents\Fomu\Engnmg\ROWpettnit_ doc
Revised 10/01/03
i
•
Consulting
Robert M. Pride, Inc. Engineer
April 14, 2005
Mr. Jon Kvemmo
Hillcrest Construction Co. Inc.
4003 Nassau Place
Everett, WA 98io9
Re: Construction Inspection
New Residential Construction (Permit No. 2005-0179)
16214 — 701" Pl W
Edmonds, Washington 98026
Field Inspection Memo, (Thursday, 4-14-05)
Arrive site this AM (l000 hrs) to check installation of subsurface drain system, as per
City of Edmonds requirement. Observe that footing and down spout drain lines had
been placed, and were exposed for inspection. These systems were separate, and not
interconnected in the dwelling area. Footing drains consist of 4 inch diameter "tripple
wall" perforated pipe (ASTM F 810), which has been placed with glued joints.
Perforations have been placed along the exterior side of the footing "holes down".
Drains have been set so that gravity drainage is established toward the north.
Understand that washed'drain rock will be placed around and over the perf. Pipe.
Down spout drains are constructed of 4 inch diameter, rigid, non -perforated pvc pipe.
Connections employ glued joints. These drains have been set above or at the level of the
footing drains, and gravity drainage has been established to the north.
Above drain systems have been constructed as per industry standards, and are
considered acceptable to this office.
W.L. Bicket, L.E.G.
Engineering Geologist
Robert M. Pride, P.E.
Principal Geotechnical Engineer
13203 Holmes Point Drive NE Kirkland, WA 98034
Phone: 425-814-3970 Fax: 425-814-5672
Return Address:
Richard R. Beresford
145 Third Ave. S., #200 CONFORMED' Copy
Edmonds, WA 98020 200507010845 9 pGS
07-01-2005 02.23pm $77.00
SNOHOMISH COUNTY, WASHINGTON
Please print or tjW information WASHINGTON STATE RECORDER'S Cover Sheet CW 65.04) •
Document Tftle(s) (or transactions contained therein). (all areas applicable to your document must be filled in)
1. Declaration of Sewer Easement
Reference Number(s) of Documents assigned or released:
Additional reference #'s on page of document
Grantor(s) (Last name, first name, Initials) ---f
1. Hillcrest Construction Company, Inc.
Additional names on page of document.
Grantee(s) (Lag name first, then first name and initials)
1. Christopher Doyle, a single person
Additional names on page of document. •
Legal description (abbreviated: i.e. lot, block, plat or section, township, range)
Lot 4 of Westmont View Division No. 2, according to Plat recorded in Volume 36 of Plats at Pages 24 and 25, in
Snohomish County, Washington
Additional legals are on pages 6 and 7 of document
Assessor's Property Tax Parcel/Account Number 0 Assessor Tax # not yet assigned
0064 9500 0004 00
The Auditor/Recorder will rely on the information provided on the foam The staff will not read the document to
verif
Y the aocuracy or completeness of the indexing information Provided herein.
I am requesting an en wgenc'y nonstandard recording for an additional fee as provided in RCW 36.18.010. I understand
that the recording processing requirements may cover up or otherwise ob== some part of the text of the onpial
docum it ;iN
Return Address:
Richard R Beresford
Beresford Booth, PLLC
145 Third Avenue South
Suite 200
Edmonds, WA 98020
Document Title(s): DECLARATION OF SEWER EASEMENT
Assessor's Property Tax Parcel I Account Number: 0064 9500 0004 00
Reference Number(s): None
Grantor(s): Hillcrest Construction Company, Inc.
n
U
Grantee(s): Christopher Doyle, a single person •
Legal Description:
Lot 4 of Westmont View Division No. 2, according to Plat recorded in Volume 36
of Plats at Pages 24 and 25, in Snohomish County,Washington.
DECLARATION OF SEWER UTILITY EASEMENT
Pro gy Qmmers and Legal Descriptions of PropgM Owned:
PARCEL 1:
Owner of Record: Hillcrest Construction Company, Inc., a Washington corporation
Legal Description (Burdened Parcel):
Situate in the County of Snohomish, State of Washington.
