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16622 72ND AVE W.PDFIIIIIIIIIIII 5618 16622 72ND AVE W BUILDING JAN 14.1994 CITY OF EDMONDS 250 5TH AVENUE NORTH, EDMONDS, WA 98020 (2017 771-3202 RCW 197-11-970 Determination of Nonsignificance (DNS) DETERMINATION OF NONSIGNIFICANCE Description of proposal: 328 Square Foot addition to a single family residence (City of Edmonds Plan Check # 93-230) Proponent: Bill and Jeannine Stapleton, 16622 72nd Ave. W., Edmonds, WA 98026 Location of proposal, including street address if any: 16622 72nd Avenue West, Edmonds Lead agency: CITY OF EDMONDS The lead agency for this proposal has determined that it does not have a probable significant adverse impact on the 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 .1994. Responsible Official: Jeffrey S. Wilson Position/Title: Current Planning Supervisor, Department of Community Services - Planning Division Phone: 771-0220 Address: City of Edmonds, 250 5th Avenue North, Edm WA 98020 Date: 1T1-t I q 4 . Signature: XX You You may appeal this determination to obeft, Cha e, Planning Manager, at 250 5th Avenue North, Edmonds, WA 98020, no later than ' .A4 C1 1994, 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 11'� (qq , 1994, at the Edmonds Public Library, Edmonds Community Services Building, and the Edmonds Post Office. XX Distribute to "Checked" Agencies, 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 Bill and Jeannine Stapleton 16622 72nd Ave. W. Edmonds, WA 98026 Page 1 of (((FILE N)))EN/(((DATE))).SEPA CITY OF EDMONDS AF9 �4 y /��0 ENVIRONMENTAL CHECKLIST co�tiT � 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 Aj he. environment. The purpose of this checklist is to provide information to help you andthe `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: i 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 youriknowledge. 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 ythis, 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 nonproject proposals: Complete this checklist for nonproject proposals, even though questions may be answered "does not apply." IN ADDITION, complete the SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (part D). For nonproject 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: 2. Name of applicant: taU— A-A-*�i--�1�� 6.lk'u CHKIT/12-19-91 WASTER Page 1 of 23 y r• ' r,rt P e�• t 3. :, ddress:;=and phone number of applicant and contact person: t' e 4. Date checklist prepared: 5. Agency requesting checklist: City of Edmonds. 6. Proposed timing or schedule (including phasing, if applicable): (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. (STAFF COMMENTS) S. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. (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. (STAFF COMMENTS) CHKLT/1 2-19-9 LMASTER Page 2 of 23 k 10. List any government approvals or permits that will be needed for your proposal, if known. V L L-y-> (1P0-.r+-t 1. T�-- (STAFF COMMENTS) 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 to repeat those answers on this page. ( STAFF COMMENTS) 12. Location of the proposal. dive 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 withany 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: CHKLTl12-19-91.MASTER Page 3 of 23 (STAFF COMMENTS) b. What is the steepest slope on the site (approximate percent slope)? 2 -Ralr-, bO� b4=- G8?�S-f"12,JC 1 ( STAFF COMMENTS) -S46V,17 IV Dcg is �ue�vno� — 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. ( STAFF COMMENTS) d. 