Tax Parcel No.: 00649500000400
PARCEL 2:
Owner of Record: Christopher Doyle, a single person
Legal Description (Benefited Parcel):
Situate in the County of Snohomish, State of Washington.
Tax Parcel No.: 00649500000500
THIS AGREEMENT is made this day of June, 2005 between Hiflcrest Construction
Company, Inc., a Washington Corporation hereinafter referred to as "Grantor," and Chnstonher
Doyle, a single person.,hereinafter referred to as "Grantee".
The Grantor, for and in consideration of mutual benefits to be derived, hereby grants and conveys
unto the Grantee the following easement:
A non-exclusive SEWER UTILITY EASEMENT across, along, -in, upon, and under the Grantor's
property described below for the purpose of constructing, reconstructing, operating maintaining, and
repairing the sewer utility line(s) and appurtenances attached thereto, but specifically excluding
sanitary (side) sewer service lines between the cleanout and the structure being served, together with
the right of ingress and egress from said property and across adjacent property of the Grantor for the
purpose of piling dirt and providing trench stabilization during the construction, reconstruction,
operation, and 'repair of the aforesaid improvement or facility.
The SEWER UTILITY EASEMENT is over and across a portion of land situated in the County of
Snohomish, State of Washington, and legally described on Exhibit A attached hereto and incorporated
herein by this reference. The easement area is further depicted on Exhibit B attached hereto.
This easement is granted subject to and conditioned upon the following terms, conditions, and
covenants:
The Grantor and the Grantee shall at all times conduct their respective activities and all other
activities conducted on Grantor's property so as not to interfere with, obstruct or endanger
the usefulness of any improvements, or other facilities, now or hereafter maintained upon or
adjacent to the easement, or in any way interfere with, obstruct or endanger the Grantor's or
the Grantee'.s use of the easement.
2. Upon completion of any construction, maintenance, repair, or work on the Easement by the .
Grantee, its agents, employees, and contractors, the Grantee shall repair, replace and restore
all grass, landscaping, trees, fences, water and/or irrigation pipes, asphalted, concrete or
Paved surfaces and any other improvements located on the Easement, orthe adjacent property
of the Grantor that may be damaged or disturbed in the prosecution of any work by the
w
Grantee or the Grantee's Agents and shall otherwise restore the surface condition to the same
or substantially the same condition that it was in prior to such work by the Grantee so that
Grantor may have free and unobstructed use thereof, subject to the rights of the Grantee
contained herein.
3. Notwithstanding the preceding condition, the Grantor hereby authorizes the Grantee to cut,
trim, and remove any and all brush, trees, and other vegetation or debris, which, in the
Grantee's reasonable judgment, constitutes a hazard to the normal use of the sewer utility
line(s) and appurtenances attached thereto within the easement area, along with the right of
access for such purposes. •
4. The Grantor agrees that title to all brush, trees, and other vegetation or debris trimmed, cut
and removed from the easement pursuant to this Agreement, and where all brush, trees, and
other vegetation or debris trimmed, cut and removed from the Grantor's land, pursuant to this
Agreement is vested in the Grantee, and that the consideration paid for conveying said
easement and rights herein described is accepted as full compensation for the exercise of any
said rights.
5. The Grantee does release, indemnify, and promise to defend and save harmless the Grantor,
its officers, employees and agents from and against any and all liability, loss, damage, expense,
actions, and claims, including costs and reasonable attorney's fees incurred by the Grantor, its
officials, employees and agents in defenses thereof, asserting or arising directly or indirectly
on account of or out of any act or omission of Grantee, its agents, contractors, licensees,
6. This easement shall be construed as a covenant running with the land, and shall be binding
upon the undersigned owners, their heirs, successors, and assigns, in perpetuity, or until
eliminated by mutual agreement of the undersigned or their successors.
7. The Grantor covenants and warrants that- it is the owner of the property on which the
easement is situated; and it has the right to convey the easement interest in the property
described herein, and that title of the property is free and clear of any encumbrances that
would interfere with the ability to grant the easement.
8_ Grantee shall be responsible for all costs, expenses, assessments, and liabilities which may •
arise in connectiod with Grantee's construction and maintenance of sewer utilities and
appurtenances within the easement area, but only to the extent that the same serve the
Grantee as the benefited property owner. ' = 0, ; . _
9. Grantee shall crake provisions satisfactory to Grantor for continued access by Grantor along,
over, and across the easement area during periods in which the Grantee is conducting
construction, maintenance or other activities in accordance with the purposes ofthe easement
granted herein.
10. This easement has been reviewed and approved by each of the parties. In the event it should
be determined that any provision of this easement is uncertain or ambiguous, the language in
all parts of this easement shall be in all cases construed as a whole according to its fair
meaning and not strictly construed for nor against either party.
Executed as of this date herein above set forth.
Grantor:
HII.LCREST CONSTRUCTION COMPANY, INC.
By: Jon Kvernmo, its President
Grantee:
0
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•
EXHIBIT A
EASEMENT LEGAL DESCRIPTION:
An easement for sanitary sewer utility pipeline purposes, ten feet in width, lying five feet on each
side of the following described easement centerline, under and through that portion of Lot 4,
Westmont View Division No. 2, according to the plat thereof recorded in Volume 36 of Plats,
pages 24 and 25, records of Snohomish County, Washington, described as foilows:
Commencing at the northwest comer of said Lot 4; thence S I'47' 5 8 . E, along the westerly line of
said Lot 4, for a distance of 21.06 feet to the intersection of the existing sewer pipeline witFsaid
westerly fine, the True Point of Beginning of this easement centerline; thence S8�3 "55' 11"E, along
said existing sewer pipeline, for a distance of 82.54 feet to a point on the easterly line of said Lot
4 which bears S22°34'59"E a distance of 32.33 feet from the northeast corner of said Lot 4;
Located in Snohomish County, Washington.
EXHIBIT B.
See attached.
•
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EASEMENT LEGAL DESCRIPTION:
An easement for sanitary sewer utility pipeline purposes, ten feet in width, lying
five feet on each side of the following described easement centerline, under and
through that 'portion of Lot 4, Westmont View Division No. 2, according to the plat
thereof recorded in Volume 36 of Plats, pages 24 and 25, records of Snohomish
County, Washington, described as follows:
Commencing at the northwest corner of said Lot 4; thence S1°47'58"E, along the
westerly line of said Lot 4, for a distance of 21.06 feet to the intersection of the
existing sewer pipeline with said westerly line, the True Point of Beginning of this S
easement centerline; thence S83°55'11°E, along said existing sewer pipeline, for
a distance of 82.54 feet to a point on the easterty fine of said Lot 4 which bears
S22034"WE a distance of 32.33 fixg from the northeast conVr of said Lot 4;
Located in Snohomish County, Washington.
rz
exw�s it . �2�q6
4•� 2a�
03/01/2006 06:22
4252590799
•
HILLCREST
PAGE 01/02
P.O. Box 3121
Everett, Washington 98213=1121
Office: (425)259-2775 Mobile: (425)870-1178
Fax: (425)2594799 E-mall: Jonkvernmo@verizcn.net
To: Jaime Hawkins From: Jon Kvernmo
Fax: 425.771.0221 Pages: 2, Including cover sheet
Phone: 425.771, 0220 Date: 311 /06
Re: Westmont View CC:
❑ Urgent ❑ For Review O Please Comment ❑ Please Reply O Please Recycle
0 Jaime, After our meeting yesterday morning, I found the sewer easement provisions that
serve the property to the east of us. I have made a copy for you to take, and will have it
with the permit. Please take it.
Also, 1 found that we had a special Inspector look at the subsurface drainage systems
(including tightlines and footing drains). I have included his report with this fax It appears
that you had also Initialed the permit card. I trust that this will take care of the inspection
requirements for these two Items.
We will be hand digging to expose the connections to the water supply this morning. I fully
expect to have them exposed for Inspection early this morning.
I received your message that you plan to be at the site at about 8:30 this morning. 1 also
had a conversation with one of your assistants regarding some of the inspection
particulars. She indicated that you would come this afternoon. Could you call me on my
cell phone to confirm when you will be coming? (425.870.1178)
We're looking forward to completion of these requirements.