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. ( STAFF COMMENTS) ,-6 Y10 1*0L f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe. _fir V�Z� 1'1, 4�D12_ t7or -To 6 -� i - S1 Zo-- (STAFF COMMENTS) CHKIT/12-19-91.MASTER Page 4 of 23 g. About what percent of the site will be covered with impervious surfaces after project construction (for example, asphalt or buildings)? .l 8 64,;, (STAFF COMMENTS) 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: • MI ( STAFF COMMENTS) CHKLT/1 2-19-9 1.MASTER Page 5 of 23 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. 00 (STAFF.CONMENTS) (2) Will the project require any work over, in, or adjacent to (within 200 feet) the described waters? If yes, please describe and attach available plans. (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. N O ( STAFF COMMENTS) CHKLT/12-19-91.MASTER Page 6 of 23 (5) Does 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 waste and anticipated volume of discharge. (STAFF COMMENTS) 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 of animals or humans the system(s) are expected to serve. (STAFF COMMENTS) CHKLT/12-19-91.MASTER Page 7 of 23 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. - 63emadzi,- (STAFF COMMENTS) (2) Could waste materials enter ground or surface waters? If so, generally describe. (STAFF COMMENTS) 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, pine, other: shrubs 4-grass pasture crop or grain wet soil plants: cattail, buttercup, bulrush, skunk .cabbage, other:_ water plants: water lily, eelgrass, milfoil, other: other types of vegetation: (STAFF COMMENTS) CHKLT/1 2-19-9 1.MASTER Page 8 of 23 b. What kind and amount of vegetation will be removed or altered? ( STAFF COMMENTS) �W�%fGk//dC� 7a (ems {ZGpnpR. �v f c. List threatened or endangered species known to be on or near the site. (STAFF COMMENTS) d.. Proposed landscaping, use of native plants, or other materials to preserve or enhance vegetation on the site, if any: F.�,... Lrub, 4,1WTTV,16 09:� tTEEf7aIJ UU-1 M E- ( STAFF COMMENTS) 5. Animals t- i a. Check or circle any birds and animals which have been observed on or near the site orareknown to be on or near the site: !/ birds: hawk, heron-, eagle,9!��# rds of r: ✓ mammals: deer, bear, elk, other: v� 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. Is the site part of a migration"route? If so, explain. CHKLT/12-19-91.MASTER Page 9 of 23 (STAFF COMMENTS) d. Proposed measures to preserve or enhance wildlife, if any: (STAFF COMMENTS) 6. Energy and Natural Resources a. What kinds of energy (electric, natural gas, oil, wood stove, solar) will be used to meet the completed project's energy needs? Describe whether it will be used for heating, manufacturing, etc. (STAFF COMMENTS) b. Would your project affect the potential use of solar energy by adjacent properties? If so, generally describe. (STAFF COMMENTS) c. What kinds of energy conservation features are included in the plans of this proposal? List other proposed measures to reduce or control energy impacts, if any: (STAFF COMMENTS) CHKLT/12-19-91.MASTER' Page 10 of 23 7. Environmental Health a. Are there any environmental health hazards, including exposure to toxic chemicals, risk of fire and explosion, spill, or hazardous waste, that could occur as a result of this proposal? If so describe. (STAFF COMMENTS) (1) Describe special emergency services that might be required. �tJ.3 (2) b. Noise (2) (STAFF COMMENTS) Proposed measures to reduce or control environmental health hazards,' if any: 1/ou�s (STAFF COMMENTS) What'types.of noise•exist-in the area'wh ch may- affact your project (for example: traffic, equipment, operation, other)? j.Jl7L�_ (STAFF COMMENTS) What types and levels of noise would be 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. CHKLT/12-19-9.1.MASTER Page 11 'of 23 (STAFF COMMENTS) (3) Proposed