Regards,
.Jon Kvemmo
03/01/2006 06:22 4252590799 HILLCREST PAGE 02/02
Consulting'
Robert M. Pride, Inc. Engineer
April 14, 2005
Mr. Jon Kvcmmo
Hillcrest Construction Co. Inc.
4003 Nassau Place
Everett, WA 98io9
Re: Construction Inspection
New Residential Construction (Permit No. 2005-0179)
16214 — 70ch PI W
Edmonds, Washington 98026
Field Inspection Memo, (Thursday, 4-14-05)
Arrive site this AM (i000 hrs) to check installation of subsurface drain system, as per
City of Edmonds requirement. Observe that footing and down spout drain lines had
been placed, and were exposed for inspection. These systems were separate, and not
interconnected in the dwelling area. Footing drains consist of 4 inch diameter "tripple
wall" perforated pipe (ASTM F 8xo), which has been placed with glued joints.
Perforations have been placed along the exterior side of the footing "holes down".
Drains have been set so that gravity drainage is established toward the north.
Understand that washed drain rock will be placed around and over the perf. Pipe.
Down spout drains are constructed of 4 inch diameter, rigid, non -perforated pvc pipe.
Connections employ glued joints. These drains have been set above or at the level of the
footing drains, and gravity drainage has been established to the north.
Above drain systems have been constructed as per industry standards, and are
considered acceptable to this office.
c
W.��
W.L. Bicket, L.E.G.
Engineering Geologist
Robert M. Pride, P.E.
Principal Geotechnical Engineer
13203 Holmes Point Drive NE Kirkland, WA o8034
Phone: 425-814-3970 1 Fax: 425-814-5672
Nov.22 04 01:08p ROBERT M PRIDE ING 425 814 5672
p.1
Consulfing
Robert M. Pride, Inc. Engineer
�ll02�� — 7•�a , mil/(%
November 22, 2004
Mr. Jon Kvemmo
I1Mcrest Construction Co. Inc.
4003 Nassau Place
Everett WA 98201
RECEIVED
Re: Report on Geotechnical Investigation
Proposed Residential Project DEC 10 2004
72a Avenue West
Edmonds, Washington PERMIT COUNTER
RMP Project No. 04-187-ox
Dear Mr. Kvemmo,
This report presents the results of our recent exploration program at the site. of your
proposed residence located at the north end of 72nd Place West in Edmonds. It is
understood that the residence footprint has been modified to provide for access off of
7ind Place ins-tead of the loth Place cul-de-sac on the east side of the property. Revised
plans for this project were prepared by Lee Kirk AIA dated September 28, 2004, and
they were used as a reference for this supplemental report. Our preliminary
geotechnical report submitted on June 28, 2004 provided basic design criteria for the
residence foundations, and will be superceded by this design report.
Site Ines bgation
A total of five exploratory test pits were dug on the slope and level pad areas to develop a
soil profile under the proposed residence. Maximum depth of these test pits was nine
feet, and their locations are shown on the a nached Drawing No.1. Summary logs of the
five test pits are shown on Table No.. i.
Each of the exploratory.pits dug on the slope showed a thick layer of topsoil and
coliuvial deposits within the upper 3 to 4 feet. Below the silty sand colluvial soils were
outwash soils consisting of fine to medium silty sands and sands. These glacial Outwash
deposits were medium dense to dense and extended the full length of the west facing;
slope on the property. Fill soils exist on the upper. 5 to 6 feet of this native slope, and
they support the westerly end of the paved cul-de-sac on 70th Place located at the top of
this slope.
Test pits TP-3 and TP-4 located at the southwesterly corner of the proposed residence
encountered fill soils and organic debris that had been buried in an old drainage swale
that originated on the west -center of this property. Depth of this organic fill ranged
13203 Holmes Point Drive NE Kirkland, WA 98034
Phone: 425-$i4-3$70Fax 425-814-5G72
STrh""EETFILE
Nov 22 04 01:08p ROBERT M PRIDE ING 425 814 5672 p.2
November 22, 2004
Mr. don Kvemmo
Page 2
from 6 to 8 feet, and the 0 did not extend a$ far as the southwest corner of the
footprint. Wow the fill was a thin topsoil layer underlain by colluvial sons similar to
those encountered in the test pits on the slope. Groundwater seepage was not found in
any of the test pit explorations.
Foundatio mmendations
On the basis of our supplemental investigation and engineering evaluation of the
subsurface soil conditions can this site, there are fill soils and loose colhuvial deposits on
this site that will require modifications to the foundation system. Existing full in the old
drainage channel that extends into the central portion of the site will require the use of
pipe piles along the entire west side of the proposed residence foundation. The
remaining foundations that extend into the existing natural slope can be supported by
the Outwash soils using conventional bearing wan footings. We have discussed these
recommendations with the architect who is in the process of modifying the foundation
plans and details.
We recommend the use of four inch diameter Schedule 80 pile piles that will hsrve a
design capacity of ten tons per pile. These piles must be driven to refusal with an 850#
pneumatic hammer mounted on a backhoe. Refusal is based on less than one inch of
penetration after three cycles of driving the pipe pile. All piles should be inspected
during driving to verify their load carrying capacity.
The tops of the pipe piles should be connected with concrete grade beams along the west
walls of the residence. Where the structure extends easterly into the slope, these grade
beams should be designed for bearing on the native soils at a minimum distance of to
feet from the corner piles at the southwest and northwest corners of the residence.
Foundations placed in direct contact with the medium dense outwash sandy soils should
be designed for an allowable soil bearing value of 2000 psf. This value May be increased
by 2/3 to account for temporary seismic or wind loading. Settlement of these foatutgs
should not exceed one inch, and a majority of this settlement will occur during
construction of the residence.
Retaining Wald
Concrete retaining walls will be constructed around the easterly side of the residence
where it extends into the slope. Design of these retaining walls should be based on
active earth pressures of 35 pef and 55 pef for level and sloping backfill conditions,
respectively. It is anticipated that the north and south walls of the house will have level
backfill, while the east walls will be supporting the rear slope that rises up to the street.
13203 Holmes Point Drive NE Kirkland, WA 98034
Phone: 425-814-3970 Fax; A25.814-5672
Nov 22 04 O1:O8p ROHERT M PRIDE INC 425 814 5672 p.3
0
November 22, 2004
Mr. Jots Kvemmo
Page 3
Resistance to lateral loads can be provided by passive earth prw.%ure, and if necessary
friction between the bottom of footings and the underlying native soils. A passive value
of 200 pef may be used for footings or retaining walls in direct contract with compacted
backfill. A friction value of 0.3 may be used in conjunction with the recommended
passive pressure. It is assumed that these retaining walls will be designed as a cantilever
and not as braced walls. For braced conditions the east walls should be designed for an
at rest pressure of 75 pef
Temporary Slopc_Enm ations
Construction of the retaining walls will require temporary slopes to be cut into the
colluvial and Qutwash soils. For these slopes that may be on the order of 10 to 14 feet in
height, it is recommended that they be cut at a gradient no steeper than 1H:]V. If the
height of the temporary cut exceeds ten feet, it is recommended that eco-blocks be
placed at the toe of the slope against a slightly inclined backeut. These blocks may
remain in place as part of the baekfill, or be removed and replace with compacted
baeldill. All temporary cut slopes should be covered with plastic sheeting and tied down
with sandbags during the winter months.
Fallowing completion of the retaining walls a 3 inch Perforated subdrain pipe should be
installed that is embedded in drain gravel and wrapped with filter fabric. The exterior
below trade retaining walls should be protected with Miradrain to prevent moisture
migration into the living spaces, and to direct subsurface seepage down to the subdrain.
Discharge of the subdrains and footing drains should outlet into an approved storm
drain or to the street.