measures to reduce or control noise impacts, if any: (STAFF COMMENTS) W Ads DF 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. L� ( STAFF COMMENTS) c. Describe any structures on the site. (STAFF COMMENTS) d. Will any structures be demolished? If so, what? . (STAFF COMMENTS) CHKLT/12-19-91.MASTER Page 12 of 23 e. What is the current zoning classification of the site? 12 S -Z > (STAFF COMMENTS) f. What is the current comprehensive plan designation of the site? ( STAFF COMMENTS) ZA 2 �, ,T�s f g. If applicable, what is the current shoreline master plan designation of the site? ( STAFF COMMENTS) h. Has any part of the site been classified,as an "environmentally sensitive" area? If so, specify. t ( STAFF COMMENTS) SL �I� /� 2 GIB' 1:i�iG i. Approximately how many people would reside or work in the completed project? (STAFF COMMENTS) j. Approximately how many people would the completed project displace? CHKLT/12-19-91.MASTER Page 13 of 23 (STAFF COMMENTS) 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: (STAFF COMMENTS) 9. Housing a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low-income housing. (STAFF COMMENTS) b., Approximately how many units, if any would be eliminated? Indicate whether high,, middle, or low-income housing. O • (STAFF COMMENTS) c. Proposed measures to reduce or control housing impacts, if any: CHKIT/12-19-91.MASTER Page 14 of 23 ( STAFF COMMENTS) 10. Aesthetics a. What is the tallest height of any proposed structure(s), "not including antennas; what is the principle exterior building material(s) proposed? L- ?-,C>` ht VIA -Jr -1 (STAFF COMMENTS) • ' b. What views.in the immediate vicinity would be altered or obstructed? (STAFF COMMENTS) c. Proposed measures to reduce or control aesthetic impacts, if any: Ln (STAFF COMMENTS) 11. Light and Glare a. What type of light or glare will the proposal produce? What time of day would it mainly occur? (STAFF COMMENTS) b. Could light or glare from the finished project be a safety hazard or interfere with views? a CHKLT/12-19-91.MASTER Page15 of 23 (STAFF COMMENTS) c. What existing off -site sources of light or glare may affect your proposal? (STAFF COMMENTS) d. Proposed measures to reduce or control light and glare impacts, if any: t (STAFF'COMMENTS) 12. Recreation a. What designated and informal recreational opportunities are in the immediate vicinity? a ; (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 project or applicant, if any: CHKLT/12-19-91.MASTER Page 16 of 23 (STAFF COMMENTS) 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. 12 IQ (STAFF COMMENTS) b. Is site currently served by public transit? If no, what is the approximate distance to the nearest transit stop? 7 CHKLT/1 2-19-9 1.MASTER Page 17 of 23 r (STAFF COMMENTS) c. How many parking spaces would.the completed project have? How many would the project eliminate? Z � (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, generally describe. (STAFF COMMENTS) f. How many vehicular trips per day would be generated by the completed project?. If known, indicate when peak volumes would occur. (STAFF COMMENTS) CHKLT/1 2-19-9 1.MASTER Page 18 of 23 r i 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 measures to reduce or control direct impacts on public services, if any: (STAFF COMMENTS) 16. Utilities a. Circle utilities currently vailable at the site: electricity,�natu�ralgas,at , refuse servic telelphon anitary sew , se0 vs em, L� (STAFF COMMENTS) CHKLT/1 2-19-9 1.MASTER Page 19 of 23 0 b. Describe the utilities that are proposed for the project, the utility providing the service, and the general construction activities on the site or in the immediate vicinity which might