ErosiotL�trol
Construction on this site will require installation of silt fencing around the lower three
sides of the building pad area, and placement of quarry spalls from 72ad Place into the
driveway access ramp. Storm water runoff is not expected to be significant from the
slope because of the presence of the upper loose sandy colluvial soils which will absorb
most of any expected rainfall. The lower level portion of the site consists primarily of
well -compacted silty fill that will produce most of the site runoff. The silt fencing should
be anchored at the base with onsitc Qutwash sand soils to act as a filter for storm water
runoff to be directed toward the natural drainage course at the north end of the
property-
" ummary
We recommend that we be retained to review those portions of the plans and
specifications that pertain to foundations and earthwork to determine that they are
13203 Holmes Point Drive NE W*Jand, WA 98034
Phone: 425-814-3970 Fax: 425-814-5072
Nov 22 04 01:08p ROBERT M PRIDE ING 425 814 5672 p.4
.. 0 •
November 22, 2004
Mr..Ton Kvemmo
Page 4
consistent with the recommendations of this report. Construction monitoring and
consultation services should also be provided to verify that subsurface conditions are
similar to those encountered during our field exploration. Should conditions be
revealed during construction that differ from the anticipated subsurface profile, we will
evaluate those conditions and provide alternative recommendations where appropriate.
Field constructions services should be considered an extension of this initial geotechnical
investigation, and are essential, to the determination of compliance with the project
drawings and specifications. Such activities would include site and slope excavations;
excavations for foundations and retaining walls; pipe pile installations; subdrain
installations; and fill placement and compaction.
The conclusions and recommendations presented in this report are based on 1) our
interpretation and evaluation of soil conditions on the site, 2) confirmation of the wMal
subsurface conditions encountered during construction, and S) the assumption that
sufficient observation and testing will be provided during Appropriate phase-s of the
work
our findings and recommendations of this report were prepared in Ucc0rdan(= with
generally accepted principles of geotechnical eAgineering as practiced in the Puget
Sound area at the time this report was submitted. We make no warranty, either express
or implied.
Please call me if there are any questions regarding the findings and recommendations of
this report,
R 4..i 1 �14 M1 �•`�a �yI` ��
obert de, . E.
Principal Geotcchnicallrvt,ir%r
: `,. ;
dist: 0) addressee
W Lee Kirk, AIA
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enel: Drawing No.1
Table No. x
rmp: Hillcxw.tstRP- id2
13203 Holmes Point Drive NE Wridand, WA 9W34
Phone: 425-8143970 F= 425.814-5672
Nov 22 04 01:08p
ROBERT M PRIDE INC
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Ret Site Plan by Lee Kirk AIA for the- Hillcrest Edmonds House on 72"d Avenue West
SITE PLAN
Proposed Residence - Pmjeet No. 04-18741
72 Avenue West
Edmonds, Washington Ma"'mg No. �
Rabert M. Pride, Inc. +Constd ' eer
Nov 22 04 01:08p ROBERT M PRIDE ING 425 814 5672 p.6
P .. •
TABLE NO. 1
Test Pit No. 1 — SE Corner
0.0 — 3.0 ft Topsoil with heavy organics; silty sand, loose, moist, brown;
3.0. — 4.5 ft Silty Sand Outwash deposits; medium dense, moist, brown;
Test Pit No. 2 — SW Corner
0.0 — 2.5 ft Topsoil and organics; silty sand, loose, moist, brown;
2.5 — 4.0 ft Sand and Silly Sand Outwash deposits; medium dense, moist;
Test Pit No. 3 — West Side
0.0 — 8.0 ft Fill; Silty sand and sand with heavy organics, tree limbs and debris;
8.0 — 9.0 ft Sand and Silty Sand Outwash deposits; medium dense, moist, gray and
light brown; no groundwater seepage;
Test Pit No_ 4 — NW Comer
0.0 — 6.0 ft Fill; Silty sand and heavy organics with tree limbs and debris; loose,
moist; gray brown;
6.0 — 7.5 ft Sand and Silty Sand Outwash deposits; medium dense, moist, brown;
no groundwater seepage;
Test Pit No. 5 — North Side
0.0 — 3.5 ft Topsoil and heavy organics; Silty sand; loose, moist, light brown;
3.5 — 6.0 ft Silty Sand and Sand Outwash deposits; medium dense, moist, light
brown and gray; no groundwater seepage;
fhc.1890
CITY OF EDMONDS
121 5TH AVENUE NORTH • EDMONDS. WA 98020 • (425) 771-0220 • FAX (425) 771-0221
Website: v ww.d.edmonds.wa.us
DEVELOPMENT SERVICES DEPARTMENT
Planning • Building • Engineering
April 25, 2005
Jon Kvemmo
PO Box 3121
Everett, WA 98213-1121
MEMO TO:
Puget Sound Energy
Edmonds Fire Department
Verizon Northwest
Edmonds Police Department
SNOCOM Police and Fire Dispatch
Edmonds Utility Billing
SNOPAC
Edmonds Public Works
Snohomish County E911
Edmonds Building/Street File
U.S. Post Office
Edmonds Address Files
Snohomish County Assessor's Office
Snohomish County Information Services
Lynnwood Disposal
Snohomish County P.U.D.
Comcast Cable
GARY HAAKENSON
MAYOR
This letter is to inform you of an address correction. Please change the following:
From
16214 70`h Place W
To
16233 72"d Avenue W
We apologize for the inconvenience this may cause you and greatly appreciate your
cooperation.
Occupancy: SFR Tax ID Number: 00649500000400
Subdivision: Westmont View 2 Lot #: 4
If you have any questions regarding this letter, please contact me at 425-771-0220 or
Harrison Cci.edmonds.wa.us. Please contact me if you wish to be removed from this list.
Respectfully,
clV(.arie 97arrisotr
Senior Permit Coordinator
Edmonds Building Department
✓d
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sxoHoMIsH CoUNr.PmwAs�,��.oN
Docu 7ntVUJ/
Title(s) g",
�
Reference Number(s).of Related Document(s)
Additional Reference #'s on Page
Gtrraaritor(s)
Additional Grantors on Page
Grantee(s)
1 LIC
Additional Grantees on Page_
Legal Description (abbreviated form: ie Lot/Block/Plat or Section/Township/Range)
LJ z1 U S�Lj 4, D 7, , 2 - 1/-a /- � �. P. i. (? 4 w- .2 �-
Assessor's Property Tax Parcel/Account Number
Complete Legal on Page
Additional Parcel #'s on Page _
The Auditor/Recorder will rely on the information provided on this form. The responsibility for the
accuracy of the indexing information is that of the document preparer.
STATEMENT ON ACCESSORY DWELLING UNITS
Property Address: _16214 70`h Place West -
Edmond s, Washington
Legal Description: _Lot 4 of Westmont View Division No. 2 according to Plat recorded
in Volume 36 of Plats at Pages 24&25, in Snohomish County, Washington
Assessor's Parcel Number: 00 6495 0000 0400
I have read the requirements for accessory dwelling units contained in Chapter 20.21 of
the Edmonds Community Development Code (ECDC) and understand that an accessory
dwelling unit as defined in ECDC Section 21.05.015 is prohibited until an Accessory
Dwelling Unit Permit is approved.
I also understand that an Accessory Dwelling Unit Permit cannot be approved unless all
the criteria in Chapter 20.21 are met, and all the necessary items are submitted,
including an affidavit of occupancy and a covenant to be filed with the Snohomish
County regarding the regulations imposed on Accessory Dwelling Units.
Property Owner Signature:(16,,
Property Owner Name (printed): (Hillcrest Const. Co., Inc.)Jon Kvernmo, its President
Date: �- 7 LOS—
STATE OF WASHINGTON )
COUNTY OF SNOHONHSH)
�o �ti�SS10N fXp�9F�
NOTARY
PUBuc
T 8-13-2008 /k
FpF WA��
I certify that I know or have satisfactory evidence that Son Kyt r n , i
signed this instrument and acknowledge it to be his/her free and voluntary act for the uses and
purposes mentioned in this instrument.
Notary's pressure seals must be smudged. Dated:
a -7/os
Signature of
Notary Public:00-OL
Residing at: Irn 01 k ` CO
My Appointment
Expires: a 13I'D
THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY
AUDITOR.
ADUstatement.doc