be needed. x (STAFF COMMENTS) C. SIGNATURE The above answers are true and complete to the best of my knowledge. that the lead agency is relying on them to make its decision. Z-4 Signature of Proponent Date Submitted I understand CHKLT/1 2-19-9 1.MASTER Page 20 of 23 STREET FILE MEMORANDUM CITY OF EDMONDS PLANNING DIVISION 250 5TH AVENUE NORTH, EDMONDS, WASHINGTON 98020 TO: BUILDING DIVISION PLAN CHECK # 93-230 FROM: John Bissell, Associate Planner. Jeffrey S. Wilson, AICP DATE: ' JANUARY 4, 1994 SUBJECT: ENVIRONMENTAL DETERNIINATION FOR AN ADDITION TO A SINGLE FAMILY RESIDENCE, PLAN CHECK # 93-230 I have had the opportunity to visit the site, review the environmental checklist, the site plan and the building elevations, 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 nonsienificance be issued. ----------------------------------------------------------------------------------------------------------------- Review by Responsible Official: I concur I do not concur Comments: Jeffrey S. Wilson, AICP Date Responsible Official Attachments pc: PLAN CHECK # 93-230 Robert Chave, Planning Manager A93XXX.DOC y CITY OF EDMONDtILE 250 - 5TH AVE. N. • EDMONDS, WA 98020 • (2061 771-0220 • FAX (2061 771-0221 COMMUNITY SERVICES DEPARTMENT ! Dc' Public Works • Planning • Parks and Recreation • Engineering 89p_19 LETTER OF TRANSMITTAL Date: November 17, 1993 To: William Witt 219 1st Ave. S. #401 Seattle WA 98104 Subject: CA793-263 Transmitting: For your information: X As you requested: For your file: Comment and return: Note attachments: Comments: LAURA M. HALL MAYOR Rece:IVED BAN 0.4 1994 PERMIT C01UNTER Planning Division Diane Cunningham, Planning Secretary • Incorporated August 11, 1890 •. Sictor C itiot lntarnatinnal — Hekinan..lanan 4 a 9 0 . ()4 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 Hall (Critical Areas inventories, maps, or soil surveys). An applicant, or his/her representative, must fill out the checklist, sign and date it, ftcj�� P Noy 01 19y3 �V&1 6 vpr. 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: Name Street Address City, State, ZIP Phone Signature Date Applicant Representative: W R-L-LA-+A W tqT Name 2la 1 `lT "V-r Street Address City, State, ZIP Phone to -Z7 q3 ature Date CA FILE NO. 11' 3 — Z(o "S­ Critical Areas Checklist Site Information (soils/topography/hydrology/vegetation) 1. Site Address/Location: Ile6Z2-1Z}'�,b,tJi 41 2. Property Tax Account Number: 5111 — OOd — 10 3. Approximate Site Size (acres or square feet): 2,, 3✓., sty 4. Is this site currently developed? [ yes; no. If yes; how is site developed? Sl �,i �F �E-tt �� 1(1. per? [�►G64�[" OA"s O`W ' 5. Describe the general site topography. Check all that apply. Flat: less than 5-feet elevation change over entire site. Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal distance of 66-feet). �C Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise —T"— 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: 00 ; Approx. Depth: _ What season(s) of the year? 8. Site is in the floodwayyo floodplain of a water course. 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year- round? Flows are seasonal? (What time of year? ). 10. Site is primarily: forested 11q ;meadow _;shrubs ; mixed urban landscaped (lawn,shrubs etc)_ . 11. Obvious wetland is present on site: _TO --- For.City. Staff Use Only ---- 1. Site is Zoned? ' Z 2. SCS mapped soil type(s)? hjT? Z + bty C-7124, VD^! 3. Wetland inventory or C.A. map indicates wetland present on site? A Lo 4. Critical Areas inventory or C.A. map indicates Critical Area on site? 5. Site within designated earth subsidence landslide hazard area? 6. Site designated on the Environmentally Sensitive Areas Map? 7 �� DETERMINATION / STUDY REQUIREDy WAIVER Reviewed by: w Planner CONDITIONAL WAIVER 1(11'01A -3 bate/ Rev 09n9/93 City of Edmonds Critical Areas Determination Applicant: William Witt Determination #: CA-93-263 Project Name: Permit Number: Site Location: 16622 72nd Avenue W. Property Tax Acct #: 5131-000-105-0708 Project Description: Minor Addition/Deck Waiver Criteria (all criteria must be found to apply): XXX There will be no alteration of the Critical Area or its required buffers; XXX The development proposal will not impact the Critical Area in a manner contrary to the goals, purposes, objectives and requirements of the Critical Areas ordinance; XXX The development proposal meets the minimum standards of the Critical Areas ordinance; XXX The above findings are based on the following conditions of approval: For projects which will affect the trees at the rear of the property, submit a tree plan with the Building Permit application showing trees to be removed and how trees to remain will be protected during construction. Name Signature D e ' CitY of Edmonds 890-19°) . RIGHT-OF-WAY CONSTRUCTION PERMIT STFRZET FILE Permit Number. - W Issue Date• A. Address or Vicinity of Construction: 16622 72 Avenue West (8906431L B. Type of Work (be specific): Install New Service C. Contractor: Washington NAtural Gas Company Contact: Frank Swan Mailing Address: 815 Mercer Street Phone: 224-2278 State License #: Seattle WA 98111 Liability Insurance: Bond: $ D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): kti E. ❑ Commercial ❑ Subdivision ❑ City Project Ja Utility (PUD, GTE, WNG, CABLE, WATER) ❑ Multi -Family ❑ Single Family ❑ Other INSPECTOR: INSPECTOR: F. Pavement or Concrete Cut: ® Yes []No 01)G. Size of Cut:. 2 x 4 H. Charge $ APPLICANT TO READ AN 'SIGN INDEMNITY: Applicant understands and by his signature to this application, agrees t of the City of Edmonds har ile&s j. fnju a a ges, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be ma a against the City of Edmonds, or any of its departments or employees, including or not limited to the defense of any legal proceedings including defense costs, and attorney fees by reason of granting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECT/ON AND ACCEPTANCE OF THE WORK. EST/MATED RESTORATION -FEE ,SrW�ILL BE HELD UNTIL T{HE FINAL�r STREET PATCH IS COMPLETED BY CITY FORCES, AT WHICH TIME DEBIT OR CREDIT WILL BE PROCF.SJF,D FOR ISSUANCE T6 ihki�PLICANT. 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 thl-end.of�thg working day; NO EXCEPTIONS. I have read the above statementss o _ d understand the permit requirements and the pink copyof thepermit will be available on site at all ti7m f6rFinspe t'n�i >poses. Signature: Date: December 27, 1993 (Contractor or Agent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR CITY USE ONLY APPROVED BY: 6 RIGHT OF WAY DEPOSIT TIME AUTHORIZED: VOID AFTER b �� DAYS DISRUPTION FEE/FUND III: , SPECIAL CONDITIONS: RESTORATION -FEE: f PERMIT FEE: TOTAL FEE: - COMMENTS: RECEIPT FEE:: DATE: ISSUED.BY:� �f���..=* NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE EnKrK. Div. 1991 FIELD INSPECTION NOTES Comments• Diaoram CONTRACTOR CALLED FOR INSPECTION (Fund 111 - Route copy to Street Dept.) y r1 ❑ YES ❑ NO Partial Work Inspection by P.W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: AV*ftVMn&vWC TpwV , Addendum to City of Edmonds Right of Way Permit Application _Submitted by: MITCHELL S . - LANKFORD Engineering Aide Washington Natural Gas ' l%Co�2 #k ' '521=5.246 -7 2- AIV W (1) 2 x4 ccst- �►.1 ��U WNG to window d_ Water main depth 2 " gas main Key: -w- water -g- gas -ss- sewer $ water hydrant O -water valve 815 Maca St. ;'P.O. Box 1869), Seattk• WA 9811. (206) 622-67, - APPLICATION Luj�o -LiA)r for The Cyj of Edmonds SIDE SEWER PERMIT ri""Now Uw7EASEMENT . .............. ............................. "MIDW CONSTRUCTION REPAIRS 13 50(- 0,36co 061) PERMIT N 7 D e V A11V W ee OWNERXqk.gA . ..................................... ................................................ CONTRACTOR ------✓* ...... ------- ------- Aveu< 00 7� j�5 d/1.4 LEGAL DESCRIPTION: LOT No . ................................ ADDREgS, .................................. .............. BLOCK No..... NAME OF ADDITION ............................................................................................... -3, A 14-tl Yl d 4 A h 46 6, .4 /? 4 RZ- ,A y "t 0" V Yl— I/ I Approved: DATE ... . ... P�9-77/ ...... By ... RECEI V� D FED 2 2 • tw..r- .. . ' ,1�'$�? 'vk.�r�J'!1 - '.Cv9 -� k��'v.���Y�r°-"�� o'�l1TJ'�•• r 1 - :�. �'i3VfFfF��1 , ..'�• 1 .1 S .l ,........ .... ' it'+1.. ��°�'t`..j'A�%''T��'i�.'� ..._ . .................... .. -__ �. .........-.. _ .._ ....... •'Y - �� r'a�tVn�„' t .. ........ .. ..... CITY OF EDMONDS - _ CI;TIC CENTER — WATER -SEWER DEPARTMENT Call PRoapect s-1107 when work is ready for Inspection. (Not - - tiona Saturday, Sunday or holidays.) N O M 0 Ey SIDE SEWER PERMIT j ADDRESS ................ .......... XMMXXK)CXE KBXN 16622 - 72ND AVENUE WEST. _. _.� :•;l `.. I l _. OWNER------------------ROBERT K. LEDFORD--------------------------- CONTRACTOR LYNNWOOD SEWER CONSTRUCTION i'y .... granted....................... --- Permission is FEBRUARY 22 -., 19--_71 for ____-_-________________ days to REPAIR or CONNECT a side sewer with City Sewers in accordance with application on file and governing ordinances. ., ATTENTION IS CALLED TO THE FOLLOWING: - - NOTE No. 1—The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct side sewer in street area. Do not cover any portion of sewer before it has been inspected. - -- - _ NOTE No. 2—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit. _ - ' '•' NOTE No. 3—Top of side sewer must have at least 30 inches coverage at property line and 12 inches inside property line; minimum grade of 2%. No bends in grade sharper than % will be permitted. _ - - NOTE No. 4—Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for . - failure due to improper work which may develop within one year of completion. - - - - r • I�^ No. 5--It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the main sewer or its appur- tenances tenances except to insert the pipe into the wye. - _ 46 '�-+•.'.�A • ... .-.`%: .....- -r 1', '-._.4 ._.r?!..C°L�ik1.' - �T ......... _....... . - --x.. .. - T �ffME ^� ���� CA FILE NO. � 3 — uP� Critical Areas Checklist Site Information (soils/topography/hydrology/vegetation) 1. Site Address/Location: f&6 2. Property Tax Account Number: 3. Approximate Site Size (acres or square feet):, 3G, sF 4. Is this site currently developed? _ [yes; no. If yes; how is site developed? C..►&wr rs-s 5. Describe the general site topography. Check all that apply. Flat: less than 5-feet elevation change over entire site. Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal distance of 66-feet). X 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: po ; Approx. Depth: 7. Site contains areas of seasonal standing water: 00 ; Approx. Depth: What season(s) of the year? 8. Site is in the floodway VO floodplain of a water course. 9. Site contains a creek or an area where water flows across the grounds. surface? Flows are year- round? Flows are seasonal? (What time of year? ). 10. Site is primarily: forested 11A_ ; meadow ; shrubs ; mixed urban landscaped (lawn;shrubs etc) 11. Obvious wetland is present on site: 11.y0 --- For. City StafiUse Only- 1. Site is Zoned? Zy 2. SCS mapped soil type(s)? - - ma)Zt.LbtD (2► 9 4� ut ,�]jy�j t&Yfi 3. Wetland inventory or C.A. map indicates wetland present on site? /0 4. Critical Areas inventory or C.A. map indicates Critical Area on site? _dam 5. Site within designated earth subsidence landslide hazard area? b 6. Site designated on the Environmentally Sensitive Areas Map? y� DETERII'fINATION STUDY REQUIRED s WAIVER Reviewed by: , Planner CONDITIONAL WAIVER Date/ Rev 00/29/93 &90.19e- 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 Hall (Critical Areas inventories, maps, or soil surveys). An applicant, or his/her representative, must fill out the checklist, sign and. date it, and submit it to the City. The City will review the checklist, make a precursory site visit, and make a determination of the subsequent steps necessary to complete a development permit application. 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: Name Street Address City, State, ZIP Phone Signature Date Applicant Representative: W U-IJA-t-A W AT Name 2lq ! ST "tE S ao l Street Address h � (•.uL�-'-.616104. •1,1e0 City, State, ZIP Phone rignature Date City of Edmonds Critical Areas Determination Applicant: William Witt Determination #: CA-93-263 Project Name: Permit Number: Site Location: 16622 72nd Avenue W. Property Tax Acct #: 5131-000-105-0708 ' Project Description: Minor Addition/Deck Waiver Criteria (all criteria must be found to apply): XXX There will be no alteration of the Critical Area or its. required buffers; XXX The development proposal will not impact the Critical Area in a manner contrary to the goals, purposes, objectives and requirements of the Critical Areas ordinance; XXX The development proposal meets the minimum standards of the Critical Areas ordinance; XXX The above findings are based on the following conditions of approval: For projects which will affect the trees at the rear of the property, submit a tree plan with the Building Permit application showing trees to be removed and how trees to remain will be protected during construction. Name Signature D e 0 0 REST FILE CITY OF EDMONDS USE yam` 7 ZONE 5— PERMIT NUMBER V�fJ CONSTRUCTION PERMIT APPLICATION ' ' OWNER NAME NAME OF BUSINESS JOB SUITE PT ADDRESS �� 7,-� /�✓ �/ /I n LEGAL DESCRIPTION CHECK SUBDIVISION NO LID NO w Z !WAILING ADDRESS O PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved ❑ CITY ZIP TELEPHONE NUMBER EXISTING REOUIRED DEDICATION RW Permit Required ❑ Street Use Permit Req'tl ❑ f7 ' "� L ^ � � Inspection Required ❑ NAME PROPOSED Sidewalk Required ❑ „ ¢ ~ (.• vl METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED ❑ Q u ADDRESS YES NO U !+ \ REMARKS Z ¢ cc CITY ZIP TELEPHONE NUMBER Lu Z Z NAM 1�i9_ eLY�/L?N CC.067,e 4cTia v W I O ADDRESS 1 ENGINEERING MEMO DATED REVIEWED BY ' CIT - ZIP �j�, ` TELEPHONE NUMBER �- ppZ OJ bli _�,.�Lf = _ 9 yE-XPIRATION FIRE MEMO DATED REVIEWED BY Er U• § I�Et7S�alu++u /!%T%JrE//L)IT�H DATE '... _ 5. N"/""! SIGN AREA SEPA REVIEW A08 NO. ��I..• Legal Description of Property - include all easements ALLOWED PROPOSED COMPLETE EXEMPT �( SHORELINE M p F- OV—c) I O a VARIANCE OR Cu PL N 1NG R W, BY ATE a W o c� ? SETBACKS — SET HEIGHT LOT COVERAGE w FRONT SIDE'') I�REAR �� l Z Property Tax Account _ C Parcel No. I �� -_ t`7 0 — 0 � — © —70 REMARK a J a NEW � RESIDENTIAL El PLUMBING El A R )� 1{, 'j Q "a`r 6 *flei T, 6xi{+S.TIR / L ADDITION COMMERCIAL MECHANICAL `I--' REMODEL APT. BLDG. A SIGN GRADING D FENCE CHECKED BY TYPE O RUC STTION CODE OCCUPANT REPAIR CYOS. ( x _FT) DEMOLISH ❑ WOOOSTOVE SWIM POOL INSERT HOT TUB/SPA SPECIAL INSPECTOR AREA OCCUPANT GARAGE RETAINING WALL/ a RENEWAL REQUIRED YES LOAD REMARKS CARPORT ROCKERY a (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: PROGRESS INSPECTIONS PER UBC 305 = s :J , NUMBER OF CRITICAL C�� toWONUMBER o OF 9 STORIES DWELLING UNITS AREAS I NUMBER -' DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) t= FINAL INSPECTION REQUIRED VALUATION FEE PLAN CHECK FEE 7, �r,�1 �/�- ✓ f� BUILDING HEAT SOURCE: GLAZING PLUMBING Plan Check No. ' MECHANICAL l� This Permit covers work to be done on private property ONLY. GRADINGIFILL Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE m av Permit Application: 180 Days Permit Limit: 1 Year - Provided Work Is Started Within 180 Days STORM DRAINAGE FEE "Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE , ,n successors in interest, agrees to indemnify, defend and hold W harmless the City of Edmonds, Washington, its officials, Qemployees, and agents from any and all claims for damages of a = whatever nature, arising directly or indirectly from the issuance be deemed PLAN CHECK DEPOSIT !� LG1J of this permit. Issuance of this permit shall not modify, waive or reduce any requirement of any city ordinance. = nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE l provision." I hereby acknowledge that I have read this applicatign; that the ATTENTION APPLICATION APPROVAL information given is correct; and that I am the owner, orthe duly authorized agent of the owner. I agree to Comply with City and THIS PERMIT This application is not a permit until state laws regulating construction; and in doing the work authoriz• AUTHORIZES THE signed by the Building Official or his/her ed thereby, no person will be employed in violation of the Labor Code of the State of Washington relating to Workmen's Compensa• ONLY WORK NOTED Deputy; and fees are paid, and receipt is tion Insurance and RCW 18.27. INSPECTION acknowledged in space provided. SIGNATURE (OWNER OR AGENT) DATE SIGNED DEPARTMENT ° FICIAL S $ N ATURE DATE / A ' CITY OF EDMONDS 6 CALL FOR RELEASE' / DATE ATTENTION INSPECTION / A'r L,�_., IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE M N.,.�,1L,,,A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ��� Owwo � 11 ORIGINAL — File YELLOW — Inspector A CERT`Fj rATE OF OCCUPANCY HAS BEEN! GRANTED. UBC CHAPTER 3.'' PINK — Owner GOLD — Assessor 10��87 STREET FILE L:..imunds, Wa.98020 i..isiuiU_uuusu & Uarage area = 2066 ON'1' 1 I 13xisting deck = 404 sf William Witt Architect New addition = 328.5 219 1st. Ave. S. #401 New deck = 144 Seattle, Wa. 98104 'Total = 2942.5 I,I?(-,ALDESC1tIPT1ON 8011, CLASSIFICATIONLot 7, Portion of track 105,, Meadowdale Beach Alderwood gravelly sandy loam '1'r1 x 11A IZCEL NUMBER 5131-000-105-0780 V ONING R;.2 0 RECEIVED JAN o " 19-9a PERMIT COUNTER, CITY COPY i•:,i:':.i;:�-�',�.� �_.''�,l_C..•:: 1'I•a'`UM t1yO.�O EXi=;.1. hJr, GL=rs.Y71�..1G,. SITE PLAN CIE, SovTIA tx l.F.r.�, .:'j �j No tz: T 4-� l-Amcmds, Wa. 98020 k;�lsuu};.iluuse 8c 4,arage area = 2066 CONTA_QjExisting deck 404 s17 William Witt Architect New. addition 328.5 219. 1st. Ave. S. #401 New deck 144 Scattic, Wa.98104Total = 2942.5 i I;(;i�l^l)I?, ldltll'I'I )N SOILCLASSIFICATION Lot 7, Portion of track 1'05, Mcadowdale Beach A Iderwood gravelly sandy loam RC El, NUMIlf R 5 t 31-•000-105-0780 zLNIN STREET FILE �q � 1tS�.20 .. A�9 *p y Fo r� 19y NTFR 1 r/ N� N o 1 11 1 11 B o / 11 - I �. . IcoB sF I Iqq F - I uPprrt. f 00 �-1 j - L -io0:5— �E�L LI1.» 1 >✓-XtGJ�It�Lo 6.t�PR.oy.l'do I 1�E.G1,- a I I I u, I 251-a' htp� IS - - - to'-o f st ae, 1 1 7 b�lVy \ APPROVED Y PLaNNIN ;a � Z Gat.c,� I�,d•'S UWl t 100 E,ca*,T IJo Z^O I i.j p, s 1013 13,��MP►i-7T. 5t-a.� 94 "SITE PLAN Ma.X -1 12.1, '1 S -- - Ho�-f'i-i �IEE �01.�•1� Ls �.arr�.1 � '��'j' .